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Airlines must pay MDs for non-emergency mid-air care: judge

A Montreal doctor has won a small-claims lawsuit against Air Canada, a victory that he hopes will compel airlines to pay physicians for their aid in non-emergency cases during flights.*

Kept up all night tending to patients on a flight to Paris, Montreal family physician Henry Coopersmith was insulted by Air Canada’s offer to compensate him for his effort with what he considered a paltry number of frequent flier miles. His flight was ruined, he had explained to the company, and he wanted Air Canada to give him two replacement tickets of equivalent value. Air Canada refused. When one of their lawyers responded to his complaints by writing that he was ethically obligated to care for the passengers (one had mixed alcohol with sleeping medications but was fine, another had a headache, and a third was having a panic attack) and therefore not entitled to anything beyond a small token of the company’s appreciation should they decide to offer it, Dr Coopersmith decided to sue.

The case -- surely one of the most complex and most consequential small-claims court cases decided in recent years -- wrapped up last month when Justice David L Cameron ruled largely in favour of Dr Coopersmith, awarding him $1,000. Dr Coopersmith believes the decision could establish legal precedent that would require airlines to pay doctors for their medical work and for any loss of enjoyment of the flight or their travel as a result of the flight.

“I am exceptionally pleased with it,” Dr Coopersmith told Canadian Medicine. “It’s a real victory with respect to protecting health professionals, both with protecting their legal and ethical obligations.”

But don’t get him wrong, he says: he’s not some “greedy doctor” trying to “gouge” the airline, as one Canadian aviation website described him. Dr Coopersmith has no quibbles with doing assessments of patients to determine if they need emergency care, or with providing Good Samaritan care to patients in genuine emergencies. But if doctors are roused from their mid-air slumber (as he was after he had initially volunteered to evaluate the sick patients and determined there was no emergency) to deal with non-emergency cases that the airline’s employees can take care of, he believes they should be compensated for their time and effort.

His reasoning is not based just on a sense of what “reasonable” limits to asking for a doctor’s help might be (he asks whether doctors should be expected to treat people’s headaches while relaxing on the beach). His position is also predicated by an important legal concern.

During his research for the case, Dr Coopersmith discovered something that hadn’t been communicated well to doctors before: the Canadian Medical Protective Association, which provides malpractice insurance for Canadian physicians, will not extend legal protection to doctors who treat patients for non-emergency cases on airplanes. ("Nobody knows that," says Dr Coopersmith. "I sent them this case and suggested they advertise the distinction.") So not only was Air Canada asking Dr Coopersmith to volunteer his expertise, they were also asking him (albeit unwittingly) to expose himself to significant liability.

This case has established a legal precedent, Dr Coopersmith argues. If doctors are explicitly asked to “volunteer” their skills to treat non-emergency cases in airplanes, they now have recourse to be paid for their work. “They can just send a bill,” says Dr Coopersmith. However, the precedent he believes was established has not yet been tested in court and is complicated by the fact the judge took pains not to generalize about other doctors' work in his ruling.

An Air Canada spokesperson told Canadian Medicine that the company is “studying the decision” and reviewing their options. It’s not possible to appeal small-claims court decisions, but the company could potentially request a judicial review. The spokesperson says the company has no plans to change its policy about providing compensation to doctors who provide care to passengers, but Dr Coopersmith says their policies and procedures will have to be brought in line with the law.

To read the full text of Justice Camerson’s decision, click here.

Photo: Shutterstock

*This article has been corrected. The original version implied that Justice Cameron's ruling had indeed established new precedent, but that is not yet clear. Canadian Medicine apologizes for the error.

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  1. sharonJuly 22, 2009 at 7:38 AM

    RE: the solicited helper for direct aid provision

    I guess it did not help that the good doctor was on his honeymoon.
    To be paid for service rendered places all of his action in category 2.


    The real question here is " who is the patient"?
    It may, in reality, be Air Canada.

    However, I think issues of "jurisdiction" inflight should be clarified for passengers performing the usual "good samaritan" efforts.
    Some disclaimer on the ticket should outline if these acts are under the jurisdiction of: of origin for the airline helper, helpee,
    2. origin of request ( intermediates)
    3. updates for maritime and high seas law as related to aircraft.

    P.S. the Good Samaritan law is wrongly titled if it is to apply to the " corrective measures" level

    The Good Samaritan merely "delivered" the injured man to appropriate help sources..and " paid" the cost.
    An argument could be made that the good Samaritan in this doctors flight .....was " the airline itself" ...and hence it was the one protected from liability.

    Remember, in Canada, we are protected in this area under " principle" of law...not precedent.

    Moral of this: it is easier to do things for free

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  3. AnonymousDecember 4, 2009 at 6:41 PM

    i've been airplane doctor 3x for air canada and haven't recieved so much as a thank you any of those 3 times. the cabin staff continued being their usual rude selves.
    I've been airplane doc for JAL once, and they were very gracious, upgrading my next flight and sending me various tokens of gratitude from Japan.
    If I should ever have the misfortune of flying Air Canada again, I certainly won't be volunteering my services to the company. If the crew thinks there's an emergency, then they should divert the flight to the nearest airport.
    If they want my professional opinion whether the "emergency" is serious enought the flight needs to be diverted in order to save on fuel, then they better assume the expense of a professional consultation. (Or perhaps ask the pilots, crew and fuel company to donate the diversion costs in the name of being a good samaritan)

  4. sharonDecember 4, 2009 at 6:57 PM

    3X medico...

    soooooo....when did the all too common joking remark that The Golden Rule is " he who holds the gold makes the rules"

    ........hold on tight.....

    when you are the victim you are too weak to keep your fists that tight :(

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