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Alison Leary: Why does healthcare reject the precautionary principle?


Calls for covid-19 to be an occupational disease have been made, but little action has been taken, says Alison Leary

Having worked in safety critical industries for many years there are things that really stick in my mind. I spent some time with a retired engineer called Allan Macdonald who worked on the space shuttle Challenger in the 1980s. The Challenger exploded on launch, killing seven astronauts. The disaster was not only a tragedy, but a cultural shift for NASA. The political pressures to launch Challenger overrode safety concerns. But Allan MacDonald’s words stuck with me. “Suddenly it was about proving launching would be dangerous, in the past we had to prove things were safe.” In the pressure of politics, NASA effectively abandoned the precautionary principle.

The precautionary principle is important in high risk, high harm, safety critical work. Risks to workers, customers, or service users are substantial, and so the precautionary principle in which precautions are taken until safety is proven, often apply. This is often because there are not large-scale randomised control trials of safety interventions. Pragmatism and a measured approach to risk often apply. A lot of safety is either tombstone legislation or precautionary.

In healthcare it’s different. […]

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