Causation and disease: biomedical science in toxic tort litigation

Inferences concerning the etiology of disease in human populations are derived from complex quantitative and biologic data. Interpreting these inferences in toxic tort litigation poses difficult problems for courts. Fundamental differences exist between courtroom and scientific criteria of causation. These differences need not be irreconcilable if courts understand the nature, strengths, and limitations of scientific evidence. We discuss the interpretation of basic scientific principles of disease causation in the context of legal rules of evidence, and develop an epidemiologic evidentiary standard for toxic tort litigation.