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  #1  
Old 05-24-2004, 02:36 PM
muldoonthief muldoonthief is offline
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Can a Doctor refuse to treat a patient?

Are there circumstances where a Doctor can refuse to provide treatment to a patient? Specifically a patient whose life is in immediate danger - I'm not talking about a PCP who trims his patient list as he goes into semi-retirement or something like that. Also, for the sake of argument assume there is no other doctor available - I'm assuming it's OK for a doctor in an ER to ask another doctor to treat a patient that he/she doesn't want to for whatever reason.

What would be the legal repercussions of a doctor refusing to treat a patient?

And for those who've guessed - yes, this was inspired by a TV movie my wife was watching on Lifetime. I cannot figure out why any women like to watch anything on that network, but that's an IMHO post (which I'm going to write next).
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  #2  
Old 05-24-2004, 03:01 PM
Shade Shade is offline
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If treating would endanger the life of the doctor or another person?
If the doctor is not licensed in that country?
If the doctor is incapacitated in some way, and thinks his help would be worse than nothing?

But I don't think these are really what you're asking. I do seem to recall that doctors ARE obliged to help (in the US and UK, I think), thought everyone else isn't, and that this law ISN'T called the "good samaritan law" though lots of people think it is. But we'll have to wait for a doctor or a lawyer for the real answer.
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  #3  
Old 05-24-2004, 03:05 PM
CrazyCatLady CrazyCatLady is offline
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Well, it kind of depends. If we're driving down the road and see a nasty wreck where someone is bleeding to death and EMS hasn't arrived yet, Dr.J is not legally obligated to stop and help. If he does stop, his legal responsibility varies by locale. In a lot of places, once he's stopped, he's legally obligated to do everything he can to help, and to stay with the patient until he has transferred care to the paramedics.

He can also refuse to see patients in his clinic because they're assholes, because they're medically noncompliant, because they're getting narcotic prescriptions from three other doctors, or a variety of other reasons. I've known patients to get kicked out of the only dialysis center in town for being verbally abusive to the nurses and continually missing appointments. Refusing to treat a patient under those circumstances is well within a doctor's right, so there are no legal ramifications at all, even though the dialysis patient will die in very short order if she doesn't get the treatment somewhere.

As far as an emergency room doctor who is currently on duty refusing to treat a critical patient who has just rolled into the ER, you can lose your license for that, as well as being sued for boucoup bucks in a wrongful death/malpractice case.
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  #4  
Old 05-24-2004, 03:14 PM
Martin Hyde Martin Hyde is offline
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The Good Samaritan law(more accurately laws) are laws that have been passed in all fifty states that govern aspects of first aid administration and other actions of persons who are attempting to help others in a medical crisis of some sort. Each state has its own laws and they differ slightly from state to state.

The basic principle is that a rescuer cannot be held negligent for causing injury to the person he is attempting to rescue as long as the rescue attempt is considered to be reasonable.

It has some grey area. But for example, pulling a person out of a burning car, and in the process say, seriously aggravating one of their broken legs, would be something you could not be sued for under the good samaritan law (well, it could be brought to court, but would almost definitely be dismissed on those grounds.)

However, say you are in a second floor apartment and an oven catches on fire, you can't throw someone out the window and say "I was saving them from the fire" because it is most obviously unreasonable.
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  #5  
Old 05-24-2004, 10:09 PM
TeaElle TeaElle is offline
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What kind of grounds are we talking about?

"I can't treat you because I'm physically incapacitated at the moment because I'm having a mini-stroke/having an allergy attack set off by the perfume you doused yourself with/in extreme pain because you, in a delusional state, grabbed and twisted my testes."

"I can't treat this man! He's the drunk driver who killed my wife and child two years ago!"

"I'm sorry, Mrs. Smith, I cannot treat your vaginal bleeding, even though you're clearly shocky and in severe pain. You see, I am an extremely observant Orthodox Jew and today is a holiday, and if I touch you, I will be unable to participate in the services at synagogue this afternoon." (Note to Orthodox Dopers: I know this is not an accurate portrayal of the situation faced by observant physicians.)

"I won't treat this (insert racial or sexuality slur of choice here)! Get Jones, he treats this kind."

"I'm sorry, I'm unable to continue. Nurse Rogers, continue with all of my orders. Nurse Andrews, please run and get Dr. Robinson, she can take over for me."

To sum up, I think that the repercussions that the doctor would face would depend largely on the circumstances.
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  #6  
Old 05-24-2004, 10:56 PM
Master Wang-Ka Master Wang-Ka is offline
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Well, duh. I could sue TeaElle for refusing to get off her computer and go get me a beer, right now.

My chances of success with the lawsuit, however, range from laughable to nil.

By the same token, you could sue a doctor for refusing to treat you, under nearly any circumstances; whether or not the case would be thrown out of court, or whether you would win it, depend largely upon the circumstances. There is no law requiring doctors to be on duty 24/7 and drop everything if someone across the dining room seems to be choking on a parsley sprig.

A doctor on duty, however, is a different beast, and it's then up to him to demonstrate to the court some compelling reason why he could not carry out his duties.
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  #7  
Old 05-24-2004, 10:57 PM
Master Wang-Ka Master Wang-Ka is offline
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Well, duh. I could sue TeaElle for refusing to get off the computer and go get me a beer, right now.

My chances of success with the lawsuit, however, range from laughable to nil.

By the same token, you could sue a doctor for refusing to treat you, under nearly any circumstances; whether or not the case would be thrown out of court, or whether you would win it, depend largely upon the circumstances. There is no law requiring doctors to be on duty 24/7 and drop everything if someone across the dining room seems to be choking on a parsley sprig.

A doctor on duty, however, is a different beast, and it's then up to him to demonstrate to the court some compelling reason why he could not carry out his duties.
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  #8  
Old 05-25-2004, 10:12 AM
muldoonthief muldoonthief is offline
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Quote:
Originally Posted by TeaElle
What kind of grounds are we talking about?

"I can't treat you because I'm physically incapacitated at the moment because I'm having a mini-stroke/having an allergy attack set off by the perfume you doused yourself with/in extreme pain because you, in a delusional state, grabbed and twisted my testes."

"I can't treat this man! He's the drunk driver who killed my wife and child two years ago!"

"I'm sorry, Mrs. Smith, I cannot treat your vaginal bleeding, even though you're clearly shocky and in severe pain. You see, I am an extremely observant Orthodox Jew and today is a holiday, and if I touch you, I will be unable to participate in the services at synagogue this afternoon." (Note to Orthodox Dopers: I know this is not an accurate portrayal of the situation faced by observant physicians.)

"I won't treat this (insert racial or sexuality slur of choice here)! Get Jones, he treats this kind."

"I'm sorry, I'm unable to continue. Nurse Rogers, continue with all of my orders. Nurse Andrews, please run and get Dr. Robinson, she can take over for me."

To sum up, I think that the repercussions that the doctor would face would depend largely on the circumstances.

OK - my original question applies to 2, 3, 4 above - cases where the doctor is physically and mentally capable of providing treatment without putting himself in physical danger, but chooses for some reason not to do so. That's what I meant to imply by the word "refuse" in my original post.

BTW, CrazyCatLady, in Massachusetts licensed health care professionals (doctors, nurses and EMTs at a minimum) are required by the terms of their license to stop and provide aid at car accidents, etc. if EMTs or other emergency services have not already arrived. My wife (a nurse) and brother (a doctor) have both confirmed this. Of course, there's no way anyone would know if they cruised by a multi car accident on the expressway.

Neither of them could definitively answer the original question though - neither has a job where they provide care for patients in immediate danger of losing their life.
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  #9  
Old 05-25-2004, 11:36 AM
CrazyCatLady CrazyCatLady is offline
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Of course they can't answer it definitively--it's going to vary somewhat depending on situation and locale. The most definitive answer you're likely to get is "it depends."

It's like the transfer of care thing. In some states, a doctor who stops to help would probably be able to go on about his business after EMS took over the patient, but in North Carolina, it would constitute abandonment. You're required to stay with the patient until someone of equal or greater training has taken over the case, ie. the doc is going to the hospital with them, like it or not. A lot of these laws are rather moot points, though. I don't know any doctor who would refuse to treat someone who was dying right before their eyes, or who wouldn't stop and help if they could, or who would leave the patient in the care of EMT's rather than riding to the hospital with them. Legal responsibility aside, they would feel morally obligated.
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  #10  
Old 05-25-2004, 12:56 PM
nocturnal_tick nocturnal_tick is offline
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Quote:
Originally Posted by CrazyCatLady
Well, it kind of depends. If we're driving down the road and see a nasty wreck where someone is bleeding to death and EMS hasn't arrived yet, Dr.J is not legally obligated to stop and help. If he does stop, his legal responsibility varies by locale. In a lot of places, once he's stopped, he's legally obligated to do everything he can to help, and to stay with the patient until he has transferred care to the paramedics.
<bolding mine>

Isn't this leaving the scene of an accident? Or is that just for those involved in the accident?
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  #11  
Old 05-25-2004, 01:42 PM
Jake4 Jake4 is offline
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It's not considered leaving the scene of an accident if you weren't involved in the accident or weren't there when the accident occurred.
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  #12  
Old 05-25-2004, 05:31 PM
DougC DougC is offline
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- - - Well living where I do, I can tell you that a doctor can refuse to treat patients for any number of reasons. Two counties in Illinois (Madison and St Clair) are famous statewide for having juries that hit doctors with huge malpractice awards. Doctors have begun to actively stop accepting patients from, and to move out of these two counties, and furthermore, patients that are transferred to hospitals in adjoining counties, or in an adjoining neighboring state are being refused treatment, just because they are from these two counties. Doctors in these two counties are moving out simply because they are finding it increasingly difficult to get any malpractice insurance--many say that they have been informed that after their current policies lapse, they will not be renewed. And the phenomenon is spreading outwards, to the Illinois counties surrounding St Clair and Madison. This has been going on for quite some time now, and there have been many instances reported in the newspapers of people with serious conditions being shifted around to two or more doctors or hospitals, jus because of their home address.

- It's rather amusing, I think--but then, I have no chronic need for medical care. For a long time, local doctors campaigned for reasonable malpractice award limits and medical board reviews, and lawyers campaigned about "removing incompetent doctors", but now that ALL the doctors seem to be leaving, the American Bar Association has not got much constructive to say--and they are about to get their collective testicles crushed. Their political endorsement is about to become the mark of Cain in Illinois politics--because they are going to get blamed for profiteering from chasing doctors out of Illinois.

Search for stories in the St Louis, Mo newspaper: http://www.stltoday.com/
I tried and didn't see more than a couple; they get archived after a week or two.
~
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