210 BOOK REVIEWS MEDIA REVIEWS

MEDIA REVIEWS

Legal Aspects of Emergency

Medical Services. BY BRUCEM. COHN and ALAN J. AZZARA.Philadelphia: W. B. Saunders,1998, 176 pp, $18.00 (softcover).

Don’t buy Legal Aspects of Emer-gency Medical Services unless youbelong to one of the following cate-gories: public or private emergencymedical services (EMS) agencies,EMS managers or supervisors, riskmanagers, EMS physician medicaldirectors, communications person-nel, emergency medical technicians(EMTs), paramedics, or EMS stu-dents.

Bruce Cohn and Alan Azzarahave accomplished two significanttasks with this book. First, throughcareful explanation and case exam-ples, they have eliminated the con-cept of ‘‘It can’t happen to me.’’ Sec-ond, they’ve explained their termscarefully, and kept the legalese to aminimum. This would be a surprisewere it not for the fact that the au-thors are both EMS providers aswell as attorneys. Mr. Cohn is anEMT-CC (cardiac care) in New YorkState, and Mr. Azzara is a para-medic in Maine. In fact, both au-thors developed years of experiencein their EMS careers before becom-ing attorneys.

While only 176 pages, it is theideal primer for dealing with the le-gal issues that surround modernEMS operations. To say it is compre-hensive requires an explanation.Given the multitude of variations inEMS law between the states, andeven between municipalities, a trulycomprehensive EMS legal manualwould take up a small library, mostof which would serve no better pur-

pose than to be an expensive door-stop. This book is comprehensive ina more general sense. Pick a subject,and Legal Aspects of EmergencyMedical Services has at least some-thing basic to say about it, whetherthe subject has to do with patientcare, malpractice, employer/employeerelations, occupational health andsafety, vehicle operations, commu-nications, or risk management. Theyeven manage to provide a basic over-view of the American legal system.

Now before you call your attor-ney to take him or her off retainer,stop. While this book provides agreat deal of useful information, it isnot a substitute for competent legalcounsel. What this book does do isgive you a basic understanding of le-gal principle, to help keep yousteered in the right direction (awayfrom legal trouble). It even offerssuggestions of when to contact yourattorney (‘‘Early, rather than late’’according to the authors, if you sus-pect an incident might lead to liti-gation). It is the authors’ hope thatthis book will help you better under-stand your attorney when you findyourself stepping out of your ele-ment and into his or hers.

Cohn and Azzara impart theirbasic legal wisdom in three ways. Aswe mentioned, they use plain En-glish to help the reader understandlegal principles. To further illustratea point, they include ‘‘case studies’’(the names are changed to protectthe innocent) and examine whowould be liable in a given situation.Finally, they offer ‘‘practice tips’’ atthe end of each chapter. These shortphrases are the things most impor-tant to take away at the end of thechapter.

From where we sit, there are two

problems with this book. First, legalissues regarding emergency vehicleoperation are buried in chaptereleven. This is despite the fact thateven according to the authors ‘‘thebiggest liability of EMS providers isemergency vehicle operations.’’ Mal-practice takes the limelight of chap-ter two. It seems that the authorsused the long-held fear of malprac-tice to hook the reader, despite thefact that there is a far greater legalrisk in simply responding to the call.

The second problem deals withcommunications. It’s lumped in witha number of other issues, giving theappearance that not much can hap-pen in the communications center.Modern EMS communications is farmore advanced than simply dis-patching ambulances. Today, emer-gency medical dispatchers (EMDs)begin providing patient care in anenvironment never imagined byEMS pioneers. You are on the phonewith a caller you’ve never met, whomay not have any medical knowl-edge or training, and you are direct-ing them to perform at least a basicphysical exam, and provide basicfirst aid, all without ever havingseen the patient. If this doesn’t spellliability risk, we don’t know whatdoes. Hopefully, in any future edi-tions, the authors will spend sometime in a modern communicationscenter, and give us the legal advicewe need.

Overall, we’re very impressedwith Messrs. Cohn and Azzara’s ef-fort to explain the myriad legal is-sues in providing EMS. Legal As-pects of Emergency Medical Servicesshould be in every EMS headquar-ters, every station, and every EMSacademy’s library. It’s found a homein ours.—ROBERT BALL, EMT-P,and CHRIS KUMMER, EMT-P/Super-visor, Hennepin County MedicalCenter EMS/Ambulance Service,Minneapolis, MN