title: Operationalizing the standard of medical care: uses and limitations of epidemiology to guide expert testimony in medical negligence allegations.
abstract: In most U.S. jurisdictions, jurors are instructed that physicians must use "the skill and care ordinarily provided in similar circumstances." A failure to do so is called malpractice. However, how is a lay juror to know what ordinary medical care is? From physician experts testifying about their experience? Given that individual recollections of experience are likely to be skewed in the direction which, in retrospect, is preferred (the "Monday Morning Quarterback" phenomenon), and that the database upon which they are drawn is likely to be small (at least when compared with what might be available elsewhere), idiosyncratic generalizations of medical expert witnesses are almost certainly fraught with potential inaccuracies. Statistical descriptions of standard medical practices, published in peer-reviewed journals whenever possible, would provide a necessary buffer for jurors specifically, and the public more generally, against the inevitable possibility that an individual expert's experience is skewed, or recollection faulty.
authors.affiliation: Department of Pediatrics, MacLean Center for Clinical Medical Ethics, University of Chicago, USA.
authors.forename: William
authors.initials: W
authors.lastname: Meadow
mesh_terms: D004813:Epidemiology; D019317:Evidence-Based Medicine; D005104:Expert Testimony; D006801:Humans; D033222:Judicial Role; D008318:Malpractice / Q000331:legislation & jurisprudence*; D011787:Quality of Health Care / Q000331:legislation & jurisprudence* / Q000592:standards*; D014481:United States