Here's a video of a public lecture followed by a discussion (about half an hour each) about my book Who Gets What and Why, which just came out in German. The location of the lecture was once an East German government building where the head of state had his office, and is now a business school, the European School for Management and Technology. I was introduced by Gerhard Caspar, the head of the American Academy in Berlin and former president of Stanford. (My talk begins about minute 11:30 of the video, the discussion begins about minute 41, with Christoph von Marschall, Managing Editor of the newspaper Der Tagesspiegel, which touches on market designers in Germany, the legal barriers to kidney exchange there, and refugee resettlement.)
Showing posts sorted by date for query "kidney exchange" AND Germany. Sort by relevance Show all posts
Showing posts sorted by date for query "kidney exchange" AND Germany. Sort by relevance Show all posts
Friday, March 25, 2016
Thursday, March 17, 2016
Transplants in Germany, further discussion of changing the transplant law, in Der Tagesspiegel
My op-ed in Der Tagesspiegel yesterday on changing the German transplant law has drawn some prompt further comment in today's paper (as near as I can tell from Google Translate).
Here's the new commentary (English courtesy of GT):
Ärzte und Politiker für mehr Lebendspenden
Here's the new commentary (English courtesy of GT):
Ärzte und Politiker für mehr Lebendspenden
VON RAINER WORATSCHKA
[Organ transplant
physicians and politicians for more living donations German reservations "no longer fit into the time", criticizing physicians. The exchange between unacquainted pairs should be allowed.]
"The demand of the American Nobel Prize winner Alvin Roth, to facilitate in Germany living donation of organs and to amend the Transplantation Act accordingly, has met with doctors and politicians on consent.
The requirement that living donation - this question come kidney or parts of the liver - may come only from the direct family environment, are too strict, the economists had in Tagesspiegel criticizes. As in other European countries and the United States would also in Germany more distant relatives, friends or colleagues may donate writes Roth. In addition, an exchange between unacquainted pairs should be allowed (cross-donation, crossover Donation) at incompatible donor organs."
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Here are my two earlier posts on the subject, with links to my earlier op-ed and the one by Axel Ockenfels and Thomas Gutmann
German organ transplant law should be amended or reinterpreted to allow kidney exchange: my op-ed in Der Tagesspiegel
During my recent visit to Germany, I spoke with a number of people about the fact that the German transplant law effectively outlaws kidney exchange. I was invited to write an op-ed on the subject for the German newspaper Der Tagesspiegel, and it has just appeared:
Normally at this point I would use Google Translate to give a sense of the article, but in this case, since I wrote the op-ed in English, I can give you the original:
German organ transplant law should be amended or reinterpreted to allow kidney exchange
Normally at this point I would use Google Translate to give a sense of the article, but in this case, since I wrote the op-ed in English, I can give you the original:
German organ transplant law should be amended or reinterpreted to allow kidney exchange
By Alvin E. Roth[i]
Kidney failure is epidemic around the world, and a shortage
of organs for transplantation condemns many patients to dialysis, and early
death.
Most transplantable organs come from deceased donors, and
there aren’t enough to fill the need. But because healthy people have two
kidneys and can remain healthy with one, a healthy person can donate a kidney to
a sick person. A living-donor kidney works
better than a deceased-donor kidney.
In the U.S. we now have around as many living donors as
deceased donors (although we still have more deceased-donor transplants, since
a deceased donor donates both kidneys).
But living donation isn’t always possible, even when a
willing donor is available, because a kidney must be well-matched to its
recipient. Often the life-saving gift cannot be given, because the donor’s
kidney is incompatible with the patient. (It is now sometimes possible to successfully
transplant an incompatible kidney, but, like a deceased-donor kidney, this does
not keep the patient as healthy for as long as would a compatible living-donor kidney.)
In the U.S., there is a way for incompatible patient-donor
pairs to help each other, through what we call kidney exchange, or kidney
paired-donation. In its simplest form, two incompatible patient-donor pairs
are identified by their doctors such that each patient is compatible with the
kidney of the other patient’s donor. Then four surgeries are performed, two
nephrectomies and two transplants, so that each donor gives a kidney and each
patient receives a compatible kidney. Kidney exchange has become a standard
form of transplantation in the U.S., and has saved thousands of lives. (This is
one of the “matching” markets I helped design, and wrote about in my recently
translated book, Wer kriegt was - und
warum?.)
Notice that no money changes hands in this paired donation.
It is just an exchange of gifts between two patient-donor pairs, which allows
each donor to save a life and see his intended recipient restored to good
health.
Laws around the world prohibit buying a kidney for
transplantation, because of fear that allowing organs to be sold would exploit
the poor and vulnerable. (The single exception is Iran, which has a monetary
market for kidneys.) But German transplant law imposes a severe further restriction: a
patient may receive a living-donor kidney only from a member of his or her
immediate family. This means that, unless a judge intervenes, kidney exchanges
are illegal in Germany. (This law also restricts the number of direct living
donations in Germany compared to countries like the U.S., in which uncles,
cousins, friends, colleagues, members of the same church, etc., are often
living donors.)
I surmise that the reason for this strict limitation in
German law is to remove any possibility that a kidney being transplanted has
been purchased rather than freely given. But if when you want to give a kidney
to your brother there is no suspicion that you are a paid organ-seller, you
should remain above suspicion even if your kidney is incompatible with your
brother. Kidney exchange allows you to give a kidney and save a life, and have your
brother’s life saved. Kidney paired donation is a mutually beneficial exchange
of life-saving gifts, not a commercial transaction.
The U.S. law that includes the prohibition on organ sales is
the National Organ Transplant Act of 1984. When American surgeons explored kidney
exchange in the first decade of this century, it wasn’t initially clear what
its legal status might be, but in 2007 Congress passed an amendment to the NOTA
making kidney exchange explicitly legal.
Kidney exchange is legal elsewhere in Europe, and is well developed in
the Netherlands and Britain. A similar amendment to the German law, or even
instructions to judges that kidney exchanges should be allowed after being
examined, could save the lives of many patients in Germany, without opening to
door to commercial transactions in body parts.
[i]
Alvin Roth, a professor of economics at Stanford University, shared the 2012
Nobel Prize in Economics for his work on market design. His recent book about
markets has just appeared in German translation, Wer kriegt was - und warum?: Bildung, Jobs und Partnerwahl: Wie Märktefunktionieren
Monday, March 14, 2016
Promoting kidney exchange in Germany: Axel Ockenfels and Thomas Gutmann
In Germany, kidney exchange isn't legal (German law only permits a patient to receive an organ from a member of his immediate family). Here's an op-ed saying that should change, by Axel Ockenfels and Thomas Gutmann in the Sueddeutsche Zeitung:
Nierentausch in Zeiten des Mangels (kidney exchange in times of shortage)
Google translate makes it pretty clear.
Nierentausch in Zeiten des Mangels (kidney exchange in times of shortage)
Google translate makes it pretty clear.
Saturday, September 12, 2015
Ethical issues concerning living donors: a European conference
ELPAT (it stands for Ethical, Legal and Psychosocial Aspects of Organ Transplantation) is organizing a conference on issues involving (chiefly) non-directed anonymous kidney donation in Brussels:
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Sunday, 13 September, 09:00 - 12:50
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Moderated by: Annette Lennerling, Gothenburg, Sweden and
Willem Weimar, Rotterdam, The Netherlands
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Antonia Cronin: "Is it unethical for doctors to
encourage healthy adults to donate a kidney to a stranger"
Antonia Cronin is Consultant Nephrologist and Honorary Senior Lecturer at the MRC Centre for Transplantation, King's College, London. She is chair of the British Transplantation Society Ethics Committee and appointed member of the UK Donation Ethics Committee. Her presentation will examine the legitimacy of allowing individuals to donate an organ to a stranger and explore the circumstances in which encouraging such a form of donation may be justified. |
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Willij Zuidema: "Unspecified donors and domino-paired
chains"
Willij Zuidema is working at Erasmus MC in Rotterdam, The Netherlands. For years she is involved in the alternative living donation programs. Especially the program of the unspecified donors has her interest. The living donation program in Rotterdam is one of the largest in Europe with an expertise in unspecified donors and domino-paired chains. She will present the data and logistics of the unspecified donations and domino-paired transplants. |
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Mihaela Frunza: "Acceptability of public
solicitation, the role of social media"
Mihaela Frunza is Associate Professor at the Department of Philosophy, Babes-Bolyai University, Cluj, Romania. She will present a presentation where public solicitation of organs is critically assessed from a legal, moral, and practical perspective. Several recommendations are discussed that aim at maximizing the organ donor pool while safeguarding the interests of potential living donors. |
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Leonie Lopp: "The legal debate on anonymous
donation"
Leonie Lopp studied law in Münster, Germany. Afterwards, she wrote her doctoral thesis with the title "Regulations regarding Living Organ Donation in Europe - Possibilities of Harmonisation". She will today present the results of comparing the legal regulations on living organ donation in Europe by focusing on anonymous living organ donation. |
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Hannah Maple: "Psychological outcomes after
unspecified donation"
Hannah Maple is a trainee Renal Transplant surgeon in London, United Kingdom. She will present an overview of the psychosocial issues pertinent to unspecified donation. Additionally she will discuss the results of her UK based study into psychosocial outcomes after unspecified donation. |
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Linda Wright: "Ethical and practical issues of
breaking anonymity"
Linda Wright conducts research on transplantation ethics with the Canadian National Transplant Research Programme in Toronto, Canada. She will discuss the experience of contact between anonymous living donors and their recipients and recommend a strategy to address this, in the absence of evidence to support best practice. |
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Tuesday, June 25, 2013
Summer School on Matching Problems, Markets, and Mechanisms: going on now in Budapest
(And don't miss the link to ruin pubs at the bottom...)
the first summer school of the COST project on Computational Social Choice
Monday, 24 June 2013
8:00-8:45 Registration
8:45-9:00 Opening
9:00-10:30 First tutorial of David Manlove
Hospitals / Residents problem and its variants
10:30-11:00 Coffee break
11:00-12:30 First tutorial of Tamás Fleiner
Two-sided problems with choice functions, matroids and lattices
12:30-14:00 Lunch break
14:00-15:30 First tutorial of Atila Abdulkadiroglu
School choice - Theory
15:30-16:00 Coffee break
16:00-17:30 Invited talk 1
Marina Nunez: Introduction to assignment games
18:30-21:30 Poster session with welcome reception
In the main building of Corvinus University of Budapest. Address: Budapest, Fővám tér 8., main hall. 33 posters will be presented.
Tuesday, 25 June 2013
9:00-10:30 Second tutorial of Tamás Fleiner
Generalised stable roommates problems
10:30-11:00 Coffee break
11:00-12:30 Second tutorial of Atila Abdulkadiroglu
Market design and recent issues in school choice
12:30-14:00 Lunch break
14:00-15:30 Second tutorial of David Manlove
The House Allocation problem (with applications to reviewer assignment)
15:30-16:00 Coffee break
16:00-17:30 Invited talk 2
Tamás Solymosi: The nucleolus and other core allocations in assignment games
Wednesday, 26 June 2013
9:00-10:30 Third tutorial of Atila Abdulkadiroglu
From design to evaluation to redesign
10:30-11:00 Coffee break
11:00-12:30 Third tutorial of David Manlove
Kidney exchange
12:30-14:00 Lunch break
14:00-15:30 Third tutorial of Tamás Fleiner
Stable allocations and flows
16:00-18:00 Facultative social program
Hiking to the Citadella (top of Gellért hill), or going to Gellért bath. Meeting after at 18:00 at the fountain in front of hotel Gellért.
18:30- Conference dinner
Buffet dinner at Trófea Grill Restaurant Újbuda.
Thursday, 27 June 2013
9:00-10:30 Invited talk 3
Ildikó Schlotter: Parameterized complexity of some stable matching problems
10:30-11:00 Coffee break
11:00-12:30 Invited talk 4
Katarína Cechlárová: Computational complexity of competitive equilibria in exchange markets
12:30-14:00 Lunch break
14:00-15:30 Invited talk 5
Francis Bloch: Dynamic matching problems
15:30-16:00 Coffee break
16:00-17:30 Invited talk 6
Joana Pais: Experimental studies in matching markets
Friday, 28 June 2013
9:00-10:30 Invited talk 7
Szilvia Pápai: Matching with priorities
10:30-11:00 Coffee break
11:00-12:30 Invited talk 8
Estelle Cantillon: Preference formation in matching mechanisms
12:30-14:00 Lunch break
14:00-15:30 Invited talk 9
Lars Ehlers: Strategy-proofness in markets with indivisibilities
15:30-16:00 Coffee break
16:00-17:30 Invited talk 10
Dorothea Kuebler: University admissions in Germany: empirical and experimental evidence
Facultative social program
Visiting ruin pubs, meeting from 18:00 in Szimpla Kert
Tuesday, February 15, 2011
Two faces of kidney transplantation
Two men who have played significant roles in kidney transplantation are both named Sonmez.
One is the great Boston College economist Tayfun Sonmez, one of the pioneers of kidney exchange.
The other is the (also) Turkish kidney transplant surgeon Yusuf Sonmez, who is once again in the news for his alleged role in both kidney black markets and in war crimes in Kosovo. In a recent interview in the NY Times, focusing primarily on the black market allegations, he is asked about both the recipients and the donor/vendors: Monster or Savior? Doctor Draws New Scrutiny.
“There are two Yusufs, one my family and friends know and the one created in the press who is a monster— this is a drama, a tragedy,” said Dr. Sonmez, 53, a trim, angular man with intense, gray-green eyes and a graying goatee. “Up to now, I didn’t kill anybody. I didn’t harm anybody, counting donors or recipients. I have not committed any kind of social harm to anyone. This is the main thing that I am proud of.”
...
"Dr. Sonmez is wanted with regard to one of the most troubling prosecutions to emerge recently— a European Union investigation into trafficking in Kosovo in which seven people, mostly prominent local doctors, have been charged with illegal kidney transplants in a private clinic. Dr. Sonmez has not been charged in Kosovo, but the prosecution contends he played a central role in the ring.
"That case has become intertwined with a volatile two-year Council of Europe inquiry that made links between the Kosovo prime minister, Hashim Thaci, and a criminal enterprise of some former Kosovo Liberation Army fighters accused of executing Serbian prisoners in 1999 and 2000 for their organs.
"Dr. Sonmez has denied wrongdoing in either situation, but a Turkish immigrant who lost consciousness at an airport in Kosovo after a kidney removal, and the patient who investigators say received his kidney, both identified Dr. Sonmez as part of the operating team. He says he was only in the operating room offering advice to others.
"Investigators have focused on the role of Dr. Sonmez in 2008 as a surgeon for the Medicus private clinic in a rundown neighborhood in Pristina, Kosovo’s capital, where they said kidneys were removed from impoverished immigrants recruited on false promises of payment that they never received. The organs were transplanted to wealthy patients from Canada, Germany, Poland and Israel who paid up to €90,000, or $122,000.
...
"By his estimate, most of the thousands of transplants he has performed since he began in 1992 involved live, unrelated donors. He said his survival rate was high because he presided over the removal and transplant of kidneys, monitoring patients side by side for 48 hours.
“This is amazing,” he said of the transplant process. “I love it — to watch the changes with the new organ, the changes in the body, to move with the changes, to make changes in the medication.”
"Typically, he said, he requires donors and recipients to submit signed, notarized statements to declare that money has not been exchanged.
"How does he know that desperately poor kidney donors are not being exploited by a murky world of brokers, fixers and wealthy donors with lavish insurance?
“I don’t need to ask these questions,” he said, “because I do believe that people have their own authority over their own body. They are not stealing, they are not cheating. So this is the shame of the system. Not their shame.”
...
"In the next few weeks, Dr. Sonmez and his lawyer are poised to head to Kosovo to give his statements.
“They want information about bigger fish,” said Murat Sofuoglu, an old friend and lawyer for Mr. Sonmez, who has been shuttling between Istanbul and Pristina to negotiate terms for the doctor to give a statement to prosecutors.
“Not me,” Dr. Sonmez said, picking at a honey-drenched piece of baklava. “I am not the big fish.”
One is the great Boston College economist Tayfun Sonmez, one of the pioneers of kidney exchange.
The other is the (also) Turkish kidney transplant surgeon Yusuf Sonmez, who is once again in the news for his alleged role in both kidney black markets and in war crimes in Kosovo. In a recent interview in the NY Times, focusing primarily on the black market allegations, he is asked about both the recipients and the donor/vendors: Monster or Savior? Doctor Draws New Scrutiny.
“There are two Yusufs, one my family and friends know and the one created in the press who is a monster— this is a drama, a tragedy,” said Dr. Sonmez, 53, a trim, angular man with intense, gray-green eyes and a graying goatee. “Up to now, I didn’t kill anybody. I didn’t harm anybody, counting donors or recipients. I have not committed any kind of social harm to anyone. This is the main thing that I am proud of.”
...
"Dr. Sonmez is wanted with regard to one of the most troubling prosecutions to emerge recently— a European Union investigation into trafficking in Kosovo in which seven people, mostly prominent local doctors, have been charged with illegal kidney transplants in a private clinic. Dr. Sonmez has not been charged in Kosovo, but the prosecution contends he played a central role in the ring.
"That case has become intertwined with a volatile two-year Council of Europe inquiry that made links between the Kosovo prime minister, Hashim Thaci, and a criminal enterprise of some former Kosovo Liberation Army fighters accused of executing Serbian prisoners in 1999 and 2000 for their organs.
"Dr. Sonmez has denied wrongdoing in either situation, but a Turkish immigrant who lost consciousness at an airport in Kosovo after a kidney removal, and the patient who investigators say received his kidney, both identified Dr. Sonmez as part of the operating team. He says he was only in the operating room offering advice to others.
"Investigators have focused on the role of Dr. Sonmez in 2008 as a surgeon for the Medicus private clinic in a rundown neighborhood in Pristina, Kosovo’s capital, where they said kidneys were removed from impoverished immigrants recruited on false promises of payment that they never received. The organs were transplanted to wealthy patients from Canada, Germany, Poland and Israel who paid up to €90,000, or $122,000.
...
"By his estimate, most of the thousands of transplants he has performed since he began in 1992 involved live, unrelated donors. He said his survival rate was high because he presided over the removal and transplant of kidneys, monitoring patients side by side for 48 hours.
“This is amazing,” he said of the transplant process. “I love it — to watch the changes with the new organ, the changes in the body, to move with the changes, to make changes in the medication.”
"Typically, he said, he requires donors and recipients to submit signed, notarized statements to declare that money has not been exchanged.
"How does he know that desperately poor kidney donors are not being exploited by a murky world of brokers, fixers and wealthy donors with lavish insurance?
“I don’t need to ask these questions,” he said, “because I do believe that people have their own authority over their own body. They are not stealing, they are not cheating. So this is the shame of the system. Not their shame.”
...
"In the next few weeks, Dr. Sonmez and his lawyer are poised to head to Kosovo to give his statements.
“They want information about bigger fish,” said Murat Sofuoglu, an old friend and lawyer for Mr. Sonmez, who has been shuttling between Istanbul and Pristina to negotiate terms for the doctor to give a statement to prosecutors.
“Not me,” Dr. Sonmez said, picking at a honey-drenched piece of baklava. “I am not the big fish.”
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