Emirates taking liberties with medical assistance?

[cqtiger]

It is very presumptuous. Many allied health professional can legally use the title including dentists vets chiros, optoms podiatrists as well as PhDs

 

[offshore171]

Where does the Hippocratic oath or code of ethics fit into all this?

 

[rechoboam]

In the case of Lufthansa, they were asking for volunteers. How is that unreasonable?

In fact, Lufthansa even has a program where frequent flyers who are doctors can enrol into, and the doctors also receive various benefits (and optional training) in return - https://www.lufthansa.com/de/en/doctor-on-board

The benefits are carefully calibrated so as to not breach Good Samaritan principles of help without reward. I already have a better textbook than they offer and from memory the FF points were worth $30...my specialty is critical care in remote environments and training is superfluous so at least in my case I would receive a warm glow, and in return they receive an on call medical specialist for free. After hearing stories of people helping multiple times in a single flight - this wasn’t the first - I think these airlines need to staff properly for the need that is clearly arising. They need a medic/paramedic/RN with resus skills, appropriately and formally indemnified legally and guaranteed to not be impaired by alcohol or sedatives. This is as much for pax safety as my convenience. But I’m also genuinely concerned about assuming a duty of care - if cabin crew ask me if I’m prepared to help, and I’m too embarrassed to refuse, and then I allow myself to become intoxicated or I’m already too fatigued by takeoff I see that as a problem. Particularly in Dubai where doctors have been quite harshly treated after deaths in flight and become quite concerned for their safety.

 

[rechoboam]

Where does the Hippocratic oath or code of ethics fit into all this?

Hippocratic oath doesn’t apply, we don’t encounter it in Australia. I think it’s an oath not to perform surgery as much as anything else. There’s no legal obligation to assist a stranger in theory in Australia. There have been cases which almost challenged this. Failure to assist is however an offense in some European countries at least.

 

[Quickstatus]

Where does the Hippocratic oath or code of ethics fit into all this?

When someone becomes a medical practitioner - “doctor” for the purposes here, there is a social license that comes with the job. That you are obliged to give medical assistance, when requested of you. In fact it is ethically wrong to refuse assistance and you may be formally called to account if you don’t.

There are many outs of that clause. For example : too far away, physically or mentally incapable - too tired / unwell or just imbibed a bottle of red, or you know someone else is officially on call.
The injunction is strong however.

So the community does not expects a Dr walking down to street to be permanently on call with the phone on for stuff like that, but when called upon be prepared to assist or find some who can.

Not so long ago, a country GP was travelling along a country road. She though a car passing her crashed. Didn’t stop but drove into town to report it. After a while the cops reported her to the medical board for not stopping and checking. She was reprimanded for not stopping and checking to see if medical assistance was required.
And what if any financial or other beneficial consideration . Always been nil.

Did you know there is no Medicare rebate for doing CPR or otherwise rendering medical assistance at an emergency?. At most you could charge a consultation fee but you wouldn’t because it’s not worth the effort and raises legal liability rather than Good Samaritan protection

Does that ethical injunction stop at the aircraft door - no.

As for me. I always book as Mr.
If they ask I will assist

Here is the GP story:

Improper professional conduct when a doctor fails to render assistance at a motor vehicle accident

Thank you to my colleague, Ruth Townsend, for bringing the case of Dr Dekker to my attention. On 27 April 2002, Dr Dekker was driving near Roebourne in Western Australia. Around 6.30pm on a dark ni…

emergencylaw.wordpress.com

Hippo oath?. Never took it

 

[moa999]

They need a medic/paramedic/RN with resus skills, appropriately and formally indemnified legally and guaranteed to not be impaired by alcohol or sedatives.

Isn't that what they do have on the other end of the sat phone.

 

[Steady]

Hippocratic oath doesn’t apply, we don’t encounter it in Australia. I think it’s an oath not to perform surgery as much as anything else. There’s no legal obligation to assist a stranger in theory in Australia. There have been cases which almost challenged this. Failure to assist is however an offense in some European countries at least.

I renewed my CPR recently and was advised it is illegal to walk past someone in need, in the NT - did I misunderstand this?

 

[p--and--t]

I'm not a Dr (not even of the mating habits of amazon ants), and although it would be nice to think assistance would be rendered in a true emergency, surely doctors are entitled to sit back and relax on their holidays from a stressful job just as much as plumbers, carpenters, accountants, crane-drivers etc etc without implied pressure being put on them being ready for anything 24/7 with no recompense.

 

[docjames]

I've had this asked of me before on Qantas - more "are you a medical doctor" - on boarding and with the old WP greeting.

I've helped out multiple times before, always happy to do so, but I would be rather annoyed if it was 'expected' that I would be willing to help in any situation (asleep, drunk, sick myself etc). So no, I don't think you're being precious.

Mind you qantas refuses to change my title from Miss to Dr for lord knows why on my QFF profile, so now Dr only goes on when work books my flight!

My QFF profile is listed with Dr so they should be able to change it for you although mine was changed some years ago now. I originally changed it because I was having difficulty with SCs not appearing when booked as Dr and FF profile was Mr. That gremlin seems to hav largely gone away (in the reverse anyway when booked now as Mr) but no need to change it back in QFF.

I do get asked occasionally what sort of doctor I am, usually in chit chat with the crew (and have responded to the overhead announcement a number of times - one with the FA standing looking at me whilst the CSM was doing the announcement - so they’d clearly checked the manifest and I was the only “listed” Dr on board) however I was always of the understanding it had to be “voluntary” to assist (mostly for the doctor’s liability under Good Samaritan act within Australia). I do wonder having now volunteered a number of times over the years that the long haul CSM’s tablet actually contains some of this info - one particular emergency which we managed onboard the CSM took quite a lot of my details at the end of the flight but I never heard any more of it (and the pax was clearly going to be ok in the end - waste of a business reward seat that was - spent most of the cruise mid-economy cabin with the unwell pax!).

If handled politely / correctly (eg. if boarding is slow and you get stalled near the entry and you’re standing there waiting with them sometimes the CSM/FAs will ask “what sort of doctor are you” or are you a medical doctor” in a casual/chit-chat sort of way - but clearly working out “who is this guy and would he be useful if there’s an issue” and not pursuing with a “we know where to find you if we need you” sort of approach).

I’ve also answered after the overhead to have the FA approach me and ask what sort (“we have a number of doctors on board tonight”) - and they told me which other sort of doctor was already attending or that they’d stopped at first and dispatched to the sick pax downstairs so I suggested that specialist would likely be well qualified to handle the issue described (abdominal pain) but I would come and assist if they wanted more help / pax deteriorated.


My gut feeling on the OP is that perhaps EK crew (remembering how many there must be and “in service” training would be difficult to get all of them beyond doing with all the mandatory stuff) have been instructed to assess qualifications of the Drs aboard, and given some basic instruction / email instruction (eg. When greeting you should ask) but it’s been lost in the translation in how it’s applied on board (ie. not subtly).

 

[tgh]

Hm .. and the electronics tech who designed the software that is now malfuctioning and may cause the aircraft to crash… has some kind of issue in deciding to help ?
Should I consider my mental and physical readiness as well as my present inclination before helping that passenger escape the burning car ?
A whole raft of humans have skills that may save other humans, medicine is just another skill.
I opine that everyone faced with the opportunity to save a life or lives should jump at the chance AND be held harmless at law if the assistance was imperfect.

 

[RooFlyer]

In the case of Lufthansa, they were asking for volunteers. How is that unreasonable?

They appear to have been asking for 'pre registration' which then seems to imply a obligation to attend later on. Whilst I don't think any doctor would with hold assistance is required, I wouldn't feel obliged to pre commit, myself ( if I was Dr.)

The benefits of their 'doctor on board' program appear to me to be light on for the significant facility being provided by the doctors.

 

[Isochronous]

Hippocratic oath doesn’t apply, we don’t encounter it in Australia. I think it’s an oath not to perform surgery as much as anything else. There’s no legal obligation to assist a stranger in theory in Australia. There have been cases which almost challenged this. Failure to assist is however an offense in some European countries at least.

That's true at least in VIC where state-sanctioned murder is now legal.

It is very presumptuous. Many allied health professional can legally use the title including dentists vets chiros, optoms podiatrists as well as PhDs

A chriopractor, optomotetrist or podiatrist is not a doctor. It may not be illegal for them to use the title but it is misleading and delusional for them to do so.

 

[Quickstatus]

I renewed my CPR recently and was advised it is illegal to walk past someone in need, in the NT - did I misunderstand this?

There is no legal duty of care to provide first aid even if you have a piece of paper to suggest you have a CPR skill.

Except if :
Personally involved in an accident
You are the first aid officer at your workplace and are paid for that skill
When you take responsibility for minding another person - say a child (babysitting) and you have first aid.
You are a medical practitioner, nurse , emergency responder - paramedic firefighter whether on duty or not.

 

[p--and--t]

A chriopractor, optomotetrist or podiatrist is not a doctor. It may not be illegal for them to use the title but it is misleading and delusional for them to do so.
[/QUOTE]

What. By what reasoning do you pick on them and leave alone the researchers into why the pyramids are shaped like pyramids who call themselves doctors? If they are legally entitled to the designation of Dr, then they are doctors.

 

[rechoboam]

When someone becomes a medical practitioner - “doctor” for the purposes here, there is a social license that comes with the job. That you are obliged to give medical assistance, when requested of you. In fact it is ethically wrong to refuse assistance and you may be formally called to account if you don’t.

There are many outs of that clause. For example : too far away, physically or mentally incapable - too tired / unwell or just imbibed a bottle of red, or you know someone else is officially on call.
The injunction is strong however.

So the community does not expects a Dr walking down to street to be permanently on call with the phone on for stuff like that, but when called upon be prepared to assist or find some who can.

Not so long ago, a country GP was travelling along a country road. She though a car passing her crashed. Didn’t stop but drove into town to report it. After a while the cops reported her to the medical board for not stopping and checking. She was reprimanded for not stopping and checking to see if medical assistance was required.
And what if any financial or other beneficial consideration . Always been nil.

Did you know there is no Medicare rebate for doing CPR or otherwise rendering medical assistance at an emergency?. At most you could charge a consultation fee but you wouldn’t because it’s not worth the effort and raises legal liability rather than Good Samaritan protection

Does that ethical injunction stop at the aircraft door - no.

As for me. I always book as Mr.
If they ask I will assist

Here is the GP story:

Improper professional conduct when a doctor fails to render assistance at a motor vehicle accident

Thank you to my colleague, Ruth Townsend, for bringing the case of Dr Dekker to my attention. On 27 April 2002, Dr Dekker was driving near Roebourne in Western Australia. Around 6.30pm on a dark ni…

emergencylaw.wordpress.com

Hippo oath?. Never took it

I’m not convinced there is any obligation, certainly there isn’t legally here (Dekker had a few unique features but was overturned anyway with no clear obligation found to exist). But if you are on xx_Xistan airlines flying from Burma to Bhutan no-one will be able to unpick the legal situation anyway and Australian precedents aren’t useful.

My increasing concern stems from the words you used “walking down the street”. You see if someone falls over in the street, anyone is free to call 000 and people whose job it is to respond will come and do their job. I’m just another civilian passing by who is free to assist an unfortunate stranger. This is different. This is a commercial enterprise taking $millions to lock hundreds of unscreened people in a tube for up to more than eighteen continuous hours, and providing no skilled assistance should a problem occur in an increasingly ageing society. They are recognising that there is a very significant chance of their needing to facilitate assistance for the passengers. They are recognising that the ground medical staff alone are not sufficient for the purpose. They are engaging paying passengers as on-call staff and applying moral pressure upon them to help. Then they are offering the very same passengers large amounts of alcohol, certainly more than enough to incapacitate them. When companies charter a ship to Antarctica they provide medical staff (is my understanding) and I don’t think the current situation is OK. The role of doctors on board should be to offer a dedicated paramedical officer assistance when a situation is out of control.

I’ll just add one other thing - I’m hearing numerous reports of people being called because of crying babies - they are being asked to help in case the child has ear pain - and other similar problems that wouldn’t even merit a GP visit on the ground.

 

[rechoboam]

There is no legal duty of care to provide first aid even if you have a piece of paper to suggest you have a CPR skill.

Except if :
Personally involved in an accident
You are the first aid officer at your workplace and are paid for that skill
When you take responsibility for minding another person - day a child and you have first aid.
You are a medical practitioner, nurse , emergency responder - paramedic firefighter whether on duty or not.

In Australia.

If you are in France, for example, the legal situation is entirely different. And we are talking about international flying here so the legalities are completely unclear and untested. And that’s where there are legalities at all, what happens when you are in, over or diverted to a country with no rule of law heaven only knows.

 

[sjk]

I know a Juris Doctor who uses Dr

I hope he’s not an utter tosser about wine and credit card churning too.

 

[drron]

Mattg that's all very well if you know it's not going to affect you.But European law is based on the French.The Good Samaritan law there says you must give aid or face prosecution.As well the person who gives the assistance is liable for any injury caused to those helped.
So I would not answer in the positive to Lufthansa's request.

https://www.daneurope.org/c/document_library/get_file?uuid=c09228f3-a745-480b-9549-d9fc8bbbd535&groupId=10103

Germany is slightly different in that if you are a German citizen you will be covered by their accident insurance if you are providing help.But it is a mandatory scheme paid for by employers so not known if foreign nationals would be covered.I don't want to be the test case.

In the case of France even if I provide assistance on a plane that is in French airspace but not landing in France I could be sued if any untoward complications.Most fortunately wouldn't know they could sue.

 

[rechoboam]

I hope he’s not an utter tosser about wine and credit card churning too.

Well he has been awarded a doctorate so can use that title I suppose. Pretty sure that the “doctorate” doesn’t involve an actual doctoral dissertation and is basically a courtesy title like a medical practictioner’s if not more so.

 

[Hvr]

That's true at least in VIC where state-sanctioned murder is now legal.

Or to give it its proper title; Voluntary Assisted Dying.

Voluntary assisted dying

The Victorian Government believes all Victorians are entitled to quality end of life care, which relieves pain and suffering, and provides compassionate support to family, friends and carers.

www2.health.vic.gov.au

Another group who use the title Doctor is veterinarians. Might be good if a support animal needs medical assistance whilst flying.

As a non-medical person who frequently uses the services (as I get older) of human medical professionals am appreciative of their skills and abilities.

I agree there needs to be a system whereby medical professionals are protected when giving urgent medical assistance and act within the limits of their qualifications and abilities.

My emergency medical attendee story.

Many, many years ago when I was a qualified first aider there was a major car collision against the premises I worked and there were injuries. By the time I got to the scene (maybe a minute, it was a big premise) there was an ambulance officer and a doctor arguing about how to treat the casualty.

With two identified medical professionals on scene there was no need for my first aid abilities. I then assumed the role of securing the scene and ensuring the medical professionals weren't disturbed.

The ambulance officer and doctor were arguing about what should be done immediately for the seriously injured casualty. The ambulance officer said it was his scene and the doctor could 'sod off'. With police arriving the doctor did indeed 'sod off' . The other ambulance officer was dealing with another casualty.

The police checked the doctors credentials and were satisfied they were a genuine doctor with the appropriate abilities to attend but sided with the ambulance officer about who had control of the scene.

It was interesting being a mute fly on the wall.