A revealing look at the disparity in the ways science, the law, and the public regard evidence.
Angell, executive editor of the New England Journal of Medicine, explores here a preposterous situation: an industrial giant, Dow Corning, forced into Chapter 11 bankruptcy by numerous lawsuits filed on behalf of recipients of Dow's silicone breast implantsdespite the fact that medical evidence to date shows no link between implants and autoimmune disorders, cancer or any other disease. In a style that ranges from gently didactic to plodding, Angell describes the events leading up to the FDA's ban on implants, the torrent of lawsuits that followed and the implications of the verdictsoverwhelmingly favorable to the plaintiffs and often carrying cash awards in the millions of dollarsfor science and industry. Manufacturers have threatened to stop producing heart valves, shunts and other vital medical devices because of the threat of liability; further, suppliers of raw materials for these devices often refuse to sell to American companies for fear of ending up in an American courtroom. The author gives a clear explanation of the way science calculates risk (by considering populations, not individuals) and ably contrasts this with our judicial system, where the focus is on the individual seeking restitution. Angell is an effective champion of the scientific method and does a good job of exposing the chaos caused by a runaway tort system, but she offers no resolution to the state of affairs she describes. (July)