Wednesday, May 31, 2023

Kidney exchange progress in Europe

 The program on European Cooperation in Science and Technology  (COST) has just published an update on steps being taken to advance kidney exchange in Europe, including the goal of more cross-border exchange.

The crucial role of Kidney Exchange Programmes and the ENCKEP and KEP-SOFT innovations making it possible

"Setting up KEPs is difficult due to the ethical, legal, practical, and logistical considerations that must be faced. These include ratifying policy decisions, establishing a software infrastructure, and satisfying clinical requirements. Additionally, KEPs vary across European countries in terms of policy, clinical practice, and optimisation methods. For instance, the maximum number of recipients allowed to exchange donors in a single “cycle” differs between the Netherlands and the UK. Furthermore, some countries allow non-directed donation while others prohibit it. Crossmatching** processes also vary. The ENCKEP and KEP-SOFT network has proved instrumental in meeting many of these challenges. And its associated software addresses many of these variations.

...

"On 15 June 2023, EU4Health will publish a call for proposals to implement an EU-wide KEP. On page 65, the announcement makes specific reference to the KEP-SOFT software. This presents an exciting potential future opportunity to influence further developments in KEPs in the European context and to widen the user-base of the KEP-SOFT software"


HT: David Manlove

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

When I first read the last paragraph above I thought that "KEP"  probably stood for "Kidney Exchange Program," and that the proposal was to make that EU-wide rather than country by country. But it turns out that "KEP" stands for Knowledge Exchange Platform (KEP), so the progress is a bit less specific than I had hoped. But on page 65 it does include a "Call for proposals: action grants on facilitating organ paired exchange." It states that "In view of the scarcity of organs available for transplantation, there is a need to strengthen the exchange schemes among Member States, with a clear added value for European patients, as such exchange schemes can save the life of patients."

Tuesday, May 30, 2023

Kidney exchange, around the world and in Germany? German Health Economics Association (DGGÖ) webinar tomorrow

Tomorrow  I'll be giving a talk in Germany (8am California time, 17:00 in Germany), hosted by the German Health Economics Association (DGGÖ).  (Bob Slonim will be giving a talk in this series in the summer.)

My title will be Kidney Exchange to increase transplantation: around the world, and in Germany?
(One big issue is that kidney exchange isn't yet supported in Germany.) 

There is a webinar address at the above link for those who might like to listen.

Monday, May 29, 2023

Further progress on course allocation, by Budish, Gao, Othman, Rubinstein and Zhang

 Here are some new developments in the course allocation mechanism used initially in Wharton and now elsewhere.  It turns out that strategy-proofness in the (very) large doesn't imply strategyproofness in samples of realistic size, but this seems to be fixable (and profitable manipulations were not easy to find). The paper concludes with some far ranging thoughts on the econ-cs interface.

Practical algorithms and experimentally validated incentives for equilibrium-based fair division (A-CEEI)   by ERIC BUDISH, RUIQUAN GAO, ABRAHAM OTHMAN  AVIAD RUBINSTEIN, and QIANFAN ZHANG

Abstract: "Approximate Competitive Equilibrium from Equal Incomes (A-CEEI) is an equilibrium-based solution concept for fair division of discrete items to agents with combinatorial demands. In theory, it is known that in asymptotically large markets:

•For incentives, the A-CEEI mechanism is Envy-Free-but-for-Tie-Breaking (EF-TB), which implies that it is Strategyproof-in-the-Large (SP-L).

•From a computational perspective, computing the equilibrium solution is unfortunately a computationally intractable problem (in the worst-case, assuming PPAD≠FP).

We develop a new heuristic algorithm that outperforms the previous state-of-the-art by multiple orders of magnitude. This new, faster algorithm lets us perform experiments on real-world inputs for the first time. We discover that with real-world preferences, even in a realistic implementation that satisfies the EF-TB and SP-L properties, agents may have surprisingly simple and plausible deviations from truthful reporting of preferences. To this end, we propose a novel strengthening of EF-TB, which dramatically reduces the potential for strategic deviations from truthful reporting in our experiments. A (variant of ) our algorithm is now in production: on real course allocation problems it is much faster, has zero clearing error, and has stronger incentive properties than the prior state-of-the-art implementation"

Here's an intriguing passage:

"In Section 6 we use our manipulation-finding algorithm in combination with our fast A-CEEI finding algorithm to explore the plausibility of effective manipulations for students bidding in ACEEI. Originally, we had expected that since our mechanism satisfies the EF-TB and SP-L properties, it would at least be practically strategyproof — if even we don’t really understand the way our algorithm chooses among the many possible equilibria, how can a student with limited information learn to strategically bid in such a complex environment? 

"Indeed, in 2 out of 3 schools that we tested, our manipulation-finding algorithms finds very few or no statistically significant manipulations at all. However, when analyzing the 3rd school, we stumbled upon a simple and effective manipulation for (the first iteration of) our mechanism. We emphasize that although the manipulation is simple in hindsight, in over a year of working on this project we failed to predict it by analyzing the algorithm — the manipulation was discovered by the algorithm

"Inspired by this manipulation, we propose a natural strengthening of envy-free (discussed below), which we call contested-envy free. We encode the analogous contested EF-TB as a new constraint in our algorithm (specifically, the integer program for finding optimal budget perturbations). Fortunately, our algorithm is still very fast even with this more elaborate constraint. And, when we re-run our manipulation-finding experiments, we observe that contested EF-TB significantly reduces the potential for manipulations in practice."

...

"Conclusion:  In this work, we give a significantly faster algorithm for computing A-CEEI. Kamal Jain’s famous formulation “if your laptop cannot find it then neither can the market” [Papadimitriou 2007] was originally intended as a negative result, casting doubt on the practical implications of many famous economic concepts because of their worst-case computational complexity results. Even for course allocation, where a heuristic algorithm existed and worked in practice, Jain’s formulation seemed to still bind, as solving A-CEEI involved an intense day-long process with a fleet of high-powered cloud servers operating in parallel. The work detailed in this paper has significantly progressed what laptops can find: even the largest and most challenging real course allocation problems we have access to can now be solved in under an hour on a commodity laptop. 

"This significant practical improvement suggests that the relationship between prices and demand for the course allocation problem—and potentially other problems of economic interest with complex agent preferences and heterogeneous goods—may be much simpler than has been previously believed and may be far more tractable in practice than the worst-case theoretical bounds. Recalling Jain’s dictum, perhaps many more market equilibria can be found by laptops—or, perhaps, Walras’s original and seemingly naive description of how prices iterate in the real world may in fact typically produce approximate equilibria. 

"Our fast algorithm also opens the door for empirical research on A-CEEI, because we can now solve many instances and see how the solution changes for different inputs. We took it in one direction: empirically investigating the incentives properties of A-CEEI for the first time. For course allocation specifically, this faster algorithm opens up new avenues for improving student outcomes through experimentation. For instance, university administrators often want to subsidize some 6 group of students (e.g., second-year MBA students over first-year MBA students), but are unsure how large of a budget subsidy to grant those students to balance equity against their expectations. Being able to run more assignments with different subsidies can help to resolve this issue."

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

Earlier related posts:

Thursday, April 23, 2009

Sunday, October 4, 2009

Thursday, May 30, 2013

Monday, August 3, 2015

Tuesday, June 9, 2020

Sunday, May 28, 2023

How do (should?) economists study repugnance?

 Here's a recent paper by Peter Cserne that looks at different ways that economists study repugnance:

Cserne, P. (2023). Economic analyses of repugnant market transactions: A modest typology. Journal of Institutional Economics, 1-14. doi:10.1017/S1744137423000139

"Abstract: Economic accounts of repugnance concern two broad questions: the rationalisation of sentiments of repugnance (do emotional and visceral reactions of repugnance track valid reasons for not engaging in or condemning certain (trans)actions?) and institutional design (how to institute, regulate, or restrict markets in response to reasonable objections). If repugnance expresses valid practical reasons for regulating or limiting markets, our institutions should acknowledge and express these. If attitudes of repugnance are not rationalisable in the sense of instrumental or moral values, we should disregard or eventually counteract or reduce them. Focusing on a special case of repugnance, when commodification, i.e., the sale of goods or services for money meets societal disapproval, this paper identifies three characteristic ways to combine conceptual, empirical, and normative arguments and map repugnance into a disciplinary ‘epistemic frame’ of economics: repugnance as taste; repugnance as proxy for market failures or moral reasons; repugnance as hypocrisy or contingent cultural fact. Correspondingly, economists advise to (1) work around; (2) make sense of; and (3) explain away people's sentiments of repugnance."

...

"In recent decades, the economic discourse on repugnance has become rich and dense. While the moral limits of markets have been discussed in philosophy and various social and policy sciences for centuries, in the last decades, repugnance as a possible limit to markets has been increasingly subject to technical economic analysis as well (Khalil and Marciano, Reference Khalil and Marciano2018; Roth, Reference Roth2007; Tirole, Reference Tirole2017: 33–50). To be sure, from a longer historical perspective, economists have always been concerned with moral sentiments, including repugnance.

...

"Regarding the moral limits of markets, there is a range of (a) substantive views. For the purposes of this paper, we roughly distinguish three stances: commodification, anti-commodification, and anti-anti-commodification. These are expressed in different (b) conceptual categories: as moral preferences; moral externalities or merit goods; and hypocrisy or cultural facts. Together, they allow to express the substantive concerns in (c) analytical frameworks, in other words, they provide the technical terms for economists to, respectively: work around; rationalise, i.e., make sense of; and explain away people's repugnance. Thus, I suggest distinguishing three substantive stances on repugnance in economics, combining conceptual choices and normative commitments into analytical frameworks.

"First, economists may conceptualise repugnance as a taste or (moral) preference. Following the dictum de gustibus non est disputandum (Stigler and Becker, Reference Stigler and Becker1977), they engage in technical normative analysis and institutional design in an engineering mode (Roth, Reference Roth2002). Normatively, they orient themselves in favour of commodification, i.e., extending the scope of markets. Correspondingly, their analytical strategy is to propose policies to ‘work around’ social sentiments of repugnance.

"Second, economists may conceptualise repugnance in terms of (moral) externality or merit goods, i.e., as versions of or proxies for market failures. In doing so, they make sense of sentiments of repugnance, in terms of ordinary economic analysis. Correspondingly, they propose policies to justify limiting or regulating markets. They engage in the rationalisation of anti-commodification sentiments in terms of public reasonableness.

"Third, economists may conceptualise repugnance as an expression of hypocrisy or as a cultural fact of no independent normative weight. Normatively, they engage in demystifying repugnance either by naturalising it or philosophically debunking sentiments of repugnance as unreasonable ‘romance’; their analytical strategy could be characterised as anti-anti-commodification insofar as they aim to explain away anti-commodification arguments as irrelevant for policy debates around institutional design."

Saturday, May 27, 2023

An upside to dowries, by Natalie Bau, Gaurav Khanna, Corinne Low & Alessandra Voena

 Dowries (like bride prices*) are often criticized, but may have indirect effects that aren't so easy to see, as in this recent NBER paper:

Traditional Institutions in Modern Times: Dowries as Pensions When Sons Migrate by Natalie Bau, Gaurav Khanna, Corinne Low & Alessandra Voena  NBER WORKING PAPER 31176, DOI 10.3386/w31176

Abstract: This paper examines whether an important cultural institution in India - dowry - can enable male migration by increasing the liquidity available to young men after marriage. We hypothesize that one cost of migration is the disruption of traditional elderly support structures, where sons live near their parents and care for them in their old age. Dowry can attenuate this cost by providing sons and parents with a liquid transfer that eases constraints on income sharing. To test this hypothesis, we collect two novel datasets on property rights over dowry among migrants and among families of migrants. Net transfers of dowry to a man's parents are common but far from universal. Consistent with using dowry for income sharing, transfers occur more when sons migrate, especially when they work in higher-earning occupations. Nationally representative data confirms that migration rates are higher in areas with stronger historical dowry traditions. Finally, exploiting a large-scale highway construction program, we show that men from areas with stronger dowry traditions have a higher migration response to reduced migration costs. Despite its potentially adverse consequences, dowry may play a role in facilitating migration and therefore, economic development.

********

*Recall this earlier paper:

Ashraf, Nava, Natalie Bau, Nathan Nunn, and Alessandra Voena. "Bride price and female education." Journal of Political Economy 128, no. 2 (2020): 591-641.

Friday, May 26, 2023

Freakonomics replay and update on kidney exchange and organ donation

 Freakonomics Radio yesterday revisited some of their old podcasts about kidney exchange. In one, they interview me, and in another, they interview Ned Brooks, who listened to that interview and went on to become a non-directed kidney donor and to found an organization to support other kidney donors, the NKDO, National Kidney Donation Organization.  You can listen and/or read the transcript at this link:

EPISODE 209

Make Me a Match (Update)

"Sure, markets work well in general. But for some transactions — like school admissions and organ transplants — money alone can’t solve the problem. That’s when you need a market-design wizard like Al Roth. Plus: We hear from a listener who, inspired by this episode, made a remarkable decision.

"Last month, the federal government announced plans to modernize the U.S. organ-donation system. They want to speed up the process by which organ-transplant patients are matched with donated organs, and they also want to reduce racial inequities in the system. When we saw this news, we decided to go into our archive and put together the episode you’re about to hear. It’s a mashup of a 2015 episode, No. 209, called “Make Me a Match,” and a portion of a 2016 episode, No. 237, which includes a personal story from a listener who was inspired by that earlier episode to make a remarkable decision. All the relevant facts and figures have been updated. As always, thanks for listening."

***********

Here are my previous posts on Freakonomics episodes.

Thursday, May 25, 2023

HRSA's Organ Procurement and Transplantation Network Modernization Initiative

 The Health Resources and Services Administration (HRSA) has announced a timeline for moving forward on the proposal to reorganize the system for obtaining and distribution deceased donor organs for transplant, aiming for a request for proposals in the Fall.

Organ Procurement and Transplantation Network Modernization Initiative   May 2023 Updates

"On March 22, 2023, the Health Resources and Services Administration (HRSA) announced a Modernization Initiative to strengthen accountability and transparency in the Organ Procurement and Transplantation Network (OPTN). The initiative is focused on five key areas: technology, data transparency, governance, operations, and quality improvement and innovation. As part of our commitment to transparency around the Modernization Initiative, HRSA is providing an update on our upcoming action steps.

The OPTN Modernization Initiative is centered on putting patients first, prioritizing information flow to clinicians, promoting innovation through continuous competition, and enhancing transparency and accountability. HRSA's planned approach and timelines for the first year of the multi-year modernization process focuses on design, implementation, and oversight, including contract solicitations that will be released Fall 2023 and Spring 2024. In addition, HRSA continues to pursue the legislative changes and increased funding included in the President's Fiscal Year 2024 budget to implement and advance the Modernization Initiative.

Summer 2023

Phase 1: OPTN Modernization Design & Strategy Development  

External Engagement and Design Planning Contract  – HRSA is currently conducting market research to inform the development of the upcoming Fall contract solicitations and will host an Industry Day for interested parties and vendors this Summer. Building on our outreach efforts over the past year, HRSA also will continue to ensure that patient, family, and clinician voices are engaged in this work, including through focus groups and other approaches. HRSA recently awarded a program management contract to support this stakeholder engagement as well as strategic and operational planning and change management.

Fall 2023

Phase 2A: OPTN Transition Management

HRSA recognizes the vital need to maintain uninterrupted access to the critical systems and functionality that support organ matching and transplantation during the modernization process. Working with the best technologists in the U.S. Government, HRSA expects to conduct this work on a dual track so that there are appropriate safeguards to ensure no disruptions in service as part of modernization implementation. Therefore, HRSA will support two significant multi-vendor solicitations between now and Spring 2024 – with the first solicitation to be issued this Fall 2023. This action will be followed by a Spring 2024 solicitation to further the next generation OPTN, as noted below. 

Competitive OPTN Transition Contracts – This Fall, HRSA plans to release a solicitation to establish new contracts that will support and enhance OPTN operations while the modernization process is underway. These contracts will ensure the continuation of critical OPTN support functions and enable appropriate upgrades on a parallel track with modernization. The Fall 2023 solicitation will seek multiple vendors for distinct functions – including supporting a separate OPTN Board of Directors – to ensure service continuity and increase oversight and accountability.

To ensure that the OPTN Transition contracts are developed in a way that meets the needs of all stakeholders, HRSA is committed to soliciting feedback from interested parties during the development and implementation of this work. By involving stakeholders in the process, HRSA can ensure that the Transition contracts advance the goals of the OPTN Modernization Initiative, provide optimal support to protect patient safety, and ensure the efficient functioning of the OPTN.

Spring 2024

Phase 2B: OPTN Modernization Implementation

In Spring 2024, HRSA intends to release a solicitation for multiple vendors to support the next generation of the OPTN, which will include enhancements in technology, governance, data transparency and operations. The separate Board of Directors contract and the deliverables from this next generation solicitation will form the foundation of a new, modernized OPTN. 

OPTN Next Generation Contracts – The proposed OPTN Next Generation contracts will represent a significant step forward in modernizing the OPTN’s foundational IT systems. In Spring 2024, HRSA expects to release a solicitation seeking multiple vendors for the OPTN Next Generation contracts to provide a comprehensive approach to modernizing the OPTN. The goal of this solicitation is to find contractors who will use innovative, best in class approaches to carrying out specific functions, including initial prototyping, testing, scaling, integration, deployment, and adoption support.  

HRSA is committed to transparency in the OPTN Modernization process and will continue to provide updates on our iterative approach toward achieving enhanced accountability, equity, and performance in the organ transplantation system, as appropriate, as this work moves forward."

***********

Here's a NYT story covering the announcement, with some background:

U.S. Organ Transplant System, Troubled by Long Wait Times, Faces an Overhaul The Biden administration announced a plan to modernize how patients are matched to organs, seeking to shorten wait times, address racial inequities and reduce deaths.  By Sheryl Gay Stolberg

Wednesday, May 24, 2023

Egg freezing in China and Hong Kong

 The FT has the story:

China’s fertility treatment rules push single women to Hong Kong

Beijing faces calls to ease access to egg freezing and IVF amid demographic crisis

“Beijing has long banned access to egg freezing or IVF for single women. While unmarried men can freeze their sperm, single women such as Sophia, who declined to give her surname, are not allowed to freeze their eggs.
As a result, more and more Chinese women travel abroad for the procedure, with Hong Kong a top destination given its proximity and strong healthcare system.
“While it is possible for single or gay women to freeze their eggs in Hong Kong, only married heterosexual couples can access IVF treatment. In practice, that means eggs are stored until women get married and begin the IVF process.”

Tuesday, May 23, 2023

Quarantine in Dubrovnik

 I’m traveling home today after a good work/vacation trip to Croatia, ending in Dubrovnik. Dubrovnik has a long history of quarantining foreign visitors to prevent the spread of disease 



Monday, May 22, 2023

Over 100 Nobel Laureates join PEN International in support of Nobel Peace Prize winner Ales Bialiatski

Over 100 Nobel Laureates join PEN International in support of Nobel Peace Prize winner Ales Bialiatski


PEN International, the literary and free expression organisation, has released a letter signed by 103 Nobel Laureates, expressing solidarity with writer, human rights defender, Nobel Peace Prize winner, and PEN member Ales Bialiatski, and condemning the Belarusian authorities’ brutal, relentless, and systematic crackdown on independent voices. Today marks the International Day of Solidarity with Prisoners of Conscience in Belarus. The solidarity action was featured in the Guardian.”


Sunday, May 21, 2023

Drug Overdose Deaths Topped 100,000 Again in 2022

 

The WSJ has the story: the headline speaks for itself  

Drug Overdose Deaths Topped 100,000 Again in 2022 https://www.wsj.com/articles/drug-overdose-deaths-topped-100-000-again-in-2022-37cd1709

Defining death for deceased organ donation

 Here’s a story from Science, about donation of a heart from a donor declared dead after circulatory death, ie after heart stoppage:

GIVING HEART: A new procedure for donating hearts and other organs is saving lives. But for some it challenges the definition of death   By 

Jennifer Couzin-Frankel


"As is customary regardless of whether organs will be donated, physicians waited 5 minutes to ensure that the heart didn’t start beating again on its own. It did not, and the man was declared dead. The baton then passed to the organ recovery and transplant team. They clamped blood vessels running from the torso to the brain and reconnected his body to machines that circulated oxygenated blood, causing the heart to begin pumping again. "These two interventions—initiating a heartbeat after death is declared and taking steps to prevent blood flow to the brain—are at the core of a raging debate about the ethics of such donations. To some people, the approach risks disrupting the dying process; to others, it allows that process to continue as the family desires, while also honoring individual or family wishes for organ donation.

The debate touches on the definition of death, Moazami says. “When the heart stops, we say, ‘time of death, 5:20 a.m.’” But, “The fact of the matter is, death is a process. Death is not a time point.” Cells can take hours to die. Sophisticated machinery can induce a heartbeat hours after death, but does that make a person “alive”?

Saturday, May 20, 2023

More governments seek to limit TikTok over data concerns

The NYT has the story:

Governments have expressed concerns that TikTok, which is owned by the Chinese company ByteDance, may endanger sensitive user data.  Sapna Maheshwari and 

In recent months, lawmakers in the United States, Europe and Canada have escalated efforts to restrict access to TikTok, the massively popular short-form video app that is owned by the Chinese company ByteDance, citing security threats.

The White House told federal agencies on Feb. 27 that they had 30 days to delete the app from government devices. A growing number of other countries and government bodies — including Britain and its ParliamentCanada, the executive arm of the European UnionFrance and New Zealand’s Parliament — have also recently banned the app from official devices. On April 4, Australia became the latest country to announce that it was prohibiting the TikTok app on government devices on advice from intelligence and security agencies.

On March 1, a House committee backed an even more extreme step, voting to advance legislation that would allow President Biden to ban TikTok from all devices nationwide. 

Lawmakers and regulators in the West have increasingly expressed concern that TikTok and its parent company, ByteDance, may put sensitive user data, like location information, into the hands of the Chinese government. They have pointed to laws that allow the Chinese government to secretly demand data from Chinese companies and citizens for intelligence-gathering operations. They are also worried that China could use TikTok’s content recommendations for misinformation.

India banned the platform in mid-2020, costing ByteDance one of its biggest markets, as the government cracked down on 59 Chinese-owned apps, claiming that they were secretly transmitting users’ data to servers outside India.”



Is an End to Child Marriage within Reach? Not yet... Unicef report, and Lancet summary

 Unicef has issued the following report focused on the continued prevalence of child marriage, particularly in the poorest communities:

Is an End to Child Marriage within Reach? Latest trends and future prospects. May 2023

"The practice of child marriage has continued to decline globally. Today, one in five young women aged 20 to 24 years were married as children versus nearly one in four 10 years ago. Yet progress has been uneven around the world, and in many places the gains have not been equitable, leaving the most vulnerable girls behind.

"This year marks the halfway point to the deadline for achieving the Sustainable Development Goals, and when it comes to ending child marriage, a number of challenges loom large. Despite global advances, reductions are not fast enough to meet the target of eliminating the practice by 2030. In fact, at the current rate, it will take another 300 years until child marriage is eliminated."


***********

And here's an article in the Lancet:
Child marriage could be history by 2030, or last 300 more years, by Claudia Cappa, Colleen Murray and Nankali Maksud 

"UNICEF's analysis reveals only slight declines in child marriage in west and central Africa, which is the region with the highest prevalence of child marriage.1 There has been no change in Latin American and the Caribbean, which, if the current trajectory continues, would have the second highest prevalence of child marriage worldwide by 2030.1 After steady progress between 1997 and 2012, the Middle East, north Africa, eastern Europe, and central Asia regions have all seen stagnation in reducing child marriage in the past decade.
...
"Countries in sub-Saharan Africa with the highest projected population growth have the highest levels of child marriage, meaning the number of marriages is expected to increase there.
...
"declining child marriage prevalence is concentrated among girls from wealthier households. Girls from the richest quintile are less likely to become child brides and are the first to benefit from progress in averting child marriage, resulting in a widening gap in child marriage prevalence between rich and poor.1 In south Asia, wealthier households had three times more averted cases of child marriages than poor households in the past 25 years.1 If the rate of success in the richest quintile of south Asian families had been achieved globally, only 9% of girls would be married in childhood, far less than the current 19% worldwide prevalence of child marriage.1 Further progress in reducing child marriage largely depends on reaching girls who are otherwise left behind, including girls from the poorest households living without the resources and opportunities of their wealthier peers."

Friday, May 19, 2023

The Comstock Act returns from the dead, post Roe

 While there's no agreement about whether life begins at conception, it appears that the Comstock Act has risen from the dead to play a role in contemporary legal duels about abortion.

CNN brings it all back:

The 150-year-old chastity law that may be the next big fight over abortion By Tierney Sneed

"A law passed 150 years ago that banned the mailing of contraceptives, lewd materials and drugs that induce abortions could provide a pathway for effectively banning abortion nationwide – even in states where the procedure is legal.

"When the Supreme Court last summer reversed Roe v. Wade and eliminated constitutional protections that guaranteed abortion rights nationwide, the conservative majority fashioned its ruling as returning the matter of abortion policy-making to elected officials, particularly in state legislatures.

"But the battle lines now being drawn around the Reconstruction-era federal law – the Comstock Act – are an example of how the picture after Roe v. Wade is far more complicated as abortion opponents are challenging the means of abortion, such as the drug mifepristone, in court.

"The most sweeping Comstock Act arguments from anti-abortion activists could at the very least end the availability of medication abortion, which make up the majority of abortions in the US today, and could have the effect of eliminating surgical abortions as well by restricting the shipment of medical instruments and supplies used in the procedure.

...

"The Comstock Act, first passed in 1873, is named after Anthony Comstock, who was a special agent of the US Postal Service and an anti-vice crusader.

...

"Prosecutions under the law were bought in the first few decades after its passage, but by the 1930s, courts began whittling down some of its provisions and enforcement of the law ceased. Congress meanwhile amended it in the 1970s to remove its ban on mailing birth control.

...

"The Biden administration, in an internal advisory opinion released by the Justice Department’s Office of Legal Counsel, argues that the law does not apply to the mailing of abortion pills if they’re not being sent with the intent of unlawful use. The opinion pointed to how 20th century courts had interpreted it narrowly as excluding drugs mailed with legitimate intent."

*********

Earlier:

Monday, April 10, 2023

Thursday, May 18, 2023

Pushback against high prices in academic publishing: open access fees and e-textbooks to libraries

 The Guardian has the story:

‘Too greedy’: mass walkout at global science journal over ‘unethical’ fees. Entire board resigns over actions of academic publisher whose profit margins outstrip even Google and Amazon  by Anna Fazackerley

"The entire academic board of the journal Neuroimage, including professors from Oxford University, King’s College London and Cardiff University resigned after Elsevier refused to reduce publication charges.

Academics around the world have applauded what many hope is the start of a rebellion against the huge profit margins in academic publishing, which outstrip those made by Apple, Google and Amazon.

Neuroimage, the leading publication globally for brain-imaging research, is one of many journals that are now “open access” rather than sitting behind a subscription paywall. But its charges to authors reflect its prestige, and academics now pay over £2,700 for a research paper to be published. The former editors say this is “unethical” and bears no relation to the costs involved.

...

"Elsevier, a Dutch company that claims to publish 18% of the world’s scientific papers, reported a 10% increase in its revenue to £2.9bn last year. But it’s the profit margins, nearing 40%, according to its 2019 accounts, which anger academics most. The big scientific publishers keep costs low because academics write up their research – typically funded by charities and the public purse – for free. They “peer review” each other’s work to verify it is worth publishing for free, and academic editors collate it for free or for a small stipend. Academics are then often charged thousands of pounds to have their work published in open-access journals, or universities will pay very high subscription charges.

...

"Meanwhile, university libraries are angry about the cost of the online textbooks they say students now overwhelmingly want to read – often many times more expensive than their paper equivalent. Professor Chris Pressler, director of Manchester University Library, said: “We are facing a sustained onslaught of exploitative price models in both teaching and research.”

"According to a spreadsheet of costs quoted to university librarians, Manchester University gave a recent example of being quoted £75 for a popular plant biology textbook in print, but £975 for a three-user ebook licence. Meanwhile Learning to Read Mathematics in the Secondary School, a textbook for trainee teachers published by Routledge, was £35.99 in print and £560 for a single user ebook.

"A spokesperson for Taylor and Francis, which owns Routledge, said: “We strive to ensure that book prices are both affordable and a fair representation of their value.” He said a print book could be checked out for weeks at a time whereas ebooks could be checked in and out rapidly and had a much wider distribution."