ABSTRACT
Any text written on the medicolegal aspects of aeromedical transport can never be complete. Although general principles are likely to be relevant throughout the world, it would be impossible in a book of this size to discuss the legal implications of every possible dilemma, situation, or incident that may arise. The discussion in this chapter is therefore an illustration based on experience in English speaking nations, especially Britain and the USA. Jurisprudence in all English speaking countries has its origins in centuries of English (not British1) common law. Compared with this, the history of aviation, and specifically of aeromedical transport, is short. Outside of North America, few legal cases involving air ambulance organizations or personnel have so far found their way into the legal literature. However, we live in an increasingly litigious society, and aeromedical organizations, and those that work for them, should be aware of their potential liabilities. Medical directors must take responsibility for the selection, assessment, training, and supervision of personnel, for documentation, quality assurance, and the periodic review of medical protocols and guidelines used by the service. The issues of standards of care, consent, liability, documentation, confidentiality, and clinical management guidelines, within the constraints imposed by operating in the flight environment, reflect those that are important in normal terrestrial practice. However, for flights that cross international borders, these problems are compounded by such issues as jurisdiction, importation and exportation of drugs, international health regulations, and birth and death in flight.
