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Brief Exercise of Policy Analysis

The case of Radiation Safety Policy of the Medical College of Georgia

2/21/2010
Environmental Policy Course

Author
Adina Roxana Munteanu
(2001721)
munteanu.adina@gmail.com
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 is
needed. According to Porter & Ronit (2006) self-regulation is 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 there
are 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 given
by 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 be distinguished 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 & Van
Snellenberg,( 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: 41–72
Short, J. L. and Toffel, M. W. (2007) Coerced Confessions: Self-Policing in the Shadow of the Regulator The Journal
of Law, Economics, & Organization, Vol. 24, No. 1,
Toffel, M. W. (2006) – “Resolving Information Asymmetries in Markets: The Role of Certified Management
Programs” 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

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