From the outside, preparing an medicolegal expert opinion can appear to be a brief process. The expert receives the records, reviews them and writes down their conclusions. Far more work takes place behind the scenes. The documents must be arranged chronologically, the information checked against one another, and every finding supported by medical reasoning.
What happens before the medicolegal expert opinion is written?
Many people imagine that an expert reads the clinical records in a few hours and then writes their opinion. The reality is far more complex.
A single case may require hundreds of pages of records to be placed in chronological order, the results of individual examinations to be compared, the scientific literature and guidelines to be reviewed, and, where necessary, experts from other disciplines to be consulted.
Every material conclusion must be traceable to the evidence and supported by medical reasoning.
The opinion begins to take shape long before I write the conclusions. By then, much of the essential work is complete. The written document sets out the results of that analysis.
Why can’t an medicolegal expert opinion be written in five minutes?
Sometimes I am asked: “Doctor, could you just take a quick look?”
Typing is only one stage in preparing a sound medicolegal expert opinion. Most of the time is spent understanding the records, comparing the information and formulating the conclusions precisely.
I have sometimes rewritten a single paragraph several times, aware of the weight one sentence may carry. A carefully worded medical conclusion must withstand scrutiny in court, even years later.
What is an expert’s most important tool?
If asked what my most important working tool is, many people would probably imagine some kind of instrument.
For me, the most important tool is a question. The right question.
A useful forensic question identifies what can be established medically, and what evidence is needed. Recognising the limits of the question is also part of the expert’s work.
What lies behind an medicolegal expert opinion?
The instructing authority or client receives the medicolegal expert opinion as a document that may be only a few pages long, or considerably longer. Behind it often lie hundreds of pages of records, research into the scientific literature, comparison and careful consideration.
Every sentence may matter. Precise wording is part of the medical assessment: it makes the opinion clear, reviewable and defensible.
