Health and Medicine

FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.

FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.

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A class was given in the dSchool last spring. In this class small interdisciplinary teams focused on a term-long design project, taking advantage of the design process structures and methods that have been developed in the d.school. The course developed as a collaboration between Stanford, the University of Nairobi and Nokia Africa Research Center.  The focus area was finding ICT solutions to the healthcare needs of people living in Kibera slum outside Nairobi.

Under the guidance of Jussi Impiö at Nokia and the Computer Science faculty, 27 students from the University of Nairobi Computer Science department conducted need finding studies at a number of health-related sites, including clinics, hospitals, community health workers, community leaders, and government offices. They read background materials, made observations, and talked with a wide variety of stakeholders. Their reports became the basis of the Stanford teams' initial understanding of users and needs. Communication with the group in Nairobi was also maintained throughout the course, using a Facebook group to facilitate discussions, as well as several teleconference sessions.

Working in small teams, 20 Stanford students from a wide range of disciplines worked over 10 weeks to develop initial design concepts to respond to some of the needs that had been identified. Click on the title of each project to view their final presentations:

  • mNote: an online archive for community health worker notes. This application empowers community health workers by preserving the flexibility and control they appreciate in their current paper notebooks, but adding digital knowledge management capabilities.
  • M-MAJI ("mobile water"): an electronic information system that allows people to use their mobile phones to identify clean water sources in their community. The application seeks to decrease the time and money spent searching for water, improve water quality, and foster vendor accountability by providing a mechanism for user feedback.
  • Babybank: a dedicated savings plan designed specifically for pregnant women in the slums of Nairobi. By leveraging a popular cell phone payment system, M-Pesa, the application aims to make savings easier, so that expecting mothers can afford the services that will keep themselves and their babies healthy.
  • Mazanick: an application to provide support and advice to pregnant women via SMS, with the aim of helping motivate them to attend prenatal appointments.
  • PillCheck (Kifaa cha Tenbe): a mobile application to help people in Kibera find information on the availability and pricing of malaria drugs quickly.
  • PatientMap :a system to make the waiting process in clinics more transparent, and to increase patient trust in the medical system.

This summer, two follow up trips are planned, with Nairobi students due to spend several weeks at Stanford, while a number of students from the Stanford group will visit Nairobi to explore possibilities for developing their projects further. Building on the success and lessons learnt so far, the Designing Liberation Technologies course will be open to a new set of students next academic year. 

Wallenberg Theater

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Encina Hall West, Room 404
Stanford University
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Marta Sutton Weeks Professor of Ethics in Society, and Professor of Political Science, Philosophy, and Law
cohen.jpg MA, PhD

Joshua Cohen is a professor of law, political science, and philosophy at Stanford University, where he also teaches at the d.school and helps to coordinate the Program on Liberation Technology. A political theorist trained in philosophy, Cohen has written extensively on issues of democratic theory—particularly deliberative democracy and the implications for personal liberty, freedom of expression, and campaign finance—and global justice. Cohen is author of On Democracy (1983, with Joel Rogers); Associations and Democracy (1995, with Joel Rogers); Philosophy, Politics, Democracy (2010); The Arc of the Moral Universe and Other Essays (2011); and Rousseau: A Free Community of Equals (2011). Since 1991, he has been editor of Boston Review, a bi-monthly magazine of political, cultural, and literary ideas. Cohen is currently a member of the faculty of Apple University.

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Professor of Computer Science
founding faculty member at Hasso Plattner Institute of Design at Stanford
and CDDRL Affiliated Faculty
winograd.jpg PhD

Terry Winograd is a co-leader of the Liberation Technology program at CDDRL and Professor of Computer Science in the Computer Science Department at Stanford University. His research focus is on human-computer interaction design, especially theoretical background and conceptual models. He directs the teaching programs and HCI research in the Stanford Human-Computer Interaction Group, and is also a founding faculty member of the Hasso Plattner Institute of Design at Stanford.

Prof. Winograd was a founding member and former president of Computer Professionals for Social Responsibility. He is on a number of journal editorial boards, including Human Computer Interaction, ACM Transactions on Computer Human Interaction, and Informatica. Some of his publications includes Understanding Computers and Cognition: A New Foundation for Design (Addison-Wesley, 1987) and Usability: Turning Technologies into Tools (Oxford, 1992). 

Terry Winograd received a B.A. in Mathematics from The Colorado College in 1966 and Ph.D. in Applied Mathematics from M.I.T in 1970.

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New Draper Hills Summer Fellows come to Stanford to study linkages between democracy, development, and the rule of law

Rising leaders from a diverse group of nations in transition, including China, Russia, Ukraine, Syria, Iran, Iraq, Pakistan, Egypt, Kenya, Zimbabwe, Mozambique, and Nigeria arrived on campus on July 25 for a three-week seminar as Draper Hills Summer Fellows on Democracy and Development. Initiated by FSI's Center on Democracy, Development, and the Rule of Law (CDDRL) six years ago, the program has created a network of some 139 leaders from 62 transitioning countries.  This year's exceptional class of  23 fellows includes a deputy minister of Ukraine, current and former members of parliament (including a deputy speaker), leading attorneys and rule of law experts, civic activists, journalists, international development practitioners, and founders of non-governmental organizations (NGOs). (One fellow needed to withdraw because he was named to the Cabinet of the new Philippine president, Noynoy Aquino).

Draper Hills Summer Fellows are innovative, courageous, and committed leaders, who strive to improve governance, enhance civic participation, and invigorate development under very challenging circumstances"
- Larry Diamond
"Draper Hills Summer Fellows are innovative, courageous, and committed leaders, who strive to improve governance, enhance civic participation, and invigorate development under very challenging circumstances," says CDDRL Director Larry Diamond. "This year's fellows are an inspiring group. They have come here to learn from us, but even more so from one another. And we will learn much from them, about the progress they are making and the obstacles they confront as they work to build democracy, improve government accountability, strengthen the rule of law, energize civil society, and enhance the institutional environment for broadly shared economic growth."

The three-week seminar is taught by an interdisciplinary team of leading Stanford faculty. In addition to Diamond, faculty include FSI Senior Fellow and CDDRL Deputy Director Kathryn Stoner; Stanford President Emeritus Gerhard Casper; FSI Deputy Director and political science Professor Stephen D. Krasner; Olivier Nomellini Senior Fellow Francis Fukuyama; professor of political science, philosophy, and law Joshua Cohen; professor of pediatrics and Stanford Health Policy core faculty Paul H. Wise; visiting associate professor Beth van Schaack; FSI Senior Fellow Helen Stacy; Walter P. Falcon, deputy director, Program on Food Security and the Environment; Erik Jensen, co-director of the Stanford Law School's Rule of Law Program; Avner Greif, professor of economics; Rick Aubry, lecturer in management, Stanford Graduate School of Business; and Nicholas Hope, director, Stanford Center on International Development.

Other leading experts who will engage the fellows include President of the National Endowment for Democracy Carl Gershman, United States Court of Appeals Judge Pamela Rymer, International Center on Nonviolent Conflict founding chair Peter Ackerman, Omidyar Network partner Matt Halprin, Conservation International's Olivier Langrand, executives of leading Silicon Valley companies, such as Google and Facebook, and media and nonprofit organizations in the Bay Area.  Michael McFaul, a Stanford political science professor and former CDDRL director, who now serves on the National Security Council as President Obama's chief advisor on Russia, will come to campus to teach a session on U.S. foreign policy in the Obama administration.

The demanding, but compelling curriculum will devote the first week of the seminar to defining the fundamentals of democracy, good governance, economic development, and the rule of law.  In the second week, faculty will turn to democratic and economic transitions and the feedback mechanisms between democracy, development, and a predictable rule of law. This week will include offerings on liberation technology, social entrepreneurship, and issues raised by development and the environment.  The third week will turn to the critical - and often controversial - role of international assistance to foster and support democracy, judicial reform, and economic development, including the proper role of foreign aid.

Our program helps to create a broader community of global activists and practitioners, intent on sharing experiences to bring positive change to some of the world's most troubled countries and regions"
- Kathryn Stoner-Weiss
The fellows themselves also lead discussions, focused on the concrete challenges they face in their ongoing work in political and economic development. "Fellows come to realize that they are often engaged in solving similar problems - such as endemic corruption in different country contexts," says Kathryn Stoner-Weiss. "Our program helps to create a broader community of global activists and practitioners, intent on sharing experiences to bring positive change to some of the world's most troubled countries and regions."

The program has received generous gifts from donors William Draper III and Ingrid Hills.  Bill Draper made his gift in honor of his father, Maj. Gen. William H. Draper, Jr., a chief advisor to Gen. George Marshall and chief diplomatic administrator of the Marshall Plan in Germany, who confronted challenges comparable to those faced by Draper Hills Summer Fellows in building democracy, a market economy, and a rule of law, often in post-conflict conditions. Ingrid von Mangoldt Hills, made her gift in honor of her husband, Reuben Hills, president and chairman of Hills Bros. Coffee and a leading philanthropist. The Hills project they ran for 12 years improved the lives of inner city children and Ingrid saw in the Summer Fellows Program a promising opportunity to improve the lives of so many people in developing countries.

Thanking the program's benefactors, Larry Diamond says, "The benefit to CDDRL faculty and researchers is incalculable, and we are deeply grateful for the vision and generosity of Bill Draper and Ingrid Hills." As he and Kathryn Stoner-Weiss state, "The Draper Hills Summer Fellows Program allows us to interact with a highly, talented group of emerging leaders in political and economic development from diverse countries and regions. They benefit from exposure to the faculty's cutting edge work, while we benefit from a cycle of feedback on whether these ideas work in the field."  Like CDDRL, which bridges academic theory and policy, the Draper Hills Summer Fellows Program, they note, "is an ideal marriage between democratic and development theory and practice."

For additional details on the program or to request permission to attend a session, please contact program coordinator Audrey McGowan, audrey.mcgowan@stanford.edu.

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This Spring quarter, while our seminar series took a break, Terry Winograd and Joshua Cohen taught a new course at the Hasso Plattner Institute of Design (the d.school): Designing Liberation Technologies.

During this class, small interdisciplinary teams focus on a term-long design project, taking advantage of the design process structures and methods that have been developed in the d.school. This year's course developed as a collaboration between Stanford, the University of Nairobi and Nokia Africa Research Center.  The focus area was finding ICT solutions to the healthcare needs of people living in Kibera slum outside Nairobi.

Under the guidance of Jussi Impiö at Nokia and the Computer Science faculty, 27 students from the University of Nairobi Computer Science department conducted need finding studies at a number of health-related sites, including clinics, hospitals, community health workers, community leaders, and government offices. They read background materials, made observations, and talked with a wide variety of stakeholders. Their reports became the basis of the Stanford teams' initial understanding of users and needs. Communication with the group in Nairobi was also maintained throughout the course, using a Facebook group to facilitate discussions, as well as several teleconference sessions.

Working in small teams, 20 Stanford students from a wide range of disciplines worked over 10 weeks to develop initial design concepts to respond to some of the needs that had been identified. Click on the title of each project to view their final presentations:

  • mNote: an online archive for community health worker notes. This application empowers community health workers by preserving the flexibility and control they appreciate in their current paper notebooks, but adding digital knowledge management capabilities.
  • M-MAJI ("mobile water"): an electronic information system that allows people to use their mobile phones to identify clean water sources in their community. The application seeks to decrease the time and money spent searching for water, improve water quality, and foster vendor accountability by providing a mechanism for user feedback.
  • Babybank: a dedicated savings plan designed specifically for pregnant women in the slums of Nairobi. By leveraging a popular cell phone payment system, M-Pesa, the application aims to make savings easier, so that expecting mothers can afford the services that will keep themselves and their babies healthy.
  • Mazanick: an application to provide support and advice to pregnant women via SMS, with the aim of helping motivate them to attend prenatal appointments.
  • PillCheck (Kifaa cha Tenbe): a mobile application to help people in Kibera find information on the availability and pricing of malaria drugs quickly.
  • PatientMap :a system to make the waiting process in clinics more transparent, and to increase patient trust in the medical system.

This summer, two follow up trips are planned, with Nairobi students due to spend several weeks at Stanford, while a number of students from the Stanford group will visit Nairobi to explore possibilities for developing their projects further. Building on the success and lessons learnt so far, the Designing Liberation Technologies course will be open to a new set of students next academic year. 

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On April 19, the Freeman Spogli Institute for International Studies convened a special conference on Technology, Governance, and Global Development, to examine how technical innovation solves, or fails to solve, the problems of chronic global underdevelopment. Experts from business, medicine, philanthropy, academia, government and non-governmental organizations, along with young Stanford alumni, addressed technology’s ability to help secure gains in health, economic development, agricultural innovation, food security, and human development.

With a wealth of expertise and on-the-ground experience, panelists tackled central issues and engaged in spirited debate, animated by moderator Phil Taubman. “The Promise of Information and Communications Technology” examined whether technology can transform lives of individuals, even in poorly governed countries, finding encouraging evidence in health and economic development.

Frances C. Arrillaga Alumni Center

Philip Taubman Moderator
Megan Smith Speaker Google.org

Program on Global Justice
Encina Hall West, Room 404
Stanford University
Stanford, CA 94305

(650) 723-0256
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Marta Sutton Weeks Professor of Ethics in Society, and Professor of Political Science, Philosophy, and Law
cohen.jpg MA, PhD

Joshua Cohen is a professor of law, political science, and philosophy at Stanford University, where he also teaches at the d.school and helps to coordinate the Program on Liberation Technology. A political theorist trained in philosophy, Cohen has written extensively on issues of democratic theory—particularly deliberative democracy and the implications for personal liberty, freedom of expression, and campaign finance—and global justice. Cohen is author of On Democracy (1983, with Joel Rogers); Associations and Democracy (1995, with Joel Rogers); Philosophy, Politics, Democracy (2010); The Arc of the Moral Universe and Other Essays (2011); and Rousseau: A Free Community of Equals (2011). Since 1991, he has been editor of Boston Review, a bi-monthly magazine of political, cultural, and literary ideas. Cohen is currently a member of the faculty of Apple University.

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Jared Cohen Speaker US Department of State
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Cubberly Auditorium

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Richard E. Behrman Professor of Child Health and Society
Senior Fellow, Freeman Spogli Institute for International Studies
rsd15_081_0253a.jpg MD, MPH

Dr. Paul Wise is dedicated to bridging the fields of child health equity, public policy, and international security studies. He is the Richard E. Behrman Professor of Child Health and Society and Professor of Pediatrics, Division of Neonatology and Developmental Medicine, and Health Policy at Stanford University. He is also co-Director, Stanford Center for Prematurity Research and a Senior Fellow in the Center on Democracy, Development, and the Rule of Law, and the Center for International Security and Cooperation, Freeman Spogli Institute for International Studies, Stanford University. Wise is a fellow of the American Academy of Arts and Sciences and has been working as the Juvenile Care Monitor for the U.S. Federal Court overseeing the treatment of migrant children in U.S. border detention facilities.

Wise received his A.B. degree summa cum laude in Latin American Studies and his M.D. degree from Cornell University, a Master of Public Health degree from the Harvard School of Public Health and did his pediatric training at the Children’s Hospital in Boston. His former positions include Director of Emergency and Primary Care Services at Boston Children’s Hospital, Director of the Harvard Institute for Reproductive and Child Health, Vice-Chief of the Division of Social Medicine and Health Inequalities at the Brigham and Women’s Hospital and Harvard Medical School and was the founding Director or the Center for Policy, Outcomes and Prevention, Stanford University School of Medicine. He has served in a variety of professional and consultative roles, including Special Assistant to the U.S. Surgeon General, Chair of the Steering Committee of the NIH Global Network for Women’s and Children’s Health Research, Chair of the Strategic Planning Task Force of the Secretary’s Committee on Genetics, Health and Society, a member of the Advisory Council of the National Institute of Child Health and Human Development, NIH, and the Health and Human Secretary’s Advisory Committee on Infant and Maternal Mortality.

Wise’s most recent U.S.-focused work has addressed disparities in birth outcomes, regionalized specialty care for children, and Medicaid. His international work has focused on women’s and child health in violent and politically complex environments, including Ukraine, Gaza, Central America, Venezuela, and children in detention on the U.S.-Mexico border.  

Core Faculty, Center on Democracy, Development and the Rule of Law
Affiliated faculty at the Center for International Security and Cooperation
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Paul H. Wise Richard E. Behrman Professor of Child Health and Society, Stanford University Speaker
Eduardo Miranda Professor of Civil and Env Engineering, Earthquake Engineering Specialist Speaker

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Stanford University
Encina Hall, C147
616 Jane Stanford Way
Stanford, CA 94305-6055

(650) 724-6448 (650) 723-1928
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Mosbacher Senior Fellow in Global Democracy at the Freeman Spogli Institute for International Studies
William L. Clayton Senior Fellow at the Hoover Institution
Professor, by courtesy, of Political Science and Sociology
diamond_encina_hall.png MA, PhD

Larry Diamond is the William L. Clayton Senior Fellow at the Hoover Institution, the Mosbacher Senior Fellow in Global Democracy at the Freeman Spogli Institute for International Studies (FSI), and a Bass University Fellow in Undergraduate Education at Stanford University. He is also professor by courtesy of Political Science and Sociology at Stanford, where he lectures and teaches courses on democracy (including an online course on EdX). At the Hoover Institution, he co-leads the Project on Taiwan in the Indo-Pacific Region and participates in the Project on the U.S., China, and the World. At FSI, he is among the core faculty of the Center on Democracy, Development and the Rule of Law, which he directed for six and a half years. He leads FSI’s Israel Studies Program and is a member of the Program on Arab Reform and Development. He also co-leads the Global Digital Policy Incubator, based at FSI’s Cyber Policy Center. He served for 32 years as founding co-editor of the Journal of Democracy.

Diamond’s research focuses on global trends affecting freedom and democracy and on U.S. and international policies to defend and advance democracy. His book, Ill Winds: Saving Democracy from Russian Rage, Chinese Ambition, and American Complacency, analyzes the challenges confronting liberal democracy in the United States and around the world at this potential “hinge in history,” and offers an agenda for strengthening and defending democracy at home and abroad.  A paperback edition with a new preface was released by Penguin in April 2020. His other books include: In Search of Democracy (2016), The Spirit of Democracy (2008), Developing Democracy: Toward Consolidation (1999), Promoting Democracy in the 1990s (1995), and Class, Ethnicity, and Democracy in Nigeria (1989). He has edited or coedited more than fifty books, including China’s Influence and American Interests (2019, with Orville Schell), Silicon Triangle: The United States, China, Taiwan the Global Semiconductor Security (2023, with James O. Ellis Jr. and Orville Schell), and The Troubling State of India’s Democracy (2024, with Sumit Ganguly and Dinsha Mistree).

During 2002–03, Diamond served as a consultant to the US Agency for International Development (USAID) and was a contributing author of its report, Foreign Aid in the National Interest. He has advised and lectured to universities and think tanks around the world, and to the World Bank, the United Nations, the State Department, and other organizations dealing with governance and development. During the first three months of 2004, Diamond served as a senior adviser on governance to the Coalition Provisional Authority in Baghdad. His 2005 book, Squandered Victory: The American Occupation and the Bungled Effort to Bring Democracy to Iraq, was one of the first books to critically analyze America's postwar engagement in Iraq.

Among Diamond’s other edited books are Democracy in Decline?; Democratization and Authoritarianism in the Arab WorldWill China Democratize?; and Liberation Technology: Social Media and the Struggle for Democracy, all edited with Marc F. Plattner; and Politics and Culture in Contemporary Iran, with Abbas Milani. With Juan J. Linz and Seymour Martin Lipset, he edited the series, Democracy in Developing Countries, which helped to shape a new generation of comparative study of democratic development.

Download full-resolution headshot; photo credit: Rod Searcey.

Former Director of the Center on Democracy, Development and the Rule of Law
Faculty Chair, Jan Koum Israel Studies Program
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Larry Diamond Hoover Institution Senior Fellow, Expert in Democratic Development Speaker
Ralph Greco Director, General Surgery Residency Program, Stanford University Speaker
Carolyn Duffey Lecturer, Comparative Studies in Race and Ethnicity, Stanford University Speaker
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In mid April, FSI convened a special conference on Technology, Governance, and Global Development, to examine how technical innovation solves, or fails to solve, the problems of chronic global underdevelopment.  Experts from business, medicine, philanthropy, academia, government and non-governmental organizations, along with young Stanford alumni, addressed technology's ability to help secure gains in health, economic development, agricultural innovation, food security, and human development.

With a wealth of expertise and on-the-ground experience, panelists tackled central issues and engaged in spirited debate, animated by moderator Philip Taubman.  "The Promise of Information and Communications Technology" examined whether technology can transform lives of individuals, even in poorly governed countries, finding encouraging evidence in technology-based medical and health services and novel approaches to economic development, including sharing vital information and banking via mobile phones. 

A panel of young Stanford alumni discussed their entrepreneurial efforts that led to the development of a low-cost, lifesaving incubator for low birth weight babies, the FACE AIDS program begun at Stanford that now has 20 chapters and has contributed some $2 million for treatment of people with AIDS in Africa, a new Global Health Corps to train health care workers, and other innovations to save lives in underserved areas.

Condoleezza Rice, former Secretary of State and National Security Advisor, gave the lunchtime keynote with a focus on why democracies are more effective and ultimately more efficient in delivering economic development. Democracies are better at protection of rule of law and property rights, she noted. Democracies are less corrupt, more in touch with their people, more stable, and better able to deliver the benefits of human capital development, health, and education to their population as a whole.

A third panel on "Governance, Innovation, and Service Delivery" addressed how innovative institutions and technologies could overcome poor governance and deliver needed services in underdeveloped regions. "Despite extraordinary growth in our technical capacity to prevent and treat child illness and death, we are seeing stagnation or a rise in mortality rates of children under five in some areas," said pediatrician Paul Wise. "This reflects gross failures in delivering highly efficacious health interventions." Some 9 million children still die each year, and 65 percent of child deaths in unstable areas are preventable, he noted. Wise has launched a new program to improve child health in areas of unstable governance through new integrated technical and political strategies.

A fourth session on "Creative Markets for Technical Innovation" honed in on the institutions, innovations, and incentives needed to stimulate development of products and services that address the needs of the poor. Panelists focused on pharmaceuticals, agricultural innovation, use of mobile technologies to share information on best practices, improved food security through innovative technology - such as solar-powered irrigation to expand growing seasons, crops, and incomes, and the development of human capital in China through rigorous evaluation, field trials, and nutritional intervention.

Among the experts addressing these vital issues were Google.org's Megan Smith, BP Solar's Reyad Fezzani, Center for Global Development President Nancy Birdsall, Gates Foundation Director of Agricultural Development Sam Dryden, Gilead Science's Clifford Samuel, dynamic Stanford alumni Nava Ashraf ‘97, Jared Cohen ‘04, Jane Chen ‘08, and Jonny Dorsey ‘07, and FSI's Coit D. Blacker, Joshua Cohen, Stephen D. Krasner, Paul H. Wise, Rosamond L. Naylor, and Scott Rozelle.

FSI Payne Lecturer Bill Gates, Co-chair of the Bill & Melinda Gates Foundation and Chairman, Microsoft, gave an address on "Giving Back: Finding the Best Way to Make a Difference."  He urged students to become involved in the central issues of global healthincluding the need to reduce child mortality through more vaccines and better delivery systemsand education, saying we need to find out "what works" and use the Internet to share lessons learned globally.

"We need to shift talent toward bigger needs," Gates said, urging students to provide the passion and ideas to drive us forward in health, education, and energy.  To make a difference, Gates advised, "Get your hands dirty, do the hard work in the actual environment, early in your career."  Telling students that he is looking for "great ideas," he challenged them to post answers on the Gates Foundation Facebook wall to three questions: What problems are you working on? What draws you in? How will you draw other people in to work on solutions to the world's great challenges.

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The extent and existence of "defensive medicine" -- excessive medical care to defend a physician against malpractice claims -- is a perennial subject of both policy and academic debate.  For example, malpractice liability and associated defensive medicine are among the most-cited reasons for escalating health-care spending in the United States.

In this colloquium, Dr. Brian Chen will present results from his research investigating the extent of defensive medicine in Taiwan. He studies the impact of a series of court rulings in Taiwan that increased physicians’ liability risks, and a subsequent amendment to the law that reversed the courts’ rulings, on physicians’ test-ordering behavior and propensity to perform Caesarean sections.  He finds that physicians faced with higher malpractice pressure increased laboratory tests as expected, but unexpectedly reduced Caesarean sections.  (The reduction in Caesarean deliveries may be due to the fact that liability risks were more closely aligned with physicians’ standard of care after the court rulings.) After the law was amended to negate the court decisions, physicians reversed their previous behavior by reducing laboratory tests and increasing Caesarean deliveries.

This pattern of behavior is highly suggestive of the existence of defensive medicine among physicians in Taiwan. In other words, by studying physicians' response to legal changes in Taiwan, we find that greater malpractice liability may, under certain circumstances, prompt physicians to perform more services without necessarily improving patient health.

Dr. Brian Chen recently completed his Ph.D. in Business Administration in the Business and Public Policy Group at the Haas School of Business, University of California at Berkeley. He received a Juris Doctor from Stanford Law School in 1997, and graduated summa cum laude from Harvard College in 1992.

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Brian Chen Shorenstein-Spogli Fellow in Comparative Health Policy Speaker
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