LEGAL COMMITTEE
Duty to Rescue: A Health Care Perspective Richard I. Suarez, JM and Tessa Haspil-Corgan, MD
I
ntroduction
"The big questions rest in the context, and whether individuals who swear their time and lives to protecting and serving people must serve and protect at all times.”
As a medical practitioner, the concept of providing your services and expertise to care for others is engrained in the training and functioning of the day-to-day happenings of being in the field. Physicians and other level practitioners consider what needs to be accomplished in order to help an individual in need, such as what parts of the physical exam should be focused on, what diagnostic studies are needed, what labs should be ordered, and what is needed to manage this condition(s), among many others. However, when the medical personnel are removed from the context of the hospital, clinic, or other care services location, what responsibility is there to help others? Specifically, what duty is owed to rescue? This question strikes deep into the sense of morality and empathy shared in a society, but assumingly more so in a profession dedicated to the care of others. A “duty to rescue” is a legal doctrine found (or rather absent) in the American tort law system. A “duty” is a matter of a policy determination in which the judge makes the decision of including the case or class of cases within tort liability or not. Therefore, a duty can be seen as the responsibility to act (or not), promoting an idea of connection to the existence of an obligation. In general, when it comes to strangers, there is no duty to rescue because strangers have no connection/relationship/obligation to one another, despite the fact that the lack of action when someone could help without endangering their lives may be seen as wrongful or unreasonable, regardless. However, do medical doctors and other practitioners not have an obligation to help all those in need based on the oaths and responsibilities set forth by their profession? The big questions rest in the context, and whether individuals who swear their time and lives to protecting and serving people must serve and protect at all times. The idea of the force, scope, and justification of this duty and its application in the medical arena has been considered by bioethicists.1 Specifically, it has been proposed that clinicians encounter these scenarios frequently within the clinical context and beyond, such as the discovery of incidental findings and their subsequent care, the participation in research, and the allocation of resources for research and development, among others.2-5 In addition, current statutes, like Good (and “Bad”)
Samaritan laws, and common law, such as the Tarasoff decision, promote this idea of rescue for practitioners. When we consider the role that the foundational principles of medical ethics—beneficence, non-maleficence, justice, and autonomy—play in the actions and moral obligations of practitioners, there is an argument for this “duty to rescue” being an unnamed fifth principle interweaved amongst the others. Though there has been legal analysis into the basis of the tort doctrine, as well as medical specialists’ commentary on the place this doctrine has within (and outside) the clinical context, there are few comprehensive integrations of the two disciplines surrounding the idea of rescue. In this article, we will describe what is the “duty to rescue” and the legal arguments that support its inclusion in modern day tort law, alongside the byproducts that have arisen because of it (Good Samaritan statutes). We will then discuss how this doctrine plays into the medical landscape and impacts, directly and indirectly, the processes of clinicians. Finally, we will incorporate the two arenas into one encompassing the idea of the “duty to rescue” in a combined, ample, multi-disciplinary approach. Overall, we aim to explain one of the many interactions of these two fields of study and demonstrate the importance of this analytic exercise in an effort to better understand the overlapping nature of these two distinct yet intertwined academic spheres. A Duty to Rescue: Legal Analysis
When we consider the morality of a society, it appears immoral to not help others in need when one is able to do so. However, bystanders have no obligation, with few exceptions, to provide aid, even when reasonably feasible without harm to self. This is due to the rule of no “duty to rescue” set forth within the American tort law system. In this section, we will explore what is this tenet, why it exists in the modern-day legal system and derivatives of its establishment, specifically, “Good Samaritan” laws. What is the “Duty to Rescue”?
Before we can discuss this duty (or lack thereof), it is important to provide a foundational understanding of legal principles. This doctrine is part of the general American tort system. A tort is defined as “an act or omission >>
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COMMON SENSE SEPTEMBER/OCTOBER 2023