Medicine
End of life care expert witnesses
Listed end of life care expert witnesses address symptom control, anticipatory prescribing, treatment escalation decisions and communication in the final phase of illness. Their evidence often arises in inquests rather than in claims for damages.
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The evidence
What an end of life care expert witness is asked to determine
End of life instructions concern decisions taken under uncertainty, frequently out of hours and across several teams. Treatment escalation plans, resuscitation decisions, prescribing charts and records of discussion with the family are the material that matters.
- Whether recognition of dying and the change in the treatment plan were documented and communicated.
- Whether symptom control, including analgesia and sedation, was proportionate to the symptoms recorded.
- Whether anticipatory medicines were prescribed and administered as the records indicate.
- Whether resuscitation and escalation decisions were made and recorded in accordance with the process in place.
- Whether discussions with the patient and those close to them are supported by the contemporaneous record.
Practitioners are listed across all four UK nations. Location can be narrowed in the register’s location listings before an instruction is made.
Claim contexts
Claims that instruct this discipline
These links describe the question end of life care evidence can answer. They do not prescribe the scope of an individual instruction.
Inquests
Care in the final phase of illness where a death is being investigated.
View claim type → 02Clinical negligence claims
Symptom control and escalation decisions during terminal care.
View claim type → 03Court of Protection matters
Treatment decisions where capacity and best interests are in issue.
View claim type →Search the register by the discipline used in the instruction.
See end of life care listingsReport routes
Reports prepared
Escalation plans, prescribing charts and records of discussion support a records review report. Where the matter is coronial rather than a claim, a screening and merits report can establish whether there is anything to answer.
A breach and causation report is appropriate where both the standard and its consequence are challenged. The report pages hold the applicable requirements.
End of life care expert witness evidence
A palliative care expert witness assesses the escalation, prescribing and communication record against the standard expected in the final phase of illness.
Listings show the discipline and the areas covered, and enquiries go to the practitioner. See the NICE end of life care guidance alongside the case material.
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