ICJEM
Intercontinental Journal of Emergency Medicine

The Intercontinental Journal of Emergency Medicine aims to publish issues related to all fields of emergency medicine and all specialties involved in the management of emergencies in the hospital and prehospital environment of the highest scientific and clinical value at an international level and accepts articles on these topics.

eISSN: 2980-1400
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Review
In-flight emergency medical ıntervention: physicians' legal responsibilities
Abstract
Medical emergencies occurring during commercial flights raise the issue of physicians' responsibility to provide in-flight medical assistance. The increasing number of passengers, the prevalence of long-haul flights, and the rising proportion of elderly individuals traveling by air contribute to the growing frequency of in-flight medical emergencies. However, the physical constraints of the flight environment, limited medical equipment, and restricted communication capabilities complicate the intervention process. This study evaluates the management of in-flight medical emergencies, intervention procedures, and the legal responsibilities of physicians. First, the most common medical conditions encountered during flights and their management strategies are discussed. Subsequently, physicians' duty to intervene, ethical responsibilities, and legal obligations according to national and international regulations are examined. Legal frameworks such as "Good Samaritan Laws," jurisdictional ambiguities, and potential legal risks are analyzed in different countries. Standardizing in-flight medical interventions, strengthening legal protections for physicians, and enhancing the capacity for emergency medical response on aircraft are of critical importance. In particular, developing pre-flight risk assessment mechanisms, regulating flight restrictions based on medical conditions, and reinforcing collaboration between airline companies and health authorities are essential. Additionally, expanding educational programs to raise physicians' awareness of aviation medicine and integrating technological solutions to support in-flight medical interventions are among the strategies that could enhance patient safety and intervention efficacy.

Keywords : Air travel, emergency, medical, first aid, physicians, legal liability

Download Article


1. Peterson DC, Martin-Gill C, Guyette FX, et al. Outcomes of medical emergencies on commercial airline flights. N Engl J Med. 2013;368(22): 2075-2083. doi:10.1056/NEJMoa1212052
2. Chandra A, Conry S. In-flight medical emergencies. West J Emerg Med. 2013;14(5):499-504. doi:10.5811/westjem.2013.4.16052
3. Hinkelbein J. Significant more research required: no further progress without sound medical data and valid denominators for in-flight medical emergencies. J Travel Med. 2015;22(6):355-356. doi:10.1111/jtm. 12227
4. Kesapli M, Akyol C, Gungor F, et al. Inflight emergencies during Eurasian flights. J Travel Med. 2015;22(6):361-367. doi:10.1111/jtm.12230
5. House of Lords. Chapter 7: Other medical concerns. In: Science and Technology Fifth Report. London: House of Lords; 2000.
6. Özüçelik DN. Uçuş sırasında karşılaşılabilecek medikal aciller ve uçuşta COVID-19 önlemleri. J Acad Emerg Med. 2020;1(2):74-97.
7. Shepherd B, Macpherson D, Edwards CMB. In-flight emergencies: playing The Good Samaritan. J R Soc Med. 2006;99(12):628-631. doi:10. 1177/014107680609901211
8. Hu JS, Smith JK. In-flight medical emergencies. Am Fam Physician. 2021;103(9):547-552.
9. Sunay D. Havacılık tıbbı. Havacılık Uzay Çalışmaları Derg. 2021;1(2): 26-41.
10. Kuvaki B. Uçakta doktor var mı? Turk J Resuscitation. 2022;1(2):72-77.
11. Cocks R, Liew M. Commercial aviation in-flight emergencies and the physician. Emerg Med Australas. 2007;19(1):1-8. doi:10.1111/j.1742-6723. 2006.00928.x
12. Borges do Nascimento IJ, Jeroncic A, Arantes AJR, et al. The global incidence of in-flight medical emergencies: a systematic review and meta-analysis of approximately 1.5 billion airline passengers. Am J Emerg Med. 2021;48:156-164. doi:10.1016/j.ajem.2021.04.010
13. Epstein CR, Forbes JM, Futter CL, et al. Frequency and clinical spectrum of in-flight medical incidents during domestic and international flights. Anaesth Intensive Care. 2019;47(1):16-22. doi:10. 1177/0310057X18811748
14. Graf J, Stüben U, Pump S. In-flight medical emergencies.Dtsch Arztebl Int. 2012;109(37):591-602. doi:10.3238/arztebl.2012.0591
15. Wong M. Doctor in the sky: medico-legal issues during in-flight emergencies. Med Law Int. 2017;17(1-2):65-98. doi:10.1177/ 0968533217705693
16. Sirven JI. Is there a neurologist on this flight?: an update. Neurol Clin Pract. 2018;8(5):445-450. doi:10.1212/CPJ.0000000000000505
17. Kodama D, Yanagawa B, Chung J, et al. Is there a doctor on board?: practical recommendations for managing in-flight medical emergencies. CMAJ. 2018;190(8):E217-E222. doi:10.1503/cmaj.170601
18. Cascante-Rodrigo JA, Iridoy-Zulet AA, Alfonso-Imízcoz M. Current legal framework and practical aspects of oxygen therapy during air travel. Arch Bronconeumol. 2015;51(1):38-43. doi:10.1016/j.arbres.2014. 06.004
19. AlShamlan NA, AlOmar RS, Alrayes MM, et al. Is there a doctor on board?: willingness and confidence of physicians in the Kingdom of Saudi Arabia in assisting with in-flight medical emergencies. BMC Emerg Med. 2021;21(1):54. doi:10.1186/s12873-021-00453-z
20. Hakeri H. Acil sağlık hizmetlerinde hukuki sorunlar. SD Derg. 2017; Spring:44-45.
21. Adwani SH, Jhorar P, Grant-Kels JM. Is there a doctor onboard?: the ethical conundrum of a specialist asked to provide in-flight medical assistance. J Am Acad Dermatol. 2018;79(2):387-389. doi:10.1016/j.jaad. 2017.12.066
22. Türk Tabipleri Birliği. Hekimlik meslek etiği kuralları [Internet]. Ankara: Türk Tabipleri Birliği; 1998. Accessed: January 15, 2025.
23. Türkiye Cumhuriyeti Resmi Gazete. Tıbbi deontoloji nizamnamesi [Internet]. 1960 Jun 19. Accessed: January 11, 2025.
24. Türkiye Cumhuriyeti Resmi Gazete. 3359 sayılı Sağlık Hizmetleri Temel Kanunu [Internet]. 1987 May 7. Accessed: January 20, 2025.
25. Türkiye Cumhuriyeti Resmi Gazete. 5237 sayılı Türk Ceza Kanunu [Internet]. 2004 Sep 26. Accessed: January 20, 2025.
26. Türkiye Cumhuriyeti Resmi Gazete. Hasta Hakları Yönetmeliği [Internet]. 1998 Aug 1. Accessed: January 15, 2025.
Article available in :
Volume 3, Issue 2, 2025
Page : 39-43
https://doi.org/10.51271/ICJEM-0056
Article Information
Received : 12 Şub 2025
Accepted : 25 Şub 2025
Published : 13 Haz 2025
Corresponding Author :

Melih Çamcı: Department of Emergency Medicine, Ankara Bilkent City Hospital, Ankara, Turkiye

[email protected]
Citation : Çamcı M. In-flight emergency medical intervention: physicians' legal responsibilities. Intercont J Emerg Med. 2025;3(2):39-43.

Read: 218
Download : 201
Cited: 0
_Footer