Tuesday, October 12, 2010

Vaccines, Autism, the Supreme Court, and the burden of (scientific) proof.

The New York Times today reports the Supreme Court will consider a case involving the relationship between vaccines and autism. Given some of the Roberts court's recent decisions it's possible to infer the interests of large corporations and science will nicely coincide in this case, but in a group of nine people where one of the two most ideologically similar members describes the other as a "nut" there is latitude for surprising outcomes.

In recent decisions, notably Citizens United v. Federal Election Commission, the Roberts court has demonstrated a muscular inclination to broaden the legal protections afforded to corporations. Cases the court has agreed to hear in the near future provide it the opportunity to continue to create an expansive definition of corporate rights.

There is no scientific evidence that autism is linked to vaccines, measles-mumps-rubella or any other kind. Despite the energy advocates pour into claims to the contrary, their position cannot be regarded as evidence-based.

Taken together, these factors would point to a slam-dunk in favor of the vaccine manufacturer. The issue before the court, however, relies not a determination of rights or preponderance of evidence but on the question of legislative intent: did congress intend to prohibit certain types of lawsuits against drug manufacturers? Their answer has implications for the effects of such lawsuits on evidenced-based medicine that reach beyond the absence of scientific grounds for the claim in the case in question.

Treatment of autism with hyperbaric oxygen therapy to facilitate development, improve behavior, or eliminate the condition remains experimental and without strong scientific support despite numerous anecdotal reports from respectable sources of positive outcomes. While changes in the legal standards for product defect lawsuits involving vaccines have no direct bearing, such a decision could be a bellwether for a change in evidentiary standards by a court that has demonstrated a willingness to overturn settled law.

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