NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. This report is the result of work done by an independent panel appointed by the Committee on Science, Engineering, and Public Policy (COSEPUP), which has authorized its release to the public. The members of the panel responsible for this report were chosen for their special competencies and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by COSEPUP and a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The National Academy of Sciences (NAS) is a private, self-perpetuating society of distinguished scholars in scientific and engineering research, dedicated to the furtherance of science and technology and their use for the general welfare. Under the authority of its congressional charter of 1863, the Academy has a working mandate that calls upon it to advise the federal government on scientific and technical matters. The Academy carries out this mandate primarily through the National Research Council, which it jointly administers with the National Academy of Engineering and the Institute of Medicine. Dr. Frank Press is President of the NAS.

The National Academy of Engineering (NAE) was established in 1964, under the charter of the NAS, as a parallel organization of distinguished engineers, autonomous in its administration and in the selection of members, sharing with the NAS its responsibilities for advising the federal government. Dr. Robert M. White is President of the NAE.

The Institute of Medicine (IOM) was chartered in 1970 by the National Academy of Sciences, to enlist distinguished members of appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy’s 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth Shine is President of the IOM.

The Committee on Science, Engineering, and Public Policy (COSEPUP) is a joint committee of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. It includes members of the councils of all three bodies.

SPONSORS: This study was supported by the Carnegie Commission on Science, Technology, and Government and by the National Research Council Fund.

Library of Congress Catalog Card No. 92-60301

S 574