Abstract
To the Editor.— I write concerning the recent article by Dr Abraham 1 on medical liability reform in the July 1 issue of JAMA . He mentions one-way and two-way fee shifting as mechanisms to limit litigation, but states that two-way fee shifting might reduce access to the courts by less prosperous plaintiffs who have otherwise meritorious claims. I suggest that another mechanism to limit litigation, which apparently has had success elsewhere, is for a system of two-way fee shifting in which a losing defendant pays the costs of the plaintiff, including legal fees (as now exists), but in which a losing plaintiff pays all costs incurred by the victorous defendant, including legal fees. Should the plaintiff be indigent or otherwise unable to pay this cost, the burden would shift to the plaintiff's attorney, and bond would be required prior to litigation to ensure that both parties could meet this potential
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