Silicone breast implants. Can emerging medical, legal, and scientific concepts be reconciled?

Unexpected post-mortem diagnosis of systemic sclerosis presenting as pneumatosis intestinalis: revised diagnostic criteria and medicolegal implications

Systemic sclerosis is a challenging diagnosis for clinicians and pathologists alike due to its protean manifestations and often insidious onset, particularly in cases without significant titres of auto-antibodies. Herein we present a case of a female in her sixties who died rapidly following a clinical diagnosis of pneumatosis intestinalis and respiratory failure of unclear etiology. Recently revised clinical diagnostic criteria were applied to the clinical history and postmortem findings to reach an unexpected diagnosis of systemic sclerosis. The diagnosis of systemic sclerosis at autopsy has important medicolegal implications largely related to premature death due to delayed treatment or poor post-operative outcome. Moreover, familial clustering of this disease underscores the importance of maintaining a high index of suspicion in the postmortem setting.

Lay experts and the politics of breast implants

This paper discusses the controversy around breast implants in the United States and Europe. It focuses on the emergence of consumer and support groups for women and offers an analysis of the role they have played in recent policy developments in UK and Europe. The politics of breast implants is seen as a politics of knowledge in which scientific expertise has consistently been deployed in ways that minimize the credibility and legitimacy of women's accounts of their bodies and illness experiences. These women have been doubly disadvantaged in a policy debate that turns on scientific controversy and uncertainty. This implies a gendered dynamic to the changing relations of knowledge and expertise. The paper contributes to an understanding of the relations between regulators, manufacturers, users, and clinicians in the global medical device industry and to wider debates around the public understanding of science.

The expert witness. Neither Frye nor Daubert solved the problem: what can be done?

Flawed expert scientific testimony has compromised truth finding in American litigation, including in medical malpractice and in product liability cases. The Federal Rules of Evidence and the Supreme Court in Daubert and other cases have established standards for testimony that include reliability and relevance, and established judges as gatekeepers. However, because of lack of understanding of scientific issues, judges have problems with this role, and juries have difficulties with scientific evidence. Professionals and the judiciary have made some advances, but a better system involving the court's use of neutral experts and a mechanism to hold experts accountable for improprieties is needed.