by Marcia Angell, M.D.
(New York: W. W. Norton & Co. 1996)
This is an enormously important book for understanding how the American legal and jury system is seriously out of order and needs reform. Angell, who is a medical doctor, lawyer, and executive editor of the New England Journal of Medicine, assures us there is no evidence that women's silicone breast implants cause immune or any other illness. Epidemiological studies completed only since the breast implants were banned, indicate that any yet unknown or hidden harm can only be minor. Yet, courts and juries have made multi-million dollar awards and lawyers have filed hundreds of individual and class action law suits for damages caused by breast implants. These have driven a major American manufacturer, Dow Corning, into bankruptcy, and stand to wreck its parent companies Corning Glass and Merrill Dow.
A number of problems are at work. The American court system is not geared to use scientific epidemiological knowledge, which is by its nature statistical. Rather, decisions always have to be made on whether this one woman plaintiff was harmed, which in the nature of medical science can not possibly be certain. In the absence of sound science, judges allow "experts" to qualify as witnesses who do not accept the scientific consensus, but ride their own idiosyncratic opinion hobby. The opinions must be in the plaintiff's favor for the experts to earn their large witness fees. Lawyers are permitted to work on a thirty to forty percent contingency fee, and thus have strong interests in promoting these cases. There is no threat of "loser pays the accused's costs" as there is in most European countries.
The average American, and thus any member of a jury, is scientifically illiterate and mathematically innumerate. Counsel in addition will be sure not to allow any well educated person to remain on the jury. Neither are lawyers and judges known for their scientific sagacity. Juries are encouraged to ignore the evidence, while counsel play on their emotions and exaggerate the health problems of their client. "The resultant verdict may have little to do with the merits of the case, and everything to do with theater. If things go well, a sympathetic jury may award large damages for emotional distress, as well as economic damages. The outcome is a gamble for high stakes." (pp. 74-75).
Using the example of the silicone breast implant litigation, Angell, demonstrates every point she makes. She further examines the role played in this and similar cases by the Food and Drug Administration, whose banning of the devices fed the legal and public furor. Yet, at the time neither the FDA, nor the company, nor the scientific community had any evidence the devices caused harm, while thirty years of use clearly showed harm to be rare. Or as Angell puts the point: "We depend greatly on science and its technological fruits, we like to talk about what research shows and what it doesn't, we think we understand risks, but when it comes to the recurrent medical scares that sweep across the land like locusts, all our sophistication goes out the window. Just give us the conclusion, tell us who to blame, and don't bother with the evidence." (p. 12).
by Keith Windschuttle
(Paddington, Australia: Macleay Press, 1996)
What Gross and Levitt1 did for the hard sciences, and Krugman2 for economics, Windschuttle is doing for the discipline of history. The world of scholarship and science is under attack by critical post-modern attitudes and philosophies which proclaim the relativity of all knowledge. Real truth, so the claim goes, does not exist, and all previous so-called science is mere opinion, called "discourse", of dead, white males. Sokal3 in his famous hoax in Social Text parodied these ideas to the delight of all reasoning mankind.
The case for history is more difficult to argue, for the discipline is admittedly not a science. Historians do not aspire to formulate general laws, nor can they engage in experiment. Nor can the complexity of human affairs ever lead to predictions some expect from secure knowledge. Distinct interests lead different historians to select diverse facts from the plethora available; and these in turn may result in quite varied interpretations. The facts themselves are frequently in question, or only imperfectly known. Moreover, honest historical writing must at the same time be good literature. It is easy to appreciate that some hard science types may think history is mere opinion and anything is possible. Only when the history called earth science, or biological evolution, or cosmology is attacked do some scientists admit there may have to be fact to back historical narrative.
In contrast a French school of literary philosophy and anthropology associated with the names of Foucault, Derrida, and Lacan has come to assert history is mere "text" open to any interpretation. In this view history is not truth, but a fiction accepted by powerful and recognized groups specific to the culture propounding it. Windschuttle defends positivistic learning which must rest on fact. Specific facts may be in dispute, but the disputes must be clearly set forth so that the known can set limits to interpretation. This distinction between history and myth or fiction has been recognized since the enlightenment. Moreover, while history can not be predictive, it is "contingent", which means events must be in accord with what went before and can not be just any fictive narrative.
History is not fiction, nor is it merely 'perspective'. The core of history--the basis for the conclusions that individual historians reach and the basis of the debates that historians conduct between each other--is factual information. Despite the speculations of Foucault and his followers, history remains a search for truth and the construction of knowledge about the past. (p. 154)
In this book we are taught and have to learn a lot about the philosophy of science--an indispensable subject for skeptics. This is not an easy read. It is, however, a powerful refutation of the multi-culturalists, afrocentrists, feminists, and other writers who would like the world to be as they want it, rather than what it is.
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