Good Samaritan Laws

This article originally appeared online at DrPullen.com, part of the HCPLive Network.

Today at church the gospel lesson was the story of the Good Samaritan. This is a story so well known that the term Good Samaritan has become a universally used term to denote a person offers help to someone in need whom they don’t know without expectation of compensation. This prompts me to outline the Good Samaritan laws that have been passed in many states to protect bystander helpers, and to relate personal experiences to show how these laws play into a physician’s thinking in the real world.

My wife and I, along with our 5 month old daughter, took a wonderful vacation and trip across the country, from West Point, NY en route to our new adventure in Puyallup, WA after my discharge from the Army in 1987. We had been travelling over a month, and were leaving Yellowstone National Park, and were making a beeline for our new home. Zipping along the highway in Montana, about 100 miles southeast of Missoula and 50 miles northwest of Butte, we drove up on a terrible accident with two cars rolled over on the 100 yard wide median strip, bodies lying around, and two ambulances on the scene. I told Kay this was one we had to stop for, and we pulled the van over. I hurried over to the site to see if I could help, and the paramedics were happy to see me. A quick triage showed one patient with a significant closed head injury, another with an open femur fracture, another with significant abdominal trauma, likely a ruptured liver or spleen, one with a badly fractured arm, and several others less severely injured. Each ambulance could hold two patients, and after helping the paramedics get the four badly injured patients stabilized with IVs and backboards, they asked me where I thought they should be taken. They were required to transport the patients to the nearest rural hospital unless they were directed otherwise, and there really was no one else to tell them. I asked if the local hospital had an OR and the ability to transfuse blood, they said yes so we headed there, given that the ride to the city hospitals was going to take nearly an hour. I rode in one ambulance while Kay chased us in the van. On arrival I quickly learned I had not been specific enough in my questions about the local hospital. There was an OR, just no anesthesia or surgeon. I think there were cobwebs in the OR. The only physician in town was the community GP, who on this Saturday morning was well into his bottle, and clearly not lucid. I spent about half the day there along with another FP from Spokane, WA who stopped shortly after I did, until we finally got all the badly injured patients off to city hospitals. They would only send one ambulance at a time, again by policy, to keep the second in reserve in case of an accident. Meanwhile the injured patients already there waited for care. In this situation I felt obliged to stay for the patient’s wellbeing, but was probably legally required to stay until no longer needed because most Good Samaritan laws though not requiring a physician to stop to help, do require us to not desert a patient in need once we have stopped.

Another less dramatic but legally more relevant event happened a few years prior. Shortly after I started dating my wife we were leaving her apartment, a walk-up studio on the upper east side of Manhattan. As we were hurrying out the stairwell to catch a cab to a Broadway play, we came across another resident who has slipped on the steep stairs and broken their ankle. She was sitting on the steps, and I asked if she was OK. Before she could tell me that they had already called for an ambulance Kay reassured her that I was a family doctor and could help her. It was quickly apparent to me that there was nothing I could do there that was going to have anything to do with being a physician, there was no gross deformity of the ankle, it appeared neurovascularly stable, and she just needed to go to the hospital for an x-ray and treatment. Still this put me in an awkward position. I knew I was not needed at the scene, but was anxious not to be perceived as abandoning the scene after beginning to provide care.

In this case the risk of leaving seemed minimal, as her outcome was nearly assured to be good. In addition I really did know I was not going to be of service. Still it made me anxious to leave prior to the ambulance showing up. Fortunately in NYC it came very quickly and we still made our show. Kay learned to let me take the lead on offering help.

At least 48 states have Good Samaritan laws covering all people who stop to offer help, and even the two that don’t have laws covering physicians in these situations. Good Samaritans cannot be sued except for gross negligence or criminal behavior in most states. Every state has somewhat different statutes, and it is a good idea to know what your state laws cover.

Ed Pullen, MD, is a board-certified family physician practicing in Puyallup, WA. He blogs at DrPullen.com — A Medical Bog for the Informed Patient.