The Irish court system needs a wider pool of medical expert witnesses, made up of clinicians who are actively practicing in Ireland and who have undertaken expert witness training, the Medical Protection Society (MPS) has insisted.

The medical defence organisaton, which currently supports the interests of around 16,000 healthcare professionals in Ireland, said that a wider pool of experts is needed to increase the quality of expert reports and to help tackle what it terms “hired gun bias”.

“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,” commented MPS deputy medical director, Dr James Thorpe.

He noted that 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,” Dr Thorpe explained.

The MPS believes that established and actively practising doctors in Ireland should be encouraged and supported to provide expert opinion.

“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,” Dr Thorpe said.

He insisted that 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,” Dr Thorpe noted.

The MPS is calling on the HSE to support established doctors who wish to undertake training and participate in medical expert work. It is also calling on the HSE to 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,” Dr Thorpe added.

The MPS's views are contained in a policy paper that can be viewed here.