Epilepsy and Neurophysiology fellowships are unravelled

Here is an article calling for a match. The opening paragraphs describe the current, unraveled recruiting process.

The Case for an Epilepsy and Clinical Neurophysiology Match  RSS  Download PDF

• Jorge Vidaurre MD
•  and Julia Campbell C-TAGME

Pediatric Neurology, 2017-07-01, Volume 72, Pages 5-6, Copyright © 2017 Elsevier Inc.

"Accredited epilepsy and clinical neurophysiology fellowships in the United States do not participate in a formal matching system to facilitate selection of trainees. For the 2015 to 2016 academic year, there were about 95 accredited clinical neurophysiology fellowship programs offering 313 positions and 43 epilepsy fellowship programs with 106 available positions. Each of these programs has their own unique recruitment process. The lack of a standardized process may be disadvantageous for both applicants and the training programs.

With our current approach, applicants may feel compelled to accept a fellowship offer before completing other program visits and with little time to consider their options. This situation occurs when a position is offered on the spot or soon after an interview. Unless the offer is quickly accepted, the candidate risks losing a guaranteed opportunity in order to explore other programs. The lack of uniformity in the application process can create additional difficulties for applicants.

Similarly, knowing that good candidates are likely to receive offers from other institutions during an interview, many institutions feel compelled to make a quick decision in their selection of fellows. In an effort to avoid vacancies, program directors may be tempted to select applicants who are available but may not be the best choice. Adopting a formal match system would create a more organized process with clear advantages for both applicants and programs."

Usury and theology

At Aeon, Alex Mayyasi writes about the work of banker turned theologian David Miller:

Of money and morals
Moneylending has been taboo for most of human history. So how did usury stop being a sin and become respectable finance?

"Vedic law in Ancient India condemned usury, and rulers routinely capped interest rates from Ancient Mesopotamia to Ancient Greece. In Politics, Aristotle described usury as ‘the birth of money from money’, and claimed it was unnatural because money was sterile and should not ‘breed’.
...
"In the 4th century CE, Christian councils denounced the practice, and by 800, the emperor Charlemagne made the prohibition into law. Accounts of merchants and bankers in the Middle Ages frequently include expressions of anguish over their profits. In his Divine Comedy of the 14th century, the Italian poet Dante Alighieri put the usurers in the seventh circle of Hell..."

"The stigma against moneylending continued well into the 1500s. To understand it, think about your reaction to the idea of a bank making a loan to a business at a 5 per cent interest rate. No problem, right? Now compare that to how you’d feel if your mother lent you money on the same terms. In Biblical times, the typical loan was more like the second case – it wasn’t an arms-length transaction, but a charitable loan from a wealthy man to a neighbour who’d experienced misfortune or had nowhere else to turn. "

THE 28TH INTERNATIONAL CONFERENCE ON GAME THEORY; IN HONOR OF PRADEEP DUBEY AND YAIR TAUMAN

The celebration of Pradeep Dubey and Yair Tauman is going on now.

Here's the program.

Declining racial disparities in deceased-donor kidney allocation

Here's an article from the June issue of Health Affairs, reporting that racial disparities among deceased-donor kidney recipients seem to have declined since the introduction of a modified allocation procedure.

New Kidney Allocation System Associated With Increased Rates Of Transplants Among Black And Hispanic Patients

1. Taylor A. Melanson1, 
2. Jason M. Hockenberry2, 
3. Laura Plantinga3,
4. Mohua Basu4, 
5. Stephan Pastan5, 
6. Sumit Mohan6,
7. David H. Howard7 and 
8. Rachel E. Patzer8,*

+Author Affiliations

1. ¹Taylor A. Melanson is a doctoral student in the Laney Graduate School, Emory University, in Atlanta, Georgia.
2. ²Jason M. Hockenberry is an associate professor in the Department of Health Policy and Management, Rollins School of Public Health, at Emory University.
3. ³Laura Plantinga is an assistant professor in the Department of Medicine, Emory University School of Medicine.
4. ⁴Mohua Basu is a data analyst at the Emory University School of Medicine.
5. ⁵Stephan Pastan is an associate professor in the Department of Medicine, Emory University School of Medicine.
6. ⁶Sumit Mohan is an assistant professor in the Division of Nephrology, Department of Medicine, and in the Department of Epidemiology at Columbia University Medical Center, in New York City.
7. ⁷David H. Howard is an assistant professor in the Department of Health Policy and Management, Rollins School of Public Health, at Emory University.
8. ⁸Rachel E. Patzer (rpatzer@emory.edu) is an assistant professor in the Department of Surgery and Department of Medicine at the Emory University School of Medicine, and in the Department of Epidemiology at the Rollins School of Public Health.

1. Health Aff June 2017 vol. 36no. 6 1078-1085

Abstract

Before the 2014 implementation of a new kidney allocation system by the United Network for Organ Sharing, white patients were more likely than black or Hispanic patients to receive a kidney transplant. To determine the effect of the new allocation system on these disparities, we examined data for 179,071 transplant waiting list events in the period June 2013–September 2016, and we calculated monthly transplantation rates (34,133 patients actually received transplants). Implementation of the new system was associated with a narrowing of the disparities in the average monthly transplantation rates by 0.29 percentage point for blacks compared to whites and by 0.24 percentage point for Hispanics compared to whites, which resulted in both disparities becoming nonsignificant after implementation of the new system.

From the paper:

"The United Network for Organ Sharing implemented a new kidney allocation system in December 2014,26 in part to address long-standing racial/ethnic disparities in the allocation of deceased donor kidneys. The primary factor for determining a patient’s priority level on the waiting list for a kidney transplant is how long he or she has been waiting. Under the new system, the starting point for calculating waiting time was changed from the date the patient was put on the waiting list to the earliest of either that date or the date of the patient’s first regular dialysis. This change was expected to benefit minorities because blacks and Hispanics spend more time on dialysis before being put on the waiting list, compared to white patients.27,28 The new system made additional changes meant to improve access to transplantation, including making it easier for patients with a highly sensitized immune system to receive transplants and increasing the sharing of kidneys across donor service area boundaries. It is important to note that this policy targets the allocation of deceased-donor kidneys, not of live-donor kidneys."

Blackmail has something in common with transactions that become repugnant when money is added

Blackmail isn't what I usually mean when I speak of a repugnant transaction, because it isn't a voluntary transaction that third parties wish to prevent, it's a crime that someone assaults someone else with. But, just as some praiseworthy transactions (like donating a kidney to someone who needs a transplant) can become repugnant when money is added (both demanding compensation and compensating the donor of a kidney for transplant is a crime almost everywhere), the crime of blackmail involves combining actions that are otherwise legal but that together are criminal.

For example, if someone knows something about you that you would like to conceal, it is quite often legal for them to reveal it to interested parties, or even in a biography of you they might write (e.g. your past arrests, affairs, political affiliations and contributions, etc.). It would also be quite legal for you to approach someone and commission them to write something about you, including something over which you might have editorial control. But if someone proposes to combine these things, by threatening to write bad things about you unless you pay him money, that is in many cases the criminal act of blackmail.

More on blackmail and it's subtleties (e.g. I can't demand that you pay me if you don't want me to reveal that you are a thief, but I could threaten to report you the police if you don't pay me for something you stole from me...) in this interesting column at the Washington Post's Volokh Conspiracy:
Blackmail is surprisingly hard to define

Supervised drug injection sites--Harm reduction

One of the problems with intravenous drug addition is that addicts can overdose and die. A number of North American cities are trying to combat this by opening supervised drug injection sites, meant to be safe places to shoot up, staffed with one or more healthcare workers and social workers.

From the Globe and Mail:
Montreal gets federal approval for two supervised injection sites

"Supervised injection sites provide a safe space for addicts and provide them with the necessary equipment — sterile syringes, gauze pads and the like — for safe injections.

"The users themselves bring their drugs, the sites pride themselves on being anonymous and confidential, and the users are accompanied on site by nurses and community and psycho-social workers.

...
"The Montreal sites are modelled after Vancouver-based Insite, which was the first city in North America to have a legal, supervised injection site beginning in 2003.

"While critics say the sites encourage drug use, experience has shown they reduce the number of overdose deaths and transmission of hepatitis C and HIV."
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Here's a 2010 article from the Canadian Medical Association Journal:
Vancouver’s supervised injection facility challenges Canada’s drug laws
Kathleen Dooling, MD MPH and Michael Rachlis, MD LLD

Here's a 2008 article in the British Columbia Medical Journal by a former Vancouver Chief of Police (he would prefer strict enforcement rather than harm reduction):
Supervised injection sites—a view from law enforcement
Issue: BCMJ, Vol. 50, No. 3, April 2008, page(s) 132-134
Jamie Graham

Here's a 1995 Editorial in the American Journal of Public Health
Editorial: Harm Reduction-A Framework for Incorporating Science into Drug Policy by Don C. Des Jarlais

And of course, all this is made topical by the opioid epidemic:
Why opioid deaths are this generation’s Aids crisis
"The soaring numbers of deaths from overdoses in the US and UK requires a radical and fast rethink of drugs policy"

21st conference of the International Federation of Operational Research Societies (IFORS): July 17-21 2017 in Quebec City

Here's the IFORS conference web page.
"Welcome to ... the 21st Conference of the International Federation of Operational Research Societies...“OR/Analytics for a better world”.


I'll be speaking Monday on Marketplace Design

How (not) to measure school choice

Here's a post I just looked at from The National Center for the Study of Privatization in Education at Teachers College at Columbia (posted in April). It is about more and less illuminating ways to discuss how popular New York City high schools are, as reflected in how often they are on students' rank order lists, how many students they make offers to, and how many seats they have.

The Real Data for NYC High School Admissions

Who Gets What and Why in French: Les marchés où l'argent ne fait pas la loi

The French translation of my book Who Gets What and Why has recently become available...

Les marchés où l'argent ne fait pas la loi
Des conceptions innovantes pour des appariements efficaces
Alvin Roth
Traducteur : Jean-François Caulier
2017 - 288 pages
("Markets where money does not make the law
Innovative designs for efficient matching")

"Prix Nobel d’économie, Alvin Roth dévoile les règles souvent surprenantes régissant un vaste nombre d’activités dans lesquelles l’argent ne joue pas ou peu de rôle. C’est le territoire des marchés d’appariement, où « vendeurs » et « acheteurs » doivent se choisir l’un l’autre. Dans cet ouvrage, il révèle les marchés d’appariement cachés autour de nous et nous apprend à reconnaître un bon appariement, pour faire ainsi des choix plus avisés et subtils."

Global Kidney Exchange at Mexico's Museo Interactive de Economia

Ivan Carillo's reporting on global kidney exchange will be featured today at Mexico's Museo Interactivo de Economía*

The Thirst Journal. How Can Economy Save Lives?

Cinema Because of MIDE’s Anniversary

July 14 2017Interactive Museum of Economy (MIDE)

• INFORMATION: (55) 5130 4600
 
• VISIT WEB SITE

Produced by the journalist Iván Carrillo, it tells the story of Marisol Robles, publisher and poet from Veracruz, who was diagnosed with kidney failure on June 28th, 2011 and who, after a failed first attempt of kidney transplant, recorded the vicissitudes of her illness in her blog: The Thirst Journal.

The documentary talks about how the encounter and collaboration with Mike Rees, MD, from Toledo University Medical Center (Ohio) and the professor in economy of Stanford University Alvin Roth, will result in a series of innovations in the field of medicine through economy, revolutionizing the form kidneys are exchanged in the world. This innovation will become an important part of the merits mentioned on 2012 for Alvin Roth to receive the Nobel Memorial Prize in Economic Sciences.

OPPENING HOURS AND ADMISSION:

July 14 2017
Friday , 10:00 - 12:00 hrs.
Free admission

****************

Here's another announcement: the film will celebrate the Museum's 11th anniversary

Festejará el MIDE onceavo aniversario con proyección de documental

****************

*From their website:

El Museo Interactivo de Economía (MIDE) surgió como una iniciativa del Banco de México para ser un espacio de divulgación de la economía y las finanzas.

Es el primer museo del mundo dedicado a explicar temas de economía, finanzas y desarrollo sustentable con las más avanzadas tecnologías, que ofrece a sus visitantes experiencias divertidas y relevantes, en un ambiente que estimula las emociones y el aprendizaje.

Google Translate:

The Interactive Museum of Economics (MIDE) emerged as an initiative of the Bank of Mexico to be a space for the dissemination of economics and finance.

It is the first museum in the world dedicated to explaining economics, finance and sustainable development with the most advanced technologies, offering visitors fun and relevant experiences in an environment that stimulates emotions and learning.

John J. Carty Award: NAS prize in Economics for 2018

The National Academy of Sciences John J. Carty Award for the Advancement of Science is to be awarded for work in Economics.

Get you nominations in before October 2... (you don't have to be a member of the NAS to make a nomination).

Scheduled for presentation in 2018 in economics. Nominations now accepted online through Monday, October 2, 2017.

About the John J. Carty Award 

The John J. Carty Award for the Advancement of Science is awarded every two years, to recognize noteworthy and distinguished accomplishments in any field of science within the National Academy of Science’s charter. The award is presented with a medal and a $25,000 prize. The American Telephone and Telegraph Company established the award to honor the memory of their Chief Engineer, Vice President, and general telecommunications innovator, John J. Carty. The Carty Award will be presented in 2018 in the field of economics. 

House Panel Lifts Ban on Slaughtering Horses for Meat (December update: false alarm...)

Hot news off the AP wire on one of my favorite examples of a US-centric repugnant transaction. Here it is from the NY Times:

House Panel Lifts Ban on Slaughtering Horses for Meat

"A House panel has voted to lift a ban on slaughtering horses at meat processing plants.

The move by the House Appropriations Committee would reverse a horse slaughter ban that was contained in a huge catchall spending bill signed into law by President Trump in early May.

A move to renew the slaughter ban, pushed by California Democrat Lucille Roybal-Allard, was defeated by a 27-25 vote.

The Horse slaughter ban has mostly been in force for more than a decade. The ban is enforced by blocking the Agriculture Department from providing inspectors at meat plants that slaughter horses and is in place through Sept. 30.

There are currently no horse slaughter facilities operating in the U.S.

The vote came as the panel approved a Department of Agriculture funding bill."
***********

See my earlier posts on horse meat and it's bans here:  http://marketdesigner.blogspot.com/search/label/horse


HT: Itay Fainmesser
**********

Update: without fanfare, the Washington Times reports in December 2017:
"A Government Accountability Office report several years ago said the ban led to even worse conditions for horses, and the slaughter ban was dropped for a while. But advocates fought back, and the ban has been revived as part of annual spending bills, which block food inspections of horse meat, effectively prohibiting the practice.
https://www.washingtontimes.com/news/2017/dec/26/wild-horse-population-control-methods-divide-lawma/

The costs of heroism: Some hidden expenses that come with donating a kidney

Here's a Chicago Tribune column on the shabby way we treat organ donors, who assume nontrivial expenses to save someone's life. (Update: a flurry of emails inform me that the insurance situation described for the donor in this article doesn't represent the general conditions of either Medicare or much private insurance.)

Why price heroism? Organ donors can save taxpayers millions. They deserve a break.
by Paul Basken, Arthur Caplan

"The big medical bills began arriving right after Brittany's beautiful kidney was tucked inside her recipient. Fortunately that recipient has pretty good insurance through his employer, and the out-of-pocket hospital and drug costs were pretty manageable.

The biggest expense, as it turns out, concerns the government. By law, Brittany cannot be paid a dime of compensation for the gift of her kidney. But markets in organs aside, shouldn't heroes be reimbursed for legitimate expenses? These amounted to maybe a few thousand dollars for trips by her and her husband to testing appointments around their home in North Carolina, and to the Baltimore hospital where she underwent additional tests and the transplant surgery.

Even more costly is Medicare. Although some kidney donors don't need any added coverage, some sign up for the government-run health plan — at $3,000 a year — because it is the only way to guarantee coverage in case they have complications related to the donation surgery. Brittany had her own private coverage through her job as a high-school counselor. But having submitted to a "voluntary" medical procedure, she could not expect private insurance to foot the bill in the rare event of a complication.

So the bottom line is that Brittany saved taxpayers hundreds of thousands of dollars a year, and in return the government's "thank you" note is a Medicare bill of $3,000 a year.

Even worse, Medicare only allows that coverage for 36 months, meaning that a hero like Brittany is on her own if she experiences some problem related to her donation after three years. It's a massive disincentive for any well-meaning person who wants to save a life and help cut government spending.

Our government's current ban on any kind of payments, other than the reimbursement of immediately obvious costs such as Brittany's airfare to Baltimore, simply goes too far. Heroes should not have to go broke as the price of their generosity."

Film on Global Kidney Exchange

Here's a video documentary by Ivan Carillo on the Global Kidney exchange in which the Mexican poet Marisol Robles received a kidney transplant.

The Journal of Thirst. Documentary by Ivan Carrillo.
"The story of Marisol Robles, a poet from Veracruz (Mexico) and how she got a kidney transplant under very hard circumstances thanks to the program Global Kidney Exchange designed by Mike Rees and, Nobel prize winner, Dr. Alvin Roth."

The Journal of Thirst. Documentary by Ivan Carrillo. from David Corcoran on Vimeo.

**************
Here's a story about the film in Spanish (and I gather that the film will soon be available in Spanish): http://www.milenio.com/salud/cadena-mundial-donacion-rinones-mike_rees_0_986301368.html 

***********
Here are my earlier posts on that exchange:

Wednesday, April 12, 2017

A bridge of life: Global kidney exchange between Mexico and the U.S.

Thursday, November 3, 2016

La maga de riñones: The kidney conjurer (a poem about kidney exchange by Marisol Robles)

***************
Update: The story continues to receive favorable coverage in Mexico, here's a link (in Spanish) that appears to be to an August TV show:
Trasplantes en cadena para pacientes con falla renal atraviesan fronteras
POR: NOTICIEROS TELEVISA
Google Translate: Chain transplants for patients with renal failure cross borders

Economics and computer science of a radio spectrum reallocation in the PNAS

A PNAS article on the recent incentive auction, by its design team.

Economics and computer science of a radio spectrum reallocation
Kevin Leyton-Brown, Paul Milgrom, and Ilya Segal
 Early Edition >  doi: 10.1073/pnas.1701997114

Abstract
The recent “incentive auction” of the US Federal Communications Commission was the first auction to reallocate radio frequencies between two different kinds of uses: from broadcast television to wireless Internet access. The design challenge was not just to choose market rules to govern a fixed set of potential trades but also, to determine the broadcasters’ property rights, the goods to be exchanged, the quantities to be traded, the computational procedures, and even some of the performance objectives. An essential and unusual challenge was to make the auction simple enough for human participants while still ensuring that the computations would be tractable and capable of delivering nearly efficient outcomes.

Conflict of interest statement: P.M. led the team of consultants on behalf of Auctionomics, which was responsible for advising the Federal Communications Commission on the design of the incentive auction. K.L.-B. and I.S. were the two other members of the Auctionomics consulting team.

Bob Slonim of Australia

Here's an announcement from down under, where Bob Slonim  will be heading the Australian Federal government's Behavioural Economics Team.

"The Behavioural Economics Team of the Australian Government will soon be led by an American professor from an Australian university, replacing its current chief, who is an Australian professor at a university in the United States.

Harvard professor Michael Hiscox ... didn’t give up his position when he came home to Australia to set up and run the Prime Minister’s nudge unit in 2016, and now he is going back to his post in Boston for six months.

He will be replaced by University of Sydney economics professor Robert Slonim, a pioneer of experimental economics who came to Sydney from the US in 2008.

Robert Slonim

Slonim was the keynote speaker at a behavioural economics workshop hosted by BETA last November. He co-edits the Journal of the Economic Science Association and sits on the editorial advisory board of the Journal of Risk and Uncertainty."

Kidney exchange job opportunity in Australia

If you're a transplant professional following this blog from Australia, maybe this could be of interest:

Australian Kidney Exchange (AKX) Coordinator

"Australian Kidney Exchange (AKX) Coordinator

The Royal Melbourne Hospital - City Campus, Parkville

Full Time Fixed Term

Full time, 3 year fixed term contract

Join an award winning health service

Opportunity to manage a national program

An exciting and unique opportunity is available at the Royal Melbourne Hospital for a Program Coordinator to manage the Australian Paired Kidney Exchange program (AKX) in conjunction with the recently appointed AKX Clinical Director.

 The role is supported by the Organ and Tissue Authority (OTA) and the Transplant Society of Australia and New Zealand (TSANZ) and will be based at the Royal Melbourne Hospital in Parkville.  We are seeking a Registered Nurse from the Renal Transplant sector with exceptional clinical, communication and organisational skills. The applicant shall have a demonstrated high level of experience with the AKX program and the capability to work across a broad range of jurisdictions and organisations"

NAS report on The Value of Social, Behavioral, and Economic Sciences to National Priorities

As Congress continues to debate funding for science, here's a new report from the National Academies of Science: The Value of Social, Behavioral, and Economic Sciences to National Priorities:  A Report for the National Science Foundation

Two paragraphs on the uses of game theory and  market design caught my eye (you should be able to make them biglier by clicking on them...) :

*********

************

Update: here's the NSF news release on the NAS report:
New report concludes social, behavioral and economic sciences help advance national health, prosperity and defense
National Academies releases 'The Value of Social, Behavioral, and Economic Sciences to National Priorities'

"The full report mentions specific examples of NSF-supported SBE research that has advanced welfare, prosperity and security, including the creation of kidney exchange programs, improved cybersecurity and improved counterterrorism efforts.

"Like all sciences, the SBE sciences bring a rigorous, methodological approach to pursuing knowledge," the report states, noting that SBE scientists have contributed new methods of data collection and analysis now used by governments, researchers and business.

The National Academies will host a public discussion Wednesday, July 19, from 9 a.m.-12:30 p.m. EDT at its headquarters at 2101 Constitution Ave. NW, Washington, D.C."

Supporting science during the budget process: an op-ed in the St. Louis Post Dispatch

Here's an op-ed that ran this week in the St. Louis Post Dispatch:

Federally funded research helps connect transplant patients with donors
By Al Roth and Stuart Sweet

"To the nearly 5,000 people in our region and millions of Americans around the country suffering from kidney disease and waiting for a donor, federally funded research into obscure-sounding economic theory may turn out to be just what the doctor ordered.

As the president of the United Network for Organ Sharing Board of Directors and a Nobel Prize-winning economic researcher who did that work, we have seen first-hand how scientific research, even in seemingly unrelated fields, has the power to connect those suffering with disease with vital cures. And yet, the budget proposed by the current administration proposes to dramatically scale back on research, rather than double down on investments in potentially life-saving research.
...
"Thanks to research funded by the Navy and the National Science Foundation, spanning multiple decades, we’ve developed a system in which kidneys can be exchanged among pairs of donors and recipients who aren’t compatible with each other. How? We pair them, or in some cases, chain them together across multiple donor-recipient pairs, so that each patient gets a compatible kidney from another patient’s donor.

"This approach has saved thousands of lives and hundreds of millions of dollars. Recipients enjoy better quality of life, and every transplant saves the government more than a quarter of a million dollars in health care costs that would have gone to prolonged dialysis treatment.

"Over the past six years, the United Network for Organ Sharing has been running a pilot program to help incompatible donors find compatible pairs for kidney paired donation. In its first five years, the pilot program helped 155 patients receive a healthy kidney despite experiencing the heartbreak of finding out that the person willing to give them the incredible gift of a kidney was not a match.

"Policymakers from both sides of the aisle and around the country have long supported robust investment in basic and applied research that makes success stories like these possible. They have seen that across every industry and sector, investments in research have impacted everything from manufacturing to agriculture and national security, and innovations like kidney paired donation that ensure more Americans can live long, healthy lives.

"We particularly applaud Sen. Roy Blunt’s work as chairman of the Senate Appropriations Subcommittee on Labor, Health, and Human Services to increase research funding, especially for the NIH, and with his colleagues throughout the Congress to protect investments in research and development overall. We urge them to reassert that federal funding for science is an important investment in our nation’s future.

Dr. Stuart Sweet is a professor of pediatrics at Washington University, medical director of the pediatric lung transplant program at St. Louis Children’s Hospital and president of the United Network for Organ Sharing Board of Directors.

Alvin E. Roth is a professor of economics at Stanford University, shared the 2012 Nobel Prize in economics, and is the author of “Who Gets What and Why.”

Eduardo Azevedo on "Market failure in kidney exchange" at Penn today

If I were at Penn today I'd attend this seminar by Eduardo Azevedo:

Wed, July 5, 12:00pm – 1:30pm

Where	G65 JMHH
Calendar	AEW Seminars for Business Economics and Public Policy
Description	Eduardo Azevedo "Market Failure in Kidney Exchange" joint w/ Clayton Featherstone, Nikhil Agarwal, Itai Ashlagi, Omer Karaduman ABSTRACT: The market for kidney exchange was created to address the shortage of kidneys for transplantation. The participants in kidney exchange markets are patients who want to receive a kidney transplant, and have a willing but incompatible live donor. These patients register in kidney exchange platforms, where they perform donor swaps with other patients. This market has grown to about 800 transplants per year. We show that this market is fragmented. Transactions take place in dozens of platforms, which are mostly very small, as opposed to in a few large platforms. This fragmentation leads to a deadweight loss of at least 200 transplants per year, because the size of most existing platforms is far below the efficient scale necessary for efficiently matching patients. The fragmentation is due to classic market failures, and simple alternative mechanisms can considerably increase efficiency.

California's End of Life Option Act: the first six months

Independence of a sort.
California's End of Life Option Act (aka medically assisted suicide; death with dignity, right to die)  has now been in effect for six months, and the first report on its take-up has been issued.  The LA Times has the story:
111 terminally ill patients took their own lives in first 6 months of California right-to-die law

"A total of 111 people in California took their own lives using lethal prescriptions during the first six months of a law that allows terminally ill people to request life-ending drugs from their doctors, according to data released Tuesday.

"A snapshot of the patients who took advantage of the law mirrors what’s been seen in Oregon, which was the first state to legalize the practice nearly two decades ago. Though California is far more diverse than Oregon, the majority of those who have died under aid-in-dying laws in both states were white, college-educated cancer patients older than 60.

"The End of Life Option Act made California the fifth state in the nation to allow patients with less than six months to live to request end-of-life drugs from their doctors.

"Physician-assisted deaths made up 6 out of every 10,000 deaths in California between June and December 2016, according to state data. That’s much lower than the 2016 rate in Oregon, where lethal prescriptions accounted for 37 per 10,000 deaths.

"But the findings have done little to calm the debate over whether allowing doctors to prescribe lethal medications is acceptable medical practice.
...
"California’s data show that 173 physicians wrote the 191 prescriptions statewide."

Cadavers and the teaching of anatomy

Hektoen International, A journal of medical humanities has several articles motivated by Rembrandt's painting of The Anatomy Lesson of Dr. Nicolaes Tulp

One of the articles is Rembrandt – The Anatomy Lesson of Dr. Nicolaes Tulp by Tan Chen. It says in part:

"Commissioned for display in the Guild Room, the painting offers a glimpse into important changes in the world of medicine. Gone are the days of public executions and dissection, and a much more subdued method has taken over. In the modern world executions are no longer public, and anatomy students no longer know the name of their corpse. Great care is taken to remain respectful of the deceased, and in doing so the hands and feet are covered so as to take away the intimacy many associate with these body parts. Today it is easy for a person to donate their body to science and allow anatomy students a real look into the human body, whereas before no choice was given.

The corpse in Rembrandt’s The Anatomy Lesson of Dr. Nicolaes Tulp gives the painting a more macabre feeling. The body being dissected is that of Aris Klindt (an alias for Adriaan Adriaanszoon), an armed robber sentenced to death by hanging. A public dissection was only a yearly event, and all bodies being dissected were that of criminals."
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Our views about cadavers have changed, and continue to change. Here's a 2016 story from the NY Times:
New York State Bans Use of Unclaimed Dead as Cadavers Without Consent
By NINA BERNSTEINAUG. 19, 2016 

"The law bans the use of unclaimed bodies as cadavers without written consent by a spouse or next of kin, or unless the deceased had registered as a body donor. It ends a 162-year-old system that has required city officials to appropriate unclaimed bodies on behalf of medical schools that teach anatomical dissection and mortuary schools that train embalmers."

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And here's the page for Stanford's Willed Body Donation Program

"Once you register to become a donor to the Willed (Whole) Body Program, Stanford’s Division of Clinical Anatomy will keep your name and contact information on file. Upon your death, a caregiver or family member must contact us right away. We take calls 24 hours/day, every day of the year. We will arrange for a funeral home to transport your body to Stanford Medical School, where it may be used to teach students about the structure of the human body and for furthering medical and scientific knowledge. 

Once study of the body is complete, we will arrange for cremation. (The study period may range from one month to two years, but it is typically about a year in duration.) At the time of donation, your family will be asked whether they wish for the cremated remains to be returned or whether they would like us to arrange for interment. Our faculty, students, and staff are very grateful for the kindness our donors have extended, and bodies are treated with the greatest respect while in our care."

The (criminal) repugnance of even child-free child pornography

Sex with children is so abhorrent that a lot of things that look like sex with children are also illegal.   Here's a story from the Guardian that raises some interesting questions (although it is complicated by the fact that the defendant in question was convicted of several offenses. However the main one was importing a doll that looked like a child.

Man who tried to import childlike sex doll to UK is jailed
Doll ordered by [the defendant] from Hong Kong was seized at airport, sparking one of first prosecutions of its kind in Britain

"[the defendant], 49, was sentenced at Chester crown court on Friday to two years and eight months behind bars after pleading guilty to importing an indecent object, two counts of making indecent images of children and one count of possessing indecent images of children.

"Border Force officers, acting under the direction of the fast parcel joint border intelligence unit, identified a parcel labelled as a mannequin, but which was found to contain an obscene childlike doll.
...
"During his interview, [the defendant] admitted buying the doll to use for sex and for his own sexual gratification.
...
DC Andy Kent, of Cheshire constabulary’s paedophile and cyber-investigation unit, said: “Knowing child sex dolls exist and are available for sex offenders to buy is sickening.
...
"“This conviction is the first of its kind for Cheshire. Cases like these are also very rare across the country. However, I want to make it clear that importing a child sex doll is a criminal offence.

“Dobson should serve as an example to those who think they can also commit this crime for their own selfish needs.”
...
"Importation of the lifelike dolls is a relatively new phenomenon and there is no offence of possession, only importing an obscene article."
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Update: here's a similar case from Canada
Canadian court to determine whether child sex doll constitutes child pornography
The court case was brought after a man ordered a doll from Japan four years ago

Postcard from the Nobel museum--treadmill desk and artistic license

 I just received a postcard from a friend who had visited the Nobel Museum in Stockholm. It is an artist's rendering of me on a treadmill desk.

I do have a treadmill desk in my office, and here's a photo (by Mohammad Kheirkhah) that might have inspired the postcard...

You can get a 360 degree view of my office by moving your mouse around this video  http://www.mediatheque.lindau-nobel.org/nobellabs/29724/laboratory-of-alvin-roth

Insurance for organ donors in Ireland: is it compensation?

Frank McCormick points out this interesting story from Ireland:

If you're donating an organ, you can now get insurance cover
The new Royal London Ireland offering has come in for criticism...

"Royal London Ireland has announced that it will now offer a "financial cushion" for policyholders who donate a kidney, bone marrow or portion of a lung or liver to another family member.

The first-of-its-kind "organ donor cover" has been introduced as part of the insurance provider's Specified Serious Illness (SSI) cover.

Under the newly-revamped policy offering, Royal London will pay a €2,500 one-off lump sum to living donors.

In the wake of the news, concerns have been raised that it amounts to "cash for organs" and is unsavoury and unethical.

Mark Murphy, chief executive of the Irish Kidney Association, has said:

"We don't need insurance companies offering these things, we have a compensation scheme... It's not necessary, it's not needed. They shouldn't be doing it, on the basis that it's not needed."

 Colette Houton, Royal London's underwriting and claims lead, commented:

"The supply of organ donations is an ongoing issue in this country, with an ever-increasing demand from those who are unfortunate enough to need organ transplantation.

"This shortage has led to more people receiving organs from living donors...

"It would be nice to think our pay-out could potentially help to offset the cost incurred as part of the admirable, altruistic acts that living donors are carrying out...

"Potential donors can face loss of earnings coupled with high medical bills and expenses and our goal is to alleviate these worries and concerns somewhat, by providing some financial aid to support them through surgery and recovery time.

"Living organ donation is an admirable, altruistic act and a lump sum can, at least, help to offset any costs the donor incurs following the operation and recovery involved."
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Here's a related press release from the Irish Brokers Association:
Royal London Launch Best-in-Class Serious Illness Cover