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APHA Scientific Session and Event Listing

Jess Alderman, MD, JD, Public Health Advocacy Institute (Tobacco Control Resource Center), Northeastern University School of Law, 102 The Fenway, 117 Cushing Hall, Boston, MA 02115, 617-373-7845, jess@tplp.org

The interaction between attorneys and the medical professionals who serve as expert witnesses is a key factor in determining the outcome of public health lawsuits. Examining depositions and trial testimony of expert witnesses for the defense in tobacco cases reveals several questionable trends.

Problems with expert testimony on behalf of the tobacco industry are subtle but significant. Many physician witnesses make initially reasonable statements that later evolve into extreme positions during cross-examination. For example, it might be perfectly logical to ask whether smoking is the cause of a specific patient's cancer, but it is epidemiologically questionable to ask whether smoking increases a person's chances of getting cancer in general. Likewise, although smoking is but one of many factors that could have caused a patient's cancer, it is problematic to conclude that smoking was not the cause simply because other risk factors were also present. Further, expert testimony about the difference between statistical association and cause and the health risks of secondhand smoke tends to obfuscate rather than clarify the important issues.

Expert testimony is a necessary and desirable part of litigation, but courts must also consider the need for juries to hear and understand the best scientific evidence available. Public health professionals should be aware of the implications of expert testimony on behalf of industries that affect public health. Such testimony falls into a “gray area” of medical ethics because it can mislead juries, adversely affect patient care and public education, and ultimately have a negative impact on public health.

Learning Objectives:

• Recognize the problems with physician expert witness testimony in some of the major tobacco lawsuits
• Identify the ways in which expert testimony can obfuscate important public health issues and mislead juries
• Analyze the ethical implications of this expert testimony in lawsuits against industries which negatively impact the public health

Keywords: Tobacco Litigation, Physicians

Presenting author's disclosure statement:

Not Answered