SCIENCE ON TRIAL

A well-crafted demonstration of how differently the law, the public, and science regard evidence, using the breast implant controversy as a case in point. When the FDA banned silicone-filled breast implants in 1992, lawsuits by women who claimed to have been damaged by them skyrocketed. Eventually the implant manufacturers, having lost one case after another, agreed to the largest class-action settlement ever ($4.25 billion), despite the fact that as yet there is no scientific evidence that implants cause connective tissue disease. For Angell, executive editor of the New England Journal of Medicine, the breast implant story has several major themes: goverment regulation and its role in American society, excessive litigation within a flawed tort system, the public's lack of understanding of scientific evidence, the role of so- called expert testimony in the courtoom, greed and corruption, and the media's alarmist approach to medical news. When Angell, a self-described feminist and liberal Democrat, began researching the breast implant story, she was prepared to find corporate greed at its core. What she found was that the shortcomings of big business paled in comparison with those of three professions: law, medicine, and journalism. As for the law, she outlines problems and suggests reforms in our tort system and calls for raising scientific standards in the courtroom, especially in the use of expert witnesses. She castigates doctors who have lucrative arrangements with lawyers to provide their clients with dubious diagnoses, and journalists who stir up health scares in a gullible public. An exceptionally clear explanation of the nature of scientific evidence, and a powerful plea for broader public understanding of it.