27 February 2023
Wider pool of medical experts in active practice could help drive out ‘hired gun’ bias
The Irish court system needs a wider pool of medical expert witnesses – made up of clinicians actively practicing in Ireland, who have undertaken expert witness training – if it is to increase the quality of expert reports and help to drive out so called ‘hired gun bias’, according to the Medical Protection.
In its new paper – Your profession needs you. Supporting doctors to become expert witness – launched at the Medico-Legal Society of Ireland’s Academic Day on Saturday 25 February 2023, Medical Protection says high-quality education and training is an important step in raising standards, so that experts are clear on the expectations of the role and their duty to the court.
The leading medical defence organisation - which protects and supports the professional interests of 16,000 healthcare professionals in Ireland – also said established doctors in Ireland who are in active clinical practice are best placed to act as medical experts as they understand the environments in which doctors work. Medical Protection is calling on HSE to support doctors in undertaking expert witness training and maintain a central list of experts.
Speaking at the event, Dr James Thorpe, Deputy Medical Director at Medical Protection, said:
“Medical expert opinion plays a critical role in a range of criminal, civil, coronial and regulatory processes. More broadly, expert opinion dictates the standards to which doctors are held.
“Given the importance of expert work, it is concerning that there are difficulties in finding appropriately qualified doctors to undertake it. Instruction often relies on word of mouth, and there is no central register.
“A 2016 Law Reform Commission report highlighted conscious bias – where parties, including those looking to build a case against a doctor, shop around for an expert that fits their case. Mr Justice Maurice Collins also recently warned that a significant change of culture is needed. These are concerning developments and clearly there is a need to both increase the quality of some expert reports and clarify the duty of the expert witness.
“The barriers to undertaking expert work - including time constraints, and a wariness of and unfamiliarity with the legal system - mean that doctors who take on expert work are often those at the end of their careers, some of whom have been out of clinical practice for a considerable time.
“Medical Protection believes that established doctors in Ireland who are in active clinical practice should be encouraged and supported to provide expert opinion, as they are best placed to understand the wider challenges of the environments in which doctors work, and appreciate the systems issues that may have played into an incident.
“With high quality medical expert training and education on their duties, established doctors should be able to provide impartial expert opinion, based on up-to-date guidelines and current evidence, as to whether care provided was of a reasonable standard.
“While medical expert witness work is a noble and rewarding duty, there are of course some risks, as the recent Duffy vs McGee case shows, and an unbalanced report could have far reaching implications. Expert witnesses are not guns for hire and their duty is to the court, rather than the lawyers.
“Awareness and mitigation of the risks associated with the role is another reason why appropriate education and training is so important, and why we advise doctors undertaking expert work to ensure they have adequate professional protection, so they can request assistance with issues arising out of their expert work.
“We are calling on HSE to support established doctors who wish to undertake training and participate in medical expert work, and maintain a list of individuals with expertise in different specialities. We also believe the Medical Council should produce specific guidance for doctors acting as expert witnesses so that both the profession and the public have a clear understanding of the expectations from medical experts.
“This is a complex issue, with many factors at play, and to bring about a change in culture regulators, employers, doctors, and others all have a part.”
Notes to editors