by Marcia Angell
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Book Description
In the early 1990s, sympathetic juries awarded huge damages to women claiming injury from silicone breast implants, leading to a $4.25 billion class-action settlement that still wasn't large enough to cover all the claims. Shockingly, rigorous scientific studies of breast implants have now shown that there is no significant link between breast implants and disease. Why were the courts and the public so certain that breast implants were dangerous when medical researchers were not? The answer to this question reveals important differences in the way science, the law, and the public regard evidence--and not just in the breast implant controversy.
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Introduced in 1962, silicone breast implants had been used by between one and two million women by the time they were virtually banned in 1992 by David A. Kessler of the Food and Drug Administration. While the ban came about because manufacturers had failed to demonstrate the safety of the devices, Marcia Angell, executive editor of The New England Journal of Medicine, argues that there actually was no medical consensus to support the contention that implants could cause widespread illness. Science on Trial examines the silicone debate and argues for the reliance on scientific evidence "to curb the greed, fear and self-indulgence" of such disputes.
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Average Customer Review:
6 of 7 people found the following review helpful:
 Science Triumphs, 2004-01-11
I read this book back in 1996 before the issue of implant safety was settled. I recall the impression it made on me with regard to the widespread ignorance that surrounds us, not only on specific scientific principles but also on the whole idea of the scientific method. This book illustrates why hypotheses and theories can never be evaluated by a court of law. It also illustrates why in any critical review of data one must have a control. If the incidence of a disorder is the same in a group getting implants as it is in a group that does not get implants then it is impossible to reasonably argue that there is any connection between implants and the disorder. Silicone is one of the most inert materials around and people are exposed to it all the time. I strongly recommend this book for anyone looking for further proof that our schools do not teach science adequately.
11 of 12 people found the following review helpful:
 Medical evidence vs court testimony vs belief, 2003-02-03
Please note that the more or less average "average ratings" come from reviewers who either rate this one star or four to five stars. In my opinion this illustrates the main point of the book, i.e. that people either evaluate things based on medical evidence, on the opinion of experts, or on their personal belief based on personal life experience/expectations. The different ways of evaluation produce conflicting perceptions, conflicting world views which we see played out many aspect of life. I think that Dr. Angell is gutsy to even take on an issue which generates tremendous controversy. I believe that she presents the arguments for medical evidence very well. Chapter 5 is the best brief and understandable description of what medical evidence is (and is not) that I have ever read. I recommend the book on that alone. I hope that some day Dr. Angell will update the book to include more recent research.
13 of 45 people found the following review helpful:
 Biases Aplenty, 1999-12-16
For the true story behind implants, one's time is better spent reading John Byrne's "Informed Consent". He was in charge of Dow's "ethics" program and his wife also had implants. Contrary to what Dr. Angell writes in her book, there are many studies showing immunological responses to silicone oils (most recently a study by researchers at the FDA - June 1999). The Institute of Medicine in their recent report termed the FDA study "interesting", choosing to rely on previous, and seriously flawed, studies purporting to show no link between silicone and disease (the same studies quoted in Dr. Angell's book). One of the studies looked at women who had implants for only one month (!), which is as ludicrous as determing smoking doesn't cause cancer after studying a person who smoked for only a brief time. There are thousands of court documents proving fraud on the part of the implant manufacturers. Reading through them makes one realize how powerful corporations are and how the bottom line is far more important than the health and safety of the consumer. Breast implants (saline and silicone) have NEVER been approved for safety by the FDA. They only have pre-market approval, which means they can be on the market pending the manufacturers submission of safety data. To date, the manufacturers have been UNABLE to prove implants safe. Unfortunately, the medical community and the corporate community are oftentimes inextricably intertwined. Money is the motivator. When Dr. Angell speaks of greed, I'm sure that's at least one thing she knows a lot about.
11 of 15 people found the following review helpful:
Finally, a rational argument!, 1999-06-02
People have a tendency to let their emotions rule their mind, or in this case, their breasts. Luckily, this book chooses the mind.
5 of 35 people found the following review helpful:
a paid expert for dow corning-biased, 1999-04-17
this woman is a front for the plastic surgeons and the chemical cos. who are responsible for the largest cover-up of facts in the history of plastic surgery--the media pr and the cruel slap at sick women and children is disgusting--she also came out against agent orange problems (also a DOW product--if the public ever gets the real story in this silicone disaster it wont be thru drs and health persons like her--she is so tainted by dow et/al money that this book reeks --its smells of corporate cover-up and misinformation--GET THE FACTS ON THIS WOMAN AND HER BACKERS!
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