Legal Aspects of Coronary Disease

T HE PATIENT with coronary disease comes into court, or his descendents for him, mainly under 3 major conditions: (1) it is claimed that he has received a personal injury which caused or aggravated his heart disease; (2) his cardiac mischief has been produced or worsened by his employment (Workmen's Compensation); or (3) he is entitled to premature pension payments, governimental or private, by virtue of an occupational hazard to his heart. In a case carried to the Supreme Court of Minnesota which was, however, not a cardiac problem, the Court said "Since we as judges lay no claim to expertness in these matters [the etiology of cancer], we can add nothing to the discussion, nor can we be expected to resolve these conflicts which the medical profession itself has been unable to resolve. Notwithstanding this uneertainty, we think we are bound to treat the opinions of these doctors as something more than speculation and conjecture, which are but polite terms for unscientific guesswork. "1 And as Larson says " Plainly, the heart cases will continue to be troublesome as long as some reach the appellate courts on a record in which the medical testimony is emphatically certain that effort and exertion have nothing whatever to do with coronary thrombosis, while most such cases are based on the opposite thought."2 Thus, the reason for litigation, in the cases of coronary disease, is referred to differenees in opinion within the medical profession. The skepticism of lawyers about medical disagreemeints is illustrated by Lambert's belief that it is best to have adversaries in court rather