Thursday, July 27, 2023

Kidney brouhaha in Israel: is a good deed still good when performed by a shmuck?

 Recently a three way kidney exchange was performed in Israel. This would have been unremarkable under most circumstances: Israel has an active kidney exchange system.  But it caused a strong reaction in the Israeli press, because one of the donors, a  well-known rightwing activist who wanted to donate a kidney so that his brother could receive one, announced that he wanted his kidney to go only to a Jew.

Here's the Ynet story (you can click to render it in English):

 kidney in a transplant marathon: "The condition was - only for a Jew

Here's the Times of Israel (already in English):

Right-wing journalist causes stir by announcing his kidney would go only to a Jew

There were many more, but you get the idea.  Some of the stories point out that the Israeli National Transplantation Center uses an algorithm* that doesn't see the religion of the recipient, so it's not clear that this was a declaration with consequences.  It was meant to provoke, and it did.

But it's a complicated issue.  In the U.S. (and in Israel), donations can be made to a specific individual, but not to a class of individuals.  With living donation, it means that the donor can choose a specific person to donate to, and it isn't an issue how they choose: no one has to donate an organ to anyone, and every donation saves a life (and maybe more than one, particularly since  living donation reduces competition for scarce deceased-donor kidneys). So if this donor had been able to donate to his brother, no one would have thought twice that he was glad to be donating to a fellow Jew.  What made his announcement provocative was that his kidney wasn't going to his brother: his brother was getting a kidney from an anonymous other donor. [Update clarification/correction: this donation was apparently an undirected (except for the 'only' condition) altruistic donation, not part of an exchange involving the donor's brother.]

Among the people I corresponded with about this is Martha Gershun, a kidney donor who thinks and writes clearly, and has given me permission to quote some of what she said.

"I’m wondering if we find the presentation of the story troubling:  “Right-wing journalist and Temple Mount activist causes stir by announcing his kidney would go only to a Jew.”  We would react badly to a story that said:  “Right-wing Trump supporter says he will only give his kidney to a white man.”

"What if instead the stories were:  “Observant Jewish father of 8 wants to donate to a fellow Jew” and “Rural man from West Virginia seeks to help another in his community”?  Would we find those stories more acceptable?"

Part of the feeling that this is a bit complicated has to do with the fact that we don't (and maybe shouldn't) look gift horses in the mouth, i.e. we don't and maybe shouldn't delve deeply into the motivation of altruistic acts that do a lot of good. We should applaud good deeds even if they aren't performed by saints. (I blogged yesterday, about paying it forward, an umbrella term for doing good deeds in a spirit of gratitude for having ourselves benefited  from past good deeds performed by others. We generally don't find it necessary to condition our approval on precisely who receives the forward-paid gifts.)

So, while I'm not sorry to see that this statement by a kidney donor is a much discussed provocation, I'm inclined to think that a good deed remains a mitzvah even if not performed by a tzadik, as we might have said in our New York English when I was growing up.

I'll give the last word to a Haaretz op-ed, also in English:

 Is It Kosher to Donate Kidneys Only to Other Jews?  A well-known religious journalist in Israel declared the " -only" donation of his kidney. His act is imperfect, but not immoral by Robby Berman

+++++++++++++++

*On the algorithm used in Israel and elsewhere, see e.g.

Wednesday, January 15, 2020 Kidney Exchange in Israel (supported by Itai Ashlagi)


and


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Update: related subsequent post 


Wednesday, July 26, 2023

Paying it forward

 Scott Cunningham, an economist who devotes a lot of his efforts to providing public goods, recently had a post on the phrase "paying it forward." He writes that he connected it with a movie with a similar name, but has recently come to view it differently (for reasons I find too embarrassing to quote, but related to the fact that I use the phrase now and then.)

Wikipedia says "Pay it forward is an expression for describing the beneficiary of a good deed repaying the kindness to others instead of to the original benefactor."  It goes on to say "Robert Heinlein's 1951 novel Between Planets helped popularize the phrase."  I could have first seen it there, as I read much of Heinlein's science fiction when I was a boy.

My associations with the phrase now mostly come from the motivations and actions of some living kidney donors, particularly in kidney exchange chains.

The phrase is certainly is evocative of what we do so much of in academia (when we're doing academia well): it describes the relationship between studying and teaching, and between teachers and students.

********

Scott's post announced that, as part of paying things forward, he's funding a prize for young economists.



Tuesday, July 25, 2023

Incentives in matching markets: Counting and comparing manipulating agents by Bonkoungou and Nesterov

 Here's a paper that caught my eye in the current issue of Theoretical Economics, Volume 18, Issue 3 (July 2023)

Incentives in matching markets: Counting and comparing manipulating agents by Somouaoga Bonkoungou and Alexander Nesterov

Abstract: Manipulability is a threat to the successful design of centralized matching markets. However, in many applications some manipulation is inevitable and the designer wants to compare manipulable mechanisms to select the best among them.  We count the number of agents with an incentive to manipulate and rank mechanisms by their level of manipulability. This ranking sheds a new light on practical design decisions such as the design of the entry-level medical labor market in the United States, and school admissions systems in New York, Chicago, Denver, and many cities in Ghana and the United Kingdom.

"First, we consider the college admissions problem where both students and schools are strategic agents (Gale and Shapley (1962)) and schools can misreport their preferences as well as their capacities. We show that when all manipulations (by students as well as by schools) are considered, the student-proposing Gale–Shapley (GS) mechanism has the smallest number of manipulating agents among all stable matching mechanisms (Theorem 1). Dubins and Freedman (1981) and Roth (1982) show that this mechanism is not manipulable by students. This result was one of the main arguments in favor of its choice for the NRMP. However, it also has the largest number of manipulating schools among all stable mechanisms (Pathak and Sönmez (2013)). Our result still supports its choice when all strategic agents are considered. What is more, it is still the best choice even when schools can only misreport their capacities, but not their preferences. All these conclusions carry over to the general model where, in addition, students face ranking constraints: although the student-proposing GS mechanism is now manipulable by students, it is still the least manipulable mechanism.

"Second, we consider the school choice problem (Abdulkadiroglu and Sönmez ˘ (2003)) where students are the only strategic agents and also face ranking constraints. Historically, many school choice systems have used the constrained immediate acceptance (Boston) mechanism, but over time shifted toward the constrained student proposing GS mechanisms and relaxing the constraint. We demonstrate that the number of manipulating students (Theorem 2) weakly decreased as a result of these changes."


Monday, July 24, 2023

Algorithms, Approximation, and Learning in Market and Mechanism Design" November 6-9, 2023 in Berkeley (register for funding)

 Here's the announcement

Register for SLMath (MSRI) Workshop: "Algorithms, Approximation, and Learning in Market and Mechanism Design"  November 6-9, 2023 in Berkeley, California, Simons Laufer Mathematical Sciences Institute (SLMath)

Priority Funding Application Deadline: August 31, 2023

Speakers:

Monday, November 6, 2023: Matching Markets without Money

  • Jiehua Chen (Technische Universität Wien)
  • Federico Echenique (University of California, Berkeley)
  • David Manlove (University of Glasgow)
  • Alvin E. Roth (Stanford University)
  • Jaychandran Sethuraman (Columbia University)

Tuesday, November 7, 2023: Non-Convex Auction Markets

  • Elizabeth Baldwin (Merton College, University of Oxford)
  • Paul Milgrom (Stanford University)
  • Shmuel Oren (University of California, Berkeley)
  • Rakesh Vohra (University of Pennsylvania)
  • Yinyu Ye (Stanford University)

(Attendee reception follows Tuesday's events)

Wednesday, November 8, 2023: Algorithmic Mechanism Design

  • Dirk Bergemann (Yale University)
  • Michal Feldman (Tel-Aviv University)
  • Jason Hartline (Northwestern University)
  • Roger Myerson (University of Illinois, Chicago)
  • Sigal Oren (Ben Gurion University of the Negev)

Thursday, November 9, 2023: Learning in Games and Markets

  • Michael Jordan (University of California)
  • David Parkes (Harvard University)
  • Lillian Ratliff (University of California, Berkeley)
  • Tuomas Sandholm (Carnegie Mellon University)
  • Eva Tardos (Cornell University)

Sunday, July 23, 2023

Organ trafficking, and how to reduce it -- Frederike Ambagtsheer in Conversation

Frederike Ambagtsheer, who studies illegal markets for organs and transplants,  has some sensible thoughts on how to combat organ trafficking, not least by increasing the availability of legal, ethical transplantation conducted in high quality hospitals.

Here she is in The Conversation:

Illegal organ trade is more sophisticated than one might think - who’s behind it and how it could be controlled  by Frederike Ambagtsheer

"The organ trade involves a variety of practices which range from excessive exploitation (trafficking) to voluntary, mutually agreed benefits (trade).

"These varieties warrant different, data-driven responses.

"For example, organ sellers are reluctant to report abuses because organ sales are criminalised and sellers will be held liable. Although many can be considered human trafficking victims and be offered protection, this rarely occurs. Law- and policymakers should therefore consider decriminalising organ sales (removing penalties in the law) and offer organ sellers protection, regardless of whether they agree to provide evidence that helps to dismantle criminal networks.

"Countries should also allow medical professionals to safely and anonymously report dubious transplant activity. This information can support the police and judiciary to investigate, disrupt and prosecute those who facilitate illegal organ transplants. Portugal and the UK already have successful organ trafficking reporting mechanisms in place.

"Finally, a contested example of a possible solution to reduce organ scarcity and avoid black market abuses is to allow payments or other types of rewards for deceased and living organ donation to increase organ donation rates. To test the efficacy and morality of these schemes, strictly controlled experiments would be needed.

...

" In short, rather than exclusively focusing on stricter laws, a broader range of responses is needed that both address the root causes of the problem and that help to disrupt organ trading networks."

***********

Here are all my posts that mention Dr. Ambagtsheer's work, which I've followed for more than a decade.

Saturday, July 22, 2023

Modify NOTA: a new effort

 Ned Brooks, who has been a force in promoting living kidney donation, is turning his efforts towards a new organization, dedicated to modifying the National Organ Transplant Act (NOTA) of 1984, to allow some compensation of kidney donors.

Here's the organization's website:  Join the Coalition to Modify NOTA

The website starts off with a quote with which I'm in full agreement:

“It’s long past time to modify the 1984 National Organ Transplant Act.”   - Al Roth

*********

Recent related post:

Monday, July 10, 2023

Friday, July 21, 2023

The Cost of Inaction and the Urgent Need to Reform the U.S. Transplant System: participant statements

 Yesterday's Senate Finance committee hearings on The Cost of Inaction and the Urgent Need to Reform the U.S. Transplant System are on video, and the following witness statements (delivered beforehand) are now also available.

If you only have time to read one, I'd recommend clicking on the testimony of Matthew Wadsworth, the President And CEO of the OPO, Life Connection of Ohio.

Witnesses 


  1. LaQuayia Goldring
    Patient
    Louisville , KY
  2. Molly J. McCarthy
    Vice Chair & Region 6 Patient Affairs Committee Representative
    Organ Procurement and Transplantation Network (OPTN)
    Redmond , WA
  3. Matthew Wadsworth
    President And CEO
    Life Connection of Ohio
    Kettering , OH
  4. Raymond J. Lynch, MD, MS, FACS
    Professor Of Surgery And Director Of Transplantation Quality And Outcomes
    Penn State Health Milton S. Hershey Medical Center
    Hershey , PA
  5. Donna R. Cryer, JD
    Founder And CEO
    Global Liver Institute
    Washington , DC
**********

Thursday, July 20, 2023

Senate Finance Subcommittee on Health Care --testimony on organ transplants, going on now

Watch right now or listen later.  UNOS is not popular in the Senate.

 https://www.c-span.org/video/?529461-1/health-advocates-testify-improving-organ-transplant-system

Health Advocates Testify on Improving Organ Transplant System

Patients and health professionals testify on the effectiveness of the organ transplant system before the Senate Finance Subcommittee on Health Care.

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Another set of links:Subcommittee Hearing
Subcommittee on Health CareDate: Thursday, July 20, 2023Time: 10:00 AMLocation: 215 Dirksen Senate Office Building

Pitfalls of digital scholarship: Machiavelli and Matching

 One of the alluring features of the digitization of texts is that they can be searched, their citations can be examined and cross-referenced, and facts about texts, and the literatures that they comprise, can be detected.  But of course,  digital searches can also lead you astray.

Something like that may have happened in this study of business ethics. (Relax, this isn't a blog post about questionable ethics in science.)  

Maity, M., Roy, N., Majumder, D. et al. Revisiting the Received Image of Machiavelli in Business Ethics Through a Close Reading of The Prince and Discourses. J Bus Ethics (2023). https://doi.org/10.1007/s10551-023-05481-2

The authors of the above paper searched in journals related to business and economics, for papers  about Niccolò Machiavelli, the 16th century author of The Prince, whose name has entered into the language to describe the kind of advice he gave: Machiavellian.

Looking at the most highly cited papers, and their network of co-citations (i.e. citations of each other) they find three clusters in the Machiavelli literature. They note that two of the clusters include many citations from one to the other, but that the third cluster (in green) is not connected to the other two.  The third cluster they label "matching problems in markets." (In fairness, the authors of the paper note this separation, and concentrate their analysis on the first two clusters.)



Here are the papers in the clusters. The papers in cluster 3 will be familiar to many readers of this blog.


Here in larger font is cluster 3, of papers on "Matching problems in markets": Abdulkadiroǧlu et al. (2003), Abdulkadiroǧlu and Sönmez (2003), Dubins and Freedman, (1981), Gale and Shapley (1962), Gale and Sotomayor (1985a), Gale and Sotomayor (1985b), Kojima and Pathak (2009), Roth (1982, 1984a, 1984b, 1985, 2002), Roth and Sotomayor (1990), Roth and Peranson (1999).

This cluster indeed contains well cited papers that cite one another. Yet I'm pretty sure that none of them cite Machiavelli, nor would most readers think that they connect to The Prince.

This latter cluster was almost surely included because of the titles of two of the included papers, neither of which in fact cites Machiavelli. (His name made it into the titles in a sort of jokey way, having to do with the fact that players in matching games may sometimes profit from behaving unstraightforwardly.) They are:

Dubins, Lester E., and David A. Freedman. "Machiavelli and the Gale-Shapley algorithm." The American Mathematical Monthly 88, no. 7 (1981): 485-494.

and

Gale, David, and Marilda Sotomayor. "Ms. Machiavelli and the stable matching problem." The American Mathematical Monthly 92, no. 4 (1985): 261-268.


But Machiavelli might be proud to be included in an economic literature on incentives.

Wednesday, July 19, 2023

Black markets for alcohol in Iran

 Prohibition (of alcohol) didn't work in the U.S. from 1920-1933, and it's not working in Iran today, despite "the Islamic Republic’s longstanding ban on the sale and consumption of alcohol, which is punishable by a penalty of up to 80 lashes and fines."

The NYT has the story:

Alcohol Poisonings Rise in Iran, Where Bootleggers Defy a Ban. Iran’s prohibition of the drinking and selling of alcohol has led to a flourishing underground market. But even officials have acknowledged a wave of hospitalizations and deaths in recent months.  By Farnaz Fassihi and Leily Nikounazar

"Rather than stopping drinking, the ban over time has led to a flourishing and  dangerous bootleg market. In the past three months, a wave of alcohol poisonings has spread across Iranian towns big and small, with an average of about 10 cases per day of hospitalizations and deaths, according to official tallies in local news reports.

"The culprit is methanol, found in homemade distilled alcohol and counterfeit brand bottles, apparently circulating widely, according to Iranian media reports and interviews with Iranians who drink, sell and make alcohol.

"The clerical rulers who took power after the 1979 revolution, instituting a theocracy, banned the consumption and selling of alcohol in accordance with Islamic rules prohibiting intoxication. Religious minorities are exempt. Over the decades, reports of methanol contaminations occasionally surfaced, but not in the scope and frequency seen in recent months....

"Even officials are now publicly acknowledging that the problem has escalated. Mehdi Forouzesh, Tehran’s chief coroner, said in a news conference in June that the number of hospitalizations and deaths from methanol poisoning had sharply risen. In only Tehran, he said, it had climbed by 36.8 percent since the beginning of March.

...

"Many Iranians love to drink, and nothing has dissuaded them from a tradition deeply rooted in ancient Persian culture. Homemade alcohol and imported bottles of liquor flow freely at many parties, weddings and social gatherings. Some upscale restaurants secretly serve patrons vodka in pots of tea."

Tuesday, July 18, 2023

Can Britain Fix Its National Health Service?

 The NYT has the story

A National Treasure, Tarnished: Can Britain Fix Its Health Service? As it turns 75, the N.H.S., a proud symbol of Britain’s welfare state, is in the deepest crisis of its history. By Mark Landler

"As it turns 75 this month, the N.H.S., a proud symbol of Britain’s welfare state, is in the deepest crisis of its history: flooded by aging, enfeebled patients; starved of investment in equipment and facilities; and understaffed by doctors and nurses, many of whom are so burned out that they are either joining strikes or leaving for jobs abroad.

...

"More than 7.4 million people in England are waiting for medical procedures, everything from hip replacements to cancer surgery. That is up from 4.1 million before the coronavirus pandemic began in 2020.

"Mortality data, exacerbated by long wait times, paints a bleak picture. In 2022, the number of excess deaths rose to one of the highest levels in the last 50 years, and those numbers have kept rising, even as the pandemic has ebbed.

"In the first quarter of 2023, more than half of excess deaths — that is, deaths above the five-year average mortality rate, before the pandemic — were caused by something other than Covid-19. Cardiovascular-related fatalities, which can be linked to delays in treatment, were up particularly sharply

...

"Seeking to solve the problem, Prime Minister Rishi Sunak last month announced a 15-year plan to recruit and train 300,000 nurses and doctors, budgeting 2.4 billion pounds (about $3 billion) for the first five years. But critics point out that the plan does not fund wage increases, the only surefire way to prevent workers from leaving.

...

"No mainstream politician proposes to privatize the N.H.S.: The specter of the inequitable U.S. health system still horrifies many Britons. And in some ways, the service remains a marvel, one of the world’s most comprehensive, taxpayer-funded health care providers — “free at the point of delivery,” in the words of its utopian motto. It still offers annual physical exams, mammograms, vaccinations and other services at a level that visiting Americans find impressive."

Monday, July 17, 2023

Affirmative action in India

 Here's an interesting paper by Orhan Aygün and Bertan Turhan. It comes with something of a backstory, which accounts for its quite delayed publication (delays both in initial acceptance and then in publication after acceptance*). I gather it will appear in the next issue of Management Science.

How to De-Reserve Reserves: Admissions to Technical Colleges in India by Orhan Aygün and Bertan Turhan, Management Science (forthcoming),  Published Online:11 Nov 2022 https://doi.org/10.1287/mnsc.2022.4566

Abstract: "We study the joint implementation of reservation and de-reservation policies in India that has been enforcing comprehensive affirmative action since 1950. The landmark judgment of the Supreme Court of India in 2008 mandated that whenever the OBC category (with 27% reservation) has unfilled positions, they must be reverted to general category applicants in admissions to public schools without specifying how to implement it. We disclose the drawbacks of the recently reformed allocation procedure in admissions to technical colleges and offer a solution through “de-reservation via choice rules.” We propose a novel priority design—Backward Transfers (BT) choice rule—for institutions and the deferred acceptance mechanism under these choice rules (DA-BT) for centralized clearinghouses. We show that DA-BT corrects the shortcomings of existing mechanisms. By formulating India’s legal requirements and policy goals as formal axioms, we show that the DA-BT mechanism is unique for the concurrent implementation of reservation and de-reservation policies."


*This paper spent a long time waiting to be published, because of what seems to have been a priority dispute that, after the paper was accepted for publication,  was pursued through  allegations of research misconduct. The editorial office of Management Science conducted an investigation that determined that there was no reason not to proceed with publication.

#######

Update: here's the citation to the published version

https://doi.org/10.1287/mnsc.2022.4566

Sunday, July 16, 2023

National Living Donor Assistance Center (NLDAC): I rotate off the advisory board

 After seven years, I'm rotating off the advisory board of the National Living Donor Assistance Center (NLDAC). During that time, NLDAC's ability to assist living donors increased substantially, and now includes some reimbursement for lost wages, for example.

 At our meetings I learned to appreciate some of the subtleties involved in the interaction between government regulation and organ transplantation.




Saturday, July 15, 2023

Marijuana and military recruitment

 Here's a proposal for a bit pf reality-based legislation that has some bipartisan support. DefenseOne has the story:

Proposed marijuana waivers acknowledge blunt recruiting truths. Lawmakers on both sides of the aisle want to remove a barrier to joining the U.S. military.  by LAUREN C. WILLIAMS 

"As the military services struggle to meet recruiting goals, lawmakers in the divided House seem united on a proposed fix: relaxing the Pentagon’s policies on marijuana use.

“I do not believe we should be testing for cannabis [in] people who want to join the military,” Rep. Matt Gaetz, R-Fla., told the House Rules Committee during a hearing on Tuesday. “We should be thinking about cannabis more in terms of alcohol.”

Gaetz testified in support of his amendment that would ban drug testing for marijuana as a condition of enlistment or to become a commissioned officer. 

“We are having a recruiting crisis,” he said, noting that many “people use cannabis under the color of state law.” So far, 23 states and Washington, D.C. have legalized the recreational use of marijuana.

"The Florida lawmaker stressed that his amendment wouldn’t preclude DOD from prohibiting marijuana use for individuals actively serving in the military, but that cannabis testing is “an unnecessary gate” for recruitment. In 2021, Gaetz sought to overturn U.S. election results."