What Are Physicians’ Ethical Responsibilities to Respond to Medical Emergencies?

How should you respond to an urgent call for a physician outside of the medical environment? What are an otolaryngologist’s ethical and professional obligations to care for these people, even if their conditions fall outside of the scope of practice of otolaryngology-head and neck surgery?

Here are three fictional cases depicting a potential scenario you may encounter, with an ethical discussion for each.

Clinical Scenario 1

Rodney Hallowell, MD, and his wife, Norma, are excited to finally embark on a two-week cruise on the Rhine River in Europe. Both feel that this is a well-deserved vacation after seeing their last child off to college and experiencing “empty nest syndrome.” Dr. Hallowell’s general otolaryngology practice will be well covered by his practice partners, and Norma is on a six-month sabbatical from the university to study, in part, the architecture of European churches built in the Middle Ages. Rodney’s plan is to catch up on a growing list of fiction books on his electronic reader and not be bothered by any medical responsibilities.

Tonight’s after-dinner entertainment on the boat features Austrian singers performing excerpts from several well-known operas. Midway through the performance, Dr. Hallowell is approached by an officer of the boat, who asks for a private word in the hallway. The officer nervously explains that there has been an altercation between two of the boat’s cooks and that one has been stabbed with a dining knife. The victim is not doing well at all, and since Dr. Hallowell is the only available physician on board, will he attend to the victim? Reluctantly, Dr. Hallowell agrees to evaluate the patient.

Immediately, Dr. Hallowell can see that the man is in trouble—pale, diaphoretic, and poorly responsive. The stab wound is in the upper right quadrant of the abdomen, with rather brisk bleeding noted. A female crewmember is applying mild pressure to the wound with a table napkin. The assailant is nowhere to be seen. All hands are expectantly waiting for Dr. Hallowell to take charge of the situation.

Clinical Scenario 2

Jane Billingsley, MD, is in flight, on her way from her home in Florida to a major otolaryngology meeting in Texas, where she is to present a research paper and serve on a panel discussion. The past two years have been very busy for Dr. Billingsley, as she has finally become board certified in neurotology. Both her academic practice and research are challenging and rewarding, and she will be presenting the results of a new clinical study on the treatment of Ménière’s disease.