Tuesday, November 6, 2012

Physician assisted suicide on the ballot today in MA

On the ballot today in MA (where I'm no longer voting, since our move) is a proposition (Question 2) that would allow physician assisted suicide for some terminally ill patients. Another would decriminalize medical marijuana.  (If I were still living in MA I would vote for both; instead I get to vote in CA to raise my taxes...also a repugnant transaction in a way...)


Here's the question on the ballot:


This proposed law would allow a physician licensed in Massachusetts to prescribe medication, at a terminally ill patient’s request, to end that patient’s life. To qualify, a patient would have to be an adult resident who (1) is medically determined to be mentally capable of making and communicating health care decisions; (2) has been diagnosed by attending and consulting physicians as having an incurable, irreversible disease that will, within reasonable medical judgment, cause death within six months; and (3) voluntarily expresses a wish to die and has made an informed decision. The proposed law states that the patient would ingest the medicine in order to cause death in a humane and dignified manner.
The proposed law would require the patient, directly or through a person familiar with the patient’s manner of communicating, to orally communicate to a physician on two occasions, 15 days apart, the patient’s request for the medication. At the time of the second request, the physician would have to offer the patient an opportunity to rescind the request. The patient would also have to sign a standard form, in the presence of two witnesses, one of whom is not a relative, a beneficiary of the patient’s estate, or an owner, operator, or employee of a health care facility where the patient receives treatment or lives.
The proposed law would require the attending physician to: (1) determine if the patient is qualified; (2) inform the patient of his or her medical diagnosis and prognosis, the potential risks and probable result of ingesting the medication, and the feasible alternatives, including comfort care, hospice care and pain control; (3) refer the patient to a consulting physician for a diagnosis and prognosis regarding the patient’s disease, and confirmation in writing that the patient is capable, acting voluntarily, and making an informed decision; (4) refer the patient for psychiatric or psychological consultation if the physician believes the patient may have a disorder causing impaired judgment; (5) recommend that the patient notify next of kin of the patient’s intention; (6) recommend that the patient have another person present when the patient ingests the medicine and to not take it in a public place; (7) inform the patient that he or she may rescind the request at any time; (8) write the prescription when the requirements of the law are met, including verifying that the patient is making an informed decision; and (9) arrange for the medicine to be dispensed directly to the patient, or the patient’s agent, but not by mail or courier.
The proposed law would make it punishable by imprisonment and/or fines, for anyone to (1) coerce a patient to request medication, (2) forge a request, or (3) conceal a rescission of a request. The proposed law would not authorize ending a patient’s life by lethal injection, active euthanasia, or mercy killing. The death certificate would list the underlying terminal disease as the cause of death.
Participation under the proposed law would be voluntary. An unwilling health care provider could prohibit or sanction another health care provider for participating while on the premises of, or while acting as an employee of or contractor for, the unwilling provider.
The proposed law states that no person would be civilly or criminally liable or subject to professional discipline for actions that comply with the law, including actions taken in good faith that substantially comply. It also states that it should not be interpreted to lower the applicable standard of care for any health care provider.
A person’s decision to make or rescind a request could not be restricted by will or contract made on or after January 1, 2013, and could not be considered in issuing, or setting the rates for, insurance policies or annuities. Also, the proposed law would require the attending physician to report each case in which life-ending medication is dispensed to the state Department of Public Health. The Department would provide public access to statistical data compiled from the reports.


Monday, November 5, 2012

Kidney exchange at Northwestern

While most of my work has been with multi-hospital kidney exchange networks, kidney exchange is also thriving at single hospital centers like Northwestern's, which recently hit the 100th transplant in its kidney exchange (kidney paired donation) program: Northwestern Medicine Surgeons Perform 100th Kidney Paired Donation Transplant, and from a somewhat different angle (and quoting some of my colleagues there), Northwestern Memorial Hospital reaches kidney-transplant landmark

Sunday, November 4, 2012

Coordination devices: daylight savings time, and the international dateline

Daylight savings time is a coordination device that we think about twice a year. The international dateline is another...

The Border That Stole 500 Birthdays
"So how exactly does drawing a line across the Pacific solve this issue? Why isn’t it enough merely to change the date at the stroke of midnight in each successive time zone? Because, if you think about it, that’s logically impossible. With only a single line moving westward across the planet, what exactly is it separating? The same date from itself? No — it is precisely because midnight separates two dates from each other that we need two date lines to separate them, one moving and one fixed.

"Picture that movable date line — the stroke of midnight — racing across the earth at the speed of one time zone an hour. When the clock strikes 12  in the first zone west of the fixed date line, a new date is born in a sliver one time zone wide, stretching from pole to pole. As the hours tick away, that slice grows wider across the Earth’s circumference. The new date races ahead of the sunrise, lighting up the east as the day races west. Inexorably, as the date circles the Earth to rejoin the fixed line, the “new” date becomes the “old” one, to be replaced in turn by the next one as the midnight hour once again crosses the date line"

Saturday, November 3, 2012

An old interview about market design

I've been giving a lot of interviews lately, so it was interesting to receive an email reminding me of an interview I did over a year ago with Julia Shew and Anagha Vaidhyanathan. Here's the first paragraph--I generally can't recall clearly what I've said in interviews, and I hope I'm answering current ones as well.


Anagha: What inspired you to leave the academic nest and begin manipulating markets in the real world?

Roth: I haven’t left the classroom! We’re trying to create market design as an academic field in Economics and make it a way for Economists to earn their living. Market design is useful for a couple of reasons. First, to see if we know what we’re talking about. Second, to learn more – of course we don’t know what we’re talking about until we go out and see why things don’t work the way we think they should work. And third, to do some good in the world. Once we think we know something about how things might work better, we try to help out.

Friday, November 2, 2012

I speak at YULA Boys High School Beit Midrash

I haven't accepted many post-Nobel invitations yet, but if you're in LA after Shabbat tomorrow, I'll be there too, at Yeshiva University High School of Los Angeles:

Market design news, in Hebrew

Tali Heruti-Sover (טלי חרותי-סובר) interviews me (in English) and writes in Hebrew here.

חתן פרס נובל לכלכלה, פרופ' אלווין רות', על המתכון לחיים טובים

Thursday, November 1, 2012

Lanie Ross speaks on deceased donor kidney allocation in Toronto

If you are in Toronto tomorrow, you can catch influential medical ethicist Lanie Ross speaking about deceased donor allocation.

Speaker Series: Lainie Ross, University of Chicago.

November 2, 2012: Deceased Donor Kidney Allocation:
Equity, Efficiency and Unintended Consequences
3:30-5pm EST, UWO
The Chu International Centre, Western Student Services Building (WSS) 2130
For information on parking, please visit here.


HT: Scott Kominers

Wednesday, October 31, 2012

Have a wedding? Need one? Bridal Brokerage...

What to do when the venue and caterers have been paid for with big upfront deposits, and at the last minute it doesn't seem like such a good idea to tie the knot?

What to do if you need a wedding in a hurry, and aren't fussy about the details of the reception?

It sounds like a missing market, and Bridal Brokerage is prepared to be the market maker, standing by to take your orders on either side...

Over 250,000 weddings are called off every year.
We purchase cancelled weddings and resell them to new couples.

Sellers recover deposits and upfront costs hassle-free.
Venues and providers enjoy uninterrupted business as usual.
Buyers find beautiful, pre-planned weddings at a fraction of the price.

Register with us and help us build a new market for weddings.

HT: Benjamin Kay

Tuesday, October 30, 2012

Spring School in Behavioral Econ at UCSD in March

Uri Gneezy writes to announce the


Spring School in Behavioral Economics
March 15 to March 21, 2013, San Diego

The Choice Lab at the Norwegian School of Economics (NHH) and the Rady School of Management at UC San Diego will host a spring school in behavioral economics. The goal of this spring school is to introduce graduate students to new and exciting research in the field. This is a great opportunity for graduate students to expand their behavioral skills and learn what behavioral economics research is about. Topics include social preferences, (psychological) games, incentives, charitable giving and behavioral interventions.

The Summer School is comprised of a series of 10 half day lectures. The lectures will be delivered by Jim Andreoni, Alexander Cappelen, Martin Dufwenberg, Armin Falk, Uri Gneezy, Theo Offerman, Bertil Tungodden, Lise Vesterlund and Angelino Viceisza. A strong emphasis is given to informal interactions, and students will also be given the opportunity to present their work.

We will cover participants’ costs during the workshop, including housing and most meals. Unfortunately, we do not have funds to cover travel costs. About twenty five participants will be invited.

To apply, please send your curriculum vitae and a short (up to 1000 words) statement of research interest, all in one pdf file to rady.spring.school@gmail.com. We will also need a letter of recommendation to be sent to the same email address. The deadline for applications is Monday, December 31, 2012.

Alexander, Bertil and Uri



Uri Gneezy | The Epstein/Atkinson Chair in Behavioral Economics
Rady School of Management, UC san Diego | 9500 Gilman Drive #0553 La Jolla CA 92093, USA
Tel: 858-534-4312 | Fax: 858-534-0745 |
http://management.ucsd.edu/faculty/directory/gneezy/

Monday, October 29, 2012

Hurricane Sandy and New York City's Specialized High School Admissions Test

Modeling a marketplace involves leaving out a lot of things that can actually happen in the market. People who work with models know this, but I'm constantly reminded by events just how rich a world it is that we try to model as simply as we can.  Take the case of New York City's elite exam schools, and Hurricane Sandy.

New York's exam schools, such as Stuyvesant and Bronx Magic (as the august Bronx High School of Science used to be called when I was in junior high) admit students on the basis of scores on the Specialized High School Admissions Test (SHSAT). So the exams are very high stakes for the very young scholars who take them, and many students engage in extensive test preparation (see e.g. this story).

The exams were scheduled for this past weekend: some students would take them on Saturday and some on Sunday. But the approach of Hurricane Sandy caused the Sunday exam to be rescheduled to November 18, three weeks later than originally scheduled, and three weeks later than the students who took the exam as scheduled on Saturday. This caused some distress to at least some parents who (because of recent news stories) emailed me. One was concerned that even some students who were scheduled to take the exam on Saturday may have contrived to get three more weeks of preparation:

"Those who thought to have more prep time for SHSAT opted to be absent today and using doctor's note to gain 3 weeks study time. I guess human nature always try to game the system.
"Inherent problem of NYC DOE system is that a student can take this test only once.  It is so high stake that some family try to game it.  I guess algorithm can not factor in this."

Sunday, October 28, 2012

The Nobel sport of football at Stanford

The Nobel committee recognized two Stanford faculty members this year. And it's the football season.
So here I am, waving to the crowd from the field, with Brian Kobilka, who shared this year's Nobel prize in Chemistry. (The bottom pic is how we looked to my wife from the skydeck of Stanford's football stadium...)



Saturday, October 27, 2012

Bartering girls in Pakistan

Pakistan court probes bartering of girls: Supreme court takes notice of barter of 13 young girls under tribal custom in Balochistan province.

"Pakistan's supreme court has ordered authorities to investigate the alleged barter of 13 children - all girls - to settle a blood feud in a remote area of the southwestern Balochistan province.
...
"Saeed Faisal, the deputy commissioner for the district, told the court that a tribal council had ordered the barter in early September.

"Faisal said that he did not know the girls' ages, but local media reported that they were aged between four and 13.
...
"Wani, the tradition of families exchanging unmarried girls to settle feuds, is banned under Pakistani law but still practiced in the country's more conservative and tribal areas."

Friday, October 26, 2012

"Kidney ethics" in Hebrew and in Israel

The phrase "מוסר כליות" (musar claiot) in Hebrew could be literally translated as "kidney ethics," but is an idiom that means something like "a guilty conscience" or maybe "remorse". It's the headline of this story in Haaretz magazine, about the grey market for organs in Israel...

This is the kind of thing that Jay Lavee wrote about trying to fix, in his op-ed that I blogged about yesterday.

Ht: Ran Shorrer

Thursday, October 25, 2012

Me on the morning joe

Not just a drink, but also a tv show, listen to me try to avoid answering questions I know little about (just the first one, fortunately:) http://www.msnbc.msn.com/id/3036789/#49549785 

Jay Lavee on organ transplantation policy in Israel

An op-ed by Jay Lavee, the Israeli transplant surgeon at the heart of recent dramatic revisions of transplant law and policy in Israel: Saving lives locally

Wednesday, October 24, 2012

Sridhar Tayur proposes an entrepreneurial way to reform organ waiting lists

Deceased donor organs in the United States are allocated through regional (not national) waiting lists, which leads to some dramatic differences in e.g. waiting times in different parts of the country. Individual candidates for transplantation can register as patients in different regions, if they are healthy and wealthy enough to move around. (e.g. Steve Jobs received a liver in Memphis, although I recall he worked at a company located in California...)  He had access to good transportation opportunities.

CMU professor Srihar Tayur, who will be speaking at Stanford GSB at noon today, has an entrepreneurial project, OrganJet,  intended to give that kind of access to transportation to people for whom it has previously been an insuperable obstacle.  Here's an article about his operation: Can Private Jets for the Poor Save Health Care Dollars?

Tuesday, October 23, 2012

Art vs. porn: do you know it when you see it?

An art museum in Vienna has had to censor the ads for its exhibits of male nudes: here's the story (in German, but with before and after pictures).  Penis-Plakat nach Protesten zensiert

HT: Muriel Niederle

Monday, October 22, 2012

Ads for kidneys in Iran

An article in Haaretz describes the market for kidneys ("kidney bazaar" בזאר הכליות) in Iran, and includes this picture of ads written on a wall  in Tehran.



"Qasemi Mustafa, head of Kidney Patients Support Association in Iran, said the average sum received by the donors ranged around $ 6,000 [paid by the recipient]. The Government adds that another thousand dollars."

HT: Ran Shorrer

Here's a closely related story in the Guardian: In the only country where the organ trade is legal, the streets near hospitals have been turned into a 'kidney eBay'



"Iran is the only country where the selling and buying of kidneys is legal. As a result, there is no shortage of the organs – but for those trying to sell a kidney, there is a lot of competition.
... "Competition means that some ads have been torn down. Some have added their information to ads by other donors. Others have placed their ads on people's doors or simply written them in marker pen on trees where they think they will catch people's attention.

"At the heart of the capital, near the Charity Association for the Support of Kidney Patients (CASKP), the number of ads has made the streets of Tehran into a sort of kidney eBay.
...
"Iran's controversial kidney procurement system, which has been praised by many experts and criticised by others, allows people to sell and buy kidneys under the state-regulated surveillance of two non-profit organisations, the CASKP and the Charity Foundation for Special Diseases. These charities facilitate the process by finding potential vendors and introducing them to the recipients, and are charged with checking the compatibility of a possible donation and ensuring a fair trade.

"After the transplant, the vendor is compensated by both the government and the recipient. In an interview with the semi-official Mehr news agency, the CASKP's director, Mostafa Ghassemi, estimated the total official price list to be around 7m rials, of which 1m is paid by the government. Iranians are not allowed to donate kidneys to non-citizens.

"In 2010, a total of 2,285 kidney transplants took place in the country, of which 1,690 kidneys were supplied from volunteers and 595 from those clinically brain-dead," he said. According to Mehr, the majority of people selling kidneys are aged 20-30. Despite the state control, bureaucracy and time-consuming procedures have left the door open for non-official direct negotiations, making the Iranian system more like a kidney market.

"Dr Benjamin Hippen, a transplant nephrologist with the Carolinas medical centre in North Carolina, US, has studied successes, deficiencies and the ambiguities of the Iranian system.

"Making a judgment about whether the 20-year-old system as a whole has been successful was complicated, he said. "The majority of those selling kidneys in Iran are disproportionately poor, and information about the long-term outcomes for sellers is quite limited. Too, it is increasingly clear that there are many different systems, rather than a single unified system in Iran.

"That said, Iran appears to have successfully addressed the shortage of organs, incentives for organs have not substantially attenuated the growth and development of organ procurement from deceased donors, and reported outcomes for recipients have been favourable."

"Comparing Iran with Pakistan, where organ trafficking is nominally illegal but still occurs, Hippen, who is an associate editor of the American Journal of Transplantation, said: "It seems to me that if Iran had not developed a system of incentives, the situation there today would look very much like the state of affairs in countries such as Pakistan."

"In the US, more than 100,000 people were estimated to be on the waiting list for kidney transplants in 2010 – waiting lists were eliminated in Iran in 1999.

"Hippen has pointed out that "since 1999, more than 30,000 US patients with kidney failure have died waiting for an organ that never arrived".

"Arguing in favour of allowing people to sell their kidneys, Sue Rabbitt Roff, a senior research fellow at the University of Dundee, said last year that it was time to "pilot paid provision of live kidneys in the UK under strict rules of access and equity".

Sunday, October 21, 2012

NBER market design meeting photo

At the NBER meetings in Cambridge on Friday and Saturday, someone called for "Al's students and postdocs" to gather for a photo:


Saturday, October 20, 2012

Ed Glaeser on Boston school choice

Ed Glaeser writes in the Boston Globe: Boston school-assignments: Listen to the Nobel committee

One sentence struck me as a little odd:
 "The current system owes much to Roth, a professor at UCLA, and Shapley, a Harvard colleague of mine (who, sadly, is leaving for Stanford)."