Nondirected liver donation in Canada--from the beginning

The Ottawa Citizen has the story:

The Gosling Effect: How one man (and his liver) forever changed Canadian health care. In 2005, Kevin Gosling became the first living Canadian to anonymously donate an organ to a stranger. It set a cascade of kindness into motion.  by Elizabeth Payne 

"It had been a long road for the then-46-year-old from Cornwall, Ont. For months, health officials wouldn’t take him seriously when he offered to donate the organ anonymously. We don’t do that here, he was told. Not only that, it had never been done before anywhere in Canada.

"Some top officials in Canada’s leading liver transplant program were adamantly opposed to Gosling’s proposal. They said it was unethical and immoral. They questioned his motives, even his sanity. But Gosling persisted, so far as to undergo months of physical and psychological testing and preparation.

"After more than a year and a half, everything was set to go.

...

"Gosling didn’t know much about the recipient. He only knew that it was a child.

...

"Gosling’s stubborn altruism and unwavering belief that he could make a life-changing difference to someone in desperate need almost single-handedly changed Canada’s health-care system.

"In the 19 years since that fateful day when transplant surgeons removed part of Gosling’s liver and transplanted it into the body of the very ill child, the Toronto General Hospital has completed more than 137 such operations involving people donating anonymously to strangers – more than any other hospital in the world.

...

"He was a pioneer in an area in which Canada is now a world leader – the act of anonymously donating part of a liver – a phenomenon that continues to be met with disbelief in some parts of the world.

...

"Gosling’s offer was turned down multiple times until he was eventually put in touch with the head of the multi-organ transplant program at University Health Network, one of only two hospitals in the country where living liver transplants are now routinely done. Along the way he met health officials who were adamantly opposed to the idea, even citing the Hippocratic oath. (Later, he was told by one staunch opponent that following Gosling’s case had made him change his mind.)"

HT: Colin Rowat

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See also:

Cattral, Mark S., Anand Ghanekar, and Nazia Selzner. "Anonymous living donor liver transplantation: The altruistic strangers." Gastroenterology 165, no. 6 (2023): 1315-1317.

and here are all my posts on nondirected donors: https://marketdesigner.blogspot.com/search/label/nondirected%20donor

A bride- price auction: “the most expensive bride in South Sudan”

 The Guardian has the story of a bride-price auction for a child bride in South Sudan:

A teenage bride wed for a record price: the ‘marriage competition’ that divided a nation   Underage marriage is illegal in South Sudan yet so commonplace it rarely attracts attention. But the case of Athiak Dau Riak, who her mother says is only 14, has gone viral, polarising her family and the country.  by Florence Miettaux 

"For months, Marial Garang Jil and Chol Marol Deng, two South Sudanese men in their 40s who come from two different Dinka clans in Jonglei state but now live abroad, had been vying to marry Athiak Dau Riak, a girl her mother says is 14.

...

"After the ceremonial part of the wedding in June, when she was given as a wife to Chol Marol Deng, for a payment of 123 cattle, 120m South Sudanese pounds (about $44,000 or £33,000) in cash and a plot of land, she was dubbed “the most expensive bride in South Sudan” in TikTok videos that gained thousands of likes.

...

"South Sudan’s 2008 Child Act prohibits early and forced marriage, but according to Unicef, child marriage is “still a common practice” and “recent figures indicate that 52% of girls [in South Sudan] are married before they turn 18, with some girls being married off as young as 12 years old”.

"An Edinburgh University-led report on the “brideprice” system in South Sudan says “customary courts often accept menstruation as the criteria for eligibility to marry” and early marriage is “a common practice … likely motivated by families’ ambitions to gain brideprices for their daughters as soon as possible”.

"Globally, 12 million girls are married in childhood every year, according to another Unicef report. Across sub-Saharan Africa, more than a third of young women were married before the age of 18."

Regulation of Organ Transplantation and Procurement (Chen and Roth in the JPE)

 Here's a new paper (in final form, online ahead of print) on how organ transplants are regulated.  The paper uses an experiment to make several points about the design of current regulations.  One of them is that transplant centers are incentivized to be risk averse, since they are measured only by the outcomes of the transplants they perform, and not on the outcomes for patients they decline to transplant (so they are reluctant to transplant risky kidneys or risky patients).

Regulation of Organ Transplantation and Procurement: A Market-Design Lab Experiment by Alex Chan and Alvin E. Roth, Journal of Political Economy, online ahead-of-print .

 Abstract: We conduct a lab experiment that shows that current rules regulating transplant centers (TCs) and organ-procurement organizations (OPOs) create perverse incentives that inefficiently reduce both organ recovery and beneficial transplantations. We model the decision environment with a two-player multiround game between an OPO and a TC. In the condition that simulates current rules, OPOs recover only the highest-quality kidneys and forgo valuable recovery opportunities, and TCs decline some beneficial transplants. Alternative regulations that reward TCs and OPOs together for health outcomes in their entire patient pool lead to behaviors that increase organ recovery and appropriate transplants.

Here's what transplants look like in our experimental environment:

And our results are robust to big changes in parameters:

California Bans Legacy Admissions at Private Universities.

 The NYT has the story:

California Bans Legacy Admissions at Private Universities. The change will affect Stanford University, the University of Southern California and other private colleges in the state. By Shawn Hubler and Soumya Karlamangla, Sept. 30, 2024

"California will ban private colleges and universities, including some of the nation’s most selective institutions, from giving special consideration to applicants who have family or other connections to the schools, a practice known as legacy admissions.

"Gov. Gavin Newsom signed legislation on Monday that will prohibit the practice starting in the fall of 2025.

...

"The University of California, the California State University System and other public California campuses have banned legacy admissions for decades. But private colleges continued to give some preference to the descendants of alumni or major donors.

...

"Only one other state, Maryland, bans legacy preferences at both private and public institutions. Illinois, Virginia and Colorado ban legacy admissions, but only at public universities and colleges.
...

"After the Varsity Blues scandal in 2019, in which parents seeking to win spots in top-ranked schools for their children were found to have paid bribes and falsified their children’s credentials, Mr. Ting tried to push through a bill banning legacy preferences in California. That effort fell short.

"But he did succeed with a measure requiring private colleges to report to the Legislature how many students they admit because of ties to alumni or donors. Those reports showed that the practice was most widespread at Stanford and U.S.C., where, at both schools, about 14 percent of students who were admitted in the fall of 2022 had legacy or donor connections. At Santa Clara University, Mr. Newsom’s alma mater, 13 percent of admissions had such ties.

"Republicans as well as Democrats in the California Legislature voted for Mr. Ting’s latest proposal, which will punish institutions that flout the law by publishing their names on a California Department of Justice website. An earlier version had proposed that schools face civil penalties for violating the law, but that provision was removed in the State Senate."