Legal & Risk Management
By Sean Riley, MS, JD
The Legalities of Emergency Care
Understand your risks and responsibilities. As a personal trainer, you work with a variety of populations, from seniors to athletes. This diversity perpetuates a number of legal issues, particularly with regard to emergency care. With the senior population, you must be able to identify the symptoms of, and remedies for, conditions resulting from cardiorespiratory disease. If you work with athletes, it’s important to know how to recognize adverse reactions to supplementation. Consequently, you should know the risks involved.
Battery is defined as harmful or offensive bodily contact. This includes touching another without consent, which is actionable (even for the lightest of touches). The touching applied in resuscitation or when using an AED could certainly constitute battery, since a person in a state of cardiac arrest cannot give consent! The question becomes, Why would you administer cardiopulmonary resuscitation (CPR) if you could be subject to battery charges? First and foremost, professional obligation and legal duty might mandate that you administer emergency care. Second, some professionals might have valid legal defenses against such claims of battery; these defenses could include implied consent and necessity (Resuscitation Council 2000). Implied consent states that if the person had been conscious and able to make a decision, she would have given consent to the emergency procedure because it was in her best interests (Resuscitation Council 2000). Necessity states that procedures vital to saving one’s life or to improving a deteriorating condition can be lawful without consent (Resuscitation Council 2000). These defenses may falter for nonprofessional rescuers or those outside the medical community. Emergency techniques are medically related procedures. It is plausible that had a victim of cardiac arrest been conscious, he would not have given consent for CPR to an untrained person. It is irrelevant that the procedure is simplistic or automated (Resuscitation Council 2000). Furthermore, being touched by an amateur may not even be in the victim’s best interests. If you administer emergency care, the above defenses may apply only if you can show that the procedures/
treatments were reasonable and in the victim’s best interests. As a fitness professional, you should have first-aid and CPR certification. Hence, you would likely benefit from the above defenses. In addition, the AED’s simplicity and reliability may bolster using these defenses in a fitness setting.
Negligence claims require the plaintiff (the victim of cardiac arrest) to show that a duty owed him was breached, causing injury. For the general population, there is no legal duty to provide emergency care to another person. However, all professionals, including trainers, have special relationships with their clients that create legal duties. You have a duty to look out for the best interests of your clients and to maximize their safety. If you are trained in CPR and first aid, you are under duty to administer them when necessary. Legal liability would result only if the assistance left the victim in a worse position than he would have been had you not administered the treatment (Resuscitation Council 2000). For example, if you performed chest compressions inappropriately, causing damage to the chest, bones or underlying organs, then you would be liable for injuries that would otherwise not have occurred. The standard to which fitness professionals are held in emergencycare administration remains unclear. Thoroughly trained medical personnel, including novices recently out of medical school, are held to the highest possible standard; lack of experience does not reduce the required standard of care (Resuscitation Council 2000). Many trainers hold current CPR and first-aid cards but have never performed the procedures in an emergency. A novice trainer might be held to
Lack of Standardization and Complications
Legally, situations involving cardiac arrest prove precarious. If you attempt to resuscitate someone who is suffering a heart attack, you risk having a legal claim brought against you if that individual is harmed as a result of your aid. Automated external defibrillators (AEDs) may readily be used by persons with no formal medical training– despite the medical nature of defibrillators. Trainers who know how to properly use these devices might be held to higher standards than those without specialized training. Unfortunately, standard of care in the fitness industry is undefined and unclear. Moreover, studies have shown that many health clubs are not aware of the requirements suggested by the American College of Sports Medicine (ACSM), nor are they prepared for cardiac emergencies (Herbert 2001). This sets the scene for legal liability. In cardiac emergencies, the primary legal claims that can occur in response to voluntarily administering emergency care are those that allege battery or negligence (Resuscitation Council 2000).
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