Thread by @BurgartBioethix

My stomach is in knots over the EMTALA case in the Supreme Court today.

Here’s what’s at stake:

EMTALA (Emergency Medical Treatment and Active Labor Act) requires hospitals to provide emergency treatment to people, even if they don’t have insurance.

The law enacted by congress in 1986, requires hospitals that receive federal funds to stabilize patients.

EMTALA is a

backbone of medical ethics and necessary to protect patients from corporate greed.

Codifying protections like this into law is supposed to protect patients from laws like Idaho’s near total abortion ban.

The Supreme Court will hear arguments today about whether Idaho’s near-total abortion ban conflicts with EMTALA.

Idaho wants to deny emergency, life saving medical and surgical treatments to pregnant patients who need abortions - to save their lives.

This is about Idaho, but if the Court allows Idaho law to override EMTALA requirements, then the 14 other anti-abortions states either similar laws may follow suit.

This case will determine access to EMERGENCY abortions in emergency rooms across the country.

This is a narrow slice of the many patients who need abortion. Specifically the patients who are most at risk for emergency related harm and death.

In the setting of the US’s abysmal rate of maternal morbidity and mortality is outrageous.

Listening to the arguments this morning - as a physician and bioethicist and as a pregnant capable person - is infuriating.

I don’t trust this conservative court to protect patients AT ALL.

Another risk today is that the court will create an avenue for fetal personhood - which makes no sense on multiple levels.

We already saw Alabama’s supreme court rule that frozen embryos in test tubes should be considered children - with inherent rights.

Ironically, arguments

for fetal personhood undermine the conservative ideology related to parental rights.

They only want parental rights when it’s convenient to the anti-abortion ideology.

Listening to lawyers talk about the ethical and moral duties of physicians is painful - ESPECIALLY when the Idaho AG he’ll bent on preventing docs from actually acting in good faith - which would involve preventing morbidity & mortality by providing emergency abortion care.

The Idaho AG refuses to acknowledge that a standard of care exists when a patient may be harmed, including the loss of reproductive organs.

This guy is claiming differences opioid laws from state to state prove his theory that there is no national standard of care for emergency services to pregnant patients.

He lacks a depth of knowledge that opioid prescribing laws have caused immense harm to patients.

Apparently unless a physician is *confident* a patient will die from the lack of abortion, then they can’t provide it.

There is no opportunity in this scenario to err on the side of preserving a person’s life and health.

This runs counter to our duty to care.

EMTALA requires transfer when a hospital can’t provide stabilization. Unfortunately, with so many abortion bans -

MANY PATIENTS ALREADY HAVE NO WHERE CLOSE TO GO

Women in Idaho are NOT getting regular emergency care - they’re being airlifted to neighboring states.

ER docs have to be worried about fines and jail time TO DO THEIR jobs

Here come the fetal personhood arguments…

FML

Listening to Alito, you would think that a fetus comes in arguing on its own behalf.

Again the massive conflict with parental rights movement is huge because they don’t want women to be able to make our own decisions.

Main takeaways from the SCOTUS oral arguments today to let Idaho law gut EMTALA:

Conservative justices were eager to make this about
🛑 Conscientious objection (already well protected)
🫄Fetal personhood
🏳️‍⚧️ denying Gender affirming care

Conservative justices showed no regard for

Pregnant people’s Personhood
Autonomy
Right to care
Physician’s duty to care - they’re so keen to protect doctors who don’t want to do their job, that they will hose any doctor who DOES want to provide standard medical care