While many may criticise the GMC’s decision to strike off Sir Roy Meadow, those affected by his flawed evidence will be able to gain some solace from the fact he has been brought to book.
Few will deny that Sir Roy Meadow had a distinguished career and contributed to child health. However it was his transition from experienced paediatrician to an expert on child abuse that led his career down a path where he ultimately substituted medical and scientific fact with statistical supposition.
It seems ironic that in his defence in front of the GMC, Roy Meadow denied he was a child abuse expert and claimed that he was simply ‘an experienced paediatrician’. Having invented Munchausen syndrome by proxy (MSBP) and edited ‘The ABC of Child Abuse’ his denial did not stand up to the scrutiny of the GMC and nor should it have.
One cannot stand before a jury in court as an expert witness whose testimony holds the freedom of a mother and future of her family in hand one minute and then claim just to be someone who is experienced rather than an expert, the next. In this sense it was right for the GMC to strike him off.
The message for expert witnesses is clear, if you are going to stand up in court as an ‘expert’ you will be judged as such. If you are experienced but don’t consider yourself an expert then stay at home.
Expert witnesses are not, as some may believe, there to back up or make out the prosecution’s case. The duty of an expert witness is to the court. They are there to assist the court in assessing the evidence and to provide their expertise in a specific area. So are we placing too much of a burden on experts? Richard Horton, editor of medical journal The Lancet believes so and recently argued that Sir Roy should not have been charged let alone stuck off. He argues that it is for the legal system to work out how it uses expert witnesses rather than blame the experts for their evidence. While valiant in its defence, The Lancet overlooks the damage that was done by Meadow’s flawed testimony. He didn’t have to give such evidence so it is right he should face the consequences. The consequences his evidence held in store for Clark, Cannings, Patel, Anthony and others was far graver. However, a key point within Mr Horton’s Lancet article is his question about the efficiency of the legal process employing expert witnesses.
This shifts the argument from not appearing as an expert unless you are sure you are and take responsibility for your testimony to one of not using expert witnesses or allowing the jury to hear their testimony unless you are sure the system works.
There are two fundamental problems with the system, one relates to evidence and the other to access. Where the forensic evidence or scientific fact is not self-evident, how do we bridge the gap between such ‘hard-fact’ evidence and interpretation of surrounding evidence and fact that is often key to proving or disproving a case. Presently the divide is bridged by the persuasiveness of the prosecution or defence and importantly, expert witnesses. This however leads to conflict. While an expert’s duty is to the court, their testimony may be perceived as belonging to the prosecution. If the jury is not clear about their role or their evidence then problems arise. Similarly, where as in Meadow’s case, the expert goes from assessing evidence to making it up, the jury may be left with a dangerously wrong impression.
At least in criminal trials there is a jury and the media have access to report on and assess the case. The problem with child protection cases, especially those involving expert witnesses is that unless and until they result in a criminal trial, they take place in secret behind closed doors. The media has no access and there is therefore minimal opportunity for transparency or scrutiny. If one wants to prevent further miscarriages of justice taking place and for a system that often relies on expert witnesses to sustain, then the answer is to open that system up to scrutiny and let the open justice principle break its way into family courts.
Given the lack of reporting rights in children and family courts, mothers can easily have their children taken from them on the basis of expert testimony. Where there are no ensuing criminal proceedings, the case will remain secret. Surely the severity of the penalty of having children taken from you demands a system that is open to scrutiny.
As if Sally Clark’s plight was not bad enough, her husband was faced with the prospect of having their surviving child taken from him on the basis of the ‘expert’ opinion of Professor David Southall, who having watched Mr Clark interviewed on a Channel 4 programme concluded the child was not safe in his care. If we are going to remove children and accuse parents on the basis of what an expert saw on TV then it is only right and the interests of justice should demand that the same media be permitted to scrutinise such experts.
Proponents of the current legal system will point to legislation such as the Children Act and argue that it is in the paramount interests of the children that they – and proceedings involving them – be given anonymity. So letting reporters into court is the last thing they would want. However, is it in the interests of children to be taken away from parents who subsequently are shown to have been wrongly accused of seeking to harm them. There is no reason why one shouldn’t or couldn’t open up the court system to allow the reporting and scrutiny of such sensitive cases while still preserving the anonymity of the children and families involved. Proper and measured reporting that allows for scrutiny is preferable to allowing a system to operate unchecked and then face sensational media coverage when things go wrong.
To the extent the courts and medical profession have some work to do on their interaction and the use of experts, the courts need to extend their dialogue with the media and allow them access to the system.
More from BBC here
The Children Act 2004
Protection of Children Act 1999
Children Act 1989
More on Meadow HERE and HERE
More on Southall HERE and HERE
The Sally Clark case Appeal Judgment and aftermath
Angela Cannings HERE and BBC Real Stories investigates HERE
Trupti Patel HERE
Donna Anthony HERE but having spent 6 years in prison gets no compensation