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New England Journal Editor Contrasts Legal and Medical Paradigms for AES Meeting

Sees Positive Trend in Greater Reliance on Expert Panels

“Justice cannot fly in the face of truth,” contends Marcia Angell, Executive Editor of the New England Journal of Medicine, who spoke on the topic of “Two Cultures: Scientists and Lawyers” at the recent meeting of the American Epidemiological Society (AES), held at the Mayo Clinic in Rochester, Minnesota. Like many others, she worries about some of the features that characterize the current toxic tort system in the United States (i.e. exorbitant contingency fees, hired partisans posing as experts, and juries faced with complex issues who vote with their hearts).

Two Different Approaches

But there is more to her concern than this. “Lawyers and judges think differently than doctors do,” said Angell, the author of a recent book about the silicone breast implant controversy. “It begins in fifth grade when some smart kids focus on English and History and other smart kids focus on Math and Science. These differences are accentuated during training so that by the time they become adults, they are quite different creatures upstairs,” she says.

Where scientists see important questions—for example, do breast implants cause disease?—lawyers see the causal question as only a trivial building block. They may be more interested in establishing failure to warn or malice, Angell told the Epi Monitor.

What solutions can improve the condition of the toxic tort system? “Maybe judges cannot resolve everything through the adversarial process when it comes to scientific disputes, and maybe they need neutral panels of experts. This represents a brand-new way of thinking for judges, who tend to think they can do everything,” says Angell.

Judges Convene Their Own Panels

The new way of thinking is emerging in the aftermath of the landmark Daubert vs. Merrell Dow decision, which required judges to determine the relevance of scientific evidence being admitted in court, and not to accept everything as equally valid. Faced with this challenge of sorting out sound vs. junk science, some district judges are turning to neutral panels of experts to give them assistance. Angell cited District Judge Robert Jones from Oregon who convened such a panel and last December threw out plaintiff cases in the breast implant controversy. Other well known judges who have undertaken to avail themselves of these panels are Sam Pointer in Alabama and Jack Weinstein in New York.

Published April 1997 
 

 
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