Physicians testified for tobacco companies against plaintiffs with cancer, Stanford study finds

http://www.eurekalert.org/pub_releases/2015-07/sumc-ptf071415.php

Public Release: 17-Jul-2015
Stanford University Medical Center

Despite scientific evidence to the contrary, a small group of otolaryngologists have repeatedly testified, on behalf of the tobacco industry, that heavy smoking did not cause the cancer in cases of dying patients suing for damages, according to a study by a Stanford University School of Medicine researcher.

"I was shocked by the degree to which these physicians were willing to testify, in my opinion in an unscientific way, to deny a dying plaintiff -- suffering the aftermath of a lifetime of smoking -- of a fair trial," said Robert Jackler, MD, professor and chair of otolaryngology-head and neck surgery, referring to the physicians cited in the study as a "pool of experts willing to say over and over again that smoking didn't cause cancer."

The study will be published online July 17 in Laryngoscope.

Jackler, who holds the Edward C. and Amy H. Sewall Professorship in Otorhinolaryngology, conducted a year and a half of research, which included reading through thousands of pages of publicly available, expert-witness depositions and trial testimony. He then reviewed the scientific literature to see if testimony by expert witnesses for the tobacco industry was supported by evidence. Jackler said that a physician serving as expert has an ethical obligation to interpret the scientific data in a fair and balanced manner. The literature, he found, repeatedly repudiated the testimony. "The study found they used scientifically invalid methods to support their testimony," he said.

The study reports that six board-certified otolaryngologists were paid by one or more of the tobacco companies R.J. Reynolds, Phillip Morris and Lorillard to serve as expert witnesses. These physicians gave testimony that indicated a multiplicity of environmental factors, ranging from exposure to cleaning solvents to the consumption of salted fish to the use of mouthwash, were more likely to have caused the plaintiff's head and neck cancers than years of heavy smoking. The cases occurred between 2009 and 2014. One physician said he was paid $100,000 to testify in a single case. Another admitted that her opinion was written by tobacco company lawyers and then approved by her. Still another rejected reports from the Surgeon General as authoritative sources.

Together, the six otolaryngologists in this study helped to defend the tobacco industry in more than 50 cases.

"Evidence shows that this testimony, which was remarkably similar across cases, was part of a defense strategy shaped by tobacco's law firms," the study said.

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The study said: "An obvious fallacy of this argument lies in the fact that literally billions of nonsmoking people are exposed regularly to gasoline fumes, use cleaning solvents, eat salted fish or live in urban environments. Were these causative factors for head and neck cancer, with even a minute fraction of the potency of tobacco, the rate of head and neck cancer among nonsmokers would be much greater than what has been observed."

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"The tobacco industry identifies the best experts that money can buy, trains them in their well-honed narrative to manufacture doubt in the minds of the jury and makes use of them over and over in case after case," the study said. Given the ethical traditions of medicine, it seems likely that these physicians believe their well-compensated testimony on behalf of tobacco companies occurs in the shadows, out of view of their families, friends and professional colleagues, Jackler said.