Should the current radiation protection paradigm and its recommendations be modified to make them more fit to protect the public in future nuclear emergencies?

Abstract The present radiation protection paradigm and its associated recommendations as developed by bodies such as the ICRP have performed very well over past decades both for those occupationally exposed to radiation and for the public in planned exposures. There is, however, growing evidence that the role played by this paradigm in the decision-making process to protect the public in nuclear emergencies in the past may have, unwittingly and unintentionally, caused more harm than good to some sections of the public. This seems to have been the case in the use of population evacuation as the principal protection response to the Chernobyl (1986) and Fukushima (2011) accidents. There is thus a need to develop improved guidelines or tools on how to apply radiation protection recommendations for the public compatible with the Principle of Justification in the event of any future major radiation emergencies. It can also be argued that the present radiation protection paradigm, with its emphasis primarily on the physical health detriments from radiation, should be more inclusive and needs to shift to a more holistic or total health approach than heretofore to include mental health effects associated with nuclear emergencies. For severe mental health effects, some of the consequences, such as suicide, can even be as or more severe than most physical detriments likely to be suffered by those affected.