AAP News •
www.aapnews.org • September 2015 23
by William M. McDonnell, M.D., J.D., FAAP
A pediatrician is dozing during an airline flight
Motivating bystanders while minimizing harm
when she hears an announcement: “If there is a doc-
tor on board, please push the attendant call button.”
When she looks to the back of the plane, she sees
an elderly man lying in the aisle with a flight atten-
dant hovering over him. The following thoughts go
through her mind: “I don’t know how to take care
of adults.” “We’re flying over California, but I’m
only licensed in New York.” “Could I be sued if I
Pediatricians are accustomed to caring for their
patients in the usual clinic or hospital settings. How-
ever, they occasionally are confronted with emergen-
cies in public places, such as on airplanes and cruise
ships, in shopping malls and in sports arenas. The
sick or injured victim usually is not the pediatrician’s
existing patient and may not even be a child. In
such situations, pediatricians appropriately may be
concerned about potential legal liabilities.
The basic legal rule provides that if a “helper” provides assistance that is harmful and unreasonable,
then a “victim” can sue the helper for injuries caused
by the unreasonable actions. Courts developed this
rule of law to protect victims from additional injuries
caused by unqualified bystanders. Unfortunately, the
rule also has the effect of discouraging help from
qualified volunteers who fear their own legal risks.
Therefore, to encourage volunteer help for victims, all 50 U.S. states have enacted so-called Good
Samaritan laws. There is variation among the states,
but these laws share the common function of encouraging bystanders to assist victims by providing
legal protection from lawsuits. Specific to airline
travel, the federal Aviation Medical Assistance Act
extends similar protections
against lawsuits in any state
or federal court to volunteers
during in-flight emergencies.
Good Samaritan laws attempt to strike a balance
of reducing liability risks
enough to motivate volunteers to act, while preserving
enough liability risks to prevent volunteers from making
reckless or harmful interventions.
To achieve this balance, Good Samaritan laws
The precise definition and application of these
limit their legal protections to the following cir-
• the situation was, or appeared to be, an emer-
• the care was provided without compensation;
• the volunteer acted rationally, in good faith, and
was not grossly negligent.
criteria vary by individual state laws.
Courts may look to subtle dis-
tinctions in applying these criteria.
For example, if the pediatrician in
the example above helps the stricken airline passenger, the airline may
decide to reward the pediatrician. If
the patient (or his heirs) decides to
sue the pediatrician, a court would
have to decide whether the pediatrician had been “compensated” for
the care. A free drink and a bag of
peanuts would not be interpreted as compensation,
and the pediatrician would be protected. On the
other hand, if the pediatrician had accepted a gift
of free air travel for life, a court likely would decide
that the pediatrician was compensated. Good Samaritan protection would not be available, and a
lawsuit could proceed.
Good Samaritan laws also are intended to
motivate volunteers who otherwise would not
act to help victims. Therefore, protection is
limited to individuals who have no pre-existing obligation to help the victim. For example, a physician has a pre-existing duty to help
her established patients, so no additional legal
protection is needed to encourage action. Similarly, an on-duty police officer has a duty to
help victims. In both cases, Good Samaritan
laws offer no special protection for the rescuer,
and these “volunteers” must provide care that
is non-negligent or face potential liability.
Many states extended this concept of physicians’ pre-existing duty even further, making
Good Samaritan protection unavailable for
physicians in all health care settings, even if
the physician is rescuing an individual who
is not her patient. In contrast, other states
expressly protect physicians who voluntarily
assist individuals who are not their patients,
even in health care settings.
Good Samaritan laws are intended to encourage, but not to compel, volunteers to help
those in need. A small minority of states, however, actively require individuals to give reasonable assistance to victims of emergencies.
Such volunteers then are protected against
claims of negligence, provided the volunteer
acted in good faith, was not grossly negligent
and did not receive compensation.
Good Samaritan laws in all U.S. states encourage good faith volunteers to help victims in
need of emergency care. Pediatricians often have the
knowledge and skills to provide the immediate care
needed to save a life. So long as the basic elements
of Good Samaritan laws are followed (emergency
assistance provided without compensation in good
faith, and not acting recklessly or grossly negligently), pediatricians can proceed with confidence in
So go ahead; push that flight attendant call button.
Dr. McDonnell is chair of the AAP
Committee on Medical Liability and
Good Samaritan laws encourage bystanders to assist victims by providing legal protection from lawsuits. However,
the situation must be an emergency, with the physician-vol-unteer acting in good faith and without compensation.
Pediatricians and the Law
State laws vary on when Good Samaritan
protections apply to physicians
To gain an in-depth understanding of
Good Samaritan laws, attend “Is There
a Doctor On Board — Good Samaritan
or Bad Decision? (S1157)” from 4-5: 30
p.m. Oct. 24 at the AAP National Conference & Exhibition in Washington, D.C.