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→Excerpt from ICRP Publication 138, 2018
(40) A key challenge for beneficence and non-maleficence is how to measure the benefits, harms, and risks. In radiological protection, this involves consideration of both their individual and societal aspects. From the viewpoint of evidence-based medicine and public health, a more comparative analysis of medical factors that affect health is needed, including not only radiation but also other exposures. In addition, a variety of social, psychological, and cultural aspects need to be considered, and there may be disagreement on what matters, or on how to value or weight these factors. Nevertheless, it is recommended that such an assessment be transparent about what was included, recognise disagreements where they arise, and go beyond a simple balancing of direct health impacts against economic costs. In this respect, it is worth recalling the WHO definition of health: ‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO, 1948). As discussed in Section 4, participation of stakeholders other than radiological protection experts is a key part of such a holistic assessment.
(41) An evaluation of beneficence and non-maleficence must also address the question of who or what counts in evaluation of potential harms and benefits, including, for example, future generations and the environment. As mentioned previously, protection of the environment is now included in the primary aim of the system in [[ICRP Publication 103 (ICRP, 2007a)]. One could ask whether environmental harm is being avoided for the sake of people (an anthropocentric view), or whether the environment is being protected for its own sake (a non-anthropocentric approach) ([[ICRP, 2003)Publication 91]]. ICRP does not endorse any specific approach, and considers both to be compatible with the value of beneficence and non-maleficence. In [[ICRP Publication 124 (ICRP, 2014a)]], it is recommended that the evaluation of actual and potential consequences of human activities involving radiation should include, and integrate, effects on both humans and the environment, ensuring that the overall outcome results in more good than harm.
