Causation: an expert’s guide

• Clinical experts must be aware of the applicable legal principles in their medico-legal practice and must apply them in providing opinion.
• Lawyers must direct experts in their instructions.
• A neuropsychological case study.

For medical experts one of the most difficult areas to address, and to communicate, in civil claims is that of causation. For lawyers too medical causation is difficult—it is frequently difficult to discern where the medical expert stands in terms of the applicable legal tests. Particular difficulty is experienced where there is a pre-existing condition impacting on deficits caused by the index event.

Experts must be fully aware of the legal principles and be able to apply them when writing reports so that their opinions are meaningful to the lawyers and the court in determining the value of a claim, while lawyers must be able to guide the expert to provide useful opinion on causation.

This article illustrates appropriate application of the legal principles