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I have a question about laws on administering health care..


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What I am looking for is state or federal laws that mandate administering care, at least to as it applies to stabilizing the patient.

 

For instance, do most states, or else the federal government, have legal precedent in place that a hospital must at least stabilize a patient in the event of a medical emergency? Even if for example the patient was financially unable to afford care, or by contrast, that the hospital was in any way morally opposed to providing the patient care?

 

In example. A patient comes into a hospital's ER with cardiac or respiratory distress, or injuries sustained in an accident, or drug overdose, or what ever have you. For what ever reason the hospital opts not to provide treatment to the patient for what ever reason. Ignoring all moral obligations by doctors and staff to "do no harm".. are there laws in place stipulating that the hospital MUST provide basic care to stabilize the patient until he may be transported to another facility? Or do hospitals just offer basic stabilization pursuant to avoiding lawsuits?

 

I'm still waking up so please ask for clarification if I phrased this in a confusing manor..

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What I am looking for is state or federal laws that mandate administering care, at least to as it applies to stabilizing the patient.

 

For instance, do most states, or else the federal government, have legal precedent in place that a hospital must at least stabilize a patient in the event of a medical emergency? Even if for example the patient was financially unable to afford care, or by contrast, that the hospital was in any way morally opposed to providing the patient care?

 

In example. A patient comes into a hospital's ER with cardiac or respiratory distress, or injuries sustained in an accident, or drug overdose, or what ever have you. For what ever reason the hospital opts not to provide treatment to the patient for what ever reason. Ignoring all moral obligations by doctors and staff to "do no harm".. are there laws in place stipulating that the hospital MUST provide basic care to stabilize the patient until he may be transported to another facility? Or do hospitals just offer basic stabilization pursuant to avoiding lawsuits?

 

I'm still waking up so please ask for clarification if I phrased this in a confusing manor..

 

There is a national law in the United States since 1986 known as the Emergency Medical Treatment and Active Labor Act. EMTALA for short. What the law states is that ANYONE who presents to a hospital emergency room and requests care must be evaluated and treated until medically stable or the baby is safely delivered if the woman is in labor without regard for their ability to pay. If the hospital lacks the capability to provide the treatment the patient needs they may legally transfer the patient to a facility that does possess those facilities. They may also transfer the patient at the patient's request.

 

So in your example, if someone presented with a drug overdose the hospital must treat the person until they are medically stable. If that is 4 weeks later so be it. However, if someone presents to the ER with a suspected broken ankle the hospital may stabilize the ankle with a temporary cast and advise them to follow up with an orthopedic surgeon and still be in compliance. They are not required to provide an orthopedic surgeon at that time for a basic fracture.

 

If someone presents to an ER with shortness of breath and chest pain and the evaluation reveals the patient needs emergency bypass surgery but the hospital does not have a cardiac surgeon on staff or the necessary operating room set up they can transfer the patient to a facility that does have those services and not be in violation of EMTALA. What a facility may NOT do is evaluate a patient in the ER, determine they need emergency brain surgery and dump them on another facility because they patient is uninsured.

 

That said there are hospitals that have violated EMTALA and been fined by the government for it. I worked with a neurosurgeon who turned in another doctor and hospital for EMTALA violations for dumping their patients on our hospital when their facility and doctor didn't want to take care of someone so he could have a weekend off.

 

You can read more about EMTALA here: http://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA/index.html?redirect=/emtala/

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Actually this was partly based on the fact that many hospitals are private businesses and I had concerns over a recent law which was passed and it's possible unseen consequences. Luckily it appears the law is overruled by a higher power in the example where my concerns applied. Thank you for the information.

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