Medicolegal Expert

Let’s face an inconvenient truth: there are no independent medicolegal experts. We, physicians, are paid by either the plaintiff or defense to produce our medical evaluations. We are called to remain impartial and nonpartisan. This is obvious nonsense. People respond to incentives, and doctors are not immune to this. Even in seemingly transparent academic endeavors, financial incentives play a significant role. Numerous studies and literature reviews show a significant influence of industry, with a correlation between funding by the manufacturers and findings that show positive results for efficacy and safety of the benefactor’s products.

Why lawyers have an opportunity to take a side, but experts can’t? It’s okay to take a side, either in daily life or even in court. A judge may implicitly sympathize with an accused perpetrator. It’s human nature because we are social creatures. Thus, if we were programmed to like someone and dislike another based on certain synaptic connections in our cortex, how we are supposed to act when the main reward center in our brain is involved? When a doctor is paid, the amygdala is pleased. Moreover, it will work hard to receive the same reward all over again and make everything possible to eliminate obstacles in this process.

The ethical standards should stand safeguards and suppress the rewarding circuit. However, when ethics are shaken in politics, society, culture and even religion, why doctors are expected to remain immune, especially when a biased report does not threaten anyone’s life?

The solution is a simple and logical. Doctors, like attorneys, should be allowed to defend their clients. In the absence of any other superior judgment, courts and mediators should unravel medical casuistic the same way deal with other legal matters.