“At the time of the discussion, Farmer was medically stable, with some vaginal bleeding that was not heavy.
“Therefore contrary to the most appropriate management based (sic) my medical opinion, due to the legal language of MO law, we are unable to offer induction of labor at this time,” the report quotes the specialist as saying.”
So yes, the law did prevent an abortion and endangered her life.
She is suing because she expected an exception for herself.
“While many state laws have recently changed, it’s important to know that the federal EMTALA requirements have not changed, and continue to require that healthcare professionals offer treatment, including abortion care, that the provider reasonably determines is necessary to stabilize the patient’s emergency medical condition,” Becerra wrote.
“The hospital’s noncompliance creates a reasonable expectation that an adverse outcome resulting in serious injury, harm, impairment, or death will occur to current or future individuals in similar situations if not immediately corrected,” the report states.
“Although her doctors advised her that her condition could rapidly deteriorate, they also advised that they could not provide her with the care that would prevent infection, hemorrhage, and potentially death because, they said, the hospital policies prohibited treatment that could be considered an abortion,” Becerra wrote. “This was a violation of the EMTALA protections that were designed to protect patients like her.”
Farmer suffered what doctors call preterm premature rupture of membranes — her water broke, followed by vaginal bleeding, abdominal pressure and cramping, the Springfield News-Leader reported in an October article. Doctors told her she would be unlikely to carry the child to term, and doing so increased her chances of infection or other severe outcome.
This is not a medical error. EMTALA is not a protective law for healthcare facilities or professionals. The state can still prosecute based on their own laws, and in Texas, for example, performing an abortion can come with a lifetime sentence.
From the medical provider and hospitals standpoint, you are now stuck between a rock and a hard place. Perform an abortion and face criminal charges from the state or refrain and face civil charges from the fed.
If you had the choice to face a criminal charge (prison sentence) or a civil charge (fine), which would you pick?
Texas law imposes severe criminal penalties for performing abortions. Medical professionals who perform abortions face first-degree felony charges punishable by five years to life in prison if the procedure results in fetal death. Attempting or inducing an abortion is a second-degree felony, carrying two to20 years imprisonment. Additionally, providers face minimum civil penalties of $100,000per violation and mandatory revocation of their medical license.
If a state tried to convinct someone of providing an emergency abortion, the federal government’s law would supercede the law prohibiting emergency abortions (which doesn’t exist). Your statement about legal threats would only make sense if a significant number of doctors had been convicted, or even just charged, of an unlawful abortion despite claiming it was an emergency. So far, nobody has.
As it stands, there is no risk of criminal charges. Your choice doesn’t exist.
Which federal law are you referring to? EMTALA does not supersede state law, nor does it prevent the state from pursuing criminal charges for abortion.
It’s unrealistic to expect a significant number of doctors to throw away their livelihoods and go to prison to prove a legal threat. Doctors are being advised by risk management divisions of the hospital to not even consider abortions in these cases (in certain states) because it means saying goodbye to your practice, your savings, and your family.
Texas successfully challenged EMTALA's application to abortion cases through a lawsuit in 2022. The 5th Circuit Court ruled that EMTALA does not mandate abortion care or override state law. Texas became the only state exempt from federal emergency care requirements for pregnant patients. Under Texas law, abortion is only permitted for "risk of death" rather than EMTALA's broader "serious jeopardy" to health standard
Tuesday’s ruling, authored by Judge Kurt D. Engelhardt, said the court “decline[d] to expand the scope of EMTALA.”
“We agree with the district court that EMTALA does not provide an unqualified right for the pregnant mother to abort her child,” Englehardt wrote. “EMTALA does not mandate medical treatments, let alone abortion care, nor does it preempt Texas law.”
EMTALA supercedes state law because it is federal law. This is standard legal doctrine.
Nobody has been prosecuted for performing an abortion since the Dobbs decision. Hundreds of abortions have happened in Missouri since Dobbs, and nobody has been prosecuted there.
There’s literally less legal danger in performing an emergency abortion/premature delivery in a ban state than in shoplifting $500 of merchandise in San Francisco. The doctors who have done the post-Dobbs abortions have clearly done the calculus and found this to be the case. Nobody has been or needs to be “sacrificed.”
EMTALA supercedes state law because it is federal law. This is standard legal doctrine.
Texas disagrees. Please see above source.
Nobody has been prosecuted for performing an abortion since the Dobbs decision. Hundreds of abortions have happened in Missouri since Dobbs, and nobody has been prosecuted there.
No one’s going to risk their livelihood on precedent. While legal precedent is important, it doesn’t provide meaningful reassurance when the stakes are this high.
Texas abortion law protects emergency abortions. The lawsuit was about an expansion of the definition of “emergency” justified by EMTALA. From the decision, quoted from the article:
Judge Leslie Southwick said there were several “extraordinary things, it seems to me, about this guidance,” and said it seemed HHS was trying to use EMTALA to expand abortion access in Texas to include “broader categories of things, mental health or whatever else HHS would say an abortion is required for.” Tuesday’s ruling, authored by Judge Kurt D. Engelhardt, said the court “decline[d] to expand the scope of EMTALA.” “We agree with the district court that EMTALA does not provide an unqualified right for the pregnant mother to abort her child,” Englehardt wrote. “EMTALA does not mandate medical treatments, let alone abortion care, nor does it preempt Texas law.”
Nobody is risking their livelihood by performing abortions because there is no legal risk for performing them in emergencies. How many prosecutions of emergency abortions since Dobbs - not threats of prosecution, because those have no teeth - can you find? Or any prosecutions at all? And here is my source for the hundreds of abortions figure.
EMTALA does not apply once the patient has been admitted to the hospital. It applies to ER care only.
There is no medicolegal standard for “life-threatening” That determination is, to a degree, subjective.
In many cases, a patient will come to the ER in a non life threatening clinical state and get sicker following admission. EMTALA no longer applies to these patients.
If, in retrospect, a doctor performs an abortion and its decided that the mother’s life was not at risk, they face a felony charge.
Per the Texas Supreme Court, exceptions apply only when death or serious physical impairment is imminent (which is probably too late to save the patient and have a good functional outcome, unfortunately)
The problem here is legislation. There is no medical error being made. Practitioners are making a risk-benefit assessment and choosing not to martyr themselves.
I feel that you’re not familiar with medical practice and are oversimplifying a very complex issue.
It wasn’t just getting sued. Your healthcare provider would face a class B felony and likely revocation of their license prior to amendment 3 passing.
Missouri faces the nation's fourth-largest shortage of healthcare professionals, with 111 of 114 counties designated as health professional shortage areas. The state projects a deficit of 3,102 doctors by 2030, including 687 primary care providers. Hospital staffing remains strained, with a 17.4% vacancy rate for registered nurses, representing 6,982 unfilled positions. The crisis is compounded by Missouri exporting one-third of medical students to out-of-state residency programs.
It’s not good business for a portion of your workforce to end up in prison when you’re already in a shortage area.
It would be cool if she won, but I don’t think she will. Super easy to argue that her circumstances had not yet reached the level of “medical emergency”.
It would also be super easy to argue the hospital is at fault given they were cited by the HHS secretary for refusing to provide care required by federal law.
It still matters because the Federal courts can set precedent that the Federal law (obviously, that’s how Federalism works) overrides state abortion bans.
This is the link I was talking about. I probably should have been clearer. But this isn’t just the plaintiff’s opinion, it’s a clear statement by the HHS secretary.
It could be very easily argued that “could deteriorate rapidly” is not a medical emergency, and therefore does not meet the requirements of the MO or federal laws to allow for inducing labor or abortion.
Given the overzealous rhetoric from state officials, I understand the hospital and doctor’s reluctance to provide care. We are fucking ourselves.
If the “overzealous rhetoric” had any teeth, any of the doctors who had performed one of the hundreds of abortions in Missouri since Dobbs would have been arrested. They haven’t.
Doctors told her she would be unlikely to carry the child to term, and doing so increased her chances of infection or other severe outcome.
When the law is a witch hunt not based on science, doctors cannot operate based on their best judgement based on science. Real issues of “unlikely” and “increased her chances” aren’t the same things as immediate medical emergency: they prevent an immediate medical emergency. Any law restricting abortions to when they are “medically necessary” will always lead to cases where its denied until its immediately medically necessary, at which point it may be too late. This is a clear-cut example of what such laws will always do and doctors being forced to tiptoe around the feelings of fanatics instead of being able to practice medicine.
How many doctors have been criminally charged for providing an abortion in states that have banned them? Emergency permissions have been in place for as long as abortion restrictions have. If they wanted to remove those restrictions, they would have had every reason to do so when the Dobbs decision came through. Although based on the HHS secretary’s words, such a thing would be a violation of federal law.
Some doctors would rather risk their patient dying than face legal issues. Many are leaving those states and forcing pregnancy centers to close due to lack of staff, which also affects the mortality of the women in those areas.
Hundreds of thousands of people die every year because of medical errors for any number of reasons. The law doesn’t need to be involved for that to happen. Blaming a law which explicitly allows abortions for emergencies, when doctors are already known to make enough fatal errors for hundreds of thousands of people to die every year, makes no sense. This isn’t exacerbating an existing issue, their interest in dodging liability is.
federal EMTALA requirements have not changed, and continue to require that healthcare professionals offer treatment, including abortion care, that the provider reasonably determines is necessary to stabilize the patient’s emergency medical condition
At the time of the discussion, Farmer was medically stable, with some vaginal bleeding that was not heavy.
Sounds like she was not experiencing an emergency medical condition that would have required stabilization. It could have become more severe, which explains why conventional care would have been abortion, but it was not, at the moment of presentation.
Sure would be nice if they would just let the physicians practice medicine, without having to second guess which law takes precedence.
There’s no need to second guess. The law is explicit. Furthermore, she had been seen by several hospitals and they all denied her treatment. The situation was exacerbated by their negligence.
That’s a misinterpretation of EMTALA and the words of the HHS secretary.
They didn’t say that they would protect providers who perform abortions. They said they would seek civil punishment for those that do not. That’s very different from providing protection.
There were multiple hospitals involved and cited for failing to treat her. One excerpt from one medical report doesn’t refute that. The HHS secretary explicitly said that, under the federal EMTALA, hospitals are required to provide emergency care, which they did not.
The HHS secretary can say whatever they want. It doesn’t mean they know how things will play out in court. Hospitals employ leagues of lawyers to assess legal risk/exposure and with criminal penalties on the table in all of the 14 states where abortion is banned, it appears that they’ve determined its better to pay the fine than have many of their doctors and nurses go to jail.
From your link:
“At the time of the discussion, Farmer was medically stable, with some vaginal bleeding that was not heavy. “Therefore contrary to the most appropriate management based (sic) my medical opinion, due to the legal language of MO law, we are unable to offer induction of labor at this time,” the report quotes the specialist as saying.”
So yes, the law did prevent an abortion and endangered her life.
She is suing because she expected an exception for herself.
According to the HHS secretary:
Medical errors are a serious issue in the US, harming over 400,000 people and killing over 200,000 in a single year. This is a clear-cut example of a harmful medical error.
This is not a medical error. EMTALA is not a protective law for healthcare facilities or professionals. The state can still prosecute based on their own laws, and in Texas, for example, performing an abortion can come with a lifetime sentence.
From the medical provider and hospitals standpoint, you are now stuck between a rock and a hard place. Perform an abortion and face criminal charges from the state or refrain and face civil charges from the fed.
If you had the choice to face a criminal charge (prison sentence) or a civil charge (fine), which would you pick?
Texas law imposes severe criminal penalties for performing abortions. Medical professionals who perform abortions face first-degree felony charges punishable by five years to life in prison if the procedure results in fetal death. Attempting or inducing an abortion is a second-degree felony, carrying two to 20 years imprisonment. Additionally, providers face minimum civil penalties of $100,000 per violation and mandatory revocation of their medical license.If a state tried to convinct someone of providing an emergency abortion, the federal government’s law would supercede the law prohibiting emergency abortions (which doesn’t exist). Your statement about legal threats would only make sense if a significant number of doctors had been convicted, or even just charged, of an unlawful abortion despite claiming it was an emergency. So far, nobody has.
As it stands, there is no risk of criminal charges. Your choice doesn’t exist.
Which federal law are you referring to? EMTALA does not supersede state law, nor does it prevent the state from pursuing criminal charges for abortion.
It’s unrealistic to expect a significant number of doctors to throw away their livelihoods and go to prison to prove a legal threat. Doctors are being advised by risk management divisions of the hospital to not even consider abortions in these cases (in certain states) because it means saying goodbye to your practice, your savings, and your family.
Texas successfully challenged EMTALA's application to abortion cases through a lawsuit in 2022. The 5th Circuit Court ruled that EMTALA does not mandate abortion care or override state law. Texas became the only state exempt from federal emergency care requirements for pregnant patients. Under Texas law, abortion is only permitted for "risk of death" rather than EMTALA's broader "serious jeopardy" to health standardhttps://www.texastribune.org/2024/01/02/texas-abortion-fifth-circuit/
EMTALA supercedes state law because it is federal law. This is standard legal doctrine.
Nobody has been prosecuted for performing an abortion since the Dobbs decision. Hundreds of abortions have happened in Missouri since Dobbs, and nobody has been prosecuted there.
There’s literally less legal danger in performing an emergency abortion/premature delivery in a ban state than in shoplifting $500 of merchandise in San Francisco. The doctors who have done the post-Dobbs abortions have clearly done the calculus and found this to be the case. Nobody has been or needs to be “sacrificed.”
Texas disagrees. Please see above source.
No one’s going to risk their livelihood on precedent. While legal precedent is important, it doesn’t provide meaningful reassurance when the stakes are this high.
Do you have any specific examples of such cases?
Texas abortion law protects emergency abortions. The lawsuit was about an expansion of the definition of “emergency” justified by EMTALA. From the decision, quoted from the article:
Nobody is risking their livelihood by performing abortions because there is no legal risk for performing them in emergencies. How many prosecutions of emergency abortions since Dobbs - not threats of prosecution, because those have no teeth - can you find? Or any prosecutions at all? And here is my source for the hundreds of abortions figure.
EMTALA does not apply once the patient has been admitted to the hospital. It applies to ER care only.
There is no medicolegal standard for “life-threatening” That determination is, to a degree, subjective.
In many cases, a patient will come to the ER in a non life threatening clinical state and get sicker following admission. EMTALA no longer applies to these patients.
If, in retrospect, a doctor performs an abortion and its decided that the mother’s life was not at risk, they face a felony charge.
Per the Texas Supreme Court, exceptions apply only when death or serious physical impairment is imminent (which is probably too late to save the patient and have a good functional outcome, unfortunately)
The problem here is legislation. There is no medical error being made. Practitioners are making a risk-benefit assessment and choosing not to martyr themselves.
I feel that you’re not familiar with medical practice and are oversimplifying a very complex issue.
Hospitals lawyers “we’d rather be maybe sued by the state than definitely sued and shut down”
Is how this plays out in real life.
It wasn’t just getting sued. Your healthcare provider would face a class B felony and likely revocation of their license prior to amendment 3 passing.
Missouri faces the nation's fourth-largest shortage of healthcare professionals, with 111 of 114 counties designated as health professional shortage areas. The state projects a deficit of 3,102 doctors by 2030, including 687 primary care providers. Hospital staffing remains strained, with a 17.4% vacancy rate for registered nurses, representing 6,982 unfilled positions. The crisis is compounded by Missouri exporting one-third of medical students to out-of-state residency programs.It’s not good business for a portion of your workforce to end up in prison when you’re already in a shortage area.
She’s suing the hospital, and good on her. If this goes to trial, precedent will be established either way.
It would be cool if she won, but I don’t think she will. Super easy to argue that her circumstances had not yet reached the level of “medical emergency”.
So fucked are we
It would also be super easy to argue the hospital is at fault given they were cited by the HHS secretary for refusing to provide care required by federal law.
It doesn’t really matter since the right to abortions was added to the state constitution.
It still matters because the Federal courts can set precedent that the Federal law (obviously, that’s how Federalism works) overrides state abortion bans.
And as the article I posted explains, those hospitals broke federal law when they refused to provide the abortion.
As your own link said, they didn’t break the law.
She was stable. The law says the hospital had to wait until she was in danger.
A lawsuit from a pro lifer who is suing because she wanted an abortion isn’t proof they broke the law.
This is the link I was talking about. I probably should have been clearer. But this isn’t just the plaintiff’s opinion, it’s a clear statement by the HHS secretary.
It could be very easily argued that “could deteriorate rapidly” is not a medical emergency, and therefore does not meet the requirements of the MO or federal laws to allow for inducing labor or abortion.
Given the overzealous rhetoric from state officials, I understand the hospital and doctor’s reluctance to provide care. We are fucking ourselves.
If the “overzealous rhetoric” had any teeth, any of the doctors who had performed one of the hundreds of abortions in Missouri since Dobbs would have been arrested. They haven’t.
It’s has the intended teeth; health care for women denied yet again.
And now we get to the real issue.
When the law is a witch hunt not based on science, doctors cannot operate based on their best judgement based on science. Real issues of “unlikely” and “increased her chances” aren’t the same things as immediate medical emergency: they prevent an immediate medical emergency. Any law restricting abortions to when they are “medically necessary” will always lead to cases where its denied until its immediately medically necessary, at which point it may be too late. This is a clear-cut example of what such laws will always do and doctors being forced to tiptoe around the feelings of fanatics instead of being able to practice medicine.
How many doctors have been criminally charged for providing an abortion in states that have banned them? Emergency permissions have been in place for as long as abortion restrictions have. If they wanted to remove those restrictions, they would have had every reason to do so when the Dobbs decision came through. Although based on the HHS secretary’s words, such a thing would be a violation of federal law.
Women are dying because doctors aren’t providing medically necessary care.
Some doctors would rather risk their patient dying than face legal issues. Many are leaving those states and forcing pregnancy centers to close due to lack of staff, which also affects the mortality of the women in those areas.
In this case, the legal issue is a felony and potentially life in prison.
Hundreds of thousands of people die every year because of medical errors for any number of reasons. The law doesn’t need to be involved for that to happen. Blaming a law which explicitly allows abortions for emergencies, when doctors are already known to make enough fatal errors for hundreds of thousands of people to die every year, makes no sense. This isn’t exacerbating an existing issue, their interest in dodging liability is.
Sounds like she was not experiencing an emergency medical condition that would have required stabilization. It could have become more severe, which explains why conventional care would have been abortion, but it was not, at the moment of presentation.
Sure would be nice if they would just let the physicians practice medicine, without having to second guess which law takes precedence.
There’s no need to second guess. The law is explicit. Furthermore, she had been seen by several hospitals and they all denied her treatment. The situation was exacerbated by their negligence.
In your opinion. Unless you’re a Missouri judge, that opinion is not useful.
Your opinion matters as much as mine, the HHS secretary said they’re in the wrong, and it would have been 100% legal by the letter of the law.
That’s a misinterpretation of EMTALA and the words of the HHS secretary.
They didn’t say that they would protect providers who perform abortions. They said they would seek civil punishment for those that do not. That’s very different from providing protection.
See my comment above for more details.
There were multiple hospitals involved and cited for failing to treat her. One excerpt from one medical report doesn’t refute that. The HHS secretary explicitly said that, under the federal EMTALA, hospitals are required to provide emergency care, which they did not.
The HHS secretary can say whatever they want. It doesn’t mean they know how things will play out in court. Hospitals employ leagues of lawyers to assess legal risk/exposure and with criminal penalties on the table in all of the 14 states where abortion is banned, it appears that they’ve determined its better to pay the fine than have many of their doctors and nurses go to jail.