Risky Business - The management of Risk and Uncertainty

John Adams
London: Adam Smith Institute, 1999
ISBN 1-902737-06-7

Statistically, it is common knowledge that flying is less dangerous than driving a car. But have you ever thought why people behave as if the opposite is true? Why is it safer on the roads now than when cars were first invented? And why did the government feel that killing so many cattle in the wake of the crisis surrounding bovine spongiform encephalopathy was justified?

Risk is something that plays a part in everyone's life. Calculations about risk are part of everything, from deciding to cross a road to deciding to have medical treatment. It is, to a certain extent, the job of government to manage public risk. Professor John Adams sets out to prove that this is easier said than done. Apparently, we tend to assume that most risks can be set out in the form of numbers. Indeed, this is what the Chief Medical Officer thought in 1995, when he proposed a series of "risk benchmarks," everyday examples of quantified risk with which new risks could be compared. This, he believed, would give us all a more rational perspective when the media starts to generate hysteria about dangers to the public.

But of course the good professor shows us that it is not that simple. Risks change immediately they are publicised, in a "Heisenberg" effect. Reducing risk (for example, by wearing a seatbelt) encourages more risky behaviour. And whether we like it or not, all risk behaviour includes a large subjective component. We do not seek to eliminate risk from our lives - rather, we manage and indeed relish it in certain situations.

This isn't really a book or even a report. It's more a monograph of insights and explanations. Professor Adams shines a little light into the fog of risk with some clear and well explained examples that act as beacons to help us find our way. It is not clear, however, what he is trying to achieve. There is no introduction or logical format, and his conclusions lack the practical application that his tangible examples promise.

So this is not a book to buy. But if you're interested in why people behave as they do when confronted with risk, and why government attempts to manage health scares are so unsuccessful, then get this from the library. This, I believe, is the least risky option.

Séamus Phillips, fith year medical student, Southampton University


studentBMJ 1999;07:394-436 November ISSN 0966-6494