Alcohol, pregnancy and the precautionary principle

Philosopher Mary Midgley (1992: 3) observed: ‘As the gap between professional science and everyday thinking widens, it gets increasingly hard to work out in what sense most of us can be said to be thinking scientifically at all.’

This occurred to me on reading the title of an article by Leppo et al (2014: 512): ‘“Why take chances?” Advice on alcohol intake to pregnant and non-pregnant women in four Nordic countries.’ The authors report that not only have the governments of Denmark, Finland, Norway and Sweden advised pregnant women to completely abstain from drinking alcohol, they also make the general point that in attempting to manage uncertainty there is a move away from the ‘estimation of risk’ in favour of what they describe as ‘a wider socio-cultural push towards broader employment of the precautionary principle’ (PP).

But where exactly does a ‘why take chances?’ approach arising from a ‘wider socio-cultural push’ towards the PP fit into a medical culture that is dedicated to proven scientific methods of risk evaluation and where the concept of evidence-based medicine is actively promoted? Leppo and Hecksher (2010: 7) acknowledge that when Denmark and Finland adopted their total abstinence message, their policy was ‘not, however, based on research evidence pertaining to the harmfulness of a small-to-moderate alcohol intake during pregnancy but rather on the principle of precaution.’