'Is there a doctor on the plane?' What to know about providing medical care while on vacation

I was on a ferry in Thailand going from Phuket to the Phi Phi Islands, taking a nap on the upper deck in the sun, when my friends woke me up saying, “Kristen, someone is having a medical emergency and needs help.” 

I wanted to respond, “I’m on vacation,” but the physician in me knew I should head down to the lower deck to assess the situation. 

Even off the clock, I'm still a physician

A young woman in her early 20s was seizing, and a layperson was contemplating CPR, even though she had a pulse and was breathing.

Each of them were wearing bandages as if they were a couple of days postoperative; within the first few questions, I found out they were recovering from reconstructive surgery—a breast augmentation and rhinoplasty. I immediately assumed she was taking medications, most likely benzodiazepines, and was potentially withdrawing. Her boyfriend told me they had been out partying the night before and consumed recreational drugs, but he could not remember what they were called. 

“Bingo,” I thought. I rolled the young woman over on her side, secured her airway and head until she stopped seizing, then went up to the boat captain to make sure they had an ambulance waiting at the marina.

This wasn’t the first time I’d been on vacation in a foreign country and witnessed a medical emergency. I couldn’t help but wonder about the legalities of rendering medical care in other countries (as well as in the United States) when I am outside the hospital and officially off the clock. I’m familiar with the good Samaritan law but not the underlying nitty gritty details. I also questioned whether I was obligated to provide medical care in these situations. 

The Good Samaritan Act

In legal terms, a good Samaritan is anyone who renders aid to an injured or ill person in an emergency.

Laws overseas and on intercontinental flights are more murky. Most good Samaritan laws provide immunity against “ordinary negligence,” including protection from damages for personal injuries, and even death.^[]

Keep these other points in mind when providing medical care as a good Samaritan:

• Aid should be provided for stabilization only. 

• Consent from the individual needing aid is imperative before aid can be rendered; implied consent exists when the patient lacks decision-making capacity. 

• You do not have a duty to render aid, meaning that it is your choice whether to render aid or not. Good Samaritan laws typically do not legally protect on-duty doctors. 

• The physician or other HCP providing aid cannot receive compensation for their care. 

• Any physician with a pre-existing relationship with the patient cannot be considered a good Samaritan.

Potential scenarios

Here are some more examples about when you are or are not protected under the Good Samaritan Act.

• If you are at an accident scene and render aid to the best of your ability, you will be protected by the Good Samaritan Act.

• If you are outside your clinic and your patient collapses in the parking lot, and you render aid, you are not protected because you are rendering aid to your patient. 

• If you are in your clinic and a staff member has a seizure, and you render aid, you are not protected because you are in a medical setting. 

• If you volunteer at a marathon in the medical aid tent and render aid to an athlete, you are not protected given the implicit duty in your agreement to serve this role. 

• If you are coaching your kid’s soccer game and render aid to one of the kids on the team, you will most likely be protected by the Good Samaritan Act because you are acting as a coach, not a medical professional by contract. 

• If you administer medical care while on a flight anywhere in the US, or overseas if the flight is registered in the US, then you are protected. (If you are on an intercontinental flight that is operated by a foreign airline, then the laws depend on the specific country.)

The importance of educating HCPs

Unfortunately, there is still a large number of medical personnel and physicians who are reluctant to help render medical aid to someone outside of a clinical setting because they are afraid of the legal ramifications.

That's why I believe lessons regarding the good Samaritan law should be built into medical school and residency curriculum.

Ideally, physicians should do the best they can with what resources they have available. Hopefully, it will give you some piece of mind that it's very rare for a physician to have lost a good Samaritan case against them.