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Institute of Medicine (US) Roundtable on Environmental Health Sciences, Research, and Medicine. Environmental Health Sciences Decision Making: Risk Management, Evidence, and Ethics - Workshop Summary. Washington (DC): National Academies Press (US); 2009.

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Environmental Health Sciences Decision Making: Risk Management, Evidence, and Ethics - Workshop Summary.

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5General Workshop Discussion1


Throughout the final discussion, the issue of transparency in the scientific processes was pervasive. This served as the underpinning for other discussion topics, which included the need for context when looking at conflicts of interest and the weight of the evidence, a possible scientific code, and the future direction of scientific decision making.


When discussing conflicts of interest, it is important to determine what it means, for example, whether it is financial or intellectual bias. Participants often noted that what individuals see as bias may in fact only be a perceived bias. Goldman pointed out the growing perception that government scientists, as well as industry scientists, will have a certain point of view or be advocates for a certain position, a perception that can make it very difficult to operate in an open and collaborative fashion. On that point, Hattis raised the issue of client-sponsor relationships and the overall need for an honest dialogue about the likely outcomes of the scientific endeavor, as well as the need for full disclosure and transparency for all outcomes, not just favorable ones.

Other participants suggested that conflict of interest needs to be put into the context of use. Some situations call for elimination of the conflict of interest, while others may necessitate managing it. Farland argued that what is problematic for the scientific decision-making process is not the conflict itself but the impact it may have on the context of a situation. Michaels agreed that there may be certain situations for which context comes into play. For example, a government advisory committee meeting for which a vote is expected should not be composed of people with conflicts of interest, as the credibility of the process may be questioned. Some participants noted that conflict of interest can derail the scientific process and needs to be resolved.


Further discussion focused on how to ensure openness and a systematic structure in the environmental health decision-making process. Goldman proposed that it may be time for the field to develop a code of ethics similar to that used in the legal profession, since there is no current agreed-on roadmap to ensure that biases and points of view are noted. In the legal profession’s code of ethics, once a conflict is identified, lawyers recuse themselves from the situation; this is looked on favorably as a way to avoid conflict and bias. Hattis explained an effort to do this in the community of risk analysts that took the form of a set of “ideals” (Hattis, 2000). On this point, Michaels argued that while codes of ethical conduct can be beneficial in certain professions, when it comes to decision making, those with financial conflicts of interest should not be in a decision-making position, regardless of a code. Ultimately, one participant stated, the facts matter, and when looking at conflict, whether from a legal or scientific perspective, facts are what should drive the decision-making process.


The discussion concluded with input from the speakers and the audience as to the future direction of scientific decision making. Numerous suggestions were offered as a path to making overall improvements in the current decision-making process. The list below does not constitute recommendations of the group, but rather captures the range of ideas that people would like to see explored in future discussions. These include

  • Not necessarily instituting a standard for how one actually weighs the evidence, but rather providing a rationale for the inclusion and exclusion of material studied in order to simply show why something should or should not be studied.
  • Tailoring the approach to decision making to eliminate the “one size fits all” risk assessment and incorporate context.
  • Discussing regulatory agency decisions to explain why agencies are regulating some substances and not others. This could eliminate the presumption of innocence in the current decision-making process.
  • Developing more examples of successful risk assessment in which the science is complete and solid enough to actually perform a service to the risk assessment process.
  • Realizing that risk assessment needs to be made from different perspectives (e.g., economics) and that these perspectives can change the outcome.
  • Creating a term appointment for the heads of scientific agencies, which would stabilize the leadership of government agencies in order to make the process more scientifically focused.
  • Engaging stakeholders, including the affected public, to a greater degree than currently exists and educating the public on the scientific decision-making process to provide opportunities to hear diverse viewpoints.
  • Focusing on risk avoidance rather than acceptable risk, as this is the information that the American public wants.
  • Recognizing that the risk assessment decision is not stagnant but dynamic and based on new science. As such, criteria should be put in place to review risk assessment decisions.
  • Developing and using a metric to quantify how scientific information is understood and translated into public health.



The general workshop discussion encompasses the discussion of the panelists’ comments in Chapter 4 and general themes of the workshop. These have been consolidated into this chapter.

Copyright © 2009, National Academy of Sciences.
Bookshelf ID: NBK50717


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