Medico-legal issues in occupational lung disease litigation.

D URING Alger Hiss’s second perjury trial, the defense called a psychiatrist, Dr. Carl Binger, to give an expert opinion on the credibility of the prosecution’s chief witness, Wittaker Chambers. After reading Chambers’ extant writings and watching him testify at both trials, Dr. Binger found himself able to testify, within “reasonably certainty,” that Chambers was suffering from a psychopathic personality. Dr. Binger opined that in Chambers’ case, his disorder manifested itself in the asocial behavior of chronic lying. The prosecutor, Thomas Murphy, crossexamined Dr. Binger relentlessly over the course of several days. Murphy elicited omitted facts about weaknesses in Dr. Binger’s credentials and about his friendship with Alger Hiss. Murphy’s dissection and destruction of the substance of Dr. Binger’s opinion has come to be considered a classic of medical crossexamination.’ In 1950, Alger Hiss was convicted; Thomas Murphy later became a federal court judge; and Dr. Binger reportedly lectured his young medical students never go to court. Today, many physicians gladly would avoid the courtroom confrontations that Dr. Binger found so discomforting. Despite these feelings, physicians have an ethical obligation, by virtue of their special training and experience, to assist in the administration of justice.2-5 Indeed, the Board of Trustees of the American Medical Association has recommended that the presentation of expert testimony should be considered part of the practice of medicine and thus subject to peer review.6 The need for truly qualified physicians to fulfill their civic obligations is nowhere greater than in the litigation of the thousands of currently pending cases in which plaintiffs claim they have an asbestos-related lung disease or disorder. The mass filing of these claims began in the 1970s and has today reached crisis proportions. Compromising traditional notions of due