A correspondent takes issue with my post earlier this week on the subject. (I see Rich Lowry has written a related article.) I’ll print it here in quotes, with my responses in brackets:
“Your comments about John Edwards and malpractice are, for you, unusually
uniformed. [Thanks for the qualifier.] You cite a 2003 study as evidence that Edwards did something wrong in the early 1990’s. This is wrong for three reasons:
“First, the study appears to be conducted by people with a motive to protect
their field. And even they, according to the Washington Times’ description, could only ‘cast doubt’ on Edwards’ winning theory.”
[The American College of Obstetricians and Gynecologists may well have a motive to keep its members in business, unharassed by trial lawyers. They did, however, get the American Academy of Pediatrics to collaborate with them on the report. The report was endorsed by the Centers for Disease Control and Prevention, the March of Dimes Birth Defects Foundation, the National Institute of Child Health and Human Development, and Australian and Canadian associations of obstetricians and gynecologists.
The study, meanwhile, does more than “cast doubt” on the theory that cerebral palsy is commonly caused by asphyxia due to obstetricians’ failures to perform c-sections. It says, “Purely dyskenetic or ataxic cerebral palsy, especially where there is an associated learning difficulty, commonly has a genetic origin and is not caused by intrapartum or peripartum asphyxia.” Dr. Murray Goldstein, medical director of the United Cerebral Palsy Research and Educational Foundation, has said that brain damage occurring at the time of delivery is “really quite unusual.”
Also worth noting is the fact that the proportion of deliveries done by c-section has risen over the last 35 years, while cerebral-palsy rates have not fallen.]
My correspondent again: “Second, the doctors and their insurers had the opportunity to prove Edwards’ science was inaccurate, but they lost. Could it be that Edwards had the better scientific argument? The Washington Times article gives no information about the relative strengths of each side’s scientific argument. The readers have no idea how to weigh Edwards’ science against the 2003 study.”
[Edwards brags about these cases in his book Four Trials. The principal evidence of medical wrongdoing on which he relied came from fetal monitoring readings. The ACOG study’s verdict on this kind of evidence: “use of nonreassuring fetal heart rate patterns to predict subsequent cerebral palsy had a 99% false-positive rate.” Anyway, Edwards famously won a trial less by presenting scientific evidence than by channeling “messages” from the dead baby for the jury. “Weighing” the evidence from science vs. a seance is unlikely to be fruitful.]
“Third, how can Edwards be faulted in 1995 for failing to anticipate a study
announced in 2003? The legal system must resolve disputes and reach
judgments based on the best evidence available at the time. Litigants and their lawyers don’t have the scientist’s luxury of postponing a decision for decades for more research.”
[Hey, it’s not as though the doctor was suing Edwards. The burden of proof was on Edwards to prove that the doctor did wrong, not on the doctor to prove the negative. Many courtrooms would not allow Edwards’ quack science and seances to be put forward–they would require that theories of causation to be generally accepted in the relevant professional community, or at least to have been peer-reviewed. The trial bar hates this kind of test, of course, and it may be that judges appointed in a Kerry-Edwards administration would seek to undermine them.]
“I look forward to watching people publicly debate Edwards’ cases. If the Right makes them an issue, Edwards will probably be as persuasive with the voters and with the jurors.”
[Maybe you’re right. Who knows? Here’s my bottom line: Edwards shook down North Carolina obstetricians for tens of millions of dollars over diseases that they did not cause and could not have caused. Those millions contributed to higher health-insurance premiums. And the lawsuits drove good doctors out of North Carolina. That Washington Times article suggests that people have died because these suits drove specialists away. In a just world, this man would be–well, let’s just say that he would not be vice president of the United States.]