Occasionally people are born, become ill, and even die on board aircraft in flight. In July last year, Paul Keetch, Liberal Democrat member of parliament for Hereford, collapsed on a flight from London to Washington, DC. He survived a potentially lethal arrhythmia after prompt treatment with an automatic external defibrillator. Earlier this year a pilot for Air Canada developed signs of acute mental illness near the end of a transatlantic flight and had to be escorted off the rapidly diverted plane into a mental health facility in Ireland.1 Less than a month later, copilot Michael Warren collapsed and died on a flight to Cyprus. The plane landed safely in Istanbul.2

When the worst happens, the captain often asks for help from medical professionals who happen to be on board. Doctors who answer the call must practise medicine in one of the remotest environments on earth. But here are some reassuring thoughts: despite these headline events, of the 36 million passengers carried by British Airways last year, only 375 needed a doctor while flying; and if you do offer to help a stricken passenger or crew member you will be acting as part of a team with shared responsibility for what happens. Industry experts say the risk of litigation is close to zero.