Deploying and using volunteer health practitioners in response to emergencies: proposed uniform state legislation provides liability protections and workers' compensation coverage

To respond effectively to natural disasters and other public health emergencies, government resources must be augmented with the resources of volunteer organizations. Governmental actors are prepared to utilize volunteer health practitioners (VHPs) to meet patient surge capacity and provide essential public health services. However, difficult legal challenges arise regarding licensure, the scope of practice of volunteers, the relationship of volunteers to local healthcare delivery systems, disciplinary enforcement, the extent of exposure to civil liability, and how to provide compensation for volunteers injured or killed during disaster response activities. The Uniform Emergency Volunteer Health Practitioner Act (UEVHPA) seeks to address these problems and provide a better legal environment that facilitates VHPs efforts. This article discusses two important provisions of the UEVHPA, Section 11 which provides immunity against claims for negligence, under certain circumstances, for volunteers and organizations engaged in the deployment and use of volunteers, and Section 12 which provides workers' compensation benefits to VHPs when other sources of coverage are not available. Disaster relief organizations and healthcare provider organizations have consistently identified uncertainty and a lack of uniformity with respect to these issues as a major source of concern to volunteer practitioners and as a potential deterrent to their effective recruitment and utilization. Uniform state enactment of the UEVHPA would resolve many inconsistencies and gaps in the regulation and protection of VHPs across states.

Volunteer health professionals and emergencies: assessing and transforming the legal environment

Volunteer health professionals (VHPs) are essential in emergencies to fill surge capacity and provide needed medical expertise. While some VHPs are well-organized and trained, others arrive spontaneously at the site of a disaster. Lacking organization, training, and identification, they may actually impede emergency efforts. Complications involving medical volunteers in New York City after September 11, 2001, led Congress to authorize federal authorities to assist states and territories in developing emergency systems for the advance registration of volunteer health professionals (ESARVHP). Through advance registration, volunteers can be vetted, trained, and mobilized more effectively during emergencies. The use of VHPs, however, raises multiple legal questions: What constitutes an emergency, how is it declared, and what are the consequences? When are volunteers liable for their actions? When may volunteers who are licensed or certified in one state legally practice their profession in another state? Are volunteers entitled to compensation for harms they incur? This article examines the legal framework underlying the registration and use of volunteers during emergencies and offers recommendations for legal reform, including: (1) establish minimum standards to facilitate interjurisdictional emergency response, improve coordination, and enhance reciprocity of licensing and credentialing; (2) develop liability provisions for VHPs that balance their need to respond without significant fear of civil liability with patients' rights to legal recourse for egregious harms; and (3) provide basic levels of protections for VHPs harmed, injured, or killed while responding to emergencies.

Barriers for PAs volunteering to serve indigent populations

Lack of liability coverage and authorization requirements for supervision can create legal barriers for PAs who want to volunteer. The good news: Some states are amending their laws so that PAs can volunteer legally.

Issue network versus producer network? ASH, the Tobacco Products Research Trust and UK smoking policy

Policy science studies of networks in smoking policy segment the smoking arena into a "producer network" of industrial and retail interests and an "issue network" of anti-smoking organisations. Case studies of ASH (Action on Smoking and Health) and the Tobacco Products Research Trust (TPRT) indicate that networks in smoking policy were more complex and overlapping. ASH pioneered a new style of media-conscious health activism in the 1970s with an anti-industry line. Nevertheless the strategy of harm reduction remained an objective for industry and government, and also for some public health interests through the work of the TPRT. First safer smoking and then nicotine were the focus of these activities.

Liability of professional and volunteer mental health practitioners in the wake of disasters: a framework for further considerations

Qualified immunity from civil liability exists for acts of disaster mental health (DMH) practitioners responding to disasters or acts of terrorism. This article reviews current legal regimens dictating civil liability for potentially wrongful acts of DMH professionals and volunteers responding to disasters. Criteria are proposed to inform determinations of civil liability for DMH workers in disaster response, given current legal parameters and established tort law in relevant areas. Specific considerations are examined that potentially implicate direct liability of DMH professionals and volunteers, and vicarious liability of DMH supervisors for actions of volunteer subordinates. The relevance of pre-event DMH planning and operationalization of the plan post-event is linked to considerations of liability. This article concludes with recommendations to minimize liability exposure for DMH workers in response efforts.

Ethical guidelines for the evaluation of living organ donors

Transplantation is an effective, life-prolonging treatment for organ failure. Demand has steadily increased over the past decade, creating a shortage in the supply of organs. In addition, the number of deceased organ donors has reached a plateau. Living-donor transplantation is increasingly an option, influenced by favourable clinical outcomes and increased waiting times at most transplant centres across North America. Living-donor kidney transplants have exceeded deceased-donor transplant rates at some centres. Organ donations from living donors have challenged transplant programs to develop a framework for determining donor acceptability. After a multidisciplinary consensus-building process of discussion and debate, the Multi-Organ Transplant Program of the University Health Network in Toronto has developed ethical guidelines for these procedures. These proposed guidelines address ethical concerns related to selection criteria and procedures, voluntariness, informed consent and disclosure of risks and benefits to both donor and recipient.