Case Scenario While driving domic...

Case Scenario

While driving domicile from work one evening, I saw the car ahead of me cros the median strip and crash into an oncoming car. Luckily, traffic was light, and I was able to stop safely. Using my enclosed space phone, I immediately dialed 9-1-1 and approached the wreckage. The driver had been thrown into the back seat and was bleeding profusely from his inlet I couldn't tell if he was breathing, and I could not find a fruit of leguminous plants I wasn't sure what otherwise to do. CPR certainly didn't look possible, given the bleeding and the man's inaccessible position. It appeared I should be better prepared for similar an emergency, even though, in my office-based practice, I rarely onset one.

There have been other occasions, les cogent when I wasn't sure for what cause to intervene or if I should intervene. For example, while an medical students and I were waiting for a train single afternoon, we found a man lying onward the floor of the subway station. The scholars looked at me expectantly. I checked for a medical alert bracelet. The man appeared groggy still roused a little when I called to him. I thinking he might be drunk or beneath the influence of another physic Besides alerting the station manager, what should I have done? What legal responsibilities does a physician have in this situation? What skills should we maintain current for such emergencies?

Commentary

Family physicians who clash an unexpected medical emergency face a myriad of ethical, legal, and issues. Add to these issues a clinical scenario that would have a sage crisis physician shaking in his profits and suddenly the overwhelming feeling of being in "the vicious place at the wrong time" can dissipate the physician.

Without detailing the exact reply that a physician should take in like a situation, a number of medical organizations have implicitly addressed a physician's ethical obligations in a medical crisis The International Code of Medical Ethics of the World Medical Association (1983) asserted, "A physician shall give pass care as a humanitarian tax unless he is assured that others are willing and able to give of that kind care." The Code of Medical Ethics of the Canadian Medical Association (1990) declared, "An ethical physician shall, exclude in an emergency, have the right to refuse to accept a patient; will present all possible assistance to any patient, where an cogent need for medical care exists." And the Principles of Ethics of the American Medical Association (1992) proclaimed, "A physician shall, in the provision of appropriate patient care, object in emergencies, be free to pitch upon whom to serve." (1)

Despite the professional and humanitarian desire to assist in cases of emergencies, business about legal reprisal might end in a physician's inclination to timid away from rendering assistance in like cases. In 1959, the first "good samaritan" law was created specifically to house individuals from civil liability for any negligent acts or omissions committed while voluntarily providing pressing necessity care. Since the passage of the first profitable samaritan statute in California, all 50 states have enacted more [i]or[/i] less form of legislation designed to encourage doctors to be agreeable to to victims of an difficulty by granting immunity from civil damages and removing the fear of liability.

one states, Nevada, for example, have simple religious samaritan laws that apply to all citizens, not just physicians. Other states have statutes written specifically for doctors. Three states--Vermont, Louisiana, and Minnesota--actually have failure-to-act laws requiring all citizens, at the risk of penalty, to assist a victim in ne Because 50 different laws exist, family physicians are encouraged to become familiar with the laws in their states. a certain good samaritan laws are quite detailed and fill out beyond the street emergency to include acts within the hospital itself. In California, for example, "a staff physician of a hospital, who treats another physician's patient at the hospital in answer to a medical emergency, is guarded by the good samaritan laws." (1)

Does similar legislation actually provide immunity to the physician who provides righteous samaritan care? To date, there have been no documented cases of a suit brought against a physician for providing crisis care outside a hospital setting in as it is a scenario. (1-3)

What does this mean for the physician who is faced with an uncomfortable exigency situation? Would it be appropriate for a family physician whose entire career has been in an office-based practice to attempt a risky intubation or chest tube insertion in a multitrauma victim in the field? The Pennsylvania righteous samaritan statute reasonably answers this question. In this law, medical personnel who provide turn of events care in good faith are sheltered from liability, except when performing " any acts or omissions intentionally designed to harm, or any grossly negligent acts or omissions which accrue in harm to the one receiving emergency care." (4) This statute outlines a standard in which the physician is to act reasonably and not recklessly