500,000 Americans on dialysis
Al Roth noted that 500,000 people are on dialysis in the United States, with almost 100,000 on the waiting list for a deceased donor kidney.
Where this was said
Al Roth on Repugnant Transactions and the Economics of MAID
At 7:13 · chapter starts 5:40
Dubner pivots from the emotional story of Kahneman to a more analytical frame, introducing Al Roth as perhaps the world's leading authority on repugnant transactions — his term for market exchanges that some people want but others morally oppose, even if they can't tell whether the transaction has occurred [1] — Al Roth "Al Roth's concept of 'repugnant transactions' — things some people want and others oppose on moral grounds, regardless of harm — puts assis…" 08:02 . Roth's new book, 'Moral Economics,' dedicates a chapter to the growing acceptance of assisted dying. The conversation first detours through kidney exchange — Roth's signature contribution, which has helped save thousands of lives by matching donors and recipients without cash — to establish his credibility in designing markets where standard pricing mechanisms are socially unacceptable. Roth then defines repugnant transactions and places MAID in historical company with same-sex marriage and interracial marriage, both once banned and now legal. The framing is dispassionate but clarifying: whether a transaction is repugnant is a social fact, not a permanent moral verdict. Roth notes that markets need social support to function, and that his job as a market designer is to understand that social landscape — not just the economics — before intervening.
Al Roth: Repugnant Transactions and Assisted Dying
Al Roth's concept of 'repugnant transactions' — things some people want and others oppose on moral grounds, regardless of harm — puts assisted dying in the same historical bucket as same-sex marriage and interracial marriage. Social support, Roth argues, is what makes or breaks any contested market.
The Global Landscape of Medical Aid in Dying
Assisted dying has been legal in Switzerland since 1942, and now 12 US states plus D.C. have followed. The American movement was slow and contentious, shaped by figures like Jack Kevorkian, and is now arriving in major states like New York.
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