35 Med. Sci. & L. 2 (1995)

handle is hein.journals/mdsclw35 and id is 1 raw text is: 


2 Med. Sci. Law (1995) Vol. 35, No. 1


Editorial: Clinical Language for Expert Witnesses


STEWART ORR, DSc FIPSM FRSE
Emeritus Professor of Medical Physics, Royal Postgraduate Medical School, London


Teams  of experts pitting their wits and their
jargon against each other do not aid the provi-
sion of justice. Lord Taylor, the Lord Chief
Justice (Lund  Lecture, pages 3-9) seeks a
change in this all too common approach. The
decisive choices in a court are for the juries and
judges. In many cases it should be possible to
focus the dispute on law and justice by resolv-
ing and agreeing on practical technical issues.
   However, each expert will express his opin-
ion in his own language and terms. Part of the
court process, often long and costly, of reconcil-
ing apparently conflicting expert evidence is to
interpret and re-interpret the experts' lan-
guage until the personal variation is wrung out
and the commonality of expert fact remains.
   Lord Taylor suggests that experts with a
common   loyalty to the court would be prefer-
able to experts appearing, as they sometimes
do, as mercenaries selling testimony to the side
that instructs them. Such a common  loyalty
may  be hard to achieve at present, but a com-
mon  language  could give immediate benefit
and also help to create conditions for a conver-
gence of loyalty.
   For medical cases, the recent drive towards
the development of a comprehensive, codified
common  language of health gives an opportu-
nity of exploring this possibility.
   The practical achievement of the first phase
of this common language is the Read Terms,
initiated by James Read, a Loughborough GP,
and Martin Severs, a Portsmouth geriatrician.
The  main credit must go to some 2000 clini-
cians for more than two years of freely given
work in the best traditions of caring. The work
has been sponsored and is being endorsed by


the Medical Royal Colleges through their Con-
ference Information Group.
   The Read Terms  have been conceived and
created to allow doctors of all specialities,
whether practising in the community or in hos-
pitals, to share and communicate extensive
and comprehensive clinical information clearly
and  unambiguously.  The  achievement  has
been to bring together and record all syno-
nyms, to distinguish and relate more specific
terms to those that are more general, and to
allow any amount  of detail to be added in a
clear and formalized way.
   If medical experts were invited to couch
their reports in Read Terms, the degree of
equivalence could become apparent and real
differences identified. The resulting brevity
and clarity would earn the appreciation of the
court. Read Terms are designed for use in com-
puters, but there can be few expert opinions
that are not produced using a word processor,
and these can be combined with access to the
Read  thesaurus for the formulation or selec-
tion of appropriate terms.
   Such a bringing together of expert medical
thought could help lay a practical foundation
for a trial of the reforms advocated by Lord
Taylor and Lord Woolf.
   A further phase of the common language of
health development is to create a mapping of
the medical terms to a vocabulary of health
comprehensible to the lay public. Already the
Read  Terms are mapped  to a wide range  of
medical classifications.
   If by this means simplicity can be combined
with brevity and clarity, members of the jury
could be helped towards greater justice and
respect for experts.


Address for corespondence and extensive reference material: NSC Centre for Coding and Classification,
Woodgate, Loughborough LE11 2TG.

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