title: The risk-benefit balance in the United States: who decides?
abstract: A health policy decision often requires a balancing of risks, costs, and benefits. In this paper we illustrate that there is no uniform answer in the United States to the question of who decides the risk-benefit balance. We use a wide range of case examples from medicine and public health to show the different approaches that are used to allocate decision-making responsibility. Our ultimate purpose is to urge the U.S. health policy community to develop a more consistent way of thinking about how risk-benefit decisions could be guided by general principles.
authors.affiliation: Frederick S. Pardee RAND Graduate School, Santa Monica, California, USA. john_graham@prgs.edu
authors.forename: John
authors.initials: J
authors.lastname: Graham
authors.forename: Jianhui
authors.initials: J
authors.lastname: Hu
mesh_terms: D017278:Air Bags / Q000331:legislation & jurisprudence; D002857:Chromium / Q000506:poisoning; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use; D003657:Decision Making; D017277:Drug Approval / Q000331:legislation & jurisprudence; D006291:Health Policy; D006801:Humans; D006278:Medicare / Q000331:legislation & jurisprudence; D016273:Occupational Exposure / Q000331:legislation & jurisprudence; D019982:Organizational Case Studies; D011050:Policy Making; D018570:Risk Assessment / Q000379:methods; D035703:Therapies, Investigational; D014481:United States
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D002857:Chromium; C074702:chromium hexavalent ion