June 2009 Contents

Which of the following measures would you be willing to allow in your care and that of family members in the name of more sustainable and affordable health care? Check all that apply.
Use of metal devices, e.g., specula, that have been sterilized rather than single-use, plastic devices.
Reusable exam table sheets and gowns made from fabric, not paper.
Use of unwrapped items in suture trays and other emergency and operating room trays after the outer package has been opened.
Elimination of all paper patient charts and records in favor of electronic records.
Having to travel up to 1 hour for expensive services such as MRI and PET scan.

A physician who diagnoses several cases of a noncontagious illness such as nitrate toxicity that is environmentally related, satisfies his or her professional duty when he or she:
Treats each of those who have the illness.
Treats those with the illness and educates the patients and their families about the causes of the illness and how to avoid it.
Treats those with the illness, educates the families, and informs public health authorities of the local environmental risk.
Treats those who have the illness, educates the families, informs public health authorities of the local environmental risk, and advocates for abatement of the environment.

According to the precautionary principle, if an activity raises threats of harm to human health or the environment, precautionary measures should be taken, even if a cause-effect relationship between the activity and the harm has not been scientifically established. On balance, which of the following statements best expresses your thought about the precautionary principle?
I would rather find out that my precautions were unnecessary than to discover too late that I had been exposed to harm and not known it.
The precautionary principle fosters unnecessary concern and possibly costly preventive measures prematurely.
The demands of the precautionary principle are unrealistic; it is nearly impossible to prove that an activity will have no harmful effects.
I don’t know what I think about it until I find out whether the precautions were necessary or not.