Tuesday, November 19, 2013

More on the law and politics of compensating bone marrow donors

The legal battle is shaping up over the decision of the department of Health and Human Services to circumvent the decision of the ninth circuit court of appeals that it is legal to compensate bone marrow donors.  The Institute for Justice, which was a successful litigant in the court ruling, has outlined their current thoughts here:
Federal Officials Move to Block Life-Saving Research
HHS’ Proposed Rules Would Undo Court Ruling Legalizing Bone Marrow Compensation

They say in part:
"The proposed regulation would ban marrow compensation just when empirical research has begun into the effects of compensating donors.  A team of economists—Nicola Lacetera of the University of Toronto, Mario Macis of Johns Hopkins University, and Robert Slonim of the University of Sydney—were in the process of finalizing a research proposal that would have investigated the effects of donor compensation when they learned of the new rule.

“These new regulations make it impossible for researchers to obtain the necessary evidence to inform policy.  Our proposed studies would be made illegal by these new provisions,” explained Macis, who, along with Lacetera and Slonim, has published some of the leading work showing that economic incentives can be effectively used to increase blood donations without affecting blood supply safety.  “Properly designed compensation for bone marrow donors could similarly lead to significant increases in donations, thus giving potentially hundreds or thousands of people in need of a transplant every year a greater chance of survival.  At a minimum, the federal government should not make it illegal for researchers to find out whether incentives can help address the shortage of bone marrow donors.”

“I don’t think that anybody should go to jail just for trying to save somebody’s life,” added Doreen Flynn, who has three children with Fanconi anemia, a blood disease that frequently requires a bone marrow transplant and who was the lead plaintiff in the original lawsuit.  “If paying donors results in more marrow donations, we should pay them.  And it shouldn’t be a crime to investigate it.”
“We know what doesn’t work,” said Robert McNamara, also a senior attorney with the Institute and co-lead counsel in the case.  “We have 30 years of experience with an altruism-only marrow-donor program, and we know that has not succeeded in recruiting enough donors.  The only question is whether offering compensation can achieve better results.  We will not allow the federal government to make it a felony to find out the answer.  Hopefully, we will do that by persuading the government not to adopt this rule, but if we have to, we will sue them again.  And we will win—again.”

The proposed regulation is currently open for a period of public comment through December 2, 2013.  Individuals who have been impacted by blood-borne cancer or bone marrow donations are encouraged to leave comments on the Department of Health and Human Services’ website:  http://www.regulations.gov/#!submitComment;D=HRSA_FRDOC_0001-0115."
****************

You can follow some of the story in my earlier posts on bone marrow and compensation.

Monday, November 18, 2013

AEA Registry for Randomized Control Trials

This just in...

Dear AEA member:

The AEA has launched a new site to register randomized control trials (RCTs). The AEA encourages all investigators to register new and existing RCTs. Registration is entirely voluntary and is not currently linked to or required for submission and publication in the AEA journals.

The site is available at https://www.socialscienceregistry.org

On this site, you can register your forthcoming, ongoing, or even completed RCTs, with as little or as many details as you wish. The site will also permit you to store and make publicly-available additional information on your RCTs (reports, articles, data, and code). We believe that this will prove to be a very valuable resource for investigators to share their work and the site will be widely used by those who wish to find out about on-going and completed studies.

The registry is characterized by:

1) Simplicity and flexibility: Registering a trial is straightforward with only a minimal number of required fields. There is considerable flexibility to provide additional material at the time of registration or at any point in the life of the study. Materials can also be hidden from public view until completion of the study, or be made accessible only with the permission of the PI.

2) Adjustability and memory: Any registry entry can be amended by the PI at any point, but the registry keeps track of all versions.

3) Ability to work as a research portal for your RCTs: The registry can serve as an access point for collaborators, other scholars, students, and the general public providing links to data sets, survey instruments, experimental findings, and experimental protocols.

To register a trial, the PI simply needs to enter the following information: PI name, project title, study location, project status, keyword(s), abstract, trial start and end dates, intervention start and end dates, proposed outcome(s), experimental design, whether the treatment is clustered, planned number of clusters, planned number of observations, and IRB information. Optional fields allowing the PI to customize and enhance the information made available include details on sponsors and partners, survey instruments, an analysis plan, and other supporting documents. Help is available if the PI encounters any problem.

The AEA registry system will provide the PI with reminders to update the registration of an RCT at appropriate points in the trial's lifecycle. For example, the submitted end date will trigger an email asking the PI to enter post-trial information. If the trial has been extended, the PI can update the trial with the new end date.

We encourage you to explore the registry and to register your RCTs.

The committee on the registry for social experiments
Larry Katz (chair)
Esther Duflo
Pinelopi Goldberg
Duncan Thomas

Ohio execution stay for Ronald Phillips for possible organ donations

This will complicate my discussions in China...

Ohio execution stay for Ronald Phillips for possible organ donations

Ohio's governor delayed the execution of a condemned child killer to consider the inmate's unprecedented organ donation request, acknowledging that it's ''uncharted territory'' but expressing hope that the man might help save a life before losing his own.
Ronald Phillips, 40, was scheduled to be put to death Thursday with a lethal injection of a two-drug combination not yet tried in the U.S., but Gov. John Kasich issued a stay of execution Wednesday. The execution date has been reset for July 2.
"I realize this is a bit of uncharted territory for Ohio, but if another life can be saved by his willingness to donate his organs and tissues then we should allow for that to happen," Kasich said in a statement. He said he wanted to allow time for medical experts to study whether Phillips could donate non-vital organs, such as a kidney, before being executed.
Phillips, who was sentenced for raping and killing a 3-year-old girl in Akron in 1993, asked this week to donate a kidney to his mother and his heart to his sister. His attorney said it was an attempt to do good, not a delay tactic.
Ohio's prison medical policy accommodates organ donations, but prison officials rejected the request, saying it came too late to work out logistics and security concerns.
Kasich said Phillips' crime was heinous but his willingness to donate organs and tissue could save another life and the state should try to accommodate that.
Some 3,500 people in Ohio and more than 120,000 nationally are awaiting organ donations, said Marilyn Pongonis, a spokeswoman for the Lifeline of Ohio organ donation program.
If Phillips is a viable donor for his mother, who has kidney disease and is on dialysis, or for others awaiting live transplants of non-vital organs, the stay would allow time for those procedures to be performed, Kasich said.
Phillips' sister suffers from a heart ailment and he also wants to donate his heart to her.
Richard Dieter, executive director of the Death Penalty Information Center, said a Delaware death row inmate was permitted in 1995 to donate a kidney to his mother while in prison, though he was not facing imminent execution like Phillips.
"This step by the governor puts it into a more normal discussion of (how) an inmate, without any security problems, can help save another person and is that the right thing to do," he said. "With 24 hours to go before an operation had to be carried out, it definitely gets in the way of that process."
Vital organ donations raise larger ethical issues and have not been allowed during U.S. executions but have occurred in China, Deiter said.
Dieter, whose group opposes the death penalty, added: "If the whole idea is to save a life, there's one life to be saved simply by not executing the person at all."
Phillips made his request after the governor denied him mercy and Phillips had exhausted his other legal options. The state had left it up to Phillips' family whether the organs would be harvested after his death.


HT: Bernadette Keller

Sunday, November 17, 2013

Saudi comedians mock the ban on women drivers with a video song


The NY Times has the story

"Their video, a play on the Bob Marley classic “No Woman, No Cry,” has gone viral, receiving more than 6.5 million views on YouTube since it was posted on Saturday. The catchy a cappella tune mocks the country’s restrictions, as well as the assertion by one Saudi cleric that driving would harm women’s ovaries."

Saturday, November 16, 2013

Repugnant transaction watch: Saudi women drivers

The NY Times has the latest on a demonstration by Saudi women who wish to be allowed to drive in the Kingdom, and the reaction it has drawn: Saudi Women Rise Up, Quietly, and Slide Into the Driver’s Seat

"The public call for women nationwide to drive on Saturday was the latest push in a decades-old effort by a small group of activists to exercise what they see as a fundamental human right. Saudi Arabia, a hereditary monarchy, is the only country in the world where women are not allowed to drive."

Friday, November 15, 2013

Is the Common App still doing what it was designed to do?

The letters to the editor of the NY Times, following a recent article on the Common App and its troubles, include one (the second letter) from one of the founders of the Common App. It says in part:

"The unavoidable standardization of the Common Application, not to mention the online debacle for students trying to use it this year, causes serious questions regarding its service to both the candidate and the college.

As co-founder of the Common Application some 40 years ago (with Jack Osander of Princeton and Fred Jewett of Harvard), I sense that the Common App’s time is up. The sole original goal of the Common Application was to make applying to highly selective colleges easier for nontraditional, less advantaged but deserving students. Clearly, it worked early on.

Now it seems that the ease of applying via the Common App has transferred from the poorest to the most affluent students, whose families have no problem paying a dozen or more application fees — the more apps, the better the chance of admission somewhere special. This phenomenon also creates thousands more “ghost applications” (from students unlikely to enroll) for the colleges."

HT: Eric Budish

Earlier posts on the common app.

Thursday, November 14, 2013

Is published economics research credible?

Not so much, is the answer given in the article below by Doucouliago and Ioannidis in the December issue of J of Economic Surveys (see, even the date isn't credible:). John Ioannidis is quite well known for his critiques of the reliability of published medical research.

Ioannidis, J. and Doucouliagos, C. (2013), WHAT'S TO KNOW ABOUT THE CREDIBILITY OF EMPIRICAL ECONOMICS?. Journal of Economic Surveys, 27: 997–1004. doi: 10.1111/joes.12032

Abstract
The scientific credibility of economics is itself a scientific question that can be addressed with both theoretical speculations and empirical data. In this review, we examine the major parameters that are expected to affect the credibility of empirical economics: sample size, magnitude of pursued effects, number and pre-selection of tested relationships, flexibility and lack of standardization in designs, definitions, outcomes and analyses, financial and other interests and prejudices, and the multiplicity and fragmentation of efforts. We summarize and discuss the empirical evidence on the lack of a robust reproducibility culture in economics and business research, the prevalence of potential publication and other selective reporting biases, and other failures and biases in the market of scientific information. Overall, the credibility of the economics literature is likely to be modest or even low.
...

4. Conclusions: Unanswered Questions and Possibilities for Improvement
Despite the aforementioned empirical evidence, much remains unknown. How credible is economics research in different subfields? Is credibility rising or falling over time? How can this market be improved? What is the impact of corporate and institutional interests, journals, funding agencies, and other stakeholders and how can we utilize this potential impact to improve the credibility of economics?

However some paths forward seem clear: strengthen the reproducibility culture with emphasis on independent replication; conduct larger, better studies; promote collaborative efforts rather than siloed, one-investigator research; and reduce biases and conflicts. The exact interventions, which might achieve these changes are not clear, and perhaps there is room for conducting experimental studies on different potential interventions. Progress may be difficult to achieve unless the rewards and incentives system of conducting and publishing research is modified. Little progress is likely if investigators get rewarded and promoted for publishing significant results and for perpetuating theories and claims even when they are wrong. Conversely, one might expect better outcomes, if replication research is encouraged, reproducibility is rewarded, and/or irreproducibility is penalized.


Answering these questions requires more meta-research (i.e. empirical research on research). Empirical studies that have been performed in other scientific disciplines may be extrapolated and conducted in economics. Tests for bias may also be adapted for economics and embraced by leading journals. Of course, meta-research is also susceptible to bias and errors of its own. The extent of bias and possible errors needs to be evaluated also for emerging meta-research tools. Nonetheless, tests for small-study effects and publication or selective reporting biases need to be applied increasingly, further developed and evaluated (Stanley and Doucouliagos, 2012).
************

See also
Why Most Published Research Findings Are False
John P. A. Ioannidis
Published: Aug 30, 2005DOI: 10.1371/journal.pmed.0020124

Wednesday, November 13, 2013

Minimum age of marriage

Israel has raised the legal minimum age of marriage to 18, but this is unlikely to prevent the early marriages which circumvented the prior minimum age of 17...

17-year-old wives: Law passed too late for us

Several groups of ultra-Orthodox Jews, Israeli-Arabs conduct underage marriages, say new law, to raise minimum age for marriage, will not make great difference. With 11,000 underage marriages a year, will law change current custom?

"A new law passed by the Knesset on Monday that permits marriage starting from the age of 18 is not impressing Hasidic members of the haredi public and several groups with the Israeli-Arab sector in which underage marriage is quite common. In many such communities, there are couples who tie the knot before their 17th birthday – the minimum age before the new law.

According to figures from the Central Bureau of Statistics, 11,747 girls under the age of 18 were married in Israel during 2011. From 2000 to 2009, 19,863 girls married at the age of 18; 15,020 girls said their vows by their 17th birthday; and 2,548 girls up to the age of 16 committed to their partner for the rest of their lives.

According to Hasidic custom, the sons of distinguished rebbis marry even earlier in order to minimize the time frame between puberty and their wedding, and to prevent young males from inappropriate thoughts or worse – sinful deeds.

The legislation is not expected to raise the minimum age for marriage in those communities, as they already ignore the existing law. The ceremony at underage marriages in these communities is conducted privately by rabbis who do not report the event to the authorities. The registration for the wedding is completed at a later date, when both the bride and the groom reach the legal age."

Tuesday, November 12, 2013

MIT news on the couples match for doctors

MIT news does a good job of science reporting (and of celebrating Parag Pathak)...

Doctor, doctor: Why the job market for married couples in medicine works well

New study in the growing ‘market design’ field of economics explains how a job-market algorithm helps land couples in the same locations.

Monday, November 11, 2013

Formerly repugnant transaction watch: Ilinois looks to be number 15 to recognize same sex marriage

Illinois House Votes to Allow Same-Sex Marriages

"SPRINGFIELD, Ill. — A historic vote Tuesday in the Illinois House positioned that state to become the largest in the heartland to legalize gay marriage, following months of arduous lobbying efforts by both sides in President Barack Obama's home state.

Fourteen states plus Washington D.C., allow same-sex marriage. Most recently, New Jersey, Minnesota and Rhode Island have legalized it.

The road to the Illinois vote was long with stalled attempts earlier this year, something that frustrated activists in the state where Democrats lead the House, Senate and governor's office. Chicago Democratic Rep. Greg Harris, who is the sponsor of the bill, decided not to bring the bill for a vote in May because he said he simply didn't have the support.

Then the U.S. Supreme Court ruled to strike down a provision of the federal Defense of Marriage Act, something he said resonated with lawmakers. Backers also launched a furious campaign, hiring a lobbyist from the state's largest union, the former head of the Illinois Republican Party and field organizers spanning the state.

"To treat all our citizens equally in the eyes of the law we must change this," Harris said on the floor. "Families have been kept apart."

Debate lasted more than two hours, and the final roll call was met with hearty cheers and applause. Supporters' speeches echoed themes of equality and civil rights with mentions of Obama, Martin Luther King Jr. and Matthew Shepard, a gay college student whose 1998 death sparked numerous hate crime bills.

Polls show support for gay marriage has surged since 1996, when Gallup found that 27 percent of Americans backed it. Now Gallup finds the majority support giving gay and lesbian couples the right to marry."

Sunday, November 10, 2013

Congestion in the market for law internships in Israel

Aviad Heifetz points me to an article in the Haaretz magazine, on law clerks (in Hebrew, but Google Translate makes it clear enough that they are talking about congestion (apparently after a period of unraveling): http://www.themarker.com/law/1.2151631

"The new rules stipulate that law firms will not be able to interview candidates to specialize before 15 March in the third year of undergraduate law students.
In March the new rules came into effect and the change was felt immediately. That day open all major law firms in the competition for employment outstanding students. Race interviews lasted for a few intense days. Although March 15 falls on a Friday this year many offices were assembly-line interviews and ambitious students frantically moved from office to office.

Saturday, November 9, 2013

Headhunters

Here's a paper (forthcoming in Organization Science) on headhunters of the modern variety, and who they hunt:

Who Says Yes When the Headhunter Calls? Understanding Executive Job Search Behavior

Peter CappelliMonika Hamori

NBER Working Paper No. 19295
Issued in August 2013
NBER Program(s):   LS 
We examine an aspect of job search in the important context of executive-level jobs using a unique data set from a prominent executive search firm. Specifically, we observe whether or not executives pursue offers to be considered for a position at other companies. The fact that the initial call from the search firm, which we observe, is an exogenous event for the executive makes the context particularly useful. We use insights from the Multi-Arm Bandit problem to analyze the individual’s decision as it emphasizes assessments of future prospects in the decision process, which are particularly relevant for executive careers. More than half the executives we observe were willing to be a candidate for a job elsewhere. Executives are more likely to search where their current roles are less certain and where their career experience has been broader. Search is more likely even for broader experience within the same employer. In the latter case, the array of likely opportunities is also broader, making search more useful.

Friday, November 8, 2013

In France: are buyers as well as sellers of prostitution criminals?

343 French sign 'Don't Touch My Whore' petition

Feminist wrath as Dominique Strauss-Kahn's lawyer joins "manifesto of the 343 b-------" in petition against plans to criminalise clients of prostitutes


HT: Ron Shorrer

Thursday, November 7, 2013

Swap clothes on swapdom.com

Swapdom is a site for trading clothes.

It came to my attention through this blog post:  Swapping clothes instead of kidneys

Wednesday, November 6, 2013

Financial Incentives for Living Kidney Donation: Ethics and Evidence

That's the title of a recent letter by Matthew B. Allen and Peter P. Reese at Penn, motivated by an article suggesting that payment to donors could be welfare improving,


Allen and Reese (may be gated) review arguments pro and con, and conclude:

Given the promise of a cost-effective strategy provided by Barnieh’s group—and a lack of empirical evidence that ethical concerns about incentivizing live donors would manifest—we propose a research agenda and necessary elements for a limited trial of incentives. First, using modeling, researchers should examine the comparative effectiveness of different incentive strategies, such as reimbursement for lost wages and expenses or provision of insurance. Expense reimbursement is a promising alternative to fixed payment. Estimates of donor financial burden range from $907 to $3089, and compensation would help ensure that donors do not suffer financially from donation (8). Because potential donors would not stand to benefit financially, expense reimbursement could ease concerns about undue and unjust inducement, but it might also fail to generate a meaningful increase in the supply of organs (5). Moreover, in contrast with fixed payment for donation, expense reimbursement is legal in the United States (1).
Second, a limited, real-world trial of regulated incentives should be conducted. Ideally, the effect of a direct payment intervention could be contrasted with expense reimbursement and usual care. A geographically limited trial should assess (1) the effect of different payment models on the number of donors (to assess the program’s benefits), (2) the socioeconomic and general health status of potential and actual donors (to assess unjust inducement), and (3) donor comprehension of risks and evidence of donor coercion (to assess undue inducement). If incentives are provided for only a subset of donors, evidence of crowding out should also be assessed. The trial should measure psychological, financial, and physical outcomes after donation. Existing protections for potential live donors will be necessary, such as use of independent donor advocates, separation of donor and recipient evaluation teams, and ability to opt-out from donation with dignity at any time (5). Additional protections may also be needed, such as a “cooling off” period between evaluation and donation to allow transplant teams multiple opportunities to assess donor motives and comprehension.
The barriers to conducting such a trial are significant. In the United States, these barriers include the National Organ Transplant Act (1). Removing the legal prohibition on payment for donation would require persistent advocacy by diverse stakeholders. So far, surveys suggest a lack of consensus for organ markets among the general public, and a minority of transplant surgeons support paying for living donation (9,10).
Current trends regarding the use of financial incentives in medicine suggest that the time is ripe for new consideration of payments for living kidney donation. The last decade has witnessed rising interest in behavioral economics and well-designed clinical trials using financial incentives to change diverse health behaviors, including smoking and weight loss (1113). In the meantime, this work by Barnieh et al. may allow advocates to make a financial case for incentives in the realm of living kidney donation. Reassurance about the ethical concerns, however, can come only through empirical evidence from actual experience.

Tuesday, November 5, 2013

Preferences for randomness in German university admissions

Here's a paper that pushed a lot of my buttons: theory, experiments, and institutional detail on university admissions to study medicine (and some other disciplines) in Germany: Flipping a Coin: Theory and Evidence, by Nadja Dwenger, Dorothea Kubler, and Georg Weizsacker

Abstract: We investigate the possibility that a decision-maker prefers to avoid making a decision and instead delegates it to an external device, e.g., a coin flip. In a series of experiments our participants often choose stochastically dominated lottery between outcomes, contradicting most theories of choice such as expected utility. A large data set on university applications in Germany shows a choice pattern that is consistent with a preference for randomization, entailing substantial allocative consequences. The findings are consistent with our theory of responsibility aversion.


Here's some of the institutional description:
"Admissions to German undergraduate university programs in the medical subjects are centrally administered by a clearinghouse. The clearinghouse assigns applicants according to the following three procedures that are implemented in a sequential order:
(1) Procedure A admits students who are top of the class to up to 20% of seats.
(2) Procedure W admits students with long waiting times to up to 20% of seats.
(3) Procedure U represents admission by universities according to their own criteria to the
remaining (at least 60% of) seats.
For each of the three procedures, applicants are asked to submit a preference ranking of universities, which may either be identical or di fferent across procedures. All rank-order lists are submitted at the same moment in time. The central clearinghouse employs the three procedures in a strictly sequential order: all applicants who are matched in procedure A are firmly assigned a seat at their matched university and do not take part in subsequent procedures. All remaining applicants enter procedure W. Likewise, after procedure W, all applicants who are still unmatched enter procedure U. The fact that applicants can submit three (potentially different) rank-order lists of universities, each of which may be relevant, is a unique property of the German mechanism and makes it suitable for our analysis."

Procedure A is apparently an immediate-acceptance ("Boston") algorithm that takes only the preferences of the students as inputs, while procedure U is a university-proposing deferred acceptance algorithm.  While there are strategic reasons for students to submit different preferences in A and U, the authors argue that these can be identified and removed from the data, and that there remain students who order their choices differently in the two procedures, in the manner of experimental subjects who display a preference for introducing some randomness into their assignment.

Georg W. further writes to me as follows:
"Arguably the most important and most interesting strategic motives in the German application system appear because of the multi-stage nature of the mechansim: Applicants need to be careful that they are not matched in the first stage of the mechanism, in cases where they plausibly have a chance to get a better match on subsequent stages."

Monday, November 4, 2013

Nalini Ambady, RIP

Stanford psychology professor Nalini Ambady passed away after a long search for a matching bone marrow donor:
Nalini Ambady, Stanford psychology professor, dies at 54
"A distinguished social psychologist, Ambady was well known for her research that showed that people can form accurate first impressions about others based only on seconds-long observations of their nonverbal behavior."

"Nalini Ambady, a Stanford professor of psychology, died Oct. 28 after a long battle with leukemia. Her passing followed a yearlong, worldwide effort by family, friends and students to find a bone marrow donor match."
**************

Professor Ambady's students and friends organized an active campaign to help her find a bone marrow donor, which you can follow here: http://ambadylab.stanford.edu/helpnalininow/

Here's a story from New Delhi TV (NDTV) that in passing emphasizes how the inability to compensate donors can make the search tragically difficult (emphasis added): Professor Nalini Ambady's death highlights lack of awareness on bone marrow transplants in India

"Because of genetic markers, a person is likely to find a match from one's own ethnic gene pool. In Ms Ambady's case her match would most likely have been from someone from her birthplace - Kerala.

"For the past six months, the Ambady family has been carrying out drives in India to encourage people to sign up for the bone marrow registry in the hopes of finding her a potential match.

"But in a country of 1.2 billion, only about 45,000 people have signed up to be bone-marrow donors. In comparison, there are over 10 million donors on the United States' National Marrow Donor Program.

"This is despite the fact that becoming a bone marrow donor is simple. All it takes is a swab test-rubbing an ear bud on the inside of one's cheek. An actual transplant is as painless as donating blood. Still, because of ignorance, lack of awareness, cultural taboos or psychological fears Indian's don't sign up to become donors.

"Ms Ambady found at least six potential matches from India. But they all dropped out. According to a childhood friend Ann Ninan, "It was heart breaking for the family."

"Ms Ambadi's family will not be able to celebrate this Diwali with her but during this festive season let's all sign up as donors. It's a few minutes of your time but it could save someone's life."
***************

My colleague Muriel Niederle, who took a class from Professor Ambady at Harvard, reflects on her passing here.

See some of my other posts on bone marrow donation, and the ongoing political/legislative/legal disputes concerning whether bone marrow donors can be compensated, or whether this should be forbidden as a repugnant transaction. (Long story short: The conventional interpretation that paying bone marrow donors was outlawed by the National Organ Transplant Act was upset by a decision of the 9th Circuit Court of Appeals, but the Department of Health and Human Services is taking steps to change the relevant regulations so that it will continue to be illegal despite the court ruling.)

Sunday, November 3, 2013

The law and politics of bone marrow and compensation for donors

The Department of Health and Human Services is proposing new regulations that would put bone marrow more clearly into the class of organs for which payment is forbidden by the National Organ Transplant Act of 1984. This is in response to the decision by the Ninth Circuit to make compensation legal for bone marrow donations made through the harvesting of blood stem cells directly from the blood.

Here's the relevant page from the Federal Register: Federal Register/ Vol. 78, No. 191 / Wednesday, October 2, 2013 / Proposed Rules

Here are my earlier posts on the courts and compensation for bone marrow donation.

Since I'm not licensed to practice law in North Carolina or anywhere else, I wrote to Kim Krawiec to ask whether HHS could simply overrule the Ninth Circuit with a regulation, or whether Congress would have to get involved.

Here is Kim's reply:
"... new legislation is probably not needed to overturn the 9th circuit ruling -- that is certainly the position of HHS.  Here is the relevant language from NOTA (with emphasis mine): (1) The term “human organ” means the human (including fetal) kidney, liver, heart, lung, pancreas, bone marrow, cornea, eye, bone, and skin or any subpart thereof and any other human organ (or any subpart thereof, including that derived from a fetus) specified by the Secretary of Health and Human Services by regulation.  

The only question would be whether HHS exceeded its authority in some way through this change. I'm sorry to say that such a claim would be an uphill battle.  One might imagine, for example, a claim that the statute only permits the addition of "organs" and HSCs drawn from peripheral blood are not an organ (as the 9th Circuit concluded).  But courts are extremely deferential to agencies on these questions of interpretation (the term is "Chevron deference", named after a Supreme Court case establishing the standard). Courts are very reluctant to overturn agency interpretations of this sort and defer to the agency interpretation unless it is unreasonable.  Hopefully the interpretation (assuming the proposed reg is enacted) will be challenged, but I think this one will be a tougher fight than the first case."


HT: Bob Slonim


Saturday, November 2, 2013

Small High Schools and Student Achievement: Lottery-Based Evidence from New York City

A new NBER paper makes use of some of the random elements of the New York City high school assignment algorithm to understand the effect of small schools:

Small High Schools and Student Achievement: Lottery-Based Evidence from New York City

Atila AbdulkadiroÄŸluWeiwei HuParag A. Pathak

NBER Working Paper No. 19576
Issued in October 2013
NBER Program(s):   ED   LS   PE 
One of the most wide-ranging reforms in public education in the last decade has been the reorganization of large comprehensive high schools into small schools with roughly 100 students per grade. We use assignment lotteries embedded in New York City's high school match to estimate the effects of attendance at a new small high school on student achievement. More than 150 unselective small high schools created between 2002 and 2008 have enhanced autonomy, but operate within-district with traditional public school teachers, principals, and collectively-bargained work rules. Lottery estimates show positive score gains in Mathematics, English, Science, and History, more credit accumulation, and higher graduation rates. Small school attendance causes a substantial increase in college enrollment, with a marked shift to CUNY institutions. Students are also less likely to require remediation in reading and writing when at college. Detailed school surveys indicate that students at small schools are more engaged and closely monitored, despite fewer course offerings and activities. Teachers report greater feedback, increased safety, and improved collaboration. The results show that school size is an important factor in education production and highlight the potential for within-district reform strategies to substantially improve student achievement.

Friday, November 1, 2013

A Finnish team takes top honors at 2013 North American wife carrying championship

Sometimes when I talk about dwarf tossing (which is illegal in many places), I also talk about wife carrying, which is not.  Here's the latest from the North American championships: Results from the 2013 North American Wife Carrying Championship

It includes a video of the competition