Medico-legal - Providing care as a Good Samaritan

GPs should consider their legal and ethical position when providing care outside of the practice, writes medico-legal adviser Dr Caroline Fryar.

A recent MDU survey of 127 doctors revealed that more than 40 per cent have provided 'Good Samaritan' emergency care more than once in their careers. It is important to be aware of your ethical and legal position should the need arise.

The GMC expects doctors to help out in an emergency. The MDU survey showed that doctors can and do step in to help, whether it is while out shopping or on an aeroplane.

The sample of 127 respondents to the MDU survey provided interesting reading.

  • 24 (44 per cent) of the GPs and GP trainees and 30 (41 per cent) hospital doctors who responded had acted as Good Samaritans between two and three times.
  • Fainting was the most common condition attended to (71 cases) followed by head injuries (38 cases), broken bones (31 cases) and heart attacks (30 cases).
  • Public transport, including aeroplanes, was the most common place for an incident to happen and this featured in 91 cases. The next most frequently mentioned place was in the street (68 cases).

The help the respondents provided included diagnosing conditions such as a heart attack or hypoglycaemic fit; providing reassurance; fixing a splint for a suspected fracture and in some cases resuscitating patients who had stopped breathing or had a cardiac arrest.

Contractual duty
Paragraph 11 of the GMC's Good Medical Practice (2006) states: 'In an emergency you must offer assistance, taking account of your own safety, your competence, and the availability of other options for care.'

GPs also have a contractual duty to 'provide treatment owing to an accident or emergency at any place in their practice area' within 'core hours', according to the standard GMS contract.

Put simply this means you should offer the assistance you can in the circumstances.

The MDU's advisory helpline receives calls from doctors concerned about what help they could be expected to offer, especially if they have no equipment, feel out of touch with emergency medicine, or feel their abilities may be impaired if, for instance, the emergency occurs at a social event and they are tired or have had a few glasses of wine.

In these circumstances, and if no-one more qualified is available to help, you should bear in mind the GMC requirement that doctors should 'recognise and work within the limits of your competence' (paragraph 3, Good Medical Practice).

The chances of a claim are extremely rare and MDU members with insurance policies are reassured that they have worldwide cover for claims arising from Good Samaritan acts.

Where you do provide treatment, even if it is simply making someone comfortable until more appropriate help arrives, your actions will be classed as a clinical intervention.

It is important to make a clinical record of what you have done, including the name of the patient. You may need to provide a hand-over to emergency services and give your name and address to them.

Remember that your duty of confidentiality applies and prevents you from passing on information about patients to third parties without their consent.

  • Dr Fryar is a medico-legal adviser at the MDU

Learning points

1. The GMC expects doctors to help out in an emergency, wherever it arises.

2. Recognise and work within the limits of your competence.

3. Where you do provide treatment, it will be classed as a clinical intervention, however basic it may seem.

4. Make a clinical record of what you have done, including the name of the patient.

5. Remember that your duty of confidentiality still applies.

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