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Reflection on Expert Work

Special Reports

Ten years ago I examined a 13 year old girl who alleged that her step-father had sexually abused her. I will always remember this case as the girl’s mother refused to believe her and as a result ofthis she was forced to leave home.


As a paediatrician, I saw my role as the advocate for this child. I believed her completely: her story was so compelling. The physical examination however was not diagnostic of sexual abuse.

At the time I wrote a detailed statement and recall how disappointed I was that I could not categorically state the evidence was diagnostic of abuse.

However, prior to my court attendance I received a copy of the expert witness report. I was in awe of the author immediately. My examination of this child as well as conclusions had been scrutinised in depth. We had agreed on all point but one- I had stated the evidence as presented to me supported sexual abuse.
The court requested that I meet with the expert witness which we did just prior to me giving evidence. What she said to me at the time has always stayed with me. She thanked me for my report and pointed out that I was acting as the advocate for the child but her duty was solely to the court and as such had to present all sides of the argument. It was at that moment I decided I wanted to engage in this work.

Why is it important that paediatricians undertake expert witness work?

The expert witness plays an essential role as courts rely on expert witness testimony in most civil and criminal cases to explain scientific matters that may or may not be understood by jurors and judges. Paediatricians have expertise in children and young people and many will have specialised skills which no one else can provide such as safeguarding.

As a profession, paediatricians are natural advocates for children but as an expert witness that role changes as their sole duty is to the court. This detachment can be immensely challenging but at the same time rewarding.

What makes a good paediatric expert?

Accuracy and research in report writing is crucial. Paediatricians should familiarise themselves with all sides of the arguments and present that to the court. Where professionals have become unstuck in the past is because they have been driven by their own beliefs. Paediatricians should know their limitations and
always defer to another expert when they are being asked for advice outside their field of expertise.

What are the main challenges faced by paediatricians undertaking expert work?

Fear is the greatest challenge to paediatricians undertaking expert work. There can be headlines which focus on high profile cases where paediatricians have been criticised.

What are the steps paediatricians take to prepare themselves to act as an expert?

Paediatricians rarely have any form of legal training. Many paediatricians first legal exposure may be a request to give evidence in court, the prospect of which, many find immensely daunting.

Attending courses to familiarise yourself with court process is highly recommended. An expert witness course is a must. Not only will it familiarise paediatricians
with the medical-legal process, it will provide the framework required when engaging in assessments and writing reports. It is important to choose a course where report writing skills and court room skills will be challenged. Meeting other expert witnesses and reading their reports is also a good way to improve skills and knowledge.

Emilia Wawrzkowicz
Consultant Paediatrician
Designated Doctor Safeguarding Children
Cambridgeshire and Peterborough CCG

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