3.25 it is the role
of the Government to provide information about risk.
But in most cases it is for the individual to decide
whether to take the risk. And there is also a balance
between risk and personal freedom. Some people enjoy
pursuing outdoor sports which others would consider
too dangerous to undertake. As long as people are
aware of the risk which they are taking, it is their
decision whether to put themselves at risk.
Guiding
principles and key steps
3.26 The guiding
principles and key steps in our approach to risk are:
Guiding
principles
- high
quality assessment of science
- full
risk/benefit evaluation
- consistency
of approach across risk areas
- clear
framework of interventions
- approach
should have integrity if judged in
retrospect
- protect
the vulnerable
- realistic
sharing of uncertainty
- information
should provide insight
- greater
public participation in risk
deliberations
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Key
steps
- ensuring
that there is access to high quality
scientific and medical advice
- communicating
to the public an assessment of risk
at an early stage making clear the
areas of uncertainty
- giving
advice where there is public anxiety
because people do not know what sort
of a risk they might be facing
- identifying
the options for intervening to
eliminate, reduce or control the risk
- selecting
the appropriate option(s) in a way
which involves the public and
evaluates its appropriateness against
specific criteria
- ensuring
that the intervention is successful
in controlling the risk for which it
was intended
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1.26 People are
responsible for their own actions in health as in
other areas. But the decisions people take over their
health are more likely to result in better health and
a healthier life if they have the opportunity to make
informed decisions.
1.29 For people to make such decisions against the
background of such powerful determinants, they need
to make informed decisions. Such decisions must be
based on information about the risks involved in a
range of activities, practices and products. People
cannot and should not be pressured into
responsibility. We do not believe in the old
nanny-state approach. But there is a powerful role
for Government in making clear the nature and scale
of risk, and in some cases, taking protective action
in the light of it.
1.33 Individuals are central to our new vision for
better health. People need to take responsibility for
their own health - and many are doing so. There is a
new and clear realisation that individuals can
improve their health, by what they do and the actions
they take.
1.37 Government will play its part by creating the
right conditions for individuals to make healthy
decisions.
1.41 ... tackling smoking depends on relieving the
conditions - social stress, unemployment, poor
education, crime, vandalism - which lead far more
people in disadvantaged communities to smoke than in
other sections of the community.
Communicating
risk
3.15 Every day
people are faced with decisions in their daily lives,
including decisions which affect their health.
Sometimes they recognise that certain decisions put
their health at greater risk than others. But it is
not always clear how great or small a risk they are
taking.
3.16 We can help
people to understand better about risk. Driving a car
is a daily necessity for many, playing sport an
occasional pleasure, and eating a plate of shellfish
from a roadside caravan a personal preference. All,
however, can carry risks of death, injury or acute
illness. Armed with knowledge and information about
risk, and being aware of the conditions under which
risks can be greater, people can make informed
decisions in managing their everyday life.
3.17 There are other
potential risks to health where individuals expect
Government or other responsible bodies to ensure that
measures are in place to protect their health. For
example, people expect to have a safe supply of pure
drinking water; they do not expect a fast food
restaurant to serve them partially cooked frozen
chicken; and they do not consider it their
responsibility to check that a train in which they
are about to travel will be operated by a properly
trained and competent driver.
3.18 There are still
other risks to health where the public accepts that
there is a need for more than passive release of
information to allow them to make a decision. For
example, in areas where lifestyle can affect health -
HIV and AIDS, cigarette smoking, use of medicines in
pregnancy - most people will expect the Government to
have an active programme of education to explain the
risks and advise the individual on the action to be
taken to avoid them. They will also expect special
efforts to be made in relation to children, young
people, and those who are vulnerable or at
particularly high risk.
3.22 Initiatives
deployed to reduce risks to health .... include:
information and labelling, health education,
counselling and support, skills training, regulation,
legislation to manage the performance of health
services and good surveillance.
3.23 Perhaps because
of the very diversity of factors which can pose a
risk to health, perhaps because of their complexity,
or perhaps because of the apparently unique
circumstances of each, no clear ground rules have
been established in the past on the interventions to
be used when a hazard poses a risk to human health.
3.24 In some fields
of health, being exposed to a risk carries with it no
benefits and therefore the aim has to be to eliminate
or substantially reduce the risk. In most other
situations a potential risk must be weighed against a
potential benefit. Vaccines carry great benefits.
They prevent diseases which can sometimes be deadly.
Against these benefits must be balanced the rare risk
of an adverse reaction to the vaccine. Similarly,
medicines can relieve pain, restore lost function
and, sometimes, save life. They carry risks in the
form of side-effects, some minor, some major.