CBA and Precaution: Policy-Making about Emerging Technologies

Hastings Cent Rep. 2018 Jan:48 Suppl 1:S88-S96. doi: 10.1002/hast.824.

Abstract

In the technology assessment literature, the leading alternative to CBA-like methods is usually held to be precaution, which is understood in various ways but is always about making decisions under conditions of uncertainty. Under such conditions, proponents of precaution commonly hold, a straightforward tallying of potential outcomes does not seem possible. Since CBA aims to tally up outcomes to determine which outcome would produce the greatest public benefit, precaution begins to look like, not just an alternative to CBA, but an incompatible alternative. Nonetheless, some of the better-known formulations of a precautionary principle expressly call for combining precaution with assessment of costs and benefits. This essay examines the possible intersection of precaution and CBA. It argues that a moderate kind of CBA is a necessary part of a moderate kind of precaution. The existing proposals for integrating CBA and precaution start with an assumption that the integrative task consists in combining decision tools that generate (contrasting) substantive guidance. An alternative approach, explored here, starts with the idea that precaution is not a decision-generating tool. Rather, it is a way of organizing the thinking that leads eventually to substantive conclusions. The appropriate policy response is reached not by applying a principle but by studying the situation-the proposed action and the problem it is meant to address-and developing recommendations tailored to it. What makes the thinking precautionary is that it emphasizes certain questions-about risk, uncertainty, and values-that CBA tends to suppress. So understood, precaution may well slow the science but is not intrinsically opposed to science or innovation. It can be understood, in fact, as continuous with the science because the contextual understanding of the science and the problems it is meant to address would emerge-in part-from a close engagement with the science.

MeSH terms

  • Cost-Benefit Analysis*
  • Policy Making*
  • Risk Assessment
  • Technology Assessment, Biomedical* / economics
  • Uncertainty