Medical aid in dying considered in Britain, and evolving in Canada

The Guardian has the story about England and Wales, and the NYT has a story on Canada.

Here's the Guardian:

Two former health secretaries join calls for new law on assisted dying

Senior Conservative and Labour figures said they would back changes to legislation on the issue in England and Wales.  by Michael Savage

"Two former health secretaries on Saturday night became the latest senior figures to join the growing demands for a new attempt to legalise assisted dying, as a prominent Tory said he is willing to champion the legislation in parliament.

"With both former Conservative minister Stephen Dorrell and Labour’s Alan Milburn stating they back changing the law in England and Wales, the Observer understands that a Labour government would make time and expert advice available for an assisted dying bill should MPs back it in a free House of Commons vote.

"The news comes as campaigners hope to hold a new vote on the issue early in the next parliament, almost 10 years after the last attempt to alter the law. Kit Malthouse, a former cabinet minister, said he was “absolutely” prepared to front a new private member’s bill on the matter.

...

"Doing nothing is not a passive choice. Leaving the law as it is will consign many thousands of people who may want a different end to a horrible death.”

...

"Milburn, who served as health secretary under Tony Blair, said: “When people today expect to have control over so many aspects of their lives, it feels paradoxical that we are denied the same about how we want to die. It’s perhaps the most important decision any of us can make. To deny that choice feels increasingly anachronistic. The time has come for a free vote in parliament on the issue.”

...

"However, other senior figures such as Michael Gove have expressed doubts about any change.

"Critics of an assisted dying law have also warned about the difficulties in defining who is eligible, the danger of people being pressured into a decision and subsequent attempts to widen the law.

"Alistair Thompson, a spokesperson for Care Not Killing, a group that opposes assisted dying, pointed to polling that suggested public support for assisted dying may have actually fallen since the mid-1990s.

"He also raised questions about the effects of the drugs used for the process in Oregon and said the law would be widened. “As we saw in the Netherlands and Belgium, limits on who qualifies for an assisted death have been swept away,” he said.

“At a time when we have seen how fragile our healthcare system is, how underfunding puts pressure on services, when up to one in four Britons who would benefit from palliative care aren’t receiving it, and when our nation’s hospices are facing a massive shortfall in their income, I would suggest this should be the focus of attention, rather than discussing again this dangerous and ideological policy.”

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And here's the NYT on the controversy in Canada:

Death by Doctor May Soon Be Available for the Mentally Ill in Canada. The country is divided over a law that would allow patients suffering from mental health illnesses to apply for assisted death.  By Vjosa Isai  Dec. 27, 2023

"Canada already has one of the most liberal assisted death laws in the world, offering the practice to terminally and chronically ill Canadians.

"But under a law scheduled to take effect in March assisted dying would also become accessible to people whose only medical condition is mental illness, making Canada one of about half a dozen countries to permit the procedure for that category of people.

...

"There is still uncertainty and debate over whether assisted death will become available to the mentally ill early next year as scheduled. Amid concerns over how to implement it, Parliament has delayed putting it into place for the past three years and could delay it again."

Why living kidney donors in England should be financially compensated

 Here's an article suggesting why England should pilot a program to compensate kidney donors.  Perhaps the argument is generalizable to other countries as well...

Rodger, Daniel, and BonnieVenter,  A fair exchange: why living kidney donors in England should be financially compensated. Medicine, Health Care and Philosophy (2023). https://doi.org/10.1007/s11019-023-10171-x

Abstract: Every year, hundreds of patients in England die whilst waiting for a kidney transplant, and this is evidence that the current system of altruistic-based donation is not sufficient to address the shortage of kidneys available for transplant. To address this problem, we propose a monopsony system whereby kidney donors can opt-in to receive financial compensation, whilst still preserving the right of individuals to donate without receiving any compensation. A monopsony system describes a market structure where there is only one ‘buyer’—in this case the National Health Service. By doing so, several hundred lives could be saved each year in England, wait times for a kidney transplant could be significantly reduced, and it would lessen the burden on dialysis services. Furthermore, compensation would help alleviate the common disincentives to living kidney donation, such as its potential associated health and psychological costs, and it would also help to increase awareness of living kidney donation. The proposed system would also result in significant cost savings that could then be redirected towards preventing kidney disease and reducing health disparities. While concerns about exploitation, coercion, and the ‘crowding out’ of altruistic donors exist, we believe that careful implementation can mitigate these issues. Therefore, we recommend piloting financial compensation for living kidney donors at a transplant centre in England."

They set the stage in their Introduction:

"In 2019, the Human Tissue Act 2004 (HT Act) was amended to allow England to adopt an opt-out system of organ donation, which was subsequently passed as The Organ Donation (Deemed Consent) Act 2019 and implemented in May 2020. This amendment aims to change the way donor consent is given for transplantable organs and tissues. Its intention is to increase the number of organs available for transplantation to save lives and improve the quality of life of those on the wait list. It was estimated by the United Kingdom (UK) Government that this amendment would save 700 lives per year (Dyer 2019). Despite these intentions, this amendment is unlikely to make a significant difference to the number of available organs.

"Currently, there is no definitive evidence to suggest that merely adopting an opt-out system will increase the pool of available organs (Etheredge 2021). Nevertheless, even if the pool of organs were to increase, it is not necessarily a panacea. Spain, though not strictly an opt-out system because it does not have an opt-out register (Etheredge 2021), is considered the gold-standard system for organ transplantation. But despite their success, Spain still has an insufficient number of organs, a growing kidney transplant wait list, and patients still die waiting for a transplant (Crespo et al. 2021). Kidney transplant wait lists continue to increase despite improving infrastructure, education, and the adoption of opt-out systems. Because only around 1% of people who die each year in the UK are eligible to donate their organs (NHS Blood and Transplant, 2022), it is becoming increasingly necessary to consider alternative approaches to increase the number of available organs for transplant."

Kidney news from Cambridge on possibility of removing blood type barriers

 Here's some very preliminary kidney news (a press release) in The Guardian and at Cambridge, that could have the potential to have an impact sooner rather than later in helping potential transplant recipients with blood type O, who can only receive blood type O kidneys (which can be received by patients of any blood type)...  

Researchers change blood type of kidney in transplant breakthrough University of Cambridge team’s work could significantly increase supply of organs for people with rarer blood types

"University of Cambridge researchers used a normothermic perfusion machine – a device that connects with a human kidney to pass oxygenated blood through the organ to better preserve it for future use – to flush blood infused with an enzyme through the deceased donor’s kidney.

"The enzyme removed the blood type markers that line the blood vessels of the kidney, which led to the organ being converted to type O."

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https://www.cam.ac.uk/stories/kidneybloodtype

The scientists mentioned are Professor Michael  Nicholson and PhD student Serena MacMillan .

Opt out organ donation in England and the Netherlands

 

Jansen, N. E., Williment, C., Haase-Kromwijk, B. J. J. M., & Gardiner, D. (2022). Changing to an Opt Out System for Organ Donation—Reflections From England and Netherlands. Transplant International, 133.

Abstract: Recently England and Netherlands have changed their consent system from Opt In to Opt Out. The reflections shared in this paper give insight and may be helpful for other nation considering likewise. Strong support in England for the change in legislation led to Opt Out being introduced without requiring a vote in parliament in 2019. In Netherlands the bill passed by the smallest possible majority in 2018. Both countries implemented a public campaign to raise awareness. In England registration on the Donor Register is voluntary. Registration was required in Netherlands for all residents 18 years and older. For those not already on the register, letters were sent by the Dutch Government to ask individuals to register. If people did not respond they would be legally registered as having “no objection.” After implementation of Opt Out in England 42.3% is registered Opt In, 3.6% Opt Out, and 54.1% has no registration. In contrast in Netherlands the whole population is registered with 45% Opt In, 31% Opt Out and 24% “No Objection.” It is too soon to draw conclusions about the impact on the consent rate and number of resulting organ donors. However, the first signs are positive."

...

"There had been many failed attempts to introduce Opt Out legislation to England over the last 30 years but was achieved on 20th May 2020. In October 2017 the Prime Minister stated her intention to shift “the balance of presumption in favour of organ donation” and “introduce an opt out system for donation.”

"Fortuitously a parliamentarian from the opposition party had successfully had his name drawn from a legislation ballot (a system which allows a few “Private Members Bills” to be considered by parliament from a randomly chosen subset of legislation suggestions), for a new Opt Out Bill. This led to an unusual alignment of opposing political parties, working together on a new policy. Due to this cross party support, the Bill progressed through Parliament and never had to be put to a vote.

"England’s Opt Out legislation built on the positive experience in Wales and Parliament was further reassured by the response to a public consultation on the draft Bill, which asked how Opt Out should be introduced. The Government usually expects between 200 and 500 responses; over 17,000 responses were received. The responses were supportive and gave a strong steer for the issues needing to be addressed.

"The main issues raised by the public were: the need for autonomy and individual choice; the role of the family; the need to respect faith and beliefs through the donation process. The government worked closely with NHSBT to identify ways to ensure that these issues were addressed. Ministerial commitments also secured additional resources such as increased recurrent funding.

"The final inspiration came from two young people—Max Johnson and Keira Ball. When the Bill was introduced, Max Johnson, a 9 year old boy, was in desperate need of a heart transplant. The UK media—particularly the Mirror newspaper—campaigned for the introduction of Opt Out legislation. Max’s life was saved through the gift of donation by Keira Ball, also aged nine, who tragically lost her life in a road traffic collision. The Opt Out legislation is known as Max and Keira’s Law, in their honour.

"Netherlands

"On the 1st of July 2020 the Opt Out system for organ donation was implemented in Netherlands. Changing the organ donation law from an Opt In consent system into an Opt Out system had not been easy. It took more than 12 years of political discussion to reach the milestone of a majority.

"In 2012 a member of the House of Representatives prepared a Bill to change the consent system into an “Active Donor Registration.” On the 16th of September 2016 the Bill was passed by the smallest possible majority in the House of Representatives, 75 members voted in favour of the Bill and 74 members against. On the 16th of February 2018 the vote in the Senate again ended in a close call, 38 senators voted in favour of the Bill and 36 members against. The Bill could only pass after a required amendment to develop a “Quality Standard Donation,” which describes the role of the doctor and the family in the donation conversation, based on the different outcomes of the Donor Register.

"The Active Donor Registration means that Dutch residents without a registration in the Donor Register, 7 million, will be asked by letter to register their donation preferences (same options as in the Opt In system). If they do not respond to a first and second letter, they will receive a third and final letter with the confirmation that they will be registered as having “No Objection” to organ and tissue donation. Under the new legislation “No Objection” would legally be considered the same as a registration of “Yes, I want to be an organ donor.” Registrations can be changed 24 h a day via the Internet. It could therefore be argued that while the change in law was to introduce Opt Out, it has similarities to a model of mandated choice for organ and tissue donation (6).

School choice using deferred acceptance algorithms increases competition for selective schools, by Terrier, Pathak and Ren

 Here's a working paper from the LSE which concludes that making it safe for parents to truthfully report their preferences increases the competition for selective schools (called grammar schools, which prioritize students based on admission tests), with the unintended consequence of disadvantaging poorer families in England. The paper contains a good description of past and present school assignment regimes in England.

From immediate acceptance to deferred acceptance: effects on school admissions and achievement in England by Camille Terrier Parag A. Pathak and Kevin Ren,  Centre for Economic Performance Discussion Paper No.1815, November 2021

"Abstract: Countries and cities around the world increasingly rely on centralized systems to assign students to schools. Two algorithms, deferred acceptance (DA) and immediate acceptance (IA), are widespread. The latter is often criticized for harming disadvantaged families who fail to get access to popular schools. This paper investigates the effect of the national ban of the IA mechanism in England in 2008. Before the ban, 49 English local authorities used DA and 16 used IA. All IA local authorities switched to DA afterwards, giving rise to a cross-market difference-in-differences research design. Our results show that the elimination of IA reduces measures of school quality for low-SES students more than high-SES students. After the ban, low-SES students attend schools with lower value-added and more disadvantaged and low-achieving peers. This effect is primarily driven by a decrease in low-SES admissions at selective schools. Our findings point to an unintended consequence of the IA to DA transition: by encouraging high-SES parents to report their preferences truthfully, DA increases competition for top schools, which crowds out low-SES students."

And here are the paper's concluding sentences:

" In England, selective schools pick students based on test scores, which favors high-SES parents. After the transition to DA, high-SES parents enroll at these schools at higher rates. Selective admissions are widespread throughout education, so our results provide an important caution to equity rationales for DA over IA in settings where selective schools have large market share."

Real estate auctions for turtledoves: Klemperer, Baldwin and Teytelboym in the Economist

 The Economist reports on efforts to reverse the decline of turtledove nesting sites:

How an auction is helping Britain’s turtle doves

"Paul Klemperer, Elizabeth Baldwin and Alex Teytelboym, all of Oxford University, are using economics to help. They have designed a reverse auction in which farmers bid publicly for contracts to provide suitable habitats. This is trickier than it sounds. Turtle doves need wildflower seeds to eat, shallow-sided open water to drink and thick scrubby hedgerows in which to nest—all in proximity. A farmer might wish to provide just one or two of these, and to rely on neighbours to provide the rest. Moreover, breeding pairs must be able to find the sites, but they must not be too clumped together. And finally, the habitats offered by farmers can vary in quality as well as price—a problem Mr Klemperer encountered during the global financial crisis, when designing an auction in which the Bank of England offered emergency loans to banks against collateral of varying quality.

"To solve it this time round, the economists constructed an index of turtle-dove happiness (tdh, or “ta-das”). An algorithm searches combinations of bids, seeking to maximise ta-das for a given budget. Bids both compete with and complement each other: a high-priced offer to grow wildflowers might beat a cheaper one if they would be nearer a nesting site, and would thus create more ta-das. The Royal Society for the Protection of Birds, a charity, has used the system in two pilot auctions in Norfolk and Suffolk, attracting 63 bidders. The latest closed in June, and seeds should be sown in the autumn.

"The experiments are funded by the government as part of a broader post-Brexit effort to redirect farming subsidies towards support for providing public goods. The European Union’s common agricultural policy, which rewards intensive farming, had led to the loss of diverse natural habitats for wildlife of all kinds."

Kidney exchange (including global kidney exchange), discussed at the European Society of Organ Transplantation meeting in Milan, Tuesday 29 June

 ESOT: The 20th Congress of the European Society of Organ Transplantation, meeting (by Zoom) in Milan, Italy (so the talks start at 9am pacific time, noon Eastern time in U.S., tomorrow)

Models of kidney exchange and chains

Tuesday 29 June 18:00 (CEST) 

18:00 – 18:12 Kidney exchange in UK Lisa Burnapp 

18:12 – 18:24 Kidney exchange in EU: where we are? Peter Biro

 18:24 – 18:36 Kidney exchange in US Michael Rees 

18:36 – 18:48 Ethical and legal issue in kidney exchange Frederike Ambagtsheer 

18:48– 19:00 Discussion Panellists 

19:00 Conclusions Nizam Mamode

Registration is free via https://us02web.zoom.us/webinar/register/WN_3sfBEFxnQleNoYezQvyjbg.

Covid has slowed transplants in the UK

The Evening Standard has the story:

Organ transplant waiting list jumps to five-year high due to pandemic, new NHS figures show

by Naomi Ackerman 

"The number people waiting for an organ transplant has soared to five-year high as a result of the coronavirus pandemic, new NHS figures have shown.

"NHS Blood and Transplant (NHSBT) said this week that an estimated 6,700 people are currently in need of a transplant across the UK - up from 6,138 prior to the start of the pandemic.

"The health body has estimated that the increase in patients waiting - expected to be the highest since 2015-16 - comes after services were impacted by the effects of the pandemic.

...

"It is hoped that the waiting list can be shortened going forward following the introduction of a new law in May, making organ donation "opt-out" rather than an active choice.

...

"The law will see that families are still consulted before organ donation goes ahead - the reason is why health officials have implored people to make their wishes about donation known to their families.

"NHSBT has said that thousands of "transplant opportunities" have been missed in recent years. In 2018-19, it reported that 835 families declined to support organ donation - with many families saying they did not know what their relative would have wanted."

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HT: Alex Chan

Internet dating while Muslim

The Guardian has the story:
SingleMuslim.com: how the Yorkshire dating site transformed Muslim romance
It is one of the biggest dating sites in the world and after 17 years, it has has led to over 50,000 marriages.

"The UK site boasts nearly a million UK active users and the company is expanding internationally. (Traffic analysis suggests there are about 1.4m page views per month).Because it is in effect a marriage site rather than a dating site, it also claims a high rate of success. There have been 50,000 SingleMuslim.com weddings, and counting.
...
"When Younis originally set up his website, the problems came from fundamentalists. “Back in the day we used to have death threats,” he says. “All from anonymous keyboard warriors. They would be like ‘it is haram [forbidden] to display photographs of women’. People would have seen their sister on there.”

"Younis was unfazed. Now, he says, he doesn’t hear of anyone who is against what they are doing, mainly because, he believes, “everyone knows someone the site has helped”.
...
"You don’t have to spend very long on SingleMuslim.com to realise it is not Tinder. The options in creating a profile on the site require users to select their level of piety (Very religious/Somewhat religious/Prefer not to say) their sect (Shia/Sunni/Just Muslim) and appearance preferences (Hijab? Beard?).

“What we are not is this kind of swipe right, one-night stand kind of service,” Younis says. “People call it ‘halal dating’ and that’s fine. Halal means being wholesome and right in your faith.”

"About 10% of members join as a family. In those cases, traditionally the mums or the grannies use the site to do the matchmaking, Khan explains. What the company mostly promotes, though, is the opportunity to broaden that search as far as possible. The case studies on the site highlight couples who have crossed national and racial barriers to marry. “We are not SingleShia.com or SinglePakistanimuslim.com,” Younis suggests. There is an empowering impulse in this – and in the insistence that photographs must be full face. “Females who are fully covered don’t get in our galleries,” Khan says. “There is no point in having an image where you just see the eyes.”

Family consent for deceased organ donation in Britain

From the BBC: Hundreds of families block organ donation

"Organs from 505 registered donors could not be made available for transplant in the last five years because of objections from relatives.
...
"The law states that consent lies with the deceased, but in practice, relatives' wishes are always respected.
The NHS wants to reduce the number of "overrides" by encouraging prospective donors to talk to their relatives.
In England, NHS figures showed that 457 people died last year whilst waiting for an organ transplant."

Uber's difficulties in London (and in general)

Here's an illuminating article on the difficulties Uber is having in London. It's hard to extract a few representative sentences, but the whole (longish) article is well worth reading.

Understanding Uber: It’s Not About The App

School choice in England

Gazumping in England: repugnant and soon to be illegal?

When does a contract to sell a home become binding? That may be about to change in England. The Telegraph has the story.
Relief for home buyers as the Government may ban 'gazumping' 

"Gazumping could be banned by the Government, as it has emerged that officials have held private meetings with industry to discuss bringing forward the point at which house sales become legal, in line with Scotland.

"The radical move would prevent millions of British housing sales falling through as 18pc, or around 200,000 transactions collapse each year.

"A major reason is a plague of buyers outbidding others who have already put down an offer, a practice commonly known as "gazumping".

"It causes frustration and disappointment for buyers who think they have secured their dream home, only to find they lose it overnight to someone with more cash. It also routinely leaves frustrated would-be-buyers paying for bills for surveying and legal fees which can run into thousands of pounds, providing a further kick in the teeth.
...
"The meeting was used in part to discuss the idea of introducing to Britain the system which already exists in Scotland and in other countries in Europe, under which property sales are legally binding at the point where an offer is accepted by the buyer.

"At present deals made in Britain are only binding once the contracts have been exchanged, giving buyers with big deposits ample chance to "gazump".

While this Scottish-style system could make life much easier for buyers of British homes, experts predicted it would be very unpopular with sellers and could even put them off moving house. "

There is no law against cannibalism in England

The Guardian has the story: Eating people is wrong, but is it against the law?

"Has José Salvador Alvarenga been reaching for the fava beans and chianti? The 36-year-old sailor survived at sea for more than a year after being cast adrift by a storm. But now the family of his fellow sailor, 22-year-old Ezequiel Córdoba, say the older man turned cannibal to survive. Alvarenga insists Córdoba died because he could not stomach the raw birds and turtle blood that were their only source of food. But Córdoba’s family are suing the Salvadorian fisherman for $1m for eating their relative.

It would not be the first time a survivor in extreme circumstances had tucked in to a fellow traveller. After a plane crash in the Andes in 1972, passengers ate the frozen remains of those who had perished, surviving 72 days before they were rescued. In 2000, three migrants from the Dominican republic survived for three weeks when their boat engine failed at sea, only by devouring some of the 60 others who succumbed to dehydration and exposure.

But is eating someone’s flesh in such extreme conditions against the law? Not in the UK, according to Samantha Pegg, senior lecturer at Nottingham Trent University. “There is no offence of cannibalism in our jurisdiction,” Dr Pegg says. She points out that Alvarenga’s story is similar to a famous case in legal history. In 1884, a four-man crew sailing from England to Australia were shipwrecked with almost no food. When the 17-year-old cabin boy became ill, two of the men, Stephens and Dudley, decided to kill and eat him. Five days later they were rescued and charged with murder. The third man was not charged, despite eating his companion’s flesh. Although their lawyers argued that killing the cabin boy was a necessity for the survival of the three other men, Stephens and Dudley wereconvicted of murder and sentenced to death – later commuted to six months’ imprisonment. “This set a precedent that there is no necessity defence for murder,” points out Pegg.

In cases of serial killers or sexually motivated cannibals, the charge is always murder, she says. In Germany, where there is also no offence of cannibalism, a court had to wrestle with a case where a man “offered” himself to be killed and consumed by an IT expert called Armin Meiwes – Meiwes was still convicted of murder. Last year, a German police officer was sentenced to eight-and-a-half years for a similar crime of “murder and disturbing the peace of the dead”. However, because his victim was said to be “willing”, he was not given the maximum sentence.

Other would-be cannibals could face charges of outraging public decency or preventing a lawful burial, says Pegg. In 1988, performance artist Rick Gibson ate human tonsils on the street; he claims to be “the first cannibal in British history to legally eat human meat in public.” With a rise in “body food”, and eating your partner’s placenta, he may not be the last."

Assisted dying: the debate in England

The Telegraph has the latest:
‘There is nothing sacred about suffering’, insist faith leaders in assisted dying call--Bishops, priests and leading Rabbis break ranks with mainstream religious case opposition to assisted dying

"Religious teachings that elevate suffering and pain as something “sacred” should not be used to prevent terminally ill people taking their own lives, leading Christian and Jewish clerics have insisted.

"An alliance of bishops, priests and rabbis have broken ranks with the religious establishment to voice support for plans to change the law to allow a form of assisted suicide in the UK for the first time.

"In a letter to The Daily Telegraph, they argue that far from being a sin, helping terminally ill people to commit suicide should be viewed simply as enabling them to “gracefully hand back” their lives to God.

"There is, they insist “nothing sacred” about suffering in itself and no one should be “obliged to endure it”, they insist.

"Signatories of the letter, in support of a bill to be debated by MPs next month, include Lord Carey, the former Archbishop of Canterbury, who stunned the Church of England last year when he announced that he had changed his mind on the issue.
...
"MPs are due to debate an Assisted Dying Bill tabled by the Labour backbencher Rob Marris next month.

"It would allow people thought to have no more than six months to live and a “settled intention” to end their life to be allowed be given a lethal dose of drugs on the authority of two doctors.

While most of the major religious groups in the UK have voiced opposition, some polls suggest a majority of people who identify themselves with a faith are in favour of relaxing the law."

Early admissions come to English universities

The Guardian has the story:
Top universities 'ignoring final A-level grades' in race to sign up students
"Universities such as Lancaster and Birmingham are making record numbers of "unconditional offers" – places awarded irrespective of final A-level grades – in 2015"

"Leading universities have been accused of undermining A-levels by accepting students before they sit their final exams in a “desperate” rush to fill places.

"Research by the Telegraph shows universities are preparing to make increasing numbers of “unconditional offers” to sixth-formers next year.

"Top research institutions including Birmingham, Lancaster, Nottingham, Leicester, Sussex and Queen Mary, University of London, will admit students en masse in some subjects without waiting for results in August.

"Numbers are expected to significantly exceed the 12,000 unconditional offers made across the UK this year, with one university alone saying it will make 10,000 in 2015.
The move coincides with a government decision to abolish all restrictions on student recruitment in England for the first time in 2015 – creating a free market in undergraduate admissions.

"It has led to intense competition between universities to sign up the most talented sixth-formers before they are attracted to opposing institutions.

"In most cases, admissions tutors will make places available to candidates based on past performance in GCSEs and their predicted A-level grades, meaning students will win places even if they go on to fail their summer exams."

Non-directed kidney donation up in Britain

The Telegraph has the story: Why I wanted to donate a kidney to a complete stranger

"Altruistic kidney donation has, in the past year, increased by 55 per cent, with 118 living people donating a kidney. The practice only became legal in 2006, and the following year only six procedures were recorded. Since then the numbers have risen exponentially.
Transplant experts believe that cases such as that of the 85-year-old woman who this year became Britain’s oldest living kidney donor – “Why do I need two kidneys to sit at home knitting and watching television?”, she asked – have inspired others to follow suit.
Before 2006, only family and close friends were allowed to give up their kidney for people suffering from kidney dysfunction. The authorities were wary of a trade in organs that could lead to an exploitative or coercive relationship between recipient and donor.
The current legislation, drawn to prevent this, states that donors are not allowed to know the identity of the recipient, although recipients are allowed to get in touch with donors, if they choose to, after the operation. This is so that the recipient is not made to feel any moral or financial obligation.

Real estate ads in Britain: "no upward chain"

Some time ago I blogged about how transactions in tight real estate markets might produce chains (or even cycles) of transactions, in which some owners might have to buy a house before they could vacate theirs (and in slow markets in which some owners might have to sell their house before they could buy one).

It turns out that right now in England, a not-so-rare feature of ads to sell houses is the phrase "No upward chain." What it means, apparently, is that this house is available to be bought/sold right now, without the owner having to wait to buy a new house before closing on the deal.

HT: Brit Grosskopf