“If there is a doctor or nurse on board, please identify yourself by pushing the attendant call button.”
For pediatricians, such calls for voluntary emergency help can be simple and ethically clear on one hand, but legally worrisome and uncomfortable on the other.
“We’ve all hesitated,” Dr. Steven M. Donn, former chair of the American Academy of Pediatrics’ Committee on Medical Liability & Risk Management, said at the AAP’s annual meeting in Washington. “We often find ourselves in various scenarios, not with our pediatric population, but with elderly and younger adults, when we feel like we may be in over our heads. And we’re also afraid we’ll get sued.”
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Good Samaritan laws in all 50 states, however, provide legal protection for good faith attempts to help, even if such attempts are technically “negligent.”
“The goal of these laws is to strike the right balance … to reduce liability enough to motivate volunteerism, but to preserve enough liability to prevent reckless or harmful interactions,” said Dr. Dunn, a professor of pediatrics at the University of Michigan, Ann Arbor.
While the laws provide legal immunity against ordinary negligence (doing something that an average, reasonable person would not do), there is not generally no immunity provided for “gross negligence,” which is defined as reckless and willful disregard for the safety of others.
He urged pediatricians to remember three criteria for immunity: That it is an emergency situation, where failure to intervene could result in death or severe bodily harm; that the responder acts without compensation; and that the responder acts rationally, in good faith, and without gross negligence.
“Don’t be afraid to get involved,” Dr. Dunn said. “Just keep within the limits of your abilities and provide help in good faith. Do the Heimlich maneuver, for instance, but don’t ask for a dinner knife to do a tracheotomy.”
And with regards to compensation, it’s fine to accept a free drink on an airplane, but not to accept free airline tickets, he said.
A case scenario: An elderly woman falls on an escalator in a shopping mall, sustaining an apparent head and neck injury. You offer assistance, stabilize the head and neck, and request a call to 911. The woman is taken to the emergency room, and the store manager gives you a $500 gift certificate in gratitude. Unfortunately, however, the woman has a bad outcome and sues you for negligence. “By accepting the gift certificate, you’ve [in all likelihood] lost your [Good Samaritan] protection,” he said.
Patients and parents can refuse help, and helping despite refusal is usually deemed to be not in “good faith.” There may be exceptions, however. “Say you’re waiting for your child in the middle school parking lot when you see another child struck by lightning. You initiate CPR, and as you’re administering CPR the father of the child arrives and greets you with ‘If anything happens to my child, I am going to sue you,’ “ Dr. Dunn said. “What are the risks of continuing care?”
“You’d just need to be aware that there could be a separate charge for care without consent, or even assault and battery,” Dr. Dunn said. “But I think it’s one you could probably win since you were acting in good faith to provide lifesaving attention.”
Good Samaritan laws generally do not apply to medical professionals while “on the job,” but some states extend protection to medical professionals who render emergency assistance in a hospital or other “health care setting” when such assistance is beyond the scope of their work duties.
“So if you’re walking down the hallway, and someone collapses and you offer assistance, even though you’re not the patient’s physician, in some states you’ll be covered by the Good Samaritan law,” Dr. Dunn said. “So it’s helpful to know your state’s laws.”
Good Samaritan assistance during commercial flights is governed by the federal Aviation Medical Assistance Act of 1998; the law protects providers who respond to in-flight medical emergencies against liability for negligence. Medical emergencies occur in about 1 of every 600 flights, and physicians assist in nearly half of these cases, according to a 2013 study (N Engl J Med. 2013 Aug 29;369[9]:877).