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Brief Exercise of Policy AnalysisThe case of Radiation Safety Policy of the Medical College of Georgia

2/21/2010Environmental Policy Course

Author

Adina Roxana Munteanu(2001721)munteanu.adina@gmail.com

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The purpose of this paper is to briefly describe and analyse the radiation safety policy of the Medical

College of Georgia, to briefly answer the question of whether this is an example of self regulation and

discuss the level of expected compliance, performance and enforcement.

1. Self regulation and government regulation

To answer the question whether the radiation safety area can be a case of self regulation, a definition isneeded. According to Porter & Ronit (2006) self-regulationis defined as an arrangement, involving formal

or informal procedures, rules and norms that are widely recognized as having the purpose of constraining

the conduct of a set of private actors, where the procedures, rules and norms are shaped to a significant

degree by some or all of these actors. According to the same study, the ambition of those actors creating

self-regulatory arrangements is that these should solve problems that neither the market, nor the state has

managed to solve, being socially beneficial and thus giving the actors legitimacy.

In the name of public safety, the State of Georgia regulated the radiation safety by normative acts as

391-3-17.-07 Notices, Instructions, and Reports to Workers; Inspections. Amended adopted since

1991. The rule states that workers have to be informed and instructed on different radiation safety issues,

that information is transparent, that monitoring and reporting duties have to be established and that the

state authorities will inspect the enforcement of the rules.Moreover, the Medical College of Georgia is authorised according to state laws to use sources of radiation

in patient care, education and research and development activities. Taking into account the state

legislation and the severity of penalties and fines on those who have failed to comply with their licences,

The Medical College of Georgia added to its Administrative Policies and Procedures a new enforcement

policy (Radiation Safety Program Enforcement Policy) to deal with the current legislation.

The Radiation Safety Program Enforcement Policy states that authorized users, the Radiation Safety

Office (RSO) and the Radiation Safety Committee (RSC) have the responsibility for safe use of

radioactive materials. In a different document, the Medical College of Georgia Radiation Safety Guide,

internal authorities (MCG Radiation Safety Committee) are created to authorize individual staff or faculty

members, as Authorized Users, to use radiation sources after a review of the proposed use, adequacy of

facilities and experience of the applicant. Although this provision allows MCG great flexibility in dealing with the multitude of radiation sources and research uses encountered on campus, it places great

responsibility on investigators and the administration to comply with State regulations so that local

Committee authorizations may continue.

According to the above mentioned definition, the internal policy on radiation safety can be seen as self

regulation because at university level the responsibilities are defined, there are monitoring and

enforcement authorities that give sanctions within the medical college and on the basis of the internal

policy. On the other hand, the governmental law sets the boundaries of the internal policy.

The regulations in the area of radiation safety in hospitals and universities are both government law and

self regulation policies. This mix is probably the most effective as either complete state regulation or self

regulation of the area would be too expensive.Even as voluntary self-regulation programs proliferate, the government still plays an important role in

encouraging self monitoring. If there are frequent inspections and/or news about recent enforcement

actions which involve significant legal costs and often result in penalties institutions are much more likely

to continue to self monitor.

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2. Policy Performance

There are many examples of performance indicators of a policy, such as goal attainment and

effectiveness, cost effectiveness and efficiency, capability to implement or learning and flexibility, only to

name a few. For the purpose of this paper, the performance of the policy on radiation safety will refer

only to reaching the goal of having the level of radiation exposures as low as reasonably achievable

(ALARA).

Medical College of Georgia clearly states its commitment to maintain radiation exposures as low as

reasonably achievable to employees, students, patients, visitors, and the general public and that this is

accomplished by enforcing the policies stated in MCG Radiation Safety Guide.

Most of the rules in the guide refer to monitoring requirements, mentioning extensive surveys, a quality

control program and personnel monitoring procedures and devices. Moreover, specific procedures for

responding to any occupational radiation dose which exceeds ALARA have been established. The guide

also states that if the limits of exposure to radiation are achieved, then the use radiation sources for

teaching and research is beneficial and ALARA is achieved. In this respect, the document gives circular

references.

There are clear mentions of who is responsible for monitoring and the respective procedures, but thereare no clear targets or definitions of what is an acceptable monitoring.

3. Expected level of compliance

Adopting a policy document or a code of conduct is an important start, but actual compliance is a

different thing. Compliance behaviour is grounded in deterrence theory which states that actors are

rational and will comply with legal directives only to the extent that the costs of expected penalties exceed

the benefits of noncompliance. According to this theory, the compliance behaviour is influenced by the

fear of being inspected, warned or penalized and by hearing about legal sanctions against others. The

deterrent effect of potential sanctions depends on both their likelihood and severity.

In the case of a regulation on safety, the risks of non-complying are not just the fines and sanctions givenby the governmental monitoring body, but also the injuries caused to people and the medical expenses

generated therefore (plus the expenses in case of suing). Both the individuals that work with radioactive

materials and patients can suffer if safety rules are not respected. As this is an example of possible high

risk, a high compliance can be expected if costs are not too high. If this is the case, it is highly likely that

the least expensive measures will be taken first.

The policy documents clearly state the responsibility of an individual user of radioactive materials to

minimize exposure not only to their selves but to others as well. Moreover, training is required in order to

become an authorised user. A knowledgeable individual is more likely to comply than a poorly informed

one.

4. Policy Enforcement

There are large differences of style in the enforcement of policies. The factors that determine this variety

are the characteristic of both enforcer and law breaker, the relation between law breaker and enforcement

body and the characteristics of the act. The styles of enforcement may differ per country, per sector, per

authority or even per person.

There can bedistinguished two 'strategies' which enforcement officers adopted towards the target group

of the policy. The first one, the compliance strategy, is basically consensus oriented while the second

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one, the deterrence strategy is oriented towards direct sanctioning (Hawkins & Thomas, 1984). In the

case of a continuous relationship between the regulator and the target group, when future encounters are

plausible, the style adopted is a more consensus-oriented as not to affect future encounters.

In the case of the Georgia Medical Centre, both the regulators and the college authorities have an

incentive to try to achieve consensus when enforcing the rules. The guide does not mention any fines,

penalties or any measure in case of non-compliance. In fact, there is no mention of the non-compliance

case at all, therefore it can be deducted that the strategy adopted is that of compliance. The internal

authorities do not want to frighten their employees as the burden of monitoring is already substantial and

the risks incurred in the case of non-compliance should be frightening enough.

Bibliography

Hawkins, K. and J.M. Thomas (eds.) (1984), Enforcing Regulation, Dordrecht: Kluwer. Cited in Huitema & VanSnellenberg,( 1999)

Huitema, D. and Van Snellenberg, T (1999) 'Policy in style', Environmental Politics, 8:3, 77 98

Porter T. & Ronit K. ( 2006) Self-regulation as policy process: The multiple and criss-crossing stages of private rule-making, Policy Sciences (2006) 39: 4172

Short, J. L. and Toffel, M. W. (2007) Coerced Confessions: Self-Policing in the Shadow of the Regulator The Journalof Law, Economics, & Organization, Vol. 24, No. 1,

Toffel, M. W. (2006) Resolving Information Asymmetries in Markets: The Role of Certified ManagementPrograms Job talk paper, Haas School of Business, University of California, Berkeley.

http://rules.sos.state.ga.us/docs/391/3/17/07.pdf

http://www.mcg.edu/policies/4502.html

http://www.mcg.edu/services/ehs/radsafe/rmanual1/documents/RSG.pdf.

http://www.yale.edu/ehs/Documents/rad/ALARA.pdf