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INSTITUTE OF MEDICINE 2101 Constitution Avenue, N.W. Washington, DC 20418 Funding: This document was produced using a combination of internal IOM funds and a generous contribution for general dissemination and communi- cation activities from the Burroughs Wellcome Fund. The Institute of Medicine was established in 1970 by the National Acad- emy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth 1. Shine is president of the In- stitute of Medicine. The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering re- search, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Al- berts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the se- lection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. Dr. William A. Wulf is president of the National Academy of Engineering. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technol- ogy with the Academy's purposes of furthering knowledge and advising the federal government. The Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of En- gineering in providing services to the government, the public, and the scien- tific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. William A. Wulf are chairman and vice chairman, respectively, of the National Research Council. Copyright 2000 by the National Academy of Sciences. All rights reserved. Printed in the Ignited States of America. i

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