International Society of Doctors for the Environment

ISDE Resolution Affirming the Precautionary Principle[1],[2]

WHEREAS the injunction "First Do No Harm" has guided physicians since the time of Hippocrates;

WHEREAS for centuries the cornerstone of public health policy and practice has been the prevention of injury and disease;

WHEREAS physicians in practice and principle act expeditiously to prevent catastrophic outcomes whenever sufficient indications are present to warrant precautionary intervention;

WHEREAS the most countries have adopted the Rio Declaration on Environment and Development, which states in principle 15[3]:

"In order to protect the environment, the precautionary approach shall be widely applied by States according to their capabilities. Where there are threats of serious or irreversible damage, lack of full scientific certainty shall not be used as a reason for postponing cost-effective measures to prevent environmental degradation."

WHEREAS the human race is experiencing warning signs that our bodies and the natural world have limits to their abilities to absorb and overcome the harm from some of our actions, technologies, and substances, and that in some cases these limits have been reached or exceeded;

WHEREAS these warning signs include the dying off of plant and animal species, the depletion of stratospheric ozone, global climate instability and increased rates of some cancers, reproductive disorders, learning disabilities, respiratory diseases including asthma, and other environmentally related illnesses;

WHEREAS current environmental regulations are aimed primarily at controlling pollution rather than taking the preventive approach of limiting the use, production, or release of toxic materials in the first place;

WHEREAS under the current system, enterprises, projects, technologies, and substances are in effect "innocent until proven guilty", and the vast majority of chemicals in production have not been adequately tested for their independent, much less their synergistic, effects on humans and ecosystems;

WHEREAS some producers of pollution have repeatedly used their influence to delay preventive action, arguing that the immediate expense of redesign to achieve pollution prevention is unwarranted in the face of any uncertainty about eventual harmful health effects,

WHEREAS physicians, who daily plan patient care based on a strategy of weighing potential harm and gain, understanding the inescapable uncertainties inherent in science and clinical medicine as well as the risk of inaction, now perceive the need for the application of a precautionary, responsible, and therapeutic approach to environmental health,


WHEREAS the Precautionary Principle is considered to be an emerging general principle of international environmental law[4][5] (2,3);

WHEREAS, in addition to the issue of pollution, precaution is required for addressing environmental problems such as global climate instability, the loss of biodiversity, and the destruction of marine fisheries, each of which may threaten food supplies and lead to disastrous human health consequences;

WHEREAS the US President's Council on Sustainable Development has established the Precautionary Principle as one of its guiding principles[6];

Whereas the Maastrich treaty establishing the European Union states that
Community policy on the environment shall aim at a high level of protection taking into

account the diversity of situations in the various regions of the Community. It shall be based on the precautionary principle and on the principles that preventive action should be taken, that environmental damage should as a priority be rectified at source and that the polluter should pay.[7]

WHEREAS the environment and health of 50 European countries ministers gathered in London in June 99 reaffirmed their commitment to the precautionary principle[8]

WHEREAS we believe that children and other sensitive populations are in particular need of protection from environmentally related hazards;

THEREFORE be it resolved that the International Society of Doctors for the Environment ISDE endorses the Precautionary Principle and encourages government at all levels, the private sector, and health professionals to promote and abide by the precautionary principle in order to protect human health and the environment;

Potential Implementation Actions could include the following:
1. Advocating significant increases in pollution prevention efforts through a broad-based approach to clean production, energy efficiency, waste minimization and reduced consumption;
2. Identifying broadly understood goals for reducing exposure to toxic chemicals, particularly in the vulnerable periods of prenatal and infant development;
3. Educating politicians and the public about the application of the precautionary approach to climate change, biodiversity, technology assessment, potential industrial accidents, Genetically Modified Organisms and other issues in addition to issues of toxic chemicals;
4. Encouraging the creation of further incentives to replace known toxic chemicals with least toxic alternatives;
5. Supporting the growth of organic agriculture to reduce the use of toxic chemicals in the agricultural sector;
6. Enunciating the urgent need for improved research methods to understand the additive, cumulative, and synergistic effects of multiple stressors on human health and ecosystems;
7. Advocating remediation of the environment where degradation has occurred that constitutes a hazard to human health and ecosystems; and
8. Urging all countries to honour the Precautionary Principle during negotiations of international agreements, while working to establish the Precautionary Principle as a guiding principle of international environmental law.


Appendix: The Precautionary Principle

There is no single exposition of the Precautionary Principle. The Rio Declaration noted above is one of the earlier statements of the Principle.

A more recent versions follow:

The formulation of the Precautionary Principle promulgated by the participants attending a meeting at the Wingspread Conference Center on January 23, 1998[9].

"When an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established. In this context the proponent of an activity rather than the public should bear the burden of proof. The process of applying the Precautionary Principle must be open, informed, and democratic and must involve potentially affected parties. The process must include a comprehensive, systematic examination of the full range of alternatives, including no action."



[1] Most of the Text is based on the PSR Resolution Affirming the Precautionary Principle ( which has been adapted for the international context

[2] Adopted by the ISDE Directing Board at its meeting on 26 March 2000 in Bonn, Germany

[3] Rio Declaration on Environment and Development, 31 ILM 874, June 14, 1992.

[4] Hickey, J. and V. Walter. Refining the Precautionary Principle in International Environmental Law. Virginia Environmental Law Journal 14: 423-436, 1995.

[5] Raffensberger C and Tickner J (eds.). Implementing the Precautionary Principle. Island Press, Washington, DC, p. 356, 1999.

[6] President's Council on Sustainable Development. Sustainable America: A New Consensus for Prosperity, Opportunity and A Healthy Environment for the Future, We Believe Statement, #10, February,1996.

[7] Art. 174.2 of the Amsterdam revision of the Maastrich treaty

[8] Paragraph 44 of the London declaration of the Third Ministerial conference on Environment and Health

[9] The Wingspread Statement of January 1998. Rachel's Environment and Health Weekly, #586, February 19, 1998.