deaths or illnesses. Should that occur, and I have little doubt that it will, the result might well be the reimposition of a federal regulatory system, but one that is more draconian and less effective than the one in place today.

Second, although I salute the conclusion in this report that the medical uses of ionizing radiation should be treated in uniform fashion, I object to the uniformity envisioned in the report, to wit, a repeal of all federal authority over its medical uses. Instead, I favor a reexamination of ionizing radiation risks as a whole and an appropriate restructuring of regulatory approaches. It may be that the regulation of reactor-generated byproducts can be minimized in a way that substantially reduces costs (and annoyance) without significantly increasing risks. If so, I favor such an approach. It may also be—and I strongly suspect it to be so—that we would find that other medical uses of ionizing radiation have been inadequately addressed under state regulation. I particularly worry about the widespread use of x-rays by medical technicians and marginal "medical" professionals such as chiropractors who may have little insight into the risks associated with these products. Let's consolidate the control of ionizing radiation but not simply end it.

CONCLUSION

I believe that the IOM report raises many important issues. As a number of my colleagues have noted, no one in the group agrees totally with all of the report's recommendations. In this spirit, I have tried to see the merits of the majority—and, indeed, there is merit in some of its views. In the end, however, I find that the case for abolishing federal regulatory authority over the medical use of ionizing radiation has not been made.



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