Lagorio Susanna, Vecchia P
Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute - Istituto Superiore di Sanità, Roma.
Med Lav. 2011 Mar-Apr;102(2):144-62.
Scientific knowledge is essential for the resolution of disputes in law and administrative applications (such as toxic tort litigation and workers' compensation) and provides essential input for public policy decisions. There are no socially agreed-upon rules for the application of this knowledge except in the law. On a practical level, the legal system lacks the ability to assess the validity of scientific knowledge that can be used as evidence and therefore relies heavily on expert opinion. A key issue is how to ensure that professionals in any field provide judges with sound advice, based on relevant and reliable scientific evidence. The search for solutions to this problem seems particularly urgent in Italy, a country where a number of unprecedented verdicts of guilt have been pronounced in trials involving personal injuries from exposure to electromagnetic fields.
An Italian Court has recently recognized the occupational origin of a trigeminal neuroma in a mobile telephone user, and ordered the Italian Workers' Compensation Authority (INAIL) to award the applicant compensation for a high degree (80%) of permanent disability. We describe and discuss the salient aspects of this sentence as a case-study in the framework of the use (and misuse) of scientific evidence in toxic-tort litigations.
Based on the motivations of the verdict, it appears that the judge relied on seriously flawed expert testimonies. The "experts" who served in this particular trial were clearly inexperienced in forensic epidemiology in general, as well as in the topic at hand. Selective overviews of scientific evidence concerning cancer risks from mobile phone use were provided, along with misleading interpretations of findings from relevant epidemiologic studies (including the dismissal of the Interphone study results on the grounds of purported bias resulting from industry funding). The necessary requirements to proceed to causal inferences at individual level were not taken into account and inappropriate methods to derive estimates of personal risk were used.
A comprehensive strategy to improve the quality of expert witness testimonies in legal proceedings and promote just and equitable verdicts is urgently needed in Italy. Contrary to other countries, such as the United States or the United Kingdom, legal standards for expert testimony, such as preliminary assessment of scientific evidence admissibility and qualification requirements for professionals acting as experts in the courtroom, are lacking in our country. In this and similar contexts, recommendations issued by professional associations (including EBEA and BEMS) could play a role of paramount importance. As examples, we refer to the guidelines recently endorsed by the UK General Medical Council and the American Academy of Pediatrics.
科学知识对于解决法律和行政应用中的纠纷(如有毒侵权诉讼和工伤赔偿)至关重要,并为公共政策决策提供重要依据。除了法律领域,对于如何应用这些知识,社会上并没有达成共识的规则。在实际层面,法律系统缺乏评估可作为证据的科学知识有效性的能力,因此严重依赖专家意见。一个关键问题是如何确保任何领域的专业人员都能基于相关且可靠的科学证据,为法官提供合理的建议。在意大利,解决这个问题的需求显得尤为迫切,在该国涉及因接触电磁场导致人身伤害的审判中,已经做出了一些史无前例的有罪判决。
意大利一家法院最近认定一名手机用户的三叉神经瘤源于职业因素,并命令意大利工伤赔偿管理局(INAIL)判定申请人因80%的高度永久性残疾获得赔偿。我们将描述并讨论这一判决的显著方面,作为有毒侵权诉讼中科学证据使用(和误用)框架下的一个案例研究。
从判决的动机来看,法官似乎依赖了存在严重缺陷的专家证词。在这个特定审判中提供证词的“专家”,总体上显然在法医流行病学方面缺乏经验,对手头的主题也缺乏经验。他们对有关手机使用导致癌症风险的科学证据进行了选择性概述,并对相关流行病学研究的结果进行了误导性解读(包括以所谓行业资助导致的偏倚为由驳回了国际癌症研究机构(Interphone)的研究结果)。没有考虑进行个体层面因果推断的必要条件,并且使用了不恰当的方法来得出个人风险估计值。
意大利迫切需要一项全面战略,以提高法律程序中专家证人证词的质量,并促进公正公平的判决。与美国或英国等其他国家不同,我国缺乏专家证词的法律标准,比如对科学证据可采性的初步评估以及在法庭上担任专家的专业人员的资质要求。在这种及类似情况下,专业协会(包括欧洲生物电磁学会(EBEA)和生物电磁学会(BEMS))发布的建议可能会发挥至关重要的作用。例如,我们参考了英国医学总会和美国儿科学会最近认可的指南。