Monday, February 27, 2017

Donor sibling registry: matching donor-conceived sibs

The Donor sibling registry is a matching service to help identify half siblings of  "donor conceived people," i.e. people who were conceived from donor sperm or eggs, and who may know only an anonymized donor number.  If your numbers match, you might want to arrange a meeting...

Sunday, February 26, 2017

Who can be a common law couple?

Being a couple is about a lot of things, including survivor rights and medical visitation and decision-making rights...

Inseparable Israeli Sisters Fighting to Be Recognized as a Common Law Couple
"A day in court with two nonagenarian sisters, refugees from the Holocaust and constant companions, who seek the unprecedented status so that the one who lives longer can inherit the other's old-age allowance."

"The claimants, it turned out, are asking the National Insurance Institute to recognize each of them as being eligible to receive a next-of-kin allowance upon the other’s death. Effectively, they want the NII to grant them common-law status recognition.
A disturbing thought ran through the judge’s head. “Are you telling me that …” she said to attorney Igra who, guessing her thought, dismissed it with an “Absolutely not,” and placed before the judge a court ruling stating that sexual relations are not a condition for common-law recognition.
Relieved, the judge went on to sum up the lives of the two sisters in a few sentences, as she began reading her judgment. The claimants have lived in the same unit of a protected housing project since 2007. The claimants never married, are single and have no children. The claimants have a joint back account, and their old-age allowances have always been deposited in that account. The claimants manage their income and their expenses from the same bank account. The claimants purchased adjoining burial plots. The claimants’ only journeys abroad took place between 1995 and 1998, and always together, according to the Interior Ministry’s border inspection records.
"The Labor Court, though acknowledging the innovation and feasibility of the claim, did not accept it"

This request was not accepted by the Israeli court, but it is food for thought.

Saturday, February 25, 2017

Interview on Who Gets What and Why: American Monetary Association, Jason Hartman

This interview was conducted some time ago, but I just now saw the link...and listening to it just now, it seems to me that we had a pretty interesting discussion.
(the link at the title below will take you to the podcast...)

AMA 126 – Who Gets What and Why, The New Economics of Matchmaking & Market Design with Alvin Roth

Jason Hartman talks with Alvin Roth, Craig & Susan McGaw Professor of Economics at Stanford and author of “Who Gets What and Why”
Key Takeaways
[5:28] – what aspect of the real estate market surprises him the most
[11:45] – The market of organ donation
[16:24] Repugnant Transactions
[20:51] Government’s role in contracts
[24:56] Signals and two kinds of messages we send

Friday, February 24, 2017

Reducing disincentives to living organ donation in New York State

Josh Morrison of Waitlist Zero is pictured in this encouraging story:

Albany considers bill to pay live organ-donors' costs
Supporters want to remove economic barriers that they say keep many potential donors from coming forward

"A new bill could make New York the first state in the country to directly compensate living organ donors—who typically donate a kidney or a portion of their liver to a transplant patient—for lost wages, child care and other expenses.

The Living Donor Support Act, introduced by Democratic Assemblyman Richard Gottfried of Manhattan and Republican Sen. Kemp Hannon of Long Island, chair of the Senate Health Committee, has broad support from lawmakers. It already unanimously passed Hannon’s committee, and it has 18 Senate co-sponsors and 27 Assembly co-sponsors.

In addition to helping donors with expenses, the bill seeks to increase education about the option of living transplants for patients, who are disproportionately poor and members of minority groups.

“Our goal is to make transplants easy to ask for and easy to give,” said Josh Morrison, executive director and co-founder of Waitlist Zero, a Brooklyn-based nonprofit that championed the bill. Morrison donated one of his own kidneys as a good Samaritan five years ago at the age of 26.

For dialysis patients in particular, getting a kidney transplant from a living donor could save money and improve their quality of life, but patients often aren't informed of that option, Morrison said."

HT: Frank McCormick

Thursday, February 23, 2017

Fifty shades of stigma: repugnance for legal but kinky sex

As a wider variety of sexual behavior becomes free of legal restrictions, some are still misunderstood or regarded as repugnant by much of the population, including medical professionals, even as they are featured (gently) in popular books and movies like “Fifty Shades of Gray.”

The Journal of Sexual Medicine explores the extent to which practitioners of kinky sex may feel that they cannot be frank with their physicians:

"Fifty Shades of Stigma: Exploring the Health Care Experiences of Kink-Oriented Patients"
Jessica F. Waldura, MD, Ishika Arora, BS, Anna M. Randall, DHS, John Paul Farala, MD, Richard A. Sprott, PhD

Abstract: "The term kink describes sexual behaviors and identities encompassing bondage, discipline, domination and submission, and sadism and masochism (collectively known as BDSM) and sexual fetishism. Individuals who engage in kink could be at risk for health complications because of their sexual behaviors, and they could be vulnerable to stigma in the health care setting. However, although previous research has addressed experiences in mental health care, very little research has detailed the medical care experiences of kink-oriented patients."

Results: "...The study found that kink-oriented patients have genuine health care needs relating to their kink behaviors and social context. Most patients would prefer to be out to their health care providers so they can receive individualized care. However, fewer than half were out to their current provider, with anticipated stigma being the most common reason for avoiding disclosure. Patients are often concerned that clinicians will confuse their behaviors with intimate partner violence and they emphasized the consensual nature of their kink interactions."

Wednesday, February 22, 2017

Hardy Hendren and the resident match

The journal Surgery has published (early online) an account by Hardy Hendren, recounting the drama at the origin of the resident match:
The 1951 Harvard student uprising against the intern match
Don K. Nakayama, MD, MBAa, , , W. Hardy Hendren III, MD, FRCSb
a Departments of Surgery, Florida International University, Sacred Heart Medical Group, Pensacola, FL
b Harvard Medical School, Massachusetts General Hospital, and Children's Hospital Boston, Boston, MA
Available online 18 January 2017

Here's the first paragraph:
"In the fall of 1951, a group of Harvard medical students led by W. Hardy Hendren, III organized a national movement against the newly instituted match that would assign graduating seniors to hospital internship programs. Before then, hospitals with intern positions to fill rushed to secure commitments from students, who in turn accepted the first decent offer that came their way. Knowing that students could not risk waiting for a better offer, hospitals pushed them into making early commitments. When some students began getting offers in their junior and sophomore years, medical schools, professional groups, and hospitals organized the National Inter-association Committee on Internships to deal with the issue. The intern match was thus organized and scheduled to take place in 1952. When the plan was announced in mid-October 1951, Hendren recognized that the proposed algorithm placed students at a disadvantage if they did not get their first choice of hospitals. Facing resistance at every step from the National Inter-association Committee on Internships and putting his standing at Harvard Medical School at risk, Hendren led a nationwide movement of medical students to change the procedure to one that favored students' choices. Their success [less than] 1 month later established in the inaugural match the fundamental ethic of today's National Resident Matching Program to favor students' preferences at every step of the process."

In my book Who Gets What and Why, I wrote about Hendren and these events in part as follows p138):
"One student who noticed this flaw in the proposed design was Hardy Hendren. He was preparing to graduate from Harvard Medical School in 1952, just as the clearinghouse was getting started. When he told me about it years later over lunch in Cambridge MA, he had already retired (in 1998) from Boston Children’s Hospital, where he had been chief of surgery. (His colleagues had given him the nickname “Hardly Human,” for the long, complicated surgeries he was able to conduct.) Hardy entered the Navy during WWII, in 1943 when he was seventeen, and trained as a pilot before returning to college and medical school. As you can imagine, with that background, as he prepared to seek his first job as a doctor, he wasn’t shy about expressing his concerns that the clearinghouse was unsafe for students.
"Hardy also wasn’t one to wait around for bureaucrats. And so, with a group of fellow students, he formed the National Student Internship Matching Committee, which organized opposition to the proposed algorithm. The Committee recommended that it be replaced with a different way of processing the preference lists to determine a match: it became known as the Boston Pool Plan. This was, in fact, the algorithm that was finally implemented when the clearinghouse was used to match students and positions in 1952."

After some discussion of stability, and the fact that the Boston Pool Plan is equivalent to the hospital proposing deferred acceptance algorithm, I wrote (p141):
"Back in 1952, economists hadn’t yet figured out any of this, which makes Hardy Hendren’s insight and his committee’s grassroots efforts all the more impressive."

Tuesday, February 21, 2017

Ken Arrow (1921-2017)

How will we do Economics without Ken Arrow?

After living to a vigorous 95, he passed away today after a mercifully short illness.  He was in the hospital for about two weeks, then went home. He had ups and downs, but a week and a half ago I found him dressed and at his computer.

 Even when he was feeling poorly, he was always the smartest person in the room.

Update: here's the NY Times obit--Kenneth Arrow, Nobel-Winning Economist Whose Influence Spanned Decades, Dies at 95

Here's the Stanford obituary: Nobel Prize-winner Kenneth Arrow dies
Nobel Prize-winning economist Kenneth Arrow was a leading figure in the field of economic theory. He inspired generations of students through his decades-long teaching at Stanford.

And the Washington Post: Kenneth Arrow, Nobel laureate and seminal economist with wide impact, dies at 95

And Scott Kominers in Bloomberg: Kenneth Arrow Made Great Models, and Was One, by 

Here's Ken's nephew Larry Summers in the WSJ: Farewell to Kenneth Arrow, a Gentle Genius of Economics
Lawrence H. Summers remembers his uncle, Nobel Prize-winning economist Kenneth Arrow

Travel bans and rank order lists for the resident match

Residency programs have to submit their rank order lists of applicants by Feb 22. Should they try to match with doctors from countries subject to a possible renewed US travel ban?

Travel Ban Confusion Complicates Match Day Decisions

"UPDATE:  The Trump administration announced February 16 that it would discontinue its legal push in appeals court to reinstate their travel ban, but would instead issue a new, revised immigration order next week. No other details were given.
As medical school students look ahead to Match Day on Friday, March 17, some international students have additional anxiety in light of the uncertainty surrounding President Trump's executive order banning travel for people in seven Muslim-majority countries.
Residency programs also have to decide whether they will hold spots for students from the targeted countries who may not be allowed to come to the United States if legal rulings change.
First comes decision day February 22, when preferences must be ranked by both programs and students.
"Some applicants are concerned that the program directors won't rank them and there's concern from programs on whether the students can begin training on time," Mona Signer, president and CEO of the National Resident Matching Program (NRMP), told Medscape Medical News.
Trump's executive order, issued on January 27, aims to prevent citizens of seven majority-Muslim countries — Iran, Iraq, Libya, Somalia, Sudan, Syria, and Yemen — from entering the United States for 90 days. It suspended entry of all refugees for 120 days and barred refugees from Syria indefinitely. A federal judge has since imposed an emergency stay, halting the key parts of the executive order.
The administration's next step is unclear, but news sources have reported that Trump may take the fight to the Supreme Court or issue a revised order.
According to the Association of American Medical Colleges (AAMC), 260 medical students have applied to US residency programs from the seven countries the ban covers.
Questions include whether the ban will be reinstated, and, if it is reinstated, whether medical students would be exempted. Some worry the ban could spread to other countries. Last year, 3769 non-US citizens who studied medicine abroad matched into a US residency program, according to the American College of Physicians."