The hospital staff first demanded to know who the men who brought the accident victim in were, Ambedkar recalls. Then they started speculating on whether it would lead to a police investigation. “We said that we would talk to the police and were not worried about the police case but they must start operating on the man. The hospital staff said we had to pay a Rs 20,000 fee before they started treatment.”
For about an hour and a half, the bystanders and the hospital staff haggled over treating the victim, who ran a motor training school. During this time, Ambedkar and other bystanders managed to collect Rs 11,000 towards the stranger’s emergency care. But by then it was too late. “For the lack of Rs 9,000 the man died,” Ambedkar said.
A new set of guidelines from the Ministry of Road Transport and Highways aims to tighten the screws on hospitals to prevent them from denying care to accident victims. The guidelines are also set up to protect Good Samaritans like Ambedkar from having to pay up at hospitals and from getting entangled in legal cases while helping strangers injured in accidents.
The ministry has asked that all registered public and private hospitals not detain bystanders bringing in the injured or demand any kind of payment from them unless they are family members of the injured person. The guidelines suggest that a lack of response be considered “professional misconduct” and disciplinary action be taken consequently.
Big step forward
India’s roads are deadly. Data from the National Crime Records Bureau shows that more than 1.37 lakh people died in road accidents in 2013, with similar numbers being reported in previous years. According to the 201st Law Commission report on emergency medical care to accident victims, doctors found that half the fatalities in accident cases, whether on the road or otherwise, could have been averted if the victims had been admitted into a hospital in the first hour after the accident. The delay is because of India’s hugely overburdened response systems but also because bystanders hesitate to help the seriously injured.
A national survey by the Save Life Foundation, an NGO focused on improving road safety in India, found that 74% of bystanders are unlikely to help victims of a serious injury.
“What we were able to do at the very outset was to rule out apathy as a reason,” said Piyush Tewari, one of the founders of the Save Life Foundation. “India faces a lot of accidents. There might be a building collapse or a bus crash. The first people to help the injured people are bystanders. It is only in the case of road accidents and violence, like the Nirbhaya case in Delhi, that people are afraid to come forward.” For 88% of the people unlikely to respond, their reluctance stemmed from a fear of being dragged into protracted police investigations and legal proceedings.
The new Good Samaritan guidelines are a result of a petition filed by the Save Life Foundation in the Supreme Court. After considering the petition, the court ordered the government in October last year to frame guidelines to shield Good Samaritans from harassment and thus enable them to help accident victims.
A bystander or Good Samaritan, the guidelines say, should be allowed to leave immediately after taking an accident victim to a hospital without having to answer any questions. Only eyewitnesses to the accident can be asked for their addresses before they leave. Neither the police nor emergency services can compel a bystander to reveal his name or personal details, neither will he be liable for any civil or criminal liability.
State governments have been advised to ensure that bystanders who voluntarily disclose that they are eyewitnesses to accidents not be subject to harassment or inconvenience while taking part in legal proceedings. Specifically, the guidelines recommend that the witness be examined on a single occasion to prevent them from repeatedly having to appear in court.
Where's the ombudsman?
The courts have repeatedly observed that emergency care should not be delayed and Good Samaritans should be protected. In 1989, the Supreme Court, while hearing a petition based on a scooterist knocked down by a car, observed that patients in accidents were being sent away from private to government hospitals on the grounds of them being medico-legal cases. There was an urgent need, the court said, to make it obligatory for doctors to provide emergency medical care. Subsequent court cases and judgments have reiterated this stand.
In the infamous BMW hit-and-run case where Sanjeev Nanda mowed down six people, the Supreme Court judgment said:
“Good Samaritans who come forward to help must be treated with respect and be assured that they will have to face no hassle and will be properly rewarded. Therefore, the Union of India and State Governments are directed to frame proper rules and regulations and conduct awareness programmes so that the situation like this could, to a large extent, be properly attended to and, in that process, human lives could be saved.”
Tewari believes that the new guidelines are a big step in the right direction. What’s missing is a way to implement the guidelines. “There is no clarity on accountability,” he said. “If these guidelines are not followed then what is the procedure, who is held responsible, how will the grievance process run, who is the ombudsman, which agency at the ground level is responsible for ensuring implementation of these guidelines and taking accountability for that? That is completely missing from this system.”
The road transport ministry has asked state governments to incentivise bystanders and Good Samaritans as they deem fit. Tewari said the next step is to make a case to the central government to enact a Good Samaritan law that will be enforceable. In the meantime, he encourages people to carry a copy of the Good Samaritan guidelines with their vehicle documents and to go ahead and help accident victims.
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