Medical Expert Opinion

Standard of Care AND Causation  
Model Instructions for Potential Medical Expert Witnesses
  
The following wording of instructions is offered as a template, to be modified for the particular circumstances.  We recommend that the instructions be combined with carefully-crafted, forced-choice questions that the medical expert witness should address in preparing draft written expert opinion.   
Please provide your opinions on both standard of care of the defendant (type of specialist[s]) and on whether standard care would have resulted in a materially different outcome.

As far as possible, express yourself in layman’s language and explain any necessary medical terminology.

Please supplement opinions that arise from your personal professional experience with contemporaneous Clinical Practice Guidelines and quality, referenced medical research papers (Evidence Based Medicine).

The standard against which the care of each defendant physician must be judged is that of a reasonably conscientious peer in his situation.

The court is interested only in identifying elements of the care that is, in your considered opinion, substandard: an aspect of care that is merely suboptimal can be considered only if it is a component of substandard care.

Distinguish clearly between possible and probable, giving percentages where possible.

The standard of certainty required in this civil action is "balance of probability", that is, greater than 50% likelihood.

Neither the criminal standard of "beyond reasonable doubt" nor scientific levels of proof are relevant.

While additional facts that are might not be available could be desirable, we ask that you provide the best opinion you can with the information available, incomplete as it may be.

If you find yourself unsupportive of our client’s position, we ask that you restrict yourself to a verbal opinion, to conserve resources.

While not wishing to impose an unfamiliar style of expert opinion, we ask that you include the following sections in any written report:

  • your qualifications as an expert witness in this area of medicine; the facts on which your opinion is based;
  • your opinions and structured arguments about, but not restricted to, the following issues of medical and legal causation;
  • a summary statement of those opinions;
  • references for the medical research papers cited.