The Risk-Benefit Balance in the United States

A health policy decision often requires a balancing of risks, costs, and benefits. In this paper the authors illustrate that there is no uniform answer in the United States to the question of who decides the risk-benefit balance. The authors use a wide range of case examples from medicine and public health to show the different approaches that are used to allocate decision-making responsibility. Our ultimate purpose is to urge the U.S. health policy community to develop a more consistent way of thinking about how risk-benefit decisions could be guided by general principles.