Duty Of Care / Proximal Obligation

[BushyFromOz]

just a note some state if you are a emt or medic and you see a mva or any thing like that you MUST STOP AND HELP ther is my 2 cents "CROC"

This is an interesting topic right here.........

I know in australia, whilst there is no written law stating that off duty medical practitioners must provide care when within a reasonable distance (though it is hard to varify exctly what is reasonable) there is case law where medical practitioners who were in close proximity to people in crises that either refused to intervene when asked, or did not intervene as they were "off duty" and the patient's outcome was seriosuly compromised.

For example a Dr being in a doctors surgery, and although it is after hours, if you are approached and asked for assistance in what appears to be an emergent situation, you are requireds to help that patient. Displaying a uniform or item that denotes you are a medical practitioner, and even though of duty, you may find yourself in close proximity to a patient in need, youy cannot refuse that need, lest open yourself to civil litigation

Im interested to know what other countries have in the way of duty of care

[Ridryder 911]

In the U.S. you do not have the "Duty to Act" or to respond off duty unless you want to. Some states do have a clause that if you display insignias (star of life, etc.) that one may be obligated to stop and render aid. I am not how successful that is.

I personally prefer not to stop. I will call EMS, FD, etc. but usually I do not make contact, and if I did then I am stuck there until released. I have found out from previous experiences that I usually do not make a difference, and EMS will be responding shortly. ( I do not carry a kit off duty as well)

R/r 911

[paramedicmike]

Vermont, here in the States, has such a law. Here's the link:

http://www.leg.state.vt.us/statutes/fullse...p;Section=00519

Basically, if you see it and no one else has stopped you need to stop. This applies to anyone. Not just a healthcare provider. It's not a national law by any means.

Hope this helps.

-be safe.

[NREMT-Basic]

Here in Illinois, and EMT of any level only has a duty to act when he/she is off duty if they have initiated contact. If you so something as simple as walk up and say "are you alright?" you have now legally initiated medical contact and are required to render aide. I dont carry a kit and tend not to stop since about all I could do would be c-spine and get stuck there for a long time or cpr which could also keep me linked to that patient. On the other hand, I do question whether I should stop when I pass an accident. I suppose it sounds contradictory to what I said in the first place but if the accident was incredibly I would probably stop. I have had neighbors come to my front door and ask for assistance but I tend to advise them to go to the ER or an immediate care walk in facility. I just tend to follow the rule that once you make contact you are treating and use that to decide if this is something that I should get involved with or not. Usually the extent of my involvement in to call 911.

[BushyFromOz]

the case law i know of specifically indicated that if you are in close proximity and aware of it you are obligated as a health care professional to assist, though how they would find out you are a health care professiopnal should you not assist is beyond me

[Michael]

Vermont, here in the States, has such a law.

http://www.leg.state.vt.us/statutes/fullse...p;Section=00519

Thanks, mike. Good to know.

Having no legal training or expertise, I find the clause "...without interference with important duties owed to others..." so vague, and open to such broad interpretation, that it is difficult to imagine a judge second-guessing the private judgment of an off-duty civilian citizen concerning its scope.

Does anyone here know of particular cases in which such statutes were applied?

[NREMT-Basic]

The only sort of similar case I know of is from personal experience a few years back. I was in an autmobile several years back here in IL. There were three vehicles involved, one belonging to and being driven by a physician. The others involved were myself and an elderly couple (the elderly driver being cited for causing the accident). The physician hopped out of her mercedes and it was somehow made known that she was a doctor, I dont recall that detail. In any case she refused to render assistance until EMS could arrive. In the ensuing court action, the elderly driver stated that he asked the doctor to help his wife and the MD refused....this fact was later entered into a complaint and sanction against the physician with the IL Board of Health.

What I know for certain is that we were told in the medical/legal portion of EMT training was that off duty we are not required to stop. I believe (but cannot verify) that we were also told that if we are on duty but have not been dispatched to an accident that we happen to drive by, that we are not required to stop, especially in jurisdictional situations outside our coverage area. I am not confident in this assertion made by my preceptor and have not been able to find this in IL law and, being a paralegal, I have really done alot of looking since we were told this and have not come across any such presidence. I look forward to reading what others have to say.

[buckeyedoc]

My partner and I were on our way back from a long distance run and were in service. We are a medic truck. We passed a rollover in which passers-by pulled the lady out of the passenger seat because of a massive leak from the vehicle. We saw the wreck not long after it happened. There were no PD or FD on the scene and we didn't even hear sirens yet. We stopped and I recognized an RN/Medic from the local ER. She told me that the patient had a GCS of 10. She had bruising around the seat belt area of her chest and some bruising around the abdomen. I was in a district in which I know most of the firemedics as well as most of the command staff. My partner and I initiated care and did what we would do on any other run. We had her packaged up (c-spine and LBB w/ CID's), on the stretcher and in our medic. I started the IV's, had her on O's and on a monitor. The first medic showed up and I knew both of the crew and the asst. chief that showed up. I told them that I would transport if they wanted or turn over care. I'm fine with each. They went ahead and had us transport her and they transported her husband, the lesser of the 2 injured. We both went to the same hospital. The crew was appreciative for our help because their back up medic was out on a run and they would have had to call mutual aid. Now after all that, I am not one who stops on every wreck I see. My POV is a slick-top so that hardly anyone knows that I am a medic. I don't have the volley plate on my car and don't have 1000 fire/ems stickers on it either.