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REPORTS: CONTROLLING THE WORDS RATHER THAN THEM CONTROLLING YOU.

Sunday 9^th 9.55am

A report represents the visible output of a medico-legal service. It is a document that will be scrutinised in both private and public forums and may carry significant implications for the patient, the investigators, the justice system and the author of the report.

There are many challenges implicit in the preparation of such a report. Comprehending the fundamental principles of this process will greatly assist the clinician and improve the quality of the output.

Associate Professor David Wells

David is head of Clinical Forensic Medicine at the Victorian Institute of Forensic Medicine and Honorary Associate Professor in the Departments of Forensic Medicine and Paediatrics at Monash University.

His recent work has been with the World Health Organisation in Geneva and with Amnesty International in Africa, assisting in the establishment of medico-legal services for victims of sexual violence in developing countries.

OVERVIEW

Medical reports and where they go wrong- David Wells

It is a delight sitting in on a David Wells report. There is always something to be learnt.

David started his presentation by standing, report in hand, and lulling his audience into a false security by telling them that the majority of the reports that he receives are excellent. He then went on to point out all the features of the ones that aren’t. I suspect by the obvious cringing and groans from the group that his observations had hit the mark.

My ‘take home’ messages from David:

Ask for help on your reports. There are many people around that are your resources. "Better a critique from a colleague in private than an overpriced Barrister in the public forum" were his words.

Prepare your report whilst it is fresh

Don’t try to make your report fit the story that you were given, there are always two sides

This is your report, don’t be bullied into including material from others.

Our reports will be read. What are we trying to tell the reader about what we saw, we heard, we did?

Remember that your report sends a message about the writer as well as the subject.

If you make a mistake, say "I made a mistake".

Don’t use the words ‘consistent with the allegations’. Juries see ‘consistent with’ as meaning ‘caused by’ –and David gets cross.

Hopefully with a little thought in your report writing, yours won’t be the one he holds up at the next FAMSAC conference!

Notes by Sheenah Van Eck

OVERVIEW

The Expert Witness - A/Prof David Wells and Helen Parker

The session began with an illustration of a poor forensic report and the impact this can have when giving evidence at court. Issues highlighted included:

Terminology – use the right term for the right condition/injury
Education of the court is an essential function of the expert witness
Impartiality – regardless of whether the expert witness has been called by the prosecution or defence, the evidence given should be the same
The expert witness’ opinion should be based on fact

The presenters generously shared their own experiences of giving evidence in court, and audience members also raised some issues they had had in court. Some of the issues discussed included:

Aging any kind of injury is difficult, if not impossible, with any degree of precision
Estimating the degree of force used to cause an injury is influenced by: the surface area the force is delivered over; variations in the victim; site of the injury (bone versus soft tissue)
The victim described severe pain with penetration but there was no injury on examination? "Fear factor", vaginismus, PID, vestibulitis, deep non-visible structures
When quoting references in a report, know them well! Take a copy of the article to court with you
If a barrister quotes from a reference in court, ask to see the reference. Is it an old text? Selective quoting from the text? Who is the author, which journal is it in?

The session was very informative and entertaining, a great way to conclude the conference.

Notes by Dr Liz Sturgiss