Virtual interviewing increased the number of interviews by (and of) candidates for medical residencies

 Here's an article on virtual interviewing of candidates for medical residencies (about which, see also this post about Erling Skancke's work on interviewing):

Beshar I, Tate WJ, Bernstein D. Residency interviews in the digital era, Postgraduate Medical Journal Published Online First: 05 October 2021. doi: 10.1136/postgradmedj-2021-140897

"Halfway through the interview cycle, however, questions were raised about system-level equity of virtual interviewing. In December 2020, the Association of American Medical Colleges (AAMC) released an open letter citing ‘a maldistribution in residency interview invitations’, with the ‘highest tier applicants hav(ing) so many interviews’.15 The letter, addressed to both programme directors and students, called on programmes ‘to recruit a diverse pool of residents’ and encouraged students ‘to release[e] some interviews if you are holding more than needed, allowing your fellow students to access those interview opportunities’.15 Medical school deans began encouraging competitive students to forgo interviews. In the words of the Dean of students at the UC College of Medicine: ‘They need to identify a reasonable number to have a successful match and release others so their peers who need them can have them’.6 By some estimates, programmes invite the same pool of highly qualified applicants, with just 7%–21% of the applicant pool filling 50% of the interview slots in some specialties.16 Meanwhile, a survey of plastic surgery programme directors demonstrated nearly one in three increased the number of interview offers per available residency spot.

"At our institution—Stanford School of Medicine—and as applicants of the 2020–2021 cycle ourselves—we saw the effect of this firsthand. We administered a survey to all students participating in the match process in both the 2019 (in-person) and 2020 (virtual) years. In the survey, respondents identified the residency programme or programmes to which they applied as well as the number of interviews they attended. Of Stanford’s 2019 and 2020 graduating classes, 83.7% (n=72) and 62.3% (n=62), respectively, completed our survey.

"Of the 2019 applicants, 97.2% (n=70) reported residency interviews that required airline travel, compared with 0% of the 2020 applicants. The median number of interviews for the 2019 applicants was 8, compared with 14 for the 2020 applicants. Across the 2 years analysed, all fields showed an increase in the number of interviews accepted (table 1). Of the four fields with the most applicants, the largest per cent change was in anaesthesia (244%), followed by ophthalmology (216%), internal medicine (144%) and psychiatry (128%), respectively. On average, across all specialties, the number of accepted interviews changed by 160%.

The costs of deceased donor organ recovery in the U.S., by Held et al. in the journal Transplantation

 Here's the report of an investigation into organ procurement costs and finances:

Cost Structures of US Organ Procurement Organizations by Held, Philip J. PhD1; Bragg-Gresham, Jennifer L. PhD2; Peters, Thomas G. MD3; McCormick, Frank PhD4; Chertow, Glenn MD, MPH1; Vaughan, William P. BS5; Roberts, John P. MD, Transplantation. 2021;105(12):2612-2619. doi:10.1097/TP.0000000000003667.

Abstract: "Background. The goal is to provide a national analysis of organ procurement organization (OPO) costs.

"Methods. Five years of data, for 51 of the 58 OPOs (2013-2017, a near census) were obtained under a FOIA. OPOs are not-for-profit federal contractors with a geographic monopoly. A generalized 15-factor cost regression model was estimated with adjustments to precision of estimates (P) for repeated observations. Selected measures were validated by comparison to IRS forms.

"Results. Decease donor organ procurement is a $1B/y operation with over 26 000 transplants/y. Over 60% of the cost of an organ is overhead. Profits are $2.3M/OPO/y. Total assets are $45M/OPO and growing at 9%/y. "Tissue" (skin, bones) generates $2-3M profit/OPO/y. A comparison of the highest with the lower costing OPOs showed our model explained 75% of the cost difference. Comparing costs across OPOs showed that highest-cost OPOs are smaller, import 44% more kidneys, face 6% higher labor costs, report 98% higher compensation for support personnel, spend 46% more on professional education, have 44% fewer assets, compensate their Executive Director 36% less, and have a lower procurement performance (SDRR) score.

"Conclusions. Profits and assets suggest that OPOs are fiscally secure and OPO finances are not a source of the organ shortage. Asset accumulation ($45M/OPO) of incumbents suggests establishing a competitive market with new entrants is unlikely. Kidney-cost allocations support tissue procurements. Professional education spending does not reduce procurement costs. OPO importing of organs from other OPOs is a complex issue possibly increasing cost ($6K/kidney)."

...

"CONCLUSION

"In the United States, deceased-donor organ recovery costs total $1B per year and represent approximately one-third the cost of an organ transplant procedure. Direct and indirect costs are reported on CMS required OPO cost reports, confirming that over half of all costs are indirect, such as the costs of organ procurement personnel, professional education, and other personnel expenses. Kidney cost increases over the 5-y study period seem reasonable compared with all medical care cost increases but increased at rates in excess of the cost increases transplant centers experienced for transplant procedures. And, kidney importation (from other OPOs) adds substantially to cost adding $4K-$6K per organ. OPO revenue over expense is largely due to profits from tissue recovery activities. Cost variations of over 100% across areas suggest less than socially efficient cost controls. The strong financial position of OPOs suggests that fiscal limits are not a likely explanation for the shortage of organs for transplantation.

"In considering individual OPOs, 2 levels of kidney costs (>$40K/kidney and <$40K) disclosed both statistically and clinically significant differences. The highest-cost OPOs (>$40K/kidney) are associated with higher direct costs (including more imported organs), higher compensation for support staff and procurement coordinators, higher professional education spending, and lower total assets, fewer organs procured, and lower performance measures-among other factors. Assessment of structural factors such as these may lead to opportunities to decrease cost and improve efficiencies. The US OPO enterprise is substantial, yet future OPO efficiency and performance improvements through competition appear unlikely considering OPO assets, current practices, and regulatory oversight issues. The inefficient financial incentives built into the U.S. OPO structure include both monopoly markets and self-reported cost reimbursement. These characteristics do not compel critical assessment, which could lead to organizational changes and more effective mission capability."

Working remotely may lessen income inequality between men and women: Claudia Goldin in the WSJ

 Here's Claudia Goldin in the WSJ, on how income inequality between men and women may be lessened by the growth of remote work. (She argues that women pay a price for flexible hours, since the highest paying jobs are "greedy" for long and on-call work.)

How the Pandemic Could Make the Future Brighter for Women in the Workplace. It could lead to less gender inequality at work, and more equity at home By Claudia Goldin Dec. 11, 2021

"Whereas the job with flexible hours paid far less than the greedy job before the pandemic, previously greedy jobs are now more flexible and the previously flexible jobs are now more productive. The working couple with children can now have a more equitable household without giving up as much income. The on-call parent will be able to compete for the previously greedy job, and employers will expand the previously flexible jobs, because these jobs have become more productive. As a result, the difference between the wages of the previously greedy and previously flexible jobs will narrow.

"Consider the mergers-and-acquisition work that once had to be done in Tokyo, or the contract that needed to be signed in Zurich. They actually don’t need to be done in person, we have learned. The on-call, at-home parent, generally the mother, hadn’t been able to do these transactions. But now they can be accomplished without being away during the evening and without flying across an ocean. The flexible job has become more productive and the greedy job has become more flexible."

What we know about labor market interviews

 Erling Skancke is on the job market from Stanford this year. You should interview him. If you do, you'll learn a lot about interviews, which are the subject of his job market paper, which provides a lot of new insight into an important practical set of isssues.

Skancke, Erling, Welfare and Strategic Externalities in Matching Markets with Interviews (November 10, 2021). Available at SSRN: https://ssrn.com/abstract=3960558 or http://dx.doi.org/10.2139/ssrn.3960558

Abstract: Recent debate in the medical literature has brought attention to issues with the pre-match interview process for residency and fellowship positions at hospitals. However, little is known about the economics of this decentralized process. In this paper, I build a game-theoretic model in which hospitals simultaneously decide on which doctors to interview, in order to learn their preferences over doctors. I show that increased interview activity by any hospital imposes an unambiguous negative welfare externality on all other hospitals. In equilibrium, both hospitals and doctors may be better off by a coordinated reduction in interview activity. The strategic externality is more subtle, and conditions are derived under which the game exhibits either strategic complementarities or substitutes. Moreover, an increase in market size may exacerbate the interview externalities, preventing agents from reaping the thick market benefits that would arise in the absence of the costly interviews. This effect increases participants' incentives to match outside of the centralized clearinghouse as markets become thicker, jeopardizing the long-term viability of the clearinghouse. The model also provides new insights into several market design interventions that have recently been proposed.

Disrupting black markets: call for papers

 Laws banning markets often create black markets. And the same technologies that facilitate legal markets may do so for illegal markets that we would like to extinguish, e.g. involving human trafficking, trade in endangered species or drugs, ransomware, etc.

How can we control such markets?

Here's a call for papers:

Call for Papers , Annals of Operations Research 

Special Issue: Applications of Operations Research and Data Science in Disrupting Illicit Markets 

Guest Editors: Mahdi Fathi, University of North Texas, TX, USA, mahdi.fathi@unt.edu 

Panos M. Pardalos, University of Florida, FL, USA, pardalos@ufl.edu 

Dursun Delen, Oklahama State University, OK, USA, dursun.delen@okstate.edu 

Stefan Gold, University of Kassel, Germany, gold@uni-kassel.de

 Marzieh Khakifirooz, Tecnologico de Monterrey, Mexico, mkhakifirooz@tec.mx 

Full paper submission deadline: 31 August 2022 

The first children with germline-edited genomes are growing up: the CRISPR story so far

 Nature has the story:

The CRISPR children.  In China, the first children with germline-edited genomes are growing up.  by Vivien Marx

"Three years ago, the world was in uproar after a journalist broke the news about two babies born with genomes edited with CRISPR-Cas9. He Jiankui had been invited to speak in the session on human embryo editing at the Second International Summit on Human Gene Editing. Some of He’s advisors thought he should speak about the twins, while others advised him to wait until his manuscripts were published, and He was purportedly leaning toward focusing just on preclinical work. Then, when the news of the twins’ birth was revealed, he adjusted existing slides to address the news.

....

"The goal of these heritable gene edits was to generate HIV-resistant people, by introducing germline mutations into the C-C chemokine receptor type 5 (CCR5) gene, which encodes a co-receptor for HIV. This thinking was roundly criticized by researchers and ethicists because of a lack of a medical need given the availability of antiretroviral treatments.He’s rationale for germline editing was that the gene was well studied, that HIV remains a devastating disease and that HIV infection status leads to discrimination. The participants in this study were HIV-discordant couples: the wives are HIV negative and their husbands are HIV positive and being treated with antiretroviral drugs.

...

"As the chorus of criticism around the experiments mounted in the days after the announcement, He disappeared from public view. Some assumed he was given a kind of escort who accompanied him around campus and monitored him. In January he was fired from his university post, and apparently detained some time thereafter.The Chinese authorities initially touted He’s achievement, then backtracked, condemned the work and shuttered the lab. After a trial in Nanshan District People’s Court behind closed doors, He was sentenced to a fine and three years in jail for ‘illegal medical practice’, along with two members of his team.

...

"One key concern for the children is genetic mosaicism—a condition in which different cells from the same individual have different genomes. Such conditions can occur naturally during development, for example through post-zygotic mutations, when mitosis proceeds irregularly and mutated cells persist. It can also happen when, after an environmental insult, a DNA break is not properly repaired.

...

"Whitehead Institute researcher Rudi Jaenisch says that mosaicism is a major problem with current approaches to heritable embryo editing. When genome edits take place after a zygote has become a two-cell or multicellular blastocyst—as likely occurred in He’s experiments—the edited and unedited cells keep dividing.

...

"Adashi fears that, given how imperfect the gene-editing tools are, the type of genetic and genomic “mayhem” that can result might lead to the loss of entire chromosomes or pieces of them. “Basically they could have a scrambled genome,” he says about the girls. He points to several papers showing such damage when CRISPR-Cas9-based gene editing is performed in human embryos.

...

"Rather than edit embryos, both Jaenisch and Church think that if germline gene editing is ever considered, it would be more promising to, for example, edit spermatogonial stem cells that give rise to sperm. But for now neither heritable gene editing in embryos nor germ-cell editing are considered ready for application in people.

"What happened in He’s lab, says Musunuru, is a textbook ethics violation that should be extensively analyzed and discussed. To date, the manuscripts describing the work that led to the gene-edited children have not been published in a journal or placed on a preprint server (Box 2). But since the birth of Lulu, Nana and Amy, a host of reports about the safety and ethics of gene editing have been published.

...

"They may well grow up healthy, says Adashi. Considering the risks endured in their creation, that would be a wonderful outcome. But he worries that germline gene editing “has a significant potential to cause harm rather than good.”

“How and if it will manifest is unknown,” he says. It’s certainly no way “to start life.”

***********

Earlier:

Monday, December 14, 2015

Technology watch: does Crispr create a new class of repugnant transactions?

Celebration of Marilda Sotomayor, livestreamed today

 Tribute to Marilda Sotomayor

Date and time: December 9th, 2021. From 14:00 to 16:15 Brazil time (GMT -3:00) (i.e. 9am to 11:15am Pacific time today)

Here's the program (and the video recording is below):

1) 14:00 - Session opening Prof. Wilfredo L. Maldonado (FEA - Universidade de São Paulo)

2) 14:05 - Academic career of Marilda Sotomayor - early friend account  Prof. Aloisio Araujo (Getulio Vargas Foundation – EPGE/RJ and IMPA)

3) 14:20 - Constrained-optimal tradewise-stable outcomes in the one-sided assignment game: A solution concept weaker than the core  Prof. Jesús David Pérez Castrillo (Universitat Autónoma de Barcelona and BSE)

4) 14:55 - Interior points of the core; Two different approaches Prof. Myrna Wooders (Vanderbilt University)

5) 15:30 - Stable and almost stables matching in centralized and decentralized markets Prof. Alvin Roth (Stanford University)

6) 16:05 - Acknowledgement and session closure Prof. Maurício Bugarin (Universidade de Brasília)

x

49º Encontro Nacional de Economia - Sessão Especial Homenagem a Marilda Sotomayor

 

Dating and Search: who should propose? by Yash Kanoria and Daniela Saban

 Dating sites are often congested, with many of them having more men than women. Here's an analysis suggesting that there are efficiency gains to having the short side of the market (in this case the women) do most of the search, by requiring them to initiate contact...

Facilitating the Search for Partners on Matching Platforms by Yash Kanoria , Daniela Saban, Management Science, Published Online:19 May 2021 https://doi.org/10.1287/mnsc.2020.3794

Abstract: Two-sided matching platforms can control and optimize over many aspects of the search for partners. To understand how matching platforms should be designed, we introduce a dynamic two-sided search model with strategic agents who must bear a cost to discover their value for each potential partner and can do so nonsimultaneously. We characterize evolutionarily stable stationary equilibria and find that, in many settings, the platform can mitigate wasted search effort by imposing suitable restrictions on agents. In unbalanced markets, the platform should force the short side of the market to initiate contact with potential partners, by disallowing the long side from doing so. This allows the agents on the long side to exercise more choice in equilibrium. When agents are vertically differentiated, the platform can significantly improve welfare even in the limit of vanishing screening costs by forcing the shorter side of the market to propose and by hiding information about the quality of potential partners. Furthermore, a Pareto improvement in welfare is possible in this limit.

*******

Earlier:

Thursday, February 13, 2020

Online dating while female--the case of Bumble

The demise of bourbon-scented hand sanitizer

The Covid pandemic isn't over, but the emergency shortage of hand sanitizer is.

Some Companies Will Stop Making Alcohol-Based Hand Sanitizer, by Rebecca Voelker, JAMA. 2021;326(19):1899. doi:10.1001/jama.2021.19919

"Nearly 2 years after the COVID-19 pandemic struck the US, the FDA will withdraw its guidance on manufacturing hand sanitizer. The withdrawal applies to nonpharmaceutical companies that followed temporary policies to produce both alcohol-based hand sanitizer and the alcohol used in them during the public health emergency.

"“In recent months, the supply of alcohol-based hand sanitizer from traditional suppliers has increased, and now, most consumers and healthcare personnel are no longer having difficulty obtaining these products,” Patrizia Cavazzoni, MD, director of the FDA’s Center for Drug Evaluation and Research, explained in a statement.

"The agency’s announcement stated that companies making alcohol-based hand sanitizer under the temporary policies must stop production by December 31. Those that plan to continue making the product will have to comply with requirements for over-the-counter topical antiseptics as well as the FDA’s Current Good Manufacturing Practice regulations."

***********

Earlier:

Thursday, June 11, 2020

The pandemic market for disinfectants (including Bourbon scented hand sanitizer)

Deceased organ allocation in the U.S., moving towards a more continuous system--Martha Pavlakis in Transplantation

 In the latest issue of Transplantation a clear description of how the transplant community is planning to move towards a more continuous way of allocating organs, in ways that have already begun (so that e.g. a lung transplant candidate in Manhattan won't be ineligible for a kidney from a deceased donor across the river in New Jersey).  One element of this that worries me is that a weighting system for priorities will be derived from focus groups of interested parties, using the Analytic Hierarchy Process, which is an orderly, matrix based process for aggregating opinions that doesn't have any ability to integrate different aspects being evaluated from the point of view of how they might effect relevant transplant outcomes, or consider how they might influence incentives for diagnosis and treatment. So I anticipate that organ allocation will continue to be in motion for the foreseeable future.

Continuous Distribution in Organ Allocation: Stepping Back From the Edge  by  Martha Pavlakis,  Transplantation: December 2021 - Volume 105 - Issue 12 - p 2517-2519, doi: 10.1097/TP.0000000000003886

"Organ allocation priorities are determined according to policies developed by the Organ Procurement and Transplantation Network (OPTN), which is operated by United Network for Organ Sharing (UNOS). In 2016, a significant shift began which will culminate in a transition of all organ allocation to be determined in the framework of an approach known as continuous distribution. The most reductive description of the change from current allocation to continuous distribution is that it will change from a classification-based (or bucket-based) system to a points-based system without hard borders. 

...

"The removal of hard boundaries in the continuous distribution system of allocation has been reviewed elsewhere6,7 and is best described by outlining the steps in its development. The steps include (1) identifying and categorizing candidate attributes; (2) building of a rating scale that assigns values for each attribute, such as candidate blood type, using UNOS and SRTR data; and (3) assigning weights to each attribute to determine how much that attribute will contribute to the candidate’s final score. This process has several parts: first, there needs to be a specific weight assigned to each attribute such that it can be prioritized against each of the other attributes. As a next step, the attributes need to be converted into points. (4) A framework will be built where a composite score is determined by combining weights and rating scales. To do this, a sensitivity tool called the analytic hierarchy process (AHP) will inform the development of the framework through a prioritization exercise.8 In these exercises, participants compare 2 attributes against each other and select their level of importance when considering a candidate for organ transplant. The information from multiple rounds of these exercises will be used to inform the weight of each attribute to the overall score. The AHP method was chosen because it has been used effectively by other healthcare groups to involve patients in making clinical decisions.9 The “participants” in this AHP method are the same participants that engage in public comment for policy change—member centers, individuals, OPOs, organizations with a vested interest in transplant such as the American Society of Transplantation, and the general public. Participants will weigh the trade-offs between effectiveness/benefit and medical urgency. Using focus groups, Oedingen et al convincingly highlighted the importance of preference studies to elucidate public preferences in organ allocation, which has multiple and sometimes competing goals.10

"Once the community has agreed on a proposed continuous distribution system, the SRTR will perform modeling to identify any potential unintended consequences of the proposal. The modeling will estimate the benefits of the new proposal and inform any needed improvements. (5) After considering community input through public comment, modeling and analysis, and committee project work, the kidney committee will then propose a composite score as a policy proposal. (6) Finally, a policy proposal will be presented to the OPTN Board of Directors for approval. Once approved, implementation of the policy is projected to take approximately 12 mo due to programming changes and education for the transplant community."

Organ shortages for transplantation: Pig kidneys won't be transplanted into people soon

 Here's an article in Medpage Today by the chief medical officer at UNOS, pointing out that xenotransplantation is not going to substitute in the near term for other efforts to increase organ transplants. (The article goes on to discuss recent progress in other directions.)

A Look at Pig Kidneys in the Broader Transplantation Puzzle— Advancements across the field are accelerating in real time  by David Klassen, MD November 29, 2021

"Last month's breaking news that the kidney of a pig functioned normally when attached for 54 hours to the body of a brain-dead patient was hailed as an eventual solution for more than 100,000 people nationwide who are waiting for life-saving organs. While xenotransplantation, or animal-to-human transplantation, has been undergoing study and experimentation for quite some time, this was a huge step in the right direction.

As first reported on October 18, the team at NYU Langone Health obtained consent from the ventilated donor's family to attach a pig kidney to her upper leg and monitor the results. They reported that the organ, which came from an animal whose genes had been modified to avoid early rejection by a human host, began to work almost immediately and produce urine and function as would a human kidney. The pig kidney functioned normally throughout the 54-hour trial.

...

"Unfortunately, the next steps remain incredibly complex. Routine xenotransplantation of non-human organs into human bodies is many years away. One of the greatest hurdles is immunological: getting non-human organs to survive long-term, not just for a 54-hour trial. Due to the need for additional research and testing, it is unlikely that xenotransplantation will arrive in time to help most of those currently on the transplant waitlist, including more than 90,000 kidney transplant candidates."

Morse lecture at INFORMS next year: market design and the study of operations

 In 1974, the year I received my Ph.D. from Stanford's (then) Department of Operations Research, it was unclear in what discipline game theory would best thrive.   As disciplinary boundaries shifted, I found that I was an economist.  But I've kept open my professional ties to OR, and indeed I think of market design as the engineering part of game theory, and very concerned with the operational detail of markets and marketplaces. So I was glad to accept an offer to compose a lecture on this for an OR audience, since market design is now a multi-disciplinary field that draws many students of operations.

Here's an announcement that includes the following:

Philip McCord Morse Lectureship Award

The Lectureship is awarded in honor of Philip McCord Morse in recognition of his pioneer contribution to the field of operations research and the management sciences. The award is given in odd-numbered years at the Annual Meeting if there is a suitable recipient. The term of the lectureship is two years. The award is $2,000, a certificate, a travel fund of $5,000, a copy of Morse's autobiography, In at the Beginnings: A Physicist's Life, and a copy of Morse and Kimball's Methods of Operations Research. Learn more about the Philip McCord Morse Lectureship Award and how to be nominated on the INFORMS website.

This year, the lectureship is awarded to:

Alvin E. Roth, Stanford University

Who exemplifies the true spirit of Professor Morse and who, like Morse, has been an outstanding spokesperson for the operations research profession in operations research tools and ideas in designing efficient markets for a range of applications. This award is given by the Institute for Operations Research and the Management Sciences in honor of Philip McCord Morse, in recognition of Professor Morse's pioneering contributions to the field of operations research and of his devoted service to the field's professional societies.

***********

See also

Tuesday, January 17, 2017

Market Design and Operations Research: an interview by the journal Mathematics of Operations Research

Sale of dinosaur fossils

 National Geographic has the story:

The controversial sale of 'Big John,' the world's largest Triceratops. The fossil's $7.7-million sale has some experts worried that ancient bones' rising prices will put more scientifically valuable fossils out of reach.  BYMICHAEL GRESHKO

"The founder of a South Dakotan firm called PaleoAdventures, which digs up fossils for commercial sale, Stein nicknamed the fossil “Big John” after the owner of the ranch where he found it. For six years, he held on to the Triceratops in hopes that a U.S. museum would purchase it—but none came forward. Then, in 2020, he sold the fossil to an Italian firm that prepared it for auction. With much fanfare and a jaw-dropping sale price of $7.7 million (6.65 million euros) to an anonymous buyer last month, Big John became a big deal—and added fuel to an ongoing, thorny debate among scientists, auctioneers, commercial paleontologists, and private landowners.

...

"Big John is one of more than 100 known fossils of Triceratops, one of the most common dinosaurs found in western North America’s Hell Creek Formation, which snakes through parts of Montana, North Dakota, South Dakota, and Wyoming.

"In the United States, only researchers with government permits can collect fossils on the millions of acres of federal lands, and these remains must be held in the public trust at institutions such as museums. However, fossils found on private land—including Big John—belong to the landowner and can be bought and sold legally.

"The U.S. is one of only a few countries that allows this sort of trade. In Alberta, Canada, for instance, fossils found in that province can’t be exported according to a 1970s law that designates fossils as part of Alberta’s natural heritage—a legal response to decades of foreign museums removing exquisite dinosaur fossils from the province. Other fossil-rich countries, such as Brazil, China, and Mongolia, have similar laws, though black markets dealing in fossils from these countries persist.

"Academic paleontologists have a range of views on the legal fossil trade, from begrudging acceptance to steadfast opposition. University of Calgary paleontologist Jessica Theodor, president of the Society of Vertebrate Paleontology (SVP), which represents paleontologists around the world, says she’s worried that auctions turn fossils into luxury collectibles and further legitimize the global fossil trade."

Supervised drug injection sites open in NYC

 The NY Times has the story:

Nation’s First Supervised Drug-Injection Sites Open in New York. During the first official day in operation at the two Manhattan facilities, trained staff reversed two overdoses, officials said.  By Jeffery C. Mays and Andy Newman

"New York, the country’s most populous city, became the first U.S. city to open officially authorized injection sites — facilities that opponents view as magnets for drug abuse but proponents praise as providing a less punitive and more effective approach to addressing addiction.

"Other cities including Philadelphia, San Francisco, Boston and Seattle have taken steps toward supervised injection but have yet to open sites amid debate over the legal and moral implications of sanctioning illegal drug use.

...

"Mayor Bill de Blasio began championing safe injection sites in 2018, citing their use and success in European and Canadian cities. The decision to officially allow the sites to open comes during the mayor’s last few weeks in office and as he considers a run for governor. He said in a statement that the decision will show other cities that “after decades of failure, a smarter approach is possible.”

"The mayor also sent a letter to the providers promising “not to take enforcement action” against their operations. Four of the city’s five district attorneys — excluding only the Staten Island district attorney, Michael McMahon — support supervised drug sites."

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

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

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

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

And here are the paper's concluding sentences:

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

Interview with Ido Erev

 Here's a short interview with Ido Erev, the great behavioral scientist at the Technion, from whom I learned a lot about learning:

Interview with Ido Erev

Here is his closing comment:

"When I started  studying the effect of experience, in the 90s, I asked several famous  researchers why they have stopped studying this effect. Here are some of  the answers that affected me the most (as I remember them): Duncan Luce: Now that I am old, I am more interested in my own mistakes.  In particular, I try to understand why I exhibit the Allais paradox.  Herb Simon: I got more reinforcements from studying bounded rationality.  Amos Tversky: It is clear that if you hit subjects with a 5Kg “feedback hammer” they will learn to be rational. I  want to study what people learn before they arrive at the lab. Alvin E.  Roth: There is no good answer, let's study it."

An experimental study whose participants are compensated donors in the legal Iranian market for kidneys, by Kelishomi and Sgroi

 A recent working paper from Warwick reports an experiment and survey study whose participants are compensated kidney donors (and prospective donors) in the legal Iranian monetary market for kidneys.

Kelishomi, Ali Moghaddasi, and Daniel Sgroi. A Field Study of Donor Behavior in the Iranian Kidney Market. No. 1381. University of Warwick, Department of Economics, October 2021.

Abstract: Iran has the world’s only government-regulated kidney market, in which around 1000 individuals go through live kidney-removal surgery annually.  We report the results of the first field study of donor behavior in this unique and controversial market. Those who enter the market have low income, typically entering to raise funds.  They have lower risk tolerance and higher patience levels than the Iranian average.  There is no difference in rationality from population averages.  There is evidence of altruism among participants.  This might shed light on the sort of people likely to participate if other nations were to operate suchmarkets.

From the introduction:

"There is no doubt that the notion of paying for a kidney raises ethical concerns and some see this form of market transaction as incompatible with the “sacred value” of human life (Elias et al., 2015). However, given the apparent success of the Iranian kidney market and the existence  of long waiting lists, patient suffering and significant loss of life elsewhere, there has also been something of a re-evaluation of the potential for regulated organ markets in the developed world

...

"Given the nature of the debate it seems important to consider the characteristics of those likely to  come  forward  as  donors  if  a  market  is  established  and  to  ask  what  special  features  they may possess.  Since there is only one existent regulated market, this must involve a controlled examination of participants in the Iranian kidney market.  Our paper reports the outcome of an unprecedented first study of patient behavior in the Iranian kidney market in which we obtained direct access to donors before and after surgery. We provided full incentives where appropriate during our experimental treatments, providing incentive payments of around $50 (in terms of purchasing power parity) on top of a show-up fee of roughly $15.2 We also collected data that is similar to existing generic data on the Iranian population. This allows us to not only provide comparisons within our sample but also between our sample and Iranian averages where data is available.

...

" The study started in August 2017 (shortly after the end of sanctions between the UK and Iran) and live sessions continued until May 2019,with further telephone interviews and follow-up sessions continuing until February 2021.  78 subjects were first interviewed post-donation while the remaining 137 were interviewed pre-donation.  Of the pre-donation group 91 were contacted a second time to confirm their final status in February 2021.  35 had donated by this point with the remaining 56 dropping out of the market (30 for medical reasons and 26 through choice).  Following this process we were able to measure behavioral variables such as risk aversion, time preference (patience), altruism, rationality (consistency with GARP, the generalized axiom of revealed preference), and a wide variety of demographic and socioeconomic data.  Where feasible we incentivized answers and used the most prominent measures available.  We also examined why these patients enter the market and what alternatives might have been available to them.  We are able to compare our patient data with available data for typical Iranians to provide a benchmark (Falk et al., 2018)

...

"While the typical donor is in considerable financial difficulty, they are significantly more patient and exhibit lower tolerance for risk than an average Iranian (though conditional on entering the market those with lower patience are more likely to have donated during our study).   Those who go through with the process exhibit higher levels of altruism than those who drop out.   We find no difference in rationality between participants in the market and the subjects in a leading study of rationality from which we take our core measure  (Choi  et  al.,  2014).   We  would  argue  that  alternative  options  for  those  in  financial difficulty such as approaching a loan shark might be more appealing to the risk-loving (and perhaps more impatient) since this offers an immediate solution but replaces it with a serious and risky long-term liability, while the organ market is a difficult short-term prospect but does not result in higher levels of debt in the long run. Our findings on altruism are consistent with the idea that, while donors are being paid, they are nevertheless taking part in a difficult process that has the potential of saving a life, and this may also be important when considering alternatives."

#####

Update: here's the published paper

Kelishomi, Ali Moghaddasi, and Daniel Sgroi. A Field Study of Donor Behavior in the Iranian Kidney Market. European Economic Review, Volume 170, 2024

The Elements of Choice (Architecture) by Eric Johnson

Eric Johnson's new book is about choice architecture, and how when choices are presented in a confusing way, we may make bad decisions.

The Elements of Choice. WHY THE WAY WE DECIDE MATTERS  By ERIC J. JOHNSON

One of the points the book makes is that having too many choices may impede the quality of your decision: you might do better if the choice architect had narrowed or better organized your choice set to make it easier for you to fluently understand the choices presented, which would enable you to make a more accurate decision.

Here is a picture of the first search result that appeared when I searched for the book, which I surmise is an ad composed by the publisher:

I read with interest his discussion of school choice, in which he argues that much of the potential welfare improvement produced by market design could potentially be undone by confused decision making by participants, and that welfare could be improved if market designers did a better job of actively curating and organizing the choices offered.

He writes "Increasing the number of options increases the probability that families will be presented with the best school for them, but it does not mean they will see it."

Some of his recommendations suggest that market designers should get involved at all level of detail: e.g. easier to read fonts may increase fluency and allow more choices to be presented effectively.

Others of his recommendations seem to me to be further removed from the actual practice of school choice: e.g. "If we can remove any terrible schools from the set, choosers, even if they were picking randomly, would on average get better outcomes." Closing underperforming schools (e.g. by not admitting new students) is much more complicated than that.

I haven't finished reading the book yet (Eric pointed me first to the section on school choice), and I'm looking forward to it.  Choice architecture is certainly an important part of market design.

Deceased donor sperm recovery and conception

I guess it's a case of deceased donor transplantation of sorts. Above the Law has the story:

Posthumous Conception: It Happens More Often Than You Think by Ellen Trachman

 "In the latest high-profile controversy over posthumous conception, last month, we learned of the birth of a baby girl to an Australian woman named Ellidy Pullin, the widow of Olympic snowboarder Alex “Chumpy” Pullin. The Olympian died tragically in a diving accident in 2020.

"Ellidy Pullin turned to their fertility doctor, Andrew Davidson, and asked that her spouse’s sperm be harvested from his body after his death. Davidson described how he entered fertility medicine never expecting to do posthumous sperm retrievals, but now, those requests are becoming more common. The doctor noted that he has done two other posthumous sperm retrievals since the Olympian’s death.

"The process was successful for Pullin — as Davidson notes, it usually is, so long as the sperm is successfully retrieved within 48 hours of death.

...

"In the United States, the hospital itself is the most frequent obstacle that prevents a surviving loved one from having a chance to conceive with the DNA of their deceased spouse or partner. Many hospitals are unwilling to permit the retrieval of reproductive material without specific written consent. And by specific consent, that frequently means not just that the deceased wanted to have children with the survivor. The bar is often set higher. The consent must be that the deceased specifically agreed for their sperm or eggs to be harvested and used for reproductive purposes after their death."

NRMP Statement On Interviewing

 The National Resident Matching Program (NRMP) has a statement on interviewing, which precedes the NRMP match for new American doctors, and that reflects concerns that the interviewing process has become congested.

NRMP Statement On Interviewing

"The National Resident Matching Program® (NRMP®) has heard the concerns of learners and programs in the medical education community about the interview process and wants to encourage equitable practices among applicants and programs. As such we have developed the following recommendations. Although especially true during the enduring times of the pandemic, the recommendations align with the NRMP’s long-standing commitment to maintaining a fair, efficient, reliable, and transparent process for all. Recommendations also foster well-being among all parties.

"NRMP Recommendations for Programs:

1. Programs should conduct all interviews virtually for the 2021-2022 cycle.

2. Programs should extend interview offers that equal, not exceed, the total number of available interview slots.

3. Applicants should be given a minimum of 48 hours to respond to an interview offer.

"NRMP Recommendations for Applicants:

1. Applicants should make timely decisions about interview offers and promptly notify programs in which they are no longer interested, freeing up interview slots.

2. Applicants should give ample, adequate (e.g., one week) notice to programs in the event they change their minds and decline accepted interviews."

Promoting Quality in Research: the inaugural Einstein Foundation Awards, 2021

 I had the privilege of being a member of the jury for the Einstein Foundation Awards, which were awarded yesterday for the first time.

Here's the award booklet: 

EINSTEIN FOUNDATION AWARD 2021 PROMOTING QUALITY IN RESEARCH

Individual Award 2021:  Paul Ginsparg

"Preprints have been shared in the physics community since the early 1950s but mostly among well established professors. Physicist Paul Ginsparg, who receives the Einstein Foundation’s Individual Award, set out to democratize access to scientific results. Today, his preprint server arXiv has spread to many other fields—and made science progress more efficient and fairer."

Institutional Award 2021: The Center for Open Science

"Open research is on the rise, but a lot of research information still remains behind closed doors. The Center for Open Science, recipient of the Institutional Award, advocates for more transparency and open access, training scientists, publishers and funders, providing technology and policy recommendations. With this multi pronged approach, it has helped create an open science community which is becoming ever more self-sustaining."

Early Career Researcher Award 2021: "ManyBabies5: Teaming up for Developmental Science → manybabies.github.io/MB5

"Unlike adult subjects, babies cannot tell you what they are thinking. Therefore, researchers studying infant development use looking patterns to understand how babies think and feel about the world. “An overwhelming majority of studies use looking time to make inferences about infant cognition,” comments Martin Zettersten from Princeton University in the United States. But what exactly is it that drives babies to pay attention to different things? To come up with a statistically sound answer to this question, he and his colleague Jessica Kosie initiated ManyBabies5, a large international consortium of infant researchers. “We aim to increase diversity amongst researchers and test subjects alike and collaboratively want to come up with the best test possible on how different factors matter in infant looking time,” Jessica Kosie explains. To that end, the ManyBabies team will put together a diverse and sizeable sample of infants around the world. “To me, team science is a useful tool for producing high quality, robust science,” says Martin Zettersten. “Embracing this approach as a field as many groups are doing right now—that feels revolutionary to me.”

THE JURY The Einstein Foundation Council has convened an outstanding group of scholars representing the natural sciences, the humanities, and the social sciences. The international jury is presided over by Dieter Imboden and both defines the objectives of the award and selects the awardees. The following jury members have been appointed for the first three year term: DIETER IMBODEN (President), PhD, Theoretical Physics; Professor Emeritus of Environmental Physics, ETH Zürich; DOROTHY BISHOP, PhD, Neuropsychology; Professor of Developmental Neuropsychology, Oxford University; ALASTAIR BUCHAN, MD, PhD, Medicine; Professor of Stroke Medicine, Oxford University; MICHEL COSNARD, PhD, Computer Science; Professor Emeritus of Informatics, Université de Côte d’Azur; LORRAINE DASTON, PhD, History of Science; Director Emerita of the Max Planck Institute for the History of Science Berlin; MOSHE HALBERTAL, PhD, Philosophy; Professor of Jewish Thought and Philosophy, Hebrew University; LENA LAVINAS, PhD, Economics; Professor of Welfare Economics, Universidade Federal do Rio de Janeiro; JULIE MAXTON, PhD, Law; Executive Director of the Royal Society, London; MARCIA MCNUTT, PhD, Geophysics; President of the National Academy of Sciences of the United States; EDWARD MIGUEL, PhD, Economics; Professor of Environmental and Resource Economics, University of California, Berkeley; ALVIN ROTH, PhD, Economics; Professor of Economics, Stanford University; SOAZIC ELISE WANG SONNE, Economist, World Bank Group; PhD Fellow, United Nations University; SUZY STYLES, PhD., Psychology; Professor of Psycholinguistics, Nanyang Technological University; E. JÜRGEN ZÖLLNER, Dr. Dr. h.c. mult., Medicine; Chairman of the Board of Trustees of the Stiftung Charité, Senator (ret.), Berlin

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

Here's my earlier description of the award:

Saturday, December 12, 2020

The Einstein Foundation Award for Promoting Quality in Research (apply or nominate now...)

Mail order catalogs, downtown department stores, suburban malls, and modern home delivery

 Here's a 10 minute video in which I discuss how retail markets have changed over the last century and more, with the invention of mail order catalogs, and the growth of downtown department stores (in part as a result of urban public transportation), and then suburban shopping malls, before our current age of digital commerce and home delivery.

This was my discussion of talks by Rob Townsend and David Autor at the October zoom conference

Technology and Equality in the Digital Era--Luohan Academy

An IVF mixup of babies

 Here are the stories, from the Guardian, and the NY Times:

Guardian:

California women gave birth to each other’s babies after IVF mix-up. Couples to sue clinic after raising girls for months that were not theirs, says lawsuit, before babies were swapped back

"Two California couples gave birth to each other’s babies after a mix-up at a fertility clinic and spent months raising children that were not theirs before swapping the infants, according to a lawsuit filed in Los Angeles.

"Daphna Cardinale said she and her husband, Alexander, had immediate suspicions that the girl she gave birth to in late 2019 was not theirs due to the child’s darker complexion.

"They suppressed their doubts because they fell in love with the baby and trusted the in vitro fertilisation process and their doctors, she said. Learning months later that she had been pregnant with another couple’s baby, and that another woman had been carrying her child, caused enduring trauma, she said.

...

"The two other parents involved in the alleged mix-up wish to remain anonymous and plan a similar lawsuit in the coming days, according to the attorney Adam Wolf, who represents all four parents.

"The lawsuit claims CCRH mistakenly implanted the other couple’s embryo into Daphna and transferred the Cardinales’ embryo – made from Daphna’s egg and Alexander’s sperm – into the other woman.

"The babies, both girls, were born a week apart in September 2019. Both couples unwittingly raised the wrong child for nearly three months before DNA tests confirmed that the embryos were swapped, according to the filing.

“The Cardinales, including their young daughter, fell in love with this child, and were terrified she would be taken away from them,” the complaint says. “All the while, Alexander and Daphna did not know the whereabouts of their own embryo, and thus were terrified that another woman had been pregnant with their child – and their child was out in the world somewhere without them.”

"The babies were swapped back in January 2020.

"Mix-ups like this are exceedingly rare, but not unprecedented. In 2019, a couple from Glendale, California, sued a separate fertility clinic, claiming their embryo was mistakenly implanted in a New York woman, who gave birth to their son as well as a second boy belonging to another couple.

*******

NY Times:

‘We Had Their Baby, and They Had Our Baby’: Couple Sues Over Embryo ‘Mix-Up’  Daphna and Alexander Cardinale, the plaintiffs in a lawsuit against a Los Angeles-area fertility clinic, say they endured a painful custody exchange after DNA testing.  By Neil Vigdor

...

"Peiffer Wolf Carr Kane & Conway, the law firm representing the Cardinales, estimated that the couple had paid $50,000 to the fertility clinic for the treatments.

...

"Mr. Cardinale, 41, said during the news conference on Monday that the most upsetting aspect of the ordeal had been breaking the news to the couple’s older daughter, who begged her parents to keep the baby.

“How do you explain that to a 5-year-old?” Mr. Cardinale said."

A naturally occurring deceased-donor-initiated kidney exchange chain, by Maghen and Veale

 Here's an interesting case report, from the innovative UCLA transplant center, about a kidney exchange chain actually, if not officially, initiated by a deceased donor.

With “reverse engineering” were some living donor kidney chains in actuality triggered by deceased donors?  by Ariella Maghen and Jeffrey Veale, Clinical Transplantation, First published: 21 September 2021 https://doi.org/10.1111/ctr.14491

"Mr. M is a 58-year-old polycystic kidney disease patient waiting for a kidney transplant in the United States (US). Although his wife Mrs. M offered to donate her kidney to him, they were not a compatible match. While waiting to be “exchanged or swapped” with another donor/recipient pair facilitated by the National Kidney Registry (NKR), Mr. M received a rare offer for a “perfectly-matched” (zero-mismatch) deceased donor (DD) kidney. Only 5% of candidates receive a perfectly matched kidney from a DD; Mr. M accepted the offer and underwent transplantation in February 2020. Currently, his allograft is functioning beautifully, and he states never feeling better. 

"One may think Mrs. M feels relief now and that she is “off-the-hook” to donate. But au contraire as she has completed the extensive donor evaluation and remains in the mindset to donate. Mrs. M's gratitude towards the DD family's gift to her husband motivated her to “pay-their-generosity-forward” and now donate her kidney.

"Mrs. M's donation performed on October 21, 2020, brings greater awareness to the concept of a DD triggered kidney chain, a relatively novel phenomenon in the United States.

...

"This case elucidates how transplant chains, believed to be initiated by non-directed living donors, when reverse-engineered may in actuality have been triggered by DDs who were at the pole position. Although this may be one of the first reported cases, it is possible that other transplant centers have been encouraging the allocation of donors in this fashion. There are likely more living donors who may still want to donate their kidney even after their intended recipient received a DD transplant via “zero-mismatch” or “high-PRA” offers."

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

Italy seems to be among the first places to formally follow up on the idea of deceased donor chains. See:

Transplant InternationalVolume 33, Issue 10 p. 1177-1184, Kidney exchange strategies: new aspects and applications with a focus on deceased donor-initiated chains, by Lucrezia Furian,Antonio Nicolò,Caterina Di Bella,Massimo Cardillo,Emanuele Cozzi,Paolo Rigotti  First published: 09 August 2020  https://doi.org/10.1111/tri.13712

Summary: Kidney paired donation (KPD) is a valuable way to overcome immunological incompatibility in the context of living donation, and several strategies have been implemented to boost its development. In this article, we reviewed the current state of the art in this field, with a particular focus on advanced KPD strategies, including the most recent idea of initiating living donor (LD) transplantation chains with a deceased donor (DD) kidney, first applied successfully in 2018. Since then, Italy has been running a national programme in which a chain-initiating kidney is selected from a DD pool and allocated to a recipient with an incompatible LD, and the LD’s kidney is transplanted into a patient on the waiting list (WL). At this stage, since the ethical and logistic issues have been managed appropriately, KPD starting with a DD has proved to be a feasible strategy. It enables transplants in recipients of incompatible pairs without the need for desensitizing and also benefits patients on the WL who are allocated chain-ending kidneys from LDs (prioritizing sensitized patients and those on the WL for longer).

...

"Melcher et al. [10] suggested merging DD programmes with KPD programmes in 2016, an idea explored more recently in a concept paper issued by the Organ Procurement and Transplantation Network (OPTN) [11]. 

...

10 M. L. Melcher, J. P. Roberts, A. B. Leichtman, A. E. Roth, M. A. Rees Utilization of deceased donor kidneys to initiate living donor chains. Am J Transplant 2016; 16: 1367.

11Rock Haynes C, Leishman R. Allowing deceased donor-initiated kidney paired donation (KPD) chains. OPTN/UNOS Kidney Transplantation Committee. Concept Paper; July 31–October 2, 2017.

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

Earlier:

Tuesday, August 7, 2018

Deceased donor chains: Market design language is entering transplantation

Monday, April 11, 2016

Using deceased donor kidneys to start living donor kidney exchange chains

Online and Matching-Based Market Design (forthcoming in 2022), edited by Echenique, Immorlica, and Vazirani

 What to read in 2022? Here's a teaser...

Online and Matching-Based Market Design, forthcoming in 2022 from Cambridge University Press

Editors: Federico Echenique, Nicole Immorlica, Vijay V. Vazirani  

With a Foreword by Alvin E. Roth

The publisher's leaflet describes the book this way:

"The field of matching markets is, due to a unique confluence of circumstances, at the same time mature and yet in its infancy. Its birth goes back to the seminal 1962 paper of Gale and Shapley on stable matching. Over the decades, this field has become known for its highly successful applications, having economic as well as sociological impact. Its recent resurgence, with the revolutions of the Internet and mobile computing, has opened up altogether new avenues of research and novel, path-breaking applications. The distinctive feature of this book lies in treating this field in its true interdisciplinary spirit --- the field veritably sits at the intersection of economics, computer science, operations research and discrete mathematics, and this viewpoint has already led to a sequence of fundamental research results. Comprised of chapters written by over 50 top researchers, it still has the clarity, cohesiveness and organization of a textbook."

CONTRIBUTORS: Atila Abdulkadiroglu, Nikhil Agarwal, Samson Alva, Itai Ashlagi, Mariagiovanna Baccara, Gabriel Carroll, Hector Chade, Jiehua Chen, Yan Chen, Nikhil Devanur, Federico Echenique, Lars Ehlers, Matthew Elliott, Michal Feldman, Zhe Feng, Tamas Fleiner, Alfred Galichon, Renato Gomes, Aram Grigoryan, Guillaume Haeringer, Hanna Halaburda, John Hatfield, Zhiyi Huang, Nicole Immorlica, Ravi Jagadeesan, Philipp Kircher, Bettina Klaus, Robert Kleinberg, Scott Kominers, Soohyung Lee, Jacob Leshno, Shengwu Li, Irene Lo, Brendan Lucier, David Manlove, Aranyak Mehta, Paul Milgrom, Jamie Morgenstern, Thanh Nguyen, Alexandru Nichifor, Michael Ostrovsky, David Parkes, Alessandro Pavan, Marek Pycia, Aaron Roth, Bernard Salanie, Aleksandrs Slivkins, Paulo Somaini, Sai Srivatsa Ravindranath, Eduard Talamas, Alexander Teytelboym, Thorben Tröbst, Vijay Vazirani, Andrew Vogt, Rakesh Vohra, Alexander Westkamp, Leeat Yariv

Oocyte ethics: financial compensation for human eggs

 New ethical guidance on egg donation, following an antitrust settlement regarding price fixing.

Financial compensation of oocyte donors: an Ethics Committee opinion.  by The Ethics Committee of the American Society for Reproductive Medicine, American Society for Reproductive Medicine, Birmingham, Alabama, Fertility and Sterility® Vol. 116, No. 2, August 2021

"Financial compensation of women donating oocytes for reproductive or research purposes is justified on ethical grounds and should acknowledge the time, inconvenience, and discomfort associated with screening, ovarian stimulation, oocyte retrieval, and postretrieval recovery and not vary according to the planned use of the oocytes or the number or quality of oocytes retrieved. This document replaces the document of the same name published in 2016. (Fertil Steril
2021;116:319-25. 2021 by American Society for Reproductive Medicine.)

"ESSENTIAL POINTS:

Financial compensation of women donating oocytes for reproductive or research purposes is justified on ethical grounds.

Compensation is in accord with principles of fairness, occurring within the framework of a professional relationship.

Compensation should acknowledge the donor’s time, inconvenience, and discomfort associated with screening, ovarian stimulation, oocyte retrieval, and postretrieval recovery. Compensation should not vary according to the planned use of the oocytes (reproductive or research) or the number or quality of oocytes retrieved.

Compensation should be fair and should not be an undue enticement that negatively impacts a donor’s ability to make an informed decision about the donation process and the risks involved with donation.

All oocyte-donor recruitment programs, including agencies, egg banks, and fertility clinics, should individually adopt and implement effective processes for information disclosure and counseling in order to promote informed decision-making by prospective donors.

Treating physicians owe the same professional duties to oocyte donors as to all other patients.

Programs should ensure equitable and fair provision of services to oocyte donors.

Programs should individually adopt and disclose policies regarding coverage of an oocyte-donor’s medical costs should she experience complications associated with the oocyte retrieval process."

...

" Because the burdens of donation are similar regardless of the ultimate use of the oocytes, compensating donors of oocytes for research is also ethically justified. There has been some movement at the state level to permit compensation to research donors, which stands in contrast to the approach articulated by the National Academy of Sciences with respect to compensation for oocyte donation for stem-cell research (21). In 2009, New York became the first US state to implement a policy permitting researchers to use public funds to reimburse women who donate oocytes directly and solely for stem-cell research, not only for the woman’s outof-pocket expenses, but also for the time, burden, and discomfort associated with the donation process (22). A law enacted in California in 2019 likewise requires women who provide human oocytes for research to be compensated for their time, discomfort, and inconvenience in the same manner as other research subjects, removing a previous prohibition of compensation of research donors (11).

...

"It is ethically permissible for a program to refuse to accept a prospective oocyte donor if they become aware that a prospective oocyte recipient or recruiting agency has offered gifts or payments that the program, in the exercise of its own ethical judgment, believes compromise the donor’s free choice or are otherwise ethically inappropriate. Programs should not assume that known donors, such as family or friends, are not being financially compensated. In one study of recipients using both known and anonymous donors, 19 of 20 of the known donors had been compensated, and there were no differences in the amounts provided to known and anonymous donors (27).

...

"This report was developed under the direction of the Ethics Committee of the American Society for Reproductive Medicine (ASRM) as a service to its members and other practicing clinicians. Although it reflects appropriate management of a problem encountered in the practice of reproductive medicine, it is not intended to be the only approved standard of practice or to dictate an exclusive course of treatment. Other plans of management may be appropriate, taking into account the needs of the individual patient, available resources, and institutional or clinical practice limitations. 

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

That last paragraph may be a bow to the antitrust settlement discussed in the post below:

Friday, May 3, 2019

Donating eggs for fertility: an update

Can it be made safe for drug users to call for help when a friend overdoses?

There are lots of ways that drug laws contribute to the design of the black market for drugs, and the behavior of its participants. Here's a recent post from the blog Bill of Health:

New Data Highlights Complexity of Good Samaritan Overdose Law Landscape, By David Momjian

 "To combat the rising death toll from drug overdoses, 47 state legislatures and the District of Columbia have passed Good Samaritan laws (GSLs) to protect bystanders from criminal prosecution if they call for medical assistance during a drug overdose. Bystanders to a drug overdose are often worried that by calling for help, they could be arrested for drug possession or evicted by the police, who often arrive first at the scene of a 911 call, even if it is a medical emergency.

A new dataset built by the Center for Public Health Law Research at Temple University’s Beasley School of Law and funded by Vital Strategies, covers the evolution of GSLs in the United States from January 1, 2007, to June 1, 2021."

Drug overdose deaths between April 2020 and 2021 reach 100,000

 The Washington Post has the story:

100,000 Americans died of drug overdoses in 12 months during the pandemic  By Dan Keating and Lenny Bernstein

"The U.S. drug epidemic reached another terrible milestone Wednesday when the government announced that more than 100,000 people had died of overdoses between April 2020 and April 2021. It is the first time that drug-related deaths have reached six figures in any 12-month period.

...

"The new data shows there are now more overdose deaths from the illegal synthetic opioid fentanyl than there were overdose deaths from all drugs in 2016."

We should be thinking about harm reduction...