[Medical expert testimony following surgery for perforating ulcers of the stomach and duodenum].
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Experiences acquired as a medical evaluator have shown that malpractice proceedings are increasingly being transformed into clarification proceedings. For this reason, the most important aspect of the dentist's obligation is to inform the patient of possible complications. In addition, injury to the lingual nerve can be prevented by protecting the mobilized lingual mucoperiosteal flap.
Case report on 2,5 years old monozygotic twins who died of starvation due to negligence. Different gradings of protein-energy-malnutrition are discussed, among them the Waterlow-classification of PEM. The advantage of the Waterlow-classification is that stunting and wasting can be distinguished. The Waterlow-classification is suitable also for the classification of fatal cases of starvation in childhood. Practical experiences with own cases and cases from the literature are presented.
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Giving testimony as an expert witness in court carries numerous ethical obligations, which are rarely delineated by the individuals who seek such testimony or even known to those who provide it. Because most expert medical witness testimony about the performance of physicians requires that a witness be medically licensed, and because verdicts based on expert testimony directly influence the standard of care that will be applied in the future, providing medical testimony legitimately can be considered to come within the realm of the practice of medicine. Testifying as an expert in legal matters should be undertaken with the same degree of integrity as the practice of medicine and is rightfully subject to the same degree of scrutiny and regulation.
CONTEXT: Pathologists work in an environment in which, to the extent possible, diagnostic decisions are based on scientific principles. It can therefore be a rather shocking experience when a pathologist finds one of his or her diagnostic decisions being evaluated by a legal system developed and controlled by lawyers and judges rather than by scientists or pathologists. This experience can be even more troubling when a key participant in the proceedings is a fellow pathologist guiding a jury toward an unfamiliar interpretation of the pathology standard of care. OBJECTIVE: To provide the interested pathologist with the background information necessary to (1) understand the role of expert testimony in malpractice litigation and (2) understand why there can be a gap between expert opinions expressed in court and expert opinions expressed in a medical care context. DATA SOURCES: Medical literature review supplemented by review of subspecialty position papers, selected articles from newspapers and magazines, and legal decisions. The medical literature review was limited to articles published in English and was based largely on articles retrieved using the MeSH terms expert testimony/legislation & jurisprudence, and pathology/legislation & jurisprudence. CONCLUSIONS: Medical error has become an increasingly important topic for pathologists, and although errors or allegations of error are evaluated in many ways, the evaluation with the most impact on the individual pathologist is a malpractice case. During the last decade physicians have increasingly become aware of the critical role played by expert testimony in malpractice litigation. Some physicians have asserted that providing expert testimony is the practice of medicine, and that it is unacceptable for juries to be presented with expert testimony that incorrectly describes medical practice standards. However, this opinion has been vigorously opposed by attorneys who feel that juries are best able to come to a correct conclusion if they base their deliberations on a broad spectrum of opinion. Gaining an increased role in the oversight of expert testimony would allow physicians to establish a closer alignment between opinions expressed in court testimony and opinions expressed in clinical practice. However, despite some physician success in inserting themselves into the oversight process, both physicians and physician organizations attempting to take action against misleading expert testimony continue to be vulnerable to legal attack.
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The authors examined whether expert testimony serves an educational or a persuasive function. Participants watched a simulated sexual abuse trial in which the child witness had been prepared for her testimony (i.e., she was calm, composed, and confident) or unprepared (i.e., emotional, confused, and uncertain). The trial contained different levels of expert testimony: none, standard (i.e., a summary of the research), repetitive (i.e., standard testimony plus a 2nd summary of the research), or concrete (i.e., standard testimony plus a hypothetical scenario linking the research to the case facts) testimony. Repetitive testimony bolstered the child's testimony, whereas concrete and standard testimony did not. Concrete testimony sensitized jurors to behavioral correlates of sexual victimization; standard and repetitive testimony desensitized jurors to these correlates. Implications for the use of procedural innovations in sexual abuse trials are discussed.
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This study examined whether participants were sensitive to variations in the quality of an experiment discussed by an expert witness and whether they used heuristic cues when evaluating the expert evidence. In the context of a hostile work environment case, different versions of the expert testimony varied the presence of heuristic cues (i.e., whether the expert's research was generally accepted or ecologically valid) and evidence quality (i.e., the construct validity of the expert's research). Men who heard expert testimony were more likely to find that the plaintiff's workplace was hostile than were men who did not hear the expert testimony; expert testimony did not influence women's liability judgments. Heuristic cues influenced participant evaluations of the expert testimony validity, but evidence quality did not. Cross-examination did not increase juror sensitivity to evidence quality. Implications for science in the legal system are discussed.