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Public Health and the
Precautionary Principle
Author
Steven G. Gilbert, PhD, DABT,
is director of the Institute of
Neurotoxicology and Neurological
Disorders (INND) in Seattle,
Washington. sgilbert@innd.org,
www.asmalldoseof.org.
Ensuring public health, and most importantly children’s health, is not only a matter of knowledge
or resources but also of policy. In his 1968 paper on the commons, Garrett Hardin pointed out that
many of the problems that we face have no technical solutions but must be managed. Management
often requires regulations, from which we need not shy away. Basic research in the biological and toxicological
sciences, combined with experience, gives us the knowledge to make decisions that protect
public health and the environment. Before discussing the precautionary principle as one approach to
decision making, I will defi ne bioethics and then consider our ethical and social responsibilities.
Van Rensselaer Potter was the fi rst to use the term bioethics in his 1971 book, but Aldo Leopold
probably provided the best defi nition in his 1949 book, A Sand County Almanac. Bioethics, as Leopold
and Potter defi ne it, is a broad concept that is inclusive of public health and environment. When
we distribute lead, mercury, or PCBs into the environment, we not only expose our children to compounds
that rob them of their potential, we also harm the much broader biotic community. While
protecting our children, we must also acknowledge a responsibility to the fi sh and other wildlife that
accumulate mercury and PCBs. Th us defi ned, bioethics provides us with a foundation upon which to
consider our ethical and social responsibilities combined with our knowledge.
We know from research that fetal or childhood exposure to even low levels of chemicals, such as
alcohol, or environmental contaminates, such as lead, adversely aff ect the developing nervous system.
Th is knowledge implies that we have a duty to protect those who cannot protect themselves, such as
children, who have a right to develop in an environment that allows them to reach and maintain their
full potential. Protecting our children is also a good investment. Environmentally related childhood
diseases cost approximately $55 billion per year. Preventing harm to public health and the environment
will require society, including the public, businesses, and government, to make fundamental
changes in their approach to regulatory policy and decision making.
One approach to preventing harm is to more broadly incorporate the precautionary principle
(PP) into our decision-making process. Th e PP promotes a broader ethical perspective as well as taking
action to protect public health even in the face of uncertainty. Th is is in contrast to a risk assessment
approach, which asks, “How much harm can we tolerate?” Instead the PP asks, “What actions
can we take to prevent harm?” A key provision is that the proponent of an activity has the responsibility
to demonstrate safety. For example, the Food and Drug Administration takes a precautionary
approach by requiring the manufacturer of a new drug to submit data demonstrating both effi cacy
and safety prior to marketing the product. In contrast, thousands of new chemicals are introduced
into commerce each year with only minimal knowledge of their potential eff ects on human health or
environmental consequences, which puts society in the position of proving harm after exposure. Our
knowledge and technical capabilities have progressed to the point where not everything that could
make money is necessarily good for society.
Th e precautionary principle consists of four basic concepts:
• Taking preventive action in the face of uncertainty
• Shifting the burden of responsibility (proof ) of demonstrating safety to the proponents of an
activity
• Exploring a wide range of alternatives to possibly harmful actions
• Increasing public participation in decision making
Emphasizing human health and a precautionary approach provides a common framework for
decision making. Many of our cities, counties, and states are required to develop comprehensive
plans addressing issues of growth, transportation, land use, and the environment. Th ese plans should
address human health issues by setting targets for specifi c indictors, such as reducing incidence of
asthma, obesity, low infant birth weight, learning disabilities, and cancer. Health indicators, combined
with a precautionary approach, would integrate decision making across the plan promoting
both sustainable growth and public health.
We have the knowledge and resources to make appropriate decisions to protect public health and
the environment. Th e precautionary principle supports an approach to policy making that emphasizes
our responsibility to future generations as we work together to manage the Commons.Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua.
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