The Clinician’s Guide to In-Flight Emergencies

Legal and Ethical Ramifications of Providing Assistance to Passengers

Whenever a physician treats a patient, a doctor-patient relationship is established, with attendant obligations and potential liability.⁴  While US healthcare providers have no legal obligation to assist in the event of an in-flight medical emergency, they may have ethical obligations. In contrast, many other countries legally require physicians to assist.⁴

The Aviation Medical Assistance Act (AMAA) protects healthcare providers from liability if they are responding to in-flight medical emergencies, both on domestic flights and usually on international flights as well.⁴ However, a “grossly negligent” provider, or one who has intentionally caused the patient harm, can be held liable.⁴

After the event, the physician should document the treatment, according to documentation protocols that may be required by the airline. The patient’s privacy should be respected, and information should not be shared with third parties (such as the media) without the patient’s authorization. However, the captain and flight crew might need medical information to enable appropriate management and potential flight diversion.²

Suggested responses to in-flight medical emergencies are listed in Table 2.