Medico-Legal Opinions Based on Review of Case-Related Material

Template for medico-legal reports prepared in order to provide opinion evidence

VFPMS Clinical Practice Guidelines

Medico-legal opinions based on review of case-related material

Professionals working with children may be required to prepare medico-legal reports as a consequence of their engagement with children and as part of their professional duties. In such situations review of case-based material, including medico-legal reports written by other health professionals might be required. In other situations requests for a medico-legal report might be made of health professionals to review case-based material in the absence of direct contact with a subject. These reviews of case-related material might also include medical reports written by other medical professionals.     

Medico-legal reports based of review of case-related material might be requested for use by statutory child protection agencies, the Family Court of Victoria, the criminal justice systems, other courts or tribunals.

There are a broad range of reasons why a doctor who works in the field of Child Abuse Paediatrics/Forensic Paediatric Medicine might review case-related materials. Review of case-related material in order to prepare a medical report and/or testimony on behalf of a person accused of a crime is one such reason.

Review of case-related materials including case files is (and should be) a process involving objective, impartial, unbiased scrutiny of case-related material followed by critical analysis of available evidence. The opinion you provide should not be influenced by differing reasons for review or the identity of the purchaser. Review of case material for the defence (that is, on behalf of an accused) is not a “special case”, free from constraints of peer review, other quality assurance activities or the usual duties and obligations of an expert witness.

The following guidelines have been written to provide advice for Victorian doctors preparing expert opinion reports in relation to medico-legal matters involving children.

Authors are encouraged to ensure that the material provided for review has been lawfully obtained.

As a matter of professional courtesy, and to enable further communication, reviewers are encouraged to ensure that authors of medico-legal reports that that have been provided for appraisal are aware of the additional review process. If the party requesting the review of case-based material specifically asks that you do not communicate with other medical practitioners then you will need to decide whether you wish to perform the case-file review under these circumstances.

Authors of medico-legal reports are reminded that their obligation is to the court. The author must confirm his/her awareness of these obligations as the provider of opinion evidence. This obligation applies to opinions expressed verbally, in written reports as well as to testimony in court.

If you believe that most of your peers could, or in all probability would, reach a different conclusion to your, and that your opinion is therefore unlikely to be shared by most of your colleagues, then this observation must be stated. Note that there is no compulsion, legal or otherwise, for any professional to merely reiterate a consensus view, but a unique hypothesis or theory must be clearly identified as such. It would be sensible to provide a comprehensive explanation of reasons for a rejection of alternative hypotheses in this situation.

All medico-legal reports should undergo review by a peer prior to release.