Kidney exchange news from Britain

David Manlove writes:

Dear Al,

I just wanted to pass on some KE news: the first 3-way kidney exchange in the UK has just been announced:

http://news.bbc.co.uk/1/hi/health/8552162.stm
http://news.bbc.co.uk/1/hi/health/8554930.stm
http://www.hta.gov.uk/newsandevents/htanews.cfm/837-First-pooled-transplants-performed-in-the-UK.html

Also I've been successful with a grant proposal to NHS Blood and Transplant and they will be funding us (i.e., me and former PhD student Gregg O'Malley; hopefully Peter Biro will be involved too) to work for a year on delivering a software package to enable them to carry out the quarterly matching runs for themselves, without having to send the data to us. The NHSBT collaboration builds on the work we've been doing together over the last 3 or so years (we've been involved in the quarterly matching runs since July 2008): http://www.organdonation.nhs.uk/ukt/about_transplants/organ_allocation/kidney_(renal)/living_donation/paired_donation_matching_scheme.jsp.

Our paper describing some aspects of this work appeared in the new journal Discrete Mathematics, Algorithms and Applications (vol. 1, no. 4, pp. 499-517, 2009, here. Also here are some slides from a talk I gave at a workshop in Bristol last year: http://www.cs.bris.ac.uk/Research/Algorithms/BAD09/Talks/BAD09-Manlove.pdf. I will be giving an updated version at a workshop on Matching Theory and Mechanism Design organised by Elena Inarra in Oxford next Tuesday.

Hopefully NHSBT will be bringing in domino paired chains triggered by altruistic donors in the near future - we are still trying to convince them of the merits of never ending altruistic chains!

Best regards,
David
The University of Glasgow, charity number SC004401

Reading, writing and apologizing about repugnant transactions: Repugnance at multiple levels

A story in Al Jazeera concerns conflicting views of repugnant transactions--things that some people think other people shouldn't do--on multiple levels. The story concerns judicial flogging of women for adultery in Malaysia, a newspaper editorial against that practice by a non-Muslim editor, a government threat to close the newspaper for publishing the editorial, and a religious ruling that Muslims should not read the editorial.

The Al Jazeera story is here: Malaysia - Caning the messenger?

The Malaysian newspaper, The Star, has withdrawn the editorial from its website, but the Al Jazeera story concludes with this paragraph containing a link to a copy of the offending editorial:

"For people who want to make up their own mind about the issue, the text is still available here, but here's a clear warning, this article has already been deemed unacceptable by some Muslims. Those who agree with Mais - that non-Muslims should not comment on matters pertaining to shariah law - are strongly advised not to follow the link."

The multiple levels of repugnance remind me of another recent story in the news: Danish newspaper provokes uproar with apology over Muhammad cartoon
"A Danish newspaper was accused yesterday of betraying the freedom of the press after it apologised to Muslims for offence caused by its reprinting a cartoon showing the Prophet Muhammad with a bomb-shaped turban.
Politiken, a leading Danish newspaper, had printed the cartoon as a gesture of solidarity after three people were arrested for planning to kill the cartoonist, Kurt Westergaard. "

I guess I'll have to add reading and apologizing to my growing list of repugnant transactions, which already included adultery and publishing.

"Tissue rights"

Who has the rights to a cell line created from cancerous tissue? The NY Times reviews the book “The Immortal Life of Henrietta Lacks” (Crown Publishers), by the journalist Rebecca Skloot.

A Lasting Gift to Medicine That Wasn’t Really a Gift

"The notion of “tissue rights” has inspired a new category of activists. The question that comes up repeatedly is, if scientists or companies can commercialize a patient’s cells or tissues, doesn’t that patient, as provider of the raw material, deserve a say about it and maybe a share of any profits that result? Fewer people these days may be willing to take no for an answer. "

Price gouging and proposed legal remedies

Some more interesting posts on price gouging from Michael Giberson at Knowledge Problem :

A private right of action on price gouging and Price gouging in Haiti.

Embryo exchange in Georgia

It's not what it sounds like, and it doesn't have tax consequences:

Embryo Exchanges and Adoption Tax Credits by
Sarah B. Lawsky and Naomi Cahn

Abstract: The “Option of Adoption Act,” a Georgia law that was introduced by a staunchly anti-abortion Georgia state representative, establishes procedures for genetic donors to relinquish their rights to embryos before birth and permits, but does not require, embryo recipients to petition a court for recognition that they are the legal parents of a child born to them as a result of an embryo transfer. This article clears up what seems to be widespread confusion about a fairly straightforward question of tax law related to such embryo “adoptions.” Notwithstanding various sources' claims to the contrary, neither a Georgia adoption tax credit nor a federal adoption tax credit is available for “adopting” an embryo.

Matching for adoption

"In most cases, a successful domestic adoption is the result of a match between a birth mother (BMO hereafter) who seeks to relinquish her child, and prospective adoptive parents (PAPs hereafter). The underlying matching process involves a bilateral search characterized by several layers of mediation: Typically, adoption agencies represent BMOs, while PAPs work vis-à-vis adoption agencies, lawyers, or facilitators. In this paper, we exploit the unique nature of a new data set documenting the operations of an adoption facilitator. We analyze the preferences of PAPs over the attributes of babies relinquished for adoption, the BMOs’ choices, and the factors that determine ultimate outcomes (i.e., a successful adoption, a decision to parent by the BMO, or the child’s placement in foster care).

That is from the paper Gender and Racial Biases: Evidence from Child Adoption, by Mariagiovanna Baccara , Allan Collard-Wexler, Leonardo Felli , and Leeat Yariv.

The paper has a market design aspect:
"Despite the social value of a well-functioning matching process that delivers suitable parents to every child, adoption has not received much attention by the economics literature. Our analysis of parents’ preferences, combined with the identification of factors facilitating an ultimate match, opens the door to policy interventions aimed at increasing the efficiency of this process."

Same sex marriage in Mexico City: starting today

Gay Marriage Puts Mexico City at Center of Debate : "A new Mexico City law goes into effect March 4 that will allow same-sex couples to marry and adopt children, propelling the city to the forefront of the global gay rights movement."
The law seems to have survived the expected judicial challenge: Mexico's Supreme Court Upholds Gay Marriage Law , and here's a nice story about the (ongoing) debate in yesterday's Washington Post, With same-sex marriage law, Mexico City becomes battleground in culture wars

Here are my other posts on same sex marriage, which strikes me as an excellent example of how views and laws can change regarding repugnant transactions.

Same sex marriage in Washington D.C., starting yesterday

Gay Marriage Is Now Legal in Washington
"Gay-rights advocates hailed the day as a milestone for equal rights and a symbolic victory as same-sex marriage became legal in the nation’s capital.
Washington is now the sixth place in the nation where same-sex marriages can take place. Connecticut, Iowa, Massachusetts, New Hampshire and Vermont also issue marriage licenses to same-sex couples.
Despite failing in court, opponents of the law vowed to fight another day. "

And here is the failure in court:
SUPREME COURT OF THE UNITED STATES No. 09A807
HARRY R. JACKSON ET AL. v. DISTRICT OF COLUMBIA BOARD OF ELECTIONS AND ETHICS ET AL. ON APPLICATION FOR STAY
[March 2, 2010] CHIEF JUSTICE ROBERTS, Circuit Justice.

"Petitioners in this case are Washington D. C. voters who would like to subject the District of Columbia’s ReligiousFreedom and Civil Marriage Equality Amendment Act of 2009 to a public referendum before it goes into effect... Without addressing the merits of petitioners’ underlying claim, however, I conclude that a stay is not warranted. "

Same sex unions in the Anglican church

Across the pond: Anglican bishops back end to ban on gay civil partnerships in church "Gay couples could soon be allowed to “marry” in church after a decision by Anglican bishops and other clergy to support a relaxation of the ban. Senior bishops in the Lords have told The Times that they will support an amendment to the Equality Bill next month that will lift the ban on civil partnership ceremonies in religious premises. The amendment would remove the legislative prohibition on blessings of homosexual couples and open the door to the registration of civil partnerships in churches, synagogues, mosques and all other religious premises." ... "The Church of England, which along with the wider Anglican Communion is divided over gay ordinations and same-sex blessings, will maintain its official ban. But if the legislative prohibition is lifted, as seems likely, the Church’s own ban is likely to be ignored by some clergy." ... "The Quakers have called for the law to be changed to give same-sex partners the same status in their ceremonies as heterosexual couples. They joined forces with Liberal Judaism and the Unitarians to support an amendment to the Equality Bill giving religious organisations the freedom to register civil partnerships. Lord Alli’s amendment would remove the bar in the Civil Partnership Act 2004 on religious premises being used for civil partnerships — and also the prohibition on religious language being used in such ceremonies. This would in effect end any remaining distinction between civil partnerships and marriage and increase the pressure on the established Church to take a more liberal line on same-sex relationships. It would also deepen the schism in the Anglican Communion over gay blessings and gay ordination."

Academic job markets in the Humanities

The American Academy of Arts and Sciences has issued a new report as a result of a set of surveys of Humanities departments. Here is the announcement:

"Challenges to Humanities Revealed in New Survey
The humanities continue to play a core role in higher education and student interest is strong, but to meet the demand, four-year colleges and universities are increasingly relying on a part-time, untenured workforce. Those are among the findings from the Humanities Departmental Survey. The survey includes data collected from English, foreign language, history, history of science, art history, linguistics, and religion departments at approximately 1,400 colleges and universities. It is the first comprehensive survey to provide general cross-disciplinary data on humanities departments. "

"Across the humanities, but especially in English and combined English/foreign language departments, the professoriate at four-year colleges and universities is evolving into a part-time workforce. During the 2006-2007 academic year, only 38 percent of faculty members in these departments were tenured. English departments had the greatest proportion of non-tenure-track faculty (49 percent)."

HT: Paul Karoff

Assisted suicide, the debate continues in England and Switzerland

Assisted suicide, a widely repugnant transaction, continues to be the subject of public discussion in England. The Telegraph reports a new poll: Assisted suicide: 4 in 5 say do not prosecute.

"The public’s support for a change in the law on assisted suicide and euthanasia was uncovered by the YouGov poll following a succession of high profile court cases.
Three quarters of those polled said the law should be amended to allow assisted suicide, a crime punishable by up to 14 years in prison. "...

"Sir Terry Pratchett, the author who suffers from Alzheimer’s disease, is due to deliver a lecture in which he will call for assisted suicide "tribunals" that would give the terminally ill permission to end their lives. In the Richard Dimbleby Lecture, he will offer himself as a test case for just such a tribunal... Sir Terry, who prefers the term "assisted death", will say that permission to end his life will make each day more precious, and that doctors should not be forced to help the terminally ill to die. ... "If I knew that I could die, I would live. My life, my death, my choice." "

The WSJ has an article about the Swiss assisted suicide clinic Dignitas, and the debate going on in Switzerland about the the laws governing assisted suicide:
Assisted-Suicide Pioneer Stirs a Legal Backlash

"From the start, Mr. Minelli has kicked up controversy for his willingness to help foreigners die. Most groups in Switzerland don't assist foreigners. Dignitas only helps foreigners. The number of foreigners Dignitas helps each year—132 in 2007, compared to 91 in 2003—has increasingly left the Swiss uncomfortable with the country's growing reputation for "suicide tourism." As of the end of last year, Dignitas had helped a total of 1,046 people to commit suicide. "...

"Under Swiss law, it is illegal for a person to assist a suicide for their own "selfish" reasons. But there are otherwise no limits on helping someone to die. By contrast, most countries allowing assisted suicide require the person to be terminally ill or demand that a doctor assist the suicide. Switzerland is also the only country permitting right-to-die organizations to help foreigners die.
"At the moment, there is really no law," says Andreas Brunner, a Zurich prosecutor who has fought for greater restrictions on right-to-die organizations, particularly Dignitas. "You have to have some rules and standards. The worst solution is what we have now."
As medical advances prolong lives even for the seriously ill, the debate over assisted suicide is surging elsewhere.
In Oregon—the one state in the U.S. where assisted suicide is legal—doctors are allowed to help only state residents who are expected to die within six months.
The U.K., which has restrictive laws on euthanasia, was forced in a court case last fall to clarify whether it would prosecute Britons who help family members make the trip to Switzerland to die. (It won't.) Luxembourg legalized euthanasia last year. Activists in Belgium and the Netherlands are pushing to broaden the group of patients who can avail themselves of assisted suicide to the elderly, minors and chronically ill. "...

"In 2008, when neighbors' complaints forced Dignitas out of the rented apartment it had long used for suicides, Zurich city officials refused permission for a new venue.
So, Mr. Minelli organized suicides in cars, a hotel room and his own home, drawing the ire of local officials. For a time, he was forced to use the industrial site criticized by Mr. Gall. "Someone who is used to a five-star hotel can't come to Dignitas and expect the same," Mr. Minelli says.
The Zurich prosecutor's office spoke with family members who complained about the 10,000-Swiss-franc fee Mr. Minelli charges people to die, but found insufficient grounds to open an inquiry. One rival right-to-die organization asks for nothing beyond a 45-Swiss-franc membership fee, while another charges 4,000 Swiss francs. Mr. Minelli says the fee helps with his legal and lobbying expenses. "...

"Mr. Minelli argues that making assisted suicide available removes a taboo around suicide, helping people who want to kill themselves open a dialogue and seek help. About 70% of people who get the green light from Dignitas for an assisted suicide never contact the group again, proving the palliative effect of knowing help is available, he says. "
...
"A vote is planned in March on a bill that would sharply restrict the activities of right-to-die organizations. For instance, two doctors must testify that a person is terminally ill, thus ruling out assistance for the chronically or mentally ill. The person seeking help must have given long consideration to his wish to die before doctors can prescribe lethal drugs. Moreover, right-to-die groups would be barred from accepting payments beyond those covering the costs of the suicide. The government also tabled a second bill that would ban assisted suicides altogether. "

The debate has taken a dramatic turn, beginning with a BBC narrator stating on air “I killed someone once.”
The Prime Minister has weighed in too: Gordon Brown: don't legalise assisted suicide.

Economics job market scramble

If you are a new economics Ph.D. and the market is going slowly, hang in there. Similarly if you are a department or other employer who is still trying to fill a position. There's still lots of action left in the market.

If you are still on the market near the end of March, you should think about registering for the 2010 Job Market Scramble

Important Dates:
March 23: Registration will Open
March 30: Registration will Close
April 1-12: Scramble Website will open for viewing by registered participants only
April 12: Scramble Viewing will Close

See the Scramble Guide for more detailed information.

Brief Description:
Occasionally prospective employers of new Ph.D. economists exhaust their candidates before hiring someone during the winter/spring "job market" period. Similarly, new economics Ph.D.s seeking a job sometimes find that all of the prospective employers with whom they have interviewed have hired someone else before they have secured an appointment.
To address these problems, the AEA has established a "Job Market Scramble" web site to facilitate communication between employers and job seekers in late spring. In March, employers that continue to have an open position previously listed in Job Openings for Economists (JOE) may post a short notice of its availability (with a link to the JOE listing). Similarly, new or recent economics Ph.D. job seekers still looking for a position may post a short announcement of their continued availability, with a link to their application materials (C.V., papers, references). The web site will open for viewing to those who have listed a position or availability soon after listings close. There is no charge for the "Job Market Scramble."

In each of the last four years between 67 and 100 employers have participated in the scramble, and (despite low response rates to the post scramble survey of participants) the AEA's Ad Hoc Committee on the Job Market (which I chair) has been able to confirm that more than 10% of the jobs offered through the scramble have been filled through contacts initiated via the scramble.

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
Regulatory:
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
Education:
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

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.

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.

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. )

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.

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.

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 http://www.ineed.co.nz/ 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. "

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).

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.

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. "

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

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 ScientificMatch.com, 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 Chemistry.com, started in 2006 by the dating giant Match.com. Helen Fisher, the biological anthropologist who developed Chemistry.com’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 Match.com.
But both ScientificMatch.com and Chemistry.com are refinements of an idea originally developed by eHarmony.com. "

..."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.
Match.com, 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. "

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."

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

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. "

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

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.

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."