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Medicalpractice版 - Good Samaritan law 及其他
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相关话题的讨论汇总
话题: samaritan话题: consent话题: good话题: patient话题: aid
进入Medicalpractice版参与讨论
1 (共1页)
f******w
发帖数: 10267
1
医护人员救死扶伤,这是大家在踏进医学院之时就开始受的熏陶。很多人从做住院医开
始就会遇到不同做义工的机会,也许是教会或某个慈善机构组织的免费就医日,或者是
某个医生组织发起的为社区的服务。在做义工或紧急时刻遇上救死扶伤的情形,怎样保
护你自己,是每一个在美国做医生首先需要考虑的。
下面是wiki上对Good Samaritan Law的解释,每个州的法律条例不一样,大家可以来说
说自己是如何处理这个问题的。
Good Samaritan law
http://en.wikipedia.org/wiki/Good_Samaritan_law
United States
The details of good Samaritan laws/acts in various jurisdictions vary,
including who is protected from liability and in what circumstances.[4] Not
all jurisdictions provide protection to laypersons, in those cases only
protecting trained personnel, such as doctors or nurses.[5]
Common features
In some jurisdictions, unless a caretaker relationship (such as a parent-
child or doctor-patient relationship) exists prior to the illness or injury,
or the "good Samaritan" is responsible for the existence of the illness or
injury, no person is required to give aid of any sort to a victim. Good
Samaritan statutes in the states of Minnesota and Vermont do require a
person at the scene of an emergency to provide reasonable assistance to a
person in need.[6] This assistance may be to call 9-1-1. Violation of the
duty-to-assist subdivision is a petty misdemeanor in Minnesota and may
warrant a fine of up to $100 in Vermont. At least five other states,
including California and Nevada, have seriously considered adding duty-to-
assist subdivisions to their good Samaritan statutes.[7] New York's law
provides for immunity for those who assist in an emergency.[8]
Good Samaritan provisions are not universal in application. The legal
principle of imminent peril may also apply.[9] In the absence of imminent
peril, the actions of a rescuer may be perceived by the courts to be
reckless and not worthy of protection. To illustrate, a motor vehicle
collision occurs, but there is no fire, no immediate life threat from
injuries and no danger of a second collision. If a 'good Samaritan' elects
to 'rescue' the victim from the wreckage, causing paralysis or some other
injury, a court may rule that good Samaritan laws do not apply because the
victim was not in imminent peril and hold the actions of the rescuer as '
reckless' and unnecessary.[10] See also, California Supreme Court decision
Van Horn vs. Torti, December 18, 2008 with similar fact pattern and
limitation of protection to medical personnel rendering medical aid.)
Any first aid provided must not be in exchange for any reward or financial
compensation. As a result, medical professionals are typically not protected
by good Samaritan laws when performing first aid in connection with their
employment.[11] Certain states make specific provisions for those trained
medical professionals acting as volunteers and for members of volunteer
rescue squads acting without expectation of financial compensation.[12]
If a responder begins rendering aid, he must not leave the scene until it is
necessary to call for needed medical assistance, a rescuer of equal or
higher ability takes over, or continuing to give aid is unsafe.[13] The
responder is not legally liable for the death, disfigurement or disability
of the victim as long as the responder acted rationally, in good faith and
in accordance with their level of training.[14]
Consent
The responder must not commit assault or battery by giving aid to a patient
without consent of the patient (or of the patient's legal guardian when the
patient is a minor) except in those cases where obtaining the consent of the
patient or guardian is not possible. All "Good Samaritans" shall state
their level of training if previously trained, and if no parent/ guardian/
relative is present to give consent, or if the victim is unconscious,
consent is implied.[citation needed]
Implied consent
Main article: Implied consent
Consent may be implied if the patient is unconscious, delusional,
intoxicated or deemed mentally unfit to make decisions regarding their
safety or if the responder has a reasonable belief that this was as such;
courts tend to be very forgiving in adjudicating this, under the legal
fiction that "peril invites rescue" (as in the rescue doctrine).[15] The
test in most jurisdictions is that of the 'average, reasonable person'. To
illustrate, would the average, reasonable person in any of the states
described above consent to receiving assistance in these circumstances if he
or she were able to make his or her own decision?
Consent may also be implied if the legal parent or guardian is not
immediately reachable and the patient is not considered an adult.
Parental consent
If the victim is a minor, consent must come from a parent or guardian.
However, if the legal parent or guardian is absent, unconscious, delusional
or intoxicated, consent is implied. A responder is not required to withhold
life-saving treatment (e.g., CPR or the Heimlich maneuver) from a minor if
the parent/guardian will not consent. The parent/guardian is then considered
neglecting, and consent for treatment is implied. Special circumstances may
exist if child abuse is suspected.[16]
[
Laws for first responders only
In some jurisdictions, good Samaritan laws only protect those who have
completed basic first aid training and are certified by health organizations
, such as the American Heart Association, or American Red Cross, provided
that they have acted within the scope of their training.[17] In these
jurisdictions, a person that is neither trained in first aid nor certified,
and who performs first aid incorrectly, can still be held legally liable for
errors made. In other jurisdictions, any rescuer is protected from
liability, so long as the responder acted rationally.[citation needed] In
Florida, paramedics and EMTs are protected statutorily from liability,
unless they were reckless.
A*******s
发帖数: 9638
2
This is a good topic and we may need some individual cases to discuss about.
S******9
发帖数: 2837
3
Let me ask a question:
You are a radiologist doctor and read a CT scan of brain which shows there
is a big tumor in the brain. Then you found out that the patient is a
colleague in your department. What will you do? Just send the report to
the PCP who is taking care of the patient or you can have a secret talk
with the patient?
Thanks
A*******s
发帖数: 9638
4
Great question.
If it is a benign tumor, maybe I'll let my collegue know.
But If it is a bad news, I'll defer to PCPs in a heart beat.
The patient-physician relationship is very tricky for this type of problems.
The patients usually have trust on their PCPs. But for radiologists? no
way. 所以radiologists很容易被诉。

【在 S******9 的大作中提到】
: Let me ask a question:
: You are a radiologist doctor and read a CT scan of brain which shows there
: is a big tumor in the brain. Then you found out that the patient is a
: colleague in your department. What will you do? Just send the report to
: the PCP who is taking care of the patient or you can have a secret talk
: with the patient?
: Thanks

f******w
发帖数: 10267
5
不摄入,因为没有直接的patient-physician关系。如果PCP需要跟你谈结果,可以跟
PCP讨论,也可以三方谈。看到过一例,radiologist读片是tumor,但是PCP认为不是,
三方讨论过之后,重新做片,重新读,第三者读,发现,那的确不是tumor。

【在 S******9 的大作中提到】
: Let me ask a question:
: You are a radiologist doctor and read a CT scan of brain which shows there
: is a big tumor in the brain. Then you found out that the patient is a
: colleague in your department. What will you do? Just send the report to
: the PCP who is taking care of the patient or you can have a secret talk
: with the patient?
: Thanks

A*******s
发帖数: 9638
6
我认为radiologist与病人应该有patient-physician关系,尽管不是直接的。 所以有
人提倡radiologist直接与病人谈结果。 而且病人也可以告radiologist。
比方说病人问radiologist超声检查的结果, 这是做完就知道结果的, 如果病人非要
知道, radiologist有责任告诉病人。 当然好结果没问题,坏结果就很tricky。

【在 f******w 的大作中提到】
: 不摄入,因为没有直接的patient-physician关系。如果PCP需要跟你谈结果,可以跟
: PCP讨论,也可以三方谈。看到过一例,radiologist读片是tumor,但是PCP认为不是,
: 三方讨论过之后,重新做片,重新读,第三者读,发现,那的确不是tumor。

S******9
发帖数: 2837
7
another question:
When you deliver a bad result to your patient who is a middle-age woman.
She is very emitional and begining to shout at you when you begin to speak
to her. What should you do?
Can we let the patient stay alone until she calms down and return to the
room later?
A*******s
发帖数: 9638
8
某些坏的疾病, 你最好setup一个family conference。 当着病人询问, how much do
you want to know?
如果出现你说的情况, 你的body language可能比verbal language更管用, give the
patient tissue, and let the patient talk/yell。 你需要让病人知道, You
feel the pain as intense as the patient has.
所以我不知道我能不能当一个oncologist。 也许他们已经不需要再deliever一次坏消
息了。

【在 S******9 的大作中提到】
: another question:
: When you deliver a bad result to your patient who is a middle-age woman.
: She is very emitional and begining to shout at you when you begin to speak
: to her. What should you do?
: Can we let the patient stay alone until she calms down and return to the
: room later?

f******w
发帖数: 10267
9
为啥会喊?坏消息还没有deliver给她呢。

【在 S******9 的大作中提到】
: another question:
: When you deliver a bad result to your patient who is a middle-age woman.
: She is very emitional and begining to shout at you when you begin to speak
: to her. What should you do?
: Can we let the patient stay alone until she calms down and return to the
: room later?

f******w
发帖数: 10267
10
这个要特别小心,set up之前一定要看病人的consent里面有没有同意家人知道结果。
很多老美,虽然是夫妻,也不希望对方知道自己的病情。

【在 A*******s 的大作中提到】
: 某些坏的疾病, 你最好setup一个family conference。 当着病人询问, how much do
: you want to know?
: 如果出现你说的情况, 你的body language可能比verbal language更管用, give the
: patient tissue, and let the patient talk/yell。 你需要让病人知道, You
: feel the pain as intense as the patient has.
: 所以我不知道我能不能当一个oncologist。 也许他们已经不需要再deliever一次坏消
: 息了。

相关主题
请问大家,三十出头的男士,年薪20万左右,受女士欢迎吗? (转载)CMG灌水是必须的
physicianThe American Medical Association has weighed in on Obama's new health care package:
有个radiation的问题 for Radiologists.中美医疗合作俱乐部--帮助中国献爱心活动
进入Medicalpractice版参与讨论
f******w
发帖数: 10267
11
现在就有很多告radiologist的例子,所以这些radiologist都狡猾狡猾地,为了cover
他们自己,一定会把他们看见的都写在报告里,而且最后一句永远都是,治疗请与你的
医生协商。这样把order片子的医生都一起套进去。

【在 A*******s 的大作中提到】
: 我认为radiologist与病人应该有patient-physician关系,尽管不是直接的。 所以有
: 人提倡radiologist直接与病人谈结果。 而且病人也可以告radiologist。
: 比方说病人问radiologist超声检查的结果, 这是做完就知道结果的, 如果病人非要
: 知道, radiologist有责任告诉病人。 当然好结果没问题,坏结果就很tricky。

S******9
发帖数: 2837
12
就是这样的呀,医生还没开始说话,这个妇女情绪不稳定,很激动。

【在 f******w 的大作中提到】
: 为啥会喊?坏消息还没有deliver给她呢。
A*******s
发帖数: 9638
13
如果病人对医生有反感, 医生的存在可能会让病人更激动, 这时选择回避一下比较好
。 可以让护士过来照看一下病人。 随便说一句, 护士非常非常重要, 我的两个护士
都不错,其中一个我是太满意了。:)

【在 S******9 的大作中提到】
: 就是这样的呀,医生还没开始说话,这个妇女情绪不稳定,很激动。
s*******1
发帖数: 428
14
太满意了,也要小心。看看施瓦哥就是对保姆太满意了。:(

我的两个护士都不错,其中一个我是太满意了。:)

【在 A*******s 的大作中提到】
: 如果病人对医生有反感, 医生的存在可能会让病人更激动, 这时选择回避一下比较好
: 。 可以让护士过来照看一下病人。 随便说一句, 护士非常非常重要, 我的两个护士
: 都不错,其中一个我是太满意了。:)

A*******s
发帖数: 9638
15
LOL!
You just can not compare a physician to a politician, like an apple to
an orange.

【在 s*******1 的大作中提到】
: 太满意了,也要小心。看看施瓦哥就是对保姆太满意了。:(
:
: 我的两个护士都不错,其中一个我是太满意了。:)

f******w
发帖数: 10267
16
提醒的好!哈哈哈。

【在 s*******1 的大作中提到】
: 太满意了,也要小心。看看施瓦哥就是对保姆太满意了。:(
:
: 我的两个护士都不错,其中一个我是太满意了。:)

1 (共1页)
进入Medicalpractice版参与讨论
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相关话题的讨论汇总
话题: samaritan话题: consent话题: good话题: patient话题: aid