Monday, October 4, 2010

To be, or not to be - health and the Good Samaritan Law

cenario 1 - A bystander is in a park where a child is having a life threatening anaphylactic reaction. The ETA on the ambulance is 15 minutes. The bystander carries their own epi-pen which could:

1) potentially save the child's life
2) potentially set him/herself up to be sued

The bystander has a choice - to step in and help, become a Good Samaritan... or not.

What would you do?

Many states have a law designed to protect those who may come upon a person needing emergency help. It's usually known as the Good Samaritan Law and it is designed to remove the fear they (the good Samaritan) may end up in court if things don't go quite right. These laws are in place so when you are a victim needing emergency action, those around you will not be afraid to help you.

Scenario 2 - A bystander who has had training as a First Responder is in a park where a child is having a life threatening anaphylactic reaction. The ETA on the ambulance is 15 minutes. The bystander carries their own
epi-pen which could:

1) potentially save the child's life
2) potentially set him/herself up to be sued

What would you do?

Either scenario could end in a legal nightmare. How much of a nightmare depends upon the particular laws of your state.

Scenario 1 - In my state, not only could I be in trouble for using my own epi-pen on someone else (it is a prescription drug) but I would be doing it as a 'non-trained' medical person. No matter that I know how to use the epi-pen from my personal experience, I am not a doctor or nurse.

Scenario 2 - In my state, not only could I, as a First Responder be in trouble for using my own epi-pen on someone else, but because I am not a nurse or doctor I am restricted from giving any medications to a patient - even their own. I cannot even give sugar to a diabetic in an emergency, or a heart attack victim his own nitro tablet.

While going through First Responder training, we debated this very situation. Legally it is a nightmare situation, but most importantly to me, morally it is a nightmare. I was honest and told my instructor that I was not sure I could stand by and watch someone die when I had something to help them in the bag at my side. Her response was that there was no way she could tell us it was okay to help someone in this situation. I can however, find someone else to administer the diabetic's dextrose to him/her, or that cardiac patient their nitro (preferably a family member), or if the anaphylactic child has an epi-pen and I can find someone else who will actually stick the child, or the child can stick him/herself with their own pen... then we are okay. The trick is finding someone who is ready to take on the legal implications of being that Good Samaritan.

At the same time, my instructor emphasized, that to avoid legal problems, remember to always do what is in the patient's best interest at the time.

Hmmm... To me this is the very definition of a dichotomy.

To me this is an unthinkable situation, yet many of my fellow responders have stories to tell when they were faced with just such a situation. Only one ended in litigation, but when you are that one person it's everything to you. Defending yourself in a lawsuit, even a bogus suit, is expensive - - life changing expensive. You risk everything you and your family has.

So, what do you do. The child can't breathe. He is blue. In 15 minutes he will likely be dead. You have 60 seconds to make up your mind...

Do you give the injection and take the risk? Why or why not? What are your thoughts?

Comment by Ellen S on October 4, 2010 at 2:32pm
Here is a list of states and their Good Samaritan laws. This is a cpr site and those parts of each state's laws that pop up seem to relate specifically to cardiac care. More information can be found by searching for the term 'your state' and the words "good samaritan law"
Comment by Emily K. on October 7, 2010 at 11:21am
I would give the injection, no question. I don't think I could live with myself if I watched someone die just because I was scared of the consequences of my action. Yet, if I did help and the child's mother/father/guardian took me to court, I know I'd be very very bitter. I looked up the Good Samaritan laws in Massachusetts and found that "EMS personnel, physicians and nurses, and the general public trained in CPR" are freed from personal liability (
I'd never thought of what I would do in this situation; I didn't know people could sue me for helping! Thanks so much for this post Ellen!
Comment by amanda on October 7, 2010 at 12:11pm
This is such a thought-provoking and difficult situation, Ellen! Thanks for bringing it to our attention.

I'm personally chewing over the idea that, yes, people should help each other in any way they can! But that not everyone knows how to. If you move someone who may have a spinal cord injury - that's a huge no. From there - I can only imagine all the awful things that could happen from someone who is so willing to help but has no real knowledge of how to do so safely. Scary to think of what people may do in a pressure situation. Now that nearly everyone has need ER or medical tv or (like me) read wikipedia - they may feel more confident and qualified to help than they actually are.

I worry about that.

But that being said - there are also so many people who do have training! Who can help. I remember a time when I was very young and we lived on a very busy main street. One day a man got in a very severe motorcycle accident a few houses down and my mother rushed over to help. She is a trained RN. I can't remember exactly how she helped but I know that it was very 'cool' and important for her to try to do anything she could - even if that was just telling someone "no don't move them" or something like that.

Additionally having a the cell phone technology we have now is also a huge helper - you can be a good samaritan just by calling for help. And, as always, you can use your body and resources available to re-direct traffic or flag down cars or just shield the injured or sick person from the public.

Can't wait to hear what others have to say about this!
Comment by Ellen S on October 7, 2010 at 2:45pm
Actually Emily, following the links to the end takes you to this provision: Section 12V. Any person, whose usual and regular duties do not include the provision of emergency medical care, and who, in good faith, attempts to render emergency care including, but not limited to, cardiopulmonary resuscitation or defibrillation, and does so without compensation, shall not be liable for acts or omissions, other than gross negligence or willful or wanton misconduct, resulting from the attempt to render such emergency care.

Unfortunately, most states determine "gross negligence" and "willful or wanton misconduct" in a situation by situation basis. There is no "list" of negligent acts or actions that constitute willful or wanton misconduct. Basically, it's going to depend on the situation and the judge. Judge A may look at you utilizing a prescription drug to save a child's life as an act of heroism, while Judge B may look at it as gross negligence because you knew it was your medicine, not the child's, and you knowingly broke the law.

In either case, defending yourself in a court of law is prohibitively expensive. Many folks are forced to settle because they can no longer afford their own defense, regardless that they are innocent of anything other than trying to help.
Comment by Ellen S on October 7, 2010 at 3:01pm

I suppose different areas of the country are different, but here there are multitudes of folks who want to get involved and help - and do - but don't have any training. Something as *simple* as searching for a missing person can be completely bungled by someone who doesn't know how to do it properly.

It's my experience that most people react in a confused manner in the presence of a life threatening emergency. This sometimes includes trained personnel. I've been present when a nurse got so excited that she pushed aside others who actually knew what they were doing, and ended up creating havoc, saying some things that had the injured child literally hysterical and thinking she was going to die.

When calling an emergency dispatcher, you will be given instructions what to do or not do. However, an emergency dispatcher cannot give you 'permission' to use an epi pen, especially one that doesn't belong to the patient.

We all hope that common sense will rule, and that parents of a saved child will want to do nothing more than thank the Good Samaritan. Common sense does not always rule, and there can be extenuating circumstances. What if it is already too late, or something else was happening and that child dies? Grieving parents need someone to blame, and most will find someone, even if that blame isn't deserved.

These are great things to think about, and I think it's really important that we all know what our local Good Samaritan laws state, so if we witness an emergency we won't be too afraid for our own safety to help someone who needs us.

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