Tort Reforms’ Winners and Losers: The Competing Effects of Care and Activity Levels

74 Pages Posted: 17 Aug 2011 Last revised: 29 May 2012

Date Written: May 5, 2008


This Article explores the relationship between medical malpractice tort reforms and death rates. Investigating this relationship is important both because of the frequent political conflict over such reforms and because medical malpractice causes tens of thousands of deaths each year. I first develop predictions from law and economics theory about medical malpractice tort reforms’ carelevel and activity-level impacts on death rates. I test the theoretical predictions using extensive data and sophisticated regressions. I find that the net effect varies by reform: Some reforms are associated with increases in death rates, while others are associated with decreases in death rates. These results confirm that the tort reforms’ care-level effects and activity-level effects are both important. My results also suggest that the reforms may produce three unintended consequences. First, two of the reforms are associated with increases in death rates. Second, because doctors relocate to tort reform states, tort reforms in one state are associated with increases in deaths in neighboring nonreform states. Third, these reforms disproportionately harm women. They not only disproportionately reduce women’s tort judgments, but they are also associated with increases in women’s death rates. I conclude by proposing modifications to the reforms that would retain their benefits, but reduce their harms.

Keywords: tort reform, tort law, medical malpractice, law and economics

JEL Classification: K00, K13

Suggested Citation

Shepherd, Joanna, Tort Reforms’ Winners and Losers: The Competing Effects of Care and Activity Levels (May 5, 2008). UCLA Law Review, Vol. 55, p. 905, 2008, Emory Law and Economics Research Paper No. 11-108, Available at SSRN:

Joanna Shepherd (Contact Author)

Emory University School of Law ( email )

1301 Clifton Road
Atlanta, GA 30322
United States
404-727-8957 (Phone)

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