Medicine And Books

Science on Trial: The Clash of Medical Evidence and the Law in the Breast Implant Case

BMJ 1996; 313 doi: (Published 23 November 1996) Cite this as: BMJ 1996;313:1340
  1. J A Muir Gray

    M Angell W W Norton, £22 (to be published January 1997), pp 256 ISBN 0 393 03973 0

    Atrend in American litigation has important implications not only for those who practise medicine but also for those who purchase and organise it and for those who make equipment that clinicians use. By describing one particular case in the United States courts, this book focuses on the clash between medical and legal definitions of evidence that has received little attention hitherto but which is relevant world wide.

    The story itself is relatively simple. A few women claimed that health problems, notably connective tissue disease, had resulted from their breast implants. A few “expert” witnesses asserted that this was the case and propounded theories about how such a causal relation might operate. There was not, and never has been, any strong evidence based on good epidemiological research that breast implants actually cause connective tissue disease, using conventional criteria for defining a causal relation. On the basis …

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