Washington, D.C. – Yesterday, 10 of the nation’s leading professional organizations of physicians and public health experts, including the leading professional societies of emergency physicians and obstetrician-gynecologists, submitted a brief in the U.S. District Court for the District of Idaho in support of the U.S. Department of Justice’s challenge to an Idaho law. The brief underscores the law’s clear conflict with the Emergency Medical Treatment & Active Labor Act (EMTALA). The case is United States v. State of Idaho.
The brief was filed on behalf of the American College of Emergency Physicians, the Idaho Chapter of the American College of Emergency Physicians, the American College of Obstetricians and Gynecologists, the American Medical Association, the Society for Maternal-Fetal Medicine, the National Medical Association, the National Hispanic Medical Association, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American Public Health Association. The organizations are represented by Debevoise & Plimpton LLP and Democracy Forward.
For nearly four decades, EMTALA has provided the foundation for the emergency care safety net and been supported by lawmakers of diverse ideological perspectives. The American public trusts physicians to provide emergency care consistent with EMTALA and medical guidelines. Emergency care, by definition, requires physicians to act quickly, often with limited information, to treat and stabilize the patient–rendering Idaho’s near-complete criminal ban on abortion “unworkable in an emergency medicine setting.”
Well-established clinical guidelines for the treatment of pregnant patients in emergency conditions require treatment that the Idaho Law prohibits as abortion. Withholding this care is “directly contrary to EMTALA’s mandate and to bedrock principles of medical ethics.” If applied to emergency medical care, the Idaho Law would force physicians to disregard their patients’ clinical presentations, their own medical expertise and training, and their obligations under EMTALA—or risk criminal prosecution.
The brief explains some of the contexts in which the conflict with federal law arises. For example, the brief describes “contexts where a patient’s pregnancy is presenting urgent risks to the pregnant patient’s life or health but where the Idaho Law would prevent medically indicated care that includes terminating the pregnancy. Indeed, the Idaho law goes so far as to prevent the termination of a pregnancy in an emergency circumstance where the fetus will otherwise not survive and where the pregnant patient’s health and life are at risk in the absence of terminating the nonviable pregnancy.”
As the brief highlights, by criminalizing necessary, medically indicated care in emergency situations, the Idaho Law will have “devastating consequences for patients.” By forcing physicians to delay or forgo care that they have been trained and are ethically required to provide, the Idaho Law creates substantial risks for patients and physicians alike.
Even under the best of circumstances, pregnancy and childbirth impose significant physiological changes that can exacerbate underlying pre-existing conditions and can severely compromise health. The Idaho Law only exacerbates these health concerns and does so amidst a broader maternal health crisis in the country. The brief highlights that the consequences of the Idaho Law will be “especially devastating for underserved populations, including patients living in rural areas, minoritized populations, and pregnant patients with low incomes.”
In light of the socioeconomic constraints these populations already face in accessing health care services, emergency departments and “emergency physicians have been given a unique social role and responsibility to act as health care providers of last resort for many patients who have no other ready access to care.”
When emergency situations that jeopardize a patient’s health and life occur, the pregnant patient is entitled to and should receive health- and life-saving medical care like anyone else in this country. The physicians who provide that care consistent with clinical best practices and longstanding federal law should not be forced to operate under the threat of criminal sanctions. As the brief notes, “the Idaho Law is not just bad law, it is bad medicine.”
Read the brief here.
Additional briefs in support of the challenge were submitted by a coalition of state attorneys general and the American Hospital Association and the Association of American Medical Colleges.