AMA meeting: Doctors who give disaster aid seek liability shield

Delegates push for legislative changes requiring plaintiffs to show malicious intent.

By Amy Lynn Sorrel, amednews staff. July 16, 2007.

Annual Meeting 2007

Meeting Notes

Resources

Chicago -- The AMA House of Delegates wants to bolster civil and criminal liability protections for physicians assisting during officially declared disasters or emergencies. The move would let doctors answer the call for help without fearing their medical judgment will be questioned.

A patchwork of federal and state laws immunize volunteer doctors from liability for certain negligence that might occur while treating patients in catastrophic situations, according to a Board of Trustees report presented at the Annual Meeting. Those laws typically do not cover misconduct, and there is no protection from criminal charges.

Delegates voted to have the AMA develop and give to state medical societies model legislation that would automatically shield eligible doctors -- whether they volunteer or already work in the area -- from civil and criminal liability when they are treating patients in response to a declared disaster. The AMA also will push to enhance existing laws by replacing the traditional negligence standard with one requiring plaintiffs to show that bad faith, malice or deliberate intent to harm a patient was involved.

Meeting Notes: Other actions
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"[Liability protection] should never be a question when people need help and have help available," said AMA board Trustee William A. Hazel Jr., MD.

A case brought in the Hurricane Katrina aftermath has raised concerns that doctors might think twice about volunteering in disaster situations, knowing they could face criminal charges for their decisions. The Louisiana attorney general is investigating New Orleans otolaryngologist Anna Maria Pou, MD, and two nurses for allegedly killing patients with lethal doses of pain drugs. Dr. Pou and the nurses deny the allegations.

In extraordinary emergencies, "normal procedures are not available to doctors and they are left only with their good-faith judgment," Dr. Pou's lawyer, Richard T. Simmons Jr., said at the AMA meeting.

No formal charges have been filed against Dr. Pou. But faced with defending possible criminal and civil charges, Simmons said he found no guidelines on how to address the case in the context of a disaster.

ADDITIONAL INFORMATION:

Meeting Notes: Other actions

Issue: Apologizing to patients for unexpected outcomes could improve physician-patient communication and help reduce lawsuits.
Proposed action: Create an AMA policy allowing physicians to make apologies, confessions of regret or admissions of error to patients or families regarding adverse events, without those statements being admissible in court, and push for state and federal legislative advocacy. [Adopted]

Issue: Physicians are frustrated that antitrust laws put them at a disadvantage when negotiating payment contracts with a consolidated managed care industry.
Proposed action: Bolster advocacy for federal legislative changes that would let independent doctors, as a group, negotiate with insurers for reasonable reimbursements without threat of antitrust violations. [Study and report back at the Interim Meeting]

Issue: New AMA leadership
Results: Nancy H. Nielsen, MD, PhD, an internist from Buffalo, N.Y., was selected president-elect. The House of Delegates elected Colorado psychiatrist Jeremy A. Lazarus, MD, as speaker. Pennsylvania hand surgeon Andrew William Gurman, MD, was elected vice speaker. Rochester, N.Y., orthopedic surgeon and clinical professor William A. Dolan, MD, was elected to a four-year term on the AMA Board of Trustees. Re-elected to the board were: Cyril M. Hetsko, MD, an internist and clinical professor of medicine at the University of Wisconsin; Edward L. Langston, MD, a family physician from Lafayette, Ind., who also will serve as board chair; Rebecca J. Patchin, MD, an anesthesiologist and pain management specialist from Riverside, Calif.; Samantha L. Rosman, MD, a third-year pediatric resident in Boston; and Chris DeRienzo, a Duke University medical student.

Issue: AMA 2006 finances
Result: In 2006, the AMA posted a $30.1 million operating profit, marking the seventh consecutive year it has finished in the black. That is up from a $28.1 million operating profit in 2005.

Issue: AMA membership dues
Result: Delegates voted not to raise dues. Regular members will continue to pay $420 annually. Dues will stay at $315 for physicians in their second year of practice, $280 for military physicians, $210 for physicians in their first year of practice, $45 for residents and $20 for medical students.

RELATED CONTENT
» Doing what's best to prepare for the worst  Editorial July 16
» Doctors still reeling after Katrina, sue state for uncompensated care  May 28
» Doctors fear criminalization of medical mistakes  Nov. 27, 2006
» Physicians' intents should be considered in pain cases  Sept. 11, 2006
» Doctor, nurses arrested in Katrina deaths  Aug. 7, 2006
» Liability and licensure hassles impede disaster response  July 3, 2006
» Delegates urge more effective use of doctors in disaster response  Nov. 28, 2005

The doctors are in the house
The AMA's House of Delegates is holding its Interim Meeting Nov. 7-10 in Houston, addressing issues such as health system reform and physician payment.
Meeting coverage - Slideshow