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20 September 2014

The Precautionary principle

 - Wednesday, 07 April 2010, 00:00

by Pierre Mallia

Imagine waking up one morning to find a very large satellite dish less than a few meters from your child’s window on the roof of a neighbour’s house. You are at first concerned about the size and the view it has destroyed. Over your morning coffee you reflect that such a dish is too large for a television. Later during the day you meet the neighbour, who does not normally use the house but who happened to be there, and jokingly asked whether he is trying to get channels direct from down-under. He replies that he was awarded a couple of thousand euros for having the dish on his rooftop. Since he does not use the place often it did not bother him. He tells you it is a relay dish belonging to a mobile phone company. You suddenly have goose skin. You remember you had heard stories about these dishes and that the electromagnetic radiation they emit are harmful to children and that countries had reported many cases of leukaemia in children where they exist.

You obviously take up the issue and try to calm down and gather as much information as possible. You confirm that the studies are true and make printouts. You write to the company and make your own research. You find that the company has breached MEPA rules, and indeed that MEPA granted an exception. You go to your local minister and have no luck. You end up going to the Minister concerned, to MEPA, to the MEP. All give you sympathy but say that no law, but only guidelines, exist. The local parliamentarian, however, contacts MEPA and asks for the nullification of the application and for the dish to be removed. The dish remains there.

This is a true story. I have omitted identities and details which can reveal them. If I were the parent of the two young girls I would be concerned. Would you? The facts above are only a mere summary of what went on and, to be sure, I am not certain whether the parents knew about the application before the dish was installed. The neighbour of course either could not be bothered, or did not know the facts. Would he have accepted the money knowing that young couples with children were in the vicinity? To date the couple have contacted the Minister of Health who asked them to check whether there is an EU law to the effect in order for him to take action. The context of this article is not merely to convince the authorities but to show that if we mean business on Bioethics, and if we are truly a caring society, we need not wait for children to get cancer to start moving in the right direction.

It is true that politicians walk a tight rope between the business world, the economy and the environment. It is not easy not to grant permits in such a small country. But neither do we conscientiously have to wait for someone in Brussels to make a law. This is not about breaking laws; it is about common sense and following clear evidence. We should be the forerunners to make use of evidence before the need for law. The only way, as a small country, to have an impact in the EU is to show that we mean business in areas that count. God forbid that this issue is politicised and certainly walking in the shoes of a politician with such an issue at hand is not an easy task when you are faced with the duties of everyday life which in turn affect all of our lives. But both UNESCO and the EU have issued guidelines to this effect. It is true that the days when a politician grabs the phone and shouts some command down the hierarchical ladder are gone. People can and do use the force of the law, where it is known that a court case can take years to resolve. These parents do not have years where their children are concerned.

Bioethics! Did you know that bioethics all started with such environmental issues? The person who actually coined the word ‘bioethics’, was an oncologist (a specialist in the treatment of cancer) who realised that we have to do something about the environment we live in, as it was the same environment which was causing much of the cancer he was seeing. From passive smoking to power stations and radiation stations, he realised that if we had to wait for epidemiological evidence all the time, we would be sacrificing the lives of too many people until we actually do something about things. It is true that the business world must move forward, but there should be an ethics of society and of the business world which takes on the biological impact of the environment we live in to prevent disease; hence bio-ethics.

It is also true that the word bioethics has been corrupted. What the oncologist meant was to take into consideration the biological effects; what it has become is a term meaning an ethics of life, seeing that ‘bio’ often is interpreted as ‘life’. Be that as it may, the final effect is the same. UNESCO has however taken this environmental stand in its manifesto, and it is spreading throughout the world. In its studies and publications on the precautionary principle, it gives examples of how in the past, when precaution was taken, considerable damage was avoided. Today, since we have the right to go to court, it is often too late when things do change. On the one hand we find the quotes of Dr John Snow, a GP working in London during the time of the cholera epidemic, who noticed that the areas of London where cholera was mostly endemic were related to a particular water-station (in those days there were private companies, and different companies provided water for different areas). His recommendation to close down the station led to a decrease in cholera and to further studies which revealed how it was actually transmitted in water.

On the other hand, we have all heard about the Asbestos experience. The UNESCO publication describes it well. Times had changed since John Snow. No precaution was taken even though evidence was accumulating about the effects of Asbestos on the lungs, giving rise to cancer and cancer-like conditions, just as lethal. But Asbestos was so much in use that it was difficult for countries to take action. When countries finally took a stand, many had died, and we still have many people suffering from Asbestoses. Even in Malta many ex-dockyard workers have this condition and the unions only managed a collective agreement with insurance to give them a pittance of compensation. The point is however that had we taken action earlier these diseases could have been avoided. They were other times in Malta and the work of people came before theoretical medicine. Would it have been different today? If we can, in conscience, answer in the affirmative to this question, we should admit that we have it on our plates again today – with radiation.

Now the EU has adopted the precautionary principle. And the EU has considered these dishes and given guidelines which are clear. The European Environment Agency (EEA) calls for immediate action to reduce exposure to mobile phone masts. The EU says they should be distanced from schools and hospitals. But if they should be distanced from schools and hospitals, then why not home. I have spoken to MEPs and they say that once one considers schools and hospitals, it is taken for granted that homes are included. There is no need for an actual law or directive and governments are expected to follow up on these recommendations.

So we have the EU, the EEA (a European institution), and UNESCO all telling us the same thing. Of course we can err. But correcting that error takes courage and energy. Sometimes being in government means that you have the force of the Law even where specific laws do not exist. You are in the position to do something about it. Politicians know the case I am speaking about (unless, God forbid, there are others). It has appeared in the media and the young couple have done all that is possible and have not gotten anywhere. Yet!!! I strongly believe we have good people in power and that the Minister of Health and the PM need not have an EU or local law about antennae. I am also sure that the mobile company also has a conscientious board of directors who do not need to be told what to do by politicians – or do they? Why should we as a people have our rights and health environments polluted unnecessarily? Do we really need to go through all this?

The precautionary principle is clear. It has been adopted by the EU. It tells governments that they do not need to wait for laws or for EU institutions to give directives. Actually neither do they need to wait for epidemiological evidence, if the indications are clear. One uses the precautionary principle because lives are important and we know that producing evidence and passing laws takes time. In the meantime we are told (as if we needed to ‘be told’) that we can and should do something about it.

Now in this case we also have enough evidence which shows that such radiation emanating from such masts cause the growth of brain cancer cells, and especially more childhood leukaemia, apart from headaches, memory loss, attention deficit (in children), increased blood pressure in health men, damage to eye cells, etc, etc, etc. There have been considerable resolutions by scientific bodies, including the Vienna Resolution, The Salzburg resolution on Mobile telecommunication Base Stations, reports to the EU by EC-sponsored studies (REFLEX), etc. The WHO, FDA, International Agency for Cancer, National Cancer Institute, the European Commission, etc have all spoken.

However, the Maltese Communications Authority acts in accordance with the ICNIPR – the International Commission on Non-Ionizing Radiation Protection – which falls short of health issues – especially long-term ones like leukaemia in children. The UK commissioned a report in this regard (the Steward Report) which states clearly that there is now scientific evidence that there may be biological effects from such masts; they also say that they cannot guarantee that even radiation below national and ICNIPR guidelines are totally without adverse effects. The report states that the gaps in knowledge are sufficient to justify a precautionary approach.

Taking a precautionary approach, using this principle of precaution, reverses the way we should do things. It tells us to ‘stop’ until we have the evidence, and not to stop when we have the evidence. It does not even speak about laws and it is pre-law – could it be otherwise? And to whom does it speak if not to our politicians? Taking a precautionary approach means picking up the phone right now and asking politely to remove that antennae. We all want the luxuries of our mobile phones. But I for one would not wish that that luxury comes at the cost of the lives of our children. It is not the onus of this family to bring to the Minister any law which exists. I am sure the Minister has people who can do this for him. But in the absence of such law, and even in the absence of evidence, there is a principle which we have been speaking about which is a moral law and a natural right. A feeble Minster will dilly-dally. A courageous and morally sound one would use this invaluable tool which has been given to him. The precautionary principle recognises that absence of evidence is not evidence of absence. He is, at the end, the true bio ethicist, given that as a matter of fact, there is the evidence.

Pierre Mallia is Associate Professor in Family Medicine, Patients’ Rights and Bioethics at the University of Malta; he is also Ethics Advisor to the Medical Council of Malta. He is also former president of the Malta College of Family Doctors.

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