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Emergency doctors, nurses relieved but not satisfied with Supreme Court ruling on abortion care

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The ruling allows Idaho’s hospitals and clinicians to provide stabilizing care, but doctors and nurses say the high court hasn’t clarified that federal law supersedes state abortion laws.

Doctors and nurses say they are glad that the Supreme Court, at minimum, allows hospitals and clinicians in Idaho to provide emergency abortion care without fear of going to jail.

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Emergency doctors and nurses say the Supreme Court ruling offers some temporary assurance that physicians in Idaho can perform abortions in emergencies. They are also seeking court rulings to protect clinicians nationwide.

But emergency physicians and nurses, who are most likely to face these dire situations, say they had hoped the nation’s highest court would have offered a more lasting solution.

The justices’ decision will allow hospitals and doctors to perform abortions in cases where there is a serious threat to the patient’s health. Idaho’s abortion law bars abortion in nearly all cases, with exceptions only to save the patient’s life or in cases of rape or incest.

Hospitals and doctors have said they are glad the high court offered a reprieve, even if it is only temporary. Healthcare leaders say that the court hasn’t definitively said that the Emergency Medical Treatment and Labor Act, the federal law known as EMTALA, supersedes state abortion laws. That’s a pressing issue with abortion bans in other states, and the legal battle over Idaho’s law will continue.

The American College of Emergency Physicians is anxious for more clarity from the court. The group said the Supreme Court decision “temporarily removes barriers to emergency abortion care for pregnant patients in Idaho, but major concerns remain as critical litigation throughout the country continues.”

The organization also said it “is hopeful that future court decisions clearly and emphatically reaffirm the broad patient protections that already exist in federal law under the Emergency Medical Treatment and Labor Act (EMTALA), a bedrock principle of emergency care.”

The Emergency Nurses Association is also hoping to see the high court offer more definitive and longer-lasting protections for providing emergency care.

Chris Dellinger, president of the Emergency Nurses Association, said that EMTALA has provided federal protection to ensure patients get the care that they need for the past four decades. Dellinger said the group is “unwavering” in its support of the federal law.

“As the Idaho case returns to the state court, ENA remains concerned about the growing ambiguity for emergency nurses – and the entire emergency care team – in certain states about the legal obligations and ramifications of delivering appropriate emergency care, particularly to those suffering an obstetric emergency,” Dellinger said in a statement.

“Equally as important, ENA recognizes there is potential for an increase in health care inequities in the future should any state law be allowed to override this important federal mandate,” Dellinger said.

Bobby Mukkamala, MD, president-elect of the American Medical Association, said Thursday that he was “relieved” the ruling will allow doctors in Idaho to perform abortions in emergencies. But he also said the court ruling leaves the larger issue of the strength of the federal emergency law unsettled.

“Today’s decision failed to confirm that patients in every state are entitled to prompt, complete, and unbiased emergency health care that is medically and scientifically sound and provided in compliance with the country’s Emergency Medical Treatment and Labor Act,” Mukkamala said in a statement.

For doctors, the Idaho law, and other state abortion laws, have left doctors puzzled on when they can intervene to care for patients.

With the Supreme Court’s 2022 ruling that abortion is not a constitutional right, some states have passed laws restricting abortion rights. Since the high court’s decision, 21 states have enacted laws restricting abortion. Over the past two years, doctors and hospitals have struggled to determine what care they can deliver.

Doctors should be able to act to protect patients, physicians and healthcare leaders say.

“All patients should be able to trust that clinicians will use their medical judgment, honed through years of education, training, and experience, to provide them with the necessary care to ensure their health and safety in a medical emergency,” Mukkamala said in a statement. “In emergency situations, where every second is critical, physicians should be able to focus exclusively on providing the best care to their patient.”

Arvind Venkat, MD, an emergency physician and a Pennsylvania state representative, took little comfort from the decision. In a post on X (formerly Twitter), Venkat wrote, “I know this decision is dangerous. Delay denies physicians & hospitals’ clarity of whether they can do their job without potential criminal liability.”

Under Idaho’s abortion law, clinicians didn’t face a theoretical threat of prison. Violators faced a minimum of two years in prison and a maximum sentence of five years. Plus, if a clinician if found to have violated Idaho’s law, the statute requires the clinician’s license to be suspended for six months, and permanently revoked on a second offense.

Hospitals have been anticipating the ruling, and the litigation will continue in Idaho and elsewhere. In her comments on the ruling, Justice Ketanji Brown Jackson pointed to a federal appeals court ruling in favor of the state of Texas, finding that federal law doesn’t supersede the state’s abortion law.

Patients have been caught in the uncertainty surrounding emergency abortion care. There’s been a substantial increase in complaints from pregnant patients who said they have been turned away by hospitals, an Associated Press investigation found.

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