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An Exploration of Justice in the Context of Ethical Guidelines
Emily Bar-Mashiah191

An appellate court in Missouri has decided to uphold a 2.1 billion dollar 
judgment against Johnson & Johnson (J&J) over the presence of asbestos 
in their baby powder, despite being unable to directly link the asbestos to 
the development of ovarian cancer in J&J consumers. By exploring the 
meaning of ‘justice,’ this paper will defend the court’s decision that J&J 
owes its consumers punitive damages for the physical and emotional 
distress caused by exposure to asbestos. This paper will draw comparisons 
between the case in question and the Anderson v WR. Grace and Beatrice 
Foods case from A Civil Action, by Jonathan Harr, to reinforce the ways 
ethics should be considered in litigation involving public health risks. 

In June 2020, the appellate court of Missouri upheld a 2.1 billion 
dollar judgment against Johnson & Johnson (J&J), a company that 
manufactures and sells healthcare-related products, in Ingham v Johnson 
and Johnson. A class action suit was filed by a group of women who 
claimed that the use of J&J’s baby powder in the genital region contributed 
to the development of ovarian cancer due to the ingredient asbestos, which 
is a known carcinogen. However, a study from the Journal of the American 
Medical Association (JAMA) highlights that the chances of women 
developing ovarian cancer that is linked to Johnson & Johnson’s Baby 
Powder are not compelling, as the risk-ratio between the women exposed to 
the baby powder and those not exposed to the baby powder was below 2 (in 
other words, the studies failed to show that, as a legal matter, it was more 
likely than not that levels of asbestos in J&J’s led to plaintiffs’ cancers).192  
Despite this research, the court upheld the multi-billion dollar verdict 
against J&J, reinforcing that the verdict against J&J is both fair and just. 
According to the legal dictionary, justice can be defined as one of three 
things including “fairness, moral rightness, and a scheme or system of law in
which every person receives his/her/their due from the system, including all 

191 Brandeis University Undergraduate, Class of 2023.
192 Gianna Melillo, “JAMA Study Finds No Significant Link Between Talc Powder, 
Ovarian Cancer”, American Journal of Managed Care, (January 2020).

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rights, both natural and legal.”193 Although these definitions seem different 
from one another, at their core they all indicate a goal of protection from 
various threats. Consumers’ safety and security were threatened by J&J, and
this breach of trust damages the informal agreement of trust between 
consumers and manufacturers. Through this understanding, the verdict of 
the case was,  indeed, “just.” 

The concept of justice is crucial in justifying the appellate court’s 
ruling. The appellate court was upholding the standard and goal of justice by
reinforcing protection for consumers from being taken advantage of. It is 
important for the law not only to create order, but to set precedents that will 
ensure the safety of the people who are governed by it. While courts should 
use reliable scientific evidence and expert testimony to make an informed 
decision, which is demonstrated in the following cases, it’s important that 
the evidence is considered within the context of justice so that decisions can 
support the greater good. 

First of all, multiple labs were able to confirm the presence of 
asbestos. A representative from the Materials Analytical Sciences lab 
surveyed containers of baby powder to check for traces of asbestos and 
found that twenty of the thirty-six containers randomly sampled did contain 
asbestos. Although the defendants attempted to invalidate these claims based
on the procedures the lab used during testing, the court found the evidence 
to be reliable. In addition to these findings, other experts testified that there 
was asbestos in J&J’s baby powder after reading nearly 1,400 studies 
conducted by the FDA and several other sources194.

The verdict of the J&J case can be compared to the similar Anderson
v WR. Grace and Beatrice Foods in 1986. Similar to J&J’s behavior, the 
defendant Grace and Beatrice Foods in the Woburn, MA case allowed 
civilians to use municipal water wells that were negligently contaminated 
with trichloroethylene (TCE). Children in Woburn developed leukemia, in 
unexplainably high numbers.  While we do not know if the TCE caused 
these cancers, there is no doubt that Grace helped pollute the wells, and was 
very slow to acknowledge this. J&J has also been less forthcoming than 
Grace; they even went so far as to try to prevent the publication of medical 
literature on the topic. For instance, when Mount Sinai School of Medicine 

193 “Justice”, dictionary.law.com, https://dictionary.law.com/Default.aspx?
selected=1086&bold= 
194 Ingham v. Johnson & Johnson, 608 S.W.3d 663 (Mo. Ct. App. 2020).

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published findings of asbestos in J&J’s baby powder, J&J requested that the 
literature be removed from materials that were being made public, and 
pressured them to take back the results of their studies. Extensive evidence 
proved there were multiple attempts on J&J’s part to conceal the health risks
of their products from consumers. Similarly, in the Woburn case the 
defendant Grace did not disclose the fact that they were dumping dangerous 
substances into wells of municipal water G and H outside of their factory 
and put consumers at an unknown risk. Cheeseman, Grace and Beatrice 
Foods’ lawyer, had said that TCE was kept in the plant’s paint shop so it 
could be used to clean machinery, but then eventually admitted that the 
company had dumped cleaning solvents into a drainage ditch behind the 
plant.195 In both of these cases, the defendants posed physical threats to their 
consumers while concealing the safety hazards of their behavior to the 
public. Under the definition of justice, this was immoral and unethical. Upon
exposure to these details, the consumers of J&J, like the families in Woburn,
experienced emotional stress due to concerns regarding their wellbeing. 

In addition to the fact that the presence of asbestos in the baby 
powder was confirmed, it should also be reiterated that asbestos is a known 
carcinogen. According to expert testimony, “...asbestos causes or 
significantly contributes to causing ovarian cancer... because it is 
microscopic in size, can travel throughout the bloodstream and the body, 
and can be found in every organ in the body, including the ovaries.”196 This 
notion is corroborated by the International Agency for Research on Cancer 
(“IARC”), the American Cancer Society, the U.S. Department of Health and
Human Services, the Environmental Protection Agency, and the National 
Cancer Institute. Additionally, the EPA has “...classified asbestos as Group 
A, human carcinogen.”197 Similar to the J&J case, the TCE in the water 
wells of Woburn was found to be a harmful chemical. According to the 
Minnesota Department of Health, TCE can affect both immune and 
reproductive systems, liver, kidneys, the central nervous system, and fetal 
development during pregnancy.198 In addition to the burden of their physical 

195 Harr, Jonathan. A Civil Action. Firsted. New York: Random House, 1995.
196 Ingham v. Johnson & Johnson, 608 S.W.3d 663 (Mo. Ct. App. 2020).
197 “Learn About Asbestos”, Environmental Protection Agency, last modified February 3, 
2021, https://www.epa.gov/asbestos/learn-about-asbestos#asbestos  .   
198 “Trichloroenthelyne and Your Health”, Minnesota Department of Health, 
https://www.health.state.mn.us/communities/environment/hazardous/topics/tce.html#health 

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conditions, the women may also be concerned about other aspects, such as 
what the implications of their diagnoses will mean for their families, careers,
and social life. It is unfair for J&J to threaten consumers and compromise 
their health and safety without paying them damages.  

Although the JAMA research claims that there was not a great 
difference between women who were and were not exposed to J&J baby 
powder and their risks of developing cancer, one can not say that any 
amount of asbestos should be considered “safe.” While the risk of cancer in 
women exposed to J&J baby powder only increased by 8% compared to 
those who were not, there is no way to prove that the exposure was not a 
contributor to the development of ovarian cancer, even if it was not the one 
main cause. Experts have stated that they believe that asbestos could 
facilitate the development of cancer that would have occurred from pre-
existing conditions and perhaps even make cancer more aggressive against 
treatment. The EPA has stated that “[i]n general, the greater the exposure to 
asbestos, the greater the chance of developing harmful health effects.”⁴ One 
of the doctors at the trial testified that the more bottles of baby powder a 
woman was exposed to, the higher chance she had of being exposed to 
asbestos which implies that over time, the plaintiffs had a high likelihood of 
being exposed to asbestos, due to the frequency with which they used the 
powder. Similarly, the risk of developing an illness was correlated with the 
amounts of exposure to TCE in the Woburn case. Even though the TCE was 
not directly linked to the development of leukemia, it was a contributor that 
may have facilitated or triggered pre-existing health conditions in children. 
In both the J&J case and in the Woburn case, the company’s actions may 
well have been catalysts for the development of the illnesses they are 
believed to have induced.

The expert testimony representing J&J would say that the verdict 
was unjust because general causation, which addresses whether or not a 
substance can cause an illness, could not be established and it is not “more 
likely than not” that the asbestos had caused cancer, as required by the legal 
standard. However, this employs an unfair understanding of what justice 
means in cases of this nature. Based on the insufficient causal relationship, 
the concept of justice would be limited to palpable evidence and hard, 
concrete claims of physical damage. This is not a sufficient definition of 
justice because it excludes emotional burdens, threats posed to plaintiffs by 
defendants, and overall allows people to take advantage of others, which 

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favors companies over individuals. This is extremely unjust because 
consumers are being taken advantage of and deceived about the safety of the
products they are using. This could harm many people as individuals have 
their own respective preferences and pre-existing conditions. Justice should 
protect consumers from all threats, including both emotional and physical. It
should not come as a shock to consumers that the products they are 
purchasing contain dangerous substances. Rather, the presence of toxins 
should be disclosed in advance so that each consumer can make the best 
decision for themself. 

The similarities in behavior between J&J in Ingham v Johnson and 
Johnson and Grace and Beatrice Foods in Anderson v WR. Grace and 
Beatrice Foods are very clear. Both defendants violated public trust by not 
being transparent about posing threats to health and safety, causing an undue
burden of emotional and physical threats and stress. Since the public had to 
suffer under the conditions that J&J put upon them unknowingly, the verdict
of the Missouri appeals case was just. It is unjust and immoral to 
purposefully deceive consumers about health threats. This breaks consumer 
trust and the implied social contract a company has with the public. The 
distress caused by the knowledge that the baby powder contains asbestos, in 
addition to the development of ovarian cancer, justifies the need for J&J to 
pay damages. 

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Works Cited
Harr, Jonathan. 1995. A Civil Action. New York: Random House.
Ingham, Gail Lucille. “UNITED STATES DISTRICT COURT 

EASTERN DISTRICT OF MISSOURI EASTERN DIVISION,” 5.
“Legal Dictionary | Law.Com.” Accessed November 10, 2021. 

https://dictionary.law.com/Default.aspx?selected=1086&bold=.
Melillo, Gianna. 2020. “JAMA Study Finds No Significant Link 

Between Talc Powder, Ovarian Cancer.” American Journal of 
Managed Care, January 2020.

“Trichloroethylene (TCE) and Your Health- EH: Minnesota 
Department of Health.” n.d. Accessed November 10, 2021. https://
www.health.state.mn.us/communities/environment/hazardous/topic
s/tce.html#health.

US EPA, OCSPP. 2013. “Learn About Asbestos.” Other Policies and 
Guidance. March 5, 2013. https://www.epa.gov/asbestos/learn-
about-asbestos.

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https://www.health.state.mn.us/communities/environment/hazardous/topics/tce.html#health
https://www.health.state.mn.us/communities/environment/hazardous/topics/tce.html#health
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