Epidemiology in the courtroom: analysis of an ethical conflict

This paper discusses one ethical conflict facing epidemiologists whose studies are used as the basis for litigation. Should they maintain independence or act for one side or the other? To describe and analyze this ethical conflict, a simple model in two dimensions is introduced. The first dimension specifies the persons involved in or affected by the legal process; the second dimension specifies the relevant ethical principles. The main result of the analysis is that to act as an expert witness for the Plaintiffs (as an alternative to maintaining independence) is that the Plaintiffs are the only people to benefit and all other groups are either unaffected or face costs. We believe that to maintain independence is ethically justified in this particular case. But since people differ over values and since some of the factual assumptions are questionable, a different conclusion as to what epidemiologists ought to do may be equally rational or irrational.