Sunday, January 24, 2010

Monday January 25, 2010


Writing headlines. Due at the close of class; please post your responses.

In reading over Thursday's stories, one problem some folks had was misleading headlines. While there were attempts at humor, the facts presented were about the boy's deaths, and not the waitress, who had served them alcohol. As a journalist, one should understand that headline writing is a difficult art. Not only is it hard to do in the space allowed, but it is full of pitfalls that can make the newspaper look foolish: mistakes in grammar and spelling, double entendres, incomprehensible ideas. Try to avoid these pitfalls.



Take a few moments to read the Dos and Don'ts of headline writing below.



DO
Read the article, especially the opening paragraphs, to understand the purpose and main idea.
Give the most general, overall focus/summary of the story.
Remember that the headline may be the only reason the reader decides to read the story (Entry point.)
Avoid headlines that can have more than one interpretation.
Limit the number of words -- 6 to 10, generally
Use strong, active verbs. (To be verbs are generally understood, but not written out.)
Use present tense verbs.
Express a complete thought. Headlines usually read like simple sentences.
Use a secondary headline -- or subhead -- to convey an additional idea of a story.
Substitute a comma for the word "and."
Capitalize only the first word and proper nouns and adjectives. (This rule can be waived if your newspaper's style is for up-style headlines.)
Write a headline that is grammatically correct.

DON'T
Mislead the reader about the content of the article. Avoid downplay, exaggeration, sensationalism.
Use the name of the school unless it's absolutely necessary.
Use the verbs "participate" or "experience."
Use labels or phrases for headlines.
Put a period at the end of a headline.
Use names, unless very well recognized. Use grades or positions instead.
Use abbreviations or slang.
Trivialize a serious story with the inappropriate use of puns or other word play.
Separate words that belong together in a phrase. (All words in infinitives and prepositional phrases should be on one line.)
Use more than one banner headline on a page.
Repeat words on the same page. (Very common on sports pages.)
Capitalize every word or every important word.
Use "a," "an" or "the."

Please read the following bad headlines and post your corrections on the blog.
You might want to copy and past the horrible one's in and write your correction below.
Horrible headlines

These are REAL headlines that appeared in daily newspapers. They were featured in the Columbia Journalism Review's Lowercase column.

1. America's new war: Japanese still eyeing Hawaii



2. Taxpayer role proposed in future terror acts



3. Editor's wife rented to two suspects, FBI says



4. Students return to ground zero high



5. Nightclub liquor license denied, close-by Lansing church objects



6. Scientists spot plant outside solar system



Many businesses say English must be spoken on by workers



7. Sikh student suspended over dagger



8. Animal movements banned



9. Brain drain small, but signnificant, study says



10. 1.6 million Cherokees recalled



11. Study offers another reason to get Pap tests: researchers



12. Reserves, National Guard: Who can keep them straight?

Thursday, January 21, 2010

Thursday January 21, 2010


Midterm exam
You have a class handout. Compose your story and post it on the blog.

FOR FRIDAY: there has been a request for a party, specifically a cereal one. So this is how it will work: 4th period (and anyone from 9th, who has permission from senior lounge or study hall) should come to 176 during 4th period. Please bring some cereal- any variety. I will provide bananas, milk, bowls, spoons and a beverage. If you prefer, bring a sweet.

Friday, January 15, 2010



The following is from the City newspaper. This impacts the community greatly. Please take the time to read the whole commentary and respond by Wednesday. This is the last class grade for this term.

REMINDER: MIDTERM IS THURSDAY! See Friday's blog for information.
COMMENTARY: Mayoral control doesn't work and is wrong
on January 14, 2010


Bill Cala, former interim superintendent of city schools. FILE PHOTO
by William C. Cala, Ed.D

(William Cala is the former interim superintendent of the Rochester City School District and former superintendent of Fairport schools.)

Looking at the statistics of urban schools across the country is enough to make anyone consider radical tactics. In nearly all of these schools graduation rates hover around 50 percent and rates for African-Americans and Latinos are as low as 30 percent. New York State is no different and Rochester has the dubious honor of leading the pack in negative statistics for children. The Children's Agenda's annual report is a must read for anyone who cares about Rochester's kids. And it's not all about graduation rates; it's about health and living conditions that are causative factors of poor school performance. One statistic alone, the teenage pregnancy rate, should make us think twice about where we are putting our reform efforts. Rochester has one of the highest teen pregnancy rates in the developed world, putting it in the same statistical arena as a third-world country. That has produced kindergarten classes that are made up of nearly 25 percent of the children coming from teenage mothers.

In "Class and Schools" by Richard Rothstein, a clear case is made demonstrating the catastrophic effects of poverty on urban school performance. From community safety to poor health due to living conditions and lack of access to adequate health care to joblessness to a lack of a family structure, children across the country are ill-equipped physically, emotionally and socially to succeed in school. Rochester is the 11th poorest city for children in the country. I have had numerous conversations with pediatricians over the past 20 years, and they have relayed horror stories about the damage that poverty has done to children before they enter the school-yard gate (i.e. the average urban kindergartener has 1/3 of the vocabulary of a suburban counterpart).

Given this scenario, a logical question to ask is, "How will mayoral control of the schools help urban children and the factors leading to the lack of success of children in urban schools?

Is it about academics?

We have heard about the "success" of mayoral control in cities such as New York, Chicago, Washington, DC, and Cleveland. Since New York has been used as an exemplar for mayoral control here in Rochester, it seems only fitting to look at what Mayor Bloomberg has done since taking over the New York City schools. Historian Diane Ravitch recently provided some eye-opening statistics about this ersatz "success."

The National Assessment of Educational Progress� is a federally funded and administered test that is considered by scholars to be the best and only valid measure of student performance in the nation having a 40-year track record of solid performance.

Ravitch points out that of the urban districts that have been tested since 2002, the highest performing districts were Charlotte, North Carolina, and Austin, Texas. The lowest performing districts were Washington, DC, Chicago, and Cleveland. Charlotte and Austin are not controlled by mayors and the lowest performing districts are all controlled by mayors (Cleveland and Chicago have been controlled by the mayor for over a decade).

The city with the most sustained gains is Atlanta, Georgia (not controlled by a mayor).

New York City has been controlled by the mayor since 2002. To date there have been no gains on NAEP in fourth-grade reading, eighth-grade reading, or eighth-grade mathematics. Additionally, there have been no gains for African-Americans, Latinos, Asians, whites or lower-income students. Is this closing the achievement gap? Is this progress? Hardly.

Let's talk about those pesky graduation rates. One of the keystones of Mayor Bloomberg's campaign this past fall was the improvement of the graduation rates in New York City. He has claimed a rate as high as 70 percent. Here are the facts: New York State Education Department statistics clearly determine that the graduation rate in New York City is 52 percent. Mayor Bloomberg has conveniently invented his own mathematical formula to determine the NYC graduation rate. What he and his chancellor of education, Joel Klein have done is create "Discharge Codes." Discharge Codes are ways of designating students who have disappeared from the city schools as "other than dropouts." In fact, they have invented so many Discharge Codes that they are unable to determine what actually happened to the student. This is a convenient manipulation to obfuscate the graduation rate. So egregious is this activity that Advocates for Children did a study this past year citing tens of thousands of children being listed as "discharged" (not dropped out) yet the New York City administration was unable to demonstrate where these children went. Over the past six years, most of the discharges are students of color. The graduation rate for African-American males is 29 percent.

The New York City Department of Education is currently under investigation for this practice. (By the way, the Houston Independent School District has its brand of Discharge Codes called "Leaver Codes." They have over 20 Leaver Codes. They too were called out for seriously manipulating the graduation rate. The "Houston Miracle" turned out to be The Houston Mirage. Unfortunately, the No Child Left Behind Act that governs education nationally was built on the Houston system, which has since been thoroughly discredited).

Is it about money?

If controlling the Rochester school district is about saving money (The City of Rochester is required by law to contribute no less than $119 million to the RCSD coffers), then perhaps we should again look to the beacon that has often been mentioned as Rochester's model, New York City. In 2002 Mayor Bloomberg took over the schools. The budget at that time was $12.5 billion. In 2009 the budget is $21 billion. Given the lack of student performance in NYC, how does Bloomberg justify a 68 percent increase? If we look to other cities controlled by mayors and were to evaluate those mayors based on student performance and cost savings, the public debate could logically center around a voter recall of those mayors.

In 2005 Wong and Shen, in a study called "When Mayors Lead Urban Schools: Assessing the Effects of Mayoral Takeover," examined finances and staffing in the nation's 100 largest urban school districts. They reported that mayoral takeovers did not produce the promised improvement in financial stability and concluded that "no general consensus is emerging about the overall effectiveness of mayoral takeover."

One has to minimally ask the question whether mayoral control is about breaking unions and creating a lower paid workforce with fewer benefits. Author Danny Weil's December 2009 post should cause serious reflection:

"This is the point, and why mayoral control and Eli Broad, Gates, The Fisher family and the Walton family (and a host of other such charitable capitalists) along with Green Dot schools and other EMO's who seek to privatize all of education are so giddy. Creating a sub-prime school system that breaks the backs of the teacher's union is the goal of the new managerial elite who seek only to turn over public schools to private operators and entrepreneurs. This way they can reduce teachers to at-will employees, de-skill them with the "best practices," force them to work longer hours for less pay and less benefits and of course eliminate collective bargaining; that will then give the new managerial elite and their corporate masters, control over the entire educational enterprise - from curriculum development to the hiring and firing of teachers."

If Rochester's City Hall is unhappy with the mandated $119 million it must contribute to Rochester school district, the mayor and council members should look at the track record for mayoral control across the country. If they were to reduce costs under a system controlled by the mayor, they would be the first to do so. While the disdain for the $119 mandate is understandable, how does the city's contribution compare to the share that Monroe County suburban taxpayers contribute to their schools? $119 million is less than 18 percent of the total Rochester school district budget. By comparison, suburban communities contribute well over 50 percent of their total budgets. The local argument is that Rochester's share to RCSD is higher than that of Syracuse and Buffalo. True enough, but it's high time to start looking to models of success rather than using other urban failures as a benchmark.

Is it about crime?

Do dropouts cause crimes or do crimes cause dropouts?

Would there be less crime if the graduation rate were higher or would the graduation rate be higher if there were intact families, less crime, safer neighborhoods, better health care, and most importantly, jobs? While it is easy and convenient to narrow the focus to one culprit (education), the answers are much more complex and require the political will to tackle all of the above issues including educational reform. (See "Class and Schools" by Richard Rothstein for additional information on this topic.)

It is a great sound bite to look at crime statistics and announce that the perpetrators are dropouts. This statistic is a "no-brainer." Of course the vast majority of crimes are committed by dropouts, but in fact in most cases, that which led up to dropping out is the initial crime. Unless we search for the root causes of problems, our efforts are misplaced, ineffective and wasteful. While in the City of Rochester, I made it my business to do a forensic study when children committed serious crimes. Without exception, the home lives of child criminals were stunning.

For example, one adolescent drop-out shot and killed another boy. His life looked like this: His father sold cocaine out of the home. He was arrested and imprisoned twice while in elementary school. His mother was repeatedly beaten by the father. The Department of Social Services was often involved in attempts to resolve domestic abuse. The boy in question was sexually abused by the father and ran away twice. All of this occurring in early elementary school! The boy eventually dropped out. Living off of the streets was less painful.

I wish this were the exception to the rule. In varying degrees, this scenario repeats itself on a daily basis. Surely we should do everything within our means to adequately educate our children and keep them in school rather than having them drop out. However, the elephant in the room cannot be ignored or denied. Our efforts must address the external forces that lead to near certain school failure. At the national, state, and local level, I am afraid that resources are not addressing the root causes. We do not need more money going to urban school districts for programs that do not address root causes.

Mayoral control will not fix this.

In addition to being ineffective, mayoral control is wrong

Clearly, mayoral control doesn't work, but beyond its failure to produce, it is quite simply, wrong.

City residents are already disenfranchised by laws governing big cities in New York State. While suburban citizens are empowered with the right to vote on their district budgets, city residents are not entitled to do so. Mayoral control effectively removes Rochesterians from any meaningful input into the education of its children. I believe that this particular issue outweighs any consideration relative to academic outcomes and political perceptions of economic feasibility. Eliminating yet one more avenue to parent and citizen participation in government is an outright assault on democracy.

I am not alone in this belief. A 1997 case study of mayoral control in Chicago found some evidence that appointed officials were "less accountable to particular constituencies and... therefore, better able to put system-wide concerns above constituency demands."

Mayoral control involves establishing boards appointed by the mayor. Frederick M. Hess has conducted the largest study of mayoral control in the nation. He states that:

"Scholars raise several important concerns about appointed boards. Appointed boards tend to be less transparent than elected boards, and minority voices are more likely to be silenced or marginalized. There is also a risk that politically savvy mayors and their appointed boards may eventually settle into comfortable accommodations with special interest groups. Mayors themselves can also be a problem if they politicize school boards in self-serving ways or neglect education in favor of other issues."

I recall one particular action by Bloomberg and his appointed board early on in the mayoral takeover of the New York City schools. The mayor's appointed board was presented with a plan to retain any third grader who did not pass a standardized test. Up until that point, the mayor empowered the board to make educational decisions. Two of the mayor's appointees could not in conscience vote for a plan that defied all research on child development. The mayor fired them and replaced them with nominees who would support the plan.

A comprehensive national study of mayoral control was presented to the general assembly of Johnson City, Missouri, in October of 2009. Citing numerous research studies on the topic across the nation they concluded that:

1) There is a lack of democracy with appointed mayoral school boards and a concern about education becoming too involved in politics.

2) The larger role mayors play, the more costly their elections become, opening the door for big business involvement in elections (Meier 2005).

3) There is a greater risk of limiting minority participation through mayoral control (Wong 2006).

4) There is debate over whether mayors or other non-educator administrators can offer the expertise necessary to transform a school (Wong & Shen 2003).

5) Mayoral control does not address root problems such as reducing top-heavy administration or the multiple layers of bureaucracy overseeing the school system (Council of Great City Schools 2007).

6) There is no evidence that there have been improvements to the budget process.

7) Financial stability remains unresolved with mayoral control (Henig & Rich, 2005: Wong & Shen, 2005).

8) Minority students are disproportionately underrepresented (educational opportunities) with appointed school boards. Elected school board members are more likely to represent the makeup of the community, and these elected officials make it their business to advocate for them (Leal et al.,2004). (N.B. the formation of the department of African-American Studies in 2007 in Rochester. This department became a reality due to the advocacy of elected minority School Board members.)

Imagine for a moment the following scenario: The New York State Legislature by 2003 had not passed an "on-time" budget in 20 years. Since 2003 it has been named as the most dysfunctional legislature in the country. And recently, a coup was attempted by the Senate to reverse the majority party by winning over two indicted members of its body. That should be sufficient background to justify the statement: The New York State Legislature doesn't work.

Using the logic of advocates of mayoral control, what should happen is that the governor should seek a change in the New York State constitution to eliminate election of legislators. Subsequently, the governor would take complete control, and citizens of New York would no longer be able to vote for their local representatives to state government. From a very cynical point of view, the thought of removing scores of down-state legislators is quite appealing, yet our democracy is much too sacred to be throwing the baby out with the bathwater.

Does a smaller-scale assault on democracy (mayoral control of schools) make the rationale any more valid?

Would a parallel scenario ever be conceived in the suburbs? Imagine the outrage if an equal coup were attempted by a town supervisor to take over a school district or eliminate elections of town board members. Not only would it never happen, such thoughts would never see the light of day. I cannot help but believe that democracy is threatened more readily in urban centers where the vast majority of its citizens are entrenched in poverty and do not have the capacity to have their voices heard. Is it any wonder why voting among the poor is so low? Losing one more opportunity to have a voice (voting in School Board elections) will bring about a deeper cascade into hopelessness and a lack of faith in our democracy.

If not mayoral control, what?

I have no doubt that Bob Duffy truly cares about education in the City of Rochester. I am convinced that he is willing to expend political capital to accomplish the goal of educating all of the city's kids. If not mayoral control, what path should he and local legislators seek instead of greasing the chute for a mayoral takeover?

1) Start a campaign to seek better School Board candidates. After the state elections this past November, editorials sprung up supporting efforts to seek out better candidates to run for the Senate and Assembly. No less of an effort should take place for the RCSD. No one called for a gubernatorial takeover of the legislature!

2) Eliminate salaries for School Board members. This has a lot to do with getting better candidates. School Board members do not get paid in the suburbs and shouldn't be paid in the city, either. Perhaps we will see candidates whose only agenda is children.

3) Eliminate party affiliation in order to be placed on the ballot. Let's face it: if you are not an endorsed Democrat, you are highly unlikely to become a RCSD school board member.

4) Institute term limits. Given the nature of the political machine and the low voter turnout due to a sense of hopelessness by the citizenry, ineffective School Board members are difficult to vote out of office. Perhaps term limits will renew a sense of promise and encouragement.

5) While huge urban districts are notoriously clumsy and overly bureaucratic, the fact of the matter is that poverty is the real issue, an issue that often seems beyond solution, leading to the endless (and fruitless) attacks on urban schools.

The real solutions that will solve the graduation puzzle have very little to do with what is being proposed by the mayor, the governor, or the national secretary of education. The real solutions are with children ages 0 to 5 and their families. There is absolutely no debate about the importance of quality pre-school education, child care, and after-school programs. There is overwhelming evidence that addressing the social, emotional, physical, and financial ailments in homes with young children produces significant increases in graduation rates (more than any power reorganization, school-only program, testing regime, or pay-for-performance scheme).

Three of the four most effective programs in the country that produce the greatest increase in graduation rates are programs involving children younger than age 5. And right here in Rochester we have the Nurse Family Partnership, which is a highly researched and greatly effective program that receives inadequate financial support.

6) And speaking of the Nurse Family Partnership, community leaders should be looking at all of the recommendations of the Children's Agenda. They are researched based and proven to work.

7) Now to go into really dangerous waters: as stated previously, poverty is the real issue as it relates to performance in poor urban settings - poverty and the concentration of poverty in cities. Our cities (specifically Rochester) are exemplars of economic apartheid (Rochester is poorer and more segregated than it was in 1954 when Brown vs. Board of Education outlawed segregated schools).

All of the recommendations above assume the maintenance of RCSD as one urban district under someone's control, be it the mayor or an elected school board. A better solution, however, eliminates the Rochester City School District and sectors off Monroe County into slices of a pie. Each slice or sector would incorporate suburban districts and a small portion of RCSD students. Each educational sector would be managed by the current suburban board with additional board representation from the ranks of the city.

Research tells us that if schools consist of more than 40 percent children and families of poverty (high concentration of poverty), they will not succeed. This recommendation pays attention to the research on what works by providing a middle-class education for the urban poor. Other significant advantages include a massive savings by eliminating one of the most costly bureaucracies in the state, maintenance of local control, and supporting democracy by not eliminating the voice of the voter.

Conclusion

Mayoral control has been a hands-down failure in this country. The mayor has stated, "Documented improvements... are a proven fact in such cities as New York City, Boston, and Washington, DC." The only improvements documented are created by the spin machines of each of the mayors of these cities and the others that I have previously mentioned. Parents and citizens in cities controlled by mayors are up in arms because they have lost their voices and lost their schools, and there is no better performance in schools created by mayors as measured by any valid scrutiny (see http://www.pureparents.org/ and http://www.timeoutfromtesting.org/ , two of scores of parent groups in Chicago and New York).

Citizens of mayoral controlled communities have experienced massive school closings and reopening with private charters that have done no better, and in most cases, worse than their public predecessors. As Danny Weil stated, this is more about breaking the backs of teachers and their unions and putting schools in the hands of investors who don't care about kids, but whose only concern is making money. Perhaps that is why hedge-fund investors are wild about taking over New York State realty (http://www.examiner.com/x-28545-NY-High-Schools-Examiner~y2009m12d9-Hedge-Funds-invest-in-Charter-Schools). Teachers are not the enemy. Poverty is the enemy.

But much more important than whether or not mayoral control is measured as an academic or financial success is the disenfranchisement of the urban poor. Taking away the right to vote is not an option in a democracy. Taking away the minority voices of the urban poor is an egregious assault on civil rights. The mayor, the governor, and the legislators who are lining up behind this ill-thought-out plan should re-think their positions and seek to tackle the root causes of poor performance in the city. If they expect city kids to graduate, it is imperative that poverty and its trappings are vigorously addressed. Paving the way legislatively for mayoral control of the Rochester City Schools would be one more flagrant act of hubris by the New York State legislature.

There are more viable paths available to achieve better results for urban kids than mayoral control. All take commitment and substantial political will and capital. And yes, they all will bring substantial and necessary "incremental" improvement. Remember that the only truly successful paths to graduation are built in pre-school programs that incrementally build to the pride and joy of graduation. The mayor and the superintendent have stated that we do not have time for incremental improvement. I would argue that we do not have time "not" to improve incrementally. We cannot afford the failed policies that emulate Chicago, New York, and Washington, DC. The public debate of this issue must take place immediately. Before any bill is drafted, all sectors of the public should weigh in.

It is not just our city's future that is at stake. Democracy is at stake.

Friday January 15, 2010

There are no additional blog posts assigned today. Anything you have completed has been recorded. There are lots of gaps! Today is the last opportunity to finish up this week's responses.

MIDTERM is NEXT THURSDAY. It will consist of a series of facts that you will turn into a well-written article, through which you will demonstate that you understand how to write a solid lead and incorporate quotes. As with an actual deadline, you'll have one class period.

Thursday, January 14, 2010

Friday January 15, 2010



Please watch this clip and respond. I have no comment that can printed.

I am having trouble with the link; so you may need to copy and paste this into another tab.


http://www.huffingtonpost.com/2010/01/13/pat-robertson-haiti-curse_n_422099.html

Thursday January 14, 2010

Please make sure you have read yesterday's information and have written a thorough response and then responded to two other people. Remember that you may also pose your own questions. The material presented is merely a foundation for anything else you might find tangential and of interest.

Wednesday, January 13, 2010

Wednesday January 13, 2010



The following is really an addendum to yesterday's topic of surrogacy, but we've moved from rental property to ownership.

Please take the time to read the article.
The Meat Market
In a race to prevent thousands of needless deaths a year, countries from Singapore to Israel are launching innovative new programs to boost organ donation. Alex Tabarrok on paying donors for kidneys, favoritism on waiting lists and the shifting line between life and death.

Harvesting human organs for sale! The idea suggests the lurid world of horror movies and 19th-century graverobbers. Yet right now, Singapore is preparing to pay donors as much as 50,000 Singapore dollars (almost US$36,000) for their organs. Iran has eliminated waiting lists for kidneys entirely by paying its citizens to donate. Israel is implementing a "no give, no take" system that puts people who opt out of the donor system at the bottom of the transplant waiting list should they ever need an organ.

Millions of people suffer from kidney disease, but in 2007 there were just 64,606 kidney-transplant operations in the entire world. In the U.S. alone, 83,000 people wait on the official kidney-transplant list. But just 16,500 people received a kidney transplant in 2008, while almost 5,000 died waiting for one.


3,363
Americans who died waiting for a kidney transplant, January to October 2009
To combat yet another shortfall, some American doctors are routinely removing pieces of tissue from deceased patients for transplant without their, or their families', prior consent. And the practice is perfectly legal. In a number of U.S. states, medical examiners conducting autopsies may and do harvest corneas with little or no family notification. (By the time of autopsy, it is too late to harvest organs such as kidneys.) Few people know about routine removal statutes and perhaps because of this, these laws have effectively increased cornea transplants.

Routine removal is perhaps the most extreme response to the devastating shortage of organs world-wide. That shortage is leading some countries to try unusual new methods to increase donation. Innovation has occurred in the U.S. as well, but progress has been slow and not without cost or controversy.

Organs can be taken from deceased donors only after they have been declared dead, but where is the line between life and death? Philosophers have been debating the dividing line between baldness and nonbaldness for over 2,000 years, so there is little hope that the dividing line between life and death will ever be agreed upon. Indeed, the great paradox of deceased donation is that we must draw the line between life and death precisely where we cannot be sure of the answer, because the line must lie where the donor is dead but the donor's organs are not.

In 1968 the Journal of the American Medical Association published its criteria for brain death. But reduced crime and better automobile safety have led to fewer potential brain-dead donors than in the past. Now, greater attention is being given to donation after cardiac death: no heart beat for two to five minutes (protocols differ) after the heart stops beating spontaneously. Both standards are controversial—the surgeon who performed the first heart transplant from a brain-dead donor in 1968 was threatened with prosecution, as have been some surgeons using donation after cardiac death. Despite the controversy, donation after cardiac death more than tripled between 2002 and 2006, when it accounted for about 8% of all deceased donors nationwide. In some regions, that figure is up to 20%.

The shortage of organs has increased the use of so-called expanded-criteria organs, or organs that used to be considered unsuitable for transplant. Kidneys donated from people over the age of 60 or from people who had various medical problems are more likely to fail than organs from younger, healthier donors, but they are now being used under the pressure. At the University of Maryland's School of Medicine five patients recently received transplants of kidneys that had either cancerous or benign tumors removed from them. Why would anyone risk cancer? Head surgeon Dr. Michael Phelan explained, "the ongoing shortage of organs from deceased donors, and the high risk of dying while waiting for a transplant, prompted five donors and recipients to push ahead with surgery." Expanded-criteria organs are a useful response to the shortage, but their use also means that the shortage is even worse than it appears because as the waiting list lengthens, the quality of transplants is falling.


Surgeons at Georgetown University Hospital in Washington perform a kidney transplant.
1,154
Americans who died waiting for a liver transplant, January to October 2009
Routine removal has been used for corneas but is unlikely to ever become standard for kidneys, livers or lungs. Nevertheless more countries are moving toward presumed consent. Under that standard, everyone is considered to be a potential organ donor unless they have affirmatively opted out, say, by signing a non-organ-donor card. Presumed consent is common in Europe and appears to raise donation rates modestly, especially when combined, as it is in Spain, with readily available transplant coordinators, trained organ-procurement specialists, round-the-clock laboratory facilities and other investments in transplant infrastructure.

The British Medical Association has called for a presumed consent system in the U.K., and Wales plans to move to such a system this year. India is also beginning a presumed consent program that will start this year with corneas and later expand to other organs. Presumed consent has less support in the U.S. but experiments at the state level would make for a useful test.

Rabbis selling organs in New Jersey? Organ sales from poor Indian, Thai and Philippine donors? Transplant tourism? It's all part of the growing black market in transplants. Already, the black market may account for 5% to 10% of transplants world-wide. If organ sales are voluntary, it's hard to fault either the buyer or the seller. But as long as the market remains underground the donors may not receive adequate postoperative care, and that puts a black mark on all proposals to legalize financial compensation.

Only one country, Iran, has eliminated the shortage of transplant organs—and only Iran has a working and legal payment system for organ donation. In this system, organs are not bought and sold at the bazaar. Patients who cannot be assigned a kidney from a deceased donor and who cannot find a related living donor may apply to the nonprofit, volunteer-run Dialysis and Transplant Patients Association (Datpa). Datpa identifies potential donors from a pool of applicants. Those donors are medically evaluated by transplant physicians, who have no connection to Datpa, in just the same way as are uncompensated donors. The government pays donors $1,200 and provides one year of limited health-insurance coverage. In addition, working through Datpa, kidney recipients pay donors between $2,300 and $4,500. Charitable organizations provide remuneration to donors for recipients who cannot afford to pay, thus demonstrating that Iran has something to teach the world about charity as well as about markets.

The Iranian system and the black market demonstrate one important fact: The organ shortage can be solved by paying living donors. The Iranian system began in 1988 and eliminated the shortage of kidneys by 1999. Writing in the Journal of Economic Perspectives in 2007, Nobel Laureate economist Gary Becker and Julio Elias estimated that a payment of $15,000 for living donors would alleviate the shortage of kidneys in the U.S. Payment could be made by the federal government to avoid any hint of inequality in kidney allocation. Moreover, this proposal would save the government money since even with a significant payment, transplant is cheaper than the dialysis that is now paid for by Medicare's End Stage Renal Disease program.

In March 2009 Singapore legalized a government plan for paying organ donors. Although it's not clear yet when this will be implemented, the amounts being discussed for payment, around $50,000, suggest the possibility of a significant donor incentive. So far, the U.S. has lagged other countries in addressing the shortage, but last year, Sen. Arlen Specter circulated a draft bill that would allow U.S. government entities to test compensation programs for organ donation. These programs would only offer noncash compensation such as funeral expenses for deceased donors and health and life insurance or tax credits for living donors.




Source: Organ Procurement and Transplantation Network
World-wide we will soon harvest more kidneys from living donors than from deceased donors. In one sense, this is a great success—the body can function perfectly well with one kidney so with proper care, kidney donation is a low-risk procedure. In another sense, it's an ugly failure. Why must we harvest kidneys from the living, when kidneys that could save lives are routinely being buried and burned? A payment of funeral expenses for the gift of life or a discount on driver's license fees for those who sign their organ donor card could increase the supply of organs from deceased donors, saving lives and also alleviating some of the necessity for living donors.

Two countries, Singapore and Israel, have pioneered nonmonetary incentives systems for potential organ donors. In Singapore anyone may opt out of its presumed consent system. However, those who opt out are assigned a lower priority on the transplant waiting list should they one day need an organ, a system I have called "no give, no take."

Many people find the idea of paying for organs repugnant but they do accept the ethical foundation of no give, no take—that those who are willing to give should be the first to receive. In addition to satisfying ethical constraints, no give, no take increases the incentive to sign one's organ donor card thereby reducing the shortage. In the U.S., Lifesharers.org, a nonprofit network of potential organ donors (for which I am an adviser), is working to implement a similar system.

In Israel a more flexible version of no give, no take will be phased into place beginning this year. In the Israeli system, people who sign their organ donor cards are given points pushing them up the transplant list should they one day need a transplant. Points will also be given to transplant candidates whose first-degree relatives have signed their organ donor cards or whose first-degree relatives were organ donors. In the case of kidneys, for example, two points (on a 0- to 18-point scale) will be given if the candidate had three or more years previous to being listed signed their organ card. One point will be given if a first-degree relative has signed and 3.5 points if a first-degree relative has previously donated an organ.

The world-wide shortage of organs is going to get worse before it gets better, but we do have options. Presumed consent, financial compensation for living and deceased donors and point systems would all increase the supply of transplant organs. Too many people have died already but pressure is mounting for innovation that will save lives.

—Alex Tabarrok is a professor of economics at George Mason University and director of research for the Independent Institute.
Correction & Amplification

Surgeons from the University of Maryland's School of Medicine have performed five transplants using kidneys that had either cancerous or benign tumors removed from them. Also, Singapore is preparing to pay donors as much as 50,000 Singapore dollars (almost US$36,000) for their organs. A previous version of this article incorrectly said that five patients received transplants of kidneys that had cancerous masses, and failed to note that the 50,000 figure was in Singapore, not U.S., dollars.