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Abstract

Consider the following hypothetical situation: A voluptuous blonde is window shopping along New York's fashionable Fifth Avenue. Her trek brings her to a corner street intersection which she begins to cross. A recklessly driven automobile careens around the corner and strikes the defenseless blonde pedestrian amidships, causing her to be hurled against a utility pole. Her breast strikes the pole and absorbs the full effect of the impact. A local hospital determines that her injuries consist of only a black and blue bruise spot on her breast. The swelling, due to the injury, subsides and the discoloration disappears within a short time. Two months later a routine breast examination reveals a lump within the breast in exactly the same location as the trauma. The examiner suggests that she enlist the aid of a physician. An operation is performed. A malignant, nonmetastasized mass is excised. The operation terminates with a radical mastectomy. Was the impact trauma the cause of the cancer? According to the medical profession, there is no experimental proof that a single trauma may cause cancer. That the cause of cancer is unknown is repeatedly asserted in reported cancer cases. However, lawsuits deal not with the question of medical cause but rather with the question of legal causation. Legal, rather than medical, questions must be dealt with in order to determine causation.

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