The retraction in ICRP Publication 103 of assessments of genetic effects after the 2nd generation needs to be corrected, for reasons of public trust at least. The medical management of persons exposed to high doses of radiation needs to be addressed. Experts’ desire to achieve ever increasing precision in dose coefficients (unfortunately much appreciated by some regulators) may be at variance with the intention to achieve a comprehensible, defensible practical system. Repeated examinations of patients may lead to excessively high doses and should be investigated. Ethical considerations require that basic philosophical principles of ethics are taken into account, calls for reasonableness are an important theme but some of the most absurd examples of ‘excessive protection’, such as the gold-plated waste handling of ‘spent’ nuclear fuel, will be hard to address. Many good older suggestions are worth re-visiting – e.g. giving greater weight to relatively high doses and to doses incurred now rather than in the far future. ICRP should also re-assess its remit and consider non-ionising radiation [in conjunction with the International Commission on Non-Ionizing Radiation Protection (ICNIRP)], safety and security [with the International Nuclear Safety Advisory Group (INSAG)], and general regulatory philosophy.