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Sat Jan 10 14:23:38 GMT 2009

From: Michael Stein M.D. (mgstein at bezeqint.net)
> the vast majority of spinal cord damage is caused by the initial impact of the injury.

--> Agreed.

> The chances are that in this case too, the patient was neurologically impaired from the onset and the poor "Good Samaritan" is being blamed for nothing

--> Agreed. This is PROBABLY correct.

> The American legal system enables the largest democracy in the world to function

--> I have no first-hand experience of the American Legal System, although I do agree that, if/until India merits the title, the USA will remain the largest democracy ;-)
Without first-hand experience, I will rely on what I read from AMERICAN doctors on this list and other lists - it hten seems that the democracy functions DESPITE the legal system, not facilitated by it!

> However, if the public (society) puts up with this kind of absurd verdicts and not close the loopholes in the laws that make these stupid decisions possible, it probably deserves to be left alone and die on the streets while everyone around will observe and wait for the EMS to arrive

--> Were I one of those members of the public, about to be thus punished after my own trauma scenario, I am not sure how I could bring about the change required. In a country governed by lawyers with the weapon of money, what can the "public" do other than be "used" as political currency?

> Although I do not wish bad things upon anybody (most of the time) wouldn't it be ironic if this judge were to one day be trapped in his burning Mercedes, or fall off his yacht while bystanders watched him and said "I'm sorry, a judge ruled once that I can be sued for helping you if it is not medical treatment"

--> Your scenario here is guided by very sound logic. I share that logic!Still, the logic you and I share is irrelevant!None of us here thinks the good samaritan was being illogical in helping the victim in the original scenario! But she still got "lawyered". And it will still be possible for the judge in your scenario to successfully mount a costly legal battle to extract big money out of the bystanders. Certainly the logic following this one other case will not stop him!

From: rfsmithmd at comcast.net> In the 7th edition of ATLS it states that "At least 5% of patients experience the onset of neurologic symptoms, or worsening... after reaching the emergency department."

--> The thing about evidence like that (let's ASSUME it was true) in the context of an ATLS course, is that the course sets its aim to CORRECT this problem and there is no logic in supposing we as the medical porfession have not improved since this was fact. IF it was a fact! No great evidence at all there and not really worth searching out to read!

The bottom line in my mind is that the problem is not with the medical profession or with good Samaritans. It goes back to Michael Stein's point about the legal system, I think. This system is built to always continue to develop new ways to extract money out of people for whatever reason. Any obstacles will be chipped at, pushed, pulled climbed or bribed around, but SOME way around will eventually be found. The system is designed so that only ONE SINGLE THING can ever be CERTAIN TO PREVENT a lawyer and that one thing is:

   Absolute perfection, including when judged in retrospect, with all available and yet-to-be-acquired evidence and knowledge...

Not sure doctors OR good Samaritans can attain such a level, so the legal system WILL eventually succeed.

What you need is not to "close loopeholes". Loopholes are created INTENTIONALLY by lawyers in order to allow OTHER LAWYERS to focus public attention on them and spend all efforts trying to close them, while thus being distracted from trying to get rid of the whole system, which is the only way out!
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