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  1. Pro Bono: Is Leaving One Patient to Help Another Abandonment? - Journal of Emergency Medical Services

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Pro Bono: Is Leaving One Patient to Help Another Abandonment? Mon, Dec 21, 2015 By Doug Wolfberg , Steve Wirth, Esq., EMT-P A recent incident in New York —where a private ambulance transporting a patient from a hospital to an assisted living center stopped to assist a 7-year-old choking victim—generated significant discussion after the EMT who stopped the ambulance to assist the young girl was suspended from his job. According to news reports, the first patient was in the back of the ambulance with an EMT while the EMT driver got out to assist the choking child. There’s no indication the first patient suffered any compromise or harm as a result of this delay in transport. The big question was: Did he abandon the first patient by assisting the second patient? This situation raises both legal and ethical issues. Whether the first patient was “abandoned” is a question of both law and fact. Medical dictionaries generally define abandonment as the unilateral termination of the provider/patient relationship at a time when continuing care is still needed. Abandonment is really a form of negligence under common law principles. It’s hard to prove, as a plaintiff must show there was a duty to the patient, and that this duty was breached by ceasing to provide care when it was still needed. Typically, if an EMS provider is already engaged in the care of one patient, there would generally not be a duty to initiate care for the second patient whom the EMS provider comes upon. But negligence is all about reasonableness. Juries could find you negligent if you didn’t act as a reasonable and prudent EMS provider would, given the same or similar circumstances. If you did absolutely nothing to assist a critical patient you came upon while transporting a stable patient in no distress, a jury could potentially find that you had a duty to assist that second patient. What may be “reasonable” to one juror may not be reasonable to another. [Native Advertisement] So whether there was legal abandonment really depends on the situation. If the first patient was in dire need of medical assistance and suffered harm as a result of the ambulance stopping for a second patient, then the EMS provider’s actions would be more likely negligent than if the first patient suffered no harm. But if the first patient was simply being transported under routine conditions with no need for medical interventions and the delay didn’t harm that patient while assisting the second patient, a successful claim of negligence would be unlikely. Anytime an ambulance is transporting a patient and a second patient who needs help suddenly appears or the ambulance literally has to drive by that patient on the route of travel, ethical dilemmas emerge. Should the ambulance stop? Should the ambulance contact dispatch for a second unit to be sent? Should the ambulance keep going without interrupting the first transport? There’s simply no easy answer as it all depends on the situation and using common sense and good judgment to help those who need care the most. The key to avoiding potential legal and ethical issues in these situations is to preplan accordingly. This means developing a policy that defines what should be done when encountering this situation and educating everyone on that policy. Under what circumstances would it be permissible for the ambulance to stop and assist a second patient? The typical scenarios can be defined. But not everything can be defined, and sometimes we have to rely on common sense and good judgment in the hopes of making the best decision possible for the patients involved when confronted with conflicting interests. As Jim Page said in his classic book  The Magic of 3 A.M. , “In the process of trying to keep everybody’s rear covered, we tend to forget that the exceptional performers in EMS occasionally need the liberty to do what they do best—make quick decisions and stick their neck out to save a patient. There will always be a need for people who are brave enough to think for themselves and take a chance when a human life is at stake.” There’s no protocol for every difficult situation we’ll encounter, and at times we need to see the bigger picture and do what we think is right, or in the best interest of all concerned when the situation doesn’t fit the policy or procedure. Pro Bono was written by the attorneys at Page, Wolfberg & Wirth,  The National EMS Industry Law Firm. Visit the firm’s website at  www.pwwemslaw.com  or find them on Facebook, Twitter or LinkedIn. More Legal & Ethical coverage from JEMS.com By Doug Wolfberg Douglas M. Wolfberg, Esq. - Doug Wolfberg is an EMS attorney and founding partner of Page, Wolfberg & Wirth, which represents EMS agencies throughout the United States.  A former EMT, Doug worked as a provider and administrator in numerous EMS systems over the decades. Doug also served as an EMS educator and instructor for many years.  Doug is a known as an engaging and humorous public speaker at EMS conferences throughout the United States. He is also a prolific author, having written books, articles and columns in many of the industry’s leading publications, and has been interviewed by national media outlets including National Public Radio and the Wall Street Journal on EMS issues. Doug is also a co-founder of the National Academy of Ambulance Compliance (NAAC). He is a JEMS editorial board member and also teaches healthcare law at the University of Pittsburgh and Commonwealth School of Law.  Doug can be reached at dwolfberg@pwwemslaw.com . Steve Wirth, Esq., EMT-P Stephen R. Wirth, Esq., EMT-P – Steve Wirth is a founding partner of Page, Wolfberg & Wirth, LLC, which represents EMS agencies throughout the United States, and a co-founder of NAAC, the National Academy of Ambulance Compliance.  In a distinguished public safety career that spans over four decades, Steve has worked in virtually every facet of EMS – as a firefighter, EMT, paramedic, flight paramedic, EMS instructor, fire officer, and EMS executive – and was one of central Pennsylvania’s first paramedics.  Steve is a dynamic and sought after speaker at EMS conferences nationwide, and has authored numerous articles and book chapters on a wide range of EMS leadership and EMS law topics.  He is a contributing writer for JEMS, (where he serves on the editorial board), EMS Insider, EMS1 and EMS World.  Steve teaches EMS law for the University of Pittsburgh EMS degree program and is also past Chair of the Panel of Commissioners for CAAS, the ambulance service accrediting body.  Steve can be reached at swirth@pwwemslaw.com . Sponsored Content is made possible by our sponsor; it does not necessarily reflect the views of our editorial staff. Journal Archives Prev 2016 2015 2014 2013 2012 2011 Next Feb 2016 Volume 41 Issue 2 Jan 2016 Volume 41 Issue 1 Prev 2016 2015 2014 2013 2012 2011 Next SUBSCRIBE DIGITAL EDITION   Featured Careers More Jobs   eNews Register for the JEMS eNewsletter, it's FREE! Sign-Up! JEMS Connect FEATURED GROUPS Disaster EMS   EMERGENCY! Lovers   Tactical Medicine   Humor In EMS     CURRENT DISCUSSIONS   JOIN JEMS CONNECT   EMS BLOGS Blogger Browser Today's Featured Posts Copyright © 2016: PennWell Corporation, Tulsa, OK. All Rights Reserved. UTILITY Home About Us Contact Us Terms of Use Subscribe Advertise Reader Service Submit a Press Release RSS Feeds Privacy Policy Topics News Patient Care Leadership Special Topics Major Incidents Operations Sections Authors Columns Community Jobs Journal Products Supplements Webcasts

    Magazine Articles

    Magazine Articles

    Mon, 21 Dec 2015

  2. EMS Providers Attend EMS on the Hill Day - Journal of Emergency Medical Services

    L ook out, Washington, here comes EMS. Paramedics and EMTs from across the country went to the hill for the third time to talk to members of Congress about what’s important to the EMS community and its patients. There’s only so much that can be done on the local and state levels. Federal funding ...

    Magazine Articles

    Magazine Articles

    Wed, 2 May 2012

  3. JEMS Founder James O. Page Honored - Journal of Emergency Medical Services

    A Worthy Honoree The National Association of EMS Physicians (NAEMSP) has dedicated next month’s keynote to an EMS pioneer. The James O. Page Memorial Lecture and Keynote Address will begin the NAMESP’s Scientific Assembly and Trade Show, Jan. 13–15, in Florida. Page, widely referred to as the ...

    Magazine Articles

    Magazine Articles

    Wed, 1 Dec 2010

  4. Speaking of Emergencies - Journal of Emergency Medical Services

    It's been about 20 years since my first workshop on therapeutic communication with a small volunteer firehouse, and I still get the same questions at my seminars: "What do I say when there's nothing to say?" or "How can I be reassuring when the situation looks pretty grim?" For instance, ...

    Online Articles

    Online Articles

    Tue, 8 Sep 2009

  1. Speaking of Emergencies - Journal of Emergency Medical Services

    Online Articles

    Online Articles

    Tue, 8 Sep 2009

  2. Must I Resuscitate? - Journal of Emergency Medical Services

    One common -- but complex -- medical-legal question that arises in EMS is whether there are circumstances when it's legally and ethically permissible not to attempt resuscitation on a cardiac arrest patient. Certainly, the decision not to resuscitate has irrevocable consequences for the ...

    Online Articles

    Online Articles

    Tue, 10 Feb 2009

  3. Must I Resuscitate? - Journal of Emergency Medical Services

    One common -- but complex -- medical-legal question that arises in EMS is whether there are circumstances when it's legally and ethically permissible not to attempt resuscitation on a cardiac arrest patient. Certainly, the decision not to resuscitate has irrevocable consequences for the ...

    Online Articles

    Online Articles

    Tue, 10 Feb 2009

  4. Priority Traffic: John Pryor killed in Iraq, economy challenges EMS, CDC promotes uniform triage - Journal of Emergency Medical Services

    Early Christmas morning, Philadelphia trauma surgeon John Pryor, MD, 42, was killed in Iraq by mortar fire while serving his second tour as an Army combat surgeon. John lived a life of service to others. He started in EMS at age 17 and, unlike some who use EMS to bolster their medical school ...

    Magazine Articles

    Magazine Articles

    Sun, 1 Feb 2009

  5. Possible Pandemic on Health Officials' Minds - Journal of Emergency Medical Services

    INDIANAPOLIS -- The discussion in Indianapolis this week is hardly light-hearted banter. If a pandemic influenza spread into the U.S. population, up to one-third of the people could be sickened, many would die, vaccines would not be available for six months and antiviral treatments might not work. ...

    Online Articles

    Online Articles

    Wed, 16 Jul 2008

  6. Pandemic Planning Strategies - Journal of Emergency Medical Services

    It's the middle of the night, and you're stepping into your rig to head out on a call. It seems like any other time in your EMS career, but as you rub the sleep from your eyes, you remember it isn't. Your community, and the nation, is entering the fifth week of a pandemic flu. ...

    Online Articles

    Online Articles

    Tue, 1 May 2007