title: Developing scientific and policy methods that support precautionary action in the face of uncertainty--the Institute of Medicine Committee on Agent Orange.
abstract: To be precautionary, decisions must be made to prevent the impacts of potentially harmful activities even though the nature and magnitude of harm have not been proven scientifically. The Institute of Medicine's Committee on the Health Effects in Vietnam Veterans of Exposures to Herbicides provides a novel example of science and policy structures that support precautionary action in the face of uncertainty. What makes this example unique is the clear set of precautionary decision rules that lowered the standard for evidence, which formed the basis for policy. These rules, established by Congress, strongly influenced the way scientific information was weighed and the subsequent compensation decisions. They encouraged committee members to think outside the confines of their disciplines and develop new tools and methods to fit their unique mandate. The result was a methodology, supported by strong institutional structures, that allowed scientists to discuss the evidence as a whole, reach decisions as a group, and clarify uncertainties.
authors.affiliation: Department of Work Environment, University of Massachusetts Lowell, 01854, USA. joel_tickner@uml.edu
authors.forename: Joel A
authors.initials: JA
authors.lastname: Tickner
mesh_terms: D015085:2,4,5-Trichlorophenoxyacetic Acid / Q000009:adverse effects*; D015084:2,4-Dichlorophenoxyacetic Acid / Q000009:adverse effects*; D026683:Advisory Committees; D000075182:Agent Orange; D015984:Causality; D035881:Compensation and Redress / Q000331:legislation & jurisprudence; D032921:Consensus; D003657:Decision Making; D003678:Defoliants, Chemical / Q000009:adverse effects*; D004781:Environmental Exposure / Q000009:adverse effects* / Q000191:economics / Q000331:legislation & jurisprudence; D006801:Humans; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division / Q000458:organization & administration*; D011050:Policy Making; D000072317:Polychlorinated Dibenzodioxins / Q000009:adverse effects*; D011640:Public Policy; D018570:Risk Assessment / Q000379:methods*; D012586:Science; D013995:Time; D035501:Uncertainty; D014481:United States; D014728:Veterans; D014744:Vietnam; D014857:Warfare
chemical_list: D003678:Defoliants, Chemical; D000072317:Polychlorinated Dibenzodioxins; D015084:2,4-Dichlorophenoxyacetic Acid; D000075182:Agent Orange; D015085:2,4,5-Trichlorophenoxyacetic Acid