Understanding the Concept of Acceptable Health Risks and Benefits

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The notion of acceptable health risks or benefits is not easy to define. Acceptable risk is essentially the measure of harm or disease that is considered acceptable by a person or an organization (e.g., EPA, CDC, FDA). Whether a risk is acceptable depends upon the benefits derived from taking the risk, the magnitude of the risk, and various economic, political and social factors. We tend to rely on others when we have to determine acceptable health risks, be they risks from exposure to contaminants, or risks and benefits from screening tests and drugs. We often assume that experts in environmental science, biology, medicine, statistics and other disciplines are more qualified to make decisions as to what constitutes an acceptable health risk or benefit. Why don’t we want to make our own decisions? Largely because there is a prevailing view that acceptable risk values are based on the analysis and interpretation of scientific data and results. But this is simply not the case. Acceptable risks and benefits are based, in large part, on public acceptance, political agenda and economic considerations. It may seem counterintuitive, but there is no science involved in this process. Having the proper data available in a user-friendly format will enable each of us to determine the level of benefits and risks which we are willing to accept. We have a right to this information, and an acknowledgement of this right will serve to empower patients and citizens. This presentation will use specific examples (e.g., cancer screening tests, lowering cholesterol, exposure to environmental contaminants) and a unique graphic (Risk Characterization Theater) to illustrate how patients and citizens can become empowered to determine their own level of acceptable risk.
Paper presented at the 1st International Symposium on Understanding Health Benefits and Risks: Empowering Patients and Citizens. Johns Hopkins University, Baltimore, Maryland. May 29, 2009