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(More customer reviews)Marcia Angell's Science on Trial: The Clash of Medical Evidence and The Law in the Breast Implant Case demonstrates what can happen when members of the bar -- and some highly paid experts -- have too much imagination. We have all read that the FDA banned silicone breast implants from the market and of the many large verdicts for women who had such implants. Angell looks at the science and policy beyond both these actions. As to the FDA's decision, she notes that the law requires the manufacturer of a medical device prove the device to be safe; the manufacturers, she concludes, had not taken this rule seriously, and suffered the consequences when the political winds changed direction at the FDA. As to the jury verdicts, she takes issue with the court adversary system itself, where each side hires experts (who often make a very good living at it) and lawyers with the stated objective of proving their side, not finding the "truth." She finds this particularly problematic in the breast implant context because no peer-reviewed epidemiological study finds any correlation between the implants and the conditions alleged. However, because juries are not scientists, and because courts are often ill-equipped to decide what is "good" science, "junk" science gets into evidence, and (to her) unsupportable verdicts occur. I find many of her points well taken, but I do not believe the system needs the extensive overhaul she recommends. What is needed (and what is happening in many courts) is closer control by judges in admitting expert proof to ensure that it has some valid, scientific basis. This is a thought-provoking and important book.
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