GOOD SAMARITAN ACTS DR NADIA CLOETE ANAESTHESIOLOGIST MBCHB (STELL), DA(SA), MMED ANAE(UFS), FCA(SA) 15 NOVEMBER 2020
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Good
Samaritan Acts
Dr Nadia Cloete
Anaesthesiologist
MBChB (Stell), DA(SA), MMED Anae(UFS), FCA(SA)
15 November 2020
Contents
Road Accidents
What about the
I should be a safety of my
“Good family?
Samaritan”
Won’t I be
providing
I should uphold suboptimal care?
the Hippocratic
Oath
Is there a Good
Am I legally
Samaritan Law to
obliged to stop?
protect me if I help?
Garneau WM, Harris DM, Viera AJ. Cross sectional survey of Good Samaritan behaviour by physicians in North Carolina. BMJ Open 2016;6:e010720.
doi:10.1136/bmjopen-2015- 010720
“If I stop to help what will happen to me”
The Good
Samaritan
Parable Craddock FB. Luke: Interpretation: A
Bible Commentary for Teaching and
Preaching. Westminster John Knox
Luke 10: 25 -37 Press; 2009 Jul 15
“If I don’t stop to help what will happen to him”
Craddock FB. Luke: Interpretation: A Bible Commentary for Teaching and Preaching. Westminster John Knox Press; 2009 Jul 15.
What about the
I should be a safety of my
“Good family?
Samaritan”
Won’t I be
providing
suboptimal care?
I should uphold
the Hippocratic
Oath
Is there a Good Am I legally
Samaritan Law to obliged to stop?
protect me if I help?
“ At this moment one enters a moral community whose defining purpose is to respond to and to advance the welfare of patients – those who are ill, who are in need of help, healing or relief of suffering, pain or disability” “Is the Good Samaritan the wrong metaphor to use for doctors? “ Dr William Cayley The BMJ Opinion December 2015
What about the
I should be a safety of my
“Good family?
Samaritan”
Won’t I be
providing
suboptimal care?
I should uphold
the Hippocratic
Oath
Is there a Good Am I legally
Samaritan Law to obliged to stop?
protect me if I help?
Who is a Good Samaritan?
A person who renders aid in an emergency to an injured or ill person
outside of the usual clinical setting.
Do you need consent from the person
Good
Unconscious/ Unresponsive: Implied consent
Samaritan Law Conscious/ Can respond: Ask permission to help
Will I get sued?
Good Samaritan will not incur legal liability even if negligent (Not
gross negligence)
“Good Samaritan Laws” – NCBI Bookshelf, National Library of Medicine, Stat Pearls Jan 2019
South African
Law
Medical Malpractice in South Africa (2017); John Saner SC, “The legal liability of the Good Samaritan doctor” Constitution Section 2
Supreme law of the Republic… and the obligations imposed
by it must be fulfilled
South African
Law governing Constitution Section 27 (3)
Emergency “No one may be refused emergency medical treatment”
Treatment
National Health Acts 61 of 2003
“Right of a person to receive emergency medical treatment”
“How and when to be a Good Samaritan” – Dr Tony Behran, MPS.org/South Africa 13 March 2019
Medical Malpractice in South Africa (2017); John Saner SC, “The legal liability of the Good Samaritan doctor”What is a “ Sudden catastrophe that calls for
“emergency immediate medical attention”
medical
Soobramoney vs KZN Health Department
treatment”
“How and when to be a Good Samaritan” – Dr Tony Behran, MPS.org/South Africa 13 March 2019
Soobramoney v Minister of Health (Kwazulu-Natal) (CCT32/97) [1997] ZACC 17; 1998 (1) SA 765
(CC); 1997 (12) BCLR 1696 (27 November 1997)What about the
I should be a safety of my
“Good family?
Samaritan”
Won’t I be
providing
suboptimal care?
I should uphold
the Hippocratic
Oath
Is there a Good Am I legally
Samaritan Law to obliged to stop?
protect me if I help?IN PRACTICE
MEDICINE AND THE LAW
When are doctors legally obliged to stop and render
assistance to injured persons at road accidents?
D J McQuoid-Mason, BComm, LLB, LLM, PhD
Centre for Socio-Legal Studies, University of KwaZulu-Natal, Durban, South Africa
Corresponding author: D J McQuoid-Mason (mcquoidm@ukzn.ac.za)
SAMJ June 2016, Vol. 106, No.6
Unlike the USA, South Africa (SA) does not have ‘Good Samaritan’ laws that oblige doctors to stop at road accidents. In SA, the conduct of
doctors in such situations is governed by the common law. Doctors coming across injured people at a road accident should stop and render
assistance, unless they are likely to be exposed to personal danger or injury, they are mentally or physically incapable of assisting, or other
medical or paramedical practitioners are at the scene. Where there is the threat of personal danger to the doctor, they must immediately Traditional
ü Law imposes a legal duty to act
ü Special relationship with another person
1.
When is there a legal
duty to act Boni Mores (Good Morals)
ü Legal convictions of the community
ü If community regards omission as wrongful – then the law
would impose legal liability on the person concerned
McQuoid-Mason DJ. When are doctors legally obliged to stop and render assistance to injured
persons at road accidents?. SAMJ: South African Medical Journal. 2016 Jun;106(6):575-7.Legal Consideration
1. Constitution and NHA
2. “No person can be refused medical treatment”
When are doctors =
legally required to “ A doctor should provide medical assistance at road accident scenes
render assistance to even when a doctor has not been requested to provide it”
injured persons at
motor accidents? Injured people are who the Constitution is protecting
2. Boni Mores
Community would be outraged if doctor didn’t assist
McQuoid-Mason DJ. When are doctors legally obliged to stop and render assistance to injured
persons at road accidents?. SAMJ: South African Medical Journal. 2016 Jun;106(6):575-7.Ethical Consideration
2. “ where persons are in a situation where their life
When are doctors or health will be seriously endangered unless
legally required to they receive immediate medical treatment, a
practitioner who is available may not ethically refuse to
render assistance to
attend such a person unless there are compelling
injured persons at circumstances that prevent the doctor from
motor accidents? acting”
NOT BINDING IN COURT
McQuoid-Mason DJ. When are doctors legally obliged to stop and render assistance to injured
persons at road accidents?. SAMJ: South African Medical Journal. 2016 Jun;106(6):575-7.What about the
I should be a safety of my
“Good family?
Samaritan”
Won’t I be
providing
suboptimal care?
I should uphold
the Hippocratic
Oath
Is there a Good Am I legally
Samaritan Law to obliged to stop?
protect me if I help? HPCSA Rules of Professional conduct:
Practitioners perform professional acts for which they are “adequately
educated, trained and sufficiently experienced” under proper conditions
3.
and in appropriate surroundings
What standard of care
is expected of doctors
who render assistance
RULE of THUMB:
at road accidents
How would a reasonably competent practitioner faced with a similar
situation would have acted?
Guidelines for Good Practice in the Healthcare Professions (HPCSA Booklet 2 – Ethical and Professional Rules
of the Health Professions Council of South Africa)What about the
I should be a safety of my
“Good family?
Samaritan”
Won’t I be
providing
suboptimal care?
I should uphold
the Hippocratic
Oath
Is there a Good Am I legally
Samaritan Law to obliged to stop?
protect me if I help? Threat to doctors safety (real not apparent)
4.
When are doctors NOT
legally required to Doctors mentally or physically incapable of rendering assistance
render assistance at
road accidents
Other medical or paramedical practitioners present
McQuoid-Mason DJ. When are doctors legally obliged to stop and render assistance to injured
persons at road accidents?. SAMJ: South African Medical Journal. 2016 Jun;106(6):575-7.Airplane
Emergencies
Physician
Passenger 48,1%
Peterson, Drew C., et al. "Outcomes of medical emergencies on commercial airline flights." N Engl J
Med 368 (2013): 2075-2083.Types of
Emergencies
Rotta AT, Alves PM, Nerwich N, Shein SL. Characterization of in-flight medical events involving
children on commercial airline flights. Annals of emergency medicine. 2020 Jan 1;75(1):66-74.Obstetric Emergencies; 1% Cardiac Arrest; 0,20% Substancea Abuse/
Types of Psychiatric ; 3% Allergic reaction ; 2%
Withdrawal; 3%
Syncope/ Near
Emergencies Trauma; 5%
Syncope; 30%
Seizures; 5%
Respiratory
Distress; 10%
Stroke ; 5% Cardiovascular ; 7%
Gastrointestinal; 15%
Martin-Gill C, Doyle TJ, Yealy DM. In-flight medical emergencies: a review. Jama. 2018 Dec
25;320(24):2580-90.In flight
Medical
Emergency
Protocol Level 2 First Aid
AED Trained
“Womb to Tomb”
“All you need to know about SA’s 4 main airlines’ in-flight emergency protocols” Traveller24 22/12/2018In flight
Medical
Emergency
Protocol
Peterson, Drew C., et al. "Outcomes of medical emergencies on commercial airline flights." N Engl J
Med 368 (2013): 2075-2083.Emergency
Equipment on
Airplanes
Martin-Gill C, Doyle TJ, Yealy DM. In-flight medical emergencies: a review. Jama. 2018 Dec
25;320(24):2580-90.Emergency
Medication
Martin-Gill C, Doyle TJ, Yealy DM. In-flight medical emergencies: a review. Jama. 2018 Dec 25;320(24):2580-90.Travelling out
of South Africa
“ According to the Department of International Relations and
– Will I be Cooperation, it is stated that when South Africans are traveling
protected? abroad, the laws of the foreign country apply to everybody. Once a
person leaves South Africa, the rights enjoyed under the Constitution
and laws cannot be guaranteed or enforced in the countries you
intend to visit ”.
Email correspondence: MPS, MacRobert Attorneys 25 October 2019 Ref: TB/lg/00052015Canada United Kingdom
The Good There is no legal duty to help, but
Samaritan the General Medical it’s Good
Doctrine is a legal Medical Practice guidance dictates
that there is a ethical duty France
principle Doctors have a
legal obligation to
assist in an
emergency and
could face
disciplinary action
Travelling Out or criminal
charges if they
of South Africa refuse
Hong Kong
No legal principle
America to protect a
Aviation Medical Assistance medically
Act (1998) Protects the qualified
actions of any medical passenger who
trained passengers who provides medical
help treat a patient on- assistance on
“Is there a Lawyer on board?” – MPS Caribbean and Bermuda Casebook Vol20, Issue 1, Jan 2012
board in an emergency. board an aircraftDisaster Situations
Disaster Render assistance as primarily humanitarian MPS will extend its
indemnity to doctors acting as good Samaritans
Situation
As long as doctor acts in “Best Interest” of the patient
“Is there a Lawyer on board?” – MPS Caribbean and Bermuda Casebook Vol20, Issue 1, Jan 2012COVID-19 Pandemic
COVID-19 Pandemic
Gifts?
Can I accept a
gift for my “ Accepting a gift or compensation for the performance
“Good of a Good Samaritan Act will render the do-gooder
stripped of any legal protection and can
Samaritan” act
accordingly be held liable for any ordinary
negligence as a result”
Email correspondence: Medical Protection Society & MacRobert Attorneys 25 October 2019
Ref: TB/lg/00052015In Summary “How and when to be a Good Samaritan” – Dr Tony Behran, MPS.org/South Africa 13 March 2019
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