Previous Fora / 2003

Speakers

Professor Harvey V. Fineberg

President
Institute of Medicine
The National Academies
USA

 

Harvey V. Fineberg is President of the Institute of Medicine. He served as Provost of Harvard University from 1997 to 2001, following thirteen years as Dean of the Harvard School of Public Health. He has devoted most of his academic career to the fields of health policy and medical decision making. His past research has focused on the process of policy development and implementation, assessment of medical technology, evaluation and use of vaccines, and dissemination of medical innovations.

The 1,429-member Institute of Medicine was chartered in 1970 by the National Academy of Sciences (NAS) to enlist distinguished members of the health professions in examining health-policy matters. Under a congressional charter granted to NAS in 1863, IOM advises the government on issues such as vaccine safety, health care delivery and quality, nutrition standards, cancer prevention and management, and military and veterans' health. At the Institute of Medicine, Dr. Fineberg has chaired and served on a number of panels dealing with health policy issues, ranging from AIDS to new medical technology. He also served as a member of the Public Health Council of Massachusetts (1976-1979), as chairman of the Health Care Technology Study Section of the National Center for Health Services Research (1982-1985), and as president of the Association of Schools of Public Health (1995-1996).

Dr. Fineberg helped found and served as president of the Society for Medical Decision Making and also served as consultant to the World Health Organization. The SMDM's mission is to "improve health outcomes through the advancement of proactive systematic approaches to clinical decision making and policy-formation in health care by providing a scholarly forum that connects and educates researchers, providers, policy-makers, and the public."(http://www.smdm.org/).

Dr. Fineberg is co-author of the books Clinical Decision Analysis, Innovators in Physician Education, and The Epidemic that Never Was, an analysis of the controversial federal immunization program against swine flu in 1976. He has co-edited several books on such diverse topics as AIDS prevention, vaccine safety, and understanding risk in society. He has also authored numerous articles published in professional journals. In 1988, he received the Joseph W. Mountain Prize from the Centers for Disease Control and the Wade Hampton Frost Prize from the Epidemiology Section of the American Public Health Association. Dr. Fineberg earned his bachelor's and doctoral degrees from Harvard University.

A paper titled "The pursuit of global health: the relevance of engagement for developed countries" was co-authored by Fineberg while serving on the Board of International Health. It makes the assertion that "By investing in global health, industrialized countries will not only benefit populations in desperate and immediate need of assistance, but also themselves-through protecting their people, improving their economies, and advancing their international interests." Many of Dr. Fineberg's research interests relate to the processes of decision making in medical care, public health practice, health policy, ethical and social implications of new medical technologies, and dissemination of medical innovations. It is clear that Dr. Fineberg will make a welcomed contribution to the discussion of Knowledge and Quality of Life.

 

Resources on the Web

Institute of Medicine:
http://www.iom.edu/iom/iomhome.nsf?OpenDatabase

National Academies, Harvey V. Fineberg_recent statements
http://www.nas.edu/president/fineberg.html

Society for Medical Decision Making:
http://www.smdm.org

Interview with Harvey V. Fineberg, Harvard Health Policy Review, Spring 2002
http://hcs.harvard.edu/~epihc/currentissue/spring2002/fineberg.php

 

Books

Robert H. Ross, Harvey V. Fineberg. Innovators in physician education: the process and pattern of reform in North American medical schools. New York: Springer Pub. Co., c1996.

Paul C. Stern and Harvey V. Fineberg, editors. Understanding risk: informing decisions in a democratic society. Washington, D.C.: National Academy Press, 1996.

Ruth Ellen Bulger, Elizabeth Meyer Bobby, and Harvey V. Fineberg, editors. Society's choices: social and ethical decision making in biomedicine. Committee on the Social and Ethical Impacts of Developments in Biomedicine, Division of Health Sciences Policy, Institute of Medicine. Washington, D.C. : National Academy Press, 1995.

Jaime Sepulveda, Harvey Fineberg, Jonathan Mann, editors. AIDS: prevention through education: a world view. New York: Oxford University Press, 1992.

Christopher P. Howson, Cynthia J. Howe, and Harvey V. Fineberg, editors. Adverse effects of pertussis and rubella vaccines: a report of the Committee to Review the Adverse Consequences of Pertussis and Rubella Vaccines. Institute of Medicine (U.S.). Committee to Review the Adverse Consequences of Pertussis and Rubella Vaccines. Washington, D.C.: National Academy Press, 1991.

Fineberg, Harvey V. Public health: meeting the challenge. Boston, Mass.: Harvard School of Public Health, 1984

Richard E. Neustadt and Harvey V. Fineberg ; foreword by David A. Hamburg. The epidemic that never was: policy-making and the swine flu scare. New York: Vintage Books, 1983, c1982.

 

Articles

Brewer, Timothy F.; Heymann, S. Jody; Krumplitsch, Susan M.; Wilson, Mary E.; Colditz, Graham A.; Fineberg, Harvey V. Strategies to Decrease Tuberculosis in US Homeless Populations.

JAMA: Journal of the American Medical Association,
8/15/2001, Vol. 286 Issue 7, p834, 9p, 4 charts, 1 graph

Abstract: Presents a study to examine the effects of tuberculosis (TB) on projected TB cases and deaths in United States homeless populations, using a computer-based simulation model. Context; Objective; Design, setting and population; Main outcome measures; Results; Conclusions, including how to decrease TB morbidity and mortality.

Heymann, S. Jody; Brewer, Timothy F.; Fineberg, Harvey F.; Wilson, Mary E. The Need for Global Action Against Multidrug-Resistant Tuberculosis. JAMA: Journal of the American Medical Association, 6/9/99, Vol. 281 Issue 22, p2138, 3p

Abstract: Discusses multidrug resistant tuberculosis (MDRTB) and the threat to human health. How the World Health Organization (WHO) advocates the use of a standardized regimen called directly observed treatment, short course (DOTS); Expense of treatment; Ramifications if the global health community does not confront MDRTB; What is necessary to control tuberculosis and move toward elimination.

Fineberg, Harvey V.; Rowe, Sylvia. Improving public understanding: Guidelines for communicating emerging science on nutrition, food. Journal of the National Cancer Institute, 02/04/98, Vol.90 Issue 3, p194, 6p

Abstract: Presents information on communicating focusing on the public's interest in nutrition and food safety. Details on the advisory group of leading experts put together by the Harvard School of Public Health and the International Food Information Council Foundation; Reason for the group; Information on the guidelines put together by the group.

Howson, Christopher P.; Fineberg, Harvey V.; et al. The pursuit of global health: The relevance of engagement for developed countries. Lancet, 02/21/98, Vol. 351 Issue 9102, p586, 5p, 3 charts

Abstract: Considers the benefits of globalization of the world economy but the risks of infectious diseases. The need to invest a global health; The presentation of ideas for industrialized countries to be involved in global health; Suggested means for coordination.

Fineberg, Harvey V.; Wilson, Mary E., Social vulnerability and death by infection. New England Journal of Medicine, 3/28/96, Vol. 334 Issue 13, p859, 2p

Abstract: Editorial. Points to the results of the study by Friedman et al. to assert that there are extreme health risks faced by the most vulnerable citizens in the United States. Ongoing responsibilities of public health authorities; Specifics in reference to AIDS and tuberculosis; The rate of death in the US from infectious diseases; Statistics from the Centers for Disease Control and Prevention.

Howson, Christopher P.; Fineberg, Harvey V. The Ricochet of Magic Bullets: Summary of the Institute of Medicine Report, Adverse Effects of Pertusius and Rubella Vaccines. Pediatrics, Feb92, Vol. 89 Issue 2, p318, 7p Abstract: Presents a summary of the report `Adverse Effects of Pertussis and Rubella Vaccines,' released by the Institute of Medicine of the National Academy of Sciences in February 1992 in the United States. Events which led to the conduction of the study; Methodology used in the study; Implications for research.

Heymann, S. Jody; Brewer, Timothy F.; Fineberg, Harvey V.; Wilson, Mary E. How Safe Is Safe Enough? New Infections and the U.S. Blood Supply. Annals of Internal Medicine, 10/1/92, Vol. 117 Issue 7, p612, 3p

Abstract: Talks about the safety of the U.S. blood supply and transfusion practices. Focus of most debate about transfusion practices; Strategy for dealing with the safety of the blood supply; Circumstances that would all factor into the development of a transfusion threshold.

Fineberg, Harvey V. Screening for HIV Infection and Public Health Policy. Law, Medicine and Health Care; 1990, 18, 1-2, spring-summer, 29-32. 1990

Abstract: The current state of policy deliberations about human immunodeficiency virus (HIV) testing is examined, & four considerations that should be incorported into such policy are discussed: (1) purpose of testing program - medical, public health/preventative, & surveillance; (2) prolonged latency or silent period of infection of HIV agent; (3) ethical basis of policy judgments & the potential conflict of individual & social interests; & (4) scientific basis of decisions. Recent changes in attitudes toward HIV testing & screening are examined & compared with the changing view of physicians that HIV infection is a treatable condition. The need for legal protection against discrimination & breach of confidentiality is explored. 2 References. D. Generoli

Fineberg, H. Education to prevent AIDS: Prospects and... (cover story). Science, 2/5/88, Vol. 238 Issue 4840, p592, 5p, 1 graph

Abstract: Lists obstacles to AIDS prevention. Extreme changes in risk-taking behaviors required; Need for a nationwide comprehensive, intensive, and targeted educational program to prevent AIDS.

Fineberg, Harvey V. The Social Dimensions of AIDS. Scientific American; 1988, 259, 4, Oct, 128-134. 1988

Abstract: The acquried immune deficiency syndrome (AIDS) epidemic exposes hidden vulnerabilities in the human condition that are both biological & social. It evokes basic human fears & inhibitions & has altered thinking about human relations, love, & sexuality. The spread of the disease & the social & ethnic groups it affects are described. Infrastructural change is required in areas where intravenous drug use flourishes. The effects of AIDS on the delivery of health care services & on the economy as a whole are discussed. The emergence of grass-roots organizations dedicated to serving people with AIDS, & the work of celebrities, foundations, & private enterprise are related. The costs of the epidemic are considered in the context of overall US health care expenditure. Objectives & a strategy for dealing with the epidemic are set forth. 5 References. F. S. J. Ledgister

Fineberg, Harvey V. Irresistible medical technologies: weighing the costs and benefits. Technology Review, Nov/Dec1984, Vol. 87 Issue 8, p17, 0p

Fineberg, Harvey V.; Hiatt, Howard H. Evaluation of Medical Practices: The Case for Technology Assessment. The New England Journal of Medicine; 1979.

Abstract: The systematic evaluation of medical practices,especially those that are risky or costly, deserves more attention. Available methods are limited, & definitive assessments of innovative or controversial practices infrequent. Nevertheless, some evaluations have successfully enhanced the use of effective practices & diminished the reliance on ineffective ones. Greater efforts at evaluation can improve the quality of patient care, avoid waste, & promote the more rational use of health resources. The cost of assessing new practices should be viewed as an intrinsic part of the cost of medical care. Physicians & medical societies bear primary responsibility for recognizing the need for this evaluation, for enlisting other experts, participating in technology assessment, & working to translate the results of evaluation into practice. The commitment of government agencies, insurance companies, & teaching institutions is also essential to an effective program evaluation.