Columnist Dr Shaba Nabi looks at GPs’ duties outside of work and recalls her own experiences of helping with emergencies in the community
The recent headline about a passing doctor being reported to the GMC for failing to assist a person who was threatening to jump off a hospital roof highlights our risks and responsibilities regarding Good Samaritan acts.
Obviously, none of us can know the full details of that case, but what is apparent is the patient had booked into the emergency department and was waiting to be seen by the psychiatrist, when he went out and climbed up to the roof. Attempts to talk him down by a nurse and policeman were met with demands to speak to a doctor who happened to be entering the hospital, who refused to assist. The GMC concluded this was more an issue of miscommunication than misconduct, but the case has inevitably polarised people into two camps.
Although there is no legal requirement for doctors to assist with medical emergencies outside the workplace setting, the GMC’s Good Medical Practice states: ‘You must offer help if emergencies arise in clinical settings or in the community, taking account of your own safety, your competence and the availability of other options for care.’ Most medical defence organisations provide indemnity for Good Samaritan acts, and the Social Action, Responsibility and Heroism Act 2015 also provides some legal protection against resulting liability.
So, if indemnity isn’t an issue, then what is? Obviously, safety and competence are important, but what about the availability of other people at the scene? In the case outlined above, why would the person demand to see a doctor above any other healthcare professional?
My own experiences of assisting with community emergencies have been less than positive. One incident involved assisting a choking child during a busy May Day fair, which I was attending alone with a baby and a two-year-old. When the drama and back slaps were over, and the child was fine, I stood up to find my two-year-old son was missing. Those next 30 minutes were probably the worst of my life, as I saw the world through the prism of the McCann family, whose tragedy had occurred exactly a year earlier. Eventually, I was reunited with him after someone identified his flying jacket spinning round in the helicopter ride that he’d managed to get onto alone!
Another incident also occurred when I was alone with a child, this time my seven-year-old daughter who had just had a swimming lesson. As we were about to leave the changing room, I witnessed a woman having a seizure on the floor and had no option but to assist with my daughter by my side. The seizure was short lived and the woman was fine, but my daughter was traumatised by the experience, and continues to have significant anxiety over any illness.
I hope I will never again be in a situation where I have to choose between helping with a medical emergency in the community and protecting my child’s mental health. I speak to my children openly about my roles and responsibilities, and fortunately they are older now, so they can independently walk away from a situation I might be dealing with.
But what about the thousands of other doctors with young children, or those who are caring for another vulnerable person or who have any of a number of issues that make helping while off duty problematic? Who decides whether our GMC duty to help should trump our obligations to ourselves and our families? I guess we won’t know unless a precedent is set in a tribunal – but I doubt that anyone is eager to test this.
Dr Shaba Nabi is a GP trainer in Bristol. Read more of her blogs here