I have been working on an article on a subject that I find intrieguing - the duty to render aid. The traditional law in the US is that absent a "legal duty" to act, no one has a duty to come to the aid of another. A blind person could be walking toward an open manhole and a bystander has no legal obligation to warn or stop him/her.

Legal duties arise primarily due to relationships (parent to child, teacher to student, ship captain to passenger), and by law (such as laws that require the driver of a car to render aid to anyone who is injured in an accident involving the car). On duty firefighters, EMTs, and paramedics have a legal duty to respond to alarms and render aid.

But the law is evolving. Many states have enacted more a generalized "duty to act" imposing a duty to render aid to anyone who may need assistance. Cases are starting to appear that question how much assistance is enough. Example - a day care center was sued when a child died and no one on staff was trained in CPR. A college was sued when a student athlete suffered a heart attack and none of the coaches were CPR trained, and a trainer was not assigned to the practice.

My question is - how much is enough? If the day care center or college had CPR trained personnel standing by but no AED - and the patient died - did they breach their duty by not having an AED? If they had CPR trained personnel and an AED but no epi-pen - did they breach their duty? It could go on and on. My concern is about the application of these theories to the fire service and EMS providers. How much is enough?

Before we get sidetracked - please understand this issue involves more than gready plaintiffs/lawyers looking to make a buck. It involves a very human desire for justice when someone feels they have been wronged. That desire is very strong and can consume the victims' family. It does not end with civil law suits but can lead to criminal charges. The families of the firefighters killed in the 30 Mile Fire in Washington state in 2001 lobbied for 5 years before the incident commander was indicted for manslaughter in 2006. When people believe justice has not been served - money is not the objective.

So what are your thoughts. Where should the line be drawn. Should the law remain that no one has a duty to help another. Should it evolve? How much is enough?

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If you iniate patient care and then decide you dont want to do it any longer that is abandoment (as long as personel safety isnt the reason). No duty to act means that you dont have to but once you start you can not change your mind so long as personel safety isnt at risk. You have to stay with that patient until relieved by someone else in the continum of care.
How about an opinion on the converse side? My small, rural department just promoted our former AC after our long-serving Chief retired. The new Chief is a great guy, but his first act was to implement a "two-in" rule, which prohibits any responder from arriving on-scene alone. We must now arrive in pairs, even if it means waiting down the block.

This is a very small, rural department, and over my 20+ year career I have been first on scene or even alone on countless occassions. My house is 12 - 14 minutes away from the next nearest responders. If my neighbor goes into arrest or suffers an injury causing arterial bleeding, I am now expected to wait in my driveway until a second responder can get here.

I understand the Chief's concerns, and agree that two-in is a great goal. But my own conscience tells me that this is a policy I'm going to be violating. I'll not delay my response to a life-threatening emergency, even if it results in the disciplinary action the Chief threatens.

Are there legal ramnifications to having the fire deparment delay its repsonse?
Darrell:
I like to give "Chiefs" the benefit of the doubt, because I was one.
A chief becomes a chief, in part, because of their decision-making skills.
In this case, I would hope that he would realize the short sightedness of this edict and write some "flex" language into it. I call it "ambiguity".
Now, with that side, I am a firm believer in scene safety, so our decisions should be made with at least giving THAT some consideration.
Like you, I was never one who could stand still and do nothing, knowing that we can hopefully make a difference.
You cannot save a life if you are standing there watching them die.
Darrell, obviously there is no end to this evolving issue. As long as there are lawyers/attorneys an money someone will be sued. If you or I attempt to render aid to the best of our ability we should be in the right. However, when we do that same job and either arnt trained to do what we are attempting and it goes wrong or we dont render aid to the level we are trained and it goes South we are opening up ourselves for trouble. I have seen the comments of some on here and heard it said more times then naught out on the street that we have an obligation to do what we do whether on duty or not. Of course if your a volunteer you may be called in at any time as well. However, I have always felt that no matter what capacity I am in I will help my fellow man if they are in jeopardy. That was what I was raised to do. It is difficult however in this day an age to be able to do that without concern over legal ramifications. We all should have and work under our protocols. We need to know what they are too. Its one thing to render aid as a civilian. Its another to render aid as a responder. Bottom line- DO YOUR BEST!
The only thing that I will add to Chief Sharp's words are:
Push past the ones who have their phones out video taping it.
Push past the ones who don't want to "get involved".
Push past the ones who are too busy or too stupid to help.
Push past the ones who don't want to "catch something".
Push past the ones who don't care because it's not THEM or someone they know.
Push past the ones who are in your way of rendering aid.
We have become a nation that has forgotten how to help others.
We have made it too easy to say "I didn't have gloves; I didn't have a pocket mask/barrier. I don't want to get sick or sued".
These are the same people who won't bend down and pick up a candy wrapper and throw it away.
Well said Chief. Especially the 1st PUSH PAST! Even have seen that with other family members inside of someones home. Ridiculous!!!
Thanks Chief,

I know that the Chief believes he's doing the right thing with his policy, and I agree with it in principle. The problem comes in practice in a small department that often has only one or two responders who might arrive several minutes apart. A minute or two can make a big difference, as you know.

I, too, believe in scene safety and well-considered decisions. Responders must take into consideration all the information available to them, but everything we do has some risk.
To me there is 2 ways to look at things....1st....a legal duty to act and just as inportant #2... a Moral duty to act.... Who in their right mind would idly stand by and watch something happen and do nothing....? Sure I know there are those that see nothing wrong with this....To me that is the biggest problem with our society today...too many are willing to "look the other way" or have the attitude..."I'm not getting involved" As for the mentioned examples...Day care center and a sports event (Or practice) that was correct...to me those were cases of negligence...no-one working in fields such as these should be employed without having at least a basic knowledge of first-aid and CPR...that would be like going hunting with no idea how a firearm functions.....it is a recipe for disaster....It is just a shame that we have to resort to making new laws to cover common human deciency......Stay safe....Keep the Faith Paul
I don't think we should get into making laws about us emergency responders having a duty to act off duty. I think there's better things our lawmakers could be spending their time doing.

After all, what percentage of us would NOT stop to render aid in a serious incident? I bet it's pretty small. Most of us are going to do the right thing. We didn't get into this for the money!
Well, I wouldn't be afraid to splint a leg. That's something they teach laypersons in a first aid class. Granted, we get more training and real world practice, and have better tools to do so with. However, it's still someting that anyone could do being a good samaritan.

You need medical command for epi-pens, inhalers, AED's, nitro, ALS stuff, etc....there is no command needed for BLS care or equipment, only BLS protocols. At least in my state, I can't say for sure everywhere.

I wouldn't be afraid to do anything at the BLS level as a good samaritan.
But if I stop and yank someone out of a burning car and they decide to sue me because I "hurt their neck" (despite their imminent demise), the legal system and all the money-grubbing lawyers involved should say, "Hey, this is ridiculous, this guy was just trying to help a fellow human being".

That's it right there. That's the kind of crap that's ruining this country. You can give someone the shirt off your back, but you better hope the tag doesn't cause them to have an itch on their neck, or they'll take you for everything your worth. Some of these people need to get a life.
Darrell....Maybe you saw it or then again maybe you didn't....and I am not saying that I think your Chief is right or wrong...it is now his sandbox and either you play by his rules or you go home...BUT....Not so long ago a local guy (EMT) responded to a call of a person experiencing chest pain....in the course of care the "patient" left the room and came back with a rifle and he shot and killed the responder....back up is not a bad thing....but as I said...you have a new Chief and its his rules that bind you now....He might be open to discussion but the buck stops with him....like it or not...its his call.....Paul

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