Abstract
It is almost universally acknowledged that risks have to be weighed against benefits, but there are different ways to perform the weighing. In conventional risk analysis, collectivist risk-weighing is the standard. This means that an option is accepted if the sum of all individual benefits outweighs the sum of all individual risks. In practices originating in clinical medicine, such as ethical appraisals of clinical trials, individualist risk-weighing is the standard. This implies a much stricter criterion for risk acceptance, namely that the risk to which each individual is exposed should be outweighed by benefits for that same individual. The different choices of risk-weighing methods in different policy areas seem to have emerged from traditional thought patterns and social relations, rather than from explicit deliberations on possible justifications for the alternative ways to weigh risks against benefits. It is not obvious how the prevalent differences in risk-weighing practices can be reconstructed in terms of consistent underlying principles of preventive health or social priority-setting.
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References
Amdur, R. J., and Biddle, C. J.: 2001. 'An algorithm for Evaluating the Ethics of Placebo-controlled Trial', International Journal of Cancer 96, 261–269.
Beauchamp, T. L., and Childress, J. F.: 2001, Principles of Biomedical Ethics. 5th ed., Oxford: Oxford University Press.
Cohen, B. L.: 2003, 'Probabilistic Risk Analysis for a High-Level Radioactive Waste Repository',Risk Analysis 23, 909–915.
Gerrard, M. B.: 2000, 'Risks of Hazardous Waste Sites Versus Asteroids and Comet Impacts: Accounting for the Discrepancies in US Resource Allocation', Risk Analysis 20, 895–904.
Gifford, F.: 1995, 'Community-equipoise and the Ethics of Randomized Clinical Trials',Bioethics 9, 127–148.
Golz, H. H. et al.: 1966, 'Report of an Investigation of Threshold Limit Values and Their Usage', Journal of Occupational Medicine 8, 280–283.
Hansson, S. O.: 1993, 'The False Promises of Risk Analysis', Ratio 6, 16–26.
Hansson, S. O.: 1998, Setting the Limit. Occupational Health Standards and the Limits of Science. Oxford: Oxford University Press.
Hansson, S. O.: 2001, 'The Modes of Value', Philosophical Studies 104, 33–46.
Hansson, S. O.: 2003, 'Ethical Criteria of Risk Acceptance', Erkenntnis 59, 291–309.
Hansson, S. O., and Peterson, M.: 2001, 'Rights, Risks, and Residual Obligations', Risk Decision and Policy 6, 1–10.
Karlawish, J. T. and Lantos, J.: 1997, 'Community Equipoise and the Architecture of Clinical Research', Cambridge Quarterly of Healthcare Ethics 6, 385–396.
Knuth, B. A., Connelly, N. A., Sheeshka, J., and Patterson, J.: 2003, 'Weighing Health Benefit and Health Risk Information when Consuming Sport-Caught Fish', Risk Analysis 23, 1185–1197.
London, A. J.: 2001, 'Equipoise and International Human-Subjects Research', Bioethics 15, 312–332.
Longwood, M.: 1983, 'Sins of Omissions: The Non-treatment of Controls in Clinical Trials, I', Aristotelian Society, Supplementary volume 57, 207–222.
Luloff, A. E., Albrecht, S. L., and Bourke, L.: 1998, 'NIMBY and the Hazardous and Toxic Waste Siting Dilemma: The Need for Concept Clarification', Society and Natural Resources 11, 81–89.
Mishan, E. J.: 1985, 'Consistency in the Valuation of Life: A Wild Goose Chase?', in E. F. Paul, F. D. Miller, Jr., and J. Paul (eds.), Ethics and Economics, Oxford: Basil Blackwell, pp. 152–167.
Otway, H.: 1987, 'Experts, Risk Communication, and Democracy', Risk Analysis 7, 125–129.
Pandey, M. D. and Nathwani, J. S.: 2003, 'Canada Wide Standard for Particulate Matter and Ozone: Cost-benefit Analysis Using a Life Quality Index', Risk Analysis 23, 55–67.
Peterson, M.: 2002, 'What is a De Minimis Risk?', Risk Management 4, 47–55.
Rolleston, F.: 2001, 'Uncertainty About Clinical Equipoise', CMAJ 164, 1831.
Sackett, D. L.: 2000a, 'Why Randomized Controlled Trials Fail But Needn't: 1. Failure to Gain 'Coal-face' Commitment and to Use the Uncertainty Principle', CMAJ 162, 1311–1314.
Sackett, D. L.: 2000b, 'Equipoise, A Term Whose Time (if it Ever Came) Has Surely Gone', CMAJ 163, 835–836.
Sackett, D. L.: 2001, 'Uncertainty About Clinical Equipoise. The Author Responds', CMAJ 164, 1831–1832.
Shapiro, S. H. et al.: 2000, 'Why Sackett's Analysis of Randomized Controlled Trials Fails, But Needn't', CMAJ 163, 834–835.
Thompson, K. M., Segui-Gomez, M., and Graham, J. D.: 2002, 'Validating Benefit and Cost Estimates: The Case of Airbag Regulation', Risk Analysis 22, 803–811.
Usher, D.: 1985, 'The Value of Life for Decision-making in the Private Sector', in E. F. Paul, F. D. Miller, Jr., and J. Paul (eds.), Ethics and Economics, Oxford: Basil Blackwell, pp. 168–191.
Veach, R. M.: 2002, 'Indifference of Subjects: An Alternative to Equipoise in Randomized Clinical Trials', Social Philosophy and Policy 19, 295–323.
von Stackelberg, K. E. et al.: 2002, 'Importance of Uncertainty and Variability to Predicted Risks from Trophic Transfer of PCBs in Dredged Sediments', Risk Analysis 22, 499–512.
Weijer, C. et al.: 2000, 'Clinical Equipoise and Not the Uncertainty Principle is the Moral Underpinning of the Randomised Controlled Trial', BMJ 321, 756–757.
Weijer, C. W. and Glass, K. C.: 2002, 'The Ethics of Placebocontrolled Trials', New England Journal of Medicine 346, 382–383.
Wikman, P.: in press, 'Trivial Risks and the New Radiation Protection System', Journal of Radiological Protection.
Ziem, G. E. and Castleman, B. I.: 1989, 'Threshold Limit Values: Historical Perspectives and Current Practice', Journal of Occupational Medicine 31, 910–918.
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Ove hansson, S. Weighing Risks and Benefits. Topoi 23, 145–152 (2004). https://doi.org/10.1007/s11245-004-5371-z
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DOI: https://doi.org/10.1007/s11245-004-5371-z