The main aim of this thesis is to advocate a more scientifically informed approach towards epidemiological evidence in disease litigation. It analyses the judicial scepticism about epidemiology in UK tort law, and finds that the myth of scientific certainty lies at the heart of the devaluation of epidemiology as proof of specific causation. It traces misconceptions about epidemiology to broader misconceptions about science as a whole (including medical science and disease), and confused legal approaches to causation. To explain why legal objections to epidemiology are erroneous, the thesis clarifies fundamental aspects of science and disease causation that lawyers need to better grasp. Scientific reasoning is inherently probabilistic. Further, medical research indicates that disease causation is usually multifactorial and stochastic. Rigid and deterministic ‘but for’ questions are thus fundamentally unsuited for assessing disease causation. The mismatch between legal and medical causal models makes courts resort to normative, ‘backwards’ causal reasoning or haphazard exceptional approaches to disease causation, where the most difficult dilemmas around causation arise. This thesis argues that courts need a better test for causation for disease that can take account of probabilistic scientific and epidemiological evidence, and suggests one such principled approach. Epidemiology can be invaluable in such an assessment of disease causation.
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UK legal approach to disease causation: examining the role for epidemiological evidence