Liability of Good Samaritans in Medical Emergencies

Introduction

The World Health Assembly in 2019, adopted Resolution 72.16 on ‘emergency care systems for universal health coverage' and emphasises the importance of urgently attending to critical medical situations. Considering the increase in medical emergencies due to climate change, infectious diseases and substance abuse as emphasised by the World Health Organisation, this blog explores the liability of medical practitioners and good Samaritans in emergency situations as unsuitable regulatory framework will discourage the willingness to assist and serve as a challenge to timely and effective emergency care. Timely and effective emergency care promotes population health, contributes significantly to untimely deaths and disabilities and advances societal development. Good Samaritans are sometimes needed to either alert appropriate authorities or assist persons in need of emergency care personally while waiting for ambulances to arrive. The term ‘good Samaritan is coined for 'an individual who intervenes to assist another without a previous responsibility and without compensation.'[1] The question that arises is whether good Samaritans will be liable if they perform a negligent act leading to accidental harm or loss of life while trying to assist a sick or injured person.  

Liability of Good Samaritans in Emergencies  

Good Samaritan Laws ('GSLs') differ between countries. In the United States of America (USA) for example, GSLs exist in all states, including the District of Columbia.[2] A similar provision in U.S.A GSLs, is the immunity from liability granted to good Samaritans who assist ill or injured people at the scene of an emergency; however, the exemption does not extend to aid that was carried out in a reckless or grossly negligent manner. This immunity usually covers healthcare providers who in good faith, intervene in medical emergencies that occur outside hospital settings without receiving compensation. Immunity does not however extend to healthcare professionals performing their regular duties in clinical settings because a duty of care exists in such circumstance.[3] Furthermore, only a few States in the United States, including Vermont, Minnesota and Rhode Island impose a duty on bystanders to assist people in distress, with minor penalties for violators who do not assist others. The laws specify that bystanders are only compelled to offer assistance where the distressed individual is at risk of, or has experienced 'grave physical harm' and where it is certain that the good Samaritans will not incur harm on themselves or others in the process.[4] Bystanders in states like Texas and Nevada, are only mandated to assist child victims being subjected to sexual abuse.[5] Virtually all European countries with civil law jurisdiction, including Portugal, Italy, France, Germany, Poland, and Russia, impose a duty on bystanders to rescue those in danger or peril.[6] These laws are contrary to the position in common law European countries where there is no duty to rescue unless an existing relationship exists between the bystander and the distressed person.[7] More specifically, in the United Kingdom, individuals are not obligated to act as good Samaritans and this is due to concerns that such responsibility would be burdensome to persons who would have to keep an eye out for people who could be in danger.[8] An individual who chooses to rescue a distressed person must however act reasonably and ensure that he or she does not cause more harm than the distressed person would have experienced if he had not been rescued. Stuart-Smith L.J in the case of Capital and Counties Plc v Hampshire County Council [1997] Q.B. 1004 at 1035, stated that '[the defendant] is not under any legal obligation [to rescue] … If he volunteers assistance, his only duty as a matter of law is not to make the victim’s condition worse'.[9] Also, it is not mandatory for medical practitioners in the UK to assist persons in need of care outside clinical settings, although they have a moral obligation to do so as encouraged by the General Medical Council. The UK Parliament has advised medical practitioners to consider their area of specialisation and its relevance to the medical issue which requires emergency care. They are then expected to allow other medical practitioners with more relevant skills to handle the situation. Those who are no longer qualified to practice are also expected to expressly make this fact known. The Medical Defence Union (MDU) also makes medical indemnity available to medical practitioners acting as good Samaritans and advises that they obtain informed consent and keep detailed notes of the assistance rendered. 

Some scholars and members of the public believe that being forced to rescue distressed persons is a moral and private decision that should not be compelled by law, adding that such a law would be contrary to the rights of individual autonomy and personal liberty. Others also oppose the duty to assist law because it would be challenging to enforce. Proponents of the duty to rescue laws however argue that bystanders who fail to assist would be easily identified in an investigation, especially through the use of technological devices like cell phones and the Closed-Circuit Television (CCTV). These supporters stress that duty to rescue laws would help educate and remind people of their moral obligation to those who require help. To encourage good Samaritans to help people in distress in the UK, the Social Action, Responsibility and Heroism Act, 2015 (SARHA) was enacted. The law seeks to protect good Samaritans from legal claims when a recipient of emergency care is harmed in the process. SARHA has however been criticised by scholars as being vague and lacking details, for example the term ‘hero’ which from the meaning does not seem to apply to medical practitioners who already have the professional duty to save lives.  

Conclusion 

Appropriate protection from liability would encourage assistance from good Samaritans when emergencies arise. More efforts are thus required to ensure that effective laws are in place and the public is aware. The SAHRA should be amended to rectify its vagueness and properly define its scope. It must be expressly stated whether medical practitioners are included or not. It seems that the ethical duty to assist is sufficient to encourage both individuals and medical practitioners in the UK to assist without the legal obligation to compel assistance as that could place a burden on potential good Samaritans. To determine the liability of medical practitioners in these situations, it is recommended that more focus is placed on the reasonableness of their actions and not whether the condition of the patient became worse. This is because the worsened condition might be as a result of the difficult circumstances under which they attend to distressed persons outside clinical settings. However, penalties could be established for 'engaged spectators', that is, individuals who have the capacity to assist yet instead take pictures of distressed persons, steal from them, or intentionally cause further harm. Mandatory assistance for children in distress should serve as an exception due to their vulnerability.

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Footnotes:

1. William M. Garneau et al., Cross-Sectional Survey of Good Samaritan Behaviour by Physicians in North Carolina, 10 BMJ Open, 1, 1 (2016). 
2. See Patricia G. Montana, Watch or Report?? Livestream or Help? Good Samaritan Laws Revisited: The Need to Create a Duty to Report, 66 Clev. St. L. Rev., 533, 537 (8.2018). 
3. See Brian West & Matthew Varacallo, Good Samaritan Laws, StatPearls (Sept. 12, 2022), https://www.ncbi.nlm.nih.gov/books/NBK542176/ [https://perma.cc/J88Z-SGJK].  
4. See generally Damien Schiff, Samaritans: Good, Bad and Ugly: A Comparative Law Analysis, 11 Roger Williams Univ. L. Rev. 77, 78 (2005).    
5. 2008 Tex. Penal Code. § 38.17(a)(1) (West, Westlaw through 2021 Reg. and Called Sess. Of 87th Legis.), Nev. Stat. Ann. § 202.882(1)(2) (West, Westlaw through 33rd Spec. Sess. 2021); Montana, supra note 2. 
6. Man Yee Karen Lee, The Role of Law in Addressing the Good Samaritan’s Dilemma: A Chinese Model? 2 Asian J. L. Soc’y, 55, 70 (2015). 
7. Lee, supra note 6 at 72. 
8. Cliffe, Charlotte. A British Doctor’s Duty to Offer Help in Emergencies Outside of a Clinical Setting. Journal Of Patient Safety and Risk Management 23.4 (2018): 149-153. 
9. Kathleen M. Ridolfi, Law, Ethics, and the Good Samaritan: Should There Be a Duty to Rescue?, 40 Santa Clara L. Rev. 957, 960 (2000).