Courts frequently look to the testimony of expert medical witnesses to assist them in the search for legal truth. In addition to Egyptian and Biblical references to forensic medicine, physicians in Greece and Rome functioned as expert witnesses. A physician testifying at the inquest into Julius Caesar's death stated that he found twenty-three stab wounds on the corpse but only one wound, a wound in the throat, that could have caused death. The Institutes of Justinian (529-533 c.e.) and the codices of Charles V, the Lex Bambergensis (1507), also made provisions for expert medical testimony (Lande; Clements and Ciccone). In the United States, physicians are called on to testify as expert witnesses in a variety of civil and criminal matters. The civil issues range from workers' compensation to child custody, from physical and emotional damages to malpractice. The issues in criminal cases range from cause of death to competence to stand trial, from deoxyribonucleic acid (DNA) typing to the insanity defense. This entry traces how a physician becomes involved as a medical expert witness, what the requirements of the role are, and the ethical issues that may arise.
Courts of law distinguish between fact witnesses and expert witnesses. Fact witnesses may be required to testify if they have some direct knowledge about the issue before the court, but may not express opinions. Expert witnesses have knowledge that goes beyond that of the ordinary citizen and agree to undertake the role of expert witness and are permitted to express opinions.
The difference between a "fact" and an "opinion" is the degree of concreteness of the description, or the difference in the "nearness or remoteness of inference" (McCormick, p. 26). The courts and the public receive expert testimony with both admiration and suspicion. There is appreciation for the clarity provided, but fear that experts may control the legal outcome. This fear may be accentuated in a democratic society that mistrusts those with special knowledge. In 1986, the American Medical Association (AMA) took the position that "as a citizen and as a professional with special training and experience, the physician has an ethical obligation to assist in the administration of justice" (Council on Ethical and Judicial Affairs of the AMA, p. 138). The participation of the medical expert may be justified on the basis that a meaningful concept of justice requires empirical data on the function of the human organism in health and disease—data that the medical expert can provide (Ciccone and Clements).
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