A still-skeptical view of transplantation in China

My recent post on transplantation in China reported on optimistic assessments of the move away from using executed prisoners as a source of organs. Not everyone is optimistic: here's a recent editorial from the BMJ:

Engaging with China on organ transplantation
BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j665  (Published 07 February 2017)
by Wendy A Rogers, Matthew P Robertson, and Jacob Lavee

It starts with a story from the bad old days, and then turns to the current environment, saying in part:

"Since January 2015, China has vowed to halt the use of organs from executed prisoners. After a pilot in 2010-14, a procurement programme using donated organs from people who meet circulatory death criteria was rolled out nationally. There are now national transplantation registries and organ procurement organisations. Yet there is no new law or regulation in China banning the use of organs from executed prisoners. Nor have existing regulations permitting the use of prisoners’ organs been rescinded. Prisoners remain a legal source of organs if they are deemed to have consented before execution, thus permitting ongoing retrieval of organs from prisoners executed with or without due process.1

"The transplant registries are not open to public scrutiny or independent verification. Inexplicably high volumes of transplantation continue to take place in China,8 and wealthy foreigners can still obtain liver and heart transplants, booked in advance.11 The Transplantation Society’s former president Francis Delmonico acknowledged under oath at a recent US Congressional hearing that he cannot verify claims about reform in China. The main evidence for reform has simply been the public assertions of Huang Jiefu and other government officials."

Harm reduction: decriminalizing drugs to reduce overdoses?

From the Toronto Star:
Should Toronto push to decriminalize all drugs? The city’s medical health officer ready to consider it
The city is convening a committee of health and drug policy experts to explore “a different approach that puts the health of the community first,” Dr. Eileen De Villa said.

"Toronto’s new Medical Officer of Health is calling for a public discussion on the merits of decriminalizing all drugs in the wake of the ongoing overdose epidemic.

“It’s clear that our current approach to drugs in this city and this country doesn’t seem to be having the desired impact,” Dr. Eileen De Villa told reporters Friday at a briefing on how the city is responding to drug users overdosing and, in some cases, dying.
...
"On Friday, following Thursday’s emergency meeting of city partners, De Villa reviewed with reporters the city’s overdose prevention strategies which include asking police to carry the fentanyl antidote and speeding up the opening of three safe injection sites.

De Villa said among the 10 key strategies in Toronto’s Overdose Action plan is a call for a public health approach to drug policy that puts the health of the community first, “rather than looking at this as an issue of criminal behavior and or an area for law enforcement.”

The city is convening a committee of health and drug policy experts to explore “a different approach that puts the health of the community first,” she said.

While acknowledging the city doesn’t have the power to change the Criminal Code, “Toronto has always been a leader … in policy and I don’t see why we wouldn’t continue to be a leader on this front,” said De Villa, who stepped into her high-profile position four months ago."
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Not everyone is interested in this kind of harm reduction. Here's a Washington Post story about a different point of view expressed by an Ohio sheriff (I think this is a point of view that also comes up in opposition to e.g. making clean needles available to drug addicts):

Why this Ohio sheriff refuses to let his deputies carry Narcan to reverse overdoses

"No one has come up with a solution to the opioid epidemic that has decimated Rust Belt states, but for people who overdose, Naloxone is about as effective an antidote as there is. The results of the opioid antagonist, which is sprayed up a person's nose and reverses the effect of opioid overdoses, have been likened to resurrecting someone from the dead.

"Paramedics and firefighters routinely carry the easy-to-administer medication in their vehicles. For police officers in the nation's hardest hit areas, like southwest Ohio, the Food and Drug Administration-approved nasal spray, known by the brand name Narcan, can be as common as handcuffs. Even some librarians have learned to use the drug to revive people who overdose in their stacks.

"But Richard K. Jones, the sheriff of Butler County, Ohio, raised eyebrows recently when he said that his deputies will never carry the medication.
...
"Jones said Narcan is the wrong approach for a war on opioids that “we're not winning,” and said he favored stronger prevention efforts to prevent people from first using the drug."

Surrogacy in France (and IVF for unmarried folks)

Surrogacy has long been illegal in France, but the fact that it is legal elsewhere in the world (such as California) has put pressure on French authorities to recognize French parents and children who have come through surrogacy.

Here's a post from frequent surrogacy-watcher Ellen Trachman at Above the Law on recent progress:
French Gay Dads Win A Surrogacy Victory

"Many European countries have either completely banned surrogacy, or at least severely limited its legality. France is among those European countries that have outlawed surrogacy within its borders. But despite the ban, high demand by French citizens — including gay couples who want a biologically-linked child — has led to many French citizens conceiving children abroad via surrogacy, and in some cases, turning to desperate measures.
...
"Last week, the Court of Cassation — which is apparently what they call France’s highest court of appeals — ruled on a surrogacy dispute. (Here’s the French manuscript for my fluent followers.) In the case, four couples with children born via surrogacy outside of France asked the court to require the government to recognize their (and especially the non-biological parent’s) parental rights to their child.

At Least It’s Not Three Years Ago. Fortunately, the couples at least had one parent with recognized rights to the child. Three years ago, France was refusing to recognize any French parental rights or French citizenship for a child born elsewhere via surrogacy. The European Court of Human Rights chastised the French government, finding that such a stance was a violation of human rights — specifically for the parentless, and possibly country-less, child. That 2014 ECHR ruling allowed a genetically-linked father to a surrogate-born child to be recognized as the legal parent, and the child be given French citizenship.

...

"[Last week]...the court agreed to a middle route, and ruled that the non-bio partner could adopt the surrogate-born child. 

...  [and on to IVF]

"While campaigning, President Emmanuel Macron took the position that single women and same-sex female couples should be eligible to use assisted reproductive technology services to conceive. Currently, the country allows those services to be available only for heterosexual couples. ...

... Macron hedged his position by saying that he would wait for the National Consultative Ethics Committee to issue a recommendation on the matter before acting. ... last week, after considering the issue for over three years, the Committee finally issued its opinion. It concluded that, indeed, singles and same-sex couples should be permitted to use assisted reproductive technology services. "

Iran's Parliament considers government distribution of drugs to addicts

Here are several English language stories that report on recent events in the Iranian Parliament that suggests a legalizing of certain forms of drugs, to allow government distribution to addicts.  It appears that the law may switch from the death penalty to imprisonment for small dealers as well.

Iran: Increased Number of Addicts Pushes Toward Bill on Drugs
Asharq Al-Awsat

"Days after the Judicial Committee of the Iranian Parliament’s House spokesman Hassan Norouzi approved a bill that would allow the Iranian government to distribute drugs among addicts, an official in the Expediency Discernment Council of the System revealed that 17 percent of Iranians tend to abuse drugs while 220,000 to 250,000 others are drug traffickers.

Head of a working group on drugs in the Expediency Council Saeed Safatian defended a new project that permits the Iranian government to distribute drugs on addicts to curb this phenomenon.

“A total of 17 percent of Iranians tends to abuse drugs,” said Safatian, adding that five percent of them are already addicts while the remaining 12 percent will fall for the trap if the consumption of drugs wasn’t controlled.

Norouzi announced that the parliament approved last Friday the draft, which was also endorsed by decision-making centers.

Commenting on the draft, he added that penalty has been reduced from execution to imprisonment for those possessing less than 100 kilograms of antidote, producing two kilograms of synthetic drugs or carrying five kilograms of it.

Ali Hashemi, head of the counter-drugs committee, stated to Iranian Students News Agency (ISNA) on Saturday that distributing drugs by the government reduces dirty money possessed by traffickers.

He added that adopting the policy of bringing down demand on drugs helps decrease the amount of money earned by gangs from selling drugs."
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Iran Mulls State Drug Distribution
Radio Farda

"After thousands of executions and countless other deaths related to addictive drugs, Iran appears to be on the verge of overhauling its drug-related policies.

While a new bill is being amended in parliament to stop the execution of petty drug smugglers, another plan is also under study for allowing state organs to distribute drugs -- primarily opium -- among addicts.

“The main purpose of the plan is to cut off the connection between drug smugglers and their addicted victims,” said Hassan Norouzi, spokesman for the Iranian Parliament’s Judicial and Legal Commission."
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Iran plans to decriminalise drug use allowing government to give diluted drugs to addicts
The Independent

"Iran could be on the verge of decriminalising some forms of drug use to allow the government to distribute drugs to addicts.

By allowing the government to give out diluted rugs to addicts, the proposal aims to cut the relationship between drug addicts and drug traffickers.

“The plan to distribute [low-grade] drugs is similar to what used to be implemented before the [1979 Iran’s Islamic] Revolution,” said Hassan Norouzi, the spokesperson for the Parliament’s Judicial and Legal Commission, according to IFPNews."

Podcast on matching markets and more from Social Science Bites

David Edmonds interviewed me in London for Social Science Bites, mostly about matching markets, but also about interdisciplinarity, and whether it's fun to win a Nobel prize:

The system that runs the ride-sharing company Uber doesn’t just link up passengers and drivers based on price. It also has to connect the two based largely on where they are geographically. It is, says Nobel laureate Stanford economist Alvin E. “Al”  Roth, a matching market.

In this Social Science Bites podcast, Roth explains to interviewer David Edmonds some of the ins and outs of market matching, starting with a quick and surprisingly simple definition.

“A matching market is a market in which prices don’t so all the work,” Roth details, “So matching markets are markets in which you can’t just choose what you want even if you can afford it – you also have to be chosen.” But while the definition is simple, creating a model for these markets is a tad more complex, as Roth shows in offering a few more examples and contrasting them with commodity markets.

“Labor markets are matching markets. You can’t just decide to work for Google – you have to be hired. And Google can’t just decide that you’ll work for them – they have to make you an offer.” And like say university admission, matching markets require something to intervene, whether it be institutions or technology, to make this exchange succeed. In turn Roth himself helped engineer some high profile matches in areas where the term ‘market might not traditionally have been used: kidney donors with the sick, doctors with their first jobs, refugees with asylum, or students and teachers with schools. Or even the classic idea of ‘matchmaking’ – marriage.

Roth turned to game theory to help explain and understand these markets, and his work won he and Lloyd Shapley the 2012 Nobel Memorial Prize in Economic Sciences. Roth has always had an eye on the real world implications as he pioneered market design, and as the Nobel Committee outlined:

Lloyd Shapley studied different matching methods theoretically and, beginning in the 1980s, Alvin Roth used Lloyd Shapley’s theoretical results to explain how markets function in practice. Through empirical studies and lab experiments, Alvin Roth demonstrated that stability was critical to successful matching methods.

Roth is currently president of the American Economics Association, and sits as the Craig and Susan McCaw professor of economics at Stanford University. He is also the Gund professor of economics and business administration emeritus at Harvard University.

To download an MP3 of this podcast, right-click HERE and save.

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Is it repugnant to give money to poor people?

Chris Blattman's weekly report includes a guest post by Jeff Mosenkis of Innovations for Poverty Action containing this interesting section on whether cash transfers to the poor are starting to be regarded as repugnant...

"Seema Jayachandran did a very popular Reddit Ask Me Anything about her Science paper on cash transfers for not cutting down trees (the AMA landed her on the front page of Reddit for the second time). In answering questions from the public, she was struck by how many people people had a moral objection to paying people not to do something (as opposed to traditional conditional cash transfers which reward people for doing something, like enrolling their children in school).

• Similarly, NPR reports that despite an evaluation showing massive benefits to giving poor people cash in Zambia, moral objections from the public to giving “lazy” people free money limited the program eventually to just the “deserving” poor, such as the elderly, and people who can’t work.
• Rich countries aren’t immune to this kind of thinking. A Vox The Weeds podcast (and parallel article) on the legacy of welfare reform from last year talks about how U.S. social safety net policy changed based on the public’s image of a single mother. At first, the U.S. image of a single mother was a widow trying to raise her children by herself. At that time it was seen as virtuous to help her stay home and raise her kids. When the public image of a single mother changed to a poor minority woman, programs began to see her as someone who should be out working and the design of the benefits changed.
• Those of us who work in the world of evaluating the economics of anti-poverty programs are used to thinking about effectiveness and cost as the primary determinants policymakers need to know, but these are good reminders that the moral view of the design of the program may be just as important in determining whether a program gets implemented or gathers dust on a shelf."

HT: Benjamin Roth

Is it repugnant to write books for children and young adults that deal explicitly with sex?

Is it repugnant to write books for teenagers that deal explicitly with sex?  How about for four year olds?

From the NY Times:
Want Teenage Boys to Read? Easy. Give Them Books About Sex.
By DANIEL HANDLER
"I write books for children under the pen name Lemony Snicket, and I’ve noticed that when I go to Lemony Snicket events, the crowds are about evenly split between boys and girls. But I also write young adult books, and if more than one boy shows up at one of my teen book club events, it’s notable, if not a miracle. Something happens once a young man hits puberty.
...
"It is a gross generalization, of course, to say that what young men want to read about is sex — or to imply that the rest of us aren’t as interested — but it’s also offensive to pretend, when we’re ostensibly wondering how to get more young men to read, that they’re not interested in the thing we all know they’re interested in. There’s hardly any real sex in young adult books, and when it happens, it’s largely couched in the utopian dreams or the finger-wagging object lessons of the world we hope for, rather than the messy, risky, delicious and heartbreaking one we live in."
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And from Haaretz:
Israelis debate: Is it okay for a children’s book to say sex is pleasurable?
The latest work by celebrated Israeli children's author Alona Frankel tells preschoolers how their parents do it. Israeli lawmakers are worried

"About two weeks ago the Knesset Committee on the Rights of the Child held a discussion on sex education for preschool children. The reason was the Hebrew-language book by the author and illustrator Alona Frankel: “A Book Full of Love – How Naftali Came Into the World.”
In the book, Frankel describes how people meet, fall in love and have sex – in one case leading to the birth of Naftali, the curly-haired protagonist of her stories whom every Israeli knows from her popular book published 40 years ago and since translated, “Once Upon a Potty.”
But MK Yifat Shasha-Biton (Kulanu), who heads the Committee on the Rights of the Child, said "How Naftali Came Into the World" raised many questions for her, including whether its descriptions were “a little too much for 3- and 4-year-olds.” Shasha-Biton objects mainly to the description of the sex act in the book, which was published two years ago by the Steimatzky publishing house.
As Naftali’s mother puts it in the book, “When people love each other, they want to be very close. We embraced, we caressed, we kissed, and it was sweet and pleasant. We were wrapped around each other and very close, when the penis on the body of Naftali’s father slipped into my vagina. And inside my body it was warm, enjoyable and exciting. A flood of sperm was ejected from him and became attached to a tiny egg that was waiting in the uterus, a special place inside my tummy.”
During the discussion, Frankel was attacked by the committee’s chairwoman, Shasha-Biton, who although she did not deny the importance of sex education for children, worried about the way it was being presented to preschoolers."

Organ transplants in China: an optimistic assessment

There are optimistic statements about China's progress on developing a system of voluntary organ donation (to replace the prior system of obtaining organs for transplant from executed prisoners.)   Some of these statements originate with the Chinese press. The Vatican is also optimistic.  The Vatican also has wide ranging diplomacy with China concerning quite different issues.  The stories below collectively reflect each of these things.

Here's a story in the SF Chronicle
China to lead in organ transplants by 2020

"China is on track to lead the world in organ transplant surgeries by 2020 following its abandonment of the much-criticized practice of using organs from executed prisoners, the architect of the country’s transplant program said Wednesday.
Chairman of the China Organ Donation and Transplantation Committee Huang Jiefu said the voluntary civilian organ donations had risen from just 30 in 2010, the first year of a pilot program, to more than 5,500 this year.
That will allow around 15,000 people to receive transplants this year, Huang said. The U.S. currently leads the world in organ transplants, with about 28,000 people receiving them each year.
“We anticipate according to the speed of the development of the organ donation in China, the momentum, in the year 2020, China will become the No. 1 country in the world to perform organ transplantation in an ethical way,” Huang said in an interview at his office in an ancient courtyard house inside Beijing’s old city.
China is seeking to expand the number of willing organ donors, but it has run up against some cultural barriers: Family members are still able to block a donation, even if the giver is willing, and Chinese are averse to registering as donors by ticking a box on their drivers’ licenses, considering it to be tempting fate.
Instead, authorities are partnering with AliBaba, China’s virtually ubiquitous online shopping and payment platform, to allow people to register in just 10 seconds, Huang said. Huang said more than 210,000 Chinese have expressed their willingness to become donors, although that’s a drop in the bucket compared with the country’s population of 1.37 billion.
...
"Huang said China has adhered to a complete ban on the use of organs from executed prisoners that went into effect in 2015, although some in the field outside China have called for the country to allow independent scrutiny to ensure it is keeping to its pledge.
Critics have questioned China’s claims of reform and suggested that the World Health Organization should be allowed to conduct surprise investigations and interview donor relatives. The U.N. health agency has no authority to enter countries without their permission.
Chinese officials say China shouldn’t be singled out for such treatment while other countries are not.
Further moving on from the days when foreigners could fly to China with briefcases of cash to receive often risky, no-questions-asked transplant surgeries, China has also taken measures to stamp out organ trafficking and so-called “transplant tourism,” including by limiting transplants to Chinese citizens."
*********
China’s organ transplantation reform hailed by international community

"By CGTN’s Yang Jinghao

A sensitive issue just a decade ago, organ donation and transplantation in China has seen a remarkable shift during the past few years. A total of 7,000 organs were voluntarily donated between January and July this year, according to a conference on organ transplantation held in China over the weekend.

Comparatively, the number in 2010 was just 34 for the whole year.

The conference, held in Kunming, southwest China’s Yunnan Province, gathered top organ transplant professionals from major international organizations. They reviewed the achievements China has made and discussed how to strengthen international cooperation."
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And here's a story from Crux (whose subhead is "Taking the Catholic Pulse")
Chinese state media highlights Vatican official at organ trafficking conference in Beijing

"In a sign of the slow thawing of relations between China and the Vatican, a Chinese state newspaper reported positively on a Vatican official’s remarks at an organ trafficking conference taking place in Beijing.
Argentine Bishop Marcelo Sánchez Sorondo, the chancellor of the Pontifical Academies of Sciences and Social Sciences, attended the conference on Thursday, part of China’s ongoing efforts to convince the world it has reformed its organ donation procedures.
In 2015, the communist country announced it was stopping the practice of using organs from executed prisoners. In 2016, official statistics stated surgeons in China had harvested organs from 4,080 donors and performed 13,263 transplant surgeries, the second highest in the world. Officials said all donors were through a registered volunteer donor system. By 2020, China is expected to surpass the United States to take the top spot.
Last month the Pontifical Academy of Sciences, the World Health Organization , the Transplantation Society (TTS), and the Declaration of Istanbul Custodian Group (DICG) - four of the most influential societies in promoting global ethical practices in organ transplantation - sent a letter expressing their appreciation for China’s efforts in organ donation and transplantation reform.
Despite the assurances of the government, many human rights activists are skeptical such numbers could be achieved through an exclusively voluntary system, especially after decades of reliance on the organs of prisoners."
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Here are comments from Chancellor Marcelo Sanchez Sorondo commending the development of the China Model

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And here's a story about another realm in which China and the Vatican are simultaneously engaged.

Vatican official hints at unofficial agreement with China on bishops
"HONG KONG (CNS) -- A senior Vatican official has hinted there is an unofficial agreement between the Holy See and Beijing on the appointment of bishops, even as negotiations to formalize arrangements continue to hit roadblocks, reported ucanews.com.

Argentine Bishop Marcelo Sanchez Sorondo, who attended a conference on the sensitive topic of organ donation and transplants in the southern Chinese city of Kunming, offered the hint during an interview with state-run Global Times Aug. 4.
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Here are my earlier posts on the positions taken by the Pontifical Academy regarding transplantation.

"Demonstrated interest" as costly signaling in college admissions

Costly signals are valuable as signals because they are costly to send. But of course they may be more costly for some to send than others.


"Demonstrated interest: Signaling behavior in college admissions" (by James Dearden, Suhui Li, Chad Meyerhoefer, and Muzhe Yang) Contemporary Economic Policy (2017)

Abstract

In college admission decisions, important and possibly competing goals include increasing the quality of the freshman class and making the school more selective while attaining the targeted size of the incoming class. Especially for high-quality applicants who receive multiple competing offers, colleges are concerned about the probability that these students accept the offers of admission. As a result, applicants' contacts with admissions offices, such as campus visits, can be viewed positively by the officers as demonstrated interest in the colleges. We provide empirical evidence on the effects of demonstrated interest on admission outcomes. Specifically, we use unique and comprehensive administrative data, which include all contacts made by each applicant to the admissions office of a medium-sized highly selective university during two admission cycles. We find that an applicant who contacts the university is more likely to be admitted, and that the effect of the contact on the probability of admission is increasing in the applicant's Scholastic Assessment Test score, particularly when the contact is costly to make. We also use a numerical example to explore policies to reduce the inequity associated with the use of demonstrated interest in admission decisions, examining in particular the subsidization of costly demonstrated interest by low-income students.

Here's an article about the paper in Inside Higher Ed...
Another Edge for the Wealthy
"Many colleges favor applicants who show "demonstrated interest" -- and the way they measure it puts those without money at a disadvantage, study finds."

More on compensation for donors

It's hard for anyone to say anything new in the long (and long-running) debate about whether we should try to increase the supply of kidneys by crafting some form of ethical, non-coercive compensation for donors, or whether this should remain illegal.
Frank McCormick points me to this recent article, which ends with what I hope is a fairly noncontroversial link to the deceased donor registries:

It May Sound Awful, but We Really Do Need to Pay for Human Organs
by Mark Joffe

It concludes:
"While there is little support for an Iranian-style organ market in the United States, there is an increasing realization that finding more live donors will involve offering them incentives to give up a kidney. A reform that compensates donors without allowing recipients to pay for organs is a viable middle ground. The government could fund such a program with cost savings on dialysis. One estimate puts the potential savings at as much as $12 billion a year.

Last year, Rep. Matt Cartwright (D-Penn.) introduced the Organ Donation Clarification Act, which would have allowed state and local governments to implement pilot programs offering non-cash benefits to live organ donors. These in-kind benefits might include a tuition voucher, loan forgiveness or a contribution to the organ donor’s designated charity. In addition, Cartwright’s legislation would have clarified language in NOTA to establish that cash reimbursement for donor travel expenses, medical costs and lost wages is permissible. The bill attracted 11 bipartisan cosponsors but did not move out of committee.

Cartwright’s office told me that he plans to reintroduce the legislation in the current Congress. Once he does, he will have the support of a group of D.C. policy wonks who have created the Organ Reform Group and Network. One of the group’s members, economist Kurt Schuler, donated a kidney to a stranger in 2014 under the current system, but believes that incentives are needed to end the nation’s kidney shortage.

Whether or not you agree that live donors should be compensated for their kidneys, I hope we can all agree that donating our organs at death is no sacrifice. While this issue is on your mind, consider signing up for the organ registry at https://organdonor.gov/register.html."

Trump Administration Withdraws Proposed Ban on Compensation for Bone Marrow

After the Ninth Circuit ruled that compensation for blood stem cells (sometimes simply referred to as bone marrow) could be compensated in some cases, the department of Health and Human Services moved to reinstate the ban.  (I coauthored one of many of the public comments they received "in opposition to the proposed rule changes by the Health Resources and Services Administration (HRSA) that would ban compensation for bone marrow donations.")

On August 1 the new administration (which hasn't done much else that I approve of)  withdrew the proposed rule change (which I gather should leave the Ninth Circuit decision as the law of the land).

Here's a news story and an editorial (the only reports I've seen so far).

First the story (which seems to incorrectly attribute the administrative agency behind the move to the Office of Management and the Budget instead of to the Department of Health and Human Services (HHS):

Trump Administration Withdraws Proposed Obama Ban on Compensation for Bone Marrow

"The Office of Management and Budget has withdrawn a proposed rule banning compensation for hematopoietic stem cells. In other words, you can get paid when someone harvests stem cells from your bone marrow.

Bone marrow transplantation is used to treat a variety of ailments, including aplastic anemia, sickle cell anemia, bone marrow damage during chemotherapy, and blood cancers such as leukemia, lymphoma, and multiple myeloma. In 1984, Congress passed the National Organ and Transplant Act, which outlawed compensation to the donors of solid organs like kidneys and livers. Oddly, the act also defined renewable bone marrow as a solid organ.

Originally, hematopoietic stem cells were obtained from bone marrow obtained by inserting a needle into donors' hip bones. Researchers later developed a technique in which donors are treated with substance that overstimulates the production of hematopoietic stem cells, which then circulate in their bloodstreams. In a process similar to blood donation, the hematopoietic stem cells are then filtered from the donors' blood. The red blood cells and plasma are returned to the donors.

More Marrow Donors, a California-based nonprofit, wanted to set up a system to encourage hematopoietic stem cell donations with $3,000 awards, in the form of scholarships, housing allowances, or gifts to charity. The Institute for Justice, a libertarian law firm, brought suit on their behalf, and in 2012 a federal appeals court sensibly ruled that the law's ban on compensation for solid organ donations did not apply to stem cells obtained from donors' bloodstreams. The Obama administration reacted by proposing a regulation defining stem cells obtained from blood as the equivalent of a solid organ.

Now the new administration has withdrawn the proposal."

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Here's the editorial, from yesterday's WSJ:
Money for Marrow, Finally

"last week the Department of Health and Human Services withdrew a proposed Obama -era regulation that would have prohibited compensation for bone-marrow donation. About 11,000 ailing Americans are currently searching the national marrow registry, hoping to find a compatible donor. This year at least 3,000 people will die waiting for a transplant."

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Here are my previous posts on bone marrow donation and the compensation controversy.


HT: Philip Held and Frank McCormick

Child marriage in California

The San Francisco Chronicle has the story:

Effort to bar child marriage in California runs into opposition
By Jill Tucker

"A Bay Area legislator was shocked when he learned from a young constituent that while Californians cannot legally consent to sex until they are 18, they can — with the permission of a parent and a judge’s order — get married at any age, even if their spouse is many years older.

“I thought, that can’t be true in California,” said state Sen. Jerry Hill, a Democrat from San Mateo. “We found that it is true in California and true in many states throughout the country.”

But Hill’s resulting proposal to bar juveniles from getting hitched has been watered down after it prompted strong objections from civil rights groups, including the American Civil Liberties Union.

As the emotional fight unfolds in Sacramento, there’s no agreement even about a basic piece of information — how many minors get married each year in California. People who want to limit such marriages say the total is in the thousands, while those who oppose the bill say that’s vastly inflated.

The state doesn’t keep such numbers, and even efforts to change that are running into resistance."
...
"Activists aiming to stop such marriages say they occur across demographic groups, spurred by religious reasons, cultural norms, pregnancy, financial incentives or, in some cases, to protect someone from statutory-rape accusations because marriage circumvents the age-of-consent requirement.

Nationally, about 5 of every 1,000 children ages 15 to 17 were married as of 2014, according to U.S. census data analyzed by the Pew Research Center — figures that don’t specify where the marriages occurred. Activists for age restrictions estimate that California sees about 3,000 marriages per year that include a minor.

The ACLU and other opponents say that estimate is inflated, noting that just 44 petitions for juvenile marriage were filed in Los Angeles County — which has a population just above 10 million — over the past five years.

The focus of efforts should be on abusive and coerced relationships, regardless of marital status, said Phyllida Burlingame of the ACLU’s Northern California chapter.

Referring to current regulations, including the requirement of a court order allowing a juvenile to marry, she said California had “a strong package of both programs and laws that prevent coerced marriage among youth, and a lack of data showing this is a widespread problem.” Hill’s original proposal, she said, “was a solution that wasn’t necessarily going to have the impact on improving young people's health and relationships that we want.”
********

HT: Jen Stack

Polygamy convictions in Canada

The CBC has the story:

Winston Blackmore and James Oler found guilty of polygamy by B.C. judge
Former bishops of Bountiful both have numerous wives and children
CBC

"Two former religious leaders in B.C. have been found guilty of polygamy after marrying more than two dozen women over the course of 25 years.

"Winston Blackmore and James Oler were convicted of practising plural or "celestial" marriage in the fundamentalist community of Bountiful, B.C.

"In B.C. Supreme Court on Monday, Justice Sheri Ann Donegan said Blackmore "subscribed to beliefs and practices of the Fundamentalist Church of Jesus Christ of Latter-Day Saints," a Mormon sect that believes in plural marriages.

"James Oler, another former leader from the same community, was accused of having five wives and Blackmore 24 wives.

"Both men are former bishops of the sect in the province's southeast. Neither denied having multiple marriages and Blackmore has fathered more than 145 children from his marriages.
...
"Blackmore's lawyer, Blair Suffredine, previously said he'd launch a constitutional challenge to the validity of the polygamy laws if his client were to be found guilty.
...
"The legal fight began in the early '90s when police first investigated allegations that residents of an isolated religious community were practising multiple marriages.

"A lack of clarity around Canada's polygamy laws initially led to failed attempts at prosecuting Blackmore, followed by several efforts to clarify the legislation, including a reference question to the B.C. Supreme Court.

"The court ruled in 2011 that laws banning polygamy were constitutional and did not violate religious freedoms guaranteed in the Charter of Rights and Freedoms.

"The mainstream Church of Jesus Christ of Latter-Day Saints, based in Utah, officially renounced polygamy in the late 1800s and disputes any connection to the fundamentalist group's form of Mormonism."
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Prosecution of polygamy in the U.S. has focused not on polygamy itself, but on the fact that some of the brides are underage.  Here's an AP report of the present case via ABC news, which includes the following:
"Oler was chosen to lead the Canadian community just north of the U.S. state of Idaho following Blackmore's excommunication from the sect in 2002 by Warren Jeffs, considered the prophet and leader of the group.

"Authorities have said Jeffs still leads the sect from a Texas prison, where he is serving a life sentence for sexually assaulting underage girls he considered brides."
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See my earlier posts on polygamy

Interview on market design in Mundo Empresarial (in Spanish)

Recent mail brought a copy of the Summer issue (Segudo Trimestre 2017) of Mundo Empresarial to my desk, and it contains a multi-page interview with me that I only dimly remember giving. It may have been a while ago: the link below lists both Saturday, July 22, 2017 and May 14, 2015 as the date of publication. (I'm guessing the web version may have come out long ago, but I missed it.)

Entrevista a Alvin E. Roth, Premio Nobel de Economía 2012

 The last question and answer (with the help of Google Translate):

Por último, además de por haber ganado el Nobel, ¿por qué querría ser recordado Alvin E. Roth?
Me haría muy feliz ser recordado como un buen maestro que ha aprendido mucho de sus alumnos.

Finally, in addition to winning the Nobel Prize, why would Alvin E. Roth want to be remembered? 
It would make me very happy to be remembered as a good teacher who has learned a lot from his students.

Data access makes research on schools (and school choice) hard

Courtesy of the Freedom of Information Act, an intrepid reporter lets us in on some of the emails about data access between the Louisiana Department of Education and school choice researchers Parag Pathak and Atila Abdulkadiroglu. These shed light on a controversy and some name calling having to do with a study showing some early problems in Louisiana's school voucher program. The name calling involved accusations that the researchers rushed to publish without waiting for more data. The emails show that they tried unsuccessfully to get more data from the D of E, without success.

Who Gets Access to School Data? A Case Study in How Privacy, Politics & Budget Pressures Can Affect Education Research  by Matt Barnum
"Just who gets access to education data? A case study in La. after a critical early study on school vouchers"

"In the early days of 2016, a study by MIT and Duke University researchers showing the first year of Louisiana’s school voucher program led to marked decreases in student achievement landed in the press and policy worlds with a degree of attention that went beyond the usual wonky provinces of education research.
...
"John White, the state’s high-profile schools superintendent whose pro-school choice policies had long been scrutinized, publicly accused the Duke and MIT researchers of improperly rushing to publish their results and The Wall Street Journal condemned them for similar reasons in an editorial.

The criticism turned on whether the researchers should have waited for additional data before publishing their findings. But even that assertion, it turns out, was complicated. Not long after the headline-grabbing study was released, Louisiana ended its data-sharing relationship with the MIT and Duke researchers, according to emails obtained by The 74 through a public records request.

...

“For a program that’s ongoing, there are real issues of who gets to evaluate the program. Is it open to many teams, which I think is a good model. Or is it restricted to partners?” said MIT professor Parag Pathak, part of the team that studied Louisiana’s voucher program. “There are real broad issues in social science — it’s something that we’re all wrestling with.”

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Read it all...you can see why access to data can be hard.

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Update: the first comment below points to this critical blog post by Professor Jay Greene:
The Chutzpah of Abdulkadiroglu, Pathak, and Walters

A comment by Christopher Walters points to  this reply by Abdulkadiroglu, Pathak, and Walters:
Statement on Allegations of Academic Fraud by Jay P. Greene
Atila Abdulkadiroglu, Duke; Parag Pathak, MIT; Christopher Walters, UC Berkeley
August 5, 2017

Kidney exchange in India: legal hurdles, and an app

An interesting story from The Tribune in Chandigarh, about kidney exchange in India, mentions  the legal hurdles that must be overcome to take part in kidney exchange there.  It also mentions that there is an app, for peer to peer kidney matching.

From sufferers to survivors, their tale is touching

The legal hurdles:
"Both Narinder and Pramod said the procedure was not easy. “First, we had to take police clearance from our respective districts. Then, we had to submit an affidavit before the tehsildar. We had to appear before a panel of doctors of the Punjab Government and submitted our case as the transplant was to be performed in a Punjab hospital. The entire exercise took nearly four months,” said the two."

The app:
"On the lines of matrimonial websites, a city-based kidney transplant surgeon has devised a mobile application to help renal failure patients.
“With this app, relatives of a kidney patient can find a right match and get the kidneys swapped with one of family members. Suppose, someone’s father has suffered a kidney failure and his son offers to donate his kidney, but the blood group and tissues do not match, then the person can look for a donor with the same blood group. This app will help needy families contact each other and get the kidney swapped,” said Dr Rajan.
Since 2009, the Paired Kidney Exchange (PKE) has been legalised under the amended Human Organ Transplant Act of India. The Incompatible Kidney App or ikidney will allow all such patients to come under one roof."
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Here it is on the apple app store:
iKidney By Pradeep Naangal

Open iTunes to buy and download apps.
 https://itunes.apple.com/us/app/ikidney/id1071816293?mt=8 

AlphaBay dark marketplace shut down, and others spring up

Here's the Telegraph:
AlphaBay: World's largest dark web site is shut down

"The US Government has shut down two of the world's largest markets on the dark web, a hidden corner of the internet often associated with the sale of illegal weapons and drugs.

"The US Department of Justice confirmed on Thursday that it had shuttered the illicit AlphaBay and Hansa websites following a "landmark" investigation involving law enforcement from around the world.

"AlphaBay and Hansa were associated with the trade of illegal goods such as drugs, guns, personal data stolen in hacks, and computer viruses. There were more than 40,000 sellers on AlphaBay who were advertising around 250,000 items of illegal drugs and chemicals, according to Europol.
 ...
"The operation is reminiscent of the 2013 closure of Silk Road, the first popular dark web marketplace, following the arrest of creator Ross Ulbricht. AlphaBay was created in the void left by Silk Road. "
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Here's the Economist:
Two of the biggest dark-web markets have been shut down
History suggests that other sites will soon fill the void

 "But governments’ drug tsars are unlikely to be celebrating for long. Numerous dark-web markets have fallen prey to the police before the latest two. And each time, as shown in a paper* by two cyber-security experts, Nicolas Christin and Kyle Soska, new sites have popped up to fill the void. The authors scraped data from the largest dark-web sites between May 2013 and January 2015 to shed light on this shadowy market. During that period, Silk Road, once the largest market on the dark web, was raided and closed by the FBI. Within months, it was replaced by the less-than-imaginatively named Silk Road 2. In late 2014 this successor site met its demise as well, in another law-enforcement sting called Operation Onymous, at which point Evolution and Agora took up the baton. And after they closed down, customers moved to AlphaBay instead. This most recent pair of closures may end up as another mighty thump in a never-ending game of whack-a-mole."

*Measuring the Longitudinal Evolution of the Online Anonymous Marketplace Ecosystem
Kyle Soska and Nicolas Christin, Carnegie Mellon University
https://www.usenix.org/conference/usenixsecurity15/technical-sessions/presentation/soska
https://www.usenix.org/system/files/conference/usenixsecurity15/sec15-paper-soska-updated.pdf
The paper has some interesting remarks on the difficulties to be overcome in surveying dark markets, and lists the following markets that were investigated:

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And here's the BBC, with a story dated August 1:
Dark web markets boom after AlphaBay and Hansa busts
By Leo Kelion

"Trade on several of the dark web's illegal markets has boomed since two major players were shut by the authorities last month, according to research carried out for the BBC.
The US and Dutch authorities forced AlphaBay and Hansa offline to prevent the sale of drugs, weapons and malware.
But over the last week of July, other sites saw their number of listings rise by as much as 28%, the study indicates.
...
" Dream Market is now the biggest illegal store with a total of 98,844 listings at the end of the month. The site was launched in late 2013 and is now one of the oldest dark web markets in existence.
Its number of listings rose by 3,818 over the course of the week.
While that was the biggest increase of the surveyed sites in numerical terms, it represented a relatively modest increase of 3.9%.
"There is some interesting buzz around Dream Market potentially being compromised and/or under law enforcement control, which is feeding fear and uncertainty amongst vendors and buyers," said Mr Ben-Meir.
"That is probably why Dream Market has not grown substantially in the wake of the takedowns."
...
 "The next biggest site is TradeRoute, which rose from 14,914 listings to 17,816 over the period - a 16.3% gain.
It includes forged documents and black market tobacco and alcohol among its wares."
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See earlier posts on the drug market known as Silk Road.
See paper Traveling the Silk Road: A Measurement Analysis of a Large Anonymous Online
Marketplace, by Nicolas Christin

Kidney Exchange Practices in Europe

Here is a new report on kidney exchange in Europe:

Kidney Exchange Practices in Europe: First Handbook of the COST Action CA15210: European Network for Collaboration on Kidney Exchange Programmes (ENCKEP)

Edited by Working Group 1 members (in ABC order): Péter Biró, Lisa Burnapp, Bernadette Haase, Aline Hemke, Rachel Johnson, Joris van de Klundert, David Manlove,

 Descriptions in templates were provided by the following national representatives:
Austria: Georg Böhmig and Gregor Bond
Belgium: Dirk Kuypers,Bart Smeulders and Frits Spieksma
Czech Republic: Jiri Fronek
Finland: Mikko Salonen
France: Christian Jacquelinet and Marie-Alice Macher
Greece: Georgia Menoudakou
Iceland: Eyjólfur Ingi Ásgeirsson
Ireland: Nic Wilson
Italy: Paola Di Ciaccio and Vito Sparacino
Netherlands: Aline Hemke and Bernadette Haase
Poland: Rafal Kieszek
Portugal: Catarina Bolotinha
Slovakia:Tatiana Baltesová and Katarína Cechlárová
Spain: María de la Oliva Valentín Muñoz
Sweden: Tommy Andersson
Switzerland: Karine Hadaya
United Kingdom: Lisa Burnapp and Rachel Johnson
USA (UNOS): Ruthanne Leishman

"This handbook provides information on the current practice of kidney paired exchange programmes in Europe  and  some  countries  outside  Europe.  It  describes  the  incidence  of  active  Kidney  Exchange Programmes (KEPs), including details of country specific schemes and identifies the interest and aims of countries that have yet to develop a KEP."

Medical school seniors are applying to more and more residency positions

Here's an article on the application process that precedes the medical match:

Residency Placement Fever: Is It Time for a Reevaluation?

Gruppuso, Philip A. MD; Adashi, Eli Y. MD, MS

Academic Medicine, 92(7), July 2017, p 923–926

Abstract: The transition from undergraduate medical education to graduate medical education (GME) involves a process rooted in the final year of medical school. Students file applications through the Electronic Residency Application Service platform, interview with residency training (i.e., GME) programs from which they have received invitations, and generate a rank-ordered preference list. The National Resident Matching Program reconciles applicant and program rank lists with an eye towards matching students and GME programs. This process has effectively served generations of graduating medical students. However, the past several decades have seen an intensification of the residency placement process that is exemplified by an inexorable increase in the number of applications filed and number of interviews accepted and attended by each student. The authors contend that this trend has untoward effects on both applicants and departments that are home to GME programs....

"... in 2015, senior U.S. medical students applied, on average, to 73 of the 163 orthopedic surgery programs and 47 of the 105 neurological surgery programs (based on data extracted from the AAMC 8 and the NRMP 9,10). What is more surprising is that even less competitive disciplines may now be seeing an ever-growing flood of applications. This contention is supported in part by recent observations according to which GME programs in nearly all disciplines have seen a marked increase in their application traffic. For example, the percentage of pediatric GME programs to which graduating U.S. medical students have applied on average increased from 9.8% to 13.7% during the five-year interval from 2010 to 2015.10 For internal medicine GME programs, the corresponding figures are 4.9% to 6.0%.8–10 In making these decisions, students appear to be keeping their own counsel against the advice of medical school advisers and mentors advocating moderation.

...

"The increasing number of applications has another important consequence for GME programs. With an expanding burden of reviewing applications, the use of quantitative metrics as “screens,” the United States Medical Licensing Examination (USMLE) Step 1 exam in particular, may assume an increasing role. This trend, one that is viewed by many as a serious problem,15 may further erode emphasis on students’ backgrounds and qualitative indicators of performance, including letters of recommendation and narrative performance evaluations. Should this occur, it could have a detrimental effect on the ability of GME programs to achieve diversity by reducing the selection of students from disadvantaged educational backgrounds who may be at risk for underperformance on standardized examinations.

Apart from the preceding considerations, the growing intensity of the residency placement process has been progressively eroding the residual educational value of the fourth and final year of medical school.16–19 This reality, in its own right, would appear to warrant a reevaluation of the extant residency placement construct. Such reassessment may prove all but inescapable before too long if and when the four-year medical school curriculum is ever replaced with a three-year counterpart.20,21 Under these circumstances, the current resident selection paradigm is likely to prove unworkable and in need of redesign.

Nesterly: matching student tenants to empty-nesters

Helping Boomers Find Millennial Roommates
LINDA POON  JUL 1, 2017
In a college town, students and older homeowners have a lot to offer each other. That’s why two urban planners built an app to bring them together.
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Here's the app: Nesterly.
"On any given night, more than 50 million bedrooms sit empty across the U.S. Many of these spare rooms belong to older homeowners whose large houses have become a burden as they age. At the same time, millions of young renters struggle to afford the high prices in areas near schools and jobs. nesterly targets both of these issues by connecting older people with extra rooms to those seeking affordable rents through unique task-housing arrangements. Renters can now pay part of their rent by helping around the house, and owners gain stability, security, and support to stay in their homes."