Day 030 - 03 Oct 94 - Page 23
1 by government. I would say the first major government
2 statement made in the States on the subject, including
3 statements on diet and cancer, were the Surgeon General's
4 report on nutrition and health, which came out in 1988.
5
6 I should explain the Surgeon General in the States is the
7 exact equivalent of our chief medical officer in that he
8 is appointed usually from outside government. He would be
9 an eminent medical person who is appointed to serve
10 government for a term and issues reports, exactly as the
11 CMO does in this country.
12
13 So to the best -- no, I am confident in saying that the
14 first government statement on nutrition and health, which
15 included conclusive statements about diet and cancer, was
16 1988 in the States. There may have been one before, but
17 I think that was the first major report.
18
19 Q. If the US government makes recommendations, what are they
20 saying about the strength of the evidence?
21 A. Well, again this goes back to a remark I made about
22 testimony of individual experts. I do not here want to
23 presume on the court because I am certainly not a lawyer,
24 but it is relevant to say that what is meant by proof in
25 the life of biological sciences, like nutrition, is
26 essentially the same as what is meant by proof in a court
27 of law. So, of course, as the court knows, in a civil
28 case you will decide on the balance of probability, which,
29 in a medical context, is rather like what a general
30 practitioner does faced with a patient.
31
32 In public health generally, the standard of proof required
33 is similar to a criminal case, which is to say proof
34 beyond reasonable doubt. The point I am making is that in
35 the biological sciences, which is what we are talking
36 about here, you cannot get anything better than proof
37 beyond reasonable doubt. This point of the parallel
38 between what the term "proof" means in the biological
39 sciences, like nutrition and public health, and what it
40 means in a court of law has actually been made itself in
41 expert reports from time to time.
42
43 Q. So when the ----?
44 A. The point, if I might explain, is that this allows for
45 the fact that there is always liable to be contrary
46 evidence, but it would be judged that evidence did not
47 change either the balance of probability or the proof
48 beyond reasonable doubt. Again if I might ----
49
50 Q. Go on.
51 A. There is a particular point which bears on something I
52 said in my statement, which is that generally speaking,
53 although there are exceptions to this, if members of an
54 expert committee are concerned to make recommendations not
55 just for their peers or not just for further research, but
56 actually public health recommendations, generally speaking
57 they would regard the proof to be beyond reasonable
58 doubt. But there are exceptions to that.
59
60 Generally, the exceptions would be in the first reports
