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June 26, 1987

The Blame Game: Injuries, Insurance and Injustice

Author Affiliations

Napa, Calif

Napa, Calif


by Jeffrey O'Connell and C. Brian Kelly, 160 pp, $24, Lexington, Mass, DC Heath & Co, 1987.

JAMA. 1987;257(24):3423-3424. doi:10.1001/jama.1987.03390240129043

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


The senior author, a distinguished legal educator, has been for decades a preeminent voice among the increasing calls for reform in our fault-based tort and liability insurance system, which compensates accident victims so unpredictably, often unfairly, and sometimes irrationally excessively or not at all.

Chapters are appropriately entitled "Unsettling Settlements," "(Mis)trial by Jury," "The Litigation Lottery," "The Injured Citizenry," and "Medical Malpractice's Malpractice," among others. The authors effectively dramatize the urgent need for a change in a system that is inefficient, expensive, and now is perniciously depriving consumers of some essential goods and services. Providers are driven out of operation because of constant threats of litigation that mock efforts at equitable compensation and destroy any expectation of reasonable reward. As examples, we note obstetricians and other specialists at high risk "retiring" to more congenial practices and are appalled that only one unwilling company remains as a source of diphtheria-pertussis-tetanus vaccine.