Should I provide basic life support or not?

Car Accident (Photo credit: neatlysliced)

If you ever seen someone in the community in need of medical attention, such as after a car accident, you have had to make a decision about whether or not to offer help. Many questions may come to mind at such a time.

• Will I be able to help?

• Will I be in the way?

• Do they even need help?

• Should I get involved?

While it may not cross your mind during an emergency, one of the underlying issues as to whether you decide to offer aid is your ultimate legal responsibility. Do I have a duty to respond? If I do respond, can I be held liable for my actions?

The Duty to Rescue

One rather common and reasonable concern of people who are considering taking a course in basic life support is whether they will, after training, have a duty to rescue people in need. They may even avoid training in basic life support because they feel they have to then respond to every accident or emergency that they encounter. To those people who have had that concern: fear not! Simply being trained in basic life support or advanced cardiovascular life support does not commit you to anything more than you were already required to do before ACLS or BLS training.

In general, you do not have a duty to rescue unless

• You caused the person to be in his/her current state (even accidentally)
• You have already started to administer aid
• You have a special relationship with the person, including
  • Parents to children
  • Spouse to spouse
  • Property owners to invited guests (not trespassers)
  • Employers to employees
  • Law enforcement agent or custodian to someone under arrest
  • Teacher/school administrator to students
  • Pilot/driver to invited occupants of a land, sea, or air vessel

What if I am a medical professional?

Perhaps surprisingly, in most US states emergency workers do not have a legal obligation to provide aid. The exceptions are listed above; if you have already started administering aid or if you have a special relationship to the victim, you must provide assistance. Therefore, if you are an EMT responding to the scene, you are already administering help before you get out of the ambulance. In addition, you must only provide assistance up to your level of training.

The duty to respond, state by state

In some states, essentially every citizen must provide basic assistance if they witness an emergency. In California, Florida, Hawaii, Massachusetts, Minnesota, Ohio, Rhode Island, Vermont, Washington, and Wisconsin you must contact emergency personnel if you witness someone in need. In Minnesota, Rhode Island, Vermont, and Wisconsin you have a duty to provide “reasonable assistance.” However, reasonable assistance is open to interpretation. At its most basic, if you are in one of these states you simply cannot leave the scene if someone needs assistance. Reasonable assistance may mean offering some assistance, but not necessarily basic life support. In actuality, these laws are rarely enforced. Even if they are enforced, the associated penalties are relatively minor.

Good Samaritan Laws

Good Samaritan laws are somewhat different than (buit related to) Duty to Respond laws. Good Samaritan laws are intended to legally protect people who assist victims whose lives are in danger. The reasoning behind the laws is to encourage people to provide assistance even if they are hesitant because of legal repercussions. Good Samaritan laws vary widely by state, but to be protected you must provide assistance within your skill level. Thus, if you are only certified in basic life support and do not have a license to practice medicine, you should not be providing advanced cardiovascular life support and administering IV epinephrine, for example. It is important to note that Good Samaritan laws do not prevent grossly negligent behavior. If you hasten someone’s death because of improper actions, you can be held accountable.

The bottom line

Obviously if you need definitive information about whether or not you have the legal duty to rescue, you should consult an attorney in your state. That said, being certified in basic life support, pediatric advanced life support, or advanced cardiovascular life support does not increase your obligation to help someone in need, regardless of what US state you live in or visit. Your duty as a citizen does not change once you become BLS certified. If you live in a state that requires you to provide “reasonable assistance,” that will not change once you obtain basic life support certification. On the other hand, Good Samaritan laws may or may not protect you if you administer aid. If you do decide to perform basic life support, it is important to provide assistance within your skill level.