Imagine where we might be today if we did not have antibiotics,
the contraceptive pill, the discovery of DNA, or the smallpox vaccine.
A recent survey by the Royal Institution asked 40 members
of the scientific community to list some significant discoveries that
would not have occurred if they had been subject to the constraints
of the ‘‘precautionary principle.’’ (British Medical
Journal, 10 May 2003) The innovations listed above were among the discoveries
that might have never happened. Nonetheless, today the so-called precautionary
principle (the assumption that experimentation should take place only
when there’s a guarantee that the outcome will not be harmful)
hampers the progress of many current policy decisions in areas such
as stem cell science, genetically modified organisms (GMOs), and a host
of other areas, threatening the future of scientific innovation.
The release of a study from researchers at Stockholm University
who found that a substance called acrylamide, which is formed during
cooking a wide range of food stuffs, can cause cancer attracted international
interest. Early reports from experts found that acrylamide was formed
during the preparation of food, and at high levels predicted explanation
of some of the cases of cancer caused by food. The evidence did not
support the claim, yet the outcome of the subsequent media frenzy continued
to produce significant doubt and mistrust.
Today confidence in government and other ‘‘credible’’
pronouncements about risk—whether of terrorist threats, food safety,
Sudden Acute Respiratory Syndrome (SARS), or Monkey pox—continue
to challenge the public to do the right thing. Competing messages by
the media and others continue to make the public uneasy about the progress
and huge
opportunities presented by areas of science including biotechnology
and information technology.
As all of us are health communicators, we ought to be
aware of the role we play in the proactive and reactive approaches to
risk. Such areas of Knowledge Management, Knowledge Sharing, and Knowledge
Utilization are amongst our arsenal to approach a wary public. If we
elicit, codify, organize, and strategically communicate knowledge so
that policymakers and the public can make use of these findings and
react appropriately, we would be contributing to progress with ideal
policy and practice decisions.
Of course, the need to tailor communication for different
audiences is resource intensive, requiring discrimination between evidence
and values, requiring medical knowledge and understanding, effective
use of language(s), and knowledge of the needs and interests of end
users.
In today’s world highly skilled experts often use
acronyms and complex terms that make their message more complicated.
This is another risk that could ‘‘turn off’’ the
audience, as they do not want inadequate or inappropriate information.
In order to stimulate appropriate use of information, clear, reliable,
and relevant information is the
key to credibility.
The overall ability to reach people with credible sources
is the fact that most people do not trust elected officials, the leaders
who join via media to communicate to the public. Hence, ‘‘trust
me’’ has given way to ‘‘show me.’’ Sometimes
it evolves to ‘‘prove it.’’ As the public is more
discriminatory about information, involvement in the process is critical
to success. Involvement could address the challenges of basing a decision
on an early, ‘‘false negative’’ that could be just
as damaging to society as failing to act because of an early, ‘‘false
positive.’’
Since the level of risk acceptable to society varies from
country to country, and individual to individual, many factors contribute
toward the feeling of well-being and the decision(s) in these areas.
Although most people realize that living in a risk-free society is an
illusion, they demand to live in a society where risk is minimized.
More importantly,
they want to retain control over when and where to assume risk. Voluntary
and involuntary risks will always have differing emotional responses.
Finally, as risk and policy are clearly intertwined, an
indictment of the precautionary principle is not the goal. Rather we
should learn from past mistakes and issues and develop a precautionary
approach to future challenges. However, such an approach will also be
subjective and susceptible to abuse by policy-makers. Involvement of
stake-holders
in society—the public—with fairness and equity at every step
of the way would be advancement of risk management and health communication
practice. With long term scientific and procedural safeguards built
into risk management decisions that are based in part on precaution,
adoption of precautionary measures that addresses the benefits,
risks, and costs of alternative precautionary measures would be valuable.
It is the sincere hope that we can advance the art and
science of health communication with the goal of making the world a
better place for ourselves, our children, and our children’s children.
_____
Scott C. Ratzan MD, MPA is Editor-in-Chief of the Journal
of Health Communication: International Perspectives.
