Engineering Emergency Medical Treatments

Practicing Medicine and Engineering on Star Trek Discovery

Star Trek Discovery season 2 opened with Brother, which captured the essential qualities of Star Trek. The episode is about a phenomenon that could be a massive threat that brought Captain Christopher Pike onboard the USS Discovery.

Our heroes discovered the USS Hiawatha, a medical frigate that had crashed on an unstable asteroid where the crew expected to find the red anomaly of unknown origin. The Hiawatha was lost ten months earlier during the Klingon War. The Away Team found the heavily damaged hull and met Commander Jett Reno. Reno was the engineering officer who had kept injured crew alive with “alternative” medicine based on her engineering skills and crash course in medical texts. For example, one crewmember she nicknamed Valentine needed a heart transplant, so she used the heart of a dead Bolian in jar with a pump system to keep the patient alive.

Did Commander Reno get consent from the patients for her engineering based medical treatments? Are there any defenses for her in the event someone sues for her “ipsumpathy” emergency medical procedures?

Duty to Inform Patient of Possible Consequences of Medical Treatment

Doctors have a duty to inform a patient of possible consequences of a medical procedure and secure informed consent of their patients. This is a defense to a malpractice action. Exceptions for not securing consent include a patient being unconscious; a doctor reasonably believed that a medical procedure should be undertaken immediately and that there was insufficient time to fully inform the patient; and procedure was performed on a person legally incapable of giving consent and there was insufficient time to obtain informed consent for that person. See, Cal. Bus. & Prof. Code § 2397(a)(1) to (3).

As fast as you can say, “Damn it, Jim, I am a doctor, not an engineer,” you can notice a problem for Commander Reno: she was an engineer, not a doctor.

Medical Treatment After a Vessel Accident 

Commander Reno has a valid defense if any of her medical decisions are questioned under a “Good Samaritan” law for vessels involved in a collision, accident, or other casualty. Vessel operators in an accident have a duty to render aid to persons affected by the accident that is practicable and necessary to save them from the accident, provided they could do so without serious injury to their own vessel. Cal. Harb. & Nav. Code § 656(a).

Anyone who in good faith renders assistance at the scene of a vessel accident without objection by any person assisted, shall not be held liable for any civil damages sought for any medical treatment, provided the assisting person acted as a “an ordinary, reasonably prudent person would have acted under the same or similar circumstances.” Cal. Harb. & Nav. Code § 656(b).

Commander Reno was likely the third or fourth person in command of the USS Hiawatha. It is highly likely the Captain and First Officer were killed in the attack that crippled the vessel; the commanding officer does not normally abandon ship while anyone is left aboard. It is highly likely Reno was in command due to death or injury of the bridge officers. Reno bravely stayed with the “sinking” ship, because the remaining injured could not be evacuated to escape pods.

Reno could argue she reasonably believed she had a duty to save the injured officers after the crash as the officer in charge of the vessel. The injured officers had varying life threatening injuries that would have resulted in death if not treated. As in the case of Valentine, the officer who needed a heart transplant, he would have died but for Reno piggybacking his heart to a Bolian heart. Reno went beyond what a reasonably prudent person would do, to what an exceptionally brilliant person would do in order to save life. While Reno lacked a medical degree, she clearly was resourceful and should avoid any liability if she did not seek consent before her unorthodox emergency medical treatments.

The better question is what awards to nominate Reno for her gallant conduct in saving the lives of others. That is one of the defining characteristics of Star Trek and it is great to see it again each week.