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The Price of Testimony |
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Author: Bruce Lanphear, MD, MPH NOTE: This article was originally published on September 25, 2025 by Plagues, Pollution & Poverty on Substack. Courts as Public Health Battlegrounds Imagine being asked to compress years of scientific nuance into a simple yes-or-no answer for a jury. That was the dilemma Dr. Andrea Baccarelli faced when he testified in lawsuits over acetaminophen and autism—and it is the same dilemma many scientists will face as the courtroom, rather than the regulator’s office, becomes the frontline of public health. A New York Times article put Dr. Andrea Baccarelli—a respected scientist at Harvard—squarely in the spotlight. The story focused on his role as a paid expert witness in lawsuits over acetaminophen and autism. As reported by the New York Times, Dr. Baccarelli wrote in his 2023 expert report for the lawsuit that “substantial evidence supports a strong, positive, causal association between acetaminophen” and neurodevelopmental disorders, particularly autism and A.D.H.D. That statement was enough to ignite a storm after Trump’s announcement that acetaminophen was linked to autism. The controversy isn’t just about one scientist or one chemical. It raises a broader, uncomfortable question: should scientists testify in court cases at all? When Courts Outpace Regulators If we look honestly at the last half-century of public health, many of the most important victories did not come from regulators. They came from courts. I was personally involved in litigation against the paint and pigment industry in California, where ten cities and counties ultimately secured a $305 million settlement to clean up lead hazards in housing. Regulators had stalled for decades while millions of children were exposed to dangerous levels of lead paint. It was the courts that finally broke through. The pattern has repeated itself. Earthjustice went to court to force the EPA to strengthen rules protecting children from lead hazards in their homes. Years of administrative dithering and industry lobbying had left the standards badly outdated. Only when the agency was sued did it move. Chlorpyrifos, a widely used pesticide that can damage children’s brains, remained in circulation long after the science was clear. Litigation—rather than regulation—finally forced its removal from agriculture, though a subsequent court case left it available for certain select applications. It may sound hyperbolic to say that nothing seems to happen in public health without the courts, but experience makes it hard to conclude otherwise. The courtroom has become the place where evidence collides with power, where delay gives way to decision, and where the hidden toll of toxic chemicals finally becomes visible. The Tension for Scientists And yet, the courtroom is not the laboratory. Science traffics in probabilities, confidence intervals, and cautious caveats. Courts demand clarity. Judges and juries want yes-or-no answers. When a scientist steps into that environment, the tension is palpable. Money complicates it further. Dr. Baccarelli was paid $150,000 for his testimony. That is a substantial sum by any measure, even for a tenured professor at an Ivy League university. We know from decades of research on conflicts of interest that financial incentives shape judgment. They may not buy opinions outright, but they bend perception in ways that scientists themselves may not recognize. Why else would journals demand disclosures, why else would advisory committees set strict financial thresholds, why else would we impose rules on clinical trials?
It is difficult—perhaps impossible—to remain fully objective when large payments are on the line. Scientists know this. The public knows this. And when the sums are large, trust erodes. What Happens If Scientists Stay Silent Still, here is the dilemma: if scientists refuse to testify, public health falters. Take paraquat, a herbicide strongly linked to Parkinson’s disease. Litigation has uncovered internal documents suggesting manufacturers knew more than they revealed. Without scientists to explain the biology to juries, those cases would wither. Atrazine, another pesticide, contaminated aquifers across wide swaths of the country. The courtroom revealed its spread and its risks long before regulators were willing to act. The sprawling settlements over PFAS—“forever chemicals” that taint water supplies across the United States—would never have materialized without scientists translating the complex toxicology into terms a judge could understand. I could add asbestos, benzene, vinyl chloride, diesel exhaust. The pattern is the same. Regulators move slowly; industry lawyers sow doubt; and public health languishes until litigation forces the issue. If scientists walk away, the only experts left are those who hire themselves out to industry to manufacture uncertainty. The absence of credible scientific testimony doesn’t make cases more objective—it tilts the scales decisively toward those who profit from pollution. How to Balance Ethics and Engagement So what should scientists do? The answer cannot be to retreat. The stakes are too high. But we also cannot ignore the corrosive effect of money. I believe scientists should serve as expert witnesses, but they must do so with care. They should choose cases where the evidence is strong enough to support their testimony and where the litigation has broad implications for public health. I avoid individual cases that hinge on personal injury alone. My focus is on lawsuits that can shape entire populations—cases that change housing codes, force cleanup of water supplies, or establish precedents that protect millions. And the financial side must be handled differently. When I work with advocacy groups, I often provide my services pro bono. I served as an unpaid expert in the recent fluoride case, Food & Water Watch v. EPA, where the question of neurotoxicity and water fluoridation was at stake. When I collaborated with the Natural Resources Defense Council to help Pittsburgh deal with its lead service lines, I did so without charging a fee. In instances where payment for my service is warranted, I direct it to my university. The funds support research or teaching, but they do not buy me a personal computer, a vacation, or a car. By drawing a bright line, I protect myself and science from the perception that my testimony is for sale. For Dr. Baccarelli, the path forward seems similar. He should continue to serve as an expert witness when the science is sufficient and when the case has implications for public health. His voice matters. But he should not pocket the money. Redirecting those funds to a nonprofit organization or to a university account for research and teaching would not only safeguard his reputation but strengthen the credibility of the work itself. The Bigger Picture This debate is not really about one scientist, one drug, or one deposition. It is about the relationship between science and the law, and about how public trust is earned or squandered. If the public comes to believe that scientists are merely hired guns, then science loses its power in the courtroom and, by extension, in society. At the same time, if scientists retreat entirely, industry voices dominate. Cases stall, exposures continue, and preventable disease spreads. The courts have become the frontline of public health. From lead paint to pesticides to PFAS, the evidence is clear: litigation often does what regulation cannot. Public Health Over Personal Gain Scientists should not abandon the courtroom. On the contrary, they must be there precisely because the stakes are so high. But they should be there on different terms—terms that prioritize public health over personal enrichment. That is how science can serve justice without selling its soul. This article was originally printed on Substack in Plagues, Pollution & Poverty. To read more content from this source subscribe to Plagues, Pollution & Poverty: https://tinyurl.com/3rfeuama |
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