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Medical related Duty to Act

Discussion in 'Legal' started by savetheclaypigeons, Jan 13, 2009.

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  1. savetheclaypigeons

    savetheclaypigeons Member

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    This is a bit of an odd legal scenario, and I am sure it changes from state to state but thought I would ask.

    I am playing a scenario of self defense over and over in my head and can not come up with an outcome and was curious how everyone thought it would play out legally.

    Self defense shooting of a BG by a medical professional. For the scenario, it fits self defense categories and the shooting in it self is justified. Scene is safe. Threat is neutralized with rapidly deteriorating health. Legally, a medically professional is required to render assistance (pending on state). Aforementioned person does not render aid to his attacker for unmentioned reason (mentally unable, unwilling, didn't consider etc). How would this play out in the legal system? Are medical professionals held to a different, more scrutinized standard?

    I see a few possible outcomes

    1) Defender not charged, deemed self defense.

    2) Not charged with shooting, but is tried for neglect/abandonment for not rendering aid

    3) Charged for manslaughter/homicide for withholding and not rendering life saving aid

    4) Counter charges with temporary mental insanity due to circumstances, unfit to render aid, etc

    Just curious what your opinions of the situation might be, or if anyone knew of any cases which have played out. Certainly the condition of the BG after neutralizing would play a key role. Perhaps the common statement of making sure a BG is dead would play important in this situation.

    Just wondering everyone's thoughts
     
  2. Treo

    Treo member

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    In Colorado I have no legal mandate to act. I also don't carry a trauma kit or a crash cart in my car(or my back pocket)

    In EMT school I was taught that my first responsibility was to secure the scene and not to enter an unsafe scene. As a responding EMT I wouldn't approach that person W/out a cop on the scene I sure wouldn't do it if I was involved.

    Picture this:

    With the best intentions you attempt to render aid. As you approach the patient he grabs for his gun or makes some other move that you interpret as aggressive. You shoot, and all the witnesses tell the cops that you put him down , walked up to him and deliberately finished him off.

    How do you think that'll play in court?
     
  3. TexasRifleman

    TexasRifleman Moderator Emeritus

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    As the OP says, it's state by state but everything I've seen in Texas agrees with this. Don't even carry the med gear with you in the first place.
     
  4. savetheclaypigeons

    savetheclaypigeons Member

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    interesting points, that's why I mentioned "Scene is safe. Threat is neutralized with rapidly deteriorating health". I was taught also the first thing is to make sure the scene is safe. Obviously you were forced into an unsafe scene, that's why you had to shoot ;). Seems like a sticky situation to me.

    Some basic first aid can be rendered such as your standard ABC's without a crash cart, your med equipment may be irrelevant. I'm thinking more about your medical knowledge.
     
  5. Treo

    Treo member

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    My medical knowledge tells me the scene isn't secure until PD is on site. What do you think the odds are that they're going to let me work on the patient?

    Do I have UPs or should I just ignore them and get the blood & body fluid of an unknown assailant all over me and anyone I direct to assist me? ( I actually do carry a CPR barrier device everywhere I go).

    Sorry but unless you alter the varibles until the scenario looks like some thing from Baywatch, (think David Hasselhoff using a AED on a speed boat covered W/salt water) there's no way in Hell I'm approaching that patient
     
  6. akodo

    akodo Member

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    Okay, as a few others have stated, no care until the scene is safe, and there is going to be NO good way of determining if and when he totally stops being a threat.

    Seriously, the guy could be 'playing dead' and stab you when you try to apply pressure to his wounds.


    There is only one way I can see your scenaio coming into play, where you know FOR SURE the scene is safe.

    Day 1, you get in an altercation, and have to shoot the subject. He flees, you don't know if you hit him or not. Call police, yadda yadda. Next day, take a day off work to recover, etc. Next day, back on the job riding in an ambulance, when you get a call the police found some guy in a back ally, unconsious, shot through the upper shoulder, tried to patch it up himself, but didn't do a very good job.

    You arrive on scene and prepare to give aid.

    OMG! this is the guy who tried to stab you 2 days ago! looks like you winged him!

    Do you give aid then? Yes.

    But that is a pretty far fetched scenario. Then again, your opening caveats NEED a far fetched scenario to fit.

    Attacker down, no way to be SURE he won't continue...not without getting close enough to put yourself in harm's way again. Call 911 ask for police AND ambulance
     
  7. savetheclaypigeons

    savetheclaypigeons Member

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    I was envisioning a scenario where the scene was indeed safe and you could clearly identify the threat as neutralized. For example, it is daylight in an open field. BG's shirt off and you see the penetration, and hear gurgling from the airway.

    A great point was raised with body substance isolation. That would be a great reason as to not initiate care, and a way to legally defend your actions. :)
     
  8. HIcarry

    HIcarry Member

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    Name one State

    I think you are incorrect if you think that a medical professional has some duty to respond outside his/her job. I have worked in several different states and found none of them to have a statue requiring a medical professional, or anyone, for that matter, to respond to a medical emergency.

    I carry an pretty advanced FA kit (IV, cric set, intubation equipment) and have used it frequently when I have happened across accidents and such. But, given the situation you describe, I would not, under any circumstances, attempt to offer medical aid to someone I just shot in a self-defense situation. Besides the very real possibility that the bad guy could make a grab for your gun or initiate another attack, there is a good chance you won't be in the best frame of mind to provide the best care. Any mistakes or omissions could become another legal nightmare to have to deal with on top of the shooting.
     
  9. XavierBreath

    XavierBreath Member

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    You are wrong on this point. There is absolutely no legal requirement for a health care professional to render aid off the job.

    There is, perhaps an ethical, moral, and professional expectation, but no legal requirement.

    None.
     
  10. Treo

    Treo member

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    Apparantly Oregon has such a law.

    That said the OP is essential postulating a 1 in a million alignmen of all the stars and planets, such that on the one day you're required to shoot you happen to hit the one guy that goes down in such a way as to make it clear that you can safely render aid.

    on that day you better buy that guy a lottery ticket
     
  11. XavierBreath

    XavierBreath Member

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    Can you cite the law requiring a health care professional to render aid Treo? I'd like to see it.

    I've been wrong before.

    edited to add:
    What Oregon has is a Good Samaritan Law, which protects the health care professional from litigation if they volunteer to render assistance.

    It is not a requirement to act.

    While 30.803 would seem to imply that the ommission of aid by a EMT could result in litigation, the statute applies only to a EMT who acts as a volunteer without expectation of compensation. In other words, the EMT who is the shooter must volunteer his or her services to the dying assailant. There is still no legal requirement to volunteer services.

    In fact, if the EMT has a lapse of judgement and does render aid when he or she is the shooter, they leave themselves wide open to prosecution under this statute.
     
    Last edited: Jan 13, 2009
  12. divemedic

    divemedic Member

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    Same here. I am an instructor for con-ed of nurses, Doctors, as well as in instructor of EMT's and Paramedics in the state of Florida. AFAIK, there is no law that requires a medical provider to render aid while off duty. To do so is to place the medical provider in the position of unpaid servitude.

    The duty to act only applies to medical personnel under certain conditions while on duty, and not all the time even then.

    ETA: After all, if there is a duty for providers to act, who pays for their supplies, drugs, gloves, and other equipment? Are the providers required to provide them free of charge? For EMT's and medics that are out of their primary jurisdiction, which set of protocols are they expected to use? If you require them to use the protocols of their employer, you are now expecting their employer to bear the legal burdens of the actions of their employees, even when those employees are off the clock and away from home. If you require them to use the protocols of the jurisdiction where the incident occurs, then you place a burden upon the provider to know every set of protocols in the state.

    I just don't see any state doing that.
     
    Last edited: Jan 13, 2009
  13. XavierBreath

    XavierBreath Member

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    In fact, looking at Oregon statute 30.803, it appears if an EMT shot someone in self defense (an intentional act that causes injury or death) and then volunteered their services to save the assailant's life, they may be held liable for the intentional act of the shooting itself. The charitable act of volunteering services to save their assailant's life may make them liable for the shooting!

    I'm not an attorney, but if I were a EMT and lived in Oregon, I would want to talk to my attorney about the specifics of this particular statute.

    Until then, I would have to assume that the liability began at the time services were volunteered. Since the shooting would have occured prior, I would hope the EMT couldn't be held liable for the actual shooting under this statute.
     
  14. -v-

    -v- Member

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    I am an EMT-IV in Tennessee, and we have no duty to render medical aid while off-duty. That said, if I was in such a situation I would keep the gun trained on him and call 911. The only way to be sure that the scene is safe is when the boys in blue disarm and cuff the offender. Then, if I feel like it, I can render aid, but once again I am under no legal (nor in that particular case do I feel any moral) obligation to do so.

    -edit-: Also, Oregon's statute is food-for-thought, since helping the assailant out could potentially open my person up to litigation by the BG. Not something I would want to run the risk of having to deal with.
     
  15. MostlyHarmless

    MostlyHarmless Member

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    Minnesota is one of the few states that has a law mandating a duty to render aid. It applies to all people, not just EMTs or docs. However, a call to 911 satisfies the letter of the statute.
     
  16. XavierBreath

    XavierBreath Member

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    Minnesota law:
     
  17. WardenWolf

    WardenWolf member

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    While medical professionals are required or expected to render aid in some areas, they are NOT required to do so if the situation endangers their own safety. That is the domain of emergency responders to deal with. Non-emergency personnel are not expected to place themselves in harm's way. In such situations, a simple, "I feared for my life" will generally suffice.

    You can also argue that you were in no condition to make sound medical decisions and provide adequate care, having been severely shaken from the situation. Your primary medical duty would be to call police and ambulance and give the dispatcher a heads-up on what they can expect.
     
  18. 45ACPUSER

    45ACPUSER Member

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    It totally fascinates me how some people carry medical equipment that they may not be covered legally to use outside of their job. I am pretty sure the medical director would deny any responsibility for cares provided. Of course you can elect to be your own first responder, but providing invasive interventions is probaly beyond the scope of practice. Then it amazes how FR and EMT Basics make reference to using a crash cart? Man you would think your were an attending MD/DO in a Level 1 Trauma Center or the like!

    Suffice to think that some people need to quit over thinking! The scene is not safe! It is not safe till the responding LE agency has established it. Till then most Good Sam laws tend to say that intervention is making contact with LE and EMS constititutes aid being rendered....
     
  19. 45ACPUSER

    45ACPUSER Member

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    MN State Statutes
     
  20. Treo

    Treo member

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    Or they could be a second year MA student who is expected to know their way around a crash cart

    Or maybe they had ACLS training in the Army Doh!

    And while we're here who do you think it is that gets you to the level one in one piece?
     
    Last edited: Jan 14, 2009
  21. WardenWolf

    WardenWolf member

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    In my opinion, "safe" is, "I hit him in the head. He's down. For good." If he's in any other condition, he's not "safe" to approach.
     
  22. MedWheeler

    MedWheeler Member

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    I've never seen a "duty to act" clause that also required the health-care provider (HCP) to endanger himself/herself, or possibly do so, to render aid. One of the departments I worked for was a "public safety" department; that is, the functions of law enforcement, fire fighting, and EMS, all fell under one agency, and we were cross-trained to at least some degree. Our paramedic unit consisted of two armed police medics that did traffic enforcement during the first eight of their 24 hours when not on calls (they patrolled in an ALS-equipped SUV.)
    They responded one night to a LEO shooting that took place just outside the city limits, in a town in which we had also been sworn in as LEO as per our mutual-aid agreement. Of course, scene safety had already been insured by that town's force, including the shooting officer. No "conflict of interest" was ever construed.
    I work in EMS now, and have for the last 17 years. I would not attempt to "work" a wounded suspect I have just shot in protection of myself or another. My "rendering of aid" would consist of two things: calling for help, and keeping him covered at gunpoint to prevent him from acting again in a manner that gets him shot again.
     
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