Definition/Introduction

The Good Samaritan law is rooted in the ancient biblical parable, defining a "Good Samaritan" as an individual who intervenes to help and assist another person without any prior obligation or expectation of compensation.[1] Good Samaritan laws are based on the principle that consensus agreement supports good public policy by limiting liability for individuals who voluntarily provide care and assistance during emergencies. Medical emergencies often occur outside clinical settings, making them a common occurrence.[2] Thus, in theory and principle, society benefits when potential rescuers—Good Samaritans—focus solely on helping individuals in need rather than worrying about potential liability for their assistance.

The general principle of most Good Samaritan laws protects individuals who provide care without expecting payment from negligence claims. These laws support public policy, as few jurisdictions impose an affirmative duty on medical professionals to offer care in the absence of an established patient relationship. Each state has its own version of the law, and federal laws apply in certain situations.

Notably, countries outside the United States have varying laws, opinions, and regulations regarding Good Samaritan situations. In most countries, there is no legal obligation to provide aid, although many Western nations acknowledge a moral duty to stop and offer assistance rather than enforcing a legal requirement.[3] In contrast, all 50 states in the United States have Good Samaritan laws, with minor differences in provisions across various states.[2] The tort system in the United States is unique, and the concept of liability varies from country to country. Please see StatPearls' companion resource, "Tort," for more information.

Legally, a Good Samaritan is someone who provides assistance in an emergency to an injured or ill person. If the victim is unconscious or unresponsive, the Good Samaritan can act under the assumption of implied consent. However, if the person is conscious and able to respond, the rescuer should first ask for permission before offering help. 

All 50 states and the District of Columbia have Good Samaritan laws along with federal laws for specific situations. Many of these laws were originally designed to protect physicians from liability when providing care outside their typical clinical environment. The specifics of Good Samaritan laws vary by jurisdiction, including who is shielded from liability and under what conditions (such as clinicians, emergency medical technicians [EMTs], and other first responders). However, these laws generally do not protect medical professionals from liability when acting within the scope of their usual duties.

Good Samaritan laws provide liability protection against "ordinary negligence," which refers to the failure to act as a reasonably prudent person under similar circumstances. This means not exercising the level of care that most people would apply in the same or similar circumstances. However, these laws do not protect against "gross negligence" or willful misconduct. Gross negligence involves a conscious and voluntary disregard for the need to use reasonable care, leading to a foreseeable risk of serious injury or harm to people, property, or both.

For Good Samaritan laws to apply to clinicians and other healthcare providers, specific conditions must be met, primarily that there is no preexisting duty to treat. For this reason, on-call physicians are generally not covered by these protections.[4] Therefore, a physician with a preexisting relationship with the patient also cannot be considered a Good Samaritan. Another common exclusion in state statutes is that the healthcare provider must not receive compensation for their assistance. If any remuneration is involved in rendering emergency care, the individual is no longer considered a Good Samaritan, and the legal protections do not apply. 

Issues of Concern

Good Samaritan laws typically do not provide legal protection for on-duty doctors. However, there have been instances in hospital settings where a physician was considered a Good Samaritan and protected by these laws.[4] In 2 separate cases in Michigan, surgeons who were not on call but were contacted by the emergency department to assist a patient were not held liable for poor outcomes due to Good Samaritan protections.[4] Conversely, a ruling in New Jersey established that "the protection of the Good Samaritan Act stops at the door of the hospital."[4] These cases highlight the variability of Good Samaritan laws, not only between states but also depending on the situation. Another striking example of this variability is that all states, except Kentucky, provide statutory immunity to physicians licensed in other states.[5] As a result, the extent of reciprocal immunity also differs from state to state. 

A recent area of interest in legislation is the opioid crisis, with drug overdose now the leading cause of accidental death in the United States, most commonly involving opioids.[6] In response, 40 states and the District of Columbia have enacted Good Samaritan laws specific to this issue. These laws are designed to reduce drug overdose deaths by encouraging victims and witnesses to call 911, thereby offering a degree of immunity in return. This immunity may protect individuals from drug-related charges or provide the possibility of a reduced sentence.[6] For instance, in 2010, Washington state passed a law to encourage more people to seek medical help after a suspected drug overdose. Following this, both emergency medical services and police prioritized patient care over drug confiscation and arrests.[7] The general consensus is that this type of immunity for callers saves more lives, and similar targeted laws are likely to be enacted in the future.

Clinical Significance

Most Good Samaritan laws do not apply to medical professionals or career emergency responders while they are performing their job duties. However, some laws extend protection to professional rescuers when they are volunteering.[5] Research shows that raising physician awareness of Good Samaritan protections increases the likelihood of assistance. In one study of residents and fellows, about half reported being present at a medical emergency outside the workplace. Many expressed reluctance to help due to concerns about liability outside the clinical setting. However, after learning about Good Samaritan laws, most indicated they would be more likely to assist if they had prior knowledge of these protections. An overwhelming majority requested that this information be included in their medical education, stating that such training would increase their likelihood of offering assistance in these situations.[2] There are numerous situations and locations where a Good Samaritan may be needed. The most common settings include sports and entertainment events (25%), road traffic accidents (21%), and wilderness areas (19%).[8]

A recent push aims to establish "Bad Samaritan" laws, which would create a duty to assist those in need. These laws are not strictly applicable to healthcare providers. Notably, Minnesota, Rhode Island, and Vermont are the 3 states that impose a broad obligation to rescue individuals in emergencies, while Hawaii, Washington, and Wisconsin have enacted laws requiring the reporting of crimes to authorities. However, enforcement of these laws has been lacking. Additionally, many states mandate that healthcare providers report certain criminal acts, such as gunshot wounds and child abuse. A few states also require healthcare professionals to stop and render aid during emergencies, but only if doing so does not endanger themselves.[9]

Although most Good Samaritan laws are state-based, one notable federal law relevant to physicians and other healthcare providers is the 1998 Aviation Medical Assistance Act (AMAA). This law protects "Good Samaritans" during flights (Section 5b).[10] Specifically, the AMAA safeguards physicians and other healthcare professionals acting in Good Samaritan roles on US-registered airlines.[5] Despite this, healthcare professionals may initially hesitate to provide care on an aircraft, often unaware that every plane is equipped with a first aid kit, an emergency medical kit, and an automatic external defibrillator. Additionally, flight crews receive training in cardiopulmonary resuscitation and have access to a support system, including a ground-based consultation service that provides radio assistance from an on-call physician.[11]

The most common in-flight emergencies include syncope or near-syncope (32.7%), gastrointestinal issues (14.8%), respiratory problems (10.1%), and cardiovascular symptoms (7.0%). An estimated 4.4% (95% CI, 4.3%-4.6%) of in-flight emergencies result in the aircraft being diverted from its scheduled destination to a different airport due to a medical emergency.[10] In the United States, minimum requirements for onboard emergency medical kits include an automated external defibrillator, equipment for basic assessments, tools for hemorrhage control, initiation of an intravenous line, and medications to treat primary conditions. Other countries have varying minimum standards for medical kits, and individual airlines may expand the contents of their kits as needed.[10]

Conclusion

Although the primary intent of Good Samaritan laws is clear, their real-world application can vary significantly. All healthcare providers should familiarize themselves with the specific rules and protections in their state. However, as this topic highlights, unique responsibilities and coverage may apply when flying or traveling in different jurisdictions. When uncertain about local liability protections, it may be best to follow the example set by the Good Samaritan.