Let’s face an inconvenient truth: there are no independent medicolegal experts. We, physicians, are paid by either the plaintiff or defence to produce our medical opinions. We are called to remain impartial and nonpartisan. It contradicts human nature. People respond to incentives, and doctors are not immune to this. Even in seemingly transparent academic endeavours, financial incentives play a significant role. Numerous studies and literature reviews show a substantial influence of industry, with a correlation found 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 one's side, but experts can’t? It’s okay to be part of a team, either in daily life or even in court. Even a judge may implicitly sympathize with an accused perpetrator. Empathy or antipathy cannot be rationalized. We endlessly connect with other people because we are social creatures. Thus, if we were programmed to like someone and dislike another based on individual 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 (e.g., Reward Centre) 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 vague in politics, society, culture and religion, why doctors are expected to remain immune, especially when a personal report does not threaten anyone’s life?
The solution is logical and straightforward. 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 they deal with other legal matters.
My expertise is Chronic Pain, and because pain experience is personal and cannot be measured the same way as the blood pressure or cholesterol level, people are perceived not trustful. Granted, malingerers and con artists are out there, but what would be a reason for any human being to retreat from personal and social life, and hide in a cocoon of suffering if they are not indeed suffering. The reason for such horrific consequences may be different, including the expected compensation, but it will be very naive and mechanistic to assign all physical, emotional and social decline to one cause.
As an Expert, I have been following a simple rule to deal with convoluted issues: trust the patient unless evidence proved otherwise.