In 2012, after only a few months of my taking my new position, Hurricane Sandy was heading to the Northeast. My passion for disaster relief kicked in. After all, I have seen many wars during my childhood which led in part to my decision to become a pediatric emergency doctor. I have always desired to help those who are in need and to rescue the disadvantaged. I found in Hurricane Sandy an opportunity to satisfy my goals of helping families suffering from displacement and hunger. Despite my working an 18-hour shift so that colleagues would not have to travel during the hurricane, I enthusiastically jumped into the relief work to help families in Far Rockaway.
I met an energetic nurse at my institution and offered to help these families with him on my days off. We managed to gather a group of health professionals and went to the devastated areas where we witnessed the destruction and the agony of that community. I could not believe that I was in a major metropolitan area in the U.S. There was no command center arranging volunteers’ work. There were so many volunteers, but a minimal ability to utilize them efficiently. I sat at an emergency clinic that was assembled in a school, surrounded by large amounts of medications that were about to expire. I didn’t see more than four patients in my ten hours there because few people in the community knew we were even there.
When a disaster hits, many physicians would like to go to the front line to help those who are in need. We take the extra steps necessary, but our efforts are shattered once we face the disorganization on the ground. I couldn’t believe that I was in the United States! And in one of the biggest cities in the world! Food and clothing is what mattered the most to the affected communities during the cold days of November. Lack of electricity and communications made our efforts patchy and ineffective. This situation continued for weeks. In an environment lacking critical resources, like electricity and water, I came to learn that my emergency relief work would be held to the same legal standards of care as those to which I am held at my hospital. This was because I was a paid employee. Had I known this before volunteering, I could have been discouraged from doing so. Our system is crippled by laws that do not protect healthcare professionals donating their time and effort to help in disasters, where a quick response time is critical. Unless it is your job or you happen to be at the site when the disaster takes place, you are just as liable for every patient you see as you would be at your hospital, despite your working under suboptimal conditions. In other words, patients you treat might sue you regardless of how terrible the conditions were or how underequipped you were.
The US immunity laws applicable to physicians are a patchwork with too many gaps and inconsistencies. No law of which I am aware comprehensively addresses liability and immunity issues for physicians responding to disasters. Only unpaid volunteers and government workers are protected. And the rest of us who are not under such protection might suffer. The rule that “no good deed goes unpunished” should not be the norm!
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