Liability and the health librarian

As information professionals, many have wondered about
potential liability if a patron were to use library resources to access content and then harmed someone with the knowledge that
they had obtained from that source.

Liability and the health librarian is a topic that often goes unaddressed in academic and hospital library settings. The areas of law that deal with liability are contracts and torts. The chances of health librarians being held liable for providing unprofessional information services (or, negligent misinformation) is a topic of some interest in the library literature and at conferences. However, a discussion of what steps might be taken to reduce the overall risk to health librarians in their work is not always emphatically stated.

How can health librarians educate users of health information not to make life and/or death decisions based on information we provide at the reference desk? Is the reliance on health librarians to provide the best information possible a reasonable expectation? Isn’t there some expectation that all patients and family members will verify the information we have provided?

In contract law, one of the recurring questions is whether our interactions with users suggest an implied contract; does the implied contract occur automatically in fee-for-service models? In fee-based services, is the health librarian obligated to provide information that will stand up to scrutiny in a court of law? Exclusion clauses are used by some hospital libraries to exclude liability, but their validity is doubtful, according to experts.

Adhering to good professional practices, and avoiding dispensing advice or interpreting health information for patients, will help to minimize liability. Another protection is to remind consumers or patients to check all health information provided by the library with their health provider or clinical team.

One of the most disturbing cases of information liability in recent memory occurred at Johns Hopkins in 2001. A healthy volunteer died from inhaling hexamethonium as part of a study. The researchers assumed that the chemical was not toxic, and they based their assumptions on literature reviews that were incomplete. The U.S. government suspended research contracts and grants involving human subjects at Johns Hopkins for a time. The U.S. Medical Library Association (MLA) seized the opportunity to say that, had the researchers consulted a qualified medical librarian, this mistake would probably not have happened.

Information malpractice

Health librarians do not seem to be especially susceptible to malpractice but it is nonetheless important to be aware of some dangers. Strictly speaking, information malpractice means the occurence of any professional conduct that shows a blatant disregard (or negligence) and a lack of duty of care. Duty of care is covered by torts under “vicarious liability” – a civil wrongdoing independent of breach of contract. A brief description of liability as it pertains to health librarians and other information professionals is worth sharing with you.

To prove liability, a case must be made that an individual’s actions derived from negligent behaviour. This negligence is viewed as deriving from four main parts of law:

  • lack of reasonable duty of care
  • serious breach of duty
  • actions that caused the problem
  • actions that led to harm of clients

Duty of care occurs where a tangible loss or injury to someone is considered a distinct possibility and actions are taken to avoid it. DoC carries the expectation that any reasonable professional person would take action against exposing someone to any unreasonable risks. A concomitant standard of care is defined as what a reasonably prudent person would do in similar circumstances. Someone may be judged as careless according to a breach of duty regardless of his or her intentions.

The remaining issue is straightforward. There must be actual harm personally or financially for a malpractice suit to be brought against someone. The court must see that the information professional was the cause of harm and is responsible for damages.

Implications for library policies

Possible disclaimers

  • No warranties, express, implied, or actual, are granted for any health or medical information used while in this library
  • The library and information service grants no warranties of any kind, expressed, implied, or statutory
  • Information provided is believed to be accurate, but is not warranteed and subject to verification
  • The library and information service disclaims any implied warranties of accuracy
  • The library and information service will not be liable in any way including but not limited to errors or omissions in any information sources
  • There is no warranty that this information or efforts of the librarian will fulfill your particular purposes or needs
  • Except for warranties stated, this information is provided with all faults, and the entire risk as to satisfactory quality, performance, accuracy is with the user.
  • Special warnings for special searches: medical, legal, etc.
  • Health librarians (or information professionals) are not medical people and consumers should consult their health providers to assist in interpreting any information
  • The search results are provided for information and educational purposes only. For ________ advice, you should see a ______ professional.

See also Bloggers – Legal aspects

4 thoughts on “Liability and the health librarian

  1. The Hopkins case is precisely the type of scenario that makes my blood run cold. What if a librarian HAD conducted the search and the information was still missed? Our professional standards require us to be proficient in our research skills but that does not translate into a legal obligation, only a moral and ethical obligation. If we are to be held liable in a court for omissions or errors then that would seem to be a compelling argument for professional licensure. Medical professionals are held accountable for grevious errors or omissions and that is partially due to the legal ramifications of holding a professional license in a given field. In most cases professions are licensed and held accountable by ruling bodies that formally monitor and enforce standards and competencies. Why not librarianship?

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