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Lawyers and medical scientists in the US are at sixes and sevens again
over who’s to blame, and who’s to pay, for the epidemic of problems with
silicone breast implants. The implants started to cause medical problems
for women in the early 1980s. In 1992 the government decided to take the
implants off the market, except for use in experimental trials. There wasn’t
much scientific evidence to damn the implants at the time; the anti-implant
tide rose largely due to the influence of anecdotal evidence and legal victories
handed out by juries to claimant women.

But hold, says the Bible of medical research in the US, the New England
Journal of Medicine. A study that it published recently (16 June) indicates
that there is no link at all between silicone implants and connective
tissue disease – one of the problems most frequently cited by the 20 000
women suing implant manufacturers. The accompanying editorial backed up
the study by crowing ‘We told you so!’

Lawyers representing the 20 000 are doing what any self-respecting partisan
would do – impugning the witness. They point out that the study was funded
in part by plastic surgeons, for whom implants mean income. They also note
that it’s a retroactive study that looks back on women’s medical histories
and tries to reconstruct what happened. Such studies are notoriously weak.

The strongest reaction, has been over the timing of the publication.
It appeared one day before the first deadline for women to decide whether
they want to continue suing implant manufacturers, or whether to opt for
an out-of-court settlement from a $4.2 billion fund set up by the manufacturers.
To qualify for the fund, a woman must drop her lawsuit. The Journal’s sceptical
view on the dangers of implants, lawyers suggest, might have swayed some
women to abandon lawsuits they might have won. Not that lawyers are completely
neutral on the subject – a drop in lawsuits mean a drop in fees.

Whether and how many American women were actually influenced by the
Journal’s articles will never be answered for sure. The only certain thing
is that, as usual, lawyers will have the last word.

* * *

Protecting ‘turf’ is everything in Washington, and sometimes innocent
bystanders can get caught in the crossfire. In a recent shoot-out between
two congressmen, it was university-based researchers who took the stray
bullet.

The case involves John Murtha, Democrat from Pennsylvania, chairman
of the appropriations committee in the House of Representatives which doles
out money to the Pentagon, and George Brown, Californian Democrat and chairman
of the House science, space and technology committee.

Murtha has a great deal to say about how the Department of Defense’s
$243 billion is divided up. You could almost say his word is law. So Murtha
was not at all happy when Brown wanted to make public some of the earmarks
Murtha had tucked away in the defence appropriations bill. Earmarks are
special awards to universities given by Congressional sanction. For example,
in the latest bill there is $2.8 million for Rutgers University in New Jersey
for what is called a ‘combat rations advanced manufacturing technology program’
and $18 million for the University of Pittsburgh for a national defence
centre of environmental excellence. Projects like these tend to be given
as political favours to Congressmen representing the university’s district,
winning them points at home. This practice is know as ‘pork barrel politics’.
Brown has been trying to limit Congressional pork, arguing that in tight
economic times, money should be handed out based on merit.

So when Brown asked Murtha for a list of earmark projects in the defence
appropriations bill, Murtha refused. Brown, exercising his committee’s
prerogatives, threatened to subpoena the documents. The Speaker of the House
of Representatives, Thomas Foley, then stepped in and told Murtha to hand
over the documents.

But Murtha appears to have had the final say. When the appropriations
bill emerged from Murtha’s committee, all the earmarks were there, but $900
million had been stripped from the other, merit-based Pentagon programmes.
Murtha brought his bill to the floor of the House as it was rushing to adjourn
for the Fourth of July holiday, and with less than thirty minutes of debate,
the House passed Murtha’s bill.

The money may well be added back by the Senate, or by a supplementary
appropriations bill from the House. But Murtha’s was a stern warning to
anyone who would tread on his turf.