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Page 48

graph it is not possible to show beneficial effects, only

harmful effects approaching zero.  Why, one wonders, when

virtually all of the therapies produced by the pharmaceu-

tical industry, including aspirin, are toxic above certain

doses and beneficial below certain doses, should the con-

ventional dose-response curve preclude the possibility of a

benign effect?  The answer, perhaps, lies in the division

of labor discussed above in the section on institutional

management of risk.  The responsibility of most risk man-

agers is to focus on the bottom loop of Figure 1, to try

to minimize the number and magnitude of adverse outcomes.

Thus the first question that the U.S. Food and Drug

Administration or the British Committee on the Safety of

Medicines will ask of a new food or drug is whether it has

harmful effects.  The emphasis of the manufacturers, the

food and drug companies, is likely to be on the top loop,

the rewards to the customer and the profits to themselves.

For medical risks there is a dearth of risk management

institutions that seek to strike a balance between poten-

tial adverse and beneficial consequences.

43. Wendy E. Wagner, "The Science Charade in Toxic Risk

Regulation," Columbia Law Review 95 (1995): 1613-1723.

44. Robert Rohwer, quoted in "Nobody Has Proven That These

Prions Really Exist," Special News Report, Science,

December 7, 1996.  "The prion hypothesis is the 'cold

fusion' of infectious disease--it's a very radical idea,

and just like cold fusion it has some very appealing

aspects.  But because it's so radical it deserves a very

high level of scepticism and scrutiny before it's adopt-

ed."

45. "Not the Last Word on the BSE Crisis," editorial,

Nature 389 (October 2, 1997): 423

46. Jeffrey Almond and John Pattison, "'Protein Only'

Prions," Nature 389 (October 2, 1997): 438.  For a popular

account of the controversy, see Richard Rhodes,

"Pathological Science," New Yorker, December 1, 1997,

pp. 34-49.

47. The propensity of authority to cope with ignorance by

denying its existence is described by Jerome Ravetz in

"The Sin of Science: Ignorance of Ignorance," Knowledge

15, no. 2 (1993): 157-65.

48. Simon Jenkins in Times (London), December 6, 1997.