Assessing the Threat: Public Concern

Abstract

In order to maintain public trust, it is important to understand the ethical priorities and values that shape public attitudes about the acceptability of blood risks and risk mitigation strategies. This chapter reviews four key aspects of this understanding—risk perception, risk communication, stakeholder engagement, and risk tolerability—which have been incorporated into the principles and systematic decision-making process of the risk-based decision-making framework for blood safety [1]. Public perceptions of blood safety and associated risks are consistent with general patterns, but more specific attitudes are associated with the recent history of blood systems, including relatively high perceptions of the risks of infections and concern with the ethical issues that arose with the deferral of some donors in response to those events. Risk communication is a core function that uses risk perception knowledge to tailor information about a risk for a specific audience to enhance understanding of risks and benefits, while stakeholder engagement is a broader function that involves building and sustaining relationships with involved and interested groups through providing opportunities for participation in decision-making processes. Finally, risk tolerability concerns the appropriateness of the societal-scale balance of risks, costs, and benefits and the contextual factors associated with a blood risk or mitigation option.