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Christiana Z. Peppard Headshot

Invasive Procedures

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Before a patient puts on his generic cotton tunic and hops onto a gurney in any United States hospital, he has talked through the benefits and costs of his surgery and has probably considered the long-term, indirect effects on his family or his company, too.

For good reason, federal law mandates that a physician or medical researcher must inform her patient about all potential risks and benefits before an invasive procedure. The patient must sign a consent form. These processes of informed consent were developed in the wake of atrocious 20th-century moral failings in medical research such as Nazi medical experimentation and the infamous Tuskegee syphilis study.

The rise of informed consent for invasive procedures demonstrates that, as a society, we take moral considerations seriously. And it is through federal regulation that these moral insights become legal requirements.

So it's a pity that our federal regulations for the invasive procedure of hydraulic fracturing continue to fall so short.

On May 4, the Obama administration announced a "compromise" on procedures for extracting natural gas via horizontal hydraulic fracturing on public lands.

What's new about the rule? Among other things, the requirement that energy companies disclose what's in the mysterious fracking solution. This is a happy, if infinitesimal, improvement from the previous status quo, in which non-disclosure ruled the day. (The federal government has taken a cue from historically conservative states -- such as Wyoming and North Dakota -- that require disclosure of fracking chemicals.)

But under the new federal rule, disclosure of fracking chemicals will happen only after the well has been drilled and extraction has begun.

What?

In a nutshell: Drill first, disclose later.

It is almost always in the interests of the powerful to act first and apologize later. What's unfortunate is that the new federal regulation enshrines this as official policy.

It's especially galling since a previous draft of the rule mandated 30 days' disclosure in advance of drilling. Of course, that draft requirement was roundly lambasted by oil and gas interests for being expensive and inefficient.

Accordingly, the "act first, apologize later" approach enshrined in the new rule is lauded by industry as "efficient."

But morally, it's adolescent. Withholding relevant information is dangerous and duplicitous. Acting first and apologizing later wasn't enough for the men in the Tuskegee study. It's not enough here, either.

The body politic needs to be informed about all chemical contents used in fracking solutions -- before they are injected at high volume and pressure into the land below us. According to an April 2011 report by the Minority Staff of the House of Representatives Committee on Energy and Commerce, often used in fracking are "29 chemicals that are (1) known or possible human carcinogens, (2) regulated under Safe Drinking Water Act for their risks to human health, or (3) listed as hazardous pollutants under the Clean Air Act."

People have a right to know -- in advance -- what chemicals are being used, the exact sites of usage, short and long term toxicological and environmental effects, and -- not least -- the current limitations of our knowledge. As the history of medical informed consent points out, it's what we're not told that tends to be the problem.

Yes, the requirement of informed consent can be onerous. When informed consent regulations for medicine were first introduced, many people warned that it would be costly and inefficient.

The same rhetoric spews out of oil and gas interests about advance disclosure of fracking chemicals. And history shows that taking precautions and fully disclosing potential risks isn't always the most efficient or profitable in the short term.

But history also shows that it's the right thing to do -- and it's the government's job to make sure the right kinds of protections are in place, particularly when it comes to possible effects on human health.

All we're asking is the fundamental freedom to know our poison before we drink it.