Thursday, August 6, 2026

Experimental Economics at Stanford SITE, August 6-7 (program)

 The summer experiment fest is on:)

Session 6: Experimental Economics | Department of Economics 

Thu, Aug 6 2026, 9:00am - Fri, Aug 7 2026, 7:00pm PDT
Gunn Building, 366 Galvez Street, Stanford, 

Thursday, August 6, 2026

Aug 6

9:00 am - 9:30 am PDT

Check-in and Breakfast

Aug 6

9:30 am - 9:45 am PDT

Introduction

Aug 6

9:45 am - 10:45 am PDT

Session 1 (Chair: Muriel)

Aug 6

9:45 am - 10:15 am PDT

AI Sycophancy and Decisions

Presented by: John J. Conlon (Carnegie Mellon University)
Peter Schwardmann (Carnegie Mellon University)

We examine whether sycophantic AI advice distorts decisions. Our experiment involves 1,500 participants in 30 decision environments that span core domains in economics and the social sciences. We find that interacting with an AI that is broadly representative of consumer-facing models depolarizes choices on average, moving participants away from their initial leanings. This result appears despite the LLM being measurably sycophantic: it disproportionately supports users’ initial leanings and uses agreeable, flattering language. Depolarization occurs across moral and non-moral, objective and subjective, strategic and non-strategic, and complex and simple tasks, and despite the vast majority of researchers in an expert survey expecting polarization. Next, we show that sycophancy is behaviorally relevant—a treatment increasing AI sycophancy reduces depolarization—but that it is outweighed by the apparent informativeness of LLM advice. Finally, we ask whether market forces are likely to push toward greater polarizing effects outside our experiment or in the future. On the supply side, we show that our baseline LLM’s level of sycophancy is typical of leading models and that these models are not becoming substantially more sycophantic over time. On the demand side, we show that participants do not prefer greater sycophancy, do not select into AI advice in tasks where it is more polarizing for them, and exhibit greater depolarizing effects when they are more frequent AI users outside of the experiment.

Aug 6

10:15 am - 10:45 am PDT

Preference for Explainable AI

Presented by: Alex Chan (Harvard University)

Participants acted as loan officers deciding whether to approve real $10, 000-loans issued by a private U.S. lender using an AI’s default-risk predictions. When explanations revealed that the AI penalized non-White or female borrowers, participants were more likely to override the AI’s profit-maximizing recommendation. When their bonuses depended on repayment, however, they sought predictions but avoided explanations, consistent with willful ignorance; this effect faded when explanations were framed as purely financial or demographics were hidden. A secondary experiment reveals a novel bias: participants failed to reason contingently and undervalued explanations even when these complemented private information and improved decision accuracy.

Aug 6

10:45 am - 11:15 am PDT

Coffee Break

Aug 6

11:15 am - 12:30 pm PDT

Session 2 (Chair: Lise)

Aug 6

11:15 am - 11:45 am PDT

Narratives, Belief Movements, and Economic Fluctuations

Presented by: Tony Q. Fan (Lehigh University)
Tilman Fries (Ludwig Maximilian University of Munich)

We study how the construction and transmission of narratives—interpretations that explain observed data—systematically distort belief formation. In a dynamic environment where signals are generated by a potentially evolving state, we show that popular, well-fitting narratives tend to overfit the data and thereby push beliefs toward greater extremeness and volatility. We test this prediction in a controlled experiment that directly compares beliefs formed with and without exposure to a singular, endogenously constructed narrative. Participants exposed to such narratives form substantially more extreme beliefs, overreact to recent data, and exhibit more volatile belief movements over time. These results identify a mechanism through which narrative-based reasoning induces overreaction to news—one that likely matters broadly given the central role of narratives in economic communication.

Aug 6

11:45 am - 12:15 pm PDT

People as Intuitive Modelers: How Model Complexity Adapts to Data

Presented by: Sevgi Yuksel (New York University)
Guillaume Frechette (New York University) and Emanuel Vespa (University of California, San Diego)

We study whether and how people respond to a fundamental tension in model selection: simple models generate high bias and low variance, whereas complex models generate low bias and high variance. We report results from an experiment in which participants rely on a limited sample of observations to construct mental models describing the relationship between two variables and are rewarded based on the out-of-sample predictive accuracy of these models. In aggregate, behavior is broadly consistent with people acting as intuitive modelers who respond to the simplicity–complexity tradeoff. Model complexity varies systematically with the size and nonlinearity of the sample, but willingness to improve in-sample fit declines when doing so requires more complex models. The main deviation from optimal benchmarks is in the direction of underinference, driven by both a preference for overly simple models and mistakes in model construction conditional on the chosen complexity level.

Aug 6

12:15 pm - 12:30 pm PDT

Communicating with Data Generating Processes: An Experimental Analysis

Presented by: Agata Farina (University of Chicago)
Clément Herman (Princeton University)

In many applications, agents can more easily influence how data are generated than manipulate the data themselves. For example, students choose which classes to take but cannot modify their grades once assigned, and firms determine how performance indicators are calculated rather than directly altering results. This paper experimentally studies information transmission when data are generated through an unobservable, strategically chosen process. We focus on settings where an informed sender—such as a student or a firm—privately selects a data-generating process (DGP)—a portfolio of classes or an accounting methodology—to shape the beliefs of an uninformed receiver, such as an employer or an investor. Across treatments, we vary which DGPs are feasible and whether some come at a cost. These variations span different levels of information verifiability and capture, within a unified framework, the core insights of disclosure, cheap-talk, and signal- ing models. Our findings reveal three main patterns. First, while senders select their DGPs strategically in line with theoretical predictions, receivers often fail to account for this strategic selection. Second, introducing differential costs across feasible DGPs mitigates this DGP selection neglect. Third, while receivers’ biases are robust across environments, their consequences vary: information transmission falters most when the evidence receivers observe is highly sensitive to the sender’s DGP choices. Finally, increasing transparency about the selected DGP—a policy often advocated in practice—does not, in general, improve information transmission.

Aug 6

12:30 pm - 2:00 pm PDT

Lunch

Aug 6

2:00 pm - 3:15 pm PDT

Session 3 (Chair: Manu)

Aug 6

2:00 pm - 2:30 pm PDT

Understanding Support for Inefficient Environmental Policy Instruments

Presented by: Dmitry Taubinsky (University of California, Berkeley)
Chenxi Jiang (Massachusetts Institute of Technology), Maximiliano Lauletta (Federal Reserve Board), Ro’ee Levy (Tel Aviv University), and Joseph S. Shapiro (University of California, Berkeley)

Many governments use environmental standards rather than more cost-effective market-based instruments like pollution taxes or cap-and-trade markets. Using a nationally representative survey experiment, we study whether and why limited understanding of economic principles helps explain this practice. Holding environmental impacts constant, respondents prefer standards over market-based instruments, and prefer producer taxes and cap-and-trade over consumer taxes. These preferences reflect consumers’ beliefs about how these policies will affect electricity bills. Respondents also prefer the weakest environmental targets for consumer taxes and the strongest targets for standards, which suggests that policymakers face a tradeoff between policy stringency and cost effectiveness. A separate survey of environmental economists shows that they have strikingly different beliefs about the effects of environmental policies than the respondents in our representative survey. For example, typical respondents—in contrast to environmental economists and textbook economic theory—believe that environmental standards increase consumer energy bills less than market-based instruments do. Educational videos on pass-through and cost-effectiveness of policies affect policy support and close some of the gap between nationally representative respondents and experts, which suggests that economic literacy is a factor in voters’ preferences.

Aug 6

2:30 pm - 2:45 pm PDT

What Motivates Partisan Selective Exposure? Experimental Evidence from the 2024 US Presidential Election

Presented by: Peter Robertson (Stanford University)
Matthew Gentzkow (Stanford University), Michael Thaler (University College London)

Partisan selective exposure — the tendency of partisans to consume like-minded news — has been widely documented in the United States, but its drivers remain debated. This paper studies the relative roles of two commonly proposed motives for polarized news choice: (i) disagreement about the accuracy value of different news sources, and (ii) disagreement about sources’ non-accuracy value, such as identity affirmation or belief confirmation. To disentangle these motives, we run large-scale experiments over 3,785 participants with both real and artificial news sources in which participants choose a source to help them predict the winner of a swing state in the 2024 US presidential election. We employ two separate experimental manipulations which affect how people are predicted to trade off accuracy and non-accuracy value in canonical models of selective exposure. Despite documenting substantial selective exposure in our experimental environment at baseline, we find precise nulls across contexts on both manipulations: neither increasing the relative value for accuracy nor non-accuracy motives affects the degree to which participants choose co-partisan sources. Meanwhile, participants are highly sensitive to source accuracy: exogenously increasing the perceived accuracy of an artificial source leads to a sizeable increase in the share of participants who choose it. Our results, both interpreted in reduced form and through the lens of a discrete choice model, indicate that partisan differences in perceived accuracy are largely sufficient to explain the level of selective exposure we observe, and that non-accuracy motives play a limited role.

Aug 6

2:45 pm - 3:15 pm PDT

Incentives, Information, and Reminders for Bureaucrats: Overcoming Barriers to the Scale Up of an Effective Policy

Presented by: Gautam Rao (University of California, Berkeley)
Patrick Agte (Stockholm School of Economics), Daniel Morales (Tecnologico de Monterrey), Christopher Neilson (Yale University), and Sebastián Otero (Columbia University)

Scaling up effective policies often requires the attention of frontline bureaucrats with many competing responsibilities. Even when policymakers adopt effective programs, implementation may not follow. In a nationwide experiment in the Dominican Republic, we test interventions to increase school principals’ implementation of an educational program proven effective in a previous RCT. Only 37% of control schools verifiably implemented the intervention when ordered to by the Ministry of Education, compared with 86% in the original trials. Implementation was no higher among schools that previously participated in the RCT, suggesting that learning costs do not explain non-adoption. We find precise null effects of sharing research evidence, providing modest financial incentives, or offering implementation assistance. In contrast, additional reminder calls increased implementation by 20 percentage points. A second experiment targeting a different mandated program yields the same pattern: reminders produce large effects, while monitoring messages have smaller effects. Our findings point to limited attention among bureaucrats as a central barrier to scaling policies.

Aug 6

3:15 pm - 3:45 pm PDT

Coffee Break

Aug 6

3:45 pm - 4:45 pm PDT

Session 4 (Chair: Christine)

Aug 6

3:45 pm - 4:15 pm PDT

Cognitive Guidance in Matching Problems

Presented by: Muriel Niederle (Stanford University)
Lucas Coffman (Boston College), Yao Luo (Boston College), and Emanuel Vespa (University of California, San Diego)
Aug 6

4:15 pm - 4:45 pm PDT

Style Over Substance: The Oversized Role of Presentation Details in School-Choice Matching Systems

Presented by: Alex Rees-Jones (University of Pennsylvania)
Lucas Coffman (Boston College), Tayfun Sönmez (Boston College), Zamir Ticknor (University of Pennsylvania), and Alexander Whitefield (University of Pennsylvania)
Aug 6

5:30 pm - 5:30 pm PDT

Drinks and Dinner at Muriel's house

Friday, August 7, 2026

Aug 7

9:00 am - 9:30 am PDT

Check-in and Breakfast

Aug 7

9:30 am - 10:45 am PDT

Session 1 (Chair: Christine)

Aug 7

9:30 am - 10:00 am PDT

When Are Decisions Improvable: An Evaluation of Diagnostic Methods

Presented by: Charles Sprenger (California Institute of Technology)
B. Douglas Bernheim (Stanford University), Aldo Lucia (Ohio State University), and Kirby Nielsen (California Institute of Technology)

We evaluate three methods for identifying improvable choices: documenting specific misconceptions (the Characterization Assessment method), gauging confidence in choices (the Decision Confidence method), and showing that specific behavioral patterns in the domain of interest also emerge in a related domain where they are objectively suboptimal (the Pattern Matching method). In experiments involving risky choice, the three methods imply that different choices are improvable and have conflicting implications regarding legitimate risk preferences. We clarify the assumptions underlying each method and reevaluate the evidence on risk-taking in light of their limitations.

Aug 7

10:00 am - 10:30 am PDT

Valuations Under Tradeoff Complexity

Presented by: Jeffrey Yang (University of California, Santa Barbara)
Cassidy Shubatt (Harvard University)

Valuation tasks are a workhorse method for testing theories of individual preferences. However, a body of evidence suggests that complexity produces systematic measurement error in valuations, which raises the question of how researchers should interpret and utilize valuation data. To formally study this issue, we develop a model of complexity-driven noise in the valuation of risky prospects, in which the difficulty of comparing options to prices produces systematic noise in their valuations. We show how this model of noise can explain a number of documented valuation patterns that are difficult to rationalize under prevailing theories of risk preferences, as well as novel experimental evidence of systematic inconsistencies across valuation formats. We then characterize which valuation-based tests of preferences are robust to complexity in our model. While complexity distorts the levels of valuations in our model, differences between valuations can be informative, so long as complexity is held fixed across valuation tasks. We provide a formal criterion for robustness and apply it to valuation designs in the literature.

Aug 7

10:30 am - 10:45 am PDT

The Structure of Sequential Updating

Presented by: Kim Sarnoff (Ohio State University)

Many real-world inference problems unfold over time: employers learn about ability across tasks, consumers evaluate products through repeated use, and policymakers revise beliefs as new data arrive. Yet despite its ubiquity, research on dynamic updating has largely focused on a single implication of Bayesian reasoning: order independence. This paper experimentally tests a broader set of restrictions implied by Bayes’ rule, emphasizing both order independence and the previously unexamined property of prior sufficiency: the principle that the most recent posterior should serve as a sufficient statistic for past information. In a multi-period updating experiment with a rich set of parameters, participants repeatedly revise beliefs after receiving signals of varying strength and structure. Three main results emerge. First, only roughly a third display order dependence, overreacting to conflicting signals. Second, violations of prior sufficiency are widespread: beliefs formed sequentially tend to grow more extreme, and models assuming prior sufficiency, such as Grether (1980), fit poorly beyond the first update. Finally, the data indicate that participants process signals in aggregate, explaining prior sufficiency violations.

Aug 7

10:45 am - 11:15 am PDT

Coffee Break

Aug 7

11:15 am - 12:30 pm PDT

Session 2 (Chair: Muriel)

Aug 7

11:15 am - 11:45 am PDT

Promise Keeping and the Internal Judge

Presented by: Chloe Tergiman (Pennsylvania State University)
Sorravich Kingsuwankul (Vrije Universiteit Amsterdam) and Marie Claire Villeval (Université Lumière Lyon)

While standard models recognize intrinsic costs of lying, they typically treat reputational concerns as a calculation of external risk—trading off the benefits of lying against the probability of detection by an outside observer. We show that honesty oaths short-circuit this calculus and function by internalizing the audience, transforming the act of lying from a calculated transgression into a categorical identity violation. In a controlled experiment, we show that while the oath dramatically increases truth-telling, those who do break their promise systematically avoid brazen, detectable lies, retreating instead to ambiguity. Crucially, this refusal to be a “brazen renegade” persists even when the oath is private and compliance cannot be traced to the participant by the experimenter. This inelasticity rejects standard reputational models: instead, our data are consistent with the oath-taker answering to an internal judge rather than an external one. Furthermore, we show that this internal audience does not strictly require the cognitive amnesia or imperfect recall required by standard self-signaling models; rather, it can also be understood as a present-moment, categorical refusal to generate inescapable evidence of one’s own transgression. Finally, we show that investors intuit this mechanism, pricing in the oath’s “psychological enforceability” by granting credibility only when the speaker has no room to hide.

Aug 7

11:45 am - 12:00 pm PDT

Hierarchical Representations

Presented by: Milena Jessen (University of Bonn)

Evidence from cognitive science suggests that people organize multi-dimensional information into hierarchies, yet we lack causal evidence on how the hierarchical ordering of dimensions shapes learning and choice. I study this question experimentally. Participants learn success probabilities of firm–project pairs over multiple rounds and repeatedly choose the pair most likely to succeed. I exogenously vary whether outcomes are grouped by firms or by projects, inducing the grouped dimension as the top level of participants’ hierarchy while holding information constant. Participants process information conditionally on this top-level dimension: they form more accurate beliefs about summaries on it and locally optimize within it, while compressing information at lower levels. As a result, participants most accurately identify the best option within whichever dimension is placed at the top of their hierarchy – and these belief distortions translate into systematic choice distortions. Choice effects are stronger among low-attention participants, and procedural data confirm that participants process their top-level dimension first. Endogenous experiments demonstrate that individuals are not passive recipients of imposed structure: they adapt their representations to both cognitive costs and environmental diagnosticity.

Aug 7

12:00 pm - 12:15 pm PDT

Fragile Learning From Others

Presented by: Alisher Batmanov (University of California, San Diego)

Behavioral biases in decision-making are widespread and often persist even in the presence of feedback diagnostic of optimal behavior. This paper examines whether exposure to others’ decisions can correct initial misconceptions and facilitate learning in an environment where departures from the theoretical benchmark arise from neglecting an informative signal in a worker hiring task. Using a laboratory experiment, I show that exposure to optimal behavior substantially improves decision quality. The analysis of the underlying mechanisms suggests that this improvement is not driven by mechanical imitation alone, as subjects respond asymmetrically to the quality of observed choices, nor entirely by the richer feedback environment that social exposure generates. I then evaluate the retention and transfer of these learning gains beyond the period of exposure and find that, for most subjects, the improvements are fragile. Comparing the effects of social exposure to those of explicit guidance further underscores the limits of observational learning as a policy tool. These findings highlight the dual role of social learning: while it can enhance decision-making, it can also generate imitation behavior that fails to generalize beyond the observed context.

Aug 7

12:15 pm - 12:30 pm PDT

Designing Experiments to Distinguish Theories

Presented by: Cassidy Shubatt (Harvard University)
Baiyun Jing (Harvard University)

We develop an interpretable measure of an experimental design’s power to distinguish between a set of competing theories. A design offers a powerful test of a theory if competing theories would be unable to explain theory-consistent behavior on the design. We use the measure to analyze a set of the most highly-cited choice under risk experiments. We show that there is substantial variation in power across designs, and that power is consequential for determining which models best fit data. We then propose and implement an algorithm for constructing power-maximizing experimental designs. We show that our algorithmically-generated designs match or exceed the power of the best designs from the literature and require substantially less data.

Aug 7

12:30 pm - 2:00 pm PDT

Lunch

Aug 7

2:00 pm - 3:15 pm PDT

Session 3 (Chair: Manu)

Aug 7

2:00 pm - 2:30 pm PDT

The Hedonic Cost of Privacy: Information Avoidance under Entertaining Content

Presented by: Eleonora Freddi (Oslo Metropolitan University)
Aug 7

2:30 pm - 3:00 pm PDT

The Impact of Work Assignments on Evaluation and Advancement

Presented by: Lise Vesterlund (University of Pittsburgh)
Marissa Lepper (Texas A&M University) and Maria Recalde (The University of Melbourne)

This paper uses controlled experiments to examine how work assignments shape evaluation and career advancement. Workers are randomly assigned tasks of varying productivity, and evaluators observe their output, assess their relative performance, and make subsequent task assignment decisions. We find that workers assigned more productive tasks are paid more and evaluated more favorably. Evaluators systematically overattribute superior output to skill rather than assignment, producing inflated performance reviews and a tendency to keep initially advantaged workers on more productive tasks. In other words, early task assignments shape perceived ability and career trajectories, entrenching unwarranted disparities. Providing evaluators with more detailed performance information only modestly attenuates this bias. The documented path dependency in task assignment is particularly concerning in light of growing evidence that stereotyped perceptions influence how tasks initially are assigned within organizations.

Aug 7

3:00 pm - 3:15 pm PDT

The Female Labor Supply Constraints of Spousal Jealousy: Experimental Evidence from India

Presented by: Kailash Rajah (Stanford University)

This study presents evidence from two field experiments studying the role of spousal jealousy in constraining married women’s employment. In a first experiment (N =1, 400), I randomize married women in India to receive a two-week job in either a mixed or women-only workplace. Women randomized to the women-only workplace are 46% more likely to apply for a job (13 percentage points) and 31% more likely to turn up (6 percentage points). A cross-randomized safety treatment suggests that workplace safety is not the main mechanism. Instead, the treatment effects are significantly stronger among women who report having more jealous and controlling husbands. In a second experiment (N = 210), I directly test for a spousal jealousy mechanism by measuring whether women are more willing to interact with a male colleague if their husbands can monitor the interaction. I offer women a job that comes with a compulsory online peer support program and give them the option to forgo 20-35% of their salary to guarantee that the peer they are matched with will be a woman as opposed to a man. Fifty-three percent of women pay for the female peer when these remote interactions are one-on-one, but this drops to 34% once their husbands have the option of joining and can therefore monitor the conversations. One-third of households still pay for a female peer even if the mentoring simply involves watching prerecorded videos of the peer, suggesting even the most innocuous interactions are enough to raise jealousy concerns.

Aug 7

3:15 pm - 3:45 pm PDT

Coffee Break

Aug 7

3:45 pm - 4:45 pm PDT

Session 4 (Chair: Lise)

Aug 7

3:45 pm - 4:15 pm PDT

Psychedelics and Well-Being: An Experiment in Brazil

Presented by: Matt Lowe (University of British Columbia)
Patrick Francois (University of British Columbia), Ieda Matavelli (University of New South Wales)

We partnered with an ayahuasca center in Brazil to study the well-being effects of a one-time ayahuasca treatment within a ritualized group setting. The center enrolled 429 first-time ayahuasca users to participate in the largest randomized controlled trial of psychedelics ever run. Relative to placebo, ayahuasca increases happiness and reduces psychological distress six months later by roughly 0.4 standard deviations. The field experimental setting allows investigation of aspects not explored in the large clinical literature. Positive effects are almost entirely driven by participants that were distressed at baseline. Improvements in well-being are strongly positively correlated with the mystical nature of trips. The mystical experience can also be induced by placebo with ritual, though less frequently, and when done so induces a similar magnitude of well-being improvement. Effects are larger for older people, consistent with the idea that psychedelics reopen a window of heightened malleability. We estimate the mental health benefits of participating in an ayahuasca ceremony to be roughly 200 times the cost of 24 USD.

Aug 7

4:15 pm - 4:45 pm PDT

The Limits of Escalating Incentives: Evidence from Substance Use Treatment

Presented by: Ariel Zucker (University of California, Santa Cruz)
Rebecca Dizon-Ross (University of Chicago) and Corina Mommaerts (University of Wisconsin Madison)

Escalating incentive contracts — where rewards increase with success — are theoretically appealing and widely used in practice, including as the standard design in contingency management programs for substance use treatment. We show that the case for escalating incentives rests on three assumptions: forward-looking behavior, limited heterogeneity in compliance costs, and a principal objective that is not too concave. We test these mechanisms in a randomized experiment in which adults in treatment for opioid and stimulant use disorders are assigned to escalating, de-escalating, or constant incentives for drug abstinence. We find that while participants are forward-looking — which favors escalation — compliance costs are highly persistent both across and within individuals. This persistence generates a targeting disadvantage for escalating contracts: they concentrate the largest payments on those with the lowest compliance costs, where incentives are least needed. Escalating contracts also generate greater dispersion in compliance outcomes, which is costly when the principal places greater weight on reducing the worst outcomes. We estimate a dynamic structural model of compliance to characterize the optimal incentive schedule. We find that escalating schedules are preferred when the objective is sufficiently convex (prioritizing complete abstinence), while de-escalating schedules are preferred when the objective is linear or concave (prioritizing reductions in severe drug use). Our results suggest a rethinking of the widespread use of escalating incentives in substance use treatment.

Aug 7

5:00 pm - 7:00 pm PDT

Dinner

 

Wednesday, August 5, 2026

Kidney exchange in Mississippi (endorsed by celebrities)

 Mississippi Today has the story:

‘Kidney chains’ could save lives and billions of healthcare dollars, advocates say.  by Pat Boone, Robert Hays and Steve Young 

"Editor’s note: Entertainer Pat Boone, Pro Football Hall of Fame quarterback Steve Young and actor Robert Hays of “Airplane” fame signed on as authors of a guest essay provided by US Blood Donors.org for Mississippi Today on “Kidney Chains.”

"This guest essay, though, written from a national perspective is of special importance to MT Ideas since Mississippi is among the states with the highest number of kidney disease-related deaths per 100,000 adjusted for age, according to the National Center for Health Statistics.* 

"Hundreds of thousands of dialysis patients in the United States could receive lifesaving kidney transplants sooner if one simple idea became widely known: “kidney chains”— sequences of living-donor transplants that allow one donor to save multiple lives. 

The goal is simple: Make “kidney chains” a household phrase. 

Kidney chains allow living donors who are incompatible with their intended recipient to help initiate a sequence of transplants that can save multiple lives. The concept builds on Nobel Prize-recognized work** in market design and has already enabled thousands of lifesaving kidney transplants. 

 

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*Figure from the NCHS 

 

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** The video link is to the last three minutes of this 15 minute talk from 2014

Thursday, September 18, 2014  Kidney exchange at Google Zeitgeist 2014: 15 minute video

 

Tuesday, August 4, 2026

Controversial markets, black markets, and market design (in Brazil)

 Below is a Youtube video of all the talks given at the 4th International Workshop on Game Theory and Economic Applications at the University of São Paulo last Wednesday.

My talk, whose title was "Controversial markets, black markets, and market design"  is introduced at minute 2:24 (and for some of you the link below should start up there). The talk before mine is by Bob Wilson, and the one after by Paul Milgrom, but the video camera was on all the time, so you have to scroll to get to the actual talks.)

 

My talk begins with some general discussion of how market design and engineering economics are related to game theory. Then I introduce kidney exchange as the talk's main example, and discuss some of the accompanying controversies, including those currently being encountered in Brazil.

Monday, August 3, 2026

Congressional Republicans find IVF repugnant (by stealth, in an election year)

 Public rhetoric and parliamentary maneuvering display opposite positions on IVF in an election year.

G.O.P. Kills Bid to Expand I.V.F. Access in the Military
In a notable shift, Republican senators voted unanimously against a proposal to expand the military’s coverage of fertility treatments.
 By Annie Karni

"Republicans in Congress have quietly blocked a proposal to expand military health coverage of in vitro fertilization treatment for service members and their families, heeding the calls of anti-abortion groups to limit access to a fertility option that President Trump vowed to make more widely available.

"The move is a shift from previous years, when there was enough bipartisan support for the idea of broadening the availability of I.V.F. for members of the military that it was included in the annual defense bill that passed both the House and Senate. Speaker Mike Johnson later stripped it out in final negotiations before the legislation became law, but the provision’s initial inclusion indicated that the vast majority of Republicans had been willing to accept it.

"This year, Republican senators banded together to bar the measure from being added to the defense bill in the first place. It illustrated how, while many G.O.P. members of Congress have said they are in favor of I.V.F. access, they have managed behind the scenes to thwart legislative efforts to ensure it."

Sunday, August 2, 2026

The New Bazaar on Moral Economics

 Cardiff Garcia interviewed me about Moral Economics, and we began by talking about medical aid in dying, and moved briskly on to other controversial markets such as pornography and prostitution.

   The New Bazaar
Economist Alvin Roth, winner of the economics Nobel in 2012 for his work on market design, joins Cardiff to discuss his new book, Moral Economics: From Prostitution to Organ Sales: What Controversial Transactions Reveal About How Markets Work.

The book is about morally contested markets: transactions that participants would like to engage in but that others think they shouldn't be allowed to, even when it’s hard to identify measurable harms to those objectors. It's also a great way to understand how markets interact with the law, politics, social norms, income inequality, human psychology, and so much more than just monetary exchange.

In this chat, Alvin and Cardiff discuss:
• Medical aid in dying and the economics of “repugnant” markets
• Sex work, trafficking, and the unintended consequences of criminalization
• Plural marriage and the challenge of designing new legal protections
• Sports gambling and the rise of prediction markets
• Kidney exchanges, the transplantation shortage, and the opposition to cross-border exchanges

Throughout the conversation, they confront the trade-offs involved in both allowing controversial markets and trying to ban them.

Related Links

• Moral Economics: From Prostitution to Organ Sales: What Controversial Transactions Reveal About How Markets Work (https://basic-venture.com/titles/alvi...) 

Saturday, August 1, 2026

Healthcare in jails

The first stop (post-arrest, pre-trial) for many people caught up in the US criminal justice system  is a local jail.  Many of the people who are jailed have healthcare issues involving, for example, mental illness and/or drug and alcohol addiction.  But jails don't view themselves as healthcare facilities.

So I'm glad to see that Stanford Impact Labs (SIL) is funding

Improving Medical Care for People Affected by Incarceration (IMPACT) 

"Local jails are a critical but often overlooked part of the American healthcare system, processing approximately 7.3 million admissions annually and housing more than 600,000 individuals on any given day. Despite this scale, healthcare quality in jails remains highly variable, and mortality rates have increased over time, with drug and alcohol-related deaths increasing as much as four times from 2000 to 2019 and suicide rates remaining approximately twice the national average.

"Our research project addresses this challenge by identifying and scaling organizational strategies to improve healthcare quality, coordination, and oversight in local jails. Building on the first randomized controlled trial of healthcare accreditation in U.S. jails, our team partnered with 46 jails nationwide to evaluate accreditation through the National Commission on Correctional Health Care (NCCHC). We found that accreditation improved compliance with healthcare quality standards, particularly in training and patient care, and reduced 12-month mortality by approximately 60 percent. These improvements happened without increases in staffing or capital investments, suggesting that organizational improvements and better coordination drive impact.

"The current phase of the project focuses on understanding how jail leaders, including sheriffs, make decisions about improving healthcare quality in local jails. Through our partnership with the National Sheriffs' Association, we aim to identify the factors that influence the adoption and implementation of healthcare improvement strategies, including voluntary healthcare accreditation and other evidence-based approaches. Through this partnership, we plan to translate evidence into sustainable improvements in correctional healthcare systems nationwide. 

 

Team
Marcella Alsan
Professor, Stanford Economics

Meghan Beal
Director, I.G.N.I.T.E., National Sheriffs' Association


Crystal Yang

Professor, Law, Harvard Law School

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Other posts about SIL supported work.

 

Friday, July 31, 2026

Delayed feedback on a controversial talk--and some positive signals of potential for change

 One feature of giving talks to unfamiliar audiences is that you only get noisy feedback on how your talk was received.  This past June, I gave the Starzl Lecture at the American Transplant Congress in Boston. (The ATC is jointly organized by the two big American transplant societies, the AST and the ASTS,*)  I spoke to an audience of about 1500 people (just a guess, but I could see some empty seats in an auditorium set up for 2,000).  My talk included topics, including global kidney exchange, that have raised controversies.  

Afterwards, what seemed like a lot of people came to speak to me, and were enthusiastic about my talk.  But "a lot of people" was fewer than 100. So what about everyone else? (It probably wouldn't be statistically kosher to assume that those who came to congratulate me were a representative sample:)   

Since global kidney exchange has led to some people calling me an organ trafficker, I didn't have any measure of the general sentiment of the meeting.

I got some reassuring news recently when the ATC sent out an email soliciting ideas for talks for next year's meeting, in Seattle.  The email came with a picture from this oat meeting:

 

 So I'm guessing this means that my talk was well received by people responsible for organizing the next meeting.

And, indeed, I'm getting multiple signals that there's an appetite for productive change in the transplant community.  I hope to have more to say about that in the coming year.

######

*Acronyms:

ATC American Transplant Congress 

 AST American Society of Transplantation

ASTS American Society of Transplant Surgeons 

Thursday, July 30, 2026

American Red Cross Declares Second-Ever National Blood Supply Crisis

 Voluntary donation of whole blood in the US has provided adequate supply for many years, but since Covid it has sometimes come close to a shortage, and now we have a second declared shortage.  This contrasts with blood plasma, which  includes supply from paid donors.

American Red Cross Declares Second-Ever National Blood Supply Crisis, Urges Immediate Blood Donations 

I think the graphic is meant to show that the US is running near empty on blood (not that the shortage is only in Southern states...) 

 

 "The American Red Cross has declared only the second national blood supply crisis in its history after blood donations fell to a four-year summer low, deepening an emergency shortage that threatens the availability of lifesaving blood for patients across the country.

Despite thousands of people answering the call to give, blood donations are not keeping pace with hospital demand — which is up during the summer trauma season. Extreme heat, poor air quality and widespread foodborne illnesses are contributing to lower donor turnout this summer, further straining the nation’s blood supply.

As the nation's largest single provider of blood products, the Red Cross now has less than a one-day national supply of type O positive blood — the most commonly transfused blood type. To help ensure blood is available for patients facing the most critical, life-threatening emergencies across the country, the Red Cross has begun limiting distributions of type O blood to individual hospitals."

Monday, July 27, 2026

Multi-hospital kidney exchange in Brazil

An article in Floha de S. Paulo, tells of the first inter-hospital kidney exchange in Brazil:

 Transplante renal pareado amplia opção para pacientes que têm doador, mas não podem receber o rim  by Claudia Collucci

English translation:
Paired kidney transplant expands options for patients who have a donor but can't receive the kidney

Article summary: 

For the first time in Brazil, two transplant centers in different cities carried out a paired kidney donation — swapping incompatible living donors so each recipient gets a compatible kidney from someone else's donor instead. The initiative was led by Hospital das Clínicas at USP's medical school (HCFMUSP) in São Paulo and Santa Casa de Juiz de Fora in Minas Gerais.

The surgeries happened simultaneously at both hospitals — a donor from São Paulo traveled to Juiz de Fora to donate to the Minas Gerais recipient, while the donor from Minas Gerais went to Hospital das Clínicas in São Paulo to donate to the São Paulo patient. 

the two hospitals use an internationally developed (U.S.-built) platform that cross-references immunological traits, body size, and donor kidney quality to identify the best-matching combinations — this is functionally the same kind of algorithm we've been discussing with NKR.

Brazil has no specific regulation for paired kidney donation under its National Transplant System, so the procedure currently proceeds only as research. 

 

HT: Dr. Gustavo Ferreira 

 ###########

Earlier:

Thursday, January 22, 2026

Kidney exchange in Brazil (a clinical trial)

Here's a video in which Mike Rees, the founder of the Alliance for Paired Kidney Donation (APKD) describes how (with the help of a grant from Stanford Impact Labs) the APKD is helping Brazilian transplant docs get kidney exchange going there. 

 Earlier:

Tuesday, February 27, 2024  Stanford Impact Labs announces support for kidney exchange in Brazil, India, and the U.S.

 Thursday, October 10, 2024  Kidney exchange in Brazil, continued (with pictures)

 

Sunday, July 26, 2026

Program for the Workshop on Game Theory and Economic Applications, São Paulo, July 26-August 2

 Here's a high level overview of the program, which begins today.

And here's the detailed day by day program

 I'm expecting to speak on Wednesday, which looks to be a busy day:

 

 

Saturday, July 25, 2026

4th International Workshop on Game Theory and Economic Applications, São Paulo, July 26-August 2

 My old friend, colleague and coauthor Marilda Sotomayor is presiding over a big game theory conference in São Paulo this coming week.

 Here are the first paragraphs of the announcement from the University of São Paulo:

USP brings together six Nobel laureates in Economics in an event on Game Theory

 The Faculty of Economics, Administration, Accounting and Actuarial Sciences of the University of São Paulo (FEAUSP) will host, between July 26 and August 2, 2026, the 4th International Workshop on Game Theory and Economic Applications (IWGTEA). The event, consolidated as one of the most important in the area, is organized by the renowned professor emeritus of FEAUSP, Marilda Sotomayor, a world authority in Theory of Matching Markets.

The workshop will bring together six Nobel laureates in Economics. In person, FEAUSP will receive Paul Milgrom (Nobel 2020), Roger Myerson (Nobel 2007) and Alvin Roth (Nobel 2012). Laureates Robert Aumann (Nobel 2005), Robert Wilson (Nobel 2020) and Eric Maskin (Nobel 2007) will participate online. It will be a rare opportunity to translate how seemingly abstract mathematical ideas influence markets, governments, and everyday decisions.

In addition to the Nobel laureates, the body of keynote speakers includes important names such as Gabrielle Demange (Paris School of Economics), Ehud Kalai (Northwestern University), Hervé Moulin (University of Glasgow) and the Brazilian Aloísio Araújo (IMPA/FGV). There will also be a plenary session with Professor Marilda Sotomayor, who shared with Alvin Roth, in 1990, the authorship of the book "Two-Sided Matching: A study in game-theoretic modeling and analysis".


 

Nobel Prize in Economics Alvin Roth and professor Marilda Sotomayor (FEAUSP)
Photo: personal archive
 

Unlike traditional congresses, the IWGTEA is structured as a "workshop and school", focusing on the training of new researchers. "The idea is aimed at the interaction of students with the most renowned researchers in game theory", explains Professor Marilda Sotomayor. According to her, the main objective is to provide students with direct contact with the minds that shaped the modern economy. The expectation is that the workshop will attract 250 participants with more than 100 students from different parts of the world. 

... 

 Conference location: Av. Prof. Luciano Gualberto, 908 - Butantã, São Paulo - SP, 05508-010 

Schedule: https://www.iwgtea.fea.usp.br/ 

 


 

Friday, July 24, 2026

Auction markets for compute capacity as a pathway to building AI

 Dr. Silvia Console Battilana who partnered with Paul Milgrom to found the auction consulting firm Auctionomics, writes about markets for compute capacity as an aid to developing AI.

The Missing Market We Need To Win The AI Race
By Silvia Console Battilana,Forbes Councils Member.
for Forbes Business Council COUNCIL POST | Membership (fee-based) 

"In 2025, the global artificial intelligence market was valued at nearly $300 billion. By 2034, it’s projected to grow to almost $2.5 trillion. Demand for AI services is soaring and AI providers are racing to keep up. Behind them, suppliers of “compute”—the chips and data centers that power AI—are scrambling to expand capacity.

"So, what can the compute market do to enable this growth?

 ...

"There’s another drag on AI growth, and it’s one that I’ve seen before in my work designing markets for radio spectrum, energy and other limited resources: inefficient use of existing capacity. I believe the key to unleashing AI’s potential is not just to build more, but to use what we already have more productively.​

...

"Speeding up our AI highways will require addressing problems with existing compute markets. And one of the primary issues is that we treat all demand for compute the same. Some large compute jobs, including training runs for new AI models, are like tractors that move slowly and take up multiple lanes. These jobs require large quantities of compute but can be completed anytime. They could run overnight without losing value. Real-time AI queries and time-sensitive regressions, on the other hand, are like race cars. Their value depends entirely on speed. If they’re late, they’re worthless.

...

"We can build more lanes on the highway, but in my experience, that tends to be more costly than adding traffic lights and congestion pricing. A well-designed market should create incentives to guide when different compute jobs run. Through real-time spot markets, urgent jobs could pay more for capacity exactly when they need it. Through forward-looking futures markets, large but flexible jobs could secure low prices in advance. "

Thursday, July 23, 2026

Kidney exchange in Germany can draw on the experience in other countries

 Here's an editorial arguing that as the recently legalized kidney exchange in Germany is implemented, attention should be paid to the controversies that have been encountered and addressed elsewhere, including those about non-directed donors, and the governance and transparency of transplant decisions.

 Benning L, Lu W, Budde K , Josephson, M.  Germany’s move toward kidney paired exchange and non-directed donation: governance lessons from abroad, Kidney International Reports, 2026 

"In 1986 F.T. Rapaport outlined a core idea behind kidney paired exchange: that a registry can coordinate incompatible donor-recipient pairs so that incompatibility becomes a solvable matching problem rather than a barrier to transplantation1. Today, forty years later, Germany is on the verge of making that coordination legally possible. In October 2025, the German federal cabinet approved a draft amendment to the Transplantation Act that would enable kidney paired exchange and non-directed anonymous living kidney donation, while strengthening donor protection and establishing the legal basis for a national program with a central matching function. If operationalized, Germany would move from a restrictive framework for living kidney donation, historically tied to a strict requirement of a close relationship between donor and recipient, toward a governance model that supports kidney exchange and donor chains at scale.


"This moment is internationally relevant because Germany now faces the same policy questions that have shaped kidney paired exchange implementation elsewhere. The impending change creates an opportunity to learn from other countries on key issues, including who should govern a registry, which safeguards ensure legitimacy, how to balance privacy and transparency regarding organ quality, and how to promote access without risking commercialization. Rather than being mere technical considerations, these questions are constitutive for the legitimacy and public trust required for kidney paired exchange to function as a public good. 

"Early debates about living kidney donation repeatedly straddled suspicion and admiration. In the 1970s, living non-related and particularly non-directed donors were sometimes portrayed in medical discourse as psychologically unstable or even pathological, raising concerns about whether such donors should be permitted to proceed2,3. 

...

" History offers two more lessons: (i) Donor protection and respecting donor agency are not mutually exclusive: psychosocial assessment, independent counseling, and rigorous consent procedures can reduce coercion and misunderstanding while still recognizing donors as autonomous agents making a deliberate moral choice. (ii) Public legitimacy is fragile and easily lost: If suspicion dominates, programs risk being viewed as illegitimate or unfair. If, on the other hand, enthusiasm and implementation moves faster than safeguards, programs risk scandal, backlash and, ultimately, lose public support. Germany’s 2012 transplant scandal, involving the manipulation of patient data to improve waiting-list positions, offers a cautionary example of how deficits in transparency and accountability can erode trust in transplantation more broadly and disrupt an entire program4."

##########

 There are many reviews of the international experience.  Below is a recent one from physicians at Erasmus University in the Netherlands:


Stijn C. van de Laar, Hidde A. de Heus, Annelies E. de Weerd, Matthijs F. Klaassen, Robert J. Porte, Robert C. Minnee Frank J.M.F. Dor, A Comprehensive Review of Strategies to Advance Kidney Exchange Programs and Optimize Effectiveness and Outcomes, Kidney International Reports, Volume 11, Issue 7, July 2026, 106539

"Living donor kidney transplantation (LDKT) offers superior graft survival and cost-effectiveness compared with deceased donor transplantation (DDKT), yet the availability of immunologically compatible living donors limits its reach. Kidney exchange programs (KEPs) can overcome these barriers by matching incompatible pairs through paired exchanges, domino chains, and nonsimultaneous extended altruistic donor (NEAD) chains. This review summarizes the evolution and current landscape of national and international KEPs. We examine operational challenges (cold ischemia time [CIT], logistical coordination, algorithmic fairness, and ethical and regulatory heterogeneity) and explore innovations in matching algorithms, international kidney exchange debates, and machine perfusion technologies. We conclude by proposing strategic priorities to optimize capacity, equity, and outcomes in future kidney exchange efforts. " 

####### 

Earlier: 

Friday, March 27, 2026 Germany legalizes kidney exchange !!

Wednesday, July 22, 2026

Surrogacy: a political scandal in Germany, and fertility tourism around the world

 Here's a story in the NYT, covering an uproar that's been in the German newspapers for a week or so now.  A leader in the German governing coalition announced on social media that he and his husband had welcomed a new baby into their family, born via surrogacy in the U.S.  But surrogacy in Germany is not legal, so this was a "for me but not for thee" hypocrisy moment there. (In general it's hard to ban effectively something that is legal in other jurisdictions: someone could write a book about that.)

Uproar Over Surrogate Baby Prompts German Official’s Sudden Resignation
Jens Spahn, a top leader of Chancellor Friedrich Merz’s party, resigned his post after announcing that he had a baby by surrogate, which is illegal in Germany. 
  By Jim Tankersley

"Mr. Spahn, 46, the leader of the party in Parliament, is a former federal health minister who has forged deep ties to the Republican Party under President Trump, including attending the 2024 Republican National Convention.

...

"Mr. Spahn stirred national outcry this week when he announced, on social media and in the tabloid paper Bild, that he and his husband, Daniel Funke, had become fathers to a son via a surrogate in the United States.

"Surrogacy is prohibited under German law. Mr. Spahn had defended that ban throughout his career, including as health minister.

"The birth announcement brought immediate cries of hypocrisy from across the political spectrum, including in Mr. Spahn’s own party. Some regional leaders of the Christian Democrats demanded his ouster. News outlets teemed with outrage. 

...

"Mr. Spahn defended himself, essentially, on a technicality: German law does not punish parents who use surrogates abroad. He told a podcast interviewer he had struggled with the decision but chose to prioritize his family." 

########

Here's a related story: German couples in need of surrogacy are not the only ones, and the US is not the only destination.

The Guardian reports:

Rise in overseas surrogates ‘increases risk of stateless babies’
Calls grow for global regulation as rising numbers of westerners use surrogates in countries with different laws
  by Jessica Murray and Rachel Hall

"The rise in the use of surrogates abroad is leaving more babies at risk of becoming stateless, experts have said, amid growing calls for urgent global regulation of the practice.

"The warning follows the suspension of a 15-year effort by The Hague Conference on Private International Law (HCCH) to establish a global surrogacy convention, which was paused due to divisions among member states. 

...

"UK surrogacy agencies argue that an outdated legal framework at home is pushing couples to seek surrogates abroad, where regulations to protect surrogates from exploitation can be less robust or do not exist at all. Anti-surrogacy campaigners say the practice is fundamentally abusive in all cases and are pushing for a global ban.

"Prof Michael Hellner, who chaired the HCCH working group, said hugely differing opinions on the ethics of surrogacy between the member states involved meant the project to create a global framework on legal parentage in surrogacy cases had proved impossible.

...

"Experts said statelessness could happen in cases where a country does not automatically grant nationality to a child born there, and where surrogacy is not legally recognised in either the country of birth or the child’s final destination.

"Hellner said the project had proved difficult when some countries were “violently opposed to anything that could be seen as legitimising surrogacy, which they think is a violation of human rights and dignity”. 

...

"Most of these children were born abroad, mostly in the US, Ukraine, Nigeria, Georgia, Colombia and Mexico. British people using surrogates abroad to have babies are forced to apply to the UK family courts for a parental order to become the legal parents of their child and, in some cases, also need to apply for British citizenship for the child." 

Tuesday, July 21, 2026

Are vouchers appropriate for hard-to-match patient-donor kidney exchange pairs?

 A recent letter from Mayo Clinic transplant providers raises concerns related to bad outcomes when some patient-donor pairs are separated (the donor donates before the intended recipient is matched to a donor), but the intended recipient is hard to match.

Donor Mentoring in Private Kidney Paired Donation Programs: The Need for Transparency and Accountability by Tayyab S. Diwan, Pooja Bhudiraja, Shennen Mao, and Carrie Schinstock, Transplantation 110(7):p e1555-e1556, July 2026. | DOI: 10.1097/TP.0000000000005764 

"it is important to recognize that some KPD organizations, such as the National Kidney Registry, operate as private organizations (POs) with distinct governance structures, priorities, and commercial interests. These objectives may not always fully align with those of transplant centers or the broader transplant community, potentially creating gaps in transparency and accountability within a process that directly affects donors and recipients.

"We recently encountered a concerning example that illustrates the ethical tensions inherent when donor mentors are employed by private KPD organizations.
... During a routine text message check-in, the mentor initiated a discussion promoting voucher donation, emphasizing that voucher donors receive priority within the system.  

...
"The donor described the interaction as uncomfortable and “pushy,” and subsequently contacted our transplant center for guidance. Notably, the communication focused on system-level benefits and prioritization metrics but did not explore critical clinical and ethical considerations specific to this donor-recipient pair.

"The discussion was insufficiently individualized and appeared framed toward a preferred outcome. The donor’s preferences and the potential downsides of voucher donation were not explored. The mentor did not ask how the donor would feel if they proceeded with voucher donation and their intended recipient never received a transplant. The discussion lacked any reference to recipient factors that could influence the advisability of voucher donation, including sensitization or recipient comorbid conditions. There was also no discussion about why KPD was being used. Often the donor can donate directly to a recipient (eg, compatible pair), but may decide to enter a KPD pool temporarily to see whether the recipient could receive a transplant with improved size or HLA matching. Finally, the average wait times for a recipient to receive a transplant after voucher donation were not mentioned.

"This interaction raises concern about whether the mentor’s guidance was fully centered on the donor-recipient pair or instead influenced, even indirectly, by organizational incentives to increase voucher participation. When donor mentors are employed by entities that operationally benefit from particular forms of donation, even well-intentioned communication can create perceived or actual conflicts of interest. Transparency regarding these structural incentives, along with a clear commitment to individualized donor-centered mentoring, is essential to maintaining ethical integrity in these situations.

...

"As stewards of living donor trust, the transplant community must ensure that innovation proceeds with appropriate oversight. Any perception that donor education or support is influenced by business interests risks eroding public confidence in living donation programs, with potentially far-reaching consequences that could discourage future donors." 

#########

 Here's an article on NKR from the NYT that discusses its particular voucher program (and also its finances):

How One Father Created an Organ Empire: The National Kidney Registry has matched thousands of kidney donors with recipients. It has also paid millions of dollars to a company owned by its founder.
By Danielle IvoryGrace Ashford and Robert Gebeloff
Dec. 27, 2025 

 "One of N.K.R.’s most innovative policies, many doctors said, is known as voucher donation: Donors can choose to give their kidneys immediately, in exchange for organ vouchers their loved ones redeem later.

"This arrangement has helped N.K.R. expand its pool. But vouchers add risk for donors giving on behalf of hard-to-match patients. They might go through surgery months or even years before their loved ones get a match. Matches are especially unlikely, doctors said, for “very highly sensitized” patients who carry antibodies likely to reject a transplant.

...

" many doctors said that given N.K.R.’s relatively small size, these rare patients would be better served waiting for a match before their loved ones donate.

"“We definitely recommend that they not go with a voucher,” said Dr. Miklos Molnar, the medical director of the kidney transplantation program at the University of Utah, which works with N.K.R.

"Dozens of highly sensitized patients who are also on kidney dialysis have waited a year or more after their loved ones donated, according to N.K.R. quarterly reports since 2022. At least three waited more than four years, and one for seven years.

"Doctors told The Times that they knew of some patients who became too sick or died before they redeemed their vouchers."

######## 

Here's a a discussion of the earliest exploration of unpaired donation that I know of:

Sunday, September 13, 2020

  

Monday, July 20, 2026

Exam schools, gifted programs, and "giftedness"

 Are some children more gifted than others, and can they be identified in ways that aren't irreparably confounded with socioeconomic status? Those questions are part of what lies behind long-standing controversies about public schools that require entrance exams (typically high schools), and interventions for gifted children at earlier ages.   

Below are two recent stories that tackle those questions from different parts of the life cycle, i.e. from exam-school admissions to adult achievements. 

Here's a NYT story about admissions:

An Elite N.Y.C. Public School Admitted 777 Students. Only 3 Were Black.  New York’s specialized high schools give disproportionately few seats to Black and Hispanic students, continuing a pattern that has drawn criticism. By Matthew Haag  July 14, 2026

"About 62 percent of the students in the city’s public schools are Black or Hispanic. But at its eight most prestigious high schools, about 10 percent of the students in the incoming freshman class are expected to be Black or Hispanic, roughly the same as last year. About 80 percent of the seats went to Asian and white students.

"At Stuyvesant High School in Manhattan, often considered the most selective of the city’s specialized high schools, three of the 777 offers were made to Black students, and 21 were for Hispanic students, together representing a nearly one-third decline from the previous freshman class. One Black student was admitted to Staten Island Technical High School.

"While only 5 percent of high school students attend a specialized school, the annual release of the admission results has stirred debate and scrutiny for decades, especially as the profile of students in those schools stands in stark contrast to the rest of the school system, the nation’s largest. Gaining entrance to the schools has been perceived as a path out of poverty and a gateway to the nation’s top colleges and, perhaps, a flourishing career.

...

"Critics have called the one-day, high-stakes test racially discriminatory, saying it does not capture a student’s intelligence or capabilities. Supporters say it is a fair, rigorous and meritocratic assessment."
...

"“It’s not how we do admissions for colleges, for law school, for business school, for medical school,” Mr. Restler said. “How on earth do we do it for these specialized high schools?”

"Yiatin Chu, a public school parent and the co-founder of Parent Leaders for Accelerated Curriculum and Education, a group that has supported gifted and talented programs, said that the entrance exam was a “race-blind, income-blind test."

###########

And here's an article from New Scientist on adult achievement:

We’re finally learning what happens to gifted children in adulthood
A spate of new studies is revealing the lifelong impact of being marked as exceptional during childhood – and the results suggest we may need to revise how we view giftedness

By David Robson, 15 July 2026

 " a spate of studies is providing answers and revealing the fascinating lifelong impacts of being marked as exceptional at a young age.

"Far from growing into troubled adults, many gifted individuals appear to flourish later in life. Long-term studies suggest they are more likely than average to achieve professional success and, contrary to popular stereotypes, often enjoy better mental health. Scientists are also starting to understand what makes gifted brains so exceptional, finding that they are better integrated and can process information more efficiently, which raises the question of whether we should view giftedness as another form of neurodiversity. While that is still an open debate, what is becoming increasingly clear is that many of our assumptions about extraordinary minds – and the lives of those who possess them – may need revising.

...

“Despite their exceptional talent, identifying gifted children is challenging, especially when accounting for differences in socioeconomic backgrounds. Even though genetics play a large role in intellectual development, family circumstances heavily influence performance on traditional intelligence tests, particularly in early childhood. Children growing up in working-class families tend to develop a smaller vocabulary in their first years, for instance, which may increase the likelihood that teachers or psychologists ignore their learning potential.”  

Sunday, July 19, 2026

Declaring death is sometimes difficult (not just in connection with organ donation)

 I've written about the determination of death prior to deceased-donor organ donation, but it turns out that there are other hard cases. Submersion in icy water is one, hence the rule  "they aren't dead till they're warm and dead."

 Medpage Today has the story:

Declaring Death Is Not So Simple
by Judy Melinek, MD 

" Hypothermia -- especially in children rescued from drowning -- can deliver us patients in a state of suspended animation, all their metabolic systems so slowed by cold that advanced cardiovascular life support and emergency medicine training teaches that "they aren't dead till they're warm and dead." Get that patient warmed to normal human body temperature, then check again for signs of life."

########

Earlier: 

Monday, July 6, 2026  When is someone dead? (dead enough to donate organs?)

 

Saturday, July 18, 2026

MAID in France

 After a multi-year legislative struggle, France's  Assemblée Nationale legalized medical aid in dying for some patients.

Le Monde has the story:

What's in France's assisted-dying law?
The law adopted on Wednesday establishes the right to assisted suicide or euthanasia for patients experiencing constant suffering from serious and incurable illnesses, under strictly regulated conditions
.
By Béatrice Jérôme 

"With this bill, we are facing death head-on," declared French President Emmanuel Macron on March 10, 2024. More than two years later, the Assemblée Nationale cast a definitive vote on Wednesday, July 15, on the bill establishing a right to assisted dying. With the adoption of the law, France joins 11 other countries where people with severe illnesses can obtain a lethal substance on medical prescription, based on criteria varying from one legal system to another.

"The "French end-of-life model," a phrase Macron used in 2023, originated from the president's own initiative. However, its design resulted solely from the work of MPs after four rounds of readings, the Sénat having rejected the bill three times. Supporters have praised the bill as "balanced" and "secure," offering safeguards to ensure that recourse to assisted dying remains "an exception." Its critics, however, argue that the "safeguards" provided are not sufficient for preventing "abuse."

##########

 The Catholic Courier summarizes some of the opposition to the bill:

France’s bishops criticize vote legalizing ‘assisted dying’
Caroline De Sury/OSV News | 07.16.2026

"PARIS (OSV News) — France’s bishops are strongly criticizing a “radical choice” made by French lawmakers to legalize “assisted dying.”

"A watershed vote by the National Assembly July 15 legalized assisted dying, including euthanasia and assisted suicide in certain cases.

"Cardinal Jean-Marc Aveline of Marseille and president of the bishops’ conference, lamented that “members of parliament have enshrined in French law the possibility of causing death.” 

...

"For the bishops, one of the greatest dangers of the law stems from the fact that the principle that death can constitute a medical response to suffering has now become part of the legal heritage of the country. The choice to die can then be asserted as a right that could be extended to others.

“Experience in other countries shows that the criteria for access to assisted dying always tend to broaden, to the detriment of palliative care,” they noted.

"Meanwhile, “the effects of such legislation are not yet fully measured, but they are already taking shape,” the bishops warned. “Our relationship to vulnerability, old age, disability, and illness will change,” they added.

“The poorest are likely to be the first to pay the price: not wanting to be a burden on their children or grandchildren, elderly people in precarious situations may feel pressured to die,” the prelates warned.

"Catholic care facilities could face legal action for refusing euthanasia, assisted suicide on their premises
For the bishops today, the most immediate and concrete concern is that, if the law goes into effect, care facilities — foremost among them Catholic institutions — could face legal action if they refuse to allow euthanasia or assisted suicide to take place on their premises. As it stands, the law will require the head of the facility or department to authorize outside practitioners to perform the lethal procedure.

"The bishops have therefore announced that they will “closely monitor the referrals to the Constitutional Council” that were announced prior to the vote. 

...

"On July 14, while France was celebrating Bastille Day — the country’s biggest national holiday — Prime Minister Sébastien Lecornu surprised many by announcing that he would appeal to the Constitutional Council to submit the text of this law — to which he is personally opposed — for review. He justified this final recourse by citing the lack of agreement between the two chambers, the National Assembly and the Senate. A few days earlier, Senate President Gérard Larcher had announced his intention to take the same step.

"The Constitutional Council may approve the entire bill, strike down certain provisions, or issue interpretive reservations before the law is promulgated by Macron. The referral requested by the prime minister will focus in particular on the absence of a conscience clause allowing healthcare facilities — such as the Catholic nursing homes run by the Little Sisters of the Poor — to be legally authorized to refuse to provide such “assisted dying” services on their premises.

"Pending the outcome of the appeal, the bishops of France have reiterated their call to Catholics in France to “bear witness that another path is possible — one of faithful presence and attentive care that alleviates physical or psychological suffering, without ever abandoning anyone.”