Pressing the Button

New in movie theaters this past weekend was a horror flick called, “The Box,” starring Cameron Diaz and James Marsden as a couple given a disturbing choice. They are presented with a mysterious box, equipped with a button. If they press the button, they’ll get $1 million, but someone they do not know will die.

The premise is striking, but it’s not quite so fictional as we’d like to think. Every day in the United States and across the globe, manufacturers produce products that cause unnecessary injury and death. Sorry to put it so bluntly, but there it is. Our lives are full of products that increase our risk of cancer or other deadly diseases – not just cigarettes, the harm from which is widely known and understood, but other products, including certain nonstick cookware, some kinds of paint, discarded computers and more. Manufacturers use production methods that pollute the air and water, doing violence to the environment and causing a broad range of public health problems. And then there’s the big one: carbon emissions from power plants and automobiles that are causing global climate change that will cause a variety of harms across the globe.

We countenance all these things for a complex set of reasons. We like our cancer-causing products, and because the risk to any one of us is small, each of us imagines we’ll beat the odds. Also, it’s difficult to trace diseases like cancer to specific environmental factors in individual cases. The connection is easier to demonstrate on a large scale, where it’s possible to compare groups that were exposed to a potential hazard with otherwise similar groups that were not, and calculate differences in disease rates. But excluding tobacco users, think about all the people you know who’ve had cancer at some point and ask yourself if you know what caused it. In my experience, there’s not typically a proximate cause suggesting itself. So I usually chalk it up to bad luck. And yet we know from a variety of studies that in fact, various products and manufacturing processes are increasing cancer rates and claiming lives.

Industry continues to make products that kill people because they make money. But more than that, they keep it up because we let them. And we do it consciously. It’s standard procedure in regulatory agencies to assign a dollar value to the expected loss of life resulting from the use or manufacture of some product in commerce. And using cost-benefit analysis rules first put into practice nearly 30 years ago, agencies try to figure out whether the projected benefits of a regulation – saving the lives of 300 people at $6 million a person, for example – are outweighed by the costs to industry of saving them. That sounds harsh and a little absurd, but in fact that’s exactly what happens.

As in the setup to the movie, the deaths are anonymous. But note, too, that the costs and benefits are paid and accrued by different people. Cost-benefit models that value life at $6 million a soul don’t bother accounting for the fact that industry gets the $6 million, not the family of their victim.

Not many of us would press thebutton, killing off a loved one for $1 million. And we certainly wouldn’t do it so that some international corporation can feather its bottom line by $6 million. But have no doubt: industry presses that button on a daily basis, with our acquiescence. While we’ve passed a variety of laws to protect ourselves from some of the harms that result, the truth is that as a society, we’re willing to let thousands of people die every year in the United States so that industry can keep making money without having to inconvenience itself by figuring out safer ways to make products. It’d be nice if regulation prevented that, but in fact, with cost-benefit analysis driving regulatory decisions, regulators are just raising the price a little.