You’re asking about the position of the Good Samaritan Physician in mid-air. To the best of my knowledge, no doctor has ever been sued for performing voluntary emergency services while in transit, yet it’s the fear of liability that bothers physicians most. With regard to the medico-legal implications, your duty as a physician is the same as it would be at all other times.

The Canadian Medical Association Code of Ethics obliges you to “provide whatever appropriate assistance you can to any person with an urgent need for medical care.” But in Canada, only Quebec imposes an actual legal obligation to help someone in peril, which counts for ordinary citizens as well as doctors.

In other provinces there’s either no special governing law, or a provision which exempts from liability those who provide aid, without expectation of compensation, in emergency medical situations, as long as there’s no gross negligence. So in Quebec, you have a duty to act, whereas in the rest of Canada you’re not obliged but you are protected from liability if you do.

In the case of the United States, the Aviation Medical Assistance Act also protects physicians from liability for the consequences of their acts and omissions, unless they’re “guilty of gross negligence or wilful misconduct.”

You ask about documentation and methods to reduce liability. Even though there doesn’t seem to be much risk of being pursued for damages, for maximum assurance I’d recommend that you show your credentials, speak with the patient or his companions, ask for an interpreter if necessary, and having obtained consent, carry out the appropriate examination and treatment. Communicate with ground support staff if possible or necessary, and report to the captain, especially regarding the necessity of diverting the plane to the nearest place for further treatment. Do the best with what’s available and keep good notes of it all. Then be proud that you’re in a position to help a person in need.

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