Why does ATS Continue to Support the United States Asbestos Litigation Scam?

Lawrence Martin, M.D., FACP, FCCP
9000 Mentor Avenue
Mentor, OH 44060

September 15, 2005

Peter D. Wagner, M.D.
American Thoracic Society
61 Broadway
New York, NY 10006-2755

Dear Dr. Wagner,

Events of the past year have validated criticisms of the ATS-AJRCCM review on nonmalignant asbestos diseases (2). You were not ATS president at the time, and probably had nothing to do with the article's preparation or publication. However, you are ATS's current leader, and in a position to effect important change.

The United States Asbestos Litigation Scam (USALS) is arguably the most notorious public health scam in the history of this country (1, 4-10). In this scam, hundreds of thousands of people were given manufactured diagnoses of asbestosis -- all for the profit of plaintiff attorneys and their hired physicians (6-9, 14, 21-23, 25, 34, 36, 38, 41-44). Diagnoses were manufactured in the sense that they were not "a product of good faith medical judgment but rather a function of the millions of dollars a year in income" that the physicians received. Furthermore, pulmonary function tests were often administered "in knowing violation of standards established by American Thoracic Society" (9).

The scam has bankrupted dozens of businesses, clogged the courts, adversely affected healthy people and delayed compensation for workers truly harmed by asbestos (1, 10-11, 15, 47-48). Even so, the 2004 ATS review supported the wholly discredited process that created these phony diagnoses. The support may be subtle to the uninitiated, but it is readily apparent to anyone involved in asbestos litigation (doctors and lawyers). The ATS review selectively quoted the medical literature to make the scam seem legitimate and blatantly ignored peer-reviewed studies to the contrary. Most egregious, however, was the way in which the ATS review carefully crafted sentences and paragraphs to support plaintiff attorneys who profit from the scam (28-33).

That 2004 ATS review was really the culmination of biases long held by two past ATS presidents, and a wholly lopsided panel of 11 physicians chosen as authors (28, 33, 39). After its publication, in response to my web sites and letters in AJRCCM (16, 31, 46, 53), ATS adopted a do-no-wrong mentality, providing only tangential or non-responses to major questions (19-20, 40). Only 7 months later did ATS even provide the authors' conflict-of-interest disclosures (19), and that listing omitted the extraordinary plaintiff-oriented bias of the past presidents and several authors (28). A "Special Session" in San Diego last May to discuss the contentious issues was not even recorded, unlike every other session held that week.

Last month, ATS News lauded an academic physician who authored a USALS-based study (3). In order to show the importance of her work, ATS News favorably cited this study, one that she co-authored for Chest (35). Unfortunately her Chest article made unsubstantiated conclusions from diagnoses generated solely by the asbestos scam, and for that reason alone qualifies it as "junk science" (26). Moreover, published criticisms of that article by myself and others have never been answered by the authors (13, 24, 27, 45).

Notwithstanding ATS's bizarre (for a scientific organization) support of the USALS, since September 2004 a wealth of information has begun to expose the scam to a wider public (12, 21, 37, 49-52). At least one physician and one plaintiff lawyer have admitted that many of the diagnoses were fabricated (21, 37, 52). By doing so they -- and other physicians involved in a sister scam on mass silicosis diagnoses (12, 21, 37) -- have acknowledged what practically every one involved (on both sides of the litigation) already knows. Last spring a New York Grand Jury began investigating phony asbestos diagnoses affecting that district (18).

Despite all this information, ATS -- the world's preeminent scientific pulmonary organization -- continues to support the USALS! Support is implicit in its official communications (2-3, 19-20, 40), as well as in ATS's continued silence over the medical corruption in asbestos diagnoses. I can only ask - Why? Why does ATS allow bias to trump science on this single issue? Why does ATS remain silent, when it should really be at the forefront of organizations seeking honest diagnoses and credible lung function testing?

I don't expect ATS to amend its wrong-headed support of the USALS during your brief term. But someone at ATS should review Judge Jack's 249-page legal opinion (21). It provides a real eye opener to the sordid details of the scam that ATS, through its publications and pronouncements, and continued silence over the medical corruption, has supported de facto. Slowly, inexorably, real science, detailed legal review and solid reporting are bringing truth to the fore (7-9, 17, 21-22, 36-37, 43, 49-52). At some point a new generation of ATS officials will look back and admit that, yes, ATS was co-opted on this issue by a bunch of unscientific, wholly-biased physicians, physicians who chose to pursue a personal agenda rather than offer objective analysis.

Anti-science should not be published or supported by ATS, but there it is, for all (including plaintiff lawyers, who love this stuff) to see and read (2-3, 19-20, 32). I look forward to the day that ATS objectively reviews the asbestos scam, stakes out an honorable position, and expunges this blot on its otherwise remarkable history.

Lawrence Martin, M.D., FACP, FCCP
Associate Professor of Medicine
Case Western Reserve University School of Medicine


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