"Fight Over Vaccine-Autism Link Hits Court"

Read the full article subtitled "Families, After Having Claims Rejected by Experts, Face Lower Burden of Proof" by Shankar Vedantam, The Washington Post, June 10, 2007.

I don't know enough even to have an opinion as to whether vaccines can cause autism, nor whether there would be ways to prepare the vaccines that would make them safer. I do believe that as terrible as autism is for the children and families affected, the current incidence of autism might well be an acceptable price to pay for the protection of society against communicable diseases, that historically killed and disabled many more children and adults than are now affected by autism.

The posting here is simply to point out the effective substitution of legal processes for scientific and medical processes -- of legal knowledge systems for scientific and medical knowledge systems -- in deliberations on this issue. Moving the decision to the courts not only changes the basis of decision from that used to judge the validity of a scientific or medical conclusion to the "preponderance of evidence" ("50 percent plus a feather") used in civil cases. It substitutes a process in which lay people judge evidence presented by legal advocates under the supervision of a judge for the consensus of scientific opinion formed through replication of peer reviewed scientific reports, or medical opinion formed (in part) through panel review by medical experts of case-controlled study data.

The legal system is probably not a good one for deciding on the merits of the evidence, but it is informed by judicial standards for expert testimony. Indeed, I think there are good efforts underway to assure that the courts have the benefit of disinterested scientific advice on interpretation of scientific evidence. On the other hand, we know that the FDA's system for judging the quality of evidence about the efficacy and safety of vaccines can be improved, as can the systems used by public health officials in deciding whether and how best to immunize populations. On the other hand, I like the use of the courts to make decisions on how best to indemnify those who are the losers in society's bets on public health efforts -- the minority of people injured by vaccines that are intended to protect the majority. The legal system is further protected by the existence of legislative processes that can limit the authority of the courts over torts, and of executive ability to veto legislation which does so.

Knowledge systems are complex and have overlapping domains, which is probably all to the good!