Event Medicine and the Law

Most of our Odyssey crew members are health care professionals or licensed care providers – so you may be wondering how the law and event medicine intersect with your role on event?

1. I have no legal obligation to help when I am not on-duty!

True, but…

While Common Law jurisdictions (i.e. most of Canada) do not impose a duty for off-duty health care professionals to act in case they come across an emergency, there are 2 exceptions to the rule in Canada:

a) If you are in Quebec: Section 2 of The Charter of Human Rights and Freedoms (not to be confused with the Canadian Charter of Rights and Freedoms) states, “Every person must come to the aid of anyone whose life is in peril, either personally or calling for aid, by giving him the necessary and immediate physical assistance, unless it involves danger to himself or a third person, or he has another valid reason.”

b) If you are piloting or mastering a boat: Section 132 of the Canada Shipping Act, 2001 states “The master of a vessel in Canadian waters and every qualified person who is the master of a vessel in any waters shall render assistance to every person who is found at sea and in danger of being lost.” The duty to render assistance at sea is not actually unique to Canada – it is an International Law requirement for every boat operator around the world.

Why this is important: Legal obligation aside – do you have a moral duty to act?

2. Good Samaritan Legislation (GSL) protects me! 

Not so fast …

(The wording of the legislations varies across Canada so you should refer to your own jurisdiction’s legislation for the exact details.)

If you assist in a motor vehicle accident as you are walking to work – you will likely be covered under the provisions of GSL. However, if you are on event, wearing a medical team t-shirt and standing at one of the medical treatment areas, arguably you WOULD NOT be covered under the GSL.

GSL was enacted with the view of unforeseen medical emergencies. With equipment that you can typically find at a medical team deployment, along with the logistics and infrastructure for support, we are in the view that the GSL will not apply to crew members on an event site where the situation is more akin to a walk-in clinic or other type of health clinic.

To be clear, even if GSL applies – it is not blanket coverage. Your provincial/territorial GSL may hold you to a higher standard of care than a lay bystander.  

“Even during an attempt to assist someone in an emergency, the law expects reasonable care to be exercised, even though the standard is relaxed to a certain extent. The Court does not expect perfection, but rescuers must be sensible. They, like anyone else, must weigh the advantages and the risks of their conduct. Their conduct, too, however laudable, must measure up to the standard of the reasonable person in similar circumstances.”

Paragraph 33 of Cleary v. Hansen, 1981 O.J. No. 1513 (Ontario Supreme Court – now known as the Ontario Superior Court of Justice)

Why this is important: We are not aware of any lawsuits in Canadian jurisdictions stemming from Good Samaritan actions. However, without sufficient general liability/malpractice insurance covering your actions at an event; you may be held personally liable for damages as a result of your action or omission.

3. I am a healthcare professional. I don’t have to abide by the same standard as I am in hospitals/ clinics/ ambulances when I am on event!  

Myth!

For example, the British Columbia College of Nurse Professionals specifies regardless of the nature of the work you do, you are expected to meet all the practice standards as you would in your “day job”.  This is also the same expectation for the College of Nurses of Ontario and the College & Association of Registered Nurses of Alberta. You will likely find similar policies from your regulator.

Why this is important: You can be disciplined by your regulator for failing to achieve the standard of care expected of you. This can range from perhaps a reprimand on record, to fines, to suspension/revocation of your license.

4. I looked after a patient, but did not write down the specific details. What’s the big deal?

YIKES!

IF YOU DID NOT WRITE IT DOWN, IT NEVER HAPPENED. PERIOD.

Imagine there is a question about the care you provided on one very busy summer night 4-5 years ago. Would you remember your patient necessarily? Even if you do, can you conclusively tell a judge or your regulator what exactly happened with the patient care if you have a spotty chart?

Why this is important: Failure to chart, or incomplete charting can lead to difficulties WAY down the road. You may have provided excellent care, however without the chart to support the assertion, you may well be on the losing end of a court case or professional investigation. Remember: It is your professional obligation to document your assessment, the care you provided, the recommendation you provided to the patient about follow-up care and, most importantly, what happened to the patient at the end.

5. I am not yet licensed by a regulator (i.e. student) SO I am not liable for my actions, right? I don’t know what I don’t know!  

NOPE!

Despite not being licensed to independent practice by a regulator, you are expected to be accountable for your actions. As the Canadian Nurses Protective Society notes, nursing students have been successfully sued in British Columbia and Nova Scotia. This is also the case with residents and medical students.  If you are unsure about a procedure or plan, ASK! You are not alone in the care of your patients, and you should never feel anything but a sense of responsibility to seek help when you are in doubt. As a student (or newly licensed member of the healthcare team), don’t be afraid to confer with your supervisors – they are invaluable resources!

Why this is important: Collaboration and communication are key to the best outcome for patient care. Multi-disciplinary teams on site allow us to pick each other’s brains and learn from each other. You will learn skills that you may never acquire working in an institutional environment. You will probably learn quickly, either on your own or with your colleagues, to adapt to the event medicine environment – reorienting yourself to the space, finding the items you need, and finding treatment options unique to our environment.

6. I have a patient who is having a psychotic episode and warrants further intervention from mental health clinicians, so I will hold the patient at the medical tent. 

Unlikely.

Mental health legislation differs in each Provinces/territories – however, in general, only certain groups of physicians, or certain facilities designated by the government can legally hold people against their wishes under evaluation. In some cases, the law dictates the person must be removed by emergency medical services to be transported to a designated hospital for further observation.

Why this is important: This has an impact on how we handle Code White (aggressive person) scenarios. If an event is held in the middle of nowhere with the nearest hospital a long ways away – what kind of logistical planning with emergency medical services is needed?

The information presented herein are for information purposes only, and does not constitute as legal advice. If in doubt, contact your regulator’s practice advisor, your employer or a lawyer for assistance.

Author: Stephen is the Legal and Compliance Advisor of Odyssey and a long-time event veteran. He is a master researcher who assists us in making sure we always colour inside the lines. 

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