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Cake day: 2024年11月18日

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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.



  • 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?


  • Let’s leave aside that a surgeon cannot operate without the infrastructure a hospital makes available to them in most cases. OR space, equipment, scrub nurses etc. If hospital management decides the risk is too high, the surgeon/obstetrician’s hand are tied.

    Let’s say that’s not an issue. Would you risk your career and livelihood in this scenario? It’s easy to talk a big game but the vast majority of people would not. I can’t blame them. I blame the legislators and those that elected them.



  • 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/


  • 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.



  • 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.
    

  • 80% white. 40% with a high school education or less.

    In 2022, over 100 anti-vaccination protesters rallied at the state Capitol against health director Donald Kauerauf’s confirmation, despite his opposition to mask and vaccine mandates. Protesters displayed signs reading “God-given natural immunity” and “We’re not guinea pigs.”

    In 2024, House Bill 1424 was introduced to prohibit COVID-19 vaccination requirements for transportation access. Missouri Senators Josh Hawley and Eric Schmitt co-sponsored federal legislation to ban mask mandates through 2024.

    The state as a whole gives a certain vibe…






  • We generally attribute discoveries to whoever documented it first. It’s almost laughable to attribute it to the French based on a kissing style that was widespread there in 1923. Surely people were doing it before then. Yet, the Americans and British found it so unique they referred to it as French kissing.

    Perhaps it was common before ancient India, but then the question is, why didn’t the ancient Babylonians, Egyptians, Chinese, Romans, and Greek document on it then?