• the_toast_is_gone@lemmy.world
    link
    fedilink
    English
    arrow-up
    5
    arrow-down
    19
    ·
    21 hours ago

    According to the HHS secretary:

    “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.

    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.

    • shawn1122@lemm.ee
      link
      fedilink
      English
      arrow-up
      2
      ·
      edit-2
      3 hours ago

      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.
      
      • the_toast_is_gone@lemmy.world
        link
        fedilink
        English
        arrow-up
        1
        arrow-down
        1
        ·
        3 hours ago

        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.

        • shawn1122@lemm.ee
          link
          fedilink
          English
          arrow-up
          1
          ·
          edit-2
          2 hours ago

          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.”

          https://www.texastribune.org/2024/01/02/texas-abortion-fifth-circuit/

          • the_toast_is_gone@lemmy.world
            link
            fedilink
            English
            arrow-up
            1
            arrow-down
            1
            ·
            2 hours ago

            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.”

    • Dkarma@lemmy.world
      link
      fedilink
      English
      arrow-up
      27
      ·
      21 hours ago

      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.

      • shawn1122@lemm.ee
        link
        fedilink
        English
        arrow-up
        2
        ·
        edit-2
        3 hours ago

        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.

        • troglodytis@lemmy.world
          link
          fedilink
          English
          arrow-up
          2
          ·
          14 hours ago

          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

          • the_toast_is_gone@lemmy.world
            link
            fedilink
            English
            arrow-up
            1
            arrow-down
            2
            ·
            14 hours ago

            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.

          • Riskable@programming.dev
            link
            fedilink
            English
            arrow-up
            10
            ·
            21 hours ago

            It still matters because the Federal courts can set precedent that the Federal law (obviously, that’s how Federalism works) overrides state abortion bans.

            • the_toast_is_gone@lemmy.world
              link
              fedilink
              English
              arrow-up
              1
              arrow-down
              7
              ·
              21 hours ago

              And as the article I posted explains, those hospitals broke federal law when they refused to provide the abortion.

              • Blue_Morpho@lemmy.world
                link
                fedilink
                English
                arrow-up
                9
                ·
                21 hours ago

                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.

                  • neatchee@lemmy.world
                    link
                    fedilink
                    English
                    arrow-up
                    7
                    ·
                    edit-2
                    21 hours ago

                    Unfortunately the HHS Secretary isn’t empowered to create law, nor are they empowered to interpret law. They can only share opinions, provide guidance, create policy, etc. So no, in this case, you are not quite right.

                    Further, as the other user pointed out: the hospital would rather be sued by the individual for violating their rights than by the state for violating the law. Regardless of potential precedent or final outcome, one is far, FAR more costly than the other.

                    As they say, when the punishment is less than the profit, it’s not a punishment, it’s a business expense

                    Ultimately, laws can only be judged on their ability to create outcomes. This one has failed miserably

                  • Blue_Morpho@lemmy.world
                    link
                    fedilink
                    English
                    arrow-up
                    1
                    ·
                    20 hours ago

                    I’ve already quoted from that exact link.

                    From link you were talking about:

                    “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.”

                    Again, she was stable at the time. The law required that they not perform an abortion.

                    A political official saying something is not the law. Filling a lawsuit is not the law.

    • troglodytis@lemmy.world
      link
      fedilink
      English
      arrow-up
      3
      ·
      14 hours ago

      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.

    • WalrusDragonOnABike [they/them]
      link
      fedilink
      English
      arrow-up
      13
      ·
      21 hours ago

      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.

      • the_toast_is_gone@lemmy.world
        link
        fedilink
        English
        arrow-up
        1
        arrow-down
        9
        ·
        21 hours ago

        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.

          • the_toast_is_gone@lemmy.world
            link
            fedilink
            English
            arrow-up
            1
            arrow-down
            4
            ·
            16 hours ago

            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.

    • tburkhol@lemmy.world
      link
      fedilink
      English
      arrow-up
      4
      ·
      20 hours ago

      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.

      • the_toast_is_gone@lemmy.world
        link
        fedilink
        English
        arrow-up
        2
        arrow-down
        5
        ·
        20 hours ago

        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.

          • the_toast_is_gone@lemmy.world
            link
            fedilink
            English
            arrow-up
            1
            arrow-down
            5
            ·
            20 hours ago

            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.

            • shawn1122@lemm.ee
              link
              fedilink
              English
              arrow-up
              2
              ·
              3 hours ago

              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.

              • the_toast_is_gone@lemmy.world
                link
                fedilink
                English
                arrow-up
                1
                arrow-down
                1
                ·
                edit-2
                3 hours ago

                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.

                • shawn1122@lemm.ee
                  link
                  fedilink
                  English
                  arrow-up
                  1
                  ·
                  edit-2
                  1 hour ago

                  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.

                  • the_toast_is_gone@lemmy.world
                    link
                    fedilink
                    English
                    arrow-up
                    1
                    arrow-down
                    1
                    ·
                    1 hour ago

                    Nobody has been prosecuted for this since Dobbs. Your alleged legal threat is barely even fiction. The lawyers were wrong in this case, and those who judged it legally acceptable to provide emergency abortions in ban states are right. You are ignoring these obvious facts to hold onto the nonsensical belief that these laws are unjust.