A widespread trend in risk management recently might be described as proceduralismthe search for procedures by which parties can be brought together, in the hope of bypassing substantive moral and political disagreements. This article argues that there are severe limits to what can be expected of proceduralism, distinguishing four basic types. It goes on to argue that a central area of substantive disagreement that must be addressed in risk management theory concerns the scope of justifiable paternalism and the scope of justifications for measures that place obligations on the ground that people have limited rights to impose costs, harms or risks upon others. The article sets out an argument about how far paternalistic arguments can be taken, and under what kind of constraints paternalism is acceptable, before setting out for comparison similar considerations in respect of arguments about harms to others. The implications of these arguments for the idea of autonomy are explored. Finally, various formulations of the precautionary principle are considered in the light of these consideration, and consequently doubt is cast upon the merits of these formulations of precaution. The article concludes by drawing together the consequences for a post-proceduralist conception of risk management that recognizes the importance of addressing substantive moral and political arguments in the course of conflict resolution.