Medico-legal examinations and reports.

Abstract

DEFINITION.-The purpose of a medical examination is usually to enable the doctor to ascertain the condition of the patient, so as to be able to advise him as to treatment. The distinctive feature of a medico-legal examination is that it is conducted primarily for the information of some third party who has an interest in knowing the facts relating to the patient's condition, and the opinion of the medical examiner on these facts, and who may use this information in taking some action with legal consequences. Such an examination may be confined to some part only of the patient, such as his blood or excreta, or even of his cadaver, and in such a case the examiner is in the fortunate position of being able to treat the matter purely objectively as a scientific enquiry, and, if he is well versed in the theory and practice of pathology, he may be able to attain a high degree of accuracy and to deliver an opinion which it would be difficult to assail. Different considerations apply, however, in the case of the medical man who is called upon to examine the living subject. Here the situation is complicated by the infinite variety of human behaviour; the ascertainment of fact may be rendered more difficult by lack of co-operation by the patient, or even his strenuous .opposition, or his attempts to pervert or obstruct the examination, or to influence the examiner in his opinion by false or misleading information. In such circumstances the doctor is obliged to exercise a considerable discretion in his observation and interpretation of the facts, and to guard against the possible intrusion of personal prejudice in forming his opinion; his report may often be challenged on the grounds that he did not pay sufficient attention to these special circumstances.