An Ethical Appraisal of Hormesis: Towards a Rational Discourse on the Acceptability of Risks and Benefits
American Journal of Pharmacology and Toxicology
It is ethically mandated that potential beneficial aspects of low exposure to potentially hazardous material are incorporated in the risk-benefit balancing procedure. The potential harm done by pollutants does not justify the invocation of a categorical principle. Minimisation of risk is not required if health benefits are also at stake. Society needs to find an informed consent on the threshold of risk below compensation of goods is legitimate and morally justified. Such a threshold can be
... hreshold can be defined context-specific but any human action associated with potential health impacts makes such an acceptability judgment -implicitly or explicitly. Incorporating hormesis into risk management forces regulators to make such thresholds explicit. Once as risk is below this threshold all positive and negative impacts are subject to a relative balancing towards reaching a final judgment on acceptability and necessary risk management options. This balancing risk cannot be reduced to body counts: equity issues, context specific circumstances (voluntary or involuntary exposure, for example), avoidance of risks, the nature of vulnerable groups and many other factors need to be taken into account. Such a complex weighing exercise is best performed by an analytic-deliberative process by which the best available knowledge of impacts (including their uncertain ties) is fed into a deliberating body of individuals representing all sides of the debate. Organizing and structuring an analytic-deliberative discourse for assigning painful trade-offs goes beyond the good intention to have all relevant stakeholders involved in decision making.. Discursive processes need a structure that assures the integration of technical expertise, regulatory requirements, and public values. These different inputs should be combined in such a fashion that they contribute to the deliberation process the type of expertise and knowledge that can claim legitimacy within a rational decision making procedure.