While doctors are no strangers to treating patients who require urgent medical attention during their work hours, they might also encounter a person in need of medical attention outside of their place of practice or when they are off-duty. The British Medical Journal surveyed 350 medics online and found that 21% would be uncertain if they should help someone in need of medical assistance when they are off-duty.
No legal duty to help in emergencies when off-dutyIn the UK and US, doctors are not legally obliged to provide assistance in a medical emergency if they are outside their place of practice or off-duty. Doctors must first owe a duty of care to their patients before they can be held liable for giving the medical treatment while they were off duty. If the doctor-patient relationship is not established, then doctors have no legal duty to provide medical assistance to strangers in an emergency.
The Handbook on Medical Ethics published by Singapore Medical Council have the same guidelines for doctors in Singapore, but encourages doctors to render help after ensuring that their own safety would not be compromised. Similarly, the General Medical Council in UK noted that doctors should offer help in emergencies after assessing ‘their own safety, competence and availability for other opportunities of care’. Caroline Fryar, head of advisory services at the medical defence organization MDU, noted that healthcare professionals are bound by ‘ethics’ rather than legal duties to act in times of emergencies when off-duty, and contrary to the survey findings most doctors do want to help in emergencies. So why are some doctors unwilling to help?
Fear of being sued for rendering medical assistanceRespondents of the survey reported that they are afraid of getting sued if they render medical assistance while off-duty. If a doctor comes across an injured person, the doctor cannot be sued for medical malpractice if he decided not to help, as no special relationship had been formed between the doctor and the injured person. However, the off-duty doctor would owe the injured person a duty of care once he commenced consultation with that person voluntarily, even if there is no conventional contract between them.
As such, if the doctor abandons treatment of the injured patient after the emergency, they may now be held liable and the patient can possibly have a legal claim against the doctor if their injuries are caused by the doctor’s medical treatment. However, it is legally hard to evaluate off-duty medical treatment as it is not performed in hospital settings, and expert testimony may be required to establish the liability of an off-duty doctor who volunteers his assistance. A possible case is where doctors may become liable is if they volunteer to perform treatment they have not been properly trained for.
Hospitals generally not liable for actions of off-duty doctorsAs the actions of an off-duty doctor are usually independent and voluntary in such cases, hospitals are rarely held liable unless the hospital has directed or controlled their off-duty actions. A doctor might also be liable for the actions of an assistant whom participated in off-duty treatment as per their instructions. Some private medical practice associations may also have their own rules regarding the actions of off-duty members and thus implications on the organization’s liability as a whole; so doctors should be familiar with related regulations of their organizations before rendering their services.
Good Samaritan Act to alleviate liability concerns?Morally and ethically, medical professionals should help in medical emergencies but also take precautions to protect themselves. MDU noted that it is rare for doctors to get sued for assisting members of the public in an emergency, but they are covered under the Good Samaritan act in the event of a litigation claim. Dr Pete Loke also opined that a Good Samaritan Act to protect medical professionals from liability for trying to help would encourage professionals to be less uncertain and step up during emergencies. MIMS
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