On a dark Saturday evening on 27 April 2002, Dr Leila Dekker was driving her Toyota Hilux home on a dirt road in a relatively remote area near Roebourne, WA, after dumping rubbish at the tip. She stopped on the dirt road at a t-intersection waiting to turn right. A Land Rover travelling at "significant speed" along the road on which she was proposing to turn suddenly veered towards her. Dr Dekker narrowly avoided collision by driving her car forward across the road ending up at the edge of the opposite embankment. The Land Rover passed just behind her, crossed the dirt road and another embankment and rolled into a ditch. Dr Dekker heard the impact but could not then see the other vehicle.
Dr Dekker was not injured, but she was "in a state of shock", "petrified" and "freaked out". She feared for her personal safety. It was dark. Dr Dekker had no torch. She was not carrying medical or first aid equipment. She had no mobile phone with her. The police station was a minute or two away and so Dr Dekker immediately went there to report the incident. She did not first check on the Land Rover or its occupants.
The disciplinary finding
The Medical Board of Australia brought disciplinary proceedings against Dr Dekker which were heard by the Western Australia State Administrative Tribunal (SAT). The SAT found Dr Dekker guilty of improper conduct in a professional respect, by leaving the scene of the accident in order to notify the police without stopping to make an assessment to see if anyone was injured and in need of medical assistance.
The West Australian Court of Appeal (the Court) reversed the decision.
The Court found there was no evidence before the SAT that there was a professional duty or obligation on Dr Dekker immediately following the accident to assess the medical condition of the occupants of the other vehicle and render medical assistance to those occupants, if necessary, and if possible. There was no evidence that this was a generally accepted professional duty by members of the medical profession of good repute and competency in 2002. In the alternative, if there was no specific professional duty to stop and render assistance, there was no evidence before the SAT that in general, other medical practitioners of good repute and competence would regard the failure to stop and render assistance as improper, disgraceful or dishonourable.
The relevant test required a finding as to whether Dr Dekker's conduct would reasonably be regarded as improper by professional colleagues of good repute and competency generally in 2002. The SAT had made that finding without any expert or other evidence to that effect. It was insufficient for the members on the SAT merely to hold a personal conviction that Dr Dekker's conduct was improper. It was not proved that this was the generally accepted view of members of the medical profession in 2002.
The Court also found that the SAT erred in finding that Dr Dekker should have used her headlights to illuminate the scene of the accident, when there was no evidence that this was possible.
The SAT had found that Dr Dekker's state of shock was not relevant to the question of whether she had engaged in improper conduct, and was relevant only to the question of penalty. It had made a finding that Dr Dekker had a professional duty to overcome or at least put aside her shock, and to render assistance. The Court of Appeal disagreed. Dr Dekker's condition of shock and distress was relevant to whether Dr Dekker was physically capable of rendering assistance.
The unusual circumstances
A number of unusual circumstances in this case were relevant to the Court reversing the disciplinary decision. There was no existing doctor/patient relationship between Dr Dekker and the other car involved in the accident. There is no specifically applicable professional duty to render assistance in the particular circumstances as suggested by the SAT. There was a lack of light. Dr Dekker was involved as a participant in a near-miss accident and was not a disinterested observer or passer-by. Dr Dekker was distressed herself and did not have a mobile phone and did not have any medical or first aid equipment on her. Further, the police station was just a minute or so away.
The appeal was allowed on the basis that:
- there was no evidence of a specific professional duty to stop and render assistance as formulated by the SAT;
- the rules of natural justice precluded the SAT from drawing on its own knowledge and experience to find a specific professional duty; and
- insofar as the SAT merely relied on a general duty to care for the sick, when applied to the specific circumstances of this case, that finding could not be upheld in the absence of evidence.
If there is good reason not to stop, medical practitioners may avoid adverse disciplinary findings if they encounter a motor accident and choose not to render assistance. Examples are given in the judgment of some such scenarios (such as when on the way to another emergency). Future cases will depend on their specific facts. Practitioners should be aware there may be circumstances where they should stop and provide medical assistance.