British professions

The London Times reports on a British government report on the socioeconomic background of new lawyers, doctors, journalists, and accountants: Top professions 'operate closed shop to exclude the poor'

"Law, medicine and other professions have become more exclusive in the past 30 years, drawing recruits from better off, middle-class families, a government report has found.
Other former trades, such as journalism, have evolved into “modern professions”. They are increasingly colonised by middle-class graduates and offer fewer opportunities for young people with lesser qualifications to get a foot on the ladder.
Barriers to all professions, traditional and modern, have also sprung up — most notably internships — making it even more difficult for children from poor backgrounds with few connections to break in.
The report on access to the professions was commissioned by Gordon Brown and written by Alan Milburn, the former Health Secretary. He said traditional and modern professions had a “closed shop” mentality, blocking mobility and shutting their doors to children from poorer backgrounds."
...
"Professions should also be obliged to report to ministers on how they offered internships. In recent years these unpaid and often lengthy periods of work experience have become the gateway to the best jobs. Mr Milburn said that too often such placements depended on who you knew.
The report revealed that the law is the most exclusive profession. Lawyers who entered the profession in the 1990s typically grew up in families with incomes 64 per cent above average. Those starting out in the 1970s came from homes with incomes 40 per cent above average. Three quarters of judges and two thirds of top barristers are privately educated. “Modern professions”, such as journalism, are not far behind, with degrees and even postgraduate qualifications and an internship now the norm for entry.
Most journalists and broadcasters are from wealthy families and more than half have been privately educated. Forty years ago, only a tiny proportion of journalists were from privileged backgrounds and most worked their way up.
Accountancy is another new preserve of the middle classes. Forty years ago accountants starting work came from families on average incomes but 20 years later in the 1990s, accountants came from families on incomes 40 per cent above average. "

Paying for unpaid work: Market for internships, continued

When "experience" is necessary for a new job, acquiring experience is worth paying for. In an earlier post, I wrote about paying for unpaid internships in Britain, and now a very well written story by Gerry Shih in the NY Times outlines similar developments in the U.S.: Unpaid Work, but They Pay for Privilege. I quote his story at length below, with the kicker being the last paragraph quoted:)

"With paying jobs so hard to get in this weak market, a lot of college graduates would gladly settle for a nonpaying internship. But even then, they are competing with laid-off employees with far more experience.
So growing numbers of new graduates — or, more often, their parents — are paying thousands of dollars to services that help them land internships.
Call these unpaid internships that you pay for.
“It’s kind of crazy,” said David Gaston, director of the University of Kansas career center. “The demand for internships in the past 5, 10 years has opened up this huge market. At this point, all we can do is teach students to understand that they’re paying and to ask the right questions.” "
...
"Andrew’s parents used a company called the University of Dreams, the largest and most visible player in an industry that has boomed in recent years as internship experience has become a near-necessity on any competitive entry-level résumé.
The company says it saw a spike in interest this year due to the downturn, as the number of applicants surged above 9,000, 30 percent higher than in 2008. And unlike prior years, the company says, a significant number of its clients were recent graduates, rather than the usual college juniors."
...
"But many educators and students argue that the programs bridge one gulf — between those who have degrees from prestigious colleges or family connections and those who do not — only to create a new one, between the students who have parents willing and able to buy their children better job prospects and those who do not.
“You’re going to increase that divide early, on families that understand that investment process and will pay and the families that don’t,” said Anthony Antonio, a professor of education at Stanford University. “This is just ratcheting it up another notch, which is quite frightening.” "
...
"The industry dismisses the criticism.
“Universities forget that they themselves are, in essence, businesses,” said C. Mason Gates, the president of Internships.com, an online placement service. “Just because they’re doing it in a nonprofit fashion doesn’t mean that those of us doing it for profit are doing it incorrectly.”"

Secondary market for prescriptions: a privacy-repugnant transaction

The information on your drug prescriptions, including your name, can be bought and sold, reports Milt Freudenheim in the NY Times: And You Thought a Prescription Was Private

"... prescriptions, and all the information on them — including not only the name and dosage of the drug and the name and address of the doctor, but also the patient’s address and Social Security number — are a commodity bought and sold in a murky marketplace, often without the patients’ knowledge or permission.
That may change if some little-noted protections from the Obama administration are strictly enforced. The federal stimulus law enacted in February prohibits in most cases the sale of personal health information, with a few exceptions for research and public health measures like tracking flu epidemics."
...
"Selling data to drug manufacturers is still allowed, if patients’ names are removed. But the stimulus law tightens one of the biggest loopholes in the old privacy rules. Pharmacy companies like Walgreens have been able to accept payments from drug makers to mail advice and reminders to customers to take their medications, without obtaining permission. Under the new law, the subsidized marketing is still permitted but it can no longer promote drugs other than those the customer already buys. "

Loss of privacy, particularly medical privacy, is a negative externality to some transactions that is increasingly seen as making them repugnant.

Gestation and the marriage market: second child still takes nine months

How long (after marriage) it takes for the first child to arrive is determined by many complex things, but the marriage market in Japan is evolving in a direction that shortens the time: Shotgun weddings on rise in Japan as attitudes to pregnancy shift.

"“From about five years ago the number of dekichatta-kon [weddings due to pregnancy] that we handle has not stopped rising,” she said. “Last year we worked out that about a quarter of the brides we worked with were pregnant, and some were about eight months along when they tied the knot.
“The couples used to be embarrassed, and our job was to try to hide the fact from the families. Now everyone is so relaxed about it we try to turn it into a double celebration and make life as easy as possible for the mother-to-be.”
...
"The shift reflects changing attitudes in Japan. The historic taboo of pregnancy outside marriage was largely abandoned during the 1990s but a strong tradition of being married by the time of the birth remained.
By 2004, however, the national average of ten months between marriage and the birth of a first child had fallen to six. "

A Toolbox for Economic Design by Dimitrios Diamantaras et al.

A new book on mechanism design theory, with a deep bow in the direction of practical market design, and a modern choice of topics (including the original mechanism design work on Kidney Exchange).

I haven't held it in my hands yet, but you can get a surprisingly good idea of the coverage by using the search function on the Amazon site:

A Toolbox for Economic Design by Dimitrios Diamantaras, Emina I. Cardamone, Karen A. Campbell Campbell, and Scott Deacle (Hardcover - March 31, 2009)

Fertility tourism and the British ban on paying egg donors

The fertility treament covered by Britain's National Health Service causes many Britons to seek treatment privately, elsewhere in Europe, the London Times reports: 'Thousands of Britons' travel abroad for IVF, research finds.

"Restricted access to fertility treatment on the NHS, the high cost of private therapy at domestic clinics and a serious shortage of donated eggs are driving couples to visit overseas clinics for help in starting a family. "
...
"IVF patients who need donated eggs are particularly likely to travel. Domestic donors are in short supply because of the removal of anonymity and tough rules against selling eggs.Spain and the Czech Republic are prime destinations, due to laws allowing donors to be paid €900 (£765) and €500 respectively for eggs. British donors get no more than £250 in expenses. "

Now the ban on payment for eggs is being reconsidered:

Pay donors to end the shortage of IVF eggs, says watchdog
"A longstanding ban on selling sperm and eggs should be reconsidered to address a national shortage of donors, the head of the Government’s fertility watchdog says. Payments to donors could cut the number of childless couples travelling abroad for treatment, Lisa Jardine, of the Human Fertilisation and Embryology Authority, told The Times. The removal of anonymity for donors in 2005 and strict rules against payments have provoked a crisis in fertility treatment, forcing many couples to wait years for the therapy they need to start a family. A recent study showed that access to eggs and sperm was the main reason why hundreds of British couples became “fertility tourists” each month."
...
"Her move will raise concerns about a market in human tissue and exploitation of women as egg donation is invasive and involves an element of risk. In countries that allow payment, such as the United States, Spain and Russia, young women often donate to wipe out debts or to fund university fees. Professor Jardine said that the law already treated eggs, sperm and embryos differently from other tissues, so there was no danger of setting a precedent for the sale of organs such as kidneys. Payment would also ensure that more women were treated in licensed domestic clinics, rather than in countries with less stringent regulations. “I’m not saying the decision arrived at before I became chair wasn’t the right one at the time,” she said. “But given the evidence that egg shortage is driving women overseas, I feel a responsibility to look at it again.” "

Mixed marriage bonus in Iraq

Iraq: $2, 000 for Shiite-Sunni Couples Who Marry

"Talib and his wife are among more than 1,700 newlywed couples who have accepted cash from a government program that encourages Sunnis and Shiites to tie the knot. The government has held 15 mass weddings for inter-sect couples from all over Iraq... While the Iraqi government doesn't track marriages bridging the two major Muslim sects, experts say mixed couples are on the rebound after a dramatic decline during the days of heavy violence. ...

"As security has improved, Iraqis are returning to their homes in mixed neighborhoods and spending more time at offices, universities and other places where they meet their future spouses, said Shiite cleric Sayyid Ahmed Hirz al-Yasiri in Baghdad's Shiite stronghold of Sadr City.
''There was a time when families were reluctant to consent to such marriages because of concerns created by certain conservative people from both sects,'' he said. ''That is over now and things are getting back to normal, like they were before the fall of Baghdad. "

MA sues to overturn Defense of Marriage Act

When views begin to change on whether some transaction is repugnant, laws may start to conflict. California legalized same sex marriage, then reversed itself. And Massachusetts, the first state to legalize gay marriage, is suing to overturn Federal legislation passed under the Bush administration that defines marriage for certain federal purposes as being between a man and a woman.

Here's a story about the suit: Mass. is 1st to fight US marriage law, and here's the text of the suit itself. The introduction to the suit states in part:

"In 2004, the Commonwealth of Massachusetts became the first state to end the exclusion of same-sex couples from marriage. Since that time, more than 16,000 qualified and committed same-sex couples have married in Massachusetts and the security and stability of families has been strengthened in important ways throughout the state. Despite these developments, same-sex couples in Massachusetts are still denied essential rights and protections because the federal Defense of Marriage Act ("DOMA") interferes with the Commonwealth’s sovereign authority to define and regulate marriage. As applied to the Commonwealth and its residents, DOMA constitutes an overreaching and discriminatory federal law.
In this case, the Commonwealth challenges the constitutionality of Section 3 of DOMA, codified at 1 U.S.C. § 7. Section 3 of DOMA creates an unprecedented federal definition of marriage limited to a union between one man and one woman. Congress’s decision to enact a federal definition of marriage rejected the long-standing practice of deferring to each state’s definition of marriage and contravened the constitutional designation of exclusive authority to the states. From its founding until DOMA was enacted in 1996, the federal government recognized that defining marital status was the exclusive prerogative of the states and an essential aspect of each state’s sovereignty, and consistently deferred to state definitions when the marital status of an individual was used as a marker of eligibility for rights or protections under federal law.
Now, because of Section 3 of DOMA, married individuals in same-sex relationships are both denied access to critically important rights and benefits and not held to the same obligations and responsibilities arising out of marriage or based on marital status. DOMA precludes same-sex spouses from a wide range of important protections that directly affect them and their families, including federal income tax credits, employment and retirement benefits, health insurance coverage, and Social Security payments. In enacting DOMA, Congress overstepped its authority, undermined states’ efforts to recognize marriages between same-sex couples, and codified an animus towards gay and lesbian people.
Section 3 of DOMA applies to all federal laws retrospectively and prospectively. In so doing, it affects the Commonwealth in significant ways. First, DOMA interferes with the Commonwealth’s exclusive authority to determine and regulate the marital status of its citizens. Although the Commonwealth views all married persons identically, Section 3 of DOMA creates two distinct classes of married persons in Massachusetts by denying hundreds of rights and protections to married individuals in same-sex relationships. Second, Section 3 of DOMA imposes conditions on the Commonwealth’s participation in certain federally funded programs that require the Commonwealth to disregard marriages validly solemnized under Massachusetts law. DOMA’s sweeping scope exceeds the powers granted to Congress and violates the United States Constitution. "


Here's a thoughtful article on the general legal issue by Martha Nussbaum: A Right to Marry? Same-sex Marriage and Constitutional Law.
A small snippet of that long (and interesting) article:

"What we’re seeing today, as five states (Massachusetts, Connecticut, Iowa, Vermont, and, briefly, California) have legalized same-sex marriage, as others (California, and Vermont and Connecticut before their legalization of same-sex marriage) have offered civil unions with marriage-like benefits, and yet others (New York) have announced that, although they will not perform same-sex marriages themselves, they will recognize those legally contracted in other jurisdictions, is the same sort of competitive process—with, however, one important difference. The federal Defense of Marriage Act has made it clear that states need not give legal recognition to marriages legally contracted elsewhere. That was not the case with competing divorce regimes: once legally divorced in any other U. S. state, the parties were considered divorced in their own.But the non-recognition faced by same-sex couples does have a major historical precedent. States that had laws against miscegenation refused to recognize marriages between blacks and whites legally contracted elsewhere, and even criminalized those marriages. The Supreme Court case that overturned the anti-miscegenation laws, Loving v. Virginia, focused on this issue. Mildred Jeter (African American) and Richard Loving (white) got married in Washington, D. C., in 1958. Their marriage was not recognized as legal in their home state of Virginia. When they returned, there they were arrested in the middle of the night in their own bedroom. Their marriage certificate was hanging on the wall over their bed. The state prosecuted them, because interracial marriage was a felony in Virginia, and they were convicted. The judge then told them either to leave the state for twenty-five years or to spend one year in jail. They left, but began the litigation that led to the landmark 1967 decision.In 2007, on the fortieth anniversary of that decision, Jeter Loving issued a rare public statement, saying that she saw the struggle she and her late husband waged as similar to the struggle of same-sex couples today:
'My generation was bitterly divided over something that should have been so clear and right. The majority believed…that it was God’s plan to keep people apart, and that government should discriminate against people in love. But…[t]he older generation’s fears and prejudices have given way, and today’s young people realize that if someone loves someone they have a right to marry. Surrounded as I am now by wonderful children and grandchildren, not a day goes by that I don’t think of Richard and our love, our right to marry, and how much it meant to me to have that freedom to marry the person precious to me, even if others thought he was the “wrong kind of person” for me to marry. I believe all Americans, no matter their race, no matter their sex, no matter their sexual orientation, should have that same freedom to marry.' "

Black market for kidneys: in the US?

The recent arrest in NJ of an alleged international kidney broker may eventually shed some light on the question of how much paid kidney donation may be going on in the U.S. itself. Here's an AP story that raises the question:

Lax hospitals may be fostering kidney-selling
"A look-the-other-way attitude at some U.S. hospitals may be fostering a black-market trade in kidneys, transplant experts say. Some hospitals do not inquire very deeply into the source of the organs they transplant because such operations can be highly lucrative, according to some insiders. A single operation can bring in tens of thousands of dollars for a hospital and its doctors."
...
"Mark McCarren, a New Jersey federal prosecutor involved in the case, said Rosenbaum indicated that the transplants he brokered took place at more than one U.S. hospital and that the hospitals were duped and were not in on the scheme.
According to prosecutors, Rosenbaum was shockingly familiar with the U.S. system and how to beat it. Sellers and recipients would concoct stories about being relatives or friends to fool hospitals into thinking no money was changing hands, McCarren said."

How large a kidney black market exists in the U.S. is an open question. A suggestion that it might not be very large at all was made at a recent transplant conference I attended, by the eminent transplant nephrologist Gabriel Danovitch, who showed some data suggesting that the socioeconomic status distribution of unrelated donors looked a lot like that of related donors. The idea is that, if there were a lot of under the table payments being made, you would expect unrelated donors to be poorer and less educated and perhaps more foreign than related donors...

Here's an earlier post on the subject.

And (not really related) here is an episode of the Daily Show with Jon Stewart that, around minute 7, has a skit lampooning organ sales, immediately following the opening discussion of health care reform.

Job market for lawyers: is a recession changing the model?

Above the Law, a blog about the legal profession, reports on recent firing and hiring, and speculates whether this may be a leading indicator of a fundamental change in the way big law firms are organized: Cadwalader Is Hiring -- Kind Of


"Many regular Above the Law readers will remember that Cadwalader, Wickersham & Taft laid off nearly 100 attorneys, back before laying off attorneys became cool. More recently, the firm put 34 associates on an involuntary sabbatical.
Cadwalader is still willing to give jobs to the 34 people let go earlier this month. Contract jobs. Multiple sources inform us that CWT is trying to bring on a gang of contract attorneys. "
...
"For those of us who are not trying to calculate the fair market value of our self-respect, we have to ask if this Cadwalader program is a sign of things to come? Cadwalader was clearly one of the first firms to realize that layoffs needed to happen. Are they also one of the first firms to realize that the associate model is dead?
We could be moving to a place where law firms are populated by partners, a few choice associates, and a gang of contract attorneys that can be added or subtracted as work demands. Is Cadwalader going to lead the way to a new and slightly terrifying future? "

Law clerks for Massachusetts courts

One consequence of the poor economy is that Massachusetts courts have reneged on offers of judicial clerkships made to new law graduates. There is a proposal to fill these positions instead, for free, with other new law graduates who have been put on half pay and had their start dates delayed by Massachusetts law firms.
Law firms may provide clerks for courts: Proposal raises ethical issues

There is some concern that having employees of law firms clerking for judges might involve impropriety or its appearance. The proposed solution strikes me as unworkable:

"But because the issue raised ethical concerns, Mulligan recently asked the committee for its opinion about a special “double blind’’ arrangement.
The Flaschner Judicial Institute, which provides continuing education to state judges, would deal with the law firms that supply the interns. Judges and court officials would have no contact with the donating firms, and the firms would be instructed not to identify the interns on their websites. The interns would be barred from disclosing which firms are paying their stipends.
On June 8, the SJC’s ethics committee approved the arrangement, emphasizing that the clerks must keep the identity of their law firms secret even from the judges they are working for.
“Structuring the program in such a way that the law firms’ involvement is unknown not only to the public but also to the judges who will be ‘employing’ the volunteer interns will negate any impression that those law firms are in a special position to influence the judge,’’ said the committee’s opinion, which was reported last week by Massachusetts Lawyers Weekly.
“I give Chief Justice Mulligan credit for making the best of a very bad situation, and it appears that the double-blind method of hiring will protect the integrity of the court and eliminate appearances of impropriety,’’ said David W. White Jr., a former president of the Massachusetts Bar Association who worked as a Superior Court law clerk in the mid-1980s.
Still, the arrangement, which requires clerks to recuse themselves from participating in cases involving their firms without identifying the conflict of interest, is “really going to test the willpower of the volunteer clerks,’’ White said."

Here is some background on the perenially troubled market for law clerks, and here is some (now dated) background on the market for new associates at large law firms, from Roth and Xing (1994).

Rejecta Mathematica

Volume 1 number 1 of Rejecta Mathematica is out. It is a journal which publishes only papers that have been rejected by peer reviewed journals. Here is the inaugural letter from the editors:
"For those unfamiliar with our mission, Rejecta Mathematica is an open access, online journal that publishes only papers that have been rejected from peer-reviewed journals in the mathematical sciences. In addition, every paper appearing in Rejecta Mathematica includes an open letter from its authors discussing the paper’s original review process, disclosing any known flaws in the paper, and stating the case for the paper’s value to the community. "

Assisted suicide, Right to Die in England: new development

The long discussion in England about the circumstances in which assisted suicide will be prosecuted has moved a step forward with a ruling from the House of Lords:

'Right to die' campaigner Debbie Purdy wins House of Lords ruling

"Families who help terminally ill relatives to end their lives will be free from the risk of prosecution after a landmark ruling yesterday.
The Director of Public Prosecutions is to rush out urgent guidance to clarify the law after Debbie Purdy, a multiple sclerosis sufferer, won an historic judgment from the House of Lords.
The guidance will not remove the offence of assisted suicide under the Suicide Act 1961 but make the situation clearer for people who help relatives to die in circumstances of “compassionate” assisted suicide.
In their unanimous ruling, five law lords said that the DPP must issue a “custom-built” policy stating the circumstances that would lead him to prosecute in such cases, and those where he would not. It is the first time that the DPP has been asked by the courts to detail the circumstances under which he would prosecute. "
...
"To date, 115 people have travelled from Britain to a Swiss clinic to be helped to die. Eight cases have been referred to the DPP but no relatives have been prosecuted. However, the uncertainty has led some people to make their last journey alone, without family members, so as not to risk their being prosecuted, Lord Hope of Craighead, giving judgment yesterday, said. Others, he added, had given up the idea of assisted suicide and “been left to die what has been described as a distressing and undignified death”.
Sarah Wootton, chief executive of Dignity in Dying, said that the ruling would clear up “the current legal muddle”. She said: “A law which is not understood, enforced or supported by the majority of the public is not fit for purpose. The ruling distinguishes between maliciously encouraging someone to commit suicide and compassionately supporting someone’s decision to die, in order that these acts are treated differently. More and more people want choice about how they end their life. Yet, until now, the law has refused to say whether people would face prosecution for accompanying someone abroad to exercise this choice.”
This month, an amendment tabled by Lord Falconer of Thoroton to remove the threat of prosecution from those who go abroad to help the terminally ill to die was defeated by peers in the Lords sitting not as a court but as the second chamber of Parliament. "

Medieval market design

The International Congress on Medieval Studies has issued a call for papers (posted by Dan Ernst on the Legal History Blog):
"We welcome proposals for papers that explicitly link legal history with economic history in explaining the dynamics of medieval life and culture.
Here are some examples of possible topics:

"The canon law generated regulations concerning Usury, the Just price etc. during the "long" Twelfth Century. Meanwhile, secular laws sought to regulate markets (through laws on forestalling, regrating, engrossing, Assize of Bread and Ale etc.) and boosted those on coining offenses. This sustained attempt to restrain economic activity through law must be largely explicable from the context of economic change against which it was made. How might the Legal Revolution (the whole or any part) and the rising "Profit Economy" (Lester Little) be causally linked?"

My one attempt to study Medieval market design, in a paper on unravelling (with Xiaolin Xing), concerned forestalling (forestalling was the medieval crime of transacting before the official opening of a market). Our discussion can be found here. (The selection is short, and on rereading it I recall that I particularly enjoyed footnote 72, partly because of the name of one of the plaintiffs in the case it describes).

Kidney exchange: moving towards a national program

Kidney exchange, which works best with a thick market (lots of patient-donor pairs), is now moving towards experimenting with a national matching program: UNOS Currently Accepting Proposals for Kidney Paired Donation Pilot Program

"United Network for Organ Sharing (UNOS) is developing a national kidney paired donation (KPD) system. UNOS, as the OPTN contractor, will administer this system and it will be open to all OPTN/UNOS-approved transplant programs that perform living donor kidney transplants.
To help prepare for the final implementation, UNOS will begin an interim implementation of the KPD Pilot Program in September 2009. The interim implementation will allow UNOS staff to gain experience with KPD and refine its business processes before rolling out the full system in 2010. We will limit the interim implementation to two to four groups initially.
Any living kidney programs who would like to participate in the interim implementation must submit a proposal... by August 5, 2009.
A complete copy of the Request for Proposal (RFP), including details about who can participate, is available on the UNOS Web site. Learn more now "

Assisted suicide in England and Switzerland, continued

The British press continues to follow British citizens who choose to end their lives in Switzerland, where assisted suicide is legal. (In Britain, as in many if not most places, it remains a repugnant transaction: it's not a crime to attempt suicide, but it is a crime to assist.) In this case, one of the members of the couple who ended their lives was not terminally ill (although it sounds like his quality of life had been severely compromised): With Help, Conductor and Wife Ended Lives

"The controversy over the ethical and legal issues surrounding assisted suicide for the terminally ill was thrown into stark relief on Tuesday with the announcement that one of Britain’s most distinguished orchestra conductors, Sir Edward Downes, had flown to Switzerland last week with his wife and joined her in drinking a lethal cocktail of barbiturates provided by an assisted-suicide clinic."
...
"“After 54 happy years together, they decided to end their own lives rather than continue to struggle with serious health problems,” the Downes children said in their statement."
...
"“Even if they arrest us and send us to prison, it would have made no difference because it is what our parents wanted,” he said.
Attempting suicide has not been a criminal offense in Britain since 1961, but assisting others to kill themselves is. But since the Zurich clinic run by Dignitas was established in 1998 under Swiss laws that allow clinics to provide lethal drugs, British authorities have effectively turned a blind eye to Britons who go there to die.
None of the family members and friends who have accompanied the 117 people living in Britain who have traveled to the Zurich clinic for help in ending their lives have been charged with an offense. Legal experts said it was unlikely that that would change in the Downes case.
But British news reports about the Downes’ suicides noted one factor that appeared to set the case apart from most others involving the Dignitas clinic: Sir Edward appeared not to have been terminally ill. There have been at least three other cases similar to the Downes’, in which a spouse who was not terminally ill chose to die with the other. "

A subsequent story in the Times reveals changing sentiments: Huge public support emerges for the right to die

"Overwhelming public support for a change in the law to allow medically assisted suicide is revealed in a poll for The Times.
Almost three quarters (74 per cent) of people want doctors to be allowed to help terminally ill patients to end their lives. Support is particularly strong among those aged 55 to 64.
Six out of ten people also want friends and relatives to be able to help their dying loved ones to commit suicide without fear of prosecution.
Changing the law has always been opposed strongly by doctors, with two out of three against legalisation. But yesterday saw the first sign of change in the medical establishment. "

Corruption and kidneys in New Jersey and Brooklyn

The NY Times reports on a corruption investigation resulting in 44 arrests in New Jersey and Brooklyn: In New Jersey Case, Nervous Jokes and a Cereal Box of Cash

Almost as an aside, the story reports that a broker for transplant kidneys was caught in the net:

"Another man in Brooklyn, Levy-Izhak Rosenbaum, was accused of enticing vulnerable people to give up a kidney for $10,000 and then selling the organ for $160,000. Mr. Dwek pretended to be soliciting a kidney on behalf of someone and Mr. Rosenbaum said that he had been in business of buying organs for years, according to the complaint."

Part of the repugnance to the transaction seems to be the buying and selling prices. (Would we/should we feel differently if the kidneys were bought for $100,000 and sold for $115,000?)

Steve Leider points me to an Indiana Jones connection: Anthropologist's 'Dick Tracy moment' plays role in arrest of suspected kidney trafficker. (The anthropologist in question, Nancy Scheper-Hughes, writes frequently about black markets for kidneys, and apparently indentified Mr Rosenbaum some years ago, although the story doesn't suggest to me an immediate connection to the recent arrest.)

Parag Pathak points me towards Benyamin Cohen's story in Slate, following up on the Jewish connection: The arrests of rabbis who trafficked body parts uncover more complicated issues, that suggests some of the nuances of Jewish religious jurisprudence about organ donation and sales.

Trying to figure out Jewish law directly from the Bible skips a couple of centuries of subsequent interpretation. Here's what I wrote about kidney sales in a footnote of my paper Repugnance as a constraint on markets:

3 While there is no central authority on the application of Jewish law to modern concerns such as transplantation, the most authoritative opinions are contained in various “responsa” or answers to particular questions by rabbis acting as legal “deciders” (poskim), whose authority arises from the respect of their peers. The consensus on the matter of live kidney donation, for example, seems to be that live donation is allowed (since it saves lives), but it is not required (since the donor becomes wounded and takes some risk to his own life), and hence it falls into the category of things for which compensation could be offered and accepted (unlike actions that are either forbidden or required). See, for example, Eisenberg (2006), Grazi and Wolowelsky (2004), Kunin (2005), and Israeli (1997) who cite eminent modern poskim such as Rabbi Shlomo Zalman Auerbach and Rabbi Moshe Feinstein."

"For example, Avraham (2004, p. 271–2) reports the opinion of the eminent Rabbi Shlomo Zalman Auerbach that someone who sells a kidney with the intention of saving a life does a good deed “even if he would not have donated his kidney only to save life.” But he goes on to note, “[I ]n spite of all that has been said above, it seems to me that it is the community that needs soul-searching for allowing a person to reach such a depth of despair that he must sell a kidney, either because of poverty, debts, or the inability to pay for a relative’s medical expenses.”

Although mainstream Jewish authorities support organ donation, some streams of ultra-orthodox Judaism do not: here's a disturbing article brought to my attention by Miran Epstein, from Yediot: Heart recipient's father: We'll never donate organs
It goes on to note
"The father's words angered Prof. Yaacov Lavee, director of the Heart Transplantation Unit at the Sheba Medical Center. "This is outrageous," he said. "I've heard such statements from many of my candidates (for a transplant), who weren't ashamed to admit they wouldn't donate organs.
"Such statements led me to initiate the bill that prioritizes transplants for people who have signed an organ donor card. This is clearly immoral behavior," he added.
The new transplant law, which will go into effect in May, states that any person in need of a transplant and who has had an organ donor card for at least three years will be given priority on the organ transplant waiting list. "

This makes some aspects of Israeli transplant law resemble parts of Singapore's transplant law, which also gives priority for organs to those who are registered as donors. (I wrote about this near the end of an earlier post.)

Update: Sally Satel's take is in the WSJ: About That New Jersey Organ Scandal It’s not surprising when 80,000 Americans are waiting for kidneys, and a background piece from Time magazine: How Does Kidney-Trafficking Work?

House flipping fraud in Florida

I received the following email from Eric Budish, the Chicago market designer:

"I came across a neat investigative journalism feature on a form of mortgage fraud called “house flipping” .

The newspaper reviewed 19mm Florida real-estate transactions, and found that 50,000 involved appreciation of 30%+ in less than 90 days. They investigate one fraud circle in depth, and have features on the local police, lenders, etc.

What makes the fraud tick is that the buyer can finance at the new price. So if A legitimately buys a house for 100, then immediately sells it to his buddy B for say 150, B can get a mortgage against the 150 (especially if his buddy C is a real-estate appraiser). Even if B makes a small down payment on the 150, together A and B have extracted 50 minus downpayment minus fees in cash from the transaction. B never intends to repay the 150, and B’s mortgage lender is severely under collateralized.

The reason I think this is all so interesting is that the fraud is only possible because houses are idiosyncratic, but not too idiosyncratic. If houses were perfect substitutes, then A, B and C couldn’t trick the mortgage lender about house values (50,000 flips is a lot, and likely an underestimate, but still less than 1% of transactions). If houses were substantially more idiosyncratic, then banks would never have gotten in the habit of financing 90%+ of the purchase price in the first place: in the event of foreclosure they’d have to worry about whether the right types of buyers would be in the market. Put differently, the housing market is not too thick, but not too thin."

Is fish-tossing repugnant?

Fishmongers in Seattle throw dead fish around the market, and it has apparently become not just a way of handling fish for sale, but a form of entertainment.

"Jeremy Ridgway, one of the managers at the market, said that he has done fish shows for the ministry of manpower in Singapore, for schoolchildren in Oklahoma and at countless other venues."

One of those other venues was a meeting in Seattle of the American Veterinary Medical Association, which decided to go ahead with "a plan to host a team-building program offered by the famous fish-throwers of Seattle's Pike Place Fish Market."

The organization People for the Ethical Treatment of Animals (PETA) finds this repugnant, and thinks such events should not be conducted.

Judge for yourself: Seattle's Pike Place fishmongers under fire .

Fly fishing

I spent last weekend in Jackson Hole Wyoming at a transplant conference. My friend Owen Phillips, the U. of Wyoming experimental economist who I first met when he visited Harvard in 2005, invited me to go fly fishing with him the next day. He hired a well recommended fishing guide, Mickey Brockman.

Fishing guides are licensed by the state, and work as subcontractors for businesses that hold outfitters' licenses (in Mickey's case, Westbank Anglers). So the arrangement is a bit like taxi drivers in cities where legal cabs require taxi medallions, except that fishing guides use their own equipment. Mickey's equipment includes a dory, which he rows facing forward, and a variety of fishing gear, including the barbless hooks that allow you to release the fish quickly after catching it. (He also packed lunch, which we ate looking up at the Grand Tetons, which sounds even better in French.)

Owen and I presented Mickey with a complicated task, since Owen is an expert angler with a lifetime of experience, and I was holding a fly reel for the first time. So, Mickey had to teach me the mechanics of casting, while keeping up a running list of likely targets for Owen to aim at.

It was an experience, and if you're in Jackson Hole and can't get Owen to take you, I certainly recommend Mickey.

(Thanks, Owen.)

To make the story long, we finished the day eating elk at Stiegler's (also recommended), which got us thinking about the market for elk: it turns out they are farm raised.

From Jackson Hole I flew to Stony Brook, Long Island, for a game theory conference. That tells you something about medicine and economics...