Risk versus risk: Tradeoffs in protecting health and the environment
Edited by John D. Graham and Jonathan Baert Wiener
Harvard University Press, 1996. 337 pp., US$39.95
Reviewed by Dot Tumney
Risk management refuses to fit into neat boxes. Those making complex decisions must therefore be weaned from the compulsion to compartmentalise and oversimplify. This book's discussion and case studies relate to the US medical and legislative processes, but much of it transfers well enough to any system with fee-for-service specialisations in the medical setting and an adversarial politico-legal method.
The nine specific subjects dealt with are oestrogen therapy and menopause, clozapine for schizophrenia, licensing elderly drivers, saving petrol and lives, eating fish, safe drinking water, recycling lead, regulating pesticides, protecting global environment.
The topics illustrated are risk offset, risk transfer, risk substitution and risk transformation. Attempting to reduce the target risk may result in any or all of these. People do these things all day every day with more or less formality, but the authors are aiming to expand the parameters of formal decision-making processes to achieve risk superior options.
The moral problems tend to arise when attempting to resolve a problem results in off-loading the damage — "externalising" as the economists have it. The authors want policy decisions to avoid these statistical cut-offs. Poisoning Africans instead of US citizens looks good only on one set of statistics. Taking an ethical approach, not poisoning anybody, wins.
To those of us who habitually ask "well yes John, but what is an economy actually for" I suspect reading through it inspires a case of "well of course it should, but..." and an insight into how to leave things out of environmental impact statements. n