by Ashlie Cox
Medical experts play a crucial role in criminal trials, offering independent and specialised knowledge to assist the court in understanding complex medical evidence.
The Law Show podcast recently explored this topic, discussing the responsibilities of expert witnesses, their independence, and their impact on high-profile cases, including the Lucy Letby trial.
Key Responsibilities of Medical Experts in Criminal Cases
Initial Case Assessment
Medical experts assist police and legal professionals in evaluating the viability of a case by analysing medical facts before it proceeds to court. This early involvement helps in identifying further lines of enquiry, formulating legal strategies and determining the strength of the case, in a more time efficient and cost-effective way.
Medical Evidence Gathering
Medical experts can assist with gathering medical evidence, including what information to request and from which hospital systems and online platforms, and whether there are any gaps in medical evidence bundles to ensure a complete disclosure of medical evidence. Additionally, understanding standard operating procedures, policies and governance in place at both local and national levels.
Analysis of Medical Evidence
Medical experts can scrutinise medical records and interpret clinical data in order to better understand injuries, medical conditions, medical procedures. This includes: cause and severity of injuries, timeline of injuries, clinical presentation during life with injuries, causal links between injuries and death, causal links between medical care and death, as well as organic or non-organic causes for injuries or death.
Courtroom Testimony
In trials, medical experts provide independent, unbiased opinions to help the court or jury understand complex medical information. Their testimony can clarify whether the standard of care was met or if medical findings support allegations made during the trial, as well as injury causation or causes and contributions of death. Medical evidence increasingly has a direct impact on case outcomes and bridges the gap between medical science and the law.
Objective Assistance to the Court
Regardless of which party engages them, medical experts have an overriding duty to assist the court impartially. Their role is not to advocate for either side but to present factual, evidence-based opinions to facilitate a fair judicial process.
Specialised Expertise
Medical evidence in criminal investigations now extends beyond forensic pathology and clinical forensic medicine, such as police custody doctors. There is an increasing reliance on clinical specialists for a better understanding of injuries, medical conditions, medical procedures and treatment and more frequently now – potential breaches in care. In certain cases, experts with niche specialisations, such as DNA analysts or toxicologists, may be called upon to interpret specific types of evidence, thereby contributing to a more precise understanding of the case at hand.
The involvement of medical experts ensures that decisions in criminal cases are grounded in accurate medical knowledge, thereby upholding the integrity of the judicial system. Their expertise not only aids in uncovering the truth but also safeguards the rights of all parties involved by ensuring that medical evidence is appropriately and thoroughly examined.
In the latest Law Show Podcast, Dr Joelle Grogan and her guests, Retired Crown Court Judge Nigel Lithman KC and Amel Alghrani, Professor of Law at the University of Liverpool discussed who can be an expert witnesses and the rules governing their use in criminal trials.
Who Can Be an Expert Witness?
An expert witness is an individual qualified, through practice, study or both, to provide independent opinion evidence on matters outside the knowledge of the average juror. The court assesses their suitability based on qualifications, experience, and impartiality before allowing their testimony.
Expert Witnesses and Their Duty to the Court
While expert witnesses are instructed by either the prosecution or defence, their primary duty is to the court. Their role is to provide an objective interpretation of the evidence, not to advocate for one side. The judge ensures that expert testimony does not overreach or attempt to determine innocence or guilt, which remains the jury’s responsibility.
Challenges in the Use of Expert Evidence
The podcast highlighted potential issues surrounding expert testimony, including the risk of bias when experts frequently work for the same legal teams. While this does not automatically compromise impartiality, opposing counsel may cross-examine to challenge an expert’s independence.
Another key issue discussed was the potential for expert overreach. For example, in the case of Dr David Sellu, two prosecution experts explicitly stated their view that he was guilty of gross negligence manslaughter, which went beyond their remit. This led to his conviction being overturned after he had already served 15 months in prison.
Another example is the wrongful conviction of Sally Clark in 1999, largely based on flawed statistical evidence. The prosecution’s expert, Sir Roy Meadow, incorrectly stated that the chance of two cases of Sudden Infant Death Syndrome (SIDS) in one family was 1 in 73 million, a figure later discredited. Key medical evidence indicating natural causes of death was also overlooked. Clark’s conviction was overturned in 2003 after she had spent more than three years in prison.
While challenges exist in the use of expert evidence, these cases underscore the indispensable role of expert witnesses when their testimony is grounded in rigorous methodology and remains within their professional remit. Ensuring proper scrutiny and impartiality can enhance the reliability of expert contributions, ultimately strengthening the integrity of the legal system.
The Lucy Letby Case and the Role of Medical Experts
A significant focus of the podcast was the role of medical experts in the Lucy Letby case. Recently, a panel of 14 international medical experts working for Letby’s defence team have “analysed the medical evidence” which has led them to believe that the infants’ deaths and injuries resulted from natural causes or poor medical care rather than deliberate harm. Their opinions have formed part of an application to the Criminal Cases Review Commission (CCRC) to assess whether there are grounds for appeal.
The CCRC will now determine whether this constitutes fresh evidence that could give rise to another appeal attempt by Letby.
Training on Medical Expert Witness Services
With a dedicated Criminal Division of clinical expert witnesses, McCollum Consultants provides specialised training to law enforcement. Their session, Medical Expert Witness Services, equips officers with essential knowledge on:
- The role of medical experts in criminal investigations
- The difference between an expert adviser and an expert witness
- Best practices for gathering medical evidence from healthcare settings
- The range of expert witness services available at McCollum Consultants
McCollum Consultants are committed to supporting law enforcement by providing independent, expert medical insight to strengthen investigative processes and legal proceedings.
For more information on expert witness services or to arrange a bespoke training session, contact Ashlie Cox – ashlie@exp-w.com.