Medicine, Health Care and Philosophy

, Volume 9, Issue 2, pp 243–247 | Cite as

The Temporal Stage Fallacy: A novel Statistical Fallacy in the medical literature

  • David Shier
  • J. Lee TilsonEmail author
Scientific Contribution


Celebrated for disproving the traditional view that lack of oxygen at birth (perinatal asphyxia) contributes significantly to cerebral palsy, a 1986 New England Journal of Medicine article by Karin Nelson and Jonas Ellenberg engineered a new consensus in the medical community: that lack of oxygen at birth rarely causes cerebral palsy. We demonstrate that the article's central argument relies on straightforwardly fallacious statistical reasoning, and we discuss significant implications -- e.g. how carefully fetuses are monitored during labor and delivery, expert testimony in malpractice cases, and public policy decisions.


asphyxia neonatorum asphyxia neonatorum/complications birth injuries/complications cerebral palsy cerebral palsy/etiology Daubert Ellenberg Jonas expert testimony fetal anoxia fetal distress/complications hypoxia-ischemia brain/etiology malpractice movement disorders/etiology/physiopathology/prevention & control National Collaborative Perinatal Project National Institutes of Health (US) Nelson Karin New England Journal of Medicine obstetrics perinatology 


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  1. American College of Obstetricians and Gynecologists: 2003a, Obstetrician-Gynecologists and Pediatricians Say Most Newborn Brain Injuries Do Not Occur During Childbirth. ACOG publicationGoogle Scholar
  2. American College of Obstetricians and Gynecologists: 2003b, Neonatal Encephalopathy and Cerebral Palsy: Defining the Pathogenesis and Pathophysiology. ACOG publicationGoogle Scholar
  3. Huber, P.: 1991, Galileo’s Revenge: Junk Science in the Courtroom. Basic BooksGoogle Scholar
  4. Nelson, K., Ellenberg, J. 1986‘Antecedents of Cerebral Palsy – Multivariate Analysis of Risk’New England Journal of Medicine3158186PubMedCrossRefGoogle Scholar
  5. McCollough, M.: 2003, ‘A Dispute on Doctors’ Cerebral Palsy Role’, Philadelphia Enquirer, Feb. 10, 2003Google Scholar
  6. U.S. Court of Appeals, 5th Circuit: 1999, Tanner v. Westbrook, 174 F3d 542Google Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  1. 1.Department of PhilosophyWashington State UniversityPullmanUSA
  2. 2.Sommers, Schwartz, Silver & SchwartzSouthfield

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