Cancer Physicians Testified For Tobacco companies

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Physicians testified for tobacco companies against plaintiffs with cancer

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.

"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."

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 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.

"The addictiveness of nicotine, the dangers of tobacco and the track record of industry deception and misconduct are considered factual in subsequent trials," the study said. "This has resulted in thousands of individual Engle progeny cases. Because the cases primarily focused on whether tobacco caused the plaintiff's diseases, expert testimony was crucial."

Although since the 1990s tobacco companies have admitted that their products cause cancer, in litigation they vigorously argue that smoking did not cause an individual plaintiff's cancer.

"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.

Stanford University School of Medicine. Laryngoscope

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