293 Assessing the on-ground impact of policy frameworks: a case study of the impact of the good samaritan judgment & its statutory provisions on road safety and injury care in India

Background Road crashes contribute significantly to trauma related deaths in the India, witnessing 19 road crash deaths every hour.1 Approximately 45% of 'registered deaths' in 2020 occurred without any medical attention at the time of death, which translates to approximately 36.5 lakh people.2 Early recognition and timely access to needed care can result in saving several lives.3 Bystanders who come forward to help road crash survivors form a key stakeholder. In India, the Good Samaritans (protection from any resulting legal and procedural liabilities) judgment was passed by the court in 2016 and subsequently included in the Motor Vehicle Act in 2019. This paper presents findings on the awareness of the Good Samaritan Law among the law enforcement and medical care providers, subsequently assessing policy implications of the Good Samaritan Law. Objective This study presents evaluation results of the longitudinal research involving KABP (Knowledge, Attitude, Behaviour Practices) Surveys conducted in seven cities across India in 2013, eleven cities in 2018, and twelve cities in 2021 to document impediments to bystander care and perceptions of the Good Samaritan Law among citizens, police, medical practitioners, and the judiciary, resulting in the evaluation of the law's implementation status before the 2016 judgment, after the judgment and after the MVAA 2019 amendment to the law. Method The study used a multi-stage purposive sampling for the KABP Surveys. Seven cities were selected in the 2013 survey based on road crashes, severity, and socio-economic diversity followed by a similar approach for 11 cities in 2018 and 12 cities in 2021. The respondents were sampled across population categories within cities and along the highways, police officials, hospital staff, judiciary to ensure a mix of all important stakeholders. Quantitative surveys, interviews and observational studies were undertaken across 1027 respondents in 2013, 3667 respondents in 2018 and 2054 respondents in 2021. Results In 2013, 3 out of 4 Indians hesitated to assist in road crashes, with 77% attributing to unnecessary detention in the hospitals and having to pay for registration charges. The unwillingness to help the injured due to legal and procedural hassles has decreased from 88% in 2013 to 62% in 2018. The level of awareness regarding the Good Samaritan Law has only marginally increased from 16% in 2018 to 23.5% in 2021. In 2018, the surveyed Good Samaritans confirmed that 59% were detained by police and 22% were detained at hospitals while trying to help injured road crash victims indicating limited awareness among the doctors and police officials. In 2018, 64% of the surveyed police officials admitted that they take personal details of Good Samaritan. In 2018, more than one third of Police officials admitted to having pursued and pressurized Good Samaritans to become eye-witnesses to the case. In 2018, 96% of medical care providers couldn't confirm the required compliance to the Supreme Court Judgment on Good Samaritan Law. Conclusions The results advocate for wider awareness of the Good Samaritan Law among the law enforcing stakeholders i.e. law enforcement and medical care providers. This paper also advocates for more sub-national research on understanding impediments to full implementation of the law as well as identification and operationalization of better implementation mechanisms at the sub-national level. Despite legislative efforts, awareness and implementation of the Good Samaritan Law is not adequate. While there has been an increase in the awareness, law enforcement and medical care providers continue to not comply with the law. Policymakers need to agree on enhanced implementation strategies to bridge the gap between legislation and on ground implementation, ensuring that in resource constrained settings where the role of bystanders is critical, they feel protected to come forward and save lives. References 1. MoRTH, 2022 2. 45% of the total registered deaths (81,15,882) according to the Vital Statistics of India based on Civil Registration System 2020 issued by the Office of the Registrar General & Census Commissioner, India (ORGI) 3. WHO