Flying Safe - Medics Onboard Qantas

[VA777]

http://www.australianfrequentflyer.com.au/community/showthread.php?t=66953

Will this need an Ethics Committee approval?

 

[Quickstatus]

Doctors are ethically required to assist in a medical emergency:

a)if called upon by another doctor or member of the public even if it is not known that they are doctors or not
b)if they are aware of a medical emergency which is not attended to by emergency first responders.
c)if the doctor cannot help they should help find medical assistance
d) the above does not apply if the doctor believes their lives or lives or others may be endangered by assisting in the emergency.

There was an Australian doctor who was reprimanded by a medical board for not stopping at an accident. the doctor apparently reported it but failed to attend.

Some Drs don't use the Dr title because they want to be treated the same as everyone else. There is an assumption which is probably true that as soon as Dr is used then the price goes up. However using "Mr/s" when you are a medical "Dr" does give absolution from attending to an emergency as above.

 

[artemis]

Doctors are ethically required to assist in a medical emergency:

a)if called upon by another doctor or member of the public even if it is not known that they are doctors or not
b)if they are aware of a medical emergency which is not attended to by emergency first responders.
c)if the doctor cannot help they should help find medical assistance
d) the above does not apply if the doctor believes their lives or lives or others may be endangered by assisting in the emergency.

There was an Australian doctor who was reprimanded by a medical board for not stopping at an accident. the doctor apparently reported it but failed to attend.

Some Drs don't use the Dr title because they want to be treated the same as everyone else. There is an assumption which is probably true that as soon as Dr is used then the price goes up. However using "Mr/s" when you are a medical "Dr" does give absolution from attending to an emergency as above.

I don't think the title used changes the ethical responsibility.

Additionally some surgeons use the title Mr/Ms/Mrs/Miss instead of doctor (I do not) so I don't think you can tell who's a doctor depending on their title.

 

[amaroo]

This is a fun read ... reaching the depths of CA or CPA or bookkeeper

 

[drron]

The law has already determined that doctors do have a duty of care to attend an emergency even if it is not a patient of theirs-
http://www.austlii.edu.au/au/journals/SydLawRw/1996/20.pdf

Interestingly the judge at the original proceedings also found that the child's paediatric neurologist at fault for not recommending to the family the use of valium rectally for fitting even though this was not recommended treatment in Australia.A specialist from the UK was found however who testified that it was the recommended treatment.That decision was overturned on Appeal and the specialist concerned went on to become the President of the Medical Council of NSW-the authority concerned with adjudicating on medical complaints.
The original judges decision though did convince many in the medical profession that the law was very fallible.

 

[medhead]

I wasn't going to post this: but no one has suggested the crew would check Ahpra rego online. What was suggested was the on the ground medical backup, for Qantas flights, have the ability to do such checks. Meaning the crew might not have to ask for ID because the check could be undertaken elsewhere, for australian registered doctors.

 

[puppysparkes]

Indeed. I would've expected such an umbrella committee to have a number of responsibilities besides just RCAs and possibly not be called the RCA committee. In any case, I'm impressed that they have a specific RCA committee.

Each state has slightly different legislation around RCA's, how a panel is formed, the objectives, reporting obligations, penalties, protections for panel members, including a person providing information for the purpose of an RCA. Patient safety is a fascinating field, especially rewarding when systemic recommendations are acknowledged and implemented, everyone wins! Edit: the improvement unfortunately comes at a cost born by the patients

 

[PaulST]

So medical thread was hijacked by lawyers?

Typical!

Medicine, in general, has been hijacked by the lawyers.

 

[puppysparkes]

The law has already determined that doctors do have a duty of care to attend an emergency even if it is not a patient of theirs-
http://www.austlii.edu.au/au/journals/SydLawRw/1996/20.pdf

Interestingly the judge at the original proceedings also found that the child's paediatric neurologist at fault for not recommending to the family the use of valium rectally for fitting even though this was not recommended treatment in Australia.A specialist from the UK was found however who testified that it was the recommended treatment.That decision was overturned on Appeal and the specialist concerned went on to become the President of the Medical Council of NSW-the authority concerned with adjudicating on medical complaints.
The original judges decision though did convince many in the medical profession that the law was very fallible.

So considering point 4 of that decision, and the fact that the practitioner concerned was on duty at his work place; I suggest there is still a grey area, and the decision may not apply to a practitioner who is 'not on duty'. This can be attributed to the plausible situation that off duty could mean a practitioner is on a flight, and is called upon for assistance. Therefore the matter reverts to the ethical obligation to provide care, if safe to do so.

 

[JohnM]

Medicine, in general, has been hijacked by the lawyers.

Not only medicine, I would suggest :evil:.

 

[drron]

So considering point 4 of that decision, and the fact that the practitioner concerned was on duty at his work place; I suggest there is still a grey area, and the decision may not apply to a practitioner who is 'not on duty'. This can be attributed to the plausible situation that off duty could mean a practitioner is on a flight, and is called upon for assistance. Therefore the matter reverts to the ethical obligation to provide care, if safe to do so.

But successful actions in Australia also for a fellow who denied he was a doctor and another for not stopping to assist at a vehichle crash he reported to authorities.So in Australia you should assist if you are aware there is a chance of someone needing medical assistance.
Most of us do anyway.
the second MVA I stopped at was a comedy.Again saw the accident and stopped.Worked out no one was in any danger and was about to go on my way when I was literally pushed to the ground by a woman screaming-"Out of my way.I am a nurse."I just laughed and went on my way.

 

[PaulST]

"Out of my way.I am a nurse."I just laughed and went on my way.

"Great, I'll have a skim flat white with no sugar, thanks"....


*I was a nurse before returning to uni so I'm allowed to make this joke.

 

[Cynicor]

But successful actions in Australia also for a fellow who denied he was a doctor and another for not stopping to assist at a vehichle crash he reported to authorities.So in Australia you should assist if you are aware there is a chance of someone needing medical assistance.
Most of us do anyway.
the second MVA I stopped at was a comedy.Again saw the accident and stopped.Worked out no one was in any danger and was about to go on my way when I was literally pushed to the ground by a woman screaming-"Out of my way.I am a nurse."I just laughed and went on my way.

Not sure which vehicle crash you are referring to, but if it is the one in WA with a female practitioner in the bush, it was overturned on appeal, as well it should have been. Terrible decision in the first place.

 

[Anna]

The law has already determined that doctors do have a duty of care to attend an emergency even if it is not a patient of theirs-
http://www.austlii.edu.au/au/journals/SydLawRw/1996/20.pdf

Interesting case. Typical that the Syd Law Review says that a decision of the NSW Court of Appeal is the law for all Australia but without quibbling too much about that, I think it's important to remember that a duty of care is a duty to take reasonable care, not an absolute duty to prevent harm. What's reasonable to do or not do is going to depend on the particular circumstances.

 

[puppysparkes]

I wasn't going to post this: but no one has suggested the crew would check Ahpra rego online. What was suggested was the on the ground medical backup, for Qantas flights, have the ability to do such checks. Meaning the crew might not have to ask for ID because the check could be undertaken elsewhere, for australian registered doctors.

I suspect that regardless of the mode of transport, bonafides should be requested and provided to remove any doubt of credentials. If the episode of care occurred on the ground, then it is highly likely that those details would be requested/required from the practitioner by a police service (within Australia). The same could occur/has occurred on board at the request of cabin crew, or at the end of a journey by the AFP, or a similar agency if travelling internationally.

 

[JessicaTam]

This has certainly been an interesting read.

I have good first aid training, and I have offered twice when assistance has been requested. I have stated my profession and ability to assist, and have not been required to assist in either case. I will continue to offer, and also continue to hope that there is a "doctor in the house" every time!

 

[medhead]

I suspect that regardless of the mode of transport, bonafides should be requested and provided to remove any doubt of credentials. If an the episode of care occurred on the ground, then it is highly likely that those details would be requested/required from the practitioner by a police service (within Australia). The same could occur/has occurred on board at the request of cabin crew, or at the end of a journey by the AFP, or a similar agency if travelling internationally.

That is my point. In the situation I've mentioned (Australia doctor, Qantas) it might very well be the case that bonafides have been checked! In this modern age asking the person to see a bit of paper may not be required to check on them. This isn't comparable to something on the ground where the backup system are unlikely to be in place.

 

[Dalescott]

My Daughter is a Doctor, and books as such. She have been called on twice to attend people on a QF Plane, one was a panic attack, and the other a Cardiac arrest (Very Serious). She has only once been upgrades to J, and never F. But they are quick to call on her services. After the Cardiac arrest she was upgraded to J, but that is the only time it has happened.
Also all QF flights carry a comprehensive medical kit.

 

[PLANT]

Maybe they should put the doctor as the pilot reliever?
Two birds one stone ( too soon?)

 

[artemis]

Maybe they should put the doctor as the pilot reliever?
Two birds one stone ( too soon?)

What a great idea! - happy to help out as long as I get the SC as well!

I enjoyed sitting in the right hand seat on my RFDS milk runs... Great to listen to ATC commentary. And try not to push any buttons.