Impact of the Good Samaritan Law on bystander intervention willingness and perceived legal risks in India.

IF 2.9 2区医学 Q2 CRITICAL CARE MEDICINE

Journal of Trauma and Acute Care Surgery Pub Date : 2025-02-01 Epub Date: 2025-01-06 DOI:10.1097/TA.0000000000004525

Divya Kewalramani, Rachel L Choron, Daniel Whitley, Amanda Teichman, Karuna Raina, Gautam Singh, Charoo Piplani, Zachary Englert, Joseph Hanna, Gregory L Peck, Philip S Barie, Piyush Tewari, Mayur Narayan

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引用次数: 0

Abstract

Background: Road traffic crashes (RTCs) are a global health burden, particularly in India, where response times for first responders can be prolonged. Prior to enactment of a Good Samaritan Law (GSL) in 2016, involved bystanders could face criminal and financial liability for assisting at an RTC site. This study evaluates the impact of GSL on bystander RTC attitudes, awareness, and experiences in India, comparing outcomes pre- and post-GSL implementation across metropolitan cities (MCs) and nonmetropolitan cities (NMCs). We hypothesized that GSL would lead to increased bystander willingness to assist the RTC victim.

Methods: This retrospective, cross-sectional, observational study analyzed data from two national surveys conducted in 2013 (pre-GSL, n = 1,027) and 2018 (post-GSL, n = 3,667) across 7 and 11 Indian cities, respectively. Difference-in-difference analysis, propensity score matching, and regression models were used to assess changes in willingness to assist RTC victims, awareness of GSL, legal and financial fears, and awareness of GSL.

Results: Post-GSL implementation saw an increase in willingness to assist RTC victims (Δ = +65.4%, p < 0.001) and substantial decreases in fear regarding legal (Δ = -81%, p < 0.001) and financial consequences (Δ = -75.8%, p < 0.001) of rendering assistance. GSL awareness was higher in NMCs (n = 2,215, 31.2%) compared with MCs (n = 838, 9.25%) among general citizens ( p < 0.001). Males showed higher willingness to assist RTC victims ( p < 0.01), whereas individuals with postgraduate education demonstrated increased awareness of GSL ( p < 0.01).

Conclusion: The implementation of GSL in India has transformed bystander intervention in RTCs, increasing the reported likelihood of assistance and substantially reducing legal and financial concerns. This shift demonstrates GSL's potential to improve outcomes for RTC victims. However, disparities in awareness between MCs and NMCs, as well as sex- and education-based differences, highlight the need for targeted educational campaigns. Future initiatives should focus on improving application of the law and strengthening the entire trauma chain of survival.

Level of evidence: Prognostic and Epidemiological; Level III.

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印度《好撒玛利亚人法》对旁观者干预意愿和感知法律风险的影响。

背景：道路交通碰撞是全球健康负担，特别是在印度，第一响应者的反应时间可能会延长。在2016年颁布《好撒玛利亚人法》（Good Samaritan Law， GSL）之前，参与其中的旁观者可能会因在RTC现场提供帮助而面临刑事和经济责任。本研究评估了GSL对印度旁观者RTC态度、意识和经验的影响，比较了大都市（MCs）和非大都市（NMCs）实施GSL之前和之后的结果。我们假设GSL会增加旁观者协助RTC受害者的意愿。方法：这项回顾性、横断面、观察性研究分析了2013年（gsl前，n = 1027）和2018年（gsl后，n = 3667）分别在7个和11个印度城市进行的两项全国性调查的数据。采用差异中差异分析、倾向得分匹配和回归模型来评估帮助RTC受害者意愿、GSL意识、法律和财务恐惧以及GSL意识的变化。结果：gsl实施后，帮助RTC受害者的意愿增加（Δ = +65.4%, p < 0.001），对提供援助的法律（Δ = -81%, p < 0.001）和经济后果（Δ = -75.8%, p < 0.001）的恐惧大幅减少。nmc的GSL意识（n = 2215, 31.2%）高于MCs (n = 838, 9.25%) （p < 0.001）。男性对RTC受害者的帮助意愿更高（p < 0.01），而研究生学历的个体对GSL的意识更高（p < 0.01）。结论：GSL在印度的实施改变了rtc的旁观者干预，增加了报告的援助可能性，并大大减少了法律和财务问题。这种转变表明GSL有潜力改善RTC受害者的结果。然而，mc和nmc之间在意识上的差异，以及基于性别和教育的差异，突出了有针对性的教育运动的必要性。未来的举措应侧重于改善法律的适用和加强整个生存创伤链。证据水平：回顾性比较研究；第三层次。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Trauma and Acute Care Surgery 医学-外科

CiteScore

6.00

自引率

11.80%

发文量

637

审稿时长

2.7 months

期刊介绍： The Journal of Trauma and Acute Care Surgery® is designed to provide the scientific basis to optimize care of the severely injured and critically ill surgical patient. Thus, the Journal has a high priority for basic and translation research to fulfill this objectives. Additionally, the Journal is enthusiastic to publish randomized prospective clinical studies to establish care predicated on a mechanistic foundation. Finally, the Journal is seeking systematic reviews, guidelines and algorithms that incorporate the best evidence available.