Medical care provided during a disaster should be immune from liability or criminal prosecution.

On August 29, 2005, Hurricane Katrina struck the Gulf Coast and resulted in widespread devastation. The collapse of social services including medical care was followed by chaos and resulted in many deaths. In this aftermath, a physician and two nurses were charged with homicide in the deaths of four patients who were under their care at a New Orleans Hospital. The circumstances surrounding these deaths are unclear, and causation far from proven. But in any disaster setting, if healthcare providers contribute to a patient's death, there are a limited number of possible scenarios. The actions may be done with criminal intent, may be the result of medical errors, may involve the principle of double effect, or finally, and most problematic, the deaths may involve euthanasia (either voluntary or involuntary). This review discusses each possibility and the ethical and legal basis for immunity in these situations. Because the circumstances were so unique, no comparison to routine practice can be made, but an interesting comparison to battlefield ethics can be made. Finally the rationale for immunity is explored, including a utilitarian approach, the good Samaritan laws, and various existing immunity statutes.