Intended for healthcare professionals

Rapid response to:


Shaken baby expert witness wins High Court appeal

BMJ 2016; 355 doi: (Published 08 November 2016) Cite this as: BMJ 2016;355:i5985

Rapid Response:

Re: Shaken baby expert witness wins High Court appeal

Dear Sirs,

Personal view:

As a medico-legal expert of 30 years' standing, I read this article with interest. It is always tempting for an expert to give evidence in a polarised way and I think the Courts recognise this easily when it happens.
In my salad days, I can recall trying desperately to defend an argument I had put forward very unsuccessfully but realised even at the time, that I was probably wrong. I learned then that to be malleable and accept when one is wrong is the only way forward, even while giving evidence. Many experts argue themselves into a corner even though it is plain that they are incorrect. One wonders why one does this - I suspect it is because one is afraid that when shown to be wrong, we feel our reputation is besmirched.

My advice is to never to be afraid to admit when you are wrong.

I have long since resolved this feeling because I always now refer to conventional wisdom and state both contrary and supportive views, because otherwise one cannot be objective. In most negligence cases I disregard which side has instructed me, because my role as an expert is not only to assist the Court but to ensure that instructing solicitors and barristers are not sent into court to do battle armed only with the 'fruit knife' of unsupportable expert opinion.

My advice to any expert is to be completely objective and state both points of view and indicate the spread of opinion. In your expressed opinion it is vital that you demonstrate why you have formulated that opinion. In some cases academic research can be used, but since in almost any case or condition, articles can be found with a contrary evidential view, it does not help the Court. This is because as trained clinicians, we have experience of the clinical picture but also we have training in assessing medical literature and its significance, which the Court does not.

In the 'shaken baby cases' the correct manifestation of objectivity would have been a stated opinion which contains the facts, then the personal opinion and then a review of contrary opinion and reference to the majority view. Doing so will provide the Court with a clear guidance upon which to base its judgements.

Bottom line - never support either side. Be objective and never fear being shown to be wrong in your views or admitting that you are.

Competing interests: No competing interests

12 November 2016
Fredrik P Nath
Department of Neurosurgery, James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW