The Good Samaritan – what if the doctor doesn’t walk on by?

On two occasions over the past few years, I have witnessed medical emergencies resulting in appeals for doctors to help.

The first occasion was during a skiing trip where a young boy had collapsed. A small crowd had gathered and were helping his parents stop skiers in the hope of finding a doctor. An orthopaedic surgeon made himself known immediately and instinctively performed CPR which successfully revived the boy. Before he had finished, a second doctor also came over to offer help. 

The second incident was in the theatre when one of the actors collapsed backstage. A member of the cast ran onto the stage during the interval and invited doctors in the audience to make themselves known. It was a full house but no one volunteered. Perhaps there were no doctors in the audience that evening, or perhaps they were not prepared to volunteer.

Pausing for a moment; what would cause a doctor to be reluctant to help? Perhaps a fear of legal repercussions, which raises the question; are doctors who volunteer in an emergency at risk of litigation?

Is there a duty to assist?

The position is clear: there is a strong ethical duty on all doctors to help anyone in need of medical care in an emergency. The GMC’s Good Practice Guidance informs doctors that in an emergency, wherever it arises, doctors ‘must offer help … taking account of your own safety, your competence, and the availability of other options for care’.

This is also recognised in the Hippocratic Oath and echoed in the International Code of Ethical Practice.

However, save for exceptions in relation to GPs, there is no legal obligation for doctors to volunteer in an emergency outside their place of work, in the UK.

What is the risk of assisting?

First, the risk to doctors of being sued in this situation in the UK is minimal, so much so that the Medical Defence Union says it is not aware of any such cases being brought. Further, the Social Action, Responsibility and Heroism Act 2015 is now enacted and offers protection from claims to those acting in an emergency.

Other countries have legislated in this area: Australia and Bermuda for example have laws in place to protect doctors from legal claims. Some jurisdictions have taken it further and made it illegal not to volunteer in certain emergency circumstances.

However, once a doctor gives assistance a duty of care will be established and the usual principles will apply. Medical practitioners will be expected to provide a standard of care comparable to that of a reasonable and responsible practitioner in that particular situation.  Also, they cannot act beyond the limit of their experience or competence. 

Practical advice

If you are asked for advice from doctors, the following tips are recommended:

• Obtaining consent: where able, doctors should obtain consent as they would in a clinical setting.
• Making a record: as close to the occasion and in as much detail as possible.
• Checking the situation abroad: different jurisdictions have different rules which should be checked.
• Check indemnity: good Samaritan acts are considered differently to doctors volunteering at organised events e.g. for a charity. Doctors should be familiar with the terms of their indemnity cover.
• Student doctors: strictly speaking, students do not have the same ethical duties but they should still help if they feel they can, provided treatment is within their competence and experience.