In the US and probably the rest of the English speaking countries, typically only medical professionals and first responders are required to render aid, but the law does protect "good samaritans" from legal culpability if they do help.

At least in California, Good Samaritan laws will protect someone if and only if they are rendering medical aid that is in line with their training. Meaning if you know CPR and attempt to resuscitate someone who has no pulse and they die / have brain failure -> the law will protect you. If you know CPR and try to remove a bullet from someone's brain and they end up in a vegetative states (IANAL but) -> law probably won't protect you.

From my EMT course: The lawyer going after you would have to prove without doubt that the patient would clearly have survived if you didn't remove the bullet. In case of getting shot in the head, it's not very plausible that the patient would have survived anyways.

From a actual lawsuit: Someone without the proper training started an IV which later caused sepsis and death. Since the patient was admitted to an hospital it was not clear if an improply placed IV caused the death or an improper care in the hospital.

There have been recent situations here in Canada where very ill people were literally on the doorstep of the ER asking for help but were refused any help.

In nearly all the situations the staff in the building told the sick people outside to call 911 to get transported inside two feet inside the door.

The hospital workers and by that I mean nurses and doctors were unwilling to help even though the people outside were very ill.

So the problem was that those people couldn't get inside the ER by themselves and the nurses and doctors refused to move them?

I ask because I once walked my relative into an ER and they were attended to, no problem.

Yes sometimes it's a person literally on the doorstep of the ER in front of the doors. One time a news report said the person was in a passenger seat of a car. But usually right there at the ER in some state of distress.

I can understand some concerns of staff but to flat out refuse seems to go against the ethics of being in the medical trade.

I also suspect it's government bureaucracy and union rules, paperwork trumps life I guess.

So, the problem in Canada is that those policies are left up to each hospital or health unit to decide, and there doesn't appear to be a consensus (which is weird)

http://www.cbc.ca/news/health/hospital-er-call-help-1.368630...

In the US, a 'duty to act' generally only exists if someone is 'on the clock'.

Unless you have a "duty to respond", you are not required to act.

Even if you are a paramedic with the local fire department, in uniform and walking down the street, unless you are on-duty, you do not have to act. You'd be a massive dick if you didn't, but there is no legal requirement.

Correct. I was an EMT, and I would have been in no legal jeopardy for driving by an accident instead of responding, if I was off duty or outside my response area. (However, I always did stop and help if other responders were not yet on scene or looked like they could use more hands.) OTOH, my EMT license meant I was not protected by good samaritan laws. As DINKDINK pointed out, if I "helped" beyond the scope of my training, I could have been sued.

From what I've heard in Austria this protection from getting sued only applies if you're not a trained professional like a paramedic or doctor.

That shouldn't be possible in Germany anyways, since helping is a constitutional responsibility.

Therefore no normal law should be able to break your cover. As long as there's no doubt on your good intentions.

Imagine you get to an emergency as a doctor and your patient has a blocked airway, so you perform an improvised tracheostomy, but because you're nervous you cut horizontally instead of vertically and kill the patient. I'm pretty sure as a doctor good intentions are not enough in cases like this.

Of course they are. If you are in that situation, then the patient would die (asphyxiate, probably, since they cannot breathe) without help. The doctor _tried_ to help, in non-optimal circumstances, so as long as the mistake was not intentional or due to negligence, the I believe the law will protect you in most countries.

Remember also that it's not enough to win, you also have to win quickly and cheaply. If that protection isn't reasonably assured, that will tend to bias people towards non-action.