Indian state’s Good Samaritan law aims to combat road deaths

New legislation in the southwestern state of Karnataka aims to remove obstacles that might deter altruistic citizens from helping crash victims – including overzealous scrutiny by the police, reports Margot Cohen

A crushed Maruti Zen car lies on the divider of the expressway in Gurgaon, a suburb south of New Delhi, on March 14, 2007. Gurinder Osan/AP Photo
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BENGALURU // India’s grisly record of fatal injuries from road accidents may have a shot at improvement, if other states follow the lead of Karnataka state and embrace a Good Samaritan law.

The initiative aims to remove obstacles that might deter altruistic citizens from helping crash victims – including overzealous scrutiny by the police.

In India, helping a road accident victim often means having to persuade a hospital to treat them, being saddled with their medical bills – or even accused of causing the accident.

The new law, expected to be signed by the governor of Karnataka within the next two weeks after being approved by the state legislature last month, has broad support from public health advocates and road safety experts. Suggestions for a public awareness campaign stretch from cinema promos to bus stop billboards.

“This will give people confidence that they can help without being troubled,” said Dr Pragati Hebbar, advocacy officer at the Institute of Public Health in Bengaluru, the state capital.

The Good Samaritan law comes after a sternly-worded Supreme Court judgment in March last year which issued guidelines for the treatment of road accident victims across India.

It is well known that medical attention administered in the so-called “Golden Hour” or better yet, the “Platinum Minutes”, following an accident can mean the difference between life and death. In a survey conducted in seven Indian cities by the SaveLIFE Foundation – a New Delhi-based NGO which played a pivotal role in lobbying for the Good Samaritan law – the vast majority of respondents wanted people to call an ambulance or rush them to the hospital and inform their relatives in the event of an accident. Yet 74 per cent of respondents also admitted that they were unlikely to assist a stranger after a crash.

And so the carnage mounts.

“Many times, we cannot save the life of the patient. They come in eight or 12 hours after the accident,” observed Dr K S Manjunath, superintendent of the Bowring and Lady Curzon Hospital in Bengaluru. According to the ministry of road transport and highways, more than 146,000 people died on India’s roads in 2015. Karnataka ranked fourth in road accidents among Indian states – after Tamil Nadu, Maharashtra and Madhya Pradesh – with 10,856 fatalities and 56,971 injured.

But unlike Good Samaritan laws passed in some parts of the United States, Karnataka’s law does not seek to punish bystanders who merely gawk and take pictures. Instead, the law brandishes a big stick over private hospitals and police, while waving a carrot in front of the potential Samaritan.

The aim is to encourage do-gooders to help anonymously, without facing legal action or pressure to pay for medical procedures. They can even be reimbursed for travel expenses incurred in taking an injured person to hospital for treatment.

“These kinds of incentives can really work,” said Amit Bhatt, director of transport for WRI India, a research group.

In particular, police are barred from collecting the name and phone number of Samaritans, unless those details are volunteered.

“In most accidents, if the information [about the incident] is coming anonymously, we can also verify it,” said Ashit Mohan Prasad, additional director general of police in Bangalore.

Also under the new law, well-meaning citizens will no longer have to wait for a patient to regain consciousness and confirm that the person who helped them was not responsible for the accident.

And most importantly, all hospitals – including those run by the government, corporate entities or charitable trusts – will be required to accept patients for treatment, without demanding payment up front. Hospitals that turn away crash victims could be sued for medical negligence and fined up to 500,000 rupees (Dh26,979). If a private hospital proves unable to extract payment from a patient’s family, it can seek recompense from the government.

Currently, anecdotal evidence, including from ambulance drivers, suggests that some private hospitals tend to reject accident victims, claiming all beds are full or equipment has broken down.

The reasons for this are various; some hospitals fear a patient’s relatives may turn violent if he or she dies and they don’t want their doctors to become entangled in time-consuming lawsuits.

Mainly, though, it is a question of the bottom line. If a crash victim turns up with no relatives to guarantee payment, he or she looks like a bad bet.

And fraudulent claims don’t help this perception.

“We see many BPL (below poverty line) cardholders coming to the hospital in Mercedes and SUVs. Those who can pay, should pay,” said Dr Alexander Thomas, executive director of the Association of Health Care Providers (India), a network of 10,000 hospitals across India.

“Everywhere we go, the hospitals give main importance to money, not life,” said Salome Jayakumar, 42, a Bengaluru resident. That became particularly clear to her one morning in June last year, when she and her daughter rushed to help a man who had come off his motorbike. After the government ambulance they called was delayed, they flagged down an autorickshaw and brought the victim to a private hospital known for expertise in trauma cases. But the doctor merely cleaned the blood off the victim’s face, said the CAT scanner was not working, and recommended another hospital.

Ms Jayakumar then spent her own money on an ambulance but the second hospital refused to accept the patient unless a relative turned up with 2,500 rupees. The patient, who had serious neck and shoulder injuries, ended up in intensive care in yet another hospital where he then recovered.

Karnataka is already persuading private hospitals to accept more road accident cases. In March last year, the southwestern state launched an insurance scheme that guarantees payment of up to 25,000 rupees for 48 hours of treatment at participating hospitals, whether private or public. While few of the major corporate – and more expensive – hospitals have signed up, officials say they have had more luck with 30-to-50 bed hospitals in smaller cities outside the capital.

So far, 30,292 accident victims have been treated under the new insurance plan at 310 private hospitals and 494 government facilities.

“Another step in the right direction,” Dr G Gururaj, head of the WHO Collaborating Centre for Injury Prevention and Safety Promotion, said of the insurance scheme.

“When it’s a matter of life and death, money is secondary,” added Dr Thomas.