Abstract
During the summer of 1999, the West Nile Virus, a mosquito-borne virus, made its first appearance in North America. Public health officials throughout New England were forced to quickly respond to a novel threat, in many cases resorting to pesticide spraying that carried real but uncertain risks. This article explores the tensions faced by public health officials when making decisions regarding uncertain risks, particularly when there might be trade-offs between those risks. It examines the role of the precautionary principle--a guide to decision making under uncertainty--in trying to mediate these trade-offs. It is concluded that by exploring and implementing a wide range of preventive options, including a broad range of perspectives in decision-making processes, using a multidisciplinary scientific lens and systems perspective to examine risks, and developing methods to monitor public health interventions for signals of problems, such trade-offs can be minimized or avoided in a truly precautionary manner.
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