Question: During a flight from Los Angeles to Newark, a passenger developed acute chest pain and diaphoresis. A flight attendant put out an emergency call, but Dr. Brown, a general internist nearing retirement, failed to respond because he was concerned about potential litigation. Unfortunately, the passenger sustained a massive MI, and died en route.
Regarding a medical malpractice lawsuit in such a scenario, which of the following is correct?
A. The Good Samaritan statute imposes upon doctors the legal duty to treat.
B. Good Samaritan statutes immunize doctors against all liability.
C. Dr. Brown need not have hesitated, as his attempts, even if negligent, would have been protected by the Aviation Medical Assistance Act.
D. All doctors have taken the Hippocratic oath to treat in an emergency situation.
E. But for Dr. Brown's negligent failure to act, the patient might have survived, so the doctor is at least partly liable.
Answer: C. If Dr. Brown had responded, his effort would not have put him in jeopardy even if his intervention had proved ineffective.
However, there is no legal duty for anyone, even a doctor, to come to the aid of a stranger.
Although doctors are generally thought to have an ethical duty to offer emergency care, the Hippocratic oath is silent on this matter, and the American Medical Association's Code of Medical Ethics states: “Physicians are free to choose whom they will serve. The physician should, however, respond to the best of his or her ability in cases of emergency where first aid treatment is essential” (AMA Code of Medical Ethics §8.11, 2006–2007 edition).
All 50 states have laws on their books called Good Samaritan statutes, whose intent is to encourage people to help those in acute distress. These statutes do not require doctors to come to the aid of strangers, although Vermont is an exception, imposing an affirmative duty to assist a victim in need.
Rather, they protect against liability arising out of negligent rescue, but typically they cover only ordinary, not gross, negligence.
The Aviation Medical Assistance Act, enacted in 1998, is the federal equivalent of the Good Samaritan statute, covering emergency treatment during flights in the United States.
In allegations of medical malpractice, the plaintiff must first show that the doctor owed a duty of due care to the injured victim. This duty arises out of the doctor-patient relationship, that is, whenever a doctor undertakes to evaluate or treat a patient. In the absence of such a relationship, a doctor is not legally obligated to treat, even in an emergency.
However, to encourage aiding strangers in distress, states have enacted so-called Good Samaritan laws to protect rescuers who act in good faith. Popularized in the 1960s in response to the perception that doctors were reluctant to treat strangers for fear of a malpractice lawsuit, these laws immunize the aid giver against allegations of negligent care. Their protective scope varies from state to state, usually offering immunity against simple negligence but not gross misconduct.
Hawaii's Good Samaritan statute is typical. It states: “Any person who in good faith renders emergency care, without remuneration or expectation of remuneration … shall not be liable for any civil damages resulting from the person's acts or omissions, except for such damages as may result from the person's gross negligence or wanton acts or omissions” (Hawaii Revised Statutes §663–1.5 [a]).
California, the first state to enact a Good Samaritan statute in 1959, is an exception, as it may excuse even gross negligence as long as the act was done in good faith. In a litigated case, a California court declared: “The goodness of the Samaritan is a description of the quality of his or her intention, not the quality of the aid delivered” (Perkins v. Howard, 232 Cal.App.3d 708 [1991]).
There is no universal definition of gross negligence, but the term is frequently equated with willful, wanton, or reckless misconduct.
One can think of gross negligence as aggravated negligence, involving more than mere mistake, inadvertence, or inattention, and representing highly unreasonable conduct, or an extreme departure from ordinary care where a high degree of danger is apparent (Prosser, W.L. et al., eds. “Prosser and Keeton on Torts,” 5th ed., St. Paul, Minn.: West Publishing Co., 1984, pp. 211–4).
Statutory protection is generally excluded for Good Samaritan acts performed within a hospital setting under the theory that doctors have an ongoing relationship with the hospital and are already obligated to provide emergency care within its walls.
A minority of states such as California and Colorado do provide immunity irrespective of the location of aid.