Health Risk Policy Analysis - Decision Making Principles

In a review of the various risk management frameworks used by agencies throughout the world, Jardine et al. (2003) proposed ten principles that can provide guidance in the risk management decision making process. These principles are based on fundamental ethical principles and values, and should be employed in a flexible manner considering the risk situation at hand. Many of these principles have been incorporated into the Canadian Government’s approach (Government of Canada).

1. Do more good than harm (beneficence, non-malificence)

Because zero risk is not attainable, all decisions will involve tradeoffs. However, remembering that the ultimate goal of risk management is preventing or minimizing the risks, decisions that result in “good” as much as possible should be made.

2. Fair process of decision making (fairness, natural justice )

Given the circumstances of each situation, decisions in risk management must be fair and objective as much as possible. Fairness can be achieved by the equal consideration of the concerns of all the parties involved, including vulnerable and sensitive populations who may be unable to voice their needs.

3. Ensure an equitable distribution of risk (equity)

To achieve an equitable distribution of risk, decision makers must consider individual risk versus the collective well being, and ensure that private gains don’t outweigh public values.  

4. Seek optimal use of limited risk management resources (utility)

Because resources available to reduce risks are always limited, they should be efficiently allocated in order to achieve most risk reduction or overall benefit.

5. Promise no more risk management than can be delivered (honesty)

Honesty in risk management will avoid conflicts and unrealistic expectations that cannot be met. Honesty can be achieved by understanding and disclosing the limitations of the risk assessment and risk management process. .

6. Impose no more risk than you would tolerate yourself (the Golden Rule)

This principle guides decision makers to understand the perspectives of those affected and can be achieved by active consideration as well as the participation of involved parties in the risk identification stage.

7. Be cautious in the face of uncertainty (“better safe than sorry”)

When faced with uncertainty regarding potential serious and irreversible risks, it is recommended that a cautious  approach should be adopted and that decisions made be open reassessment as new information becomes available.  

8. Foster informed risk decision making for all stakeholders (autonomy)

Because people have the right for self determination and informed decision making, they should be involved in making decisions that affect their lives, as well as have access to all the available information required for making informed decisions.

9. Risk management processes must be flexible and evolutionary to be open to new knowledge and understanding (evolution, evaluation, iterative process)

Risk management process must be flexible in order to accommodate new information as it becomes available. Consequently, decisions should be constantly revised and changed if found necessary.

10. The complete elimination of risk is not possible (life is not risk free)

Because risks cannot be eliminated from our environment, safety cannot be defined in terms of zero risk. Hence, management decision made should arrive at a sufficiently low level of risk that constitutes safety.

References:

Jardine C.G., Hrudey S.E., Shortreed J.H., Craig L., Krewski D., Furgal C. and McColl S. (2003). Risk management frameworks for human health and environmental risks. Journal of Toxicology and Environmental Health, Part B. 6: 569–641.

Government of Canada, (May 2000). A Framework for Science and Technology Advice: Principles and Guidelines for the Effective Use of Science and Technology Advice in Government Decision Making. Industry Canada. online: http://dsp-psd.pwgsc.gc.ca/Collection/C2-500-2000E.pdf.