The draft ICRP report Ethical Foundations of the System of Radiological Protection has been submitted for public consultation on the Internet. The present document includes comments from ACRO, a French NGO.
ICRP claims that the purpose of the draft report is to “describe how the Commission has used ethical values in developing the system of radiological protection with the objective of presenting a coherent view of how ethics is part of this system”. Actually, this is not what is really done in the draft report.
ICRP rather consider how the three fundamental principles of protection - justification, optimisation, and limitation - that are central to the system and apply to the different types of exposure situations are related to four core ethical values: beneficence/non-maleficence, prudence, justice and dignity. It never considers whether these ethical values are fully taken into account in radiation protection rules.
ICRP notes that “this relatively recent interest in ethical aspects of radiological protection is certainly not unrelated to the difficulties encountered for decades by radiological protection professionals facing the questions and concerns of citizens. The traditional emphasis on the science of radiation has been shown to be insufficient, and it is now recognised that human and ethical dimensions of exposure situations are important and sometimes decisive in both the decision making process and in communication”. As examples, ICRP cites the management of the consequences from the Chernobyl accident, radioactive waste management and the increasing use of medical applications, all situations where its recommendations have been challenged and criticized by exposed persons. Ethical values are then seen as a tool to communicate with the public.
For the sake of completeness, let us recall the three fundamental principles of the present radiological protection system:
• “The principle of justification, which states that any decision that alters the exposure situation should do more good than harm. This means that, by introducing a new radiation source in planned exposure situations, or by reducing exposures in existing and emergency exposure situations, one should achieve sufficient benefit to offset any costs or negative consequences. The benefits are deemed to apply to society as a whole, to specific individuals and also to biota.
• The principle of optimisation, which stipulates that all exposures should be kept as low as reasonably achievable taking into account economic and societal factors. It is a source-related process, aimed at achieving the best level of protection under the prevailing circumstances through an ongoing, iterative process. This principle is the cornerstone of the system of protection. Furthermore, in order to avoid inequitable outcomes of the optimisation procedure the Commission recommends restricting doses to individuals and biota from a particular source.
• The principle of limitation, which declares that individual exposures should not exceed the dose limits recommended by the Commission, and applies only to planned exposure situations other than medical exposure to patients or exposure of biota.”
The first two principles can lead to conflicting situations. The benefit of some people or the society as a whole could lead to the exposure of other people who do not benefit from this exposure. Similarly, the economic and societal factors are vague enough to lead to conflicting situations that are never addressed in the present draft report. This is the case for example with uranium mining in countries that do have nuclear power plants. Neighbouring communities generally do not benefit from the mine although they are exposed to the radioactive dust. Their societal and economical factors do not weight much in front of the societal and economical factors of the countries where the nuclear power plants are implented.
Regarding existing exposure situations after a large-scale nuclear accident, the economic and societal factors of the population living in contaminated territories are not the same as the ones of the other parts of the country. For example, the former want to sell their agricultural production and the later avoids internal contamination.
These two examples raise difficult ethical issues related to radiological protection that are never addressed in the draft ICRP report.
Let us consider now the four core ethical values. ICRP explains that “beneficence means promoting or doing good, and non-maleficence means avoiding causation of harm […] In a narrower sense, beneficence includes consideration of direct benefits, for individuals, communities, and the environment. The use of radiation, although coupled with certain risks, undoubtedly can have desirable consequences, such as the improvement of diagnostics or therapy in medicine, or the production of electricity. These have to be weighed against the harmful consequences.”
ICRP recognize that the assessment of beneficence and non-maleficence is a key challenge but has nothing else to propose than recommending, “that such an assessment [should] be transparent about what was included, recognise disagreements where they arise, and go beyond a simple balancing of direct health impacts against economic costs.” ICRP provides no example of good practice arising from these recommendations that are rarely implemented.
“Prudence is the ability to make informed and carefully considered choices without the full knowledge of the scope and consequences of actions […] The implications of this prudent attitude have been significant for the subsequent structuring of the system of radiological protection.” However, exposure limits have always been reduced over the years and the ICRP never asks itself whether its recommendations where prudent enough in the past.
ICRP notes that “neither prudence nor the precautionary principle should be interpreted as demanding zero risk, choosing the least risky option, or requiring action just for the sake of action.” But populations do have the right to choose the least risky option and requiring actions for the sake of a better protection.
“Justice is usually defined as fairness in the distribution of advantages and disadvantages among groups of people (distributive justice), fairness in compensation for losses (restorative justice), and fairness in the rules and procedures in the processes of decision-making (procedural justice). […] As with dose constraints and reference levels, dose limits are tools to restrict individual exposure in order to ensure fairness in the distribution of risks across the exposed group of individuals.”
Before considering a “fair” distribution of the risks one should wonder whether such risks are acceptable or not.
Moreover some categories of people are more sensitive to radiations than others. It is particularly the case of children and infants. Justice would mean a better protection with lower limits for them. This is a strong request from families living around the Fukushima dai-ichi nuclear power plant. Some of them evacuated without any support in order to protect their children.
Similarly, individuals are not all equal in terms of genetic heritage and part of this population of hypersensitivity to the adverse effects of radiation (1 to 3% are heterozygous for ataxia telangiectasia). The radiation protection system cannot be built to protect the majority of citizens, but all citizens.
Anand Grover, Special Rapporteur of the Human Rights Council, in his report about the situation in Fukushima notes that “ICRP recommendations are based on the principle of optimisation and justification, according to which all actions of the Government should be based on maximizing good over harm. Such a risk-benefit analysis is not in consonance with the right to health framework, as it gives precedence to collective interests over individual rights. Under the right to health, the right of every individual has to be protected.”
ICRP does not address this issue of individual health in its draft report. How can it expect to answer to the demands of the populations and be understood by them?
“Intergenerational justice has been addressed by the Commission for the management of radioactive waste […]. The Commission introduces responsibilities towards future generations in terms of providing the means to deal with their protection”. Justice could also be extended spatial consideration by forbidding the export of radioactive waste to foreign countries that did not benefit from the electricity production.
Implementation of radiological protection requires democracy to avoid abuses. Nevertheless, democracy is not considered as a core ethical value by ICRP.
In this draft report, application of ethical principles is limited to few topics such as waste management. These principles are mainly used to justify a posteriori the choices done by the ICRP. ACRO considers that ethical values should be fully applied to all aspects of radiological protection and the Commission should ask itself whether it has achieved this full implementation. Examples presented before show that this is probably not the case.
The ICRP finally consider procedural values and introduce accountability, transparency and inclusiveness (stakeholder participation). “Accountability can be defined as the procedural ethical value that people who are in charge of decision-making must answer for their actions to all those who are likely to be affected by these actions. In terms of governance this means the obligation of individuals or organisations to report on their activities, to accept responsibility, and to be ready to account for the consequences if necessary.”
Transparency “concerns the fairness of the process through which information is intentionally shared between individuals and/or organisations […] Transparency does not simply mean communication or consultation. It relates to the accessibility of information about the activities, deliberations, and decisions at stake and also the honesty with which this information is transmitted. It is part of corporate social responsibility, ensuring that decision-makers act responsibly in the social, economic and environmental domains in the interest of individuals and groups concerned.”
Finally, “stakeholder participation, also referred to as stakeholder involvement or engagement, means “involving all relevant parties in the decision-making processes related to radiological protection””.
ACRO strongly supports the implementation of these three procedural values and considers that they should be implemented from the justification stage. This is not mentioned in the draft report, although it is a requirement the Aarhus convention for environmental issues. This should be extended to radiological protection.
The draft report mentions: “experience from the management of the consequences of the Chernobyl accident, and more recently the Fukushima accident demonstrated that empowerment of affected people helps them to regain confidence, to understand the situation they are confronted with, and finally to make informed decisions and act accordingly.” This is true for the very limited number of people. Most of citizen living around the Fukushima dai-ichi nuclear power plant still do not trust authorities. “Accountability” and “transparency” have being ignored by Japanese authorities. The arbitrary evacuation limit of 20 mSv/y has never been explained nor justified. People refusing this limit might have no other choice than remaining in contaminated territories due to economical constrains.
It is a pity that the ICRP has never tried to grasp the situation in contaminated territories as whole and has limited its so-called “dialogues” to a limited number of people that agrees with the Commission. It would have learned much more about the consequences of its recommendations in talking to all categories of people.
As conclusion, ACRO considers that studying the ethical basis of the radiological protection is a necessity but it is not achieved in the present draft report. It should be submitted to various stakeholders and discussed by other means than a simple public consultation on the Internet.