"Post crash" care: ethical implications arising out of behavioral and health system determinants

Tamil Nadu ranks first with high number of road accidents (65562) and second-highest in the number of deaths (16, 157) after Uttar Pradesh. The DALY's due to injuries is 14.2% among all other diseases of which RTI contributes to 61%, especially in males between 15–39 yrs of age.

An Epidemiological Explorative Cross-sectional study was conducted in a tertiary care government hospital in Tamil Nadu. The post crash ethical implications were assessed by interviewing good Samaritans, on-lookers, the EMT/Pilot, the health care personnel providing emergency management services at the hospital level and injured patients.

The study pointed out the various ethical challenges at the pre-hospitalization stage and hospitalization stage from the perspective of common people as well as health professionals while dealing with road traffic injuries. Further systemic issues pertaining to health systems such as refusal of admission, multiple referrals etc were also found. The inability of health systems to provide proper rehabilitation in the post-hospitalization stage is another outcome.

It's high time the post crash ethical challenges are addressed appropriately as we move forward. Further Health systems should be strengthened to provide critical care during the golden hour and also at the post hospitalization stage providing adequate rehabilitation.