American Council on Science & Health (ACSH)  [Printer-friendly version]
June 25, 2002


[Rachel's introduction: Henry I. Miller is one of the most flamboyant
opponents of the precautionary principle. He is a professor at
Stanford University who rarely lets mere facts stand in the way of a
good yarn about the dangers of foresight and forecaring.]

By Henry I. Miller, M.D.

It used to be said that the most fearsome statement in the world is,
"I'm from the government and I'm here to help you." Now, government
officials have the "precautionary principle," which supposedly will
make our lives safer. In fact, the principle -- which is not really a
principle at all but a seemingly plausible excuse for opposing
innovation -- has already laid waste to several industries and boasts
a body count in the millions.

The Environmental Protection Agency has just provided another
egregious example: a crackdown on the most reliable kind of blood
pressure cuffs -- which I and other doctors consider to be the
standard for accuracy -- in order to cut down on the use of mercury,
which can pollute the air and water if disposed of carelessly.

The basic idea of the precautionary principle, which the EPA and other
regulatory agencies often employ senselessly, is that even if there is
no scientific evidence of actual dangers of a product, technology or
activity, merely conjectural concerns should be a reason to limit or
prohibit it. For example, although used for decades, I have never
heard of a mercury spill from a broken blood pressure cuff. In any
event mercury toxicity under these conditions would be modest. The
EPA's action is ill-considered, myopic and dangerous: Inaccurate blood
pressure measurements can lead to under- or over-medication of a
person with a life-threatening disease.

The precautionary principle is sometimes represented as being like
Mom's admonition "better safe than sorry," or is said to reflect
regulators' remonstrations that they're just "erring on the side of
safety." But the way the precautionary principle is typically applied
can actually increase risk.

The principle focuses on the possibility that technologies could pose
unique or unmanageable risks, even after considerable testing has
already been conducted. Missing from precautionary calculus is an
acknowledgment that even when technologies introduce risks, most
confer net benefits -- that is, their use reduces many other, more
serious hazards. The danger in the precautionary principle is that it
distracts from known threats to health. For example, in eighteenth-
century Europe, excessive precautionary bias delayed for decades the
introduction of the first smallpox vaccine, while millions died

And thirty years ago, on the basis only of suspicion of toxicity to
fish and migrating birds (but no evidence of harm to humans), the EPA
drastically restricted production and use of DDT, an inexpensive and
stunningly effective pesticide once widely used to kill mosquitoes and
other disease-carrying insects. With the ensuing reduction of global
DDT use, the World Health Organization estimates that 300 million to
500 million cases of malaria occur annually and more than one million
people die. (See our article "DDT and Chemophobia" and ACSH's press
release and report on the DDT ban.)

Another horrendous example of the precautionary principle in action
occurred in the late 1980s, when environmental activists, claiming
that carcinogenic byproducts from the chlorination of drinking water
posed a potential cancer risk, persuaded Peruvian officials to stop
chlorinating much of their country's drinking water. That decision
contributed to the acceleration and spread of Latin America's 1991-96
cholera epidemic, which afflicted more than 1.3 million people.

Anti-chlorine campaigners recently have focused their attacks on
certain plastics used for important medical devices, particularly
fluid containers, blood bags, tubing and gloves; children's toys such
as teething rings; and household and industrial items including
flooring. Invoking the precautionary principle, activists claim that
these plastics might have numerous adverse health effects -- even in
the face of significant scientific evidence to the contrary.

Whole industries have been terrorized, consumers denied product
choices, and doctors and their patients deprived of lifesaving tools.
The precautionary principle inflates the cost of research, inhibits
new product development, wastes resources, restricts consumer choice,
creates serious new risks, and costs lives.

Just thinking about it raises my blood pressure.

Henry I. Miller, a physician, is a fellow at the Hoover
Institution and a Director of the American Council on Science and
Health. He was an official at the U.S. Food and Drug Administration
from 1979 to 1994.