Sunday, February 28, 2010

The market for cooked food (and thoughts of D'Artagnan at Maastricht)

The market for pleasure boats ranges from canoes to yachts, and air transport ranges from economy class to big private jets, but the market for cooked food must rival them in its range. Here's an account of an enterprise yacht/jumbo jet meal: The D’Artagnan Anniversary Party.

"To mark the 25th anniversary of her company, D’Artagnan, Ariane Daguin, a native of the Gascon region in the southwest of France, flew in over two hundred of her countrymen for a week-long celebration in New York. ... What’s more, throughout the week Ms. Daugin installed a handful of Michelin-starred Gascon chefs in some of the most venerated kitchens in the city. The collaborations between the visiting chefs and their hosts culminated last Sunday in what D’Artagnan billed as, “The 32 Star Dinner: A Progressive Dining Experience.” Thirty-two is the total number of Michelin and New York Times stars achieved by the group of chefs responsible for the meal, which, true to the epicurean spirit of the evening, was served not in one restaurant, but in four: cocktails, hors d’oeuvres, and the first two courses at Daniel, the next at Jean-Georges, two more at Per Se, and dessert at Le Bernardin. The buses that chauffeured us from stop to stop were filled with Gascon Armagnac."

(The headline of the article had led me to think it might be about the historical D'Artagnan, whose experience of Maastricht, in 1673, was more unfortunate than mine in 2009:)

Living Liver and Kidney Donation

The American Journal of Transplantation has assembled a "virtual issue" of articles they have published on various aspects of live donation, including kidney exchange. It seems to be ungated.

Living Liver and Kidney Donation

Guest Editor: Dr. Jonathan Bromberg
"This virtual issue of the American Journal of Transplantation is focused on living donation. For practical purposes, the articles are restricted to only liver and kidney donation. It would not be an overstatement to say that donation has probably been the number one issue to dominate the field for the last decade, as organ quality and availability determine all activities in transplantation. The breadth of importance and ramifications of donation are reflected in the wide variety of articles and topics that cover this area of interest. Novel sources of donors, such as altruistic, anonymous, and non-directed donation among others are covered in the first section. While considered even unusual a few years ago, many of these sources are now firmly partly of the mainstream of living donation. Exchanges, swaps, chains, and dominos are included in the second section, reflecting the evolution of the field as ever more complex donor and recipient algorithms are implemented, and their attendant ramifications on quality, cost, and outcomes. The third section covers organ utilization and outcomes, with an emphasis on matching the optimal donor with the correct recipient, and comparing deceased to living donor organs. The fourth section covers regulatory issues at the national and local levels, and their influence on donation and outcomes. The fifth section comprises issues relating to the donor and donor safety. The work-up process, safeguards, operative techniques, short term outcomes, and very long term outcomes are major issues the have dominated recent trends. The sixth and last section covers educational issues as they related to donor and family knowledge and attitudes toward donation, and that affects donation rates. These reports should provide the reader with a comprehensive view of issues in living liver and kidney donation, and the diverse paths taken that have moved the field forward."

Novel Donor Sources:
Twenty-Two Nondirected Kidney Donors: An Update on a Single Center's ExperienceC. L. Jacobs, D. Roman, C. Garvey, J. Kahn, A. J. Matas
Altruistic Living Donors: Evaluation for Nondirected Kidney or Liver DonationM.D. Jendrisak, B. Hong, S. Shenoy, J. Lowell, N. Desai, W. Chapman, A. Vijayan, R.D. Wetzel, M. Smith, J. Wagner, S. Brennan, D. Brockmeier, D. Kappel
Living Anonymous Liver Donation: Case Report and Ethical JustificationL. Wright, K. Ross, S. Abbey, G. Levy, D. Grant
Successful Expansion of the Living Donor Pool by Alternative Living Donation ProgramsJ. I. Roodnat, J. A. Kal-van Gestel, W. Zuidema, M. A. A. van Noord, J. van de Wetering, J. N. M. IJzermans, W. Weimar
Elective Surgical Patients as Living Organ Donors: A Clinical and Ethical InnovationG. Testa, P. Angelos, M. Crowley-Matoka, M. Siegler
Kidney Donor Exchanges, Chains, and Dominos:
A Comparison of Populations Served by Kidney Paired Donation and List Paired DonationS. E. Gentry, D. L. Segev, R. A. Montgomery
The Dutch National Living Donor Kidney Exchange ProgramM. de Klerk, K. M. Keizer, F. H. J. Claas, M. Witvliet, B. J. J. M. Haase-Kromwijk, W. Weimar
Characterization of Waiting Times in a Simulation of Kidney Paired DonationD. L. Segev, S. E. Gentry, J. K. Melancon, R. A. Montgomery
Attitudes of Minority Patients with End-Stage Renal Disease Regarding ABO-Incompatible List-Paired ExchangesP. D. Ackerman, J. R. Thistlethwaite Jr, L. F. Ross
Incompatible Kidney Donor Candidates' Willingness to Participate in Donor-Exchange and Non-directed DonationA. D. Waterman, E. A. Schenk, A. C. Barrett, B. M. Waterman, J. R. Rodrigue, E. S. Woodle, S. Shenoy, M. Jendrisak, M. Schnitzler
Utilizing List Exchange and Nondirected Donation through 'Chain' Paired Kidney DonationsA. E. Roth, T. Sönmez, M. U. Ünver, F. L. Delmonico, S. L. Saidman
Expanding Kidney Paired Donation Through Participation by Compatible PairsS. E. Gentry, D. L. Segev, M. Simmerling, R. A. Montgomery
Successful Three-Way Kidney Paired Donation with Cross-Country Live Donor Allograft TransportR. A. Montgomery, S. Katznelson, W. I. Bry, A. A. Zachary, J. Houp, J. M. Hiller, S. Shridharani, D. John, A. L. Singer, D. L. Segev
The Roles of Dominos and Nonsimultaneous Chains in Kidney Paired DonationS. E. Gentry, R. A. Montgomery, B. J. Swihart, D. L. Segev
Asynchronous, Out-of-Sequence, Transcontinental Chain Kidney Transplantation: A Novel ConceptF. K. Butt, H. A. Gritsch, P. Schulam, G. M. Danovitch, A. Wilkinson, J. Del Pizzo, S. Kapur, D. Serur, S. Katznelson, S. Busque, M. L. Melcher, S. McGuire, M. Charlton, G. Hil, J. L. Veale
Clinical Outcomes of Multicenter Domino Kidney Paired DonationY. J. Lee, S. U. Lee, S. Y. Chung, B. H. Cho, J. Y. Kwak, C. M. Kang, J. T. Park, D. J. Han, D. J. Kim
Organ Utilization and Outcomes:
Living-Donor Liver Transplantation for HepatoblastomaM. Kasahara, M. Ueda, H. Haga, H. Hiramatsu, M. Kobayashi, S. Adachi, S. Sakamoto, F. Oike, H. Egawa, Y. Takada, K. Tanaka
Living Donor Liver Transplantation for Biliary Atresia: A Single-Center Experience with First 100 CasesC.-L. Chen, A. Concejero, C.-C. Wang, S.-H. Wang, C.-C. Lin, Y.-W. Liu, C.-C. Yong, C.-H. Yang, T.-S. Lin, Y.-C. Chiang, B. Jawan, T.-L. Huang, Y.-F. Cheng, H.-L. Eng
Association Between Waiting Times for Kidney Transplantation and Rates of Live DonationD. L. Segev, S. E. Gentry, R. A. Montgomery
Regional and Racial Disparities in the Use of Live Non-Directed Kidney DonorsD. L. Segev, R. A. Montgomery
Recipient Morbidity After Living and Deceased Donor Liver Tranasplantation: Findings from the A2ALL Retrospective Cohort StudyC. E. Freise, B. W. Gillespie, A. J. Koffron, A. S. F. Lok, T. L. Pruett, J. C. Emond, J. H. Fair, R. A. Fisher, K. M. Olthoff, J. F. Trotter, R. M. Ghobrial, J. E. Everhart
Incidence and Severity of Acute Cellular Rejection in Recipients Undergoing Adult Living Donor or Deceased Donor Liver TransplantationA. Shaked, R. M. Ghobrial, R. M. Merion, T. H. Shearon, J. C. Emond, J. H. Fair, R. A. Fisher, L. M. Kulik, T. L. Pruett, N. A. Terrault
Resource Utilization of Living Donor Versus Deceased Donor Liver Transplantation Is Similar at an Experienced Transplant CenterJ. C. Lai, E. M. Pichardo, J. C. Emond, R. S. Brown Jr.
Organ Donation and Utilization in the United States: 1998–2007J. E. Tuttle-Newhall, S. M. Krishnan, M. F. Levy, V. McBride, J. P. Orlowski, R. S. Sung
Unique Early Gene Expression Patterns in Human Adult-to-Adult Living Donor Liver Grafts Compared to Deceased Donor GraftsJ. de Jonge, S. Kurian, A. Shaked, K. R. Reddy, W. Hancock, D. R. Salomon, K. M. Olthoff
Incentive Models to Increase Living Kidney Donation: Encouraging Without CoercingA. K. Israni, S. D. Halpern, S. Zink, S. A. Sidhwani, A. Caplan
Limiting Financial Disincentives in Live Organ Donation: A Rational Solution to the Kidney ShortageR. S. Gaston, G. M. Danovitch, R. A. Epstein, J. P. Kahn, A. J. Matas, M. A. Schnitzler
Public Attitudes Toward Incentives for Organ Donation: A National Study of Different Racial/Ethnic and Income GroupsL. E. Boulware, M. U. Troll, N. Y. Wang, N. R. Powe
The Association of State and National Legislation with Living Kidney Donation Rates in the United States: A National StudyL. E. Boulware, M. U. Troll, L. C. Plantinga, N. R. Powe
The Evolution and Direction of OPTN Oversight of Live Organ Donation and Transplantation in the United StatesR. S. Brown, Jr, R. Higgins, T. L Pruett
Stimulus for Organ Donation: A Survey of the American Society of Transplant Surgeons MembershipJ. R. Rodrigue, K. Crist, J. P. Roberts, R. B. Freeman Jr., R. M. Merion, A. I. Reed
Donor Procedures, Outcomes and Safety:
Obesity in Living Kidney Donors: Clinical Characteristics and Outcomes in the Era of Laparoscopic Donor NephrectomyJ. K. Heimbach, S. J. Taler, M. Prieto, F. G. Cosio, S. C. Textor, Y. C. Kudva, G. K. Chow, M. B. Ishitani, T. S. Larson, M. D. Stegall
Laparoscopic Procurement of Kidneys with Multiple Renal Arteries is Associated with Increased Ureteral Complications in the RecipientJ. T. Carter, C. E. Freise, R. A. McTaggart, H. D. Mahanty, S.M. Kang, S. H. Chan, S. Feng, J. P. Roberts, A. M. Posselt
Pre-donation Assessment of Kidneys by Magnetic Resonance Angiography and Venography: Accuracy and Impact on OutcomesS. A. Ames, M. Krol, K. Nettar, J. P. Goldman, T. M. Quinn, D. M. Herron, A. Pomp, J. S. Bromberg
Long-Term Consequences of Live Kidney Donation Follow-Up in 93% of Living Kidney Donors in a Single Transplant CenterJ. Gossmann, A. Wilhelm, H.G. Kachel, J. Jordan, U. Sann, H. Geiger, W. Kramer, E.H. Scheuermann
More on Parental Living Liver Donation for Children with Fulminant Hepatic Failure: Addressing Concerns About Competing Interests, Coercion, Consent and Balancing ActsA. Spital
Predictive Capacity of Pre-Donation GFR and Renal Reserve Capacity for Donor Renal Function After Living Kidney DonationM. Rook, H. S. Hofker, W. J. van Son, J. J. Homan van der Heide, R. J. Ploeg, G. J. Navis
Laparoscopic-Assisted Right Lobe Donor HepatectomyA.J. Koffron, R. Kung, T. Baker, J. Fryer, L. Clark, M. Abecassis
Cold Ischemia Time and Allograft Outcomes in Live Donor Renal Transplantation: Is Live Donor Organ Transport Feasible?C. E. Simpkins, R. A. Montgomery, A. M. Hawxby, J. E. Locke, S. E. Gentry, D. S. Warren, D. L. Segev
Evaluating Living Kidney Donors: Relationship Types, Psychosocial Criteria, and Consent Processes at US Transplant ProgramsJ. R. Rodrigue, M. Pavlakis, G. M. Danovitch, S. R. Johnson, S. J. Karp, K. Khwaja, D. W. Hanto, D. A. Mandelbrot
The Medical Evaluation of Living Kidney Donors: A Survey of US Transplant CentersD. A. Mandelbrot, M. Pavlakis, G. M. Danovitch, S. R. Johnson, S. J. Karp, K. Khwaja, D. W. Hanto, J. R. Rodrigue
Rescue of a Living Donor with Liver TransplantationB. Ringe, G. Xiao, D. A. Sass, J. Karam, S. Shang, T. P. Maroney, A. E. Trebelev, S. Levison, A. C. Fuchs, R. Petrucci, A. Ko, M. Gonzalez, J. C. Reynolds, W. C. Meyers
Nephrectomy Elicits Impact of Age and BMI on Renal Hemodynamics: Lower Postdonation Reserve Capacity in Older or Overweight Kidney DonorsM. Rook, R. J. Bosma, W. J. van Son, H. S. Hofker, J. J. Homan van der Heide, P. M. ter Wee, R. J. Ploeg, G. J. Navis
Pregnancy and Birth After Kidney Donation: The Norwegian ExperienceA. V. Reisæter, J. Røislien, T. Henriksen, L. M. Irgens, A. Hartmann
Pregnancy Outcomes After Kidney DonationH. N. Ibrahim, S. K. Akkina, E. Leister, K. Gillingham, G. Cordner, H. Guo, R. Bailey, T. Rogers, A. J. Matas
Preferences, Knowledge, Communication and Patient-Physician Discussion of Living Kidney Transplantation in African American FamiliesL. E. Boulware, L. A. Meoni, N. E. Fink, R. S. Parekh, W. H. L. Kao, M. J. Klag, N. R. Powe
Organ Donation Decision: Comparison of Donor and Nondonor FamiliesJ. R. Rodrigue, D. L. Cornell, R. J. Howard
Increasing Live Donor Kidney Transplantation: A Randomized Controlled Trial of a Home-Based Educational InterventionJ. R. Rodrigue, D. L. Cornell, J. K. Lin, B. Kaplan, R. J. Howard
Emigration from the British Isles to Southeastern Spain: A Study of Attitudes Toward Organ DonationA. Ríos, P. Cascales, L. Martínez, J. Sánchez, N. Jarvis, P. Parrilla, P. Ramírez
Virtual Issue compiled online 2 Feb 2010

Saturday, February 27, 2010

Herb Scarf explains mathematical economics

Herb Scarf (who certainly knows) explains what is mathematical economics to a Humanities audience. His powerpoint slides for that talk are here, along with videos of some other talks (that I wasn't able to download, however).

His examples include matching of medical residents, school choice, and kidney exchange.

Friday, February 26, 2010

The Future of Same Sex Marriage

The University of San Francisco Law Review's Spring Symposium, held today, is on The Future of Same-Sex Marriage.

I like the sound of the first panel discussion, called
Crunching the Numbers: Examining empirical data regarding the material consequences of denying or recognizing same-sex marriage.

Stability may be hard to achieve in decentralized matching

So says a paper by Muriel Niederle and Leeat Yariv: Decentralized Matching with Aligned Preferences

Abstract. We study a simple model of a decentralized market game in which firms make directed offers to workers. We focus on markets in which agents have aligned preferences. When agents have complete information or when there are no frictions in
the economy, there exists an equilibrium that yields the stable match. In the presence of market frictions and preference uncertainty, harsher assumptions on the richness of the economy have to be made in order for decentralized markets to generate stable outcomes in equilibrium.

Thursday, February 25, 2010

Compatible pairs in kidney exchange

The question of whether compatible patient-donor pairs should be invited to take part in kidney exchange is gaining some exposure with recent articles and news items in the medical literature. The issue is that if kidney exchange is restricted to patients who are incompatible with their live donors, we will be seeing many fewer blood type O donors than are in the general population, so exchanges will be more difficult to find, and there will be fewer transplants than if there weren't such a shortage. (Since O donors don't have a blood type incompatibility with any recipient, most of them will be compatible with their intended recipients; O donors are only incompatible if there is some other, immunological incompatibility.)

Here's a story from the most recent, Feb 2010 Nephrology Times: Dramatic Increase in Transplant Rates Projected if Compatible Pairs Are Included in Kidney Swaps

It follows up on a recent article by Lloyd Ratner, of Columbia University/New York–Presbyterian Hospital, reporting such a three-way exchange (Transplantation, 2010;89:15-22). The story also interviews some of the other pioneering surgeons involved in kidney exchange, including Frank Delmonico, Bob Montgomery and Steve Woodle.

Inviting compatible pairs to participate in exchanges seems like a very good idea indeed. (An early discussion, with simulations to provide quantitative estimates of the effect of including compatible pairs (which is quite large), was reported in Table 1 of:
Roth, Alvin E., Tayfun Sonmez, and M. Utku Unver, "A Kidney Exchange Clearinghouse in New England" American Economic Review, Papers and Proceedings, 95,2, May, 2005, 376-380. )

Wednesday, February 24, 2010

Market design at Yahoo!

Here's a project description from Yahoo! Research: Microeconomics and Market Design
By Michael Schwarz and David Reiley

What are the effects of complexity in mechanism design? Participating in an auction mechanism (or any market institution) requires time and effort on the side of the buyers. That in turn may lead some buyers to bid very conservatively, or not to participate at all, in order to economize on effort. We lack a theory for quantifying the complexity of a mechanism.

Auction theory and matching theory offer models and algorithms for allocating goods or matching market participants. However, the majority of markets do not use structured mechanisms (such as auctions and matching algorithms). Why are some markets (such the medical residency match) using centralized matching procedure while other markets (such as the purchases of automobiles with various options packages) do not? Answering this question may help to design structured market mechanisms for the markets where chaotic negotiations rule the day.

Understanding when and how reputations emerge, and how to improve the designs of structured reputation systems. Reputations of individuals and businesses play an important role in economic and personal life. With some exceptions, most notably in electronic commerce, the mechanisms for accumulating reputation are informal rather than structured.

How should a firm set posted prices for a menu of products? Although economics offers a theoretical framework for how to set prices, most theory assumes omniscience about demand. To build a practical pricing engine, one needs a system that generates exogenous price variation and then uses it to calculate appropriate prices going forward. Yahoo! offers thousands, even millions, of different advertising products, so estimating a demand system suffers from the curse of dimensionality as well as practical constraints (perceived fairness, etc.) in generating price variation. We are looking for better theory and econometrics for the problem of building a pricing engine.

Tuesday, February 23, 2010

Choosing schools (in NYC and SF)

I've written elswhere about the school choice process for public schools in San Francisco and for high schools in New York City. But, regardless of whether the process is a good one or not, the problem facing parents who have to decide how much they like each school can be a tough one, especially if there are a lot of schools.

Two articles help you feel the pain:

New Plan on School Selection, but Still Discontent discusses San Francisco, and
It’s a nightmare to apply for high schools in city discusses New York.

Some more background information here.

HT: Parag Pathak

Determining death for deceased organ donation

Darshak Sanghavi, writing a while ago in the NY Times Sunday Magazine, discusses When Does Death Start?

"Organ transplantation must abide by the so-called dead-donor rule: a person has to be declared dead before any vital organs can be removed. Yet organs have to be alive if there is any hope of successful transfer to a recipient. Medical professionals have handled this paradoxical situation — finding a dead body with live organs — by fashioning a category of people with beating hearts who are said to be brain-dead, usually after a traumatic head injury, and who are considered just as dead as if they had rigor mortis.
To diagnose brain death, doctors typically go through a checklist of about a dozen items, including assessing reflexes like blinking, coughing and breathing, which are all controlled by the brainstem. The criteria are extremely strict, and only a tiny fraction of severely brain-injured people meet them."

Before brain death, the traditional definition of death involved irreversible cessation of heart beat, and you can also donate after cardiac death (DCD), but things have to move fast, since once circulation stops the organs begin to die. "D.C.D. requires doctors to confront the shadowy question of exactly when somebody dies after the heart stops."

In the U.S., we seem to be converging on a 5-minute rule.

Monday, February 22, 2010

Kim Krawiec on selling virginity

Kim Krawiec has a post commenting on recent news stories and linking to a new paper: Like A Virgin? We Sell That Here!

"A few days ago, an anonymous 19-year-old New Zealand student offered her virginity to the highest bidder on the Web site under the name "Unigirl," saying she would use the money to pay for her tuition. According to Unigirl, more than 30,000 people have viewed her ad and over 1,200 made bids before she accepted a $32,000 offer. Story from NPR. (HT: Tonja Jacobi)
Though the story is creating a ruckus, including international press, the attention pales in comparison to that bestowed on the very similar story of “Natalie Dylan,” a pseudonym adopted by a 22-year old UC San Diego graduate who auctioned her virginity on the website of the Moonlight Bunny Ranch, a Carson City brothel, in January of 2009 in order to foot the bill for graduate research in women’s studies. In contrast to Unigirl’s paltry returns, Dylan reportedly received over 10,000 bids, the highest of which was $3.8 million, receiving both condemnation and praise in the auction process. Critics have argued that she is degrading herself and women generally, risks exporting Nevada’s poor morals to the rest of the country, and is selling something (virginity) for profit that should be cherished and freely given.
In an article I posted to SSRN over the weekend, A Woman’s Worth, I consider the reactions to Dylan’s virginity auction plan and the possible motivations underlying those reactions. What drives the attention and controversy generated by the Dylan auction? What are the perceived harms associated with Dylan’s actions, and in what ways are they greater than the harms associated with similar common activities? "

And here's the abstract to her paper on SSRN:

A Woman's Worth
Kimberly D. Krawiec Duke University - School of LawFebruary 6, 2010 North Carolina Law Review, Forthcoming

Abstract: This Article examines three traditionally “taboo trades”: (1) the sale of sex, (2) compensated egg donation, and (3) commercial surrogacy. The article purposely invokes examples in which the compensated provision of goods or services (primarily or exclusively by women) is legal, but in which commodification is only partially achieved or is constrained in some way. I argue that incomplete commodification disadvantages female providers in these instances, by constraining their agency, earning power, and status. Moreover, anticommodification and coercion rhetoric is sometimes invoked in these settings by interest groups who, at best, have little interest in female empowerment and, at worst, have economic or political interests at odds with it.

Keywords: Sex Work, Virginity, Prostitution, Oocyte Donation, Sperm Markets, Surrogacy, Medical Marijuana

See also her related post Chicago Students Have All the Fun

Beer legally for sale in another Mississippi county

Another repugnant transaction bites the dust: A Voting Result That Faulkner Could Drink To

"NEW ALBANY, Miss. — There was a vote here last month. It was hard-fought, with dueling newspaper advertisements and yard signs, tableside debates in restaurants, a prayer rally and a fusillade of last-minute phone calls.
But only one side could win, and the victory was a historic one: in a couple of months, a person will be able to buy a beer legally here in William Faulkner's birthplace for the first time in more than 50 years.
Liquor and wine, of course, are still illegal, because the vote concerned only the sale of beer and wine coolers. But there is no shortage of bad news for teetotalers.
At a post-election meeting of the Board of Aldermen, people opposed to alcohol urged, among other things, that beer not be sold on Sundays, or in single bottles, or even refrigerated. They recommended that cases of beer be available only warm, as they are in the city of Oxford 30 miles down the road, requiring a degree of premeditation on the part of the discriminating beer buyer.
The aldermen ruled against them on all counts."
"Mississippi, the first state to ratify Prohibition, has a peculiar history when it comes to temperance. Liquor was banned here long after federal Prohibition was repealed in 1933, under an arrangement that pleased everyone: the Baptists, the bootleggers and the state, which, curiously enough, levied taxes on illegal alcohol. "

Sunday, February 21, 2010

A National kidney exchange takes another tentative step forward

UNOS issued the following press release on Friday: Participants Named for National Pilot Project for Kidney Paired Donation

"Four organizations representing more than 80 kidney transplant programs nationwide have been selected to enroll patients and potential living donors in a national pilot project to facilitate kidney paired donation (KPD) transplants. Kidney paired donation involves the coordinated matching of living donors with medically compatible recipients in cases where the original intended recipient is not compatible with his or her potential donor.

The national Organ Procurement and Transplantation Network (OPTN), operated under federal contract by United Network for Organ Sharing (UNOS), will coordinate the project. Its goals include assessing whether more compatible matches are made possible through a large pool of donors and candidates, as well as studying the feasibility of implementing a national program.

The following organizations, each affiliated with a number of additional transplant programs, will participate in the initial phase of the pilot:

Alliance for Paired Donation, Maumee, Ohio
Johns Hopkins Hospital, Baltimore, Md.
New England Program for Kidney Exchange, Newton, Mass.
UCLA Medical Center/California Pacific Medical Center, Los Angeles and San Francisco, Calif.

"Each group was chosen for its experience with kidney paired donation and its willingness to broaden the availability of this procedure to a much wider group of people needing transplants," said James Wynn, M.D., president of the OPTN and UNOS and chair of the OPTN/UNOS Board of Directors. "Kidney paired donation offers the possibility of hundreds more transplants per year, perhaps over a thousand per year as the transplant community gains more experience. In turn this may enhance opportunities for more candidates to get deceased donor transplants."

Participants replied to an OPTN request for proposal and were selected by a group drawn from the OPTN/UNOS Kidney Transplantation Committee, the Kidney Paired Donation Work Group and OPTN/UNOS leadership. No member of the selection group was directly affiliated with any of the applicants. In addition, all information identifying the specific applicants was blinded to allow the group to focus on objective criteria in each application.

"In addition to the thousands of hours of volunteer expertise donated by kidney professionals and the living donation community," said Dr. Wynn, "this program depends on the gracious support of project partners, charitable gifts and in-kind donations. The software to be used in the matching process has been donated by various institutions, and we continue to be guided by the people and programs with the greatest expertise in kidney paired donation."

The Organ Procurement and Transplantation Network (OPTN) is operated under contract with the U.S. Department of Health and Human Services, Health Resources and Services Administration, Division of Transplantation by the United Network for Organ Sharing (UNOS). The OPTN brings together medical professionals, transplant recipients and donor families to develop organ transplantation policy."

A number of tough challenges remain, among them how to organize the national exchange to attract full participation from hospitals and exchange networks, so as to have a thick pool of donors and patients (and not just those who hospitals find hardest to match).

Saturday, February 20, 2010

Sipping lattes while bearing arms

A NY Times editorial suggests that coffee drinking while carrying is repugnant. (Background: it's legal to carry unconcealed weapons in California, and in a number of other states, under some restrictions.)

"Two sizable chains, Peet’s Coffee & Tea and California Pizza Kitchen, have banned patrons carrying guns, and a struggle is under way at the prized Starbucks coffee shops.
Should customers be free to sip Skinny Cinnamon Dolce Lattes at their laptop screens while brandishing a gleaming Ruger .357? So far, Starbucks executives say yes, claiming they are quite safety-minded within a policy that “supports the federal, state and local laws in the communities in which we do business.”
Fortunately, Californians are treating the showdown at Starbucks as far from settled. Thousands are signing petitions from the Brady Campaign to Prevent Gun Violence, wisely begging the chain not to jangle its trademark caffeine serenity by tolerating firearms. Starbucks should listen."

Books about markets for body parts (for and against)

Below are a mix of books, some scholarly some popular, mostly harvested by clicking on the Amazon links "people who bought this book also bought," from one book to the next. The descriptions are from Amazon:

Body Shopping: Converting Body Parts to Profit by Donna Dickenson
Product Description
According to law, you don't actually own your own body, and you might be shocked by the cunning ways everyone from researchers and entrepreneurs to doctors, insurers, and governments are using that fact to their advantage. Thanks to developments in biotechnology and medicine, cells, tissues, and organs are now viewed as both a valuable source of information and as the raw material for new commercial products.This 'currency of the future' might be fueling the new biotechnology industry, but the former owners of that flesh and bone aren't entitled to one fraction of the proceeds. In "Body Shopping", award-winning writer Donna Dickenson makes a case against the newfound rights of businesses to harvest body parts and gain exclusive profit from the resulting products and processes. To illustrate her case, she presents a series of compelling stories of individuals injured or abused by the increasingly rapacious biotechnology industry. Some cases have become public scandals, such as the illicit selling of the late broadcaster Alastair Cooke's bones by a body parts ring involving surgeons and undertakers.Others are hardly known at all, including the way in which for-profit umbilical cord blood banks target pregnant women with offers of a 'service' that professional obstetrics bodies view as dangerous, the leukemia patient who tried and failed to claim property rights in a $3 billion cell line created from his tissue, and the real risks facing women who provide eggs for the global market in baby-making. "Body Shopping" offers a fresh, international, and completely up-to-date take on the evolving legal position, the historical long view, and the latest biomedical research - an approach that goes beyond a mere recital of horror stories to suggest a range of new strategies to bring the biotechnology industry to heel. The result is a gripping, powerful book that is essential reading for everyone from parents to philosophers, and from scientists to lawmakers - everyone who believes that no human should ever be reduced to the sum of their body parts.

Black Markets: The Supply and Demand of Body Parts by Michele Goodwin, 2006
From Publishers Weekly
Law professor and bioethicist Goodwin sheds much needed light in this disturbing examination of yet another failure of the American health care system: an organ donation process that leads to the sale of human organs. Despite some highly technical sections, the author artfully uses case law and tragic stories of people caught in the machinery of an organ marketplace that favors the well connected. Even readers well versed in current events are likely to be shocked by the prevalence of "presumed consent" legislation in 28 states that shifts the choice to donate away from potential donors —corneas, for instance, are routinely harvested by local coroners unless a specific prior refusal has been communicated (and sometimes even despite such a directive). The author does a good job of linking this country's history of medical scandals that victimized African-Americans to that community's misgivings about serving as either donors or seekers of a spot on the coveted transplant waiting lists. Her controversial recommendations, which include lifting the taboo on selling cadaveric organs to address the organ deficit, should spark much discussion. (Mar.)

Tissue Economies: Blood, Organs, and Cell Lines in Late Capitalism (Science and Cultural Theory) ~ Catherine Waldby (Author), Robert Mitchell (Author)
Product Description
As new medical technologies are developed, more and more human tissues—such as skin, bones, heart valves, embryos, and stem cell lines—are stored and distributed for therapeutic and research purposes. The accelerating circulation of human tissue fragments raises profound social and ethical concerns related to who donates or sells bodily tissue, who receives it, and who profits—or does not—from the transaction. Catherine Waldby and Robert Mitchell survey the rapidly expanding economies of exchange in human tissue, explaining the complex questions raised and suggesting likely developments. Comparing contemporary tissue economies in the United Kingdom and United States, they explore and complicate the distinction that has dominated practice and policy for several decades: the distinction between tissue as a gift to be exchanged in a transaction separate from the commercial market and tissue as a commodity to be traded for profit.
Waldby and Mitchell pull together a prodigious amount of research—involving policy reports and scientific papers, operating manuals, legal decisions, interviews, journalism, and Congressional testimony—to offer a series of case studies based on particular forms of tissue exchange. They examine the effect of threats of contamination—from HIV and other pathogens—on blood banks’ understandings of the gift/commodity relationship; the growth of autologous economies, in which individuals bank their tissues for their own use; the creation of the United Kingdom’s Stem Cell bank, which facilitates the donation of embryos for stem cell development; and the legal and financial repercussions of designating some tissues “hospital waste.” They also consider the impact of different models of biotechnology patents on tissue economies and the relationship between experimental therapies to regenerate damaged or degenerated tissues and calls for a legal, for-profit market in organs. Ultimately, Waldby and Mitchell conclude that scientific technologies, the globalization of tissue exchange, and recent anthropological, sociological, and legal thinking have blurred any strict line separating donations from the incursion of market values into tissue economies.

Body Brokers: Inside America's Underground Trade in Human Remains (Paperback)~ Annie Cheney 2006
From Booklist
*Starred Review* Here's one with the potential to keep folks up nights, wondering whether the urn on the mantel contains 100-percent Uncle Fred or a blend. Before journalist Cheney began an assignment for My Generation magazine, she had never suspected there might be diverse career opportunities for cadavers, that whatever one wants to be when one grows up, options continue to exist postmortem. But consider the ever-popular organ donor program. And then there's the option of donating one's body to a medical school for the betterment of mankind through science. Once that latter choice is made, Cheney learned, alternatives multiply, and a corpse can follow one of several roads. On a lower thoroughfare, big bucks are waiting for the cold-blooded entrepreneur ready to carve human bodies up like chickens and parcel them out to the highest bidder for such uses as military bomb test dummies, lifelike operative subjects for medical seminars, and resource troves for the machine-tooling of bones into orthopedic apparatus. Even if one never willingly donates one's body, there are enough unscrupulous morticians and morgue workers who will surreptitiously carve out an ulna or a femur and replace it with a PVC pipe, then sell the goods on the not-so-open open market. This is a chilling expose of the grisly industry of body trading. Donna ChavezCopyright © American Library Association. All rights reserved --This text refers to the Hardcover edition.

Kidney for Sale by Owner: Human Organs, Transplantation, and the Market )~ Mark J Cherry, 2005
Product Description
Over the past decade in the United States, nearly 6,000 people a year have died waiting for organ transplants. In 2003 alone, only 20,000 out of the 83,000 waiting for transplants received them - in anyone's eyes, a tragedy. Many of these deaths could have been prevented, and many more lives saved, were it not for the almost universal moral hand wringing over the concept of selling human organs. Bioethicist Mark Cherry explores the why of these well-intentioned misperceptions and legislation and boldly deconstructs the roadblocks that are standing in the way of restoring health to thousands of people. If most Americans accept the notion that the market is the most efficient means to distribute resources, why should body parts be excluded? Kidney for Sale by Owner contends that the market is indeed a legitimate - and humane - way to procure and distribute human organs. Cherry stakes the claim that it may be even more just, and more compatible with many Western religious and philosophical traditions, than the current charity-based system now in place. He carefully examines arguments against a market for body parts, including assertions based on the moral views of John Locke, Immanuel Kant, and Thomas Aquinas, and shows these claims to be steeped in myth, oversimplification, and contorted logic. Rather than focusing on purported human exploitation and the irrational "moral repugnance" of selling organs, Cherry argues that we should focus on saving lives. Following on the thinking of the philosopher Robert Nozick, he demonstrates that, with regard to body parts, the important core humanitarian values of equality, liberty, altruism, social solidarity, human dignity, and, ultimately, improved health care are more successfully supported by a regulated market rather than by well meant but misguided, prohibitions.

The Ethics of Organ Transplants: The Current Debate (Contemporary Issues (Buffalo, N.Y.).) (Paperback 1999)~ Arthur L. Caplan (Author, Editor), Daniel H. Coelho (Editor)
From Library Journal
Renowned bioethicist Caplan (Ctr. for Bioethics, Univ. of Pennsylvania) and medical writer Coelho have selected 35 articles that are representative of the ethical issues surrounding organ transplantation. Scarcity of organs and the high costs involved in these procedures force difficult legal, philosophical, scientific, and economic choices. What are the sources of organs used in transplantation? How can we make the procurement system more efficient? Should we pay for organs? Should someone who has already received one transplant be allowed a second? Should alcoholics be given liver transplants? Are transplants really worth the tremendous costs? These are just a few of the questions discussed here. In many cases, the editors have selected companion articles that illustrate contrasting viewpoints on a particular issue. Although some articles are slightly dated, the issues are still relevant. This well-balanced, reasonably priced compilation is recommended for all libraries.ATina Neville, Univ. of South Florida at St. Petersburg Lib.Copyright 1999 Reed Business Information, Inc.

The U.S. Organ Procurement System: A Prescription for Reform (AEI Evaluative Studies.) (Hardcover) by David L. Kaserman and A. H. Barnett
Product Description
Experts make a compelling and persuasive case for markets in human organs.

Kieran Healy, Last Best Gift. Altruism and the Market for Human Blood and Organs. Chicago University Press, 2006

The Baby Business: How Money, Science, and Politics Drive the Commerce of Conception (Hardcover)~ Debora L. Spar
From Publishers Weekly
Among the troubling aspects of new reproductive technologies is the takeover of reproduction by the marketplace. This probing study accepts the free market process while casting a discerning and skeptical eye at its pitfalls. Harvard business prof Spar (The Cooperative Edge: The Internal Politics of International Cartels) explores many aspects of the high-tech commodification of procreation: the fabulous revenues commercial fertility clinics earn from couples' desperate desire for children and the ensuing conflicts between medical ethics and the profit motive; the premiums paid for sperm and eggs from genetically desirable donors; the possible exploitation of poor, nonwhite and Third World surrogate mothers paid to gestate the spawn of wealthy Westerners; the fine line between modern adoption practices and outright baby selling; and the new entrepreneurial paradigm of maternity, in which the official "mother" simply finances the assemblage of sperm, purchased egg and hired womb and lays contractual claim to the finished infant. Spar considers most of these developments inevitable and not undesirable (they provide kids to parents who want them), but calls for government regulation to curb excesses and protect the interests of all involved. Her sanguinity will not satisfy all critics, but she offers a lucid, nuanced guide to this brave new world. (Feb. 14) Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

Friday, February 19, 2010

College admissions in England

In England, universities faced with unexpectedly many applicants are raising the grades required for admission, which is apparently regarded as somewhat suspect:

A-level entry requirement shock for university applicants

"LEADING universities have been accused of unjustly raising A-level entry requirements at the last minute because of a surge in applicants and severe government cuts. "

Thursday, February 18, 2010

SF School Board Meeting, Feb 17: new choice system

At the latest public meeting of the San Francisco Board of Education (last night, Wednesday, Feb. 17), the commissioners and the public were engaged in a detailed discussion of the algorithms and priorities being proposed for the new school choice system.

Muriel Niederle explains and answers questions about the new Assignment with Transfers school choice plans being proposed (with variations for elementary school, middle school, and high schools). She comes on just after minute 36 of this video of the 3 hour meeting, and her presentation, interspersed with questions and answers, continues for a little over an hour (to minute 1:39), although she's back answering questions at the end again. Also presenting the general plan and answering questions is Orla O'Keefe, the SFUSD official leading the effort to design the new school choice system.

There's something very encouraging about seeing the public policy discussion focusing on choice systems that are non-wasteful (Pareto efficient, for you economists), strategically simple for parents (so that truthful preference revelation is a dominant strategy), and flexible (so that the school board can tweak the system in years to come without harming the first two properties). The 'political' issues are the priorities that different children have at different schools.

Another attractive aspect of the proposal (discussed by Ms. O'Keefe following Muriel's presentation) is that data would be collected each year for continual monitoring of how the choice and assignment system is working.

The discussion touches on a number of interesting questions. (Even if the algorithm makes truthful preference revelation the best strategy, there are still issues of checking e.g. addresses in any system in which priorities at schools depend on home address...). But it looks like SF is well launched on adopting a sensible, workable, well thought out and flexible framework.

Why isn't the queue longer for deceased donor kidneys?

There are approximately 80,000 people signed up on the waiting list for deceased donor kidneys in the U.S., and this list has been getting longer. We only manage to do about 11,000 deceased donor transplants a year. (There are another approx. 6000 live donor transplants per year).

Kidney exchange and other innovations in transplantation are attempts to make the list shorter.
But a different kind of public health question is, why isn't the list longer? According to the latest Kidney and Urologic Diseases Statistics for the United States, there are presently just over half a million people suffering from End Stage Renal Disease, of whom just over 350,000 are undergoing dialysis. Why aren't all these folks on the deceased donor transplant list?

Some of them may not be in a position to benefit from a transplant, e.g. they may have other critical illnesses, or may not be healthy enough to undergo major surgery. But some of them may just not be getting adequate information about transplantation. Here's a story about that from the St. Louis Post Dispatch: Program touts kidney transplants over dialysis.

"Several years ago, Amy Waterman, assistant professor of medicine and a social psychologist at Washington University, realized that most people with kidney failure go on dialysis and stay on it until they die.

She studied more than 1,000 renal patients and living donors and found that they're often so overwhelmed with information about dialysis, including necessary lifestyle changes, that they're given little or no information on kidney transplants in the crucial months after being diagnosed"
..."But time is of the essence because patients spend an average of four years on transplant waiting lists, yet only about a third of all dialysis patients live more than five years after diagnosis, Waterman says. In comparison, 70 percent to 80 percent of those who get kidney transplants live more than five years."

On a related matter, Dorry Segev of Johns Hopkins is quoted in a press release about a forthcoming article in the AJT suggesting that too few elderly patients are put on the waiting list for extended criteria deceased donor kidneys: Seniors Stymied in Wait for Kidney Transplants

Wednesday, February 17, 2010

Cat stew

Italian Food TV Host Under Fire For "Succulent" Cat Stew Recommendation (VIDEO)

"Leading Italian food expert, writer and TV host Beppe Bigazzi has been suspended indefinitely from his TV program for curiously recommending a cat stew to viewers, and explaining a rough method of preparation. Bigazzi's spectacle occurred on a recent episode of his midday show, La Prova del Cuoco ("The proof of the cook"), which appears on Italy's main public broadcasting channel, RAI.
Said Bigazzi, as his co-host (and cat-owner) Elisa Isoardi nervously looked on, "I've eaten it myself and it's a lot better than many other animals. Better than chicken, rabbit or pigeon... I've eaten its delicious white meat many times."
Leading animal rights groups in Italy are predictably enraged. The Italian Animal Protection Agency has called for his firing, explaining, "anyone who goes on television to promote the taste of cat meat is guilty of instigating viewers to commit an act of cruelty to animals, a crime punishable by up to 18 months in prison."
Italy's Deputy Health Minister, Francesca Martini, decried Bigazzi's rant as well, saying it was "absolutely unheard of for a public service broadcaster to tell people how delicious cats are to eat" and "offensive to the growing number of people who care about the way we treat animals." She also noted that "cats are pets protected by law [against] cruelty, maltreatment and abandonment."
Bigazzi, previously the author of "Cooking with Common Sense," has since explained that he was joking, although he indeed has enjoyed feasting on cat. "Mind you, I wasn't joking all that much. In the 1930s and 1940s, when I was a boy, people certainly did eat cat in the countryside around Arezzo," he explained. "

HT: Bettina Klaus

Matrimony and dating sites with attitude

The NY Times reports on the market for online dating and marriage sites that have ideas about who should be matched with whom: Better Loving Through Chemistry.

"Now, a handful of dating Web sites are competing to impose some science, or at least some structure, on the quest for love by using different kinds of tests to winnow the selection process. In short, each of these sites is aiming to be the Netflix of love.
Instead of using a proprietary algorithm to recommend movies you might enjoy, based on your past choices, however, these dating sites offer you a list of romantic candidates whose selection is based on proprietary analyses of personality characteristics or biological markers.

Consider, founded about two years ago, which aims to create romantic chemistry via genetic testing. The site, which matches people based on certain genetic markers for the immune system, takes its cue from studies showing that women are more attracted to the smell of men who have very different immune systems from their own. The site charges $1,995.95 for a lifetime membership — the lofty fee includes a cheek swabbing kit, DNA processing, a criminal and bankruptcy background check, as well as verification of age and marital status, the site says.
Then there’s, started in 2006 by the dating giant Helen Fisher, the biological anthropologist who developed’s questionnaire, says the site is designed to predict compatibility based on traits of temperament like adventurousness, decisiveness or empathy. And it charges a premium for its services: about $50 for a one-month membership, compared with about $35 for
But both and are refinements of an idea originally developed by "

..."Online dating is a $976 million annual industry in the United States, according to estimates from Marketdata Enterprises, a research firm. So, to stand out among hundreds of mass-market, open-community sites that attract everyone from people trolling for quick hookups to those headed for holy matrimony, a few services offer more elaborate mate-finding methods.
They build brand identity when they “target people who are looking for relationships rather than just dating,” says John LaRosa, the research director at Marketdata Enterprises. That means matchmaking sites with fewer users can charge more per subscriber than larger sites that list online personals., with an estimated 1.2 million paid subscribers, had revenue of about $365 million in 2008, Mr. LaRosa estimates. EHarmony, meanwhile, with about 656,000 paid members, had estimated revenue of $216 million that year, he says. "

Tuesday, February 16, 2010

Girls and the Little League

An obituary of Judge Sylvia Pressler reminds us of some recent history: NJ Judge Who Opened Little League to Girls Dies

"While serving as a hearing examiner with New Jersey's Division on Civil Rights, Pressler ruled that a 12-year-old northern New Jersey girl should have been allowed to play on a Little League team.
''The institution of Little League is as American as the hot dog and apple pie,'' Pressler wrote in a sharply worded opinion. ''There is no reason why that part of Americana should be withheld from girls.''
The ruling was decried by Little League as ''conceived in vindictive and prejudicial fashion of the worst kind,'' but it was upheld on appeal, and New Jersey became the first state to bar sex discrimination in Little League.
By the following year, Little League amended its charter to allow girls and also created a softball division."
"The Little League case reached Pressler in 1973. Maria Pepe, a 12-year-old Hoboken resident, had played three games for her Little League team the year before but stopped when Little League's national office threatened to revoke the league's charter. The National Organization for Women filed a lawsuit on her behalf.
Pressler said his wife didn't consider the Little League case one of her more difficult decisions, despite its ramifications and the publicity surrounding it.
''It was an important case because of its timing,'' he said. ''But it was perfectly obvious to her that they were completely cockeyed in barring girls if they were physically able.'' "

Ending "Don't ask don't tell" in the US military

The day when gay and lesbian soldiers, sailors and airmen will be able to serve openly is coming closer, and Admiral Mike Mullen has called for an end to the makeshift compromise under which they presently serve. In the NY Times, Frank Rich notes that this has become politically feasible as the country's mood has shifted: Smoke the Bigots Out of the Closet

"Mullen’s heartfelt, plain-spoken testimony gave perfect expression to the nation’s own slow but inexorable progress on the issue. He said he had “served with homosexuals since 1968” and that his views had evolved “cumulatively” and “personally” ever since. So it has gone for many other Americans in all walks of life. As more gay people have come out — a process that accelerated once the modern gay rights movement emerged from the Stonewall riots of 1969 — so more heterosexuals have learned that they have gay relatives, friends, neighbors, teachers and co-workers. It is hard to deny our own fundamental rights to those we know, admire and love.
But that’s not the whole explanation for the scant pushback in Washington to Mullen and his partner in change, Defense Secretary Robert Gates. There is also a potent political subtext. To a degree unimaginable as recently as 2004 — when Karl Rove and George W. Bush ran a national campaign exploiting fear of gay people — there is now little political advantage to spewing homophobia. Indeed, anti-gay animus is far more likely to repel voters than attract them. "

This of course parallels the slow shift in attitude towards slavery and, presently, same sex marriage. I'm reminded of the 2004 New Yorker cartoon in which a wife is pictured, suitcase in hand, leaving her husband and explaining "There's nothing wrong with our marriage, but the spectre of gay marriage has hopelessly eroded the institution."

Update: today's NY Times also has a column on the complex relationship of women in the military, who presently aren't allowed to have combat specialties: Women's Work
"While it may be a D.O.D. policy to keep women out of combat, the reality doesn’t match the policy. Right now, a plan is being formulated to phase out “Don’t Ask, Don’t Tell,”, so that openly homosexual soldiers can serve in the military. If all goes according to plan, gay men will be able to serve in both combat and support units, depending on their chosen M.O.S. They will have to adhere to the same performance standards as straight male soldiers. So while we’re at it, can we phase out the policy of underestimating women? If Israel did it, why not the U.S.? Legislation like the Women Veterans Health Care Improvement Act, which aims to make sure women veterans get the services they need at home, is a step in the right direction, but it only addresses a symptom of the inequality women face in the active military. In reality, American women do engage in combat, so it’s probably time to make it a written policy. If the policy changes, maybe attitudes will too."

Monday, February 15, 2010

Changes in repugnant transactions are sometimes gradual

Years from now we may look back on the gradual change in the status of same sex marriage , for example, or the ability of gays and lesbians to serve openly in the military, and be puzzled at what took so long. But it's useful to look back on the abolition of slavery to get some perspective.
In 1780, the Commonwealth of Pennsylvania passed An Act for the Gradual Abolition of Slavery, starting with children born in Pennsylvania following the passage of the act, but not altering the status of slaves owned by Pennsylvanians at the time of the act.

It took another 85 years before the 13th Amendment to the Constitution declared that "Neither slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall exist within the United States, or any place subject to their jurisdiction." The 13th Amendment was passed by the Congress on January 31, 1865, and ratified by the states on December 6, 1865.

HT: Volokh conspiracy

Sunday, February 14, 2010

Ten at one blow

One further thought on National Donor Day. The famous fairy tale "Seven at one blow" reminds us of the power of a succinct summary.

So I was moved by this Australian white paper on organ transplantation, which highlights the phrase

"One donor can save the lives of up to ten people."

Since the paper talks about both deceased donation (of multiple organs) and live kidney donation and kidney exchange, that could refer to several things. I suspect they are thinking of deceased donors of multiple organs. But (and this is what first caught my eye), they could also be referring to the first non-simultaneous extended altruistic donor chain, organized by Mike Rees (see this post too), which accomplished ten transplants (here are the pictures of the donors and recipients from People magazine). Since then, long, non-simultaneous chains have started to become a common form of kidney exchange.

Today is (also) National Donor Day

Happy Valentine's Day! Isn't it good to love and be loved?

Food for thought: Today is also National Donor Day.

"February 14 is the 10th National Donor Day -- a day to give the gift of life.
Fill out an organ and tissue donation card, register with your State Donor Registry and make sure your family knows you want to be a donor.
Join the National Registry of potential volunteer marrow and blood stem cell donors.
Learn how you can donate your baby's umbilical cord blood stem cells at birth.
Donate blood.
Why be a Donor?
The need is great and growing.
Almost 95,000 people are in need of an organ for transplant.
Approximately 35,000 children and adults in our country have life-threatening blood diseases that could be treated by a marrow/blood stem cell or cord blood transplant.
Every two seconds someone in America needs blood, more than 39,000 units each day, according to the American Red Cross.
Why do it Today?
Valentine's Day is the day of love and donation is the gift of life. Can you think of a more loving gesture than making February 14 the day you join thousands of Americans in making the donation decision?

National Donor Day was started in 1998 by the Saturn Corporation and its United Auto Workers partners with the support of the U.S. Department of Health and Human Services and many nonprofit health organizations. "

Saturday, February 13, 2010

Bioethics and bioethicists

Sally Satel on bioethicists:

"Ask almost any hospital physician about bioethicists and you will get, in reliable sequence, an eye roll, a sigh, and then an earful of anecdotes about swaggering cowboys posing as arbiters of right and wrong (“Wizards of Oughts,” as one critic put it). In the media, the coverage of almost any biomedical controversy is sure to contain a quotation from a bioethicist with oracular pretensions. The unmistakable message of ethics punditry is clear: anyone who disagrees with us is thoughtless or unethical.
Such arrogance discomfits some bioethicists..."

From The Right (and Wrong) Answers, her book review of Observing Bioethics by Renee C. Fox and Judith P. Swazey

And here: The Limits of Bioethics

Friday, February 12, 2010

Cheating on CS homeworks, and social pressure

The Temptation to Cheat in Computer Science Classes at Stanford is apparently great (just cut and paste some code if your assignment isn't running as the deadline nears), but the tools for catching this kind of cheating are also effectively automated.

"The number of honor code violations have prompted Professor Roberts to implement a new system. Describing this method as a “collective incentive” for students to maintain academic standards, the professor said he will add 5 percent for every honor-code violation in his class to the weight of the final exam, which is currently 15 percent of the class grade.
In other words, if one person cheats, the whole class will face more pressure on the final exam, because it will make up a greater portion of a person’s grade. Whether the scorn of fellow students is a bigger deterrent to cheating than being personally disciplined by the university remains to be seen."

Experiments on moral intuitions

As I'm not at all sure what is involved in judgments of repugnance, I follow various lines of work, including the very interesting intersection between psychology and philosophy that involves peoples' moral intuitions.

Here's a review of a book that interviews some of the researchers about their work:

Review - A Very Bad Wizard Morality Behind the Curtain by Tamler Review by Joshua May

"The distinguished interviewees are Galen Strawson, Philip Zimbardo, Franz De Waal, Michael Ruse, Joseph Henrich, Joshua Greene, Liane Young, Jonathan Haidt, Stephen Stich, and William Ian Miller.

Thursday, February 11, 2010

Anti-social claiming of parking spots in South Boston (before snow has started)

A social norm in South Boston that allows people to reserve public parking spots that they have dug out of the snow is unraveling, the Globe reports: Claiming a spot before shoveling? That’s not Southie

"The trash barrels, plastic crates, and lawn chairs lining the streets of South Boston yesterday morning were hardly unusual in a neighborhood famous for its you-shovel-it, you-own-it moral code in claiming curbside parking in snow storms. But there was a difference yesterday: The place-holders were out before a flake had fallen.
Even though commuters woke up hearing forecasts for up to a foot of snow during the day, the fact that so many had staked out spots without earning them by shoveling first was too much for some longtime residents.
“That was not the original idea,’’ said Kelly Watts, a 40-year-old lifelong resident, as she frowned at a wicker stool saving a spot of dry pavement on Emerson Street near Tynan Elementary School. “We would never have done that growing up. Claiming a spot you haven’t even dug out? That’s just lazy.’’
Laying claim to curbside parking is practiced around the city, but in Southie, where residents defied mayoral orders to stop - and an army of garbage trucks he sent to dispose of place-holders - it’s considered a birthright.
Protocol has long held that shoveling is a required down payment, but increasingly drivers are snatching up spaces in advance, knowing they will be harder to come by after the snow falls. Residents say the preemptive strikes are exposing rifts.
“Whoever did this is new Southie,’’ said Eddie Phillips as he walked his dog past a claimed spot on N Street near East Broadway shortly after noon.
By then, a gallery of household items lined the streets - a plastic recylcing bin on N Street, a turned-over trash can on P, lawn chairs weighted with bricks on West Ninth.
Each makeshift marker rested on bare asphalt, untouched save a preventive dusting of salt. The anticipated storm hadn’t arrived.
“You would never have seen this in the old days. Not in a million years,’’ said Phillips, a 66-year-old who said neighbors used to stick together, not selfishly scramble to get theirs. “Back in the day, you’d shovel your spot out, then you’d shovel your neighbor’s out, then you’d save it for him so he’d have it when he got home. That’s old Southie.’’ "
"When she first arrived in South Boston, she respected the sanctity of parking barrels and paint cans. But then people started stealing her hard-dug spot, so she took someone else’s. Retribution was swift.
“My car got boxed in so badly I couldn’t wedge out,’’ the 49-year-old recalled with a sigh. “I went back to following the rules.’’
Paybacks like the kind Medina got led Mayor Thomas M. Menino in 2005 to declare war on the claiming of parking spaces, and he ordered city workers to remove all the markers. Furious South Boston residents, led by the late Councilor James M. Kelly, revolted.
Menino compromised, with a rule that allowed the practice as long as the markers were cleared from the street 48 hours after the end of a snow emergency.
Even with many residents dismayed now at the claiming of spots before snow has fallen, the deck furniture and picnic coolers that show up on the street go undisturbed.
“You move it, you might find it tossed through your windshield,’’ said Kevin Watts, 38."

Dispute resolution by kidnapping in Yemen

Al Jazeera reports: Abductions rife in lawless Yemen

"The government of Yemen has had to deal with years of severe internal conflicts in the north and south, crippling it from implementing an effective legal system throughout the country.
As a result, the people of Yemen have developed the practice of taking the law into their own hands.
For numerous tribes - the ancient old method of abduction - especially of children - continues to be a common way to settle disputes among one another.
Some Yemenis even accuse the government of being guilty of the same practice."

Iran's nuclear program, and incentives

A new paper argues that Iran's leaders have succeeded in making Iran's nuclear program a protected transaction, that may not respond well to ordinary incentives:
Emerging sacred values: Iran’s nuclear program by Morteza Dehghani, Rumen Iliev, Sonya Sachdeva, Scott Atran, Jeremy Ginges and Douglas Medin, Judgment and Decision Making, Vol. 4, No. 7, December 2009, pp. 930–933

In a small survey, they find that Iranians who don't think Iran should give up its nuclear program "no matter how great the benefits" react more negatively to deals that involve monetary incentives.

HT: Luke Coffman

Wednesday, February 10, 2010

Job search in Japan

The Chronicle of Higher Education reports: In Bleak Economy, Japanese Students Grow Frustrated With Endless Job Hunt (subscription required)

"The recruiting system, which began in the early 1950s as a response to labor shortages, has caused years of tension between corporations and universities, which complain that it disrupts study."
"Japan is not unique in effectively forcing college students to look for jobs before graduation, but Mr. Slater says the system does demand that they start early. "They must begin figuring out what they want to do by second year," he says, "and it becomes really heavy-duty in third."
A voluntary code adopted by Japan's largest business lobbying group, the Keidanren, in 2007 does not allow companies to start recruiting graduates before October, but the code is widely flouted, say critics, with recruitment beginning as early as the summer before students' senior year."
"Recruitment is being pushed back earlier into the third and even the second year, says Mr. Hori, the Waseda student. "I'm as afraid as anyone of not being able to get work, but university just becomes a waste of time."
Those who miss out on recruitment the first time around are instantly relegated to the back of the pack, students agree. "You don't belong anywhere if you don't get a job straight after you graduate," says Yumi Nishikawa, also a fourth-year student at Sophia. "If you fail, you're stigmatized." "

For some background on this market, apparently not yet out of date, see

Roth, A.E. and X. Xing, "Jumping the Gun: Imperfections and Institutions Related to the Timing of Market Transactions," American Economic Review, 84, September, 1994, 992-1044.(the section on the Japanese market, focusing on the period 1970-1990 is also here.)

The market for lawyers, a modest proposal

Ashish Nanda at the Harvard Law School has a modest proposal for how the jobmarket for new associates at large law firms should be organized, particularly in light of some of the problems that have been exposed in the current recession: Lawyers Should Be Recruited Like Doctors

"The current oversupply of new associates has sent law firms scrambling to implement short-term adjustments, such as secondments and deferrals. But the legal profession needs more than temporary half-measures. The new-associate recruitment market is fundamentally broken, and it has been for some time. Incremental changes are not going to address its underlying problems. The market needs a structural fix -- a centralized matching authority, like the one that the medical profession has been using for more than half a century. "

HT: Guhan Subramanian

Tuesday, February 9, 2010

Jerusalem summer school in economic theory

The 21st Jerusalem Summer School in Economic Theory will be on market design writ large, namely Political Economy, from June 25-July 6, with an all star cast of lecturers.

The market for history professors

Robert Townsend of the American Historical Association reports on A Grim Year on the Academic Job Market for Historians.

"The number of job openings in history plummeted last year, even as the number of new history PhDs soared. As a result, it appears the discipline is entering one of the most difficult academic job markets for historians in more than 15 years."

Townsend concludes:

"While it is small comfort to candidates on the current job market, it is worth noting that the near perpetual sense of crisis in history employment over the past 20 years had very little to do with a diminishing number of jobs, or even the growing use of part-time and contingent faculty.
More than half of the full-time history faculty in U.S. colleges and universities have retired and been replaced over the past 20 years, while the number of full-time faculty employed in history has grown steadily.
Among the 604 departments that were listed in the Directory in 2000 as well as in 2009, the number of full-time history faculty (at the assistant, associate, or full professor level) grew by 7.6 percent—from 8,772 to 9,436 over the decade. Other federal surveys conducted over the past two decades have shown similar growth in the number of full-time jobs for historians in academia as a whole, at both two- and four-year colleges and universities.
This hiring has been buoyed by significant growth in the number of undergraduate students taking history classes. According to the most recent figures from the federal government, the number of new bachelor’s degrees in the discipline recently reached the highest point in 35 years.3
The use of part-time and adjunct faculty in the discipline undoubtedly siphoned off some potential full-time job lines for historians, but that does not appear to be the most important causative factor for the problems of the history job market. The primary problem today, as it was a decade ago, seems to lie on the supply side of the market—in the number of doctoral students being trained, and in the skills and expectations those students develop in the course of their training."

For a dissenting view on this latter paragraph, see Marc Bosquet's column: At the AHA: Huh?

Bosquet, the author of How the University Works (here is the introductory chapter) advocates more stringent licensing of who can teach history to undergraduates, to increase the demand for Ph.D.s in full time positions, by displacing graduate student teaching fellows and part time faculty.

As an economist, I was struck by several things about Bosquet's book, the first of which was in the foreword by AAUP president Cary Nelson. Nelson speaks of the need for theory to help understand the situation of university employees: "There is no escaping the great bring theory to bear on the thirty-five-year employment crisis that has defined professional life for so many humanities graduate employees and Ph.D.s."
He then enumerates the failure to do so of "Every body of theory with broad implications for understanding our own practices...", naming each such body of theory in turn "Psychoanalytic criticism...Marxist theory...feminist theory," concluding "The one institutional site where one might have hoped for a theorized account of the job system was the Modern Language Association."

It's humbling (and perhaps illuminating) to note that nowhere do these scholars look to economics for a theory of employment...

Monday, February 8, 2010

Sex ratio and competition, in China and American colleges

With more than 120 boys born for every 100 girls in China, parents of boys know that their sons will face a competitive marriage market. Shang-Jin Wei of Columbia and Xiaobo Zhang of the International Food Policy Research Institute argue that this accounts for a substantial portion of the high savings rate in China, as parents anticiipate that wealthier sons will marry more successfully, and that this spills over to the general economy:

The Competitive Saving Motive: Evidence from Rising Sex Ratios and Savings Rates in China
NBER Working Paper No. 15093 June 2009

Abstract: While the high savings rate in China has global impact, existing explanations are incomplete. This paper proposes a competitive saving motive as a new explanation: as the country experiences a rising sex ratio imbalance, the increased competition in the marriage market has induced the Chinese, especially parents with a son, to postpone consumption in favor of wealth accumulation. The pressure on savings spills over to other households through higher costs of house purchases. Both cross-regional and household-level evidence supports this hypothesis. This factor can potentially account for about half of the actual increase in the household savings rate during 1990-2007.

And here's a summary by Wei at VOX: The mystery of Chinese savings

In the meantime, there's a shortage of boys on many American college campuses: this NY Times report suggests that this has changed the dating equilibrium in ways that concern not only savings behavior, but also sex . (The story doesn't explicitly mention savings behavior, the Times is a family newspaper): The New Math on Campus

Sunday, February 7, 2010

An unexpectedly repugnant transaction: singing "My Way" in the Philippines

A NY Times story on karaoke in the Philippines is full of interesting and unexpected detail: Sinatra Song Often Strikes Deadly Chord "The authorities do not know exactly how many people have been killed warbling “My Way” in karaoke bars over the years in the Philippines, or how many fatal fights it has fueled. But the news media have recorded at least half a dozen victims in the past decade and includes them in a subcategory of crime dubbed the “My Way Killings.” " ... [While Karaoke sometimes leads to violence elsewhere] "the odds of getting killed during karaoke may be higher in the Philippines, if only because of the ubiquity of the pastime. Social get-togethers invariably involve karaoke. Stand-alone karaoke machines can be found in the unlikeliest settings, including outdoors in rural areas where men can sometimes be seen singing early in the morning. And Filipinos, who pride themselves on their singing, may have a lower tolerance for bad singers. Indeed, most of the “My Way” killings have reportedly occurred after the singer sang out of tune, causing other patrons to laugh or jeer. “The trouble with ‘My Way,’ ” said Mr. Gregorio, “is that everyone knows it and everyone has an opinion.” Others, noting that other equally popular tunes have not provoked killings, point to the song itself. " ... "Defenders of “My Way” say it is a victim of its own popularity. Because it is sung more often than most songs, the thinking goes, karaoke-related violence is more likely to occur while people are singing it. The real reasons behind the violence are breaches of karaoke etiquette, like hogging the microphone, laughing at someone’s singing or choosing a song that has already been sung. “The Philippines is a very violent society, so karaoke only triggers what already exists here when certain social rules are broken,” said Roland B. Tolentino, a pop culture expert at the University of the Philippines. But even he hedged, noting that the song’s “triumphalist” nature might contribute to the violence." ... "But in karaoke bars where one song costs 5 pesos, or a tenth of a dollar, strangers often rub shoulders, sometimes uneasily. A subset of karaoke bars with G.R.O.’s — short for guest relations officers, a euphemism for female prostitutes — often employ gay men, who are seen as neutral, to defuse the undercurrent of tension among the male patrons. Since the gay men are not considered rivals for the women’s attention — or rivals in singing, which karaoke machines score and rank — they can use humor to forestall macho face-offs among the patrons. In one such bar in Quezon City, next to Manila, patrons sing karaoke at tables on the first floor and can accompany a G.R.O. upstairs. Fights often break out when customers at one table look at another table “the wrong way,” said Mark Lanada, 20, the manager. “That’s the biggest source of tension,” Mr. Lanada said. “That’s why every place like this has a gay man like me.”"

RepoMen (the movie)

Joshua Gans points me to the trailer for the upcoming movie RepoMen. It touches on both repugnance and organ transplantation:

In the futuristic action-thriller Repo Men, humans have extended and improved our lives through highly sophisticated and expensive mechanical organs created by a company called The Union. The dark side of these medical breakthroughs is that if you don’t pay your bill, The Union sends its highly skilled repo men to take back its property…with no concern for your comfort or survival. Jude Law plays Remy, one of the best organ repo men in the business. When he suffers a cardiac failure on the job, he awakens to find himself fitted with the company’s top-of-the-line heart-replacement…as well as a hefty debt. But a side effect of the procedure is that his heart’s no longer in the job. When he can’t make the payments, The Union sends its toughest enforcer, Remy’s former partner Jake (Academy Award® winner Forest Whitaker), to track him down. Now that the hunter has become the hunted, Remy joins Beth (Alice Braga), another debtor who teaches him how to vanish from the system. And as he and Jake embark on a chase across a landscape populated by maniacal friends and foes, one man will become a reluctant champion for thousands on the run.

Australia to Lift Ban on Xenotransplants

Australia to Lift Ban on Animal Transplants

"Australia will join some 14 other countries -- including Japan, New Zealand and the United States -- in allowing xenotransplantation, the transplanting of animal organs and cells into humans to substitute for human organ donors and to treat diseases like diabetes.
The Australian moratorium was introduced in 2004 based on concerns that research in the area could prompt animal viruses, particularly pig viruses, to jump the species gap into humans.
The World Health Organization has called on countries to establish regulatory control and surveillance mechanisms before allowing xenotransplantations."

HT: Steve Leider

Saturday, February 6, 2010

Unraveling in college football

We're used to hearing of career decisions by very young basketball players, but there's been a tradition in football of waiting until players' adult weights could be estimated. But now (multiple readers point out to me), the Trojans of USC have recruited 13 year old quarterback David Sills to their entering class in 2015.

Unraveling has a fine sporting tradition.

Ingredient lists, and farmed fish

Consumer protection laws work in strange ways, but one thing they do fairly well is to require that ingredients be listed on processed food. On a recent morning, drinking coffee imported from a warm place and eating smoked salmon from a cold place, I looked at the ingredient list on the front of the package of salmon, which read: "Atlantic Salmon, Salt, Hardwood Smoke." On the back of the package, this:

"Synthesized carotenoids are added to the feed of this farmed salmonoid to achieve the color that wild salmonoids develop from eating carotenoids found in their natural diet."

Some years ago, when I hosted a conference on sustainable fisheries , the fishermen present insisted that the conference dinner should be at a restaurant that served only wild fish...

Friday, February 5, 2010

Market Design conference at the NBER, October 8-9 2010

Susan Athey and Parag Pathak have circulated the following email.

The National Bureau of Economic Research workshop on Market Design is a forum to discuss new academic research related to the design of market institutions, broadly defined. The next meeting will be held in Cambridge, Massachusetts, on Friday and Saturday, October 8-9, 2010.

We welcome new and interesting research, and are happy to see papers from a variety of fields. Participants in the past meeting covered a range of topics and methodological approaches. Last year's program can be viewed at:

The conference does not publish proceedings or issue NBER working papers - most of the presented papers are presumed to be published later in journals.

There is no requirement to be an NBER-affiliated researcher to participate. Younger researchers are especially encouraged to submit
papers. If you are interested in presenting a paper this year,
please upload a PDF or Word version by September 1, 2010 to this link

Preference will be given to papers for which at least a preliminary draft is ready by the time of submission. Only authors of accepted papers will be contacted.

For presenters and discussants in North America, the NBER will cover the travel and hotel costs. For speakers from outside North America, while the NBER will not be able to cover the airfare, it can provide support for hotel accommodation.

Please forward this announcement to any potentially interested scholars. We look forward to hearing from you.

Would Professor Moriarty have invented an eBay, a Paypal or a Craigslist?

Professor Moriarty was, of course, Sherlock Holmes' nemesis (or was it the other way around)? I ask the question in the title of this post because a much more modern criminal mastermind has just been sentenced. Here's the headline from the London Telegraph: Mastermind behind 'eBay for criminals' is facing jail

"Renukanth Subramaniam, from north London, established the website DarkMarket, which threatened every bank account and credit card holder in Britain and caused tens of millions of pounds of losses.
It was described as a "one-stop shop" for fraudsters buying and selling stolen details such as PIN numbers, account balances, answers to account security questions and passwords for social networking websites.

"The site even offered criminal users a secure payment system, training and advertising space to sell equipment used to clone bank and credit cards.
DarkMarket operated for almost three years as a “criminals only” forum, with more than 2,500 members at its peak, who could buy up to 10 credit card numbers along with other personal information for around £30.
It was shut down after a two-year global investigation in which undercover agents from the FBI and the Serious Organised Crime Agency infiltrated the site by posing as criminals.
A spokesman for Soca called it “one of the most pernicious online criminal websites in the world” and estimated that its victims lost tens of millions of pounds.
Officials said there was a code of “honour amongst thieves” on the site.
There was a secure payment system between criminals – described by Judge John Hillen as a "PayPal for criminals". "

See my earlier post: More on Darkmarket, the Craigslist of Crime

Thursday, February 4, 2010

Mentoring (and a pet peeve: maybe women should be athena-ed?)

There are lots of reasons to think that young employees of many kinds may benefit from mentoring, and, because networks of various sorts may be important, employees from underrepresented populations may particularly benefit if their mentor can help them connect.

This is the idea behind the recent NBER report Can Mentoring Help Female Assistant Professors? Interim Results from a Randomized Trial
by Francine D. Blau, Janet M. Currie, Rachel T.A. Croson, Donna K. Ginther

Abstract: "While much has been written about the potential benefits of mentoring in academia, very little research documents its effectiveness. We present data from a randomized controlled trial of a mentoring program for female economists organized by the Committee for the Status of Women in the Economics Profession and sponsored by the National Science Foundation and the American Economics Association. To our knowledge, this is the first randomized trial of a mentoring program in academia. We evaluate the performance of three cohorts of participants and randomly-assigned controls from 2004, 2006, and 2008. This paper presents an interim assessment of the program’s effects. Our results suggest that mentoring works. After five years the 2004 treatment group averaged .4 more NSF or NIH grants and 3 additional publications, and were 25 percentage points more likely to have a top-tier publication. There are significant but smaller effects at three years post-treatment for the 2004 and 2006 cohorts combined. While it is too early to assess the ultimate effects of mentoring on the academic careers of program participants, the results suggest that this type of mentoring may be one way to help women advance in the Economics profession and, by extension, in other male-dominated academic fields. "

On a less serious note, I've always wondered whether "mentor" was the right word for an advisor for female professors, particularly if the advisor is also female. The reason is that Mentor is a male character in Homer's Odyssey who only appears to give advice in the beginning of the story. In fact, the goddess Athena is giving the advice, disguised as Mentor (presumably because advice from someone with a grey beard was given more weight in those days than from someone advising while female, however divine). So maybe, nowadays, female professors should be athena-ed?