Learning from a mock trial

Doctors take valuable skills from 
a simulated shaken baby case

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Photo of Soosan Jacob

A mock trial relating to non-accidental injury in children proved to be a very interesting session at the World Congress of Paediatric Ophthalmology and Strabismus in Hyderabad, India. Pediatric ophthalmologists enacted an interesting courtroom trial playing the roles of fact witness, expert witness, judge, defence and prosecuting attorneys. The attending delegates played the role of the jury. The trial started with a presentation of the details of the case. The expert witnesses – paediatric ophthalmologists – were then questioned by the defence and prosecuting attorneys followed by the jury. The verdict was finally given by a vote from the jury. The case presented was that of a baby with injuries for the jury to decide whether it was a case of shaken baby syndrome/abusive trauma or accidental trauma because of an alleged fall of the 70-year-old nanny down five carpeted steps on to the baby. Fundus photographs showing multiple retinal haemorrhages and retinoschisis with blood collection within the retinoschisis were shown with similar picture in both eyes. The drama proceeded to show a simulated experience and how it was also possible in real life that as an expert witness, the paediatric ophthalmologist could be questioned and heckled. Valuable teaching points on to how to handle such a situation were discussed. The case that was in fact one of abusive head trauma showed that words, language and attitude could be used to sway even a group of ophthalmologists and therefore, possibly, much more easily the laymen and women who compose a jury. Alex Levin MD, MHSc, of the Wills Eye Hospital in Philadelphia, shared some important tips on testifying in court. He advised that it was important to maintain one’s demeanour, be calm and state facts without getting ruffled or flustered even if badgered. It was also important to be prepared and know the relevant literature. He also said that it was worthwhile remembering that the expert witness’ job was only to educate the court by providing information and it is wise to not get emotionally involved with the case by trying to “win” for one side. He advised using layman’s terms and explaining in as simple a manner as possible, telling the truth and acknowledging uncertainty when not sure, remembering to speak only when spoken to and to answer only what is asked. Physician experts play a critical role in these legal situations and must be prepared, within their level and area of expertise, to assist the legal system. Alex Levin: alevin@willseye.org
Tags: paediatric ophthalmology