UVC: Dr. Herman Edeling: Principles of Causation and Medico-Legal Reports
The inaugural Understanding Vaccine Causation Conference, convened by World Council for Health Steering Committee Member, Shabnam Palesa Mohamed, took place on Feb. 5, 2022. The WCH Law and Activism Committee brought together legal practitioners, doctors, scientists, and jab victim data and advocacy groups to explore a key question: How are jab adverse events proved?
Dr. Herman Edeling joined the Law and Rights panel for his presentation, Principles of Causation and Medico-Legal Reports.
Transcript
Dr. Herman Edeling
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Shabnam Palesa Mohamed: [00:00:00] Next up we have the law and rights session. We’re going to begin with Dr. Herman Edeling.
Dr. Edeling, let’s kick off with you telling us about yourself and why this conference is so important before your presentation.
Herman Edeling: Thank you very much Shabnam, and thank you to everybody for the honor of being able to participate in this very important conference. I qualified in medicine at Witwatersrand University,
in 1975. At that stage and for a number of decades after that, I was very proud of Wits. The University of the Witwatersrand.
Unfortunately, more recently I’ve lost that pride and attachment, not only to Wits, but to other medical faculties in South Africa, unfortunately. I was a general practitioner for 10 years. I was a neurosurgeon and practiced in a very general operative neurosurgery practice or in private practice. And then I started medical legal practice in amoungst, ~a box.~ my [00:01:00] neurosurgical clinical practice. Until 2008, the medical legal demand became too large and I retired from surgical practice. So since 2008 ~I~ I’ve been
Herman Edeling: exclusively doing medical legal practice more recently, also mediation, which I think is a marvelous way of approaching particularly medical legal disputes.
Of course, as a neurosurgeon, nobody would expect me to understand anything about COVID or vaccines or immunity or anything. And generally, if the specialists in those fields had stuck to the Hippocratic oaths. And if I had stuck to the ethical rules, that we’ve practiced by for years and years, there would be no need for neurosurgeons to get involved in the field.
But during the course of 2020, it became more and more apparent to me that all health authorities and institutions, which we had traditionally trusted as being there, [00:02:00] populated by serious minded, expert, advanced scientists and doctors who are ethical and they’re there to look after the health of humanity; seemed to have totally changed their priorities.
And it became more and more apparent that statements and guidelines and rules were coming out of those institutions that bore no relation to reality. And then it became a crisis of philosophy. Philosophy of medical science. Do you believe something because the authoritative council has said it, or do you believe it because it makes scientific sense.
And previously there’s never been a conflict. What we learned in medical school was limited, but at least it might sense and as we advanced we saw more and more, and we experienced more and more, but everything fitted into a matrix of rational medical science. And the scientific method was reliable. It always worked, we could always discuss with colleagues. So [00:03:00] medical science and the scientific method, and evidence-based medicine were always marvelous. Until things changed.
So that’s why, I’m now in addition to a neurosurgical medical legal practitioner, I started to become a COVID medical-legal practitioner.
I’d like to start off with the actual topic that Shabnam asked me to address. And for this, I really want to thank Michael for introducing this topic so well, and also thank ~you,~ Mark and Megha for their very valuable comments and introduction.
And I’m going to talk about the standards of proof, which Michael has already addressed very well. Interesting though, Michael, I can see that you’ve approached it from the experience of somebody in a courtroom. And I’m going to approach it from the experience of somebody in the doctor’s room who has to write a report and then go give evidence in court.
And it’s funny how the same thing looked at from different sides develops in a slightly different way. But of course, one has to [00:04:00] understand from both points of view. So what I would like to show you is
really just a very simple little thing.
So there, you can see I’ve written standards of proof and I’ve written four standards. Medical certainty beyond reasonable doubt, balance of probabilities and possibility.
Now this is essentially what Michael presented to us, except Michael didn’t mention medical certainty. But medical certainty is pretty much the same to doctors and academics and scientists as the concept of beyond reasonable doubt, which is a legal concept. And what it means is a very high probability of truth.
So if, at sometimes it can be a hundred percent, very often it can’t be a hundred percent, but as close as possible to a hundred percent, is regarded in scientific, especially academia and medicine as medical certainty.
Now that is a standard [00:05:00] that doctors are aware of. And doctors are generally aware that when they say things and they make diagnoses and they express opinions, whether they are expressing an opinion with that degree of certainty or whether it’s less than that. And when they express an opinion with medical certainty, they are confident and they’re happy to express the opinion.
When it’s less than that doctors generally become uncomfortable and less willing to express opinions. And one of the big frustrations I’ve had in medical legal practice is asking expert colleagues to come to court to address a particular issue that’s in dispute in the matter. And one would find that the specialist would conclude that because on this issue, but there’s no definite proof. There’s no absolute guarantee, whether it’s like this or like that, therefore, I don’t know, and therefore I can’t give evidence.
Now it’s a very important thing to me, that [00:06:00] medical experts who are going to assist the legal process in deciding claims for vaccine injury, must understand the standard of balance of probabilities. Michael addressed that in terms of the 51%, a 75 and the 90%. And of course, I agree with Michael that in its simple form balance of probabilities means 51% or more. Anything above 50% is probable.
Now, when doctors go to court, they seem to have difficulty conceptualizing, what does balance of probabilities mean? Because they keep on wanting to have certainty. And almost always, they can’t have certainty. And one of the ways of explaining it to a doctor is it’s really the same process that you do in your clinical practice. If you got a right back to the very beginning of clinical practice, when [00:07:00] you see a patient, the patient complains of three or four symptoms. You say right, then you ask some questions, ‘_When did it start? Did it get better? Did it get worse? What made it better? What made it worse? Where have you been traveling? What circumstances_?’ From that you build up a picture of what’s going on. Then you examine the patient, you make certain findings and certain negative findings. Then you’ve developed a clinical picture. And then in your mind you have, whether you write it down in your notes or it’s just floating around in your mind, you have what’s called a differential diagnosis.
So you have, okay, ‘_Maybe this is Tonsilitis. Maybe it’s Pharyngitis. Maybe it’s Quinsy. I’m not sure which of those three, but I’m pretty sure it’s one of those three_.’
Now at that stage where you’ve placed them in a differential diagnosis, they are all possibilities. So you think of the guy hasn’t obviously got appendicitis, he hasn’t got cholecystitis. He hasn’t got a fractured femur. No, those are not possible. But any one of these three are possible. Then one [00:08:00] looks at them and sees from what I already know can I arrange them in order of likelihood? Is one of them more likely than another one? And if one finds that, that one is a lot more likely than the other, based on your clinical findings, you will make that as your working diagnosis
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