Medical expert witnesses are key players in the administration of justice. The evidence of an expert is relied upon by both parties to narrow the issues being disputed in a case and inform the judge in reaching a decision. In medical negligence litigation, the Court is likely to hear expert evidence about the standard of care the claimant should have received, did receive, and its impact on their condition and prognosis.
As Caren Scott, MD of Inspire MediLaw, says:
“…judges are not experienced in every area of the law. So, when a clinical negligence or personal injury case goes to Court, it is essential to have reliable, independent clinical experts who can explain to the judge exactly what the key medical issues in the case are, and to give their unbiased opinion regarding these issues”.
Isn’t it disloyal to the medical profession to criticise colleagues in Court?
Some medical professionals feel that there is a stigma attached to participating in the litigation process. There is, perhaps, a fear that others will see them as being out to undermine the practice of colleagues. On the contrary, an expert witness is crucial in determining the reasonable standard of care which should be afforded to patients. It is of value for the profession and the public to ensure that doctors guide the Courts in defining a reasonable standard of care, not just lawyers.
Clinical negligence litigation is used to compensate an individual, known as the claimant, who has suffered harm in the care of a medical provider. They may seek compensation for something that was ‘done’ to them, known as a negligent act, or for something that was not done, known as a negligent omission.
The harm suffered by the claimant must be quantifiable. Putting a value on the effect of negligence on an individual can be a complex process. The solicitors will instruct medical and other professionals to help them quantify various elements to the claim; the injury or loss itself and a range of associated costs. These may include the costs of care and/or living aids that would not have otherwise been required, and past and predicted loss of earnings.
The role of the medical expert witness
The medical expert plays a key role in establishing whether the individual or their family has a claim in negligence. Regardless of whether the expert is instructed by the claimant or the defendant, they must give an objective opinion. The expert’s evidence can result in the discontinuation of an investigation into alleged negligence, or it may provide the foundation for a successful claim or the successful defence of a claim.
A breach of duty expert should have proven clinical experience in the specific area of medicine being investigated. Furthermore, they should have been in practice at the time of the alleged negligence. The expert will set out the reasonable standard of care the claimant should have expected, given the circumstances, and comment on the care afforded to them.
Medical experts will be asked to comment on causation. This requires the expert to look at the failures in the care provided, the outcome for the patient, and discuss the relationship between the two.
The current condition of, and prognosis for, the claimant is a key element of the claim. Often, the expert will be asked to assess the claimant, review medical records and relevant witness statements, and report on their current state of health and the likely development of any conditions caused or affected by the alleged negligence. This forms the basis for further reports from allied health professionals and other experts, such as forensic accountants or employment experts. It helps to build a picture of the financial impact of the alleged negligence and future impact for the claimant and/or their dependants.
Should a medico-legal expert have a legal qualification?
“There’s a common myth that a good medico-legal expert should have a legal qualification. This is absolutely not the case.
Lawyers are primarily looking for someone with clinical expertise and they are not seeking legally qualified medical experts. The Court requires a medical expert to give their opinion first and foremost as an experienced clinician, regardless of legal experience.”
Caren Scott, MD Inspire MediLaw
The role of an expert witness calls for a good eye for detail, a flair for reviewing and questioning evidence and relevant research, and the ability to form and communicate a reasoned opinion.
Specific legal tests must be applied when investigating breach of duty and causation. These should be set out in the letter of instruction from the solicitor, and the expert must know and apply the tests in their report. Expert witness training can help cement the expert’s understanding of these legal tests and enable you to discuss the practical application of these tests with medical lawyers and fellow medico-legal experts.
Often the most daunting element of the process is being faced with the evidence of the opposing expert. Crucially, the expert must remember that the Court is not necessarily persuaded by the eminence of the experts involved. What is far more important is the clarity, logic, and persuasiveness of their opinions.
Medical experts will find that their opinion is tested and disputed during the litigation process, not just in the witness box, but from the early stages of an investigation when the legal team must build a robust case. The expert must be ready to respond to criticism, differing viewpoints, and detailed questioning. It is an intellectually challenging role, and this is a real attraction for many.
If you are thinking of venturing into medico-legal practice, it is helpful to talk it through with someone already in the role. An experienced expert witness can offer a balanced view of what is really involved.
There are many benefits to expert witness work…
An obvious reason to take on medico-legal work is the financial reward. Medical experts are very well paid for their time and expertise, and rightly so. In return, though, they work hard! Expert witness work is time-consuming – in terms of reviewing all the documents, medical records, and witness statements associated with a case. You’ll need a methodical approach for the report-writing stage and dedicate time to ensure that you’re giving a reasoned, objective view, clearly explaining medical terms.
It’s often said that acting as a medico-legal expert witness brings a fresh perspective to one’s own clinical practice. Many experts comment that they have developed and improved their clinical practice because of something they have seen in, or learnt from, a case they have worked on.
Acting as a medical expert broadens a clinician’s understanding of the medico-legal processes intrinsically woven into the provision of healthcare. This is invaluable for senior clinicians, especially those involved in investigating serious incidents, complaints, and similar.
For many in the profession, the opportunity to apply their expertise to secure justice for patients and healthcare professionals is a significant attraction in itself.
Interested in becoming a medical expert witness? We offer expert witness training for medical professionals in Oxford, Edinburgh and online, delivered by highly experienced lawyers and medical professionals at the top of their fields. This training is interactive, with practical exercises involving real cases. We offer post-course mentoring and support to help expert witnesses grow their skills.