Imposed risks

The last method is simply an appeal to reason. If a QRA indicates that the risk of a member of the public dying because of an industrial activity is very low (e.g., less than one chance in some very large number), then the risk is negligible in comparison to other imposed risks commonly tolerated by our society (e.g., having an airliner crash into your home). However, such comparisons are often misleading because the risk per year does not necessarily reflect the risk per activity or the risk per hour of exposure. 

Voluntariness. A voluiitaiy risk is much more acceptable to people titan an imposed risk. People will accept tlie risk from skiing, but not from food prcser ativcs, altltough the potential for injury from skiing is 1,000 times greater titan from preser atives... 

Yet, at least some medications have the capacity to significantly impact the health and well-being not only of the individuals who take them, but also of others. In essence, these medications have positive externalities, benefits that are not captured by the individuals who consume the drugs. Medications may also impose risks, or... 

Voluntary Aspects. People voluntarily accept some risks, such as driving a car, and have others imposed upon them, such as water pollution. The line between voluntary and involuntary risks is often hard to define and is frequently determined by availabilty of resources and social practices, e.g., if one has a filter, one could drink only filtered water. In general, the American public, probably reflecting our individualistic biases, is more tolerant of voluntary risks (8). Americans do not readily accept their government to be the arbiter of personal risk, demonstrated by the brouhaha that developed over governmental attempts to mandate use of seat belts and motorcycle helmets (9). (For a good discussion of the broader concept of risk and consent, see 10). Much more acceptable appears to be government efforts to protect the public from imposed risks. 

The major receptor-mediated adverse effect is water intoxication, which can occur with desmopressin or vasopressin. Many drugs, including carbamazepine, chlorpropamide, morphine, tricyclic antidepressants and NSAIDs, can potentiate the antidiuretic effects of these peptides, while lithium, demeclocycline and ethanol can attenuate the antidiuretic response to desmopressin. Desmopressin and vasopressin should be used cautiously when a rapid increase in extracellular water may impose risks (e.g., in angina, hypertension, and heart failure) and should not be used in patients with acute renal failure. Patients receiving desmopressin to maintain hemostasis should be... 

Literature is abundant on the opposition people have to risks they believe to be imposed on them. For some safety practitioners, their resistance to the acceptable risk concept derives from their view that imposed risks are objectionable and are to be rebelled against. Conversely, they accept the risks of activities in which they choose to engage—for example, skiing, bicycle riding, driving an automobile. 

Choice. Imposed risks are less acceptable than voluntary risks. 

In the event that the state or society imposes risks on the individual, this joy of freedom motivating readiness to accept risk is missing and more so with increasing superiority and anonymity of the imposition. This point will have to be looked at more closely later on. 

On the basis of statistical data on risk of death in the United States, C. Starr [9-18] tried to provide a quantitative view off the difference in readiness in the case of voluntarily accepted as compared to imposed risks. 

Thus, if the demand for zero risk must be rejected as a nonsensical, absolute demand in view of technicabpractical conditions prevailing in this world, while the basic claim of the citizen to protection from dangers remains, the measure of protection, and the imposed risk can be determined only in concrete instances according to the principle of the relationship between means and ends. The limitations of our abilities only permit that we transform into reality some of that which is feasible in view of outside, factual reality in this case the moral law commands selection of the best possible alternative. Between equally good or, if the occasion arises, between only probably equally good means and ends there is free choice. What will determine our choice is morally a matter of indifference [9-26]. 

The level of public outrage following device failure and failed risk control is determined by a number of aspects lethality, scale and chances of survival, and risk perception (i.e., voluntary risk versus imposed risk). A lack of fairness on the part of a perpetrator and a lack of social equality for a victim increase public outrage (Sandman 1991). 

Voluntary risks are accepted more readily than those that are imposed Risks under individual control are accepted more readily that those under government control... 

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