Los Altos High School STEM Week. Oct 25-27

Here's the program for the Los Altos High School STEM week.
I'll be speaking Wednesday morning.

New York City high school admissions, signaling 'demonstrated interest,' in The Atlantic

High school admissions in NYC may end with a (well designed) deferred acceptance algorithm, but the process starts long before students and some schools submit their preference lists. The Atlantic writes about how it is hard to form preferences over high schools, and to signal them to the schools through 'demonstrated interest'...

Broken Promise of New York City's High-School Admissions System
Its high-school fair is designed to give attendees a leg up in the application process—but that’s not always the case
(The URL is more informative than the headline:  http://www.theatlantic.com/education/archive/2016/10/the-broken-promise-of-demonstrated-interest/503168/ )

Raj Chetty at the LSE: How Can We Improve Economic Opportunities for Low-Income Children?

Lionel Robbins Memorial Lecture Series

How Can We Improve Economic Opportunities for Low-Income Children?

Date: Monday 24th, Tuesday 25th and Wednesday 26th October 2016
Time: 18:30 - 20:00
Venue: LSE Old Theatre
Speaker: Professor Raj Chetty

In this series of lectures, Raj Chetty will discuss findings from the Equality of Opportunity Project, which uses big data to develop new answers to this important and timely policy question. The presentation will show how children's opportunities to climb the income ladder vary substantially depending upon where they grow up.It will then identify factors that contribute to this geographic variation in opportunities for upward mobility. The talks will conclude by offering policy lessons for how social mobility and economic opportunity can be increased in the next generation.

Lecture 1: The Geography of Intergenerational Mobility
(Chair: Prof. Steve Machin, CEP Director)
Lecture 2: Policies to Improve Upward Mobility
(Chair: Prof. Robin Burgess, IGC & STICERD, LSE)
Lecture 3: Upward Mobility, Innovation, and Economic Growth
(Chair: Prof. Henrik Kleven, CEP, IGC & STICERD, LSE)

About the speaker: Raj Chetty is a Professor of Economics at Stanford University. His research combines empirical evidence and economic theory to help design more effective government policies. His work on tax policy, unemployment insurance, and education has been widely cited in media outlets and Congressional testimony.

This event is free and open to all with no ticket or pre-registration required. Entry is on a first come, first served basis

For more information on how to attend, please visit the LSE Events office webpage at:

Monday:http://www.lse.ac.uk/publicEvents/events/2016/10/20161024t1830vOT.aspx
Tuesday:http://www.lse.ac.uk/publicEvents/events/2016/10/20161025t1830vOT.aspx
Wednesday:http://www.lse.ac.uk/publicEvents/events/2016/10/20161026t1830vOT.aspx

Airbnb faces regulatory headwinds in NY

The FT has the story:
Airbnb faces fight for survival in New York City
Governor set to sign legislation likely to end start-up’s business in Big Apple


"The online service, which connects owners of homes and flats with tourists and other renters in cities around the world, has often clashed with regulators which accuse the company of facilitating illegal hotel businesses and reducing affordable housing stock.

In New York, hotel unions and New York City officials have been particularly vociferous on the company’s failure to comply with a 2010 accommodation law that banned short-term rentals in Manhattan, but which is rarely enforced.

On Wednesday, Airbnb said that it wanted to pay taxes in New York, estimating that it could generate about $90m a year in the state under its new registration scheme. The company also proposed a new “three strikes” rule that would permanently ban hosts who broke the 2010 law more than three times.

The company has already reached agreements on collecting and remitting taxes with many other cities, including Paris, its largest market. In New York City, Airbnb hosts 46,000 flats and homes.

Like other such Silicon Valley start-ups that have disrupted traditional business models, Airbnb has been forced, often through confrontation, to become more responsive to local regulators and interest groups as it expands."
*********

And, after the governor signed the bill,
Airbnb Sues Over New Law Regulating New York Rentals
"Hours after Gov. Andrew M. Cuomo of New York signed a bill that would impose steep fines on Airbnb hosts who break local housing regulations, Airbnb filed a federal lawsuit contending the new law would cause it “irreparable harm.”

The heightened battle in New York follows lawsuits that Airbnb has filed against its hometown San Francisco and in Santa Monica, Calif., which have both moved to fine the company for illegal listings.

The company, which operates in a regulatory gray area around the globe, is also fighting tough battles in Amsterdam and Barcelona, Spain, which penalizes hosts who list illegal rentals, and in Berlin, which has banned most short-term rentals."

Soros on refugee resettlement as a matching problem

 George Soros on refugees, earlier this summer:
This is Europe’s Last Chance to Fix Its Refugee Policy
Foreign Policy Magazine, Jul 19, 2016

"Fifth, once refugees have been recognized, there needs to be a mechanism for relocating them within Europe in an agreed way. It will be crucial for the EU to fundamentally rethink the implementation of its stillborn resettlement and relocation programs; a tentative step in this direction was taken last week in new proposals put forth by the European Commission. The union cannot coerce either member states or refugees to participate in these programs. They must be voluntary; a matching scheme could elicit preferences from both refugees and receiving communities so that people end up where they want to be and where they are welcome. EASO has begun to develop such a matching scheme."

A somewhat shorter summary of his whole argument is here:
Saving Refugees to Save Europe

China, transplants, and executed prisoners: is the situation getting clearer?

A recent meeting in China cautiously suggests that there may be some concrete change in the practice of transplanting organs from executed prisoners:
Doctors hail China’s pledge to stop harvesting inmate organs

"Doctors from the World Health Organization and the Montreal-based Transplantation Society who were invited to the conference by China praised Chinese officials for reforms they have made in the transplant system, including a ban put in place last year on using organs from executed inmates.

"Doubts persist that China is accurately reporting figures or meeting its pledge given its severe shortage of organ donors and China’s long-standing black-market organ trade. By its own figures, China has one of the lowest rates of organ donation in the world, and even the system’s advocates say it needs hundreds of additional hospitals and doctors.

"While China suppresses most discussions about human rights, government officials and state media have publicly talked about their commitment to ending a practice opposed by doctors and human rights groups due to fears that it promotes executions and coercion.
...
"Others offered praise for Chinese officials, but stopped short of saying whether they could confirm China had stopped using executed inmates’ organs.

“It’s not a matter for us to prove to you that it’s zero,” said Dr. Francis Delmonico, a longtime surgeon and a professor at Harvard Medical School. “It’s a matter for the government to fulfill what is the law, just as it is in the other countries of the world that we go to.”

"China is believed to perform more executions than any other country, though the government does not disclose how many.

"The former vice minister of health, Dr. Huang Jiefu, publicly acknowledged in 2005 that China harvested executed inmates’ organs for transplant, and a paper he coauthored six years later reported that as many as 90 percent of Chinese transplant surgeries using organs from dead people came from those put to death.

"Huang has also responded to a report earlier this year that a Canadian patient apparently received a kidney from an executed inmate by announcing that the doctor and the hospital in question were suspended from performing more transplants."

Normative Ethics and Welfare Economics at HBS, and Behavioral Ethics, also at HBS (at the same time:)

There are two (competing) conferences on ethics at Harvard this weekend, one on Friday and Saturday and the other on Friday, both at HBS.

I'll be speaking at this one:

2016 Normative Ethics and Welfare Economics Conference

October 21-22, Harvard Business School

Organizers: Itai Sher and Matt Weinzierl

All sessions will take place in the Chao Center, room 340

Transportation to the HBS campus from the Hyatt Regency Cambridge Hotel will be provided.

Oct 21

A Harvard University shuttle bus will depart the Hyatt at 8:00 am

8:15-8:45	Breakfast
8:45-9:00	Opening Remarks
9:00-10:30	Population Ethics Partha Dasgupta and Johann Frick Discussant: Glen Weyl Papers: Birth and Death Socially Embedded Preferences, Environmental Externalities, and Reproductive Rights
10:30-11:00	Break
11:00-12:30	Reasons and Preferences Justin Snedegar and Itai Sher Discussant: Caspar Hare Papers: Overlapping Reasons Comparative Value and the Weight of Reasons
12:30-2:00	Lunch
2:00-3:30	Public Reason Matt Weinzierl and Sean Ingham Discussant: Lucas Stanczyk Papers: A Dilemma for Theories of Public Reason A Welfarist Role for Nonwelfarist Rules: An Example with Envy
3:30-4:00	Break
4:00-5:30	Forbidden Transactions Michael Sandel and Al Roth Discussant: Stefanie Stantcheva
5:30-6:00	Break
6:00-8:30	Dinner for Speakers & Discussants Location TBA Transportation will be provided.

Oct 22

A Harvard University shuttle bus will depart the Hyatt at 8:00 am

8:30-9:00	Breakfast
9:00-10:30	Business Ethics Rebecca Henderson, Karthik Ramanna, and Wayne Norman Discussant: Nien-hê Hsieh Papers: Business Ethics, Democratic Theory, and the Regulatory State: Merriment & Diversion when Regulators and the Regulated Meet? Business Ethics Do managers have a role to play in sustaining the institutions of capitalism?
10:30-11:00	Break
11:00-12:30	Behavioral Economics and Welfare Economics John Doris, Julia Haas, and Dan Benjamin Discussant: Ben Lockwood Papers: Moral Psychonomics Reconsidering Risk Aversion
12:30-1:30	Lunch​​
1:30 - 3:00	Prioritarianism Matthew Adler and Hilary Greaves Discussant: Jerry Green Papers: Justice, Claims and Prioritarianism: Room for Desert? Antiprioritarianism
3:00-3:30	Break
3:30-5:00	Closing Panel Marc Fleurbaey, Dan Hausman, Greg Mankiw, Tim Scanlon Moderator: Nathan Hendren
	Adjourn

************************
It turns out that there is a lot of interest in ethics at Harvard, and so there is another ethics conference at the same time, also meeting at HBS:

Symposium - "Behavioral Ethics: Philosophical and Psychological Perspectives" Featuring Peter Singer

Date: 

Friday, October 21, 2016 (All day)

See also: Ethics

Location: 

Spangler Auditorium, Harvard Business School

Organizers: Max Bazerman and Joshua Greene

Sponsors: Edmond J. Safra Center for Ethics, Harvard Business School, Center for Public Leadership at Harvard Kennedy School

This symposium will integrate psychology and philosophy to explore a goal state for ethical behavior, why we fail to achieve that goal state, and what society can do create more ethical behavior.

Event Participant Bios

9:30 a.m. - 10:00 a.m.
Welcome
Danielle Allen and Max Bazerman

10:00 a.m. - 12:00 p.m.         
What does the greatest good look like in contemporary society?
Peter Singer, "What is the Most Good We Can Do?"

Joshua Greene, TBD

Steven Pinker, “Measuring and Defining Progress”

12:00 p.m. - 1:00 p.m.           
Lunch Break

1:15 p.m. - 2:45 p.m.             
Why don’t we get there?
Mahzarin Banaji, "The Difficulty with Discretion"

Fiery Cushman, “Is Non-Consequentialism a Feature or a Bug?”

Michael Norton, "Spreading the Wealth (and Health): Evidence for a Universal Desire for Greater Equality"

3:00 p.m. - 4:30 p.m.
What can be done to change behavior (nudging and beyond)?
Francesca Gino, “To Do or Not To Do: Motivating Ethical Behavior”

Iris Bohnet, "Gender Equality by Design"

Max Bazerman, "Prescriptions for Creating Greater Good"

4:30 p.m. - 4:45 p.m.             
Closing Statement
Max Bazerman

Foreign students recruited to Canadian Universities

Inside Higher Ed reports on concerns that universities' eagerness for high tuition payments is leading to unqualified students are being recruited:
Corruption in Higher Ed: Canada in the Crosshairs
It is overwhelmingly evident that there is a remarkable and callous disregard for academic ethics and standards in a scramble by Canadian universities to sign up foreign students.

"It is overwhelmingly evident that in the last two decades we have witnessed first-hand a remarkable and callous disregard for academic ethics and standards in a scramble by Canadian universities and colleges to sign up foreign students, who represent tens of millions of dollars to their bottom lines.
We have been in a school auditorium in China and listened to the school owner tell prospective parents that the Grade 12 marks from the Canadian provincial school board program can be manipulated to secure admission for their children into Canadian universities. This, while the Canadian teachers sat oblivious to the presentation in Chinese.
In hundreds of our own interaction with students who completed the Canadian provincial school board’s curriculum in China and who achieved grades of 70% and higher in their English class have been unable to achieve even a basic level of English literacy in the written tests we have administered.   But when the largest country of origin for incoming international students and revenue is China - the Canadian universities admitting these students salivate over the dollars and focus less on due diligence.
We were once asked by a university on Canada’s west coast to review 200 applications from Saudi Arabia, in order to identify the two or three Saudi students who were actually eligible for conditional admission to that university's undergraduate engineering program. But the proposal was scuttled by the university's ESL department that wanted all 200 to enroll in its language courses. It insisted on and managed conditional admissions for all 200. It’s common at Canadian universities for the ESL program “tail” to wag the campus “dog” when it comes to admissions. In fact, recent Canadian government regulations have been proposed to crack down on this practice as it is an affront to academic integrity."

Organ donation rates in Canada

http://www.cbc.ca/news/health/organ-donation-1.3755193

"Despite the progress, Canada lags behind "top-tier" countries such as the U.S. and Spain, where deceased donation rates exceed 30 donors per million population. Canada's rate currently stands at 18.2 donors per million population, up from 14.1 for that measure in 2006.

Spain fostered a culture of donation over three decades and Canada is now embarking on creating one, said Dr. Peter Nickerson, vice-dean of research at the University of Manitoba and a medical adviser to CBS.

About 21 per cent of donations come after cardiac death, said Kimberly Young, director of donation and transplantation at CBS. Before those programs were implemented, most deceased organ donations occurred after catastrophic brain injury. Now organs can be donated after the heart stops.

Young also acknowledged the hundreds of Canadians who've chosen to become living donors, many without ever knowing the recipient.

The living donation rate hasn't increased in the past decade, Young said. One of the reasons it hasn't decreased, as in some countries, is due to the national paired kidney donation program. It pairs compatible donors, including those in different parts of the country. Doctors consider kidney donations the best treatment for end-stage kidney disease.

Lung transplants are in the top tier of comparable wealthy countries, thanks to pioneering research at lung retrieval centres such as Toronto General Hospital, Nickerson said. Likewise, liver donation rates are high. Heart access is relatively equal, he said.

There have also been significant improvements in access to transplants among those who have the hardest time finding a donor match because of a highly sensitive immune system. "

Who Gets What and Why, in Korean

Here is the Korean translation of my book Who Gets What and Why:

Who Gets What-and Why in Korean

Eun Jeong Heo tells me that the title in Korean is "Matching: a strong drive to uncover hidden markets"

Eun Jeong points me to these two URL's where you can buy the book:

http://www.kyobobook.co.kr/product/detailViewKor.laf?ejkGb=KOR&mallGb=KOR&barcode=9788952777171

and
http://www.yes24.com/24/goods/30659143?scode=032&OzSrank=1

Two papers on repugnance and payments for body parts

Here's an NBER paper by Nicola Lacetera, which includes this in the acknowledgments: "I dedicate this paper to the memory of my friend Julia Fletcher, whose life could have been longer if a bone marrow match were found for her."

Incentives and Ethics in the Economics of Body Parts

Nicola Lacetera

NBER Working Paper No. 22673
Issued in September 2016
NBER Program(s):   HE      PE 

Research shows that properly devised economic incentives increase the supply of blood without hampering its safety; similar effects may be expected also for other body parts such as bone marrow and organs. These positive effects alone, however, do not necessarily justify the introduction of payments for supplying body parts; these activities concern contested commodities or repugnant transactions, i.e. societies may want to prevent certain ways to regulate a transaction even if they increased supply, because of ethical concerns. When transactions concern contested commodities, therefore, societies often face trade-offs between the efficiency-enhancing effects of trades mediated by a monetary price, and the moral opposition to the provision of these payments. In this essay, I first describe and discuss the current debate on the role of moral repugnance in controversial markets, with a focus on markets for organs, tissues, blood and plasma. I then report on recent studies focused on understanding the trade-offs that individuals face when forming their opinions about how a society should organize certain transactions.

******

And here's another, by Julio J. Elias, Nicola Lacetera, and Mario Macis

Efficiency-Morality Trade-Offs in Repugnant Transactions: A Choice Experiment

Julio J. Elias, Nicola Lacetera, Mario Macis

NBER Working Paper No. 22632
Issued in September 2016
NBER Program(s):   HE   LE   PE 

Societies prohibit many transactions considered morally repugnant, although potentially efficiency-enhancing. We conducted an online choice experiment to characterize preferences for the morality and efficiency of payments to kidney donors. Preferences were heterogeneous, ranging from deontological to strongly consequentialist; the median respondent would support payments by a public agency if they increased the annual kidney supply by six percentage points, and private transactions for a thirty percentage-point increase. Fairness concerns drive this difference. Our findings suggest that cost-benefit considerations affect the acceptance of morally controversial transactions, and imply that trial studies of the effects of payments would inform the public debate.

A look into how transplant centers are monitored (and organs are allocated)

Here's a press release saying that the University of Pittsburgh's iconic transplant center has been taken off probation by UNOS. The reason they were on probation is interesting:
University of Pittsburgh Medical Center released from probation

"The Board had placed UPMC on probation in June 2015. Its lung transplant program had an unusually high number of instances where they accepted lung offers for one transplant candidate, then transplanted another candidate at the program. This inappropriately limited opportunity for consideration of other candidates identified on the match run."

A kidney donor at 18 who is now a medical student feels he didn't give sufficiently informed consent (and some reactions)

Here's the story in the Washington Post: At 18 years old, he donated a kidney. Now, he regrets it.

"Five years after the surgery, when I was 23 and getting ready to go to medical school, I began working in a research lab that was looking at kidney donors who had gone on to develop kidney failure. For that research, I talked to more than 100 such donors. In some cases, the remaining kidneys failed; in others, the organ became injured or developed cancer. The more I learned, the more nervous I became about the logic of my decision at age 18 to donate.

"And then in 2014, a study looking at long-term risks for kidney donors found that they had a greater risk of developing end-stage renal disease. Another study that same year raised the possibility that they may face a heightened risk of dying of cardiovascular disease and all-cause mortality (although this point remains controversial).

"Other studies and surveys, though, suggest that the risk, while greater, isstill fairly small.

"The truth is, it is hard to get good numbers about what happens to donors. Hospitals are required to follow them for only two years post-donation, which does not catch such long-term complications as chronic kidney disease, cardiovascular issues or psychiatric issues. There is no national registry for kidney donors or other large-scale means of tracking long-term outcomes."

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

Here are some responses posted on Trio (TRANSPLANT RECIPIENTS INTERNATIONAL ORGANIZATION)

Response to living kidney donation regret Washington Post news story

CATEGORIES // General Interest, UNOS News

A recent news story appearing in the Washington Post talked about an 18 year old living kidney donor's concerns and regret for that donation.  In a response to that, TRIO board member, Josh Morrison, offers his own thoughts on that concern based on his altruistic living kidney donation.  Photo is of Josh and his unrelated recipient, John, whose story is shared in Josh's article linked below (along with a link to the original 'regret' story).

RELATED ARTICLES

• The original 'concern &regret' Washington Post story
• Josh's response article  (Almost all kidney donors are proud, like me. So why did one negative story go viral? Updated by Josh Morrison Oct 11, 2016
• Letter to the Editor by another 'no regrets' living donor  (I donated a kidney. I have no regrets.)

*********

Here's a different take on nondirected donation (and the resulting chains...)

These six people donated their kidneys to complete strangers and saved 140 lives in the process — here’s why

Nondirected donor kidney exchange chains come to the UK

In the U.S., many kidney exchange transplants now occur in chains begun by nondirected donors. Rule changes in Britain may allow transplants to increase this way too

Progress is being made in kidney exchange in the UK. The Mirror has the story:
Kidney 'triple transplant chain' rule change brings hope to thousands and has already saved 48 people

"Rule changes last year mean more healthy kidneys are available – bringing fresh hope to ­thousands of patients on the waiting list.

"From April 2015, it became possible for a stranger to give up a kidney and spark a series of donations. We have discovered that for each of 16 such donations, three people received a transplant.

"Previously, the chain was limited to two people who were in the National Living Donor Sharing Scheme, set up to allow pooling of organs from willing donors not a match for their own sick loved ones.

"Under triple transplant chains, a stranger’s kidney is allocated to the first recipient, a patient who is enrolled in the sharing scheme.

"In turn, the first recipient’s friend or relative, who wants to donate to their loved one but cannot because they are not a match, donates to another patient in the scheme, the second recipient.
...
"Any adult can ­volunteer to be ­considered an altruistic donor. You must be over 18 in England, Northern Ireland and Wales, and over 16 in Scotland.

The 16 Brits who gave their kidneys to patients they did not know first had several months of physical and psychological tests at their local transplant centre to ensure they were able to safely donate, and to confirm which recipients would be a suitable match."

Are promises made to living donors being upheld?

Here's a press release from the American Society of Nephrology on a forthcoming article:
Are promises made to living donors being upheld?

• Most prior living kidney donors in the United States who later need a transplant receive one quickly, but some are not readily given the priority they were promised when they donated.
• About 40 to 50 prior living donors in the United States are added to the kidney waiting list each year, and more than 130,000 living kidney donors have donated over the past several decades.

Washington, DC (September 1, 2016) -- A new study finds some shortcomings by the transplant community in providing prompt access to transplantation for living kidney donors who later develop kidney disease and need a transplant. Donors are told that they will have priority for transplantation if they ever need a kidney, so any delays in providing this access must be addressed. The study's results appear in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN).

Jennifer Wainright, PhD (United Network for Organ Sharing, or UNOS) and her colleagues examined how consistently living donors get transplant priority in a timely fashion, using information from the Organ Procurement and Transplantation Network (OPTN), which includes data on all donors, wait-listed candidates, and transplant recipients in the United States. UNOS is the private, non-profit organization that manages the nation's organ transplant system under contract with the federal government..

Among the major findings:

• There were 210 prior living donors added to the OPTN kidney waiting list between January 1, 2010 and July 31, 2015.
• As of September 2015, 167 of the donors received deceased donor transplants, 6 received living donor transplants, 2 died, 5 were too sick to transplant, and 29 were still waiting.
• Median waiting time to receive a deceased donor transplant for prior living donors was 98 days.
• Only 40.7% of the donors were listed before they began dialysis; 68.3% were in inactive status, which means they were not eligible for organs, for <90 1-2="" 17.6="" 5.4="" 8.6="" 90-365="" and="" days="" for="" years="">2 years.
• Median time for prior living donors waiting in active status before receiving priority was 2 days; 67.4% received priority within 7 days after activation, but 15.4% waited 8-30 days, 8.1% 1-3 months, 4.1% 3-12 months, and 5.0% waited >1 year in active status for priority.
• After receiving priority, most were transplanted quickly, and the median time in active status with priority before deceased donor transplant was 23 days.

"We found that most prior living kidney donors on the kidney waiting list are transplanted quickly, but some spend periods of time waiting in inactive status. Others wait weeks or months on the waiting list without priority access, which must be requested by their transplant hospital," said Dr. Wainright. "UNOS has developed procedures and education that aims to reduce these delays in the future."

************
HT: Philip Held

John F. Nash, Jr.'s 1994 Nobel Prize in Economic Sciences medal and memorabilia: Auction at Sotheby's

 Here's the auction page:
John F. Nash, Jr.'s 1994 Nobel Prize in Economic Sciences 
17 OCTOBER 2016 | 2:00 PM EDT | NEW YORK,
Estimate  2,500,000 — 4,000,000  USD.

There are some essays and paragraphs from colleagues and relatives at the auction link.
Here's a 3 minute video from Sotheby's, advertising the auction...

***************
Update:
I'm guessing that this results page means that the auction closed without a sale (perhaps because the reserve price was not reached...):
http://www.sothebys.com/en/auctions/results.results.sale.pdf/2016/john-f-nash-jrs-1994-nobel-memorial-n09586.pdf

JOHN F. NASH, JR.'S 1994 NOBEL PRIZE IN ECONOMIC SCIENCES October 17, 2016 Sale Number N09586 Sale Total (Including Buyer's Premium) 0 USD

Hart and Holmstrom 2016! Congratulations to Oliver and Bengt:)

https://www.nobelprize.org/nobel_prizes/economic-sciences/laureates/2016/

Family consent to deceased donation remains a concern in Britain

The Guardian has the story
Organ donation rates for transplants still too low in UK, says NHS
Consent rate one of lowest in Europe, with black, Asian and ethnic minority communities of particular concern

"A record number of organs were donated and transplanted in the UK in 2015-16 but the consent rate is still one of the lowest in Europe, with a worrying shortfall of donors from black or Asian communities.

In the 12 months to the end of March, 1,364 people became organ donors when they died and their donations resulted in 3,519 transplants taking place, figures published on Thursday show.

The consent rate stood at 62%, slightly up on 2012-13 when it was 57%, but well short of the target of 80% by 2020 with the biggest obstacle being family refusal, mostly when they were unaware of their deceased relative’s intentions.

The consent rate was much lower (34%) among potential black, Asian and minority ethnic (BAME) donors, which is of particular concern as 26% of the current waiting list are BAME."

More on kidney black markets in India

Top Indian Hospital Complicit In Lucrative Black Market for Human Organs

"Five doctors from one of India’s most distinguished hospitals were charged ... with performing illegal kidney transplants connected to an organ harvesting ring.

"The doctors, including a medical director and a chief executive, worked out of the prestigious L.H. Hiranandani Hospital in Mumbai. The trafficking racket was discovered in July after police were tipped off by poor villagers from Gujarat state who sold their kidneys.
...
"Unrelated donors can donate organs if the government confirms that no money has changed hands in the transaction. People can also source organs from cadavers or brain-dead patients, with the family’s permission, but these options are not common.
...
"A similar ring was broken up in June at the Indraprastha Apollo Hospital in New Delhi. Handlers at Indraprastha forged documents to show that recipients were related to donors. In reality, donors were paid about 300,000 Rupees (roughly $4,500) for their kidneys, which were then resold at a high profit.

*********

see earlier post:

Tuesday, June 21, 2016

Kidney black market arrests at Apollo hospital in Delhi

Drug deaths and deceased organ donors

Traffic accidents are down, but drug deaths are up, not just in total numbers but among deceased organ donations. ("Hypoxia" has entered my vocabulary in the last year...)
The NY Times has a story:
As Drug Deaths Soar, a Silver Lining for Transplant Patients

"As more people die from overdoses than ever before, their organs — donated in advance by them or after the fact by their families — are saving lives of people who might otherwise die waiting for a transplant.
...
"So far this year, 69 people in New England who died from an overdose have donated their organs, according to the New England Organ Bank. They account for 27 percent of all donations in the region, up sharply from 2010, when eight donors, or 4 percent, were drug users.

Because doctors can use multiple organs from each person, these 69 deceased drug users saved the lives of 202 other people, according to the organ bank.

Nationwide, more than 790 deceased drug users have donated organs this year, accounting for about 12 percent of all donations. That is more than double the 340 drug users who donated in 2010, or about 4 percent of the total, the organ bank said.

“It’s an unexpected silver lining to what is otherwise a pretty horrendous situation,” said Alexandra K. Glazier, chief executive of the New England Organ Bank, which procures organs for transplant in the six New England states and Bermuda.

Drug users have long been considered high risk because they often carry diseases like H.I.V. or hepatitis C. But at a time of a severe organ shortage, the volume of organs available from overdose deaths has led transplant centers to try to use them instead of throwing them away. With rigorous screening, officials say, the risk of transplanting an infected organ is small. Moreover, they say, hepatitis C can be treated if not cured and H.I.V. made manageable. Either is usually preferable to death.

“We know now that the mortality rate of being on the waiting list for several years is higher than that of getting an organ with an infection that is treatable,” said Dr. Robert Veatch, a professor emeritus of medical ethics at Georgetown University, who has written extensively about organ transplants.
...
"Transplants were initially associated with deaths from car accidents, which is why organ donors are noted on driver’s licenses. But overdoses (47,000 in 2014) have surpassed car crashes (32,000 in 2014) as the leading cause of accidental death in the United States. The growing numbers of overdoses from synthetic opioids like fentanyl and carfentanil have only heightened the drug toll.

Drug users are now the fastest-growing category of donor. They rank fourth, behind donors who died of strokes, blunt injuries and cardiovascular problems.

But even as drug users are making a life-or-death difference for some recipients, the need for organs remains vast.

There are 120,000 people on the national wait list for transplants. While 85 people receive one every day, 22 others die every day before a match is found.

One advantage of drug users as donors is that they tend to be younger and healthier than other donors, said Dr. David Klassen, chief medical officer for the United Network for Organ Sharing, which administers the nation’s organ procurement network.
...
"Dying of an overdose, which usually occurs when oxygen cannot reach the brain, does not affect kidney function or other organs. The drugs and blood are flushed from the organs when they are removed from the body."