pubmed-article:14582241 | pubmed:abstractText | This paper focusses on the role of epidemiology in demonstrating causality in criminal trials of toxic tort litigation. First of all, consideration is given of the specificity of the criminal trial and of the role of the epidemiologist as expert witness. As a second step the concept of causality is examined separating general from specific (individual level) causality. As regards general causality, strategies based on some criteria (example: Bradford-Hill criteria) are contrasted with approaches that do not consider causality a matter of science but one of health policy; and specific methods frequently used (meta-analysis, risk assessment, International Boards evaluation,....) are discussed, with special reference to the adoption of high-level standards and to the context of cross-examination. As regards individual level causality the difficulties of the epidemiologic approach to such evaluation are stressed, with special reference to topics like expected value, attributable risk, and probability of causation. All examples are taken from Italian court trials. A general comment on the difficulties of using the criminal trial (dominated by the "but for" rule) for toxic tort litigation and on the opportunity to switch to trials (civil, administrative) with less stringent causal rules ("more probable than not") is offered, with a consideration also of what are called "class actions". | lld:pubmed |