Today’s question relates to the impact on good Samaritans of their efforts to assist. The case at hand involved two bystanders who assisted a person who had collapsed, providing CPR until the arrival of the ambulance.
When the paramedics arrived and took over they told the boys that they did a great job and most probably saved her life. They were however really shaken and upset all weekend and they felt awful that they didn’t know if the woman lived or not and whether they had done everything they could and that they felt there should have been a follow up from AV showing appreciation and giving them an indication of the condition of the woman.
It occurs to me that there may be immediate or long term mental health outcomes for the community members who assist a person when waiting for paramedics to arrive. Is it possible that the Services have a duty of care to check up on and debrief people who are involved as described?
The answer is that there could be no duty on the ambulance service to ‘check up on and debrief people who are involved as described’.
With respect to the establishment of a duty of care, in the circumstances described the ambulance service is not responsible for the person’s decision to assist or the trauma that they face. A person’s decision to step up is there’s alone. In the absence of any control over the risk the ambulance service can’t be under a duty of care to protect people from the risk.
Even if there is a foreseeable risk of harm, ambulance services are responders. They respond when requested. An ambulance service may not transport a patient either because the patient refuses or after discussion it’s agreed that transport is not the best option. Either way ambulance doesn’t have to ring back to the next day to see how the patient is going. If there’s no duty in those circumstances, there could be no duty in the more general case.
Even if there could be a duty the question becomes what would a reasonable service do about it? Remember that the response to a foreseeable risk (where there is a duty to respond to the risk) requires a consideration of “… the magnitude of the risk and the degree of the probability of its occurrence, along with the expense, difficulty and inconvenience of taking alleviating action and any other conflicting responsibilities’ (Wyong Shire v Shirt (1980) 146 CLR 40, 48).
Consider the ‘expense, difficulty and inconvenience of taking alleviating action’ ie the expense, difficulty and inconvenience of following up with those that assist at an emergency. First it is a truism that all first responders are local – that is meant to capture the idea that the emergency services are not the first responders, in nearly every emergency neighbours or bystanders will have come forward to assist. At nearly every event where an ambulance attends someone will have got there first (the exception is the person collapsed or injured at home who manages to call their own ambulance) so the list of potential affected people is very large. Some people will have stepped back so the paramedics may not recognise or identify everyone who was involved. Paramedics would have to attend everyone at the site to ask if they were involved
Even where people could be identified, the record keeping would be significant. There would have to be records of each person and they would need to be stored and someone given the responsibility for the follow up. The cost of that record keeping and follow up would be significant.
That is not to say that ambulance services shouldn’t, or don’t, follow up with good Samaritans. There are many instances of patients and bystanders being reunited and people being given awards in recognition of their efforts to save a life. See
- Royal Life Saving Society Australia, Honours and awards;
- St John Ambulance (NSW) Save a life Awards; and
- St John Ambulance (WA) Community Hero Awards.
That there is follow up and even awards doesn’t show that there is a duty – that is an obligation – to provide that sort of follow up or recognition.
A number of well meaning people went to the assistance of the victims of the Flinders Street Car Attack on 20th December last year in which many were seriously injured and one man died. Some of those that bravely provided help to the injured were not health care professionals and most likely had little training to prepare them psychologically for the carnage that occurred. I witnessed one woman involved in the initial response who appeared to be deeply affected by the experience, it is likely there were others similarly affected. Victoria Police offered counselling services immediately after the incident, in the period following, and again more recently. There may be no legal requirement for Victoria Police to follow-up in this way but it is the right and responsible thing to do. and fullcredit to Victoria Police for doing so.
This is taken from the CPR unit of competency
Legal, workplace and community considerations, including:
– awareness of potential need for stress-management techniques and available support following an emergency situation
– duty of care requirements
– respectful behaviour towards a casualty
– own skills and limitations
– privacy and confidentiality requirements
– importance of debriefing
So basically, anyone who does a CPR course at a minimum should (if they have been trained correctly/adequately) be given some information on measures to take following an incident.
It’s great that some organisations/services offer follow up support following large scale and high profile incidents. Having said that, there are plenty of organisations who can offer assistance following a smaller scale (but large for those involved) event should the person affected seek it out. If the person/s doing CPR were affected, the onus is really on them to seek any care they may need, as should have been explained in their CPR course.