Opinion ID: 746887
Heading Depth: 4
Heading Rank: 4

Heading: Relevance: The opinion or inference must be relevant to the case.

Text: 36 Rule 702 further requires that the evidence or testimony assist the trier of fact to understand the evidence or to determine a fact in issue. This condition goes primarily to relevance. Daubert, 509 U.S. at 590, 113 S.Ct. at 2795.  'Expert testimony which does not relate to any issue in the case is not relevant and, ergo, non-helpful.' 3 WEINSTEIN & BERGER p 702, p. 702-18. See also United States v. Downing, 753 F.2d 1224, 1242 (3d Cir.1985)('An additional consideration under Rule 702--and another aspect of relevancy--is whether expert testimony proffered in the case is sufficiently tied to the facts of the case that it will aid the jury in resolving a factual dispute').  Id. at 591, 113 S.Ct. at 2795. The study of the phases of the moon, for example, may provide valid scientific 'knowledge' about whether a certain night was dark, and if darkness is a fact in issue, the knowledge will assist the trier of fact. However (absent creditable grounds supporting such a link), evidence that the moon was full on a certain night will not assist the trier of fact in determining whether an individual was unusually likely to have behaved irrationally on that night. Id. 37 e. The trial judge is the gatekeeper. 38 Accordingly, when faced with a proffer of a qualified expert's testimony to scientific, technical or other specialized knowledge, the trial judge must determine at the outset, pursuant to Rule 104(a), whether the proffered opinion or inference is soundly grounded in the methodology of the expert's discipline and whether that opinion or inference is relevant to a fact in issue or to an understanding of the evidence. Cf. Daubert, 509 U.S. at 589-592, 113 S.Ct. at 2794-2796. 39 The Court emphasized that the trial judge's inquiry under Rule 702 is a flexible one. Different approaches may be permissible, but the focus must be on the principles and methodology upon which the expert's opinion is based, not on the merits of the expert's conclusion. Id. at 594-595 n. 12, 113 S.Ct. at 2797-2798. Vigorous cross-examination, presentation of contrary evidence, and careful instruction on the burden of proof are the traditional and appropriate means of attacking shaky but admissible evidence. Id. at 596, 113 S.Ct. at 2798 (citing Rock v. Arkansas, 483 U.S. 44, 61, 107 S.Ct. 2704, 2714, 97 L.Ed.2d 37 (1987)). Additionally, in the event the trial court concludes that the scintilla of evidence presented supporting a position is insufficient to allow a reasonable juror to conclude that the position more likely than not is true, the court remains free to direct a judgment, Fed. Rule Civ. Proc. 50(a), and likewise to grant summary judgment, Fed. Rule Civ. Proc. 56. Id. (citing cf., e.g., Turpin v. Merrell Dow Pharmaceuticals, Inc., 959 F.2d 1349 (6th Cir.), cert. denied, 506 U.S. 826, 113 S.Ct. 84, 121 L.Ed.2d 47 (1992); Brock v. Merrell Dow Pharmaceuticals, Inc., 874 F.2d 307 (5th Cir.1989), modified, 884 F.2d 166 (5th Cir.1989), cert. denied, 494 U.S. 1046, 110 S.Ct. 1511, 108 L.Ed.2d 646 (1990)). 40 f. The Daubert 41 factors are hard scientific methods that 42 generally are inappropriate for the 43 reliability assessment of 44 clinical medical testimony. 45 After declaring that evidentiary reliability of an expert's scientific opinion depends on whether it is soundly grounded in the the scientific method, the Daubert Court identified several individual methods or techniques within the body of hard or Newtonian scientific methodology as appropriate for trial judges' use in testing the methodology-relatedness of particular hard scientific opinion proffers. Daubert, 509 U.S. at 593, 113 S.Ct. at 2796. These hard scientific methods, now sometimes called Daubert factors, are empirical testing, peer review and publication, known or potential rate of error, the existence and maintenance of operational standards, and acceptance within a relevant scientific community. Id. at 593-94, 113 S.Ct. at 2796-2797. 46 Because the objectives, functions, subject matter and methodology of hard science vary significantly from those of the discipline of clinical medicine, as distinguished from research or laboratory medicine, the hard science techniques or methods that became the Daubert factors generally are not appropriate for assessing the evidentiary reliability of a proffer of expert clinical medical testimony. 47 First, the goals of the disciplines of clinical medicine and hard or Newtonian science are different. In hard science, the usual motive is inquiring: to gain a new understanding of some mechanism of nature. Alvan R. Feinstein, Clinical Judgment 22 (1967)[hereinafter Feinstein]. In contrast, the care and treatment of the individual patient is the ultimate, specific act that characterizes a clinical physician. Id. at 27; Pellegrino and Thomasma, For The Patient's Good 71 (1988); Pellegrino and Thomasma, A Philosophical Basis of Medical Practice 120 (1981)([T]he whole process is ordained to a specific practical end--a right action for a particular patient--and ... this end must modulate each step leading to it in important ways.). The clinical physician, therefore, must take account of the immediacy of the problem confronting her for she bears an essential relationship to each patient. Additionally, she has many human values to consider--ethics, compassion, and must have a willingness to take responsibility in the face of the unknown. Edmond A. Murphy, The Logic of Medicine 6 (1976)[hereinafter Murphy]. The pursuit of these different goals of hard science and clinical medicine serves to shape the distinct objectives of the scientific experiment and the clinical treatment of a patient: 48 In clinical treatment, the main motives are remedial, or prophylactic: to change what nature has done or to prevent what it may do. In laboratory work, the premise is innovative: the goal is to test a new hypothesis or a new procedure. In ordinary clinical treatment, the premise is repetitive: the goal is to reproduce (or surpass) the best results of experiments conducted before in similar circumstances. A clinician chooses treatment in a new situation by reviewing what was done and what happened in previous situations that resembled the one at hand; he then selects whatever mode of treatment had the most successful outcome in the past. Id. at 22. 49 In ordinary clinical treatment, the purpose is not to gain new knowledge but to repeat a success of the past. Id. at 23. 50 Second, the subject matter and conditions of study are different. In laboratory work, the experimental material is an intact animal, a part of a person or of an animal, or an inanimate system; in clinical treatment, the material is an intact human being. Id. at 22. The hard scientist initiates the experiment at a time of his own convenience and chooses the material usually without regard to its desire or consent for participation. Id. In clinical medicine, the patient initiates the treatment, choosing the time, place, duration, and clinician. Id. The physician is not studying the properties of chemical compounds in a test tube; he cannot postpone dealing with cancer in a patient for fifty years because he hopes by then to have a much clearer insight into the nature of the disorder. Id. 51 Finally, clinical medicine and hard science have markedly different methodologies. A clinician observes at least three types of data for each patient who undergoes treatment: A disease in morphologic, chemical, microbiologic, physiologic, or other impersonal terms; the host in whom the disease occurs and his environmental background, including his personal properties (such as age, race, sex, and education) and external surroundings (such as geographic location, occupation, and financial and social status) before the disease began; and the illness that occurs in the interaction between the disease and its environmental host, consisting of clinical phenomena: the host's subjective sensations, or symptoms, and signs, which are findings discerned objectively during the physical examination. Feinstein, at 24-25. 52 Using these data, the clinician determines a present diagnosis (which gives the disease a name and tells what is wrong), a past etiology and pathogenesis (or how it got that way), and a future prognosis and therapy (or what to do about it). Id. at 25. Some of the data used by the clinician can often be obtained by examining the patient's fluids, cells, tissues, excreta, roentgenograms, graphic tracings, and other derivative substances. The patient's personal environmental data can often be elicited by nurses, secretaries, social workers, or other interviewers. But the history-taking, physical examination, and the determination of symptoms and signs can properly be done only by a doctor skilled in the clinical procedures described above. Id. Moreover, the [clinical physician's] capacity to make judgments in cases of a kind which he has never seen before must depend ultimately on a cultivated capacity to see equivalences between quite disparate things, that is, on analogy. Murphy, at 9. 53 In sum, hard or Newtonian scientific knowledge does not comprehend all subjects that theoretically might be subjected to its methodology. It is knowledge of a particular and limited kind, gathered or tested by a particular and characteristic method. T.H. Savory, The Language of Science (1953). Although clinical medicine utilizes parts of some hard sciences, clinical medicine and many of its subsidiary fields are not hard sciences. The purposes, criteria, values and methods of hard or Newtonian science and clinical medicine are far from identical. Fred A. Mettler, The Medical Sourcebook xxxiv (1959). Consequently, the Daubert factors, which are hard scientific methods selected from the body of hard scientific knowledge and methodology generally are not appropriate for use in assessing the relevance and reliability of clinical medical testimony. Instead, the trial court as gatekeeper should determine whether the doctor's proposed testimony as a clinical physician is soundly grounded in the principles and methodology of his field of clinical medicine. 2