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Observational Study
. 2025 Feb 1;98(2):228-235.
doi: 10.1097/TA.0000000000004525. Epub 2025 Jan 6.

Impact of the Good Samaritan Law on bystander intervention willingness and perceived legal risks in India

Divya Kewalramani  1 , Rachel L Choron, Daniel Whitley, Amanda Teichman, Karuna Raina, Gautam Singh, Charoo Piplani, Zachary Englert, Joseph Hanna, Gregory L Peck, Philip S Barie, Piyush Tewari, Mayur Narayan
Affiliations
Observational Study

Impact of the Good Samaritan Law on bystander intervention willingness and perceived legal risks in India

Divya Kewalramani et al. J Trauma Acute Care Surg. .

Abstract

Background: Road traffic crashes (RTCs) are a global health burden, particularly in India, where response times for first responders can be prolonged. Prior to enactment of a Good Samaritan Law (GSL) in 2016, involved bystanders could face criminal and financial liability for assisting at an RTC site. This study evaluates the impact of GSL on bystander RTC attitudes, awareness, and experiences in India, comparing outcomes pre- and post-GSL implementation across metropolitan cities (MCs) and nonmetropolitan cities (NMCs). We hypothesized that GSL would lead to increased bystander willingness to assist the RTC victim.

Methods: This retrospective, cross-sectional, observational study analyzed data from two national surveys conducted in 2013 (pre-GSL, n = 1,027) and 2018 (post-GSL, n = 3,667) across 7 and 11 Indian cities, respectively. Difference-in-difference analysis, propensity score matching, and regression models were used to assess changes in willingness to assist RTC victims, awareness of GSL, legal and financial fears, and awareness of GSL.

Results: Post-GSL implementation saw an increase in willingness to assist RTC victims (Δ = +65.4%, p < 0.001) and substantial decreases in fear regarding legal (Δ = -81%, p < 0.001) and financial consequences (Δ = -75.8%, p < 0.001) of rendering assistance. GSL awareness was higher in NMCs (n = 2,215, 31.2%) compared with MCs (n = 838, 9.25%) among general citizens ( p < 0.001). Males showed higher willingness to assist RTC victims ( p < 0.01), whereas individuals with postgraduate education demonstrated increased awareness of GSL ( p < 0.01).

Conclusion: The implementation of GSL in India has transformed bystander intervention in RTCs, increasing the reported likelihood of assistance and substantially reducing legal and financial concerns. This shift demonstrates GSL's potential to improve outcomes for RTC victims. However, disparities in awareness between MCs and NMCs, as well as sex- and education-based differences, highlight the need for targeted educational campaigns. Future initiatives should focus on improving application of the law and strengthening the entire trauma chain of survival.

Level of evidence: Prognostic and Epidemiological; Level III.

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References

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