by: Nachman Brautbar M.D

Introduction

Occupational and environmental exposure to potentially toxic chemicals has been reported more frequently in the last five (5) years, most likely as the result of 1) increased public awareness, 2) improved reporting by physicians, 3) unlimited access to the information data banks, 4) more efficient regulatory support, 5) increased recognition by treating and evaluating physicians.

A physician who evaluates and treats patients with toxic exposure has to address the issue of causation. This issue of medical causation in toxic exposures has been the subject of ongoing scientific evolution over the last forty (40) years. As science evolves so does the understanding of causation and scientific evidence.

The Methodology For Establishing Cause And Effect

The evaluating and treating doctor has to establish cause and effect in the process of providing treatment, diagnosis or the evaluation of a population of patients for the purposes of consultations for forensic toxicology opinions. The methodology for establishing causation in the medical profession is not new and has been established and published in various texts, international and national conferences, and scientific peer-reviewed papers. Despite the fact that the methodology required to establish causation in toxic exposures has been well-described, the applicability of that methodology in the forensic medicine (medical-legal) arena has been a subject of deep division among experts, attorneys, and the judicial system.

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