Monday, May 31, 2010

Money and medicine in Britain's National Health Service

The London Times reports NHS bars woman after she saw private doctor

"A WOMAN has been denied an operation on the NHS after paying for a private consultation to deal with her severe back pain.
Jenny Whitehead, a breast cancer survivor, paid £250 for an appointment with the orthopaedic surgeon after being told she would have to wait five months to see him on the NHS. He told her he would add her to his NHS waiting list for surgery.
She was barred from the list, however, and sent back to her GP. She must now find at least £10,000 for private surgery, or wait until the autumn for the NHS operation to remove a cyst on her spine. "

The managing of waiting lists for scarce resources is a tough business.

Sunday, May 30, 2010

Kidney exchange at VA hospitals

It's exciting to see kidney exchange growing. The issues that the Veterans Affairs hospitals face reflect the progress in the last few years at other kinds of hospitals and kidney exchange networks.

Paired kidney exchange attracts VA: Growing practice may be allowed at four hospitals that do transplants

"Sometime in the next month, more than 600 veterans waiting for kidney transplants at VA hospital transplant centers in Pittsburgh and three other locations across the country could have a new option for finding an organ match.
William Gunnar, national director of surgery for the Veterans Health Administration, said he is reviewing the idea of letting the four VA hospitals that do kidney transplants -- in Pittsburgh, Nashville, Iowa City and Portland -- join the still novel but growing practice known as paired kidney exchange."
...
"Kidney transplant administrators at all four VA hospitals said they would like to take part in paired kidney exchanges after discussing it for four years, and are hoping for a favorable review from the central office.
"It's a no-brainer," said Mohan Ramkumar, kidney transplant program medical director at VA Pittsburgh Healthcare, which has 194 people on its waiting list and does about 40 transplants annually. "The more transplants you can do, the more money you save from dialysis, and the more people you help."
"I don't know if it will do a tremendous amount to cut down on our waiting list, but it could help. It would be one more option," said Dr. Ramkumar.
Last year, of the roughly 17,000 kidney transplants done nationally, 304 of them were the result of paired exchanges. But that's up from just 74 in 2006, according to The United Network for Organ Sharing, an organization that oversees the nation's organ and transplant network. Experts expect those figures to continue to grow rapidly as the concept takes hold."
...
"The VA used to have 20 hospitals that did kidney transplants. But when Medicare in 1973 started paying for all kidney transplants, veterans chose private hospitals for transplants, and the VA closed its programs.
When Medicare started charging co-pays for its services in the 1990s, veterans asked the VA to do kidney transplants. In 2001, the VA chose three hospitals to restart their programs, with Pittsburgh joining them a year later."
...
"Though most of the nation's kidney transplant centers already are members of at least one of the various paired kidney exchange consortium -- which orchestrate exchanges between different hospitals -- the VA has moved more cautiously.
"There have been some accusations over the years that this ethically and legally borders on potentially selling organs," said Dr. Gunnar.
A 2007 federal law specifically said that paired kidney exchanges was not selling organs, which would be a violation of the National Organ Transplant Act, but Dr. Gunnar said a legal opinion was still needed to move forward.
Ethically, a big issue for paired kidney exchanges is dealing with altruistic donors not tied to a specific transplant recipient, said Judy Kazmar, kidney transplant coordinator for the Portland VA hospital, which has 152 people on its waiting list and does about 30 transplants a year there.
"We're pretty conservative here. And with donors, we need to know, what's their motive for donating?" Ms. Kazmar said. "I think paired donations is a good idea, but it has a lot of logistics to it to work out."
If the VA does decide to go ahead with paired exchanges, one idea would be to start with its own pilot program of sorts.
"I think a consortium among ourselves would be best to start with, and then look at joining a larger consortium or national program," said Anthony Langone, kidney transplant medical director for the Nashville VA hospital, which has about 200 people on its waiting list and does about 30 kidney transplants a year.
The VA also is debating how to pay the thousands of dollars to pre-screen potential donors -- some of whom might not donate -- and how to assign long-term, post-surgical care to donors who aren't veterans, said Dr. Thomas.
"We as a nation have done badly dealing with long-term care for living donors," he said. "We want to make sure we get it right." "

Saturday, May 29, 2010

Veil travails

French cabinet approves veil ban
" The French cabinet has approved a draft law to ban the wearing of full-face veils in public spaces, opening the way for the text to go before parliament in July.The bill calls for $185 fines and, in some cases, citizenship classes for women do not comply with the ban.
Addressing the cabinet meeting on Wednesday, Nicolas Sarkozy, the French president, said: "Citizenship should be experienced with an uncovered face. There can be no other solution but a ban in all public places."...
"The bill includes a new offence - inciting to hide the face - with anyone convicted of forcing a woman to wear such a veil risking a year in prison and a $18,555 fine."
...
"The bill is set to go before parliament in July and is widely expected to become law."

Friday, May 28, 2010

Design of financial clearinghouses: Over the counter derivatives markets

The Bank for International Settlements' Committee on Payment and Settlement Systems has, in a followup to the recent financial crisis, issued two reports.


The first concerns clearinghouses-- Central Counterparties (CCPs). Here is the summary, and the report. From the summary:

"Over the past several years, public and private sector entities have undertaken a coordinated effort to improve the post-trade infrastructure for OTC derivatives transactions. The recent financial crisis demonstrated the need to further enhance the safety and transparency in the OTC derivatives markets. As a result, authorities in many jurisdictions have set out several important policy initiatives encouraging greater use of CCPs for OTC derivatives markets. The CPSS and the Technical Committee of IOSCO support these positive developments.
A well designed CCP can reduce the risks and uncertainties faced by market participants and contribute to the goal of financial stability. Nevertheless, because of the complex risk characteristics and market design of OTC derivatives products, clearing them safely and efficiently through a CCP presents unique challenges that clearing listed or cash-market products may not. "


Some of the challenges seem to be in making the products well defined...


These apply also to Trade Repositories, which are meant to be simple registers of what positions are held. Again, here's the summary and the report.

Promoting young faculty at Harvard

The Chronicle reports At Harvard, Tenure Isn't Just for Old People Anymore (and the issue, they surmise, is two career households).

"For decades, assistant professors at Harvard University knew better than to get too comfortable. After all, they probably wouldn't be staying there very long.
Unlike the typical university, Harvard didn't have a tenure track. Instead, most young scholars spent several years capitalizing on the university's famous name and resources, then moved on to a tenured job somewhere else. Meanwhile, Harvard usually reserved tenure for senior stars with established reputations whom it lured away from other universities.
In the last several years, however, Harvard has changed. Of the 41 people to whom the university offered tenure last year, half started as junior scholars there. The university had been finding it harder to persuade senior faculty members to pick up their families and move, even to storied Cambridge, so it has developed a tenure track and begun grooming those coming up through the ranks."...

"Plucking senior scholars from other campuses worked well for Harvard when the desired scholars had spouses or other partners who didn't work. "It used to be that if you were Harvard, you crooked your finger and people came," says Susan Carey, who heads the university's psychology department.
But over the last couple of decades, as dual-career couples became the norm, Harvard's offers were less compelling. Many senior scholars were unwilling to move if it meant spouses had to give up their jobs.
"The old days when the guy came home and said, 'Honey, we're moving to Cambridge, pack up,' just don't exist anymore," says Lizabeth Cohen, chairwoman of the history department. "We were investing huge amounts of time in senior searches and not getting the yield to make it worth it." "

Thursday, May 27, 2010

Spousal Hiring

In The Intricacies of Spousal Hiring, David Bell, a former Johns Hopkins dean writes

"My experience in the dean's office confirmed my impressions as to the need for spousal hiring. Johns Hopkins simply could not have built its faculty without a willingness to create positions for spouses and partners.
In case after case, that willingness was, by far, the single most important factor in recruitment. We could increase a salary offer by tens of thousands of dollars a year; provide lavish research accounts; promise a scandalous number of sabbatical leaves—none of it mattered if it meant that a candidate still faced the prospect of a long-distance commute or a major professional sacrifice by a spouse."

Wednesday, May 26, 2010

Paul Milgrom on spectrum auctions in India and Germany

Paul Milgrom writes on Success in Spectrum Auctions in India and Germany, in which he played an active role consulting to bidders.

Organ sales in China

MSNBC reports Organ trafficking trial exposes grisly trade: Chinese man accused of selling black market body parts
"China in 2007 banned organ transplants from living donors, except spouses, blood relatives and step or adopted family members, but only launched a national system to coordinate donation after death last year.
Its efficiency has yet to be proved. Nearly 1.5 million people in China need organ transplants each year, but only 10,000 can get one, according to the Health Ministry.
The defendants in the two Beijing trials face up to five years for their role as go-betweens between donors and buyers, which could "damage society and moral values", the Procuratorial Daily reported. They are still waiting for their verdict.
But at least two of them say they are being unfairly hounded for playing a vital role in helping both the sick and poor.
"I believe I was helping people, not harming others," the paper quoted defendant Liu Qiangsheng as saying.
Liu says he got into the business after selling half his own liver in 2008 to help pay for this father's medical bill. A friend of the recipient, who was waiting in despair for a liver, asked him to find another organ provider.
"I saved the life of the person who received my liver. He was only in his 30s. I do not regret it," he said.
His partner, Yang Shihai, had also sold one of his own kidneys, the paper reported.
"The donors were free. They were not controlled by us. They sold their organs voluntarily," it quoted Yang saying.
Middlemen specialized in faking documents allowing donations between strangers have helped raise transplants from living donors to 40 percent of donations, from 15 percent in 2006, the official China Daily reported last year.
However the majority of organs for transplant are still harvested from executed criminals, the paper said. Beijing hopes the new system will end both live transplants and taking organs from prisoners, which makes senior officials uncomfortable.
"(Executed prisoners) are definitely not a proper source for organ transplants," Vice Minister Huang Jiefu told China Daily."

An incongruous note: In the middle of the story was an ad saying "Buy 1 Get 1 Free." (It turned out to be an ad for eyeglasses...)

Tuesday, May 25, 2010

Kidney exchange at Northwestern

Tomorrow (Wednesday) afternoon I'll be giving the Nancy L. Schwartz Memorial Lecture at Northwestern, and I'll talk a lot about kidney exchange.

So it's a good time to mention a big exchange chain that was completed last month entirely at Northwestern Memorial Hospital, which has one of the biggest living donor transplant programs in the country: Sixteen Patients, Eight Kidney Transplants, Three Days... One Life Changing Event .

This was an innovative non-simultaneous altruistic donor chain, conducted over three days (with 3 transplants done the first day, 3 the second, and 2 the third.)

Here's a page containing (scroll down) a May 19 video interview with the non-directed donor, and two of the transplant docs, John Friedewald and Joseph Leventhal.

Some of my earlier posts on the revolution caused by non-simultaneous chains are below:




(John Friedewald, the Northwestern transplant nephrologist interviewed about the story at the top of this post, is the chair of the UNOS Kidney Paired Donation Work Group charged with organizing a pilot national program...)

Monday, May 24, 2010

Predicting behavior in games: a competition

Sometimes an experimental design is meant in part to solve a market design problem. That's the case with the call for entries reproduced below. You are invited: Enter and win:)

The market design issue is twofold. Scientific publishing gives a lot of incentives for reporting positive results about interesting problems, but can have the effect of suppressing negative results (the "file-drawer effect") or sometimes promoting false positives. It is also hard for researchers to report how models perform on representative random samples of problems, both because this requires relatively big and costly experiments, and because randomly chosen problems (some of which are, by themselves, boring) may not be as rewarding to examine as are problems carefully selected to showcase the virtues of a particular model.


The competitions we're proposing are an attempt to ameliorate both incentive problems. The hosts of the competition will run the necessary experiments on random samples of games, and invite researchers to submit models to predict the observed behavior. (Researchers can test their model on a first random sample of games for which the experimental results are reported before the competition, and they are invited to predict results for a second random sample of games that will not be published until all the models are submitted.) So the competition is cheap to enter (the random sampling experiments are already taken care of), and the entries are submitted before their authors know how well they will perform.


Here's the call for a competition to predict behavior in market entry games. And here is a version just sent out by email:

Ido Erev, Eyal Ert, Al Roth and Games Editorial Office invite you to participate in the choice prediction competitions that will be conducted as part of the special issue of the journal Games (http://www.mdpi.com/journal/games/) on “Predicting Behavior in Games” (http://www.mdpi.com/si/games/predict-behavior/). Below is the call to participate in the first competition which focuses on market entry games.
The first “Games” competition: Predicting behavior in market entry games.
The first competition focuses on the prediction of behavior in repeated 4-person market entry games. The organizers first ran (in March 2010 at Harvard) an experimental study of (40) games that were randomly selected from a well-defined space of market entry games. The raw experimental results of this study, referred to as the “estimation experiment,” are presented in the competition’s website (http://sites.google.com/site/gpredcomp/).
In addition, the competition website includes the rules of the competition, and a link to a paper that summarizes the results of the estimation experiment and explores the value of several baseline models (http://www.mdpi.com/2073-4336/1/2/117/.)
The site explains that the goal of the participants in the competition is to predict the results of a second experiment. This study, referred to as the “competition experiment,” will be run by the organizers in May 2010 (but the results will be kept confidential until 2 September 2010). The competition experiment will use the same method as the estimation experiment, but will study different games (drawn from the same space of games) and different subjects.
To participate in the competition you will have to email us a computer program (in MATLAB, Visual Basic, or SAS) that reads the parameters of the games (the incentive structure) as input, and predicts the main results as output. The program should be an implementation of your favorite model. To develop and/or estimate your model you are encouraged to analyze the data of the estimation experiment, and to build on the baseline models that were posted in the competition website.
The submitted models will be ranked based on the mean squared deviation between the predictions and the results of the competition experiment. The prize for the winners will include an invitation to publish a paper that describes the winning model in Games, and an invitation to a special workshop.
The submission deadline for this competition is 1 September 2010. You are allowed to submit one model as a first author and to co-author up to three additional submissions.
Best regards,

Ido Erev, Eyal Ert and Al Roth
Guest Editors
Games Special Issue "Predicting Behavior in Games"
http://www.mdpi.com/si/games/predict-behavior/

Sunday, May 23, 2010

Gifts of kidneys and gifts of gratitude

The ethics column in today's NY Times Sunday Magazine begins with this query:
"Last fall, a stranger donated a kidney to my husband. We offered her a gift after the operation, which she declined. Recently she wrote us that her house is in foreclosure, and she needs money. We obviously have no legal responsibility to respond, but what is our ethical responsibility? I wish it were legal to sell organs; it would be much cleaner in many ways. NAME WITHHELD "

The column's author and resident ethics guru, Randy Cohen, offers this response:
"You’ve no moral obligation to send money to the organ donor. She admirably — heroically — provided her kidney as a gift. An essential quality of a gift is that it comes with no strings, with no reciprocal obligations. Otherwise, it would be a sort of disguised sale. United States law prohibits the sale of organs, wisely, in my view. To permit such transactions is to allow those with money to harvest the organs of those without. Even if you prefer that system of organ allocation — many honorable people do — it was not what you and the donor agreed to.

That said, it is a fine thing to echo generosity, to respond to the subsequent and unanticipated travails of someone who has done so much for you. You need not put yourself in dire financial peril to send this woman money, but if you choose to help her, that would be estimable.

Perhaps it is my suspicious nature, an occupational hazard, but I see at least the possibility that she might have known about her money trouble for some time, and the hope of alleviating it may have been part of her motivation to donate a kidney, a desperate and pitiable measure. If you believe that she planned to psychologically pressure you into, in effect, paying for a kidney, you should decline to collaborate in cloaking an organ sale as a gift."


Update: my colleague Greg Mankiw, reflecting on his favorite textbook, summarizes the article this way.

Do two rights make a wrong?

via Greg Mankiw's Blog by Greg Mankiw on 23/05/10


Users of my favorite textbook know that it includes, in Chapter 7, a case study on whether kidneys should be traded in a market. Today's NY Times has a related article.

The paper's so-called "Ethicist" is dealing with this situation:

1. Person A receives a kidney transplant as a donation from person B.
2. A short time later, person B is having financial troubles and her home may go into foreclosure. Person A is considering her giving some money to help out.

So what does the "Ethicist" say about all this? Apparently, both of these gifts are noble acts, worthy of the highest praise and admiration. Unless, that is, there is some reason to think they are linked together. In that case, the reallocation of resources (kidney, cash) would be a despicable market transaction.

I suspect that few economists would concur. Indeed, the essence of market transactions is a kind of reciprocal altruism, enforced by contract. It might be nice if the world could work using pure altruism alone, but that seems highly unrealistic. The sad truth is that under the Ethicist's code of conduct, we have more deaths and more foreclosures than necessary, all in the name of fairness.

Saturday, May 22, 2010

Scalping world peace as NY ticket resale laws expire

The NY Times reports on Scalping World Peace, Outside Radio City
"The appearance of the Dalai Lama at Radio City Music Hall has inspired a certain chant on the Avenue of the Americas.

“Tickets for the Dalai Lama, tickets,” intoned a not-particularly-spiritual-seeming 55-year-old scalper from Brooklyn, standing on the corner of 50th Street on Friday afternoon. “Anyone selling tickets? Tickets.
...
“It’s difficult to bargain with Dalai Lama fans,” Richie said later. “They don’t even know what ‘orchs’ are,” meaning orchestra seats. “They’re always looking for cheap seats. They have no concept of premium seating.” "

This is taking place in an unsettled legal environment: The Times reported last week
Legal Ticket Scalping Law to Lapse as Albany Debates a New Provision, and here's yesterday's Daily News: Gov. Paterson reenacts 1920s ticket scalping law, serving notice to StubHub, Ticketmaster and others

Usury in the middle ages

From Walsh, Adrian “The Morality of the Market and the Medieval Schoolmen,” Politics, Philosophy & Economics 2004; 3; 241-259

“Exploring the evils of usury exercised the minds of a great many medieval philosophers, writers and artists. Consider Dante’s Inferno. As Dante descends into the depths of Hell, he discovers usurers (along with sodomites) in the smallest and most terrifying ring (Round 3 of Circle VII) of the Inferno. Dante inquires as to the nature of the sins of the usurers and is told that their sins are classified as a kind of violence towards God because usury was an attack on the natural use for money given by God and it implied contempt for God’s bounty.
Dante’s views are typical of the moral condemnation of his society for those who made a living out of interest. The practice of usury was not only subject to moral disapprobation; theological and legal injunctions against the practice were in force during the period over much of Europe. In 1274 Gregory X, in the Council of Lyons, ordained that no community, corporation or individual should permit foreign usurers to hire houses, but that they should expel them from their territory; and the disobedient, if laymen, were to be castigated with ecclesiastical censures. In 1311 the Council of Vienne declared all secular legislation in favour of usury null and void, and branded as heresy the belief that usury was not sinful. Anti-usury laws, although subsequently subjected to numerous modifications, persisted across Europe for over 500 years until the time of the Napoleonic Code. After the Napoleonic Code had allowed the taking of interest, the Church too decided to abandon the old usury doctrine. It was quietly buried (although not revoked) in 1830, when the Church issued instructions to confessorsnot to disturb penitents who lent money at the legal rate of interest without any title other than the sanction of Civil Law."

Friday, May 21, 2010

Market orders, programmed trading and loss of thickness

I haven't yet read a convincing account of the one-day stock market crash and rebound on May 6, but here's an early (May 9, NY Times) story that makes a case that a lot of conventional market tools could have interacted to produce a bad outcome: Thursday’s Stock Free Fall May Prompt New Rules.

"The S.E.C., which oversees the nation’s equity markets, requires a suspension in trading only in the event of a broad market collapse, defined as a drop of at least 10 percent in the Dow Jones industrial average, which is based on the share prices of 30 large American companies.
Other countries, like Germany, impose similar circuit breakers on trading in shares of any individual company that has a similar drop, but the S.E.C. has never done so. A former S.E.C. official said the possibility had been discussed in recent years, but “I don’t think there was quite the urgency to deal with it.”
The S.E.C. and the Commodity Futures Trading Commission said in a joint statement on Friday that the issue now had their attention.
“We are scrutinizing the extent to which disparate trading conventions and rules across various markets may have contributed to the spike in volatility,” the statement said. “This is inconsistent with the effective functioning of our capital markets and we will make whatever structural or other changes are needed.”
Early this year, the S.E.C. also began a broad review of equity markets, including whether computerized trading is properly regulated.
The heads of several of the largest electronic exchanges said Friday that they would support industrywide rules for breaking free falls.
But there are other ideas to keeping computerized markets in check. Lawrence E. Harris, a finance professor at the University of Southern California, said regulators should simply require all sellers to specify a minimum price below which they do not want to complete the sale of their shares. Market orders, placed at the best available price, can be too risky in the fast-moving age of electronic trading.
On Thursday, some sellers placed orders that were not fulfilled until prices had plunged as low as a penny a share. If sellers had placed “limit orders” instead, those transactions would not have happened, Professor Harris said.
“Electronic exchanges in most other countries only accept limit orders,” said Professor Harris, a former S.E.C. chief economist. “Without any mechanisms to stop the market, we just had stocks falling through the ice.”
But Rafi Reguer, a spokesman for the electronic exchange Direct Edge, said retail investors liked market orders because limit orders could be rejected, forcing the seller to try again, in some cases at a lower price.
“Sometimes what people value is the certainty of execution,” Mr. Reguer said.
Experts also note that the value of limit orders can be subverted if investors routinely set unrealistically low limits, to avoid the inconvenience of having their orders rejected.
The BATS Exchange, a large electronic exchange based near Kansas City, rejects orders if the price would be more than 5 percent or 50 cents away from the last completed transaction.
During the market panic on Thursday, between 2:40 and 3 p.m., BATS prevented more than 47.6 million orders from executing — more than 95 percent of all orders during that period, according to Randy Williams, a spokesman for the company. "

And here's a May 19 NY Times story on the SEC's new rules: New Rules Would Limit Trades in Volatile Market
"The Securities and Exchange Commission said Tuesday that it would temporarily institute circuit breakers on all the stocks in the Standard & Poor’s 500-stock index after the huge market gyrations on May 6.
The circuit breakers will pause trading in those stocks for five minutes if the price moves by 10 percent or more in a five-minute period. The trial run will begin after a 10-day comment period and will last through Dec. 10, the commission said. The circuit breakers will apply both to rising and falling stock prices.
But in a separate report, the S.E.C. and the Commodity Futures Trading Commission said that they had not been able to pinpoint the cause of the sharp market decline that shook investors and markets two weeks ago.
Generally, the agencies said, the drop was caused by traders stepping back from the market and refusing to buy or sell, in both the stock and futures markets. The government found that there was also a heavy reliance by investors on automated orders to sell at the market price once stock prices had declined by a certain amount. Further, there were different rules on different exchanges about when trading is automatically slowed or stopped. "

Thursday, May 20, 2010

College admissions fraud, at Harvard

The Globe weighs in: Trust-based admissions process leaves elite colleges open to fraud
"The former Harvard College senior accused of duping one of the world’s most selective universities seems to have exploited an application system at elite colleges that is largely based on trust and where admissions officers verify credentials only when they suspect that something is awry.
As questions mount about how 23-year-old Adam B. Wheeler could have pulled off such a sophisticated charade — doctoring transcripts and College Board scores and submitting fake letters of recommendation on official-looking letterhead — neither Harvard admissions officials nor a university spokesman would discuss its admissions process.
Nor would they say whether policies will change as a result of the alleged scam by Wheeler, who pleaded not guilty in Middlesex Superior Court in Woburn yesterday to 20 counts of larceny, identity fraud, and other charges and was ordered held on $5,000 cash bail.
Admissions officials at other colleges said the sheer volume of applicants makes it impractical to independently verify every document submitted unless they discover inconsistencies."

The Crimson takes up the story, with an account of how the fraud(s) came to light: Former Harvard Student Indicted For Falsified Applications, Identity Fraud
"A former Harvard student was indicted Monday for falsifying information in his applications to Harvard and for several scholarships.
Adam Wheeler, 23, was indicted on 20 counts of larceny, identity fraud, falsifying an endorsement or approval, and pretending to hold a degree. Wheeler was allegedly "untruthful" in his applications to the University and in scholarship applications, according to a statement released Monday by Middlesex District Attorney Gerry Leone.
As a senior in September 2009, Wheeler allegedly submitted fraudulent applications for the Harvard endorsement for both the United States Rhodes Scholarship and the Fulbright Scholarship.
His application packet included fabricated recommendations from Harvard professors and a college transcript detailing perfect grades over three years. Wheeler's resume listed numerous books he had co-authored, lectures he had given, and courses he had taught, according to authorities.
Wheeler's transgressions came to light when a Harvard professor noticed similarities between Wheeler's work and that of another professor during the application review process for the Rhodes Scholarship. The professor then compared the two pieces and voiced concerns that Wheeler plagiarized nearly the entire piece.
Wheeler’s file was referred to University officials, who decided—upon discovering the falsified transcript—to open a full review of Wheeler’s academic file
."

Wednesday, May 19, 2010

More on payments for egg donors

Payment Offers to Egg Donors Prompt Scrutiny
" a study in the most recent issue of The Hastings Center Report, a leading bioethics journal, found that the compensation being touted in ads aimed at young women often exceeded industry guidelines. The study is the latest development in a long-running debate over how much — or even whether — egg donors should be paid. "...
"Last fall, California adopted a law requiring egg donor advertisements to include specific warnings about health risks. The state already bans the sale of eggs for research purposes, in accordance with guidelines issued by the National Academy of Sciences.
In contrast, New York’s Empire State Stem Cell Board decided last year that state research money could be used to pay women up to $10,000 for donating eggs."
Kim Krawiec over at Faculty lounge has an update on the extra problems facing egg donation in Israel: What Religion Is Your Egg?

Tuesday, May 18, 2010

Organ donor registry mishap in Britain

The Telegraph reports: Organs removed without consent after IT blunder

"The records of 800,000 people were affected by an error that meant their wishes about the use of their organs after death were wrongly recorded.
An investigation has found that 45 of those for whom wrong records were stored have since died – and in approximately 20 cases organs were taken where consent had not been given.

Donors can give permission for any of their organs to be taken, or provide more specific agreements. A glitch in the system more than a decade ago removed the distinctions expressed by people.
Many donors have strong views about what can be taken. Often consent is not given for eyes to be removed, while some people who agree to donate organs are uncomfortable with the idea of their body tissue being used in research.
Joyce Robins, from the pressure group Patient Concern said: "This Government has got an absolutely dreadful record when it comes to data, but it is absolutely horrific that such sensitive details were handled in such a careless way."
The NHS is about to contact approximately 20 families who allowed organs to be taken from their relations after being misinformed about what consent had previously been given.
It is illegal to remove organs without prior consent from the person who died or their next of kin. A view is sought from relations before decisions are taken. In the cases where errors were made, it is understood that families were asked for permission, but their decisions were based on misinformation about the wishes of their relations.
After detecting the fault last year, NHS Blood and Transplant, which holds the organ donation register, was able to correct 400,000 of the flawed records. But 400,000 more people will shortly be contacted to be told that the wrong information may be held about them, and asked to provide consent again.
Until fresh consent is obtained, organs will not be taken from any of those people in the event of death. "

Monday, May 17, 2010

Deceased organ donation, misc. links

Number of Americans willing to donate organs rises, but still not keeping pace with need: Survey reveals pervasive donation myths "The online survey of 5,100 U.S. adults, which was supported by Astellas Pharma US, Inc., also uncovered some pervasive myths regarding donation. For example, the majority (52 percent) of respondents were open to the idea that doctors may not try as hard to save their lives if their wish to be organ donors is known, and 61 percent are open to the idea that it is possible for a brain dead person to recover from his or her injuries. In addition, 8 percent believe that organ or tissue donation is against their religion."
...
"Additional survey findings include: More than three-fourths of adults (78 percent) correctly realize there are more people who need organ transplants in the U.S. than the number of donated organs available. 61 percent of adults would donate the organs or tissue of a family member if they died suddenly without indicating their wishes. The number of African Americans who wish to donate all their organs and tissue has increased to 41 percent versus 31 percent in 2009 – encouraging news as African Americans comprise nearly 35 percent of the national kidney transplant waiting list."


Why New Yorkers Don’t Donate Organs. Susan Dominus writes in the NY Times: "When I started thinking about writing about New York State’s exceptionally low number of registered organ donors — 13 percent of people 18 and older — I remembered that I had never signed up on the official registry to designate myself a donor. So I went online, assuming I would be able to click somewhere quickly, and was delighted at the prospect. ...
"Except that it was nowhere near as easy as getting broccoli delivered to my door. I had to print out a form and mail it....What, specifically, did I want to donate, it wanted to know: Bone and connective tissue? Heart with connective tissue? Pancreas with iliac vessels? ...
"Were I not writing about the subject, I would quite likely have avoided it forever — which puts me in good (or, I should say, equally flawed) company, said Elaine Berg, president of the New York Organ Donor Network. In her opinion, the snail-mail process is a major barrier to increasing New York’s low rate of registration. All but 5 of the 49 states that have organ donor registries — Vermont is the holdout — allow for an electronic signature. That enumerated list of donation options is another hurdle. “It even turns me off,” Ms. Berg said. “It becomes a visual.” Only four states rank lower than New York on the recently released national report card from Donate Life America, a national advocacy group. ...
"But the department maintains that the enumerated list is the best way to meet the requirements of the legislation governing the registry, which was established in 2000 but became binding in 2008. The law states that “the registry shall provide persons enrolled the opportunity to specify which organs and tissues they want to donate.” So let them, Ms. Berg said. As many other states do, give would-be donors a blank space in which they can specify, or give them two options: “All” and “Everything except (blank).” As a journalist, I’m all for full disclosure, except for full disclosure about the gory details of a gesture I’d like to make regarding my organs in the event that I end up brain-dead on a respirator. It’s amazing how a matter of marketing can mean so much for a matter of life and death. In the downstate region of New York, which includes the city, Long Island and the five counties immediately north of the city, Ms. Berg said, 8,000 people are waiting for organs. In the downstate region, about 600 people die a year under circumstances conducive to organ donation (the typical qualifying donor is a middle-aged stroke victim); in these emergency circumstances, New York has around a 50 percent consent rate — much better than the 13 percent on the official registry, but still below the 67 percent rate nationally. And yet cynicism plays in: New Yorkers are more likely than the average American to think doctors put less effort into saving the lives of organ donors, Donate Life America reports. "


Should Laws Push for Organ Donation? discussion and commentary of a proposed NY law to shift to presumed consent. Interesting followup discussion by Alex Tabarrok at MR: Presumed Consent and Organ Donation

Informal money transfer networks: "hawala"

The informal money transfer system known as Hawala (or hundi) is in the news with the arrest of three Pakistani men in New England who are believed to have provided funds to the Times Square bomber. The Boston Globe reports Possible ties to murky finance system examined
"An informal money-exchange network known as “hawala’’ — a centuries-old system that operates outside conventional banking networks — is at the center of the investigation into three Pakistanis arrested Thursday in Massachusetts and Maine with alleged ties to the suspect in the failed Times Square bomb plot, law enforcement officials said yesterday."
...
"Hawala, which originates from the Arabic word for change or transform, is a practice that predates modern banking systems and has been around for centuries. There are believed to be thousands of hawala brokers operating in the United States, and they are not necessarily operating outside US laws if they register with the US Department of Treasury. Many don’t, however, operating more like black-market, cash-based versions of Western Union.
Relying on an informal network of brokers who use designated couriers, the networks are used to transfer money in relatively small amounts in and out of developing nations where modern financial systems are scarce, such as in South Asia, the Middle East, and Africa. Transactions often can be completed within 24 hours and at a lower cost than a traditional wire transfer or bank draft that could take as long as a week and require official paperwork.
Hawaladars, as the brokers are known, often operate out of cash-intensive businesses such as restaurants, convenience stores, or gas stations, the officials said."

The informal nature of the transfers, which circumvent banks and regulated record keeping, and the fact that the broker on one end doesn't know the customer on the other end, have made the hawala system a concern for law enforcement involving money laundering. Here's a report from Interpol: The hawala alternative remittance system and its role in money laundering

Sunday, May 16, 2010

Piracy and anti-piracy: recent developments

Russian Destroyer Frees Hijacked Oil Tanker (May 6, 2010)

"Cmdr. John Harbour, a spokesman for the European force, said Thursday that the Russian warship had freed the tanker, the Moscow University, after its crew members locked themselves into the rudder compartment of the ship."