Perhaps due to the advent of the Internet, twenty-four-hour news networks, and the tendency of the media to hype health scares, the public has faster and more extensive access to information (or misinformation) regarding health risks than ever before. So says Ragnar E. Lofstedt in his Risk Management in Post-Trust Society (Palgrave Macmillan, 2005).
It is perhaps this illusion of overnight expertise that has led to the erosion of public trust in technocrats, industry, the government, and others involved in risk management. The public now demands a high level of involvement in regulatory decision-making (particularly in the U.S., which Lofstedt describes as "adversarial" and "litigious" in its approach to public/regulator dialogue), but the public lacks the expertise to make sound decisions regarding the benefits and risks of regulations. Under these circumstances, risk management is difficult. According to Lofstedt, public trust in industry and government regulations cannot be assumed. It must be gained proactively, and the best method of risk management will vary according to the level of and reason for public mistrust.
Through the use of four case studies, Lofstedt argues convincingly that risk management must be approached on a case-by-case basis, with the degree of public involvement, the role of interest groups, and the role of technocrats left fluid and adjustable to specific situations. A case from Germany involving planning for the location of a waste incinerator required extensive public participation in order to ensure the success of the process. In Sweden, decisions by a strict technocracy without public participation resulted in acceptable nuclear safety regulations but only because a high level of public trust existed from the outset. In the United States, a company with a poor environmental and social record achieved its goals and regained public trust by voluntarily including environmental NGOs in its decision-making, but this was done at a high cost to the company. In the UK, a powerful special interest group purposely promoted mistrust between the public and industry, resulting in the failure of regulatory efforts. Although a deliberative approach (one which involves a high level of dialogue between risk managers and the public and/or special interest groups) is currently in vogue, Lofstedt makes the case that this approach will not always lead to the most desirable outcome.
Lofstedt's analysis is both timely and perpetually relevant. The recent clamor over the mercury and autism scare and the controversy surrounding DuPont's management of dioxins in Mississippi are two current examples of public distrust leading to the disconnection of sound science and risk management policy, and doubtless these sorts of debates will continue to arise.
The concepts outlined in Risk Management are informative for those seeking to make sense of the battle for legitimacy in the eyes of an increasingly jaded public. It is, however, probably not for the casual reader.
Mara Burney is a research associate at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).
