Legal history of emergency medicine from medieval common law to the AIDS epidemic

What does the law say to Good Samaritans?: A review of Good Samaritan statutes in 50 states and on US airlines

Physicians may encounter medical emergencies outside a hospital or clinical setting, such as on an airplane or at a sporting event. Physicians, particularly critical care physicians, should feel a call of duty to assist in a medical emergency and may do so without complete knowledge of existing laws for protection. The intent of this article is to encourage physicians to have a detailed awareness of Good Samaritan laws in the United States. The authors reviewed and summarized the Aviation Medical Assistance Act (AMAA) as well as the Good Samaritan laws and external defibrillator laws in 50 states and the District of Columbia. Physicians have an ethical duty to provide appropriate emergency care outside hospital or clinical settings and, therefore, should be aware of applicable protective laws. On airplanes, the AMAA provides protection to those physicians acting in Good Samaritan roles on airlines registered in the United States. On the ground, physicians should understand that statutes exist in all jurisdictions to protect Good Samaritans from liability in medical emergencies and in the use of defibrillators. Although there are common elements, each state has its own unique statutory language protecting physicians licensed in that state. All states except Kentucky have statutory language providing immunity to physicians licensed in any other state as well. Some states have interesting statutes relative to other aspects of medical emergency care. A physician entrusted to practice medicine by society and law should be willing to provide appropriate medical care wherever needed.

The role of internists during epidemics, outbreaks, and bioterrorist attacks

Internists are well-positioned to play significant roles in recognizing and responding to epidemics, outbreaks, and bioterrorist attacks. They see large numbers of patients with various health problems and may be the patients' only interaction with the medical community for symptoms resulting from infectious diseases and injuries from radiation, chemicals, and/or burns. Therefore, Internists must understand early warning signs of different bioterrorist and infectious agents, proper reporting channels and measures, various ways that they can assist the public health response, and roles of different local, state, and federal agencies. In addition, it is important to understand effects of a public health disaster on clinic operations and relevant legal consequences.

Cardiopulmonary resuscitation: current guidelines

It is critical for health care providers to have the skills and composure required to administer cardiopulmonary resuscitation (CPR) when necessary. Unfortunately, it is easy to postpone updating one's CPR certification when confronted with the demands of leading a practice. New guidelines for CPR have been in effect since 2000. This clinical update provides a brief overview of the new guidelines, some suggestions for incorporating CPR training into the clinician's practice, and clarification for some common legal misconceptions that doctors may have pertaining to administering CPR.

Problems and risks of unsolicited e-mails in patient-physician encounters in travel medicine settings

BACKGROUND

International travel and use of modern information technology are expressions of modern life style. Seeking on-line travel health advice via E-mail for preventive (teleprevention) or diagnostic reasons may become increasingly popular among patients with financial resources and Internet access. This study was undertaken to compare the behavior of travel clinic or tropical medicine physicians and other providers of travel-related medical information services toward unsolicited E-mails from fictitious patients in pretravel and post-travel scenarios. We also wanted to test the potential of E-mail advice for preventive medicine (teleprevention), and to find out how the "Good Samaritan Law" is observed.

METHODS

Two different E-mails were posted to E-mail addresses of 171 physicians (members of travel health and/or tropical medicine societies) and services offering advice on travel health issues identified by an AltaVista search. These E-mails, from two different fictitious travelers, were asking for advice regarding malaria prophylaxis in a pretravel scenario and describing symptoms suggesting acute malaria.

RESULTS

Of the contacted addresses 43.3% and 49.7% respectively, replied to the pre- and post-travel E-mail. Of those suggesting antimalarial chemoprophylaxis in the pretravel scenario, 13.2% proposed inadequate regimens, and at least 3.5% of the post-travel replies were inappropriate. The "Good Samaritan Law" was observed by a significant number of physicians.

CONCLUSION

Both patients and physicians have to be aware of the limitations of E-mail communication. Guidelines protecting physicians against legal and ethical consequences of this new communication technology are urgently needed.

Good Samaritan acts

Good Samaritan Acts are those in which aid is rendered to a needy victim of injury or sudden illness. No antecedent relationship exists with the good samaritan, and no remuneration is anticipated. Emergency physicians have an ethical obligation beyond that of other citizens to provide aid in such situations of medical need; professional and legal standards support that obligation.