More transplant troubles in Germany

Rosemarie Nagel points me to this article, in German: Transplantationen: Prüfer decken Manipulationen am Berliner Herzzentrum auf

Google Translate gives this for the summary:
"The German Heart Institute Berlin has manipulated according to a report in 14 cases in transplantation. Syndromes were described incorrectly and the dose of medication was overstated in order to get donor organs faster."

Some earlier posts are here:
Deceased donor waiting lists in Germany: scandal and aftermath

Incentives and organ donation in Germany

Tanzverbot: dancing bans in Germany on Good Friday

Sven Seuken points out this story from last year related to the German ban on dancing--Tanzverbot--on Good Friday: Ban on Dancing on Good Friday Draws Protests; Conga Line in Cologne

"FRANKFURT—Every year on Good Friday, Germany becomes a little like the fictional town in the movie "Footloose"—dancing is verboten.

The decades old "Tanzverbot," or dance ban, applies to all clubs, discos and other forms of organized dancing in all German states."

Here is Wikipedia on dancing bans

Preferences for randomness in German university admissions

Here's a paper that pushed a lot of my buttons: theory, experiments, and institutional detail on university admissions to study medicine (and some other disciplines) in Germany: Flipping a Coin: Theory and Evidence, by Nadja Dwenger, Dorothea Kubler, and Georg Weizsacker

Abstract: We investigate the possibility that a decision-maker prefers to avoid making a decision and instead delegates it to an external device, e.g., a coin flip. In a series of experiments our participants often choose stochastically dominated lottery between outcomes, contradicting most theories of choice such as expected utility. A large data set on university applications in Germany shows a choice pattern that is consistent with a preference for randomization, entailing substantial allocative consequences. The findings are consistent with our theory of responsibility aversion.

Here's some of the institutional description:

"Admissions to German undergraduate university programs in the medical subjects are centrally administered by a clearinghouse. The clearinghouse assigns applicants according to the following three procedures that are implemented in a sequential order:

(1) Procedure A admits students who are top of the class to up to 20% of seats.

(2) Procedure W admits students with long waiting times to up to 20% of seats.

(3) Procedure U represents admission by universities according to their own criteria to the

remaining (at least 60% of) seats.

For each of the three procedures, applicants are asked to submit a preference ranking of universities, which may either be identical or di fferent across procedures. All rank-order lists are submitted at the same moment in time. The central clearinghouse employs the three procedures in a strictly sequential order: all applicants who are matched in procedure A are firmly assigned a seat at their matched university and do not take part in subsequent procedures. All remaining applicants enter procedure W. Likewise, after procedure W, all applicants who are still unmatched enter procedure U. The fact that applicants can submit three (potentially different) rank-order lists of universities, each of which may be relevant, is a unique property of the German mechanism and makes it suitable for our analysis."

Procedure A is apparently an immediate-acceptance ("Boston") algorithm that takes only the preferences of the students as inputs, while procedure U is a university-proposing deferred acceptance algorithm.  While there are strategic reasons for students to submit different preferences in A and U, the authors argue that these can be identified and removed from the data, and that there remain students who order their choices differently in the two procedures, in the manner of experimental subjects who display a preference for introducing some randomness into their assignment.

Georg W. further writes to me as follows:
"Arguably the most important and most interesting strategic motives in the German application system appear because of the multi-stage nature of the mechansim: Applicants need to be careful that they are not matched in the first stage of the mechanism, in cases where they plausibly have a chance to get a better match on subsequent stages."

German kidney transplant surgeon on trial

Prosecutors in Germany have accused a transplant surgeon of attempted murder, for allegedly manipulating the waiting list to obtain organs for his patients, and thus victimizing those who should have been ahead of them in line to receive the organs in question

Google translate renders the headline as "He killed without being a murderer"

"The surgeon Ayman O. is on trial. He is said to have manipulated information to patients to transplant organs to them. The prosecution sees this as attempted murder, he had taken the death of the other into account. The process in Göttingen will make the system of organ allocation to the test."

HT: Rosemarie Nagel

Deceased donor waiting lists in Germany: scandal and aftermath

In an article entitled "Trust is Everything," Sue Pondrom reports in the American Journal of Transplantation (May 2013, vol 13 issue 5 pp1115-6) on the aftermath of a German transplant scandal.

"After a scandal regarding transplant corruption in Germany, the Deutsche Stiftung Organ transplantation (DSO), Germany's organ procurement organization, has announced that organ donations in the country were down nearly 13% by the end of last year.

"Public confidence in Germany's transplant system has suffered dramatically since newspapers throughout the country described cases of waitlist manipulation over the last 10 years at four liver transplant centers: University of Göttingen, University of Regensburg, Munich Klinikum rechts der Isar hospital and University Hospital Leipzig. At all four centers, doctors falsified liver patient medical records to indicate the patients were also undergoing dialysis. As a result, those patients were erroneously moved up the waiting list."

Incentives and organ donation in Germany

Bettina Klaus writes:  There is an article about a recent organ donation scandal at the university hospital Goettingen. 

One of the transplant surgeons there seems to have manipulated patient files (25 cases are currently under investigation) in order to push his patients up on the waiting list. Interestingly his salary depended on the numbers of transplants he did and the article states that under his lead the number of liver transplants at the university hospital Goettingen had significantly increased in 2009 and 2010. 

Here's an English account of that, and organ sales as well: Desperation, Greed and the Global Organ Trade 
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Something similar  to the Goettingen events led to a change in the deceased-donor liver allocation system in the U.S.
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See also http://www.spiegel.de/gesundheit/diagnose/organspende-skandal-goettingen-montgomery-fordert-schaerfere-kontrollen-a-847985.html, for a related story (also in German), which focuses on recent changes in the German transplant and organ donation systems. (HT Rosemarie Nagel)
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And Markus Mobius points to this article (also in German, but the headline is clear): Transplantationsskandal

He writes "The article says that an increasing share of transplants in Germany are now bypassing the waiting list and go straight to in-house patients.
"10 years ago, 9.1% of livers, 8.4% of hearts, 10.6% of lungs and 6.3% of pancreas bypassed the waiting list. Now the shares are 37.1%, 25.8%, 30.3% and 43.7%, respectively. "

More on circumcision in Germany

Further developments on the ruling of a German court earlier this summer, banning circumcision.

"German lawmakers have passed a cross-party motion to protect religious circumcision, after a regional court ruled it amounted to bodily harm.

The resolution urges the government to draw up a bill allowing the circumcision of boys.

Germany's main political parties - together with Jewish and Muslim groups - have criticised the ruling by the Cologne court in June.

Chancellor Angela Merkel said it risked making Germany a "laughing stock".

The Cologne ruling involved a doctor who carried out a circumcision on a four-year-old that led to medical complications.

The doctor involved in the case was acquitted and the ruling was not binding. However, critics feared it could set a precedent for other German courts.

Germany's Medical Association told doctors after the ruling not to perform circumcisions.

'Tolerant country' The motion approved on Thursday in the lower house of parliament says the government should "present a draft law in the autumn... that guarantees that the circumcision of boys, carried out with medical expertise and without unnecessary pain, is permitted".

"Jewish and Muslim religious life must continue to be possible in Germany. Circumcision has a central religious significance for Jews and Muslims," it added.

The new law would overrule the decision by the Cologne court.

Ahead of the vote, Foreign Minister Guido Westerwelle said the proposed motion showed that Germany was a "tolerant and cosmopolitan country".

European Jewish and Muslim groups earlier also joined forces to defend circumcision.

An unusual joint statement was signed by leaders of groups including the Rabbinical Centre of Europe, the European Jewish Parliament, the European Jewish Association, Germany's Turkish-Islamic Union for Religious Affairs and the Islamic Centre Brussels.

"We consider this to be an affront [to] our basic religious and human rights," it said.

The BBC's Stephen Evans in Berlin says opinion in Germany about the issue has been mixed, though slightly more Germans were in favour of the ban.

He says that many readers' comments on newspaper websites have indicated anger that this generation of Germans seems to be being constricted in its actions because of the Holocaust."

Angela Merkel intervenes over court ban on circumcision of young boys--Spokesman says right to circumcision must be restored as a matter of urgency, after Cologne court's ruling against practice

"Angela Merkel's spokesman has promised Germany's Jewish and Muslim communities they will be free to carry out circumcision on young boys, despite a court ban that has raised concerns about religious freedom.

"The government said it would find a way around a ban imposed by a court in Cologne in June as a matter of urgency.

"For everyone in the government it is absolutely clear that we want to have Jewish and Muslim religious life in Germany," said Merkel's spokesman, Steffen Seibert.
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Ynet covers the story this way: Chancellor told party members she did not want Germany to be 'only country in which Jews cannot practice their rites'
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 July 19: German MPs vote to protect religious circumcision

"German lawmakers have passed a cross-party motion to protect religious circumcision, after a regional court ruled it amounted to bodily harm.

The resolution urges the government to draw up a bill allowing the circumcision of boys.

Germany's main political parties - together with Jewish and Muslim groups - have criticised the ruling by the Cologne court in June.

Chancellor Angela Merkel said it risked making Germany a "laughing stock".

The Cologne ruling involved a doctor who carried out a circumcision on a four-year-old that led to medical complications.

The doctor involved in the case was acquitted and the ruling was not binding. However, critics feared it could set a precedent for other German courts.

Germany's Medical Association told doctors after the ruling not to perform circumcisions.

...

The motion approved on Thursday in the lower house of parliament says the government should "present a draft law in the autumn... that guarantees that the circumcision of boys, carried out with medical expertise and without unnecessary pain, is permitted".

"Jewish and Muslim religious life must continue to be possible in Germany. Circumcision has a central religious significance for Jews and Muslims," it added.

The new law would overrule the decision by the Cologne court.

Ahead of the vote, Foreign Minister Guido Westerwelle said the proposed motion showed that Germany was a "tolerant and cosmopolitan country".

...

The BBC's Stephen Evans in Berlin says opinion in Germany about the issue has been mixed, though slightly more Germans were in favour of the ban.

He says that many readers' comments on newspaper websites have indicated anger that this generation of Germans seems to be being constricted in its actions because of the Holocaust.

Will circumcision become a repugnant transaction in Germany?

A court in Germany has ruled that circumcising young boys for religious reasons amounts to bodily harm.

Earlier attempts to ban circumcision in California lost support because of the “grotesque anti-Semitic imagery" employed by activists in favor of the ban.

HT: Sven Seuken