This morning the Washington Post published my op-ed online (which is scheduled to appear in the print edition on Sunday). 800 words is hardly enough to explain why I think what I do...I could write a whole book about that.
But here's the op-ed:
With 90,000 patients waiting for a kidney, compensating living donors would save lives.
Is the state of Louisiana harmed if women living there can receive abortion pills by mail?
Federal Appeals Court Temporarily Halts Abortion Pill Access by Mail The court order, in a lawsuit by the state of Louisiana, pauses a Food and Drug Administration regulation that greatly expanded access to the abortion pill mifepristone.
By Pam Belluck
"A federal appeals court issued a ruling on Friday temporarily halting the ability of abortion providers to prescribe pills using telemedicine and send them to patients by mail, blocking what has become a major avenue for women seeking abortions in recent years.
"The order comes in a case in which the state of Louisiana is suing the Food and Drug Administration, seeking to sharply curtail access to the abortion pill mifepristone. In the order, a panel of the U.S. Court of Appeals for the Fifth Circuit granted Louisiana’s request for a temporary stay of the F.D.A.’s decision several years ago to remove a requirement that patients see a medical provider in person before the pills could be prescribed.
"The court order, citing Louisiana’s claims that making pills available by mail has allowed patients there to access the medication despite the state’s near-total abortion ban, said that “Louisiana has shown that it is irreparably harmed without a stay.”
"In April, a Federal District Court in Louisiana had declined to pause the availability of pills by mail, instead saying that the proceedings should be delayed until the F.D.A. completes a safety review of mifepristone that is underway and is expected to take until late this year."
#######
And here's the NYT on the appeal by pharma companies to the Supreme Court:
Supreme Court Asked to Restore Access to Abortion Pill by Mail By Ann E. Marimow and Pam Belluck
"Administration officials recently told The New York Times that the review would not be finished until the end of this year, a time frame that would fall after the midterm elections.
"The mifepristone case puts the Trump administration in a politically tricky position, given that many of President Trump’s supporters oppose abortion."
A column (on unemployment) in the Sunday Times by it's economics editor David Smith, ends with a brief review of Moral Economics, as a postscript:
PS
"A lot of economics books cross my desk, but a new one, by the Nobel prize-winning economist Alvin Roth, grabbed my attention. Called Moral Economics: What Controversial Transactions Reveal About How Markets Work, to be published soon by Basic Books, it is not a title designed to send it racing off the shelves.
However, it starts in an arresting way with a story I had not heard before of another celebrated Nobel prize-winning behavioural economist, Daniel Kahneman, known to many for his bestselling book Thinking, Fast and Slow. Two years ago, he celebrated his 90th birthday with family in Paris before flying to Zurich and ending his life in an assisted suicide clinic. “Danny,” Roth recalls, “was still in relatively good health, but he wanted to avoid the prospect of a long, disabling decline.”
...
It is a fascinating and very different economics book, from which I may bring you more as I find it."
In the Netherlands, not only is it legal to receive medical aid in dying (MAID), but a growing number of MAID patients are able to successfully achieve their desire to become deceased organ donors.
From the American Journal of Transplantation:
Wijbenga, N., Gan, C.T., Ruigrok, D., Berg, E.M., Hagenaars, J.A.M., Siregar, S., van der Kaaij, N.P., Mathot, B.J., van Pel, R., Seghers, L. and Manintveld, O.C., 2026. The Increasing Contribution of Organ Donation after Euthanasia to the Lung Transplantation Donor Pool in the Netherlands. American Journal of Transplantation.
"Abstract: The number of organ donation after euthanasia (ODE) procedures in the Netherlands has grown substantially, yet their contribution to the lung-donor pool remains unclear. There is no clinical consensus on how these potential ODE lung-donors should be assessed. We aimed to describe the total contribution of ODE to the lung-donor pool in the Netherlands and describe the assessment of potential ODE lung-donors.
We collected data from all ODE procedures performed between 2012-2024 in the Netherlands. We assessed the number of ODE-lungs offered, rejected, accepted, and transplanted, comparing characteristics of discarded and transplanted lungs.
Of 1166 lung-donor, 664(60%) were DCD donors of which 154(23%) were ODE lung-donors. The total proportion of donor lungs from ODE lung-donors acceptable to offer for lung transplantation was 117 of which 104 (89%) were transplanted. Evaluation prior to donation was highly variable, with medical history and chest CT most affecting acceptance decisions. Short-term outcomes were excellent, with 1-year survival of 84%.
Our findings indicate that ODE lung donors are increasingly important in the Netherlands, with high acceptance rates, despite highly variable evaluation methods. Standardizing the assessment of potential ODE lung donors could further improve acceptance rates and enhance the contribution of ODE to the lung-donor pool."
The Harvard Gazette points to this interview with HBS professor Alex Chan:
Designing Incentives That Matter—Even After Death: Interview with Alex Chan By Avery Forman
"In “Reimagining Transplant Center Incentives Beyond the CMS IOTA Model,” published in January in the Journal of the American Medical Association, Chan explores a government experiment that pays kidney centers for volume and efficiency—not just outcomes—which could increase transplant numbers. Chan cowrote the article with Alvin E. Roth, the George Gund Professor of Economics and Business Administration, Emeritus, at HBS.
In addition, covering funeral costs for organ donors could increase donation rates by up to 35%, and save up to 419,000 life years and as much as $800 million in Medicare expenses, Chan and coauthor Kurt Sweat of the University of Texas Southwestern Medical Center write in “Funeral Expense Reimbursement as a Strategy to Enhance Organ Donation and Transplantation Access,” published in October in NPJ Health Systems.
...
"Why Chan felt compelled to study the organ market
“Two things pulled me in. First, this is a market where the stakes are brutally clear. Organ transplantation is one of the few places where inefficiency shows up not as a deadweight loss in a textbook, but as people dying on a waiting list. When a market fails here, it fails loudly.
Second, the level of inefficiency is staggering. Each year, more than 5,000 organs are recovered and then discarded, while roughly the same number of people die waiting for an organ. These are million-dollar transactions once you account for surgery, lifelong care, and avoided dialysis. So even small improvements in incentives can save lives directly and save the healthcare system billions of dollars.
For an economist or market designer, that’s a rare alignment: moral urgency and economic leverage pointing in the same direction.”
“Incentive design is much harder than we like to admit. Organ transplantation is a supply chain. You have procurement organizations, hospitals, surgeons, patients, regulators, all responding to different incentives.
Designing a good incentive for one actor is already difficult. Designing incentives so that the entire chain works well is not just adding up the optimal incentives for each link. Sometimes improving one part of the system quietly breaks another.
The choice isn't between market and no market. It’s between a system we design on purpose and a system that fails by accident.
This is a market with moral and political constraints embedded in it. In healthcare, and frankly now in most markets, the incentives that are economically sensible also need to be socially legitimate.
Incentives don’t just change behavior; they express values. In markets that touch life, death, or dignity, people react not only to what the incentive does, but to what it seems to say. That makes incentive design less like tuning a machine and more like negotiating a fragile social contract.
...
"The ‘ick factor’ might prevent progress
“Very often people do not want to use the right incentives because they have this concept of it being repugnant.
[For instance], we would pay for the funeral of someone who gives their life for their country when they serve in the military. We will pay for the funeral of someone who donated their body for scientific research to advance society. But if people want to donate an organ to save another person's life? If [that donor’s] family would very much welcome some support at a moment of crisis, we are not going to pay for the funeral. Even a very sensible incentive sometimes is bound by social norms, or even what we call the ‘ick factor,’ and we have a less effective system at the end.
People worry that incentives will corrupt the gift of life. But the truth is that we already have incentives; they’re just accidental and poorly distributed. The choice isn't between market and no market. It’s between a system we design on purpose and a system that fails by accident. Ignorance of incentives doesn't make a system moral; it just makes it inefficient.”
The American market for guns is among the most complex of controversial markets, since gun purchases are regarded by many Americans as repugnant, while to many others (and in the eyes of the law*) they are protected. So the US debate about guns is conducted in a restricted space.
Here's a new paper that takes an unusually nuanced, empirical approach to understanding possible paths forward. In particular, it introduces non-lethal firearms into a survey and experiment.
The Universal Pursuit of Safety and the Demand for (Lethal, Non-Lethal or No) Guns, by Marcella Alsan, Joshua Schwartzstein & Stefanie Stantcheva, NBER Working Paper 34962, DOI 10.3386/w34962, March 2026
Abstract: "Lethal firearm ownership is deeply polarizing in the United States. We show that beneath this polarization, owners and non-owners share a common objective — safety — but disagree sharply about whether lethal firearms achieve it. Using an original survey of more than 5,400 respondents combined with randomized experiments, we document that owners feel safe and confident with firearms, while non-owners on balance feel less safe around them and perceive large private costs and social harms. Demand for lethal firearms is nonetheless potentially large and growing: one-third of non-owners express interest in acquiring one — these individuals report the lowest day-to-day safety — while very few owners would consider reducing their holdings. Persuading owners to relinquish firearms without any replacement appears unrealistic; the more tractable margins may be safe storage and non-lethal substitution for additional purchases. We organize these patterns through a framework centered on a perceived safety possibilities frontier (SPF) — the safety outcomes a household believes achievable with different combinations of lethal and non-lethal tools. Households may differ in firearm demand because they face different risk environments, weigh protective benefits against harms differently, or hold different beliefs about the frontier. Our descriptive evidence points to heterogeneous beliefs as important drivers, suggesting that levers such as information could shift the perceived frontier. These patterns motivate three experimental treatments: one on the private legal/medical costs of lethal firearm ownership, and two on a non-lethal firearm (NLFA), with and without a conservative pundit’s endorsement. The private-cost treatment increases concern about harms among all respondents and support for safe storage policies, and modestly raises stated willingness to keep lethal firearms locked. NLFA treatments raise willingness to pay for an NLFA, to keep lethal firearms locked, and support for incapacitating over lethal firearms and for policies encouraging NLFAs. These effects are largely persistent. Importantly, NLFA information does not increase willingness to reduce lethal firearm ownership but does increase willingness to store lethal firearms safely. Our results suggest that many owners perceive the SPF differently from nonowners, neglecting harms or less-lethal alternatives, yet remain open to such tools. Overall, individuals share a common goal — safety — yet disagree about the means. Although these disagreements appear entrenched, people remain receptive to alternatives that might command broader agreement."
#########
*The 2nd Amendment to the Constitution says
"A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed."
(Only the part in bold seems, to my unlawyerly eyes, to have played much part in American jurisprudence.)
Strategy sets are big, so we’re not going to be able to end illegal drug use by spraying defoliants on fields of poppies, or arresting dealers, or attacking speedboats. If we can’t stop the spread of drugs even in prisons, the chance of purely police/military solutions for stopping drugs on the streets isn’t looking good.
The NYT has the story:
No Pills or Needles, Just Paper: How Deadly Drugs Are Changing
Lab-made drugs soaked into the pages of letters, books and even legal documents are being smuggled behind bars, killing inmates and frustrating investigators. By Azam Ahmed and Matt Richtel
" Today, fringe chemists are ushering in a total transformation of the illicit drug market. Operating from clandestine labs, they are churning out a dizzying array of synthetic drugs — not only fentanyl, but also hazardous new tranquilizers, stimulants and complex cannabinoids. Sometimes, several unknown drugs appear on the streets in a single month. Many are so new they are not even illegal yet.
"Nearly all of them are harder to trace than conventional drugs, less expensive to produce, much more potent and far deadlier, according to scientists and law enforcement officials across the globe.
...
"After that first death in the Cook County jail in January 2023, it took months for Mr. Wilks’s team to realize that these mysterious new drugs were being sprayed onto the pages of the most innocuous-seeming items: books, letters, documents, even photographs.
"The sheets of drugs, worth thousands of dollars a page, were being torn into strips and smoked by inmates
...
"But the traffickers were cunning. When regular mail got checked more closely, smugglers began lacing legal correspondence. Soon, officers discovered sealed packages that looked as if they had been shipped directly from Amazon, with drug-soaked books inside. "
############
It’s hard to shut down markets that people want to participate in.
Someone should write a book about this.
The NYT has the story:
The Middle-Class Suburbanites Who Sell Their Blood Plasma to Get By. Across the United States, plasma centers are opening in wealthier areas as more people struggle with the high cost of housing, groceries and health care. By Kurtis Lee and Robert Gebeloff March 20, 2026
"Every day, an estimated 215,000 people donate plasma, the yellowish liquid component of blood. Mr. Briseño is among them. He is not jobless or facing eviction, but, like many in the American middle class, he is caught in the vise of rising expenses and wages that aren’t growing fast enough to cover them. So he is turning to a method more commonly associated with the lowest-income Americans. For people like him, an extra $600 or so a month can mean making a mortgage payment or covering increased health-insurance costs.
"A recent study by researchers at Washington University in St. Louis and the University of Colorado, Boulder, observed that while older plasma centers are clustered in low-income areas, newer centers were increasingly likely to open in middle-class neighborhoods. A New York Times analysis shows the trend has continued: Centers have sprung up in more than 100 such neighborhoods, in suburbs and wealthier sections of cities, since researchers finished collecting their data in 2021."
#########
Here's an earlier post on the study that sparked the NYT report:
Some controversies are familiar all over the world.
The NYT has the story:
The Faroe Islands Are Changing Some of Europe’s Strictest Abortion Rules
A new law allowing abortion up to 12 weeks will be a major shift in an archipelago of 55,000 people, and there are strong feelings on both sides. By Amelia Nierenberg and Regin Winther Poulsen
"The Faroes, a self-governing part of the Kingdom of Denmark in the North Atlantic hundreds of miles from Copenhagen, allowed abortion only in rare cases.
...
"The Faroes have had a near-total abortion ban, one of Europe’s most restrictive, under a law that dates back to 1956. Like Ms. Jacobsen, some women lied to their doctors to get around the restrictions and end their pregnancies, doctors, lawmakers and advocates on both sides of the issue have said.
...
"But late last year, the Parliament in the archipelago of 55,000 people ratified a law that allows women to end a pregnancy within its first 12 weeks, a major shift in a place that has long been more religious and socially conservative than its Nordic peers. The law is set to take effect in July.
...
"But a parliamentary election is set for late March and polls suggest that power could pass to a conservative coalition that may try to block implementation of the law or change it."
Peter Jaworski collects the statistics from Europe and North America:
Plasma donation is safe
And commercial plasma donation is not less safe than non-commercial donations
Peter Jaworski
Mar 16, 2026
"Source plasma donation (also called “plasmapheresis”) is inordinately safe (so is whole blood donation). And the best publicly-available donation safety data give us no reason to think that commercial plasma collection is less safe than non-commercial plasma collection.
" That claim may be surprising in light of the recent heartbreaking deaths reported after plasma donations in Winnipeg. These tragedies have raised questions about the safety of plasma donation in general, with some critics suggesting that commercial plasma donation is inherently less safe than non-commercial plasma donation.
"The evidence for the claim that plasmapheresis, including commercial plasmapheresis, is safe can be found in countries with the largest plasmapheresis programs, which publish annual reports on serious donor adverse events. Some of these countries have exclusively non-commercial plasma collection, while others have predominantly commercial systems. "
Here's a story from the NYT, about the recent regularization of paid plasma donation in (some provinces of) Canada.
How Safe Is Plasma Donation?
Two recent deaths tied to for-profit clinics in Canada raised concerns about the health effects of having plasma drawn as often as twice a week. By Roni Caryn Rabin and Vjosa Isai
"Donating plasma, which is used to make lifesaving medicinal products, is widely perceived as low-risk. But questions about the safety of the practice arose this week when Canadian health authorities confirmed they were investigating two recent deaths of people who gave plasma at for-profit clinics in Winnipeg operated by Grifols, a Spanish health care company.
"Millions of people donate frequently in North America. An estimated 60 to 70 percent of plasma-derived medicinal products worldwide are made from plasma donated in the United States.
And demand for plasma is growing. The market for plasma-derived medicinal products is valued at $40.35 billion and is expected to double over the next eight years, as the products are used to treat an expanding number of conditions, including immune deficiency syndromes and bleeding disorders.
But the health impact of frequent plasma donation on the donors themselves has not been well studied, and there is no consensus among health regulators about how long donors should wait between plasma draws.
In both Canada and the United States, companies can pay people an honorarium for donating their plasma, and health regulations say that people can donate up to twice a week.
...
"A 2020 investigation by the F.D.A. into 34 deaths reported as being associated with plasma donation did not determine that donation was the cause of death in any of the cases. It ruled donation out entirely as a cause in 31 cases. "
There's a tension between privacy (some of it constitutionally protected) and security, involving everything from street crime to terrorism, and citizen observers of government agents and others. Cameras make a difference (even before facial recognition software), and the debate on how to reach a balance that yields appropriate safety in both dimensions is likely to continue.
The NYT has the story, motivated by the Ring doorbell Superbowl ad:
Ring’s Founder Knows You Hated That Super Bowl Ad
Since the commercial aired, Jamie Siminoff has been trying to quell an outcry over privacy concerns with his doorbell cameras. By Jordyn Holman
"The commercial showed a new Ring feature called Search Party, which uses artificial intelligence and images from its cameras to trace a lost pet’s wanderings across a neighborhood. Critics said the feature felt dystopian, showing the potential for far-reaching invasive surveillance. Senator Edward J. Markey, Democrat of Massachusetts and a critic of corporate data collection, called out “the serious privacy and civil liberties risks” in Ring’s technology.
...
"The ad landed at a tense media moment involving home surveillance. In the search for Nancy Guthrie, the missing mother of the TV news anchor Savannah Guthrie, law enforcement agencies were able to recover footage from her Google Nest doorbell, despite reports that she did not have a subscription to the device.
But Ring, which is owned by Amazon, is so ubiquitous that is has become a generic term for any doorbell camera, and users raised questions about how much Ring was monitoring them.
Mr. Siminoff took pains in his media appearances to clarify Ring’s privacy policies. He said his company does not store users’ footage if they don’t have a subscription with Ring.
...
"Mr. Siminoff defended his technology, saying that protecting privacy and providing useful tools for helping people are both possible. He said that he understood people’s concerns, and that maybe people were “triggered” by an image in the ad that showed blue rings radiating out from suburban homes. "
The New York Times editorial board thinks about the current environment for (now legal) marijuana, and calls for more careful regulation, and federal taxation:
It’s Time for America to Admit That It Has a Marijuana Problem
"Thirteen years ago, no state allowed marijuana for recreational purposes. Today, most Americans live in a state that allows them to buy and smoke a joint. President Trump continued the trend toward legalization in December by loosening federal restrictions.
This editorial board has long supported marijuana legalization. In 2014, we published a six-part series that compared the federal marijuana ban to alcohol prohibition and argued for repeal. Much of what we wrote then holds up — but not all of it does.
At the time, supporters of legalization predicted that it would bring few downsides. In our editorials, we described marijuana addiction and dependence as “relatively minor problems.” Many advocates went further and claimed that marijuana was a harmless drug that might even bring net health benefits. They also said that legalization might not lead to greater use.
It is now clear that many of these predictions were wrong. Legalization has led to much more use. Surveys suggest that about 18 million people in the United States have used marijuana almost daily (or about five times a week) in recent years. That was up from around six million in 2012 and less than one million in 1992. More Americans now use marijuana daily than alcohol.
...
"The unfortunate truth is that the loosening of marijuana policies — especially the decision to legalize pot without adequately regulating it — has led to worse outcomes than many Americans expected. It is time to acknowledge reality and change course."
Pain experienced while dying may be partly spiritual.
National Geographic has the story:
These drugs could be a game changer for end-of-life care
Certain psychoactive substances can improve the mental health of terminally ill cancer patients—but few patients can currently access them. By Meryl Davids Landau
"Several years ago in Vancouver Island, Canada, a 32-year-old mother with advanced metastatic cancer was so wracked with pain and a fear of dying she constantly wept in bed. Through a targeted Canadian government program, the woman accessed psilocybin, the main psychedelic ingredient in magic mushrooms. The day after taking a dose of the drug she was pain-free, able to joke with family members and reconnect with old friends before she died the following week.
...
"The drugs can help with “the existential component of pain that is tied in with spiritual and psychological experiences,” something conventional medicine has few tools to address, says Masuda, a physician with SATA Centre for Conscious Living, who has since facilitated dozens of psychedelic sessions for similar patients.
"Some 400 terminal patients in Canada have legally accessed psilocybin in the past five years via its special programs, and several countries already allow for similar uses. Due to federal drug laws, terminally ill people in the U.S. cannot currently take psilocybin outside of a handful of clinical trials.
"But this may finally change, as government agencies are evaluating whether to allow its use for end-of-life care—thanks to pressure from physicians and years of research. Many palliative care doctors in the U.S. say the change can’t come soon enough."
When a national monument is designated around a private business in a liberal state, the ability of the President to alter its message is at least partially circumscribed.
Trump Administration Removes Pride Flag From Stonewall National Monument The enduring symbol of LGBTQ+ liberation has been taken down from the historic site.
By James Factora and Quispe López February 10, 2026
"Manhattan borough president Brad Hoylman-Sigal told the New York Times that the directive to remove the Pride flag came from the Trump administration. The monument itself was designated in 2016 to honor the origin of Pride in the United States, and was also the first U.S. national monument dedicated to LGTBTQ+ rights.
"But like the 1969 rebellion that cemented Stonewall into history books, queer and trans people are not taking it without a fight. While the park and monument across from the original Stonewall Inn is now a federal park, the business itself is private property.
“Bad news for the Trump Administration: these colors don’t run,” Human Rights Campaign Press Secretary Brandon Wolf said in a statement. “The Stonewall Inn & Visitor’s Center is still privately owned, their flags are still flying high, and that community is just as queer as it was yesterday. While their policy agenda throws the country into chaos, the Trump administration is obsessed with trying to suffocate the joy and pride that Americans have for their communities.”
##########
N.Y.C. Officials Reinstate Pride Flag at Stonewall After Federal Removal By Liam Stack and Olivia BensimonUpdated Feb. 13, 2026, 2:40 a.m. ET
"A group of New York elected officials gathered on Thursday to replace the Pride flag that was removed from the Stonewall National Monument after a directive from the Trump administration, mounting a defiant response to the government’s assault on diversity initiatives at a federal site honoring the L.G.B.T.Q. rights movement.
"The plan to re-raise the flag in the center of the small park outside the historic Stonewall Inn in Greenwich Village had been widely publicized on social media, and hundreds of spectators cheered as its rainbow colors made their way back up the flagpole under a cloudy winter sky."
Here's a new HBS working paper on repugnance of A.I.
Performance or Principle: Resistance to Artificial Intelligence in the U.S. Labor Market
By: Simon Friis and James W. Riley
Abstract
From genetically modified foods to autonomous vehicles, society often resists otherwise beneficial technologies. Resistance can arise from performance-based concerns, which fade as technology improves, or from principle-based objections, which persist regardless of capability. Using a large-scale U.S. survey quota-matched to census demographics and assessing 940 occupations (N = 23,570 occupation ratings), we disentangle these sources in the context of artificial intelligence (AI). Despite cultural anxiety about artificial intelligence displacing human workers, we find that Americans show surprising willingness to cede most occupations to machines. Given current AI capabilities, the public already supports automating 30% of occupations. When AI is described as outperforming humans at lower cost, support for automation nearly doubles to 58% of occupations. Yet a narrow subset (12%)—including caregiving, therapy, and spiritual leadership—remains categorically off-limits because such automation is seen as morally repugnant. This shift reveals that for most occupations, resistance to AI is rooted in performance concerns that fade as AI capabilities improve, rather than principled objections about what work must remain human. Occupations facing public resistance to the use of AI tend to provide higher wages and disproportionately employ White and female workers. Thus, public resistance to AI risks reinforcing economic and racial inequality even as it partially mitigates gender inequality. These findings clarify the “moral economy of work,” in which society shields certain roles not due to technical limits but to enduring beliefs about dignity, care, and meaning. By distinguishing performance- from principle-based objections, we provide a framework for anticipating and navigating resistance to technology adoption across domains.
Posts
All Comments
