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This was a string of malpractices. The Missouri law didn't prohibit an abortion in this case, but it was incorrectly judged by the doctors/their legal staff. The law allows abortions in case of a medical emergency - which this was.
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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.
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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.
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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.
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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.
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She's suing the hospital, and good on her. If this goes to trial, precedent will be established either way.
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It doesn't really matter since the right to abortions was added to the state constitution.
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It still matters because the Federal courts can set precedent that the Federal law (obviously, that's how Federalism works) overrides state abortion bans.
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And as the article I posted explains, those hospitals broke federal law when they refused to provide the abortion.
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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.
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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.
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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
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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.
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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
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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.
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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.
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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.
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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.
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In this case, the legal issue is a felony and potentially life in prison.
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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.
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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.
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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.
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In your opinion. Unless you're a Missouri judge, that opinion is not useful.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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It's has the intended teeth; health care for women denied yet again.
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And now we get to the real issue.
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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.
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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 standardTuesday’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/
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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."
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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.
Do you have any specific examples of such cases?
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Texas disagrees.
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.
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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. 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.
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Your entire argument is founded on paranoid conjecture.
She was admitted to the hospital ER, kept overnight, and released without treatment. She was at risk of severe injury or death if she didn't receive appropriate treatment. Per 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." Therefore, the hospitals are liable for not providing essential care.
"Life-threatening" is somewhat subjective, and doctors can be charged for providing non-emergency abortions. However, no doctors have been charged post-Dobbs with providing any abortions at all, therefore there is no meaningful risk of prosecution in emergency cases. If I was a doctor in such a situation, I wouldn't hesitate to provide the necessary care if I believed there was an emergency.
Nobody has been charged in post-Dobbs Texas for providing emergency abortions, or any at all. The law is working as intended.
The medical error is in believing that the law restricts doctors from performing life-and-limb-saving procedures. That leads to negligence, as in this case.
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Yeah but I can't blame the doctors for refusing, when in doubt a right wing jury without medical training will decide if it was an emergency or not, and your freedom depends on their verdict.
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It's either provide the treatment, or people become gravely injured or die. She quite nearly died as a result of the mistreatment. We can't predict juries, but I haven't seen any cases of doctors being arrested and convicted of providing an abortion.
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But that is the explicit threat. That is what law makers are saying they are setting as precedent.
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But the law explicitly says there's an exception for emergencies and there's no guarantee that they'll be charged. In fact, there have been hundreds of abortions in Missouri alone since the ban. I wasn't able to find any instances of a doctor being criminally charged under these laws, but if you find one, it's in an extreme minority.
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There’s no guarantee they will be charged is not the same as there is a guarantee they will not be charged. And that is the issue, the hospitals were directly threatened by republicans with jail time, and contradictory statements, as proof when she reached out to get clarification from the governor even he noped out when it mattered. Also remember that the doctors do not run the hospital, administrators and bean counters do.
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Nobody has been charged so far. If they wanted to make an example of someone, it would have made far more sense to do it around when the law was passed. There's no Machiavellian scheme trying to trap doctors in unwinnable situations, this was an obvious case of medical error. Hundreds of thousands of other similar errors severe enough to cause harm or death happen every year.
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There only has to be the threat. Because as long as hospitals are afraid to perform abortions the republicans win… well “win” in this case. We are just people arguing could have should have, when the hospital doctors recommended it, but the hospital with their lawyers and the fact they have been doing this as a profession was not as convinced as you seem to be.
Besides, is your argument the hospital was out to kill this lady specifically?
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Any threat is entirely imagined. Nobody has been prosecuted for this. The law states it is legal. My argument is that either the hospital misunderstood the law in an honest error or they were more interested in covering their own butts than treating a patient in obvious need - in either case, they were wrong and should be held responsible.
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Doctors swear an oath, "first, do no harm." So yes we can blame the doctors!
Doctors are supposed to behave ethically regardless of the law. This is not a new thing! Doctors providing appropriate treatment despite the law is a very fucking long tradition in medicine.
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Doctors providing appropriate treatment despite the law is a very fucking long tradition in medicine.
It isn't. Name one time that happened.
"Do no harm" doesn't mean "risk your livelihood and freedom to perform an operation that a patient can get elsewhere".
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Just one? Sherwin Raymond: https://newrepublic.com/article/167633/roe-wade-abortion-doctors-dobbs-prison
...but doctors have been imprisoned or killed for treating the "enemy" since, well, doctors.
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What defines a medical emergency in rhe eyes of the law? How many hospitals are going to perform an abortion they deem a medical emergency only to be potentially sued by an AG who disagrees that it was medically necessary?
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Missouri law has a definition of "emergency" here, which this situation fits. Also, if I tell my doctor friend Bob not to call 911 unless an emergency is happening, my other friend Tom starts having a seizure he believes is life-threatening, and Bob doesn't call 911, is that my fault or Bob's fault? If hospitals start getting sued en masse for these obvious mistakes, they'll probably be more likely to see reason. This is either a genuine error in reading the law or liability dodging.
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What hospital is going to test the boundaries of what immediate or imminent risk to life in the eyes of the law? Especially with any government official salivating at the chance to punish any abortion care.
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So if the law didn't exist there'd be nothing to misjudged...
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Should we allow thievery by law because people might misunderstand that buying things isn't theft?
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It's not even close to the same. Abortion laws shouldn't exist in the first place. The decision should be left up to the woman alone. All this law is doing is making providers worry about the consequences of performing one. A law against theft deters theft.... There is a purpose to that.
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Why doesn't the baby get to decide what happens to it? Isn't its life important?
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It's not a baby. It's a blob. It has no sentience and the mother doesn't want it in her body. It's basically a parasite.
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A fetus/baby is a human being. It is an organism composed of human cells, and the mother's body is made to accommodate it. The only difference between an adult and a fetus is the stage of development. If a fetus is a "blob," so are born babies, children, and adults.
A parasite is a different species which the host's body isn't meant to accommodate. Calling a fetus a parasite is insane.
Oh, and tumors aren't organisms, so fetuses don't fit that definition either.
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No one should be forced to carry a fetus. End of story
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Nobody is forced to carry a fetus any more than they're forced not to shoot their born children in the head.
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Except for the laws that punish people who seek medical aid. As exemplified by the post. Also flase equivalency.
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If a fetus is a “blob,” so are born babies, children, and adults.
No, those are fully formed individuals that can survive on their own if separated from the mother. The fetus is surviving off it's mother's body. Stealing her nutrients. The only thing separating it from fitting the definition of a parasite is the "different species" caveat.
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What's the difference between a "blob" and a "fully formed individual" and why is killing one acceptable while killing the other isn't? You also missed the "mother's body is made to accommodate the child" thing, too. That's what the uterus is for. If there was no such thing as a uterus and the fetus was a different species, then it would be a parasite. As it is though, a fetus is no more a parasite than someone living at home with their parents.
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What’s the difference between a “blob” and a “fully formed individual” and why is killing one acceptable while killing the other isn’t?
The fully formed individual has sentience and can live more or less on it's own. An infant can be passed off to someone else to care for. The blob can only survive by leeching resources from it's mother's body. If she doesn't want to participate in that it's her decision. Similar to how if someone living with their parents outlasts their welcome they can be evicted.
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Do people revert to being blobs when they go to sleep, become comatose, disabled, or otherwise under the care of another person? The fetus/baby is guaranteed to leave the mother at some point, and evicting it prematurely without a very good reason or regard for its safety would end its life. That is murder. Your argument would justify cutting people off from disability benefits.
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EMTALA is a federal law. The doctors are caught. Between state law that says they can't perform an abortion and federal law that says they have to do it. It's a choice between a fine for violating EMTALA, of being charged with a class B felony and maybe losing their license.
And yes, the law allows abortions in the case of an emergency, but it doesn't define what constitutes an emergency. It just says:
- It shall be an affirmative defense for any person alleged to have violated the provisions of subsection 2 of this section that the person performed or induced an abortion because of a medical emergency. The defendant shall have the burden of persuasion that the defense is more probably true than not.
They can (and will) still be charged, and they will have to justify that the situation really was an emergency.
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They are also caught in the ethical dilemma of "if I don't treat this patient, it is highly likely they'll be gravely injured or die." Missouri law defines "emergency" elsewhere, and this case fits that bill. There was no actual legal impediment here.
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"At risk" isn't an emergency. All pregnancies have risk to the life of the mother.
An abortion was proactive healthcare. The law prevents it.
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If your water breaks at 16 weeks, that is an emergency. According to the lawsuit, they knew this quite well:
By the time Ms. Farmer arrived at TUKH, she had been evaluated and it was clear that she had lost all her amniotic fluid, and her pregnancy—which she had dreamed of and longed for—was no longer viable. And unless she received immediate medical intervention to end the pregnancy in a medical setting, she was at risk of severe blood loss, sepsis, loss of fertility, and death.
It could not be a more obvious example of a medical error. When the law says this is allowed, the law is not at fault.
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You again quoted "at risk". High blood pressure is "at risk". It's not an immediate life threatening condition requiring surgery.
She wanted an early abortion but didn't get it because she voted against it.
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You skipped over the "if she does not receive immediate medical treatment" part. Normal pregnancies, outside of giving birth, do not require immediate medical treatment at all times to avoid the risks outlined above. When you're giving birth, you then receive the medical treatment you need.
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If she received immediate care, she would no longer be at risk. In the same way if you take drugs for high cholesterol, you will no longer be at risk for a heart attack.
Stopping risk is preventative care, not an immediate life threat.
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If someone was stabbed and at immediate risk of bleeding to death, by your logic, immediate treatment would be "preventative care" and therefore not necessary. There's a league of difference between taking a pill to stave off a death that will happen within a few years, and receiving physical intervention to stave off a death that will happen in a matter of days.
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If someone is stabbed and not bleeding to death, they aren't immediately dying. They will be given a bandaid and sent home.
She wasn't at risk of dying when they sent her home. The early abortion would have been preventative care.
Are you ok with every woman at 10 weeks being allowed an abortion as long as she can find any doctor that tells her, "You might be at risk." Because all pregnancies are a risk.
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The doctors stated that if she didn't receive immediate treatment, she was at risk of death. Similarly, if someone was stabbed and at risk of death, they would receive treatment. She should have received treatment.
If every doctor decided that every pregnancy was a severe, immediate enough risk to warrant an immediate abortion, those people should be prosecuted. That would be a grave medical error. This has not happened, and for the sake of society, I hope doctors do not come to that conclusion.
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