This masterful short story initially deceives, then shocks the reader into the realization of the dynamics of scapegoating. Its value lies in this narrative technique which dramatically engages the reader in the textual process such that the reader participates in the act of scapegoating through identification with the townspeople. At the same time as (s)he comes to this realization, (s)he is struck by the perils of too early closure on the interpretation of a narrative.

The pitfalls of pattern (mis-) recognition in medicine cannot be more ably demonstrated. Moreover the reader feels manipulated by the text and ultimately identifies with Mrs. Hutchinson’s cry, "It isn’t fair." The resulting feelings of anger reproduce the common feeling of anger at oneself and the patient when one comes upon an unforeseen diagnosis, evolution, or outcome. The dynamics of scapegoating are highly relevant to medical practice, medical school, and the medical profession, where patients, students, colleagues and the profession itself can become scapegoats for the broader collective. They are also important in interactions with the identified patient’s family and in family therapy (see family therapy texts).

The cross-cultural and transcultural nature of scapegoating is explored in Sir James Frazer’s "The Golden Bough"; and the underlying structure is elaborated in René Girard’s "Le bouc émissaire." "The Lottery" also serves well to illustrate the role of literary theory in literature and medicine, particularly reader response theory, hermeneutics, and narratology.