“Physician on board”: legal aspects of providing first aid and medical assistance by a physician on board a civil aircraft. A narrative review

Abstract

INTRODUCTION: The legal status of a physician — a passenger on a civil aircraft when providing medical assistance and/or first aid to other passengers or the crew is not fully regulated. OBJECTIVE: Assess the legal regulation of first aid and medical assistance by a physician who is a passenger on a civil aircraft. The article presents analysis of Federal Laws, orders, a review of literature. MAIN PART: According to Federal Law No 323-FZ, first aid is not considered medical assistance, but first aid kits and sets approved by orders of the Russian Ministry of Health are equipped with medical devices and pharmaceutical preparations. In a passenger aircraft, flight attendants are required to provide first aid according to their job descriptions, are required to provide first aid, using medical devices and pharmaceutical preparations from a first aid kit, as regulated by an order of the Russian Ministry of Transport. No other persons are required to provide first aid on a passenger aircraft, including passengers registered with the airline as a “physician on board”. This service is intended to identify passengers who, according to the order of the Ministry of Transport of the Russian Federation, have medical competencies and can use medical devices and pharmaceutical preparations both from the first aid kit and first aid set when providing first aid. The conditions for which first aid is provided are approved in the list of the First Aid Procedure of the Russian Ministry of Health, but they do not list natural childbirth and many life-threatening conditions for the relief of which first aid sets are equipped. The use of medical devices and pharmaceutical preparations from the first aid set and pharmaceutical preparations from the first aid kit, except for those prescribed to the passenger by the attending physician in accordance with the Procedure, do not refer to first aid, but to medical assistance provided without a licensure, which falls under the administrative and criminal liability in the Russian Federation. CONCLUSIONS: A medical professional may provide first aid on board a civil aircraft. To regulate the relationship of an aircraft passenger with a medical diploma, valid accreditation in any specialty with other passengers or the crew of the aircraft in case they have developed conditions that are imperative to provide not only first aid, but also medical assistance, it is necessary to urgently adopt the Ministry of Health of the Russian Federation of orders on the provision of extended first aid by physicians with a more complete list of life-threatening conditions and measures to eliminate them, management of natural childbirth and the ability to use all medical devices and pharmaceutical preparations from first aid kits and first aid sets approved by the Ministry of Health of the Russian Federation.

Full-text of the article is available for this locale: Russian.