ABSTRACT
Causes often influence their effects via multiple routes. Moderate alcohol consumption can raise the level of HDL (‘good’) cholesterol, which in turn reduces the risk of heart disease. Unfortunately, moderate alcohol consumption can also increase the level of homocysteine, which in turn increases the risk of heart disease. The net or overall effect of alcohol consumption on heart disease will depend upon both of these routes, and no doubt upon many others as well. This is a familiar fact of life for engineers and policy makers, one that often gives rise to unintended consequences. Suppose, for example, that the American Federal Aviation Administration were to institute new regulations requiring that aeroplanes be equipped with some expensive new safety feature. Would this regulation save lives? Not necessarily. Every dollar (or pound, or euro, or yen …) that an airline spends to upgrade its fleet is a dollar that must be recouped in some way, most likely through higher fares. Higher fares may, in turn, persuade some travellers to drive instead of fly – especially on shorter routes. But it is inherently more dangerous to drive a given route than to fly it, so the net effect of the new regulation may cost lives, rather than saving them (Glassner 1999: 188).
