NURS 6412 week 7 Discussion Paper
Health Risk Messages
In a setting of public debate—such as congressional hearings, congressional debates, formal regulatory adjudication, and notice-and-comment rule making—democratic risk communication includes a wide range of messages, sources, and audiences. Interested groups raise questions for the experts, who respond; experts from different perspectives dispute with each other; and citizens and their representatives dispute using, among other things, the experts’ findings and criticisms of each other’s results. Messages describing and summarizing scientific knowledge about risks and benefits are important, as are critiques of those messages and that knowledge. In the United States, regulatory decisions must generally be based on the best available scientific knowledge to be defensible against legal challenges. As a result, much risk communication in the regulatory context deals with the adequacy and proper interpretation of scientific evidence. But risk communication also includes expressions of opinion, concern, frustration, and the like by all participants, directed at whomever will hear and might act. Such decision making tends to be adversarial, with political actors making the strongest possible case for their positions, overtly expressing their interests and values or citing expert judgment and analysis depending on which arguments seem most effective. Recipients of risk messages understand that those messages are guided by interests and political positions and so do not expect any single source to offer an unbiased assessment of available scientific knowledge.NURS 6412 week 7 Discussion Paper
Public policy about tobacco smoking illustrates the range of risk messages that come out of public debate. The policy options for risk management involve decisions to be made in different bodies, each using different rules of debate and assigning different roles to the general public within those rules. For instance, the federal government has considered increasing excise taxes on cigarettes, placing warning labels on cigarette packages, funding anti smoking advertising campaigns, distributing informational pamphlets on the health hazards of smoking, and banning smoking in various public places. Other options that might be considered for cigarettes, and that have been used for other health hazards, include outright prohibition on manufacture or sale and restriction to use by prescription only. In state and local governments, debates have also proceeded on options such as banning cigarette advertisements in some public places, raising the minimum age for purchasing tobacco products, banning smoking in municipal buildings, and requiring no-smoking sections in restaurants.NURS 6412 week 7 Discussion Paper
Risk communication varies from one of these decision-making arenas to another. Citizens participate in legislative settings by attempting to influence their representatives directly or by affecting the general climate of opinion and thus achieving indirect influence. In federal regulatory decision making, there is also wide latitude for participation, although the Administrative Procedures Act and agencies’ practices constrain the time and type of participation and the kinds of arguments that can be introduced (Greenwood, 1984). Agency procedures differ, particularly in terms of how much two-way communication they allow and how much they do to provide expert knowledge to the citizenry at large. Nevertheless, public debate in the regulatory or legislative context allows for risk messages and other related messages from a large number of sources.NURS 6412 week 7 Discussion Paper
We consider risk communication in a setting of public debate successful to the extent that it raises the level of understanding of relevant issues or actions among the affected and interested parties and those involved are satisfied that they are adequately informed within the limits of available knowledge. As noted in Chapter 1, successful risk communication does not imply optimal risk decisions; it only ensures that the decisions are informed by the best available knowledge. Also as noted in Chapter 1, raising the level of understanding requires more than making accurate information accessible to the interested parties. Success requires increased understanding of the issues to the extent that the parties involved desire to understand. Although individual risk messages may contribute to increased understanding, the net effect of risk communication on understanding depends on all the messages individuals receive and their interpretation of them. Therefore, the designers of risk messages who wish to increase the recipients’ understanding need to take into account the recipients’ willingness and ability to receive and understand the messages as well as the effects of other, sometimes conflicting, messages that they may also receive.NURS 6412 week 7 Discussion Paper