Legal Obligation? Help!

[peady2]

I did some additional research and apparently in some states if you are present and appear to the public to be a rescuer on duty, you will have a legal responsibility to render aid. So EMT plates or being in uniform might be enough for the public to believe you are on duty as an EMS personnel and therefore are legally required to assist. However, an RN license plate is less clearly a duty to assist because an RN is not an emergency responder. Scrubs certainly do not equate to a legal responsibility but a visible hospital badge might-again in certain states and more for EMS personnel (firefighters, police, EMTs).

Duty-to-rescue laws: Legislation that requires certain people-those who perform rescues as part of their job-to rescue people in need. These people include firefighters, police officers, and emergency medical technicians. Only a few states apply duty-to-rescue laws to nurses.
From Nurse's Legal Handbook by Stacey A. Follin page 381
One source stated that there are eight states that have duty-to-rescue laws requiring people to assist at accident scenes: Florida, Massachusetts, Minnesota, Ohio, Rhode Island, Vermont, Washington, and Wisconsin. (from Wikipedia, which I don't consider an absolute source due to lack of complete source citing). Another source, from the Texas Law Review, I do consider accurate and this stated there are 3 states with these laws, but didn't list the states, except for Vermont. However, this source was older so perhaps in the interim, these additional states have adopted such laws.

[insenescence1]

So it does appear there is nothing requiring health care professionals to stop just because they are professionals.
I can assure you that "EMT plates" do not constitute being "on duty," even if someone believes it does. They are novelty plates and nothing more, and in no way constitute any legal obligation to stop and assist. No obligation whatsoever.
An off-duty EMT or paramedic has no obligation to place themselves at personal and professional risk just because they have an EMT novelty plate.
Duty-to-rescue laws only apply to health-care professionals in the scope of their employment. Driving to the grocery store is not a function of an RN or EMT's employment.
Regarding the states that allegedly have dtr laws, these seem to apply to everyone, not health-care professionals.
So if folks don't want to stop and help, they don't have to, unless they are actually working in a manner that constitutes an obligation. i.e. a home-health nurse driving to see patients is not even required to stop at an accident along the way unless that nurse's employer tells them they have to.

[peady2]

If you do some in depth research on duty to rescue laws, you will see that emergency responders who are presumed by the public to be on duty do have a duty to rescue in some cases. I will try to find the articles and post links when I have time. The specific scenarios I read included specialty license plates bearing EMT and off duty uniformed personnel who were still in uniform. It didn't say that novelty EMT plates legally require a person to stop and assist; rather it stated that these plates might give the public the impression that a person is an EMT and therefore capable of rendering assistance, which in turn would create the obligation to do so. These were specific cases and not general law but it appears that under certain duty to rescue laws EMS personnel do have a legal obligation to render assistance, whether or not they are on duty. That said, it was also stated that there has never been a prosecution of a failure of duty to rescue in the 3 states that have such laws.
I finally had the time to read the entire article from the Texas Law Review and it does mention the names of the 3 states that have enacted duty-to-rescue laws. See below:
Three states have enacted statutory duties to rescue: Vermont,66 Rhode Island,67 and Minnesota.68 Vermont and Rhode Island require individuals to perform non-risky rescues; Minnesota requires individuals to either perform the non-risky rescue or provide notice of the problem to police or rescue personnel. One other state, Wisconsin, has a statute that requires persons present at the scene of a crime to either report the incident to the police or to assist the crime victim.69 Several other states have imposed limited duties to report crimes,70 and every state imposes a duty to remain at the scene of a car accident at least long enough to render aid and exchange information, when it is safe to do so.
From: Rescue Without Law: An Empirical Perspective on the Duty to Rescue
By Hyman, David A
Publication: Texas Law Review
Date: Wednesday, February 1 2006

[peady2]

Excerpts from an article at:
www.EMSresponder.com
Where Duty Ends: The Perils & Pitfalls of Off-Duty Response
By John Erich
Associate Editor

“It’s a complicated issue,” says Rick Patrick, MS, FF, EMT-P, director of EMS programs and services for York, PA-based emergency-services insurer/consultant VFIS. “Sure, people should stop and render care. But that’s just a Good Samaritan issue. It’s not necessarily more of a responsibility for a trained provider. The states vary on requiring fire and EMS providers to stop—some do, some don’t, and it can be a very controversial subject.”
“If everybody’s paid, it’s clear what ‘off-duty’ is,” says Patrick. “But from a volunteer standpoint, there’s a school of thought that as a volunteer, you’re always on duty, no matter where you are.”
In other words, you may, by state or local law, have a duty to respond to accidents or injuries you encounter (and this may be true for paid providers as well as volunteers). And there may even be further distinctions beyond that: Does your state law distinguish between public and private agencies? (Florida’s does: That mutual-aid agreement and line-of-duty assumption do not apply to private EMS agencies—individual medical directors set the policies for those.) What about responding directly to an incident versus responding after you return to the station first? (The latter may make you part of an official response, and thus provide additional protections.)
What You Need to Know About Off-Duty ResponseState Laws:
How is “off-duty” defined? Are there requirements or prohibitions re. how and when you can assist? Must your department pay you if you do?

Good Samaritan Laws: If you’re not part of an official response, how much of what you do is legally shielded? Can you use all your training and skills?

Department Policy: If off-duty responses are allowed, are there specific guidelines or procedures to follow?

[reesern-63]

So it does appear there is nothing requiring health care professionals to stop just because they are professionals.
I can assure you that "EMT plates" do not constitute being "on duty," even if someone believes it does. They are novelty plates and nothing more, and in no way constitute any legal obligation to stop and assist. No obligation whatsoever.
An off-duty EMT or paramedic has no obligation to place themselves at personal and professional risk just because they have an EMT novelty plate.
Duty-to-rescue laws only apply to health-care professionals in the scope of their employment. Driving to the grocery store is not a function of an RN or EMT's employment.
Regarding the states that allegedly have dtr laws, these seem to apply to everyone, not health-care professionals.
So if folks don't want to stop and help, they don't have to, unless they are actually working in a manner that constitutes an obligation. i.e. a home-health nurse driving to see patients is not even required to stop at an accident along the way unless that nurse's employer tells them they have to.

Another thing to consider about the license plate issue: Just because the car has specialty plates doesn't mean the driver is the licensed professional. It could be the licensee's spouse/child, etc.

[insenescence1]

In a previous life (that seems like a lifetime ago), I worked full-time in EMS; I was essentially immersed in EMS, working full-time as a paramedic while going through college. I still maintain my paramedic and Prehospital RN certifications, and I have a BS in Emergency Medical Services that I obtained before I attended nursing school, and it included EMS Law and operations courses. I helped start and run an ambulance service before I became an RN, worked as an instructor, evaluator, and public info officer, and I had EMT novely tags on one of my vehicles until I moved south. I know Rick Patrick personally; we've hired him for speaking engagements, consulting, and insurance and I've met some of his family. I worked in EMS in four states...I could be mistaken, but I think I might be at least a little bit familiar with this topic.
Public presumption in no way obligates an off-duty provider to assist. The only time a provider obligates themselves is when they STOP...then they must provide assistance, and cannot simply leave. Choosing to drive on by is not illegal nor constitute liability or malpractice. There are variations on this policy, but this is a pretty consistent consensus.
No matter what impression a license plate may give, it also does not create any obligation, especially since it's not on an emergency vehicle, and since not everyone who works in EMS and might have a tag is actually trained to provide hands-on care (i.e. uniformed dispatchers). In fact, many times if the police are on scene first, they will wave on by any non-jurisdictional providers who offer to stop and assist.
The 'duty to rescue' statutes you note have nothing to do with RN's, healthcare professionals or EMS personnel; they apply to everyone regardless of their occupation, or what kind of tag or clothing they are wearing.
Rick is a very smart man; it is rare that he does not give a straight and solid answer. In this case, it's probably because there is no law requiring off-duty personnel to stop at an accident. The volunteer issue is moot for several reasons; volunteer services still will often have 'on-duty' crews who will go in and respond on the call. And if a volunteer is on-duty and they encounter the accident within their jurisdictino, then they are expected to stop by virtue of being on duty. Off-duty volunteers are not obligated. If they DON'T have an on-duty crew and rely solely on the random generosity of it's members (who are not assigned on duty), then you'd be surprised how lenient the rules are. Some states only require that such a service actually roll an ambulance on a certain percentage of those calls and accept a certain amount of 'turnover.' You might actually be surprised to learn how jurisdition and call assignment DISALLOWS ON-DUTY providers to respond to incidents WITHIN their own assigned territory.
Promoting the myth that there is any substantial legislation requiring off-duty providers to stop is dangerous and unfair. The paramedic who just picked up her kids on the way home from work has no obligation to place herself or her children at risk. The worn out EMT who just wrapped up a busy 24 hour shift at the fire station is not doing anyone any favors to stop at an accident and inject his fatigue into the situation.
Change is slow in EMS, but the culture of safety is increasing. You may notice that fire apparatus are often parked in a manner to purposefully impede traffic when there are providers working in the roadway. This is because we've learned that a huge fire truck is a great barrier to protect providers who must turn their back on traffic and attend to their patients while inattentive teens and cell-phone yapping jagoffs barrel mindlessly into accident scenes. If such protection is not available, no-one is obligated to place themselves at risk.
I still maintain many of my EMS certifications (along with a handful of nursing licenses from various states). Anyone will be hard pressed to present a law that obligates me by virtue of my certifications to ever stop and render assistance when I'm not working.

[peady2]

Choosing to drive by the scene of an accident is not illegal except in those 3 states I mentioned-and yes, as I stated, the law applies to all, not just emergency services or healthcare providers. Otherwise there is no obligation to stop. However if you do stop in some other states and can be identified as EMS or other emergency services personnel, then you are obligated to assist. Obviously, license plates can identify you as an EMT. That is not to say that anyone driving a car with EMT plates is an EMT; obviously that is not always the case. But if you are and do not render aid and are later identified as such, it can be a problem. I did read of a case where license plates were used against an off duty paramedic or EMT (I can't remember which) who was present at a scene but did not render care but I can't find it again and don't have time to look. So in the absence of "proof" I will just withdraw the comment.

Promoting the myth that there is any substantial legislation requiring off-duty providers to stop is dangerous and unfair.

I agree. If you are implying that I said otherwise you are wrong. However, you qualified the above statement with the word "substantial." Is there "substantial" legislation-no. Is there any legislation-yes, there is. I will end this with the quote from Rick Patrick, the director of EMS programs and services for York, PA, and by your own admission "a very smart man."
The states vary on requiring fire and EMS providers to stop—some do, some don’t, and it can be a very controversial subject.”

[insenescence1]

Choosing to drive by the scene of an accident is not illegal except in those 3 states I mentioned-and yes, as I stated, the law applies to all, not just emergency services or healthcare providers. Otherwise there is no obligation to stop. However if you do stop in some other states and can be identified as EMS or other emergency services personnel, then you are obligated to assist.

I'm pretty sure I said this.

Obviously, license plates can identify you as an EMT. That is not to say that anyone driving a car with EMT plates is an EMT; obviously that is not always the case.

I'm thinking you meant to word this differently? It seems to say that plates can identify the occupant as an EMT, but then again, not necessarily?
The reality is that I'm not aware of any tag that specifically identifies the owner or occupant as an EMT, just that the person to whom the car is registered is employed in EMS in some manner. Usually these tags say "EMS" or "Emergency Medical Services" or something like that, not "EMT." These tags don't reflect any kind of certification or skill level. As I've said before, they merely recognize that the person to whom the car is registered is involved in EMS in some way, i.e. a dispatcher with no hands-on clinical skills or training. Even an administrative person who never so much as took a CPR class can get these tags.

But if you are and do not render aid and are later identified as such, it can be a problem. I did read of a case where license plates were used against an off duty paramedic or EMT (I can't remember which) who was present at a scene but did not render care but I can't find it again and don't have time to look. So in the absence of "proof" I will just withdraw the comment.

Promoting the myth that there is any substantial legislation requiring off-duty providers to stop is dangerous and unfair.

I agree. If you are implying that I said otherwise you are wrong. However, you qualified the above statement with the word "substantial." Is there "substantial" legislation-no. Is there any legislation-yes, there is. I will end this with the quote from Rick Patrick, the director of EMS programs and services for York, PA, and by your own admission "a very smart man."
The states vary on requiring fire and EMS providers to stop—some do, some don’t, and it can be a very controversial subject.”

Just to clarify, Mr. Patrick is not a director of anything related to EMS in York, PA. He is employed by a consulting/insurance company that just happens to have it's offices in York, PA, and has nothing to do with local EMS operations other than possibly providing them with insurance. I don't know the date of this quote, but I pointed out that this is an atypical grey answer from him. As of yet, no-one has identified any of this alleged legislation.

[peady2]

This is a link to the actual article, it was from the September 2004 issue of Emergency Medical Services.
http://publicsafety.com/article/arti...&siteSection=4

I did incorrectly identify Mr Patrick-I inadvertantly left out the second half of the title when I copied/pasted it. Insen is correct, Mr Patrick is "director of EMS programs and services for York, PA-based emergency-services insurer/consultant VFIS."

Perhaps I did word the comment about EMT plates poorly. I meant that as Reese pointed out earlier, the driver or an occupant of the car is not necessarily the EMT to whom the plates were issued. But if the EMT were present and did not assist, that person could later be indentified as an EMT who did not assist at the scene. This was exactly what I read happened to an EMS person at some kind of fair-however as I said above I can't locate the article.

BTW, if anyone goes to the home page of the site above there is an article about a young EMT from my area who lost her right arm in an accident on Monday while she was a passenger in a transport ambulance. Please pray for her and her family, as well as the driver of the vehicle.

[Woodmist]

Personally, I would want to stop and render assistance, whether I have a duty to do so or not. Unless I was already on a rescue mission where time was of the essence. Maybe that was really the reassurance the nursing instructor was looking for orginally. Or maybe not. Nursing instructors! Sheesh!

[reesern-63]

Frankly, the EMT who stopped at the accident but didn't help deserved to get sued. The last thing an accident scene needs is more gawkers. If you're not helping, you're in the way--and sometimes even helpers get in the way.

[insenescence1]

Frankly, the EMT who stopped at the accident but didn't help deserved to get sued. The last thing an accident scene needs is more gawkers. If you're not helping, you're in the way--and sometimes even helpers get in the way.

I agree. An accident is not a spectator event in spite of our voyeuristic tendencies. That EMT should've not only been sued, they should've been decertified for stopping and not-assisting.
They should've simply driven on by.

[insenescence1]

BTW, if anyone goes to the home page of the site above there is an article about a young EMT from my area who lost her right arm in an accident on Monday while she was a passenger in a transport ambulance. Please pray for her and her family, as well as the driver of the vehicle.

Sad story. When I was working full-time in EMS, I had a strong interest in ambulance crashes, and actually spoke with Rick P. about this on several occassions. Rick and I were a minority in our matching beliefs on the use of emergency signals on ambulances and we believe they are drastically overused and result in too many such sad stories. I am of the belief that there are only two situations that require emergency signals to be used when transporting a patient, and that would be when the provider is unable to fix Airway or Circulation.
Rick says that for every one claim his company has to pay for medical malpractice (by an EMT or medic), they pay out for something like 20 claims for accidents involving an ambulance they've insured. I was amazed to learn that my EMS colleagues were better clinicians than drivers, especially considering most of them had been driving a lot longer than they had been working in EMS.
I also noted the headlines about proper staging at accident scenes. Such danger is exactly why I simply don't stop anymore. One of our ambulances was struck by a truck on the interstate; the patient inside was being treated for cuts, but then suffered a broken leg after being struck in the ambulance that now could not transport him. Another paramedic friend was hit by a car that drove into an accident scene.
I was returning home from the fire department one morning after another tiring and jaded shift of wheezers, queasers, sh...ters and spitters and encountered a fresh accident on a high speed secondary road. The wheels were still spinning on the overturned car. A early 20's girl was running around all over the place crying and the poor fellow who pulled out in front of her was unconscious in his car. I told her to get off the road and stay in one place and I crawled into the wreckage with the unconscious man. I looked out to see her running around on the road again and cars were swerving to miss her. I crawled out and shouted to her from the side of the road to get back in the grass and sit down. She told me to STFU and quit yelling at her because she "was just in an accident." Call it occupational burnout, but I wasn't about to walk out there and risk myself for someone who had abandoned her sense of self-preservation, and I shrugged and crawled back into the wreckage with the unconscious fellow. Another passerby saw our exchange and they walked out and forced her off the roadway.
With one exception involving children, that was the last time I stopped when I was off-duty. I just didn't see the sense in risking my safety for people who didn't have the sense to protect themselves.

[Edson!]

I think this instructor should be careful about how she defines the law versus what it really says.

To me, at the end of the day, it is an ethical/moral decision. There are influences and powers that should definitely be more powerful and compelling than something produced by some legislature or judge. (I would think you would need to refer to the individual hospital's policies on such things as well.) But you either are directed by your internal compass or you are not. You either choose to be or choose not to be...and then you have to live with it either way. That is truly "LIFE," as they say.

I also agree that one shouldn't offer to help if there is a mob at the scene helping and in control already. That's using your head and making a fair judgment call.

Same thing goes in the hospital. In some bays or rooms or wherevers, when you get there, are packed full of people--healthcare personnel. I asked if there is anything I can do outside the room or in anyway to help. If not, I say a pray for the pt and team and leave. There are other patients that still need focus, and I fail to see how cramming one more person in the room is going to do anything helpful in many situations.

[peady2]

I agree it is very dangerous to stop at the scene of an MVA, especially on a highway. I also don't think it is smart to simply stop at a disaster scene w/o first ensuring that someone in authority knows you are there. Look what happened at the WTC-while all of those emergency services people had the best of intentions they put themselves in mortal peril because no one officially knew they were there and because they were unable to receive communications (so were a lot of the people on duty, but that's another topic). My husband is a very active EMT but I always ask him not to get involved unless he is first on the scene. Usually he complies. But I don't think he or myself could drive past a scene where there was no one there yet. In fact I know he wouldn't; I might but I would certainly call 911.

The young EMT who lost her arm was riding in a transport ambulance and not going to or coming from a call. The Westchester papers were more in depth than the website and stated that the truck was parked illegally on the shoulder. Apparently the ambulance was going at a pretty high rate of speed and maybe swerved to avoid another vehicle or what have you.The impact sheared off the entire right side of the ambulance-the pictures were pretty graphic. I agree with insen about the drivers abilities-while this young driver might be an excellent EMT (although at 19 how much EMT experience can he even have?) it is very difficult to drive an ambulance and 19 y/o men do not have lots of driving experience to begin with. Weather was not an issue, it was a sunny morning. And it wasn't a big box rig, which are even harder to drive; the transport was more of a large van type. I never worry about my husband on a call because of any consequences of treating a patient, but I do pray that the driver is careful and competent. And with volunteer EMS, it is a fact that a majority of members are young and relatively inexperienced drivers.