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January 2, 1991

Technology Assessment and the Fear of Litigation

Author Affiliations

Oklahoma City, Okla

Oklahoma City, Okla

JAMA. 1991;265(1):29. doi:10.1001/jama.1991.03460010029020

To the Editor.—  The July 11 issue of The Journal contained a fascinating article dealing with the reassessment of health care technology.1 The general conclusion was that we are inadequate in our assessment of the cost and benefits of technology and unduly slow to give up the use of those technologies that appear not to be worthwhile. Surprisingly, the article totally disregarded a major factor in the persistant use of technologies that should largely have been abandoned, and that is the influence of our legal system.Electronic fetal monitoring may well be expensive and useless, but regardless of what the recommendations of physicians may be, until the courts accept a similar position, obstetricians abandon the procedure only at their own peril.Many of the presentations regarding the cost and effectiveness of medical care fail to adequately address the increasing influence of our legal system in the determination of what