New York State’s Governor Cuomo today issued a ruling, backed by a long awaited report on the public health implications of “high volume hydraulic fracturing for shale gas development,” to ban the practice in New York State. The report is as important for what it does not find as what it does. It does not find a public health smoking gun. Indeed, the primary conclusion is that there is great uncertainty about what the public health effects are. Put in this light, Governor Cuomo made a decision, not unlike the French or other EU countries, to abide by the precautionary principle. That is, he is willing for the people of New York to forgo the benefits of shale gas development to avoid the highly uncertain risks posed by this development. The implication is that if and when the uncertainty about public health is reduced, another determination could be made about whether the benefits of development are worth the health (and environmental) damages. This is a perfectly legitimate point of view, although one not shared by many other governors in the United States.