The Role of Medical Illustration as Demonstrative Evidence
“In virtually every personal injury of wrongful death case the opportunity will present itself for the use of either medical illustrations or X-rays” (Dombroff, 1983)
The above-quoted author continues to explain that while they are true diagnostic tools, x-ray are at a disadvantage in the courtroom: they review special viewing equipment, are potentially confusing, and lack colour. Medical illustrations, he writes, should always be shown alongside an x-ray to hold the attention of the jury. Though written 40 years ago and in need of any update, these statements are still basically true. Today we can supplement ‘x-rays’ with CT scans, MRIs and Ultrasounds, and ‘illustrations’ with animation and plastic models, while still honouring the author’s intent.
Because medicine, like law, requires a specialized vocabulary, medical writing can be obscure even to the initiated. While physicians’ reports describe, often tersely, complex anatomical relationships, injuries and surgical procedures, medical illustrations can clarify these descriptions in a way that is immediate to grasp. A picture really is worth a thousand words when it comes to comprehending the course of arteries and nerves, a broken ankle, or a discectomy.
When used as demonstrative evidence, medical art informs the trier of fact of pertinent data relative to the issues in litigation which cannot be described as effectively without its use. It is justified on the grounds that it pictorially reproduces descriptive testimony and accurately reflects expert evidence, acting as an aid to that testimony or evidence.
Nonetheless the inconvenience and expense of commissioning custom medical art may make the use of hospital films alone, being faithful representations, seem pragmatic. However, there are compelling advantages to the use of illustrations based on such films:
relating an injury to the rest of the body;
adding vital soft tissue injury otherwise unclear or invisible;
relating an injury to a pre-existing condition;
and relating an injury to future impairment
Illustrations can also help explain abstract medical concepts and surgical procedures described in operative notes. What’s more, injuries, pathology and surgery make sense when seen in the context of normal anatomy, and a medical illustrator can provide such artwork alongside.
Properly developed medical art for evidence greatly assists the understanding of the judge and jury. Reference to visuals during explanation ensures that all viewers have the same image in mind rather than their own interpretation of a verbal description. Additionally, medical art furthers the advocacy of plaintiff’s counsel, who will appear favourably for having brought forward such understanding.
