A Break for Good Samaritans

Legislation has been introduced in Sacramento to broaden the protection from malpractice suits for on-call obstetricians providing emergency-room deliveries for women for whom they have not provided prenatal care. It deserves support because it may help stem the exodus of doctors from this important service.

In effect AB 3473, by Assemblyman William J. Filante (R-Greenbrae), would extend to these obstetricians the protections of the so-called good-Samaritan law. They already have those protections when they provide emergency help outside the hospital.

There is no question of the high medical risks for poor women who, without any medical care during their pregnancies, come to emergency rooms for deliveries. They and their babies are subject to serious complications, and the obstetrician has only limited ways of anticipating the problems in the absence of a medical history. It is less clear whether there is a high risk of litigation from such patients when things go wrong. But doctors think that there is that risk, and many hospitals report serious problems in recruiting on-call obstetricians to back up emergency-room staffs. Under the proposed legislation, doctors would still be subject to legal action in the case of gross negligence.

This piecemeal remedy would not contribute to a solution to the more basic and pervasive problem of providing adequate prenatal care. The Legislature has other bills to address that problem. As matters now stand, many obstetricians refuse to provide care under the Medi-Cal program because its levels of compensation are so far below their costs. That compounds the problem of the women who, ineligible for Medi-Cal and lacking other insurance, rely on emergency rooms to deliver their babies. There probably is no better example of poor public policy in the field of medicine than this failure to fund adequately the prenatal program--a policy that results in much higher expenditures in the long run to treat complications that could have been prevented.