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What Is Left of Futility?: The Convergence of Anencephaly and the Emergency Medical Treatment and Active Labor Act

What Is Left of Futility?: The Convergence of Anencephaly and the Emergency Medical Treatment and... Abstract In 1986, Congress passed legislation intended to prevent hospitals from "dumping" patients who were unable to pay for their care. This legislation was appended to the Consolidated Omnibus Budget Reconciliation Act as the Emergency Medical Treatment and Active Labor Act (EMTALA).1 The EMTALA imposes two sets of duties on all hospitals that receive Medicare funds. Since 98% of hospitals in the United States participate in the Medicare program, EMTALA applies to nearly all hospitals in the United States. In short, hospitals with an emergency department must provide an appropriate screening examination to any patient who requests treatment. The purpose of the medical screening examination is to determine whether an "emergency medical condition" exists. If an emergency medical condition is discovered, the hospital must either provide treatment sufficient to stabilize the patient's condition or transfer the patient to another medical facility in an acceptable fashion. References 1. 42 USC 1395dd. 2. In the matter of Baby K. 16 F3d 590 (4th Cir 1994). 3. 42 USC 1395 dd (a). 4. 42 USC 1395dd (e)(1)(A). 5. 42 USC 1395dd (e). 6. In the matter of Baby K. 832 FSupp 1022 (ED Va 1993). 7. Brett AS, McCullough LB. When patients request specific interventions: defining the limits of the physician's obligation . N Engl J Med . 1986; 315:1347-1351.Crossref 8. Nelson LJ, Nelson RM. Ethics and the provision of futile, harmful, or burdensome treatment to children . Crit Care Med . 1992;20:427-433.Crossref 9. Paris JJ, Crone RK, Reardon F. Physicians' refusal of requested treatment: the case of baby L . N Engl J Med . 1990;322:1012-1015.Crossref 10. Paris JJ, Schreiber MD, Statter M, Arensman R, Seigler M. Beyond autonomy: physicians' refusal to use life-prolonging extracorporeal membrane oxygenation . N Engl J Med . 1993;329:354-357.Crossref 11. Ramos T, Reagan JE. 'No' when the family says 'go': resisting families' requests for futile CPR . Ann Emerg Med . 1989;18:898-899.Crossref 12. Truog RD, Brett AS, Frader J. The problem with futility . N Engl J Med . 1992;326:1560-1564.Crossref 13. Schneiderman LJ, Jecker NS, Jonsen AR. Medical futility: its meaning and ethical implications . Ann Intern Med . 1990;112:949-954.Crossref 14. Solomon MZ. How physicians talk about futility: making words mean too many things . J Law Med Ethics . 1993:21:231-237.Crossref 15. Fleischman AR, Nolan K, Dubler NN, et al. Caring for gravely ill children . Pediatrics . 1994;94: 433-439. 16. Spielman B. Collective decisions about medical futility . J Law Med Ethics . 1994;22:152-160.Crossref 17. Department of Health and Human Services. Child abuse and neglect prevention and treatment program . Federal Register . 1985;50:14887-14892. 18. Helton v Phelps County Regional Medical Center. 794 FSupp 332 (ED Mo 1992). 19. Smith v Richmond Memorial Hospital. 416 SE 2nd 689 (Va 1992). 20. Thornton v Southwest Detroit Hospital. 895 F2d 1131 (6th Cir 1990). http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Pediatrics & Adolescent Medicine American Medical Association

What Is Left of Futility?: The Convergence of Anencephaly and the Emergency Medical Treatment and Active Labor Act

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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
1072-4710
eISSN
1538-3628
DOI
10.1001/archpedi.1995.02170230110017
Publisher site
See Article on Publisher Site

Abstract

Abstract In 1986, Congress passed legislation intended to prevent hospitals from "dumping" patients who were unable to pay for their care. This legislation was appended to the Consolidated Omnibus Budget Reconciliation Act as the Emergency Medical Treatment and Active Labor Act (EMTALA).1 The EMTALA imposes two sets of duties on all hospitals that receive Medicare funds. Since 98% of hospitals in the United States participate in the Medicare program, EMTALA applies to nearly all hospitals in the United States. In short, hospitals with an emergency department must provide an appropriate screening examination to any patient who requests treatment. The purpose of the medical screening examination is to determine whether an "emergency medical condition" exists. If an emergency medical condition is discovered, the hospital must either provide treatment sufficient to stabilize the patient's condition or transfer the patient to another medical facility in an acceptable fashion. References 1. 42 USC 1395dd. 2. In the matter of Baby K. 16 F3d 590 (4th Cir 1994). 3. 42 USC 1395 dd (a). 4. 42 USC 1395dd (e)(1)(A). 5. 42 USC 1395dd (e). 6. In the matter of Baby K. 832 FSupp 1022 (ED Va 1993). 7. Brett AS, McCullough LB. When patients request specific interventions: defining the limits of the physician's obligation . N Engl J Med . 1986; 315:1347-1351.Crossref 8. Nelson LJ, Nelson RM. Ethics and the provision of futile, harmful, or burdensome treatment to children . Crit Care Med . 1992;20:427-433.Crossref 9. Paris JJ, Crone RK, Reardon F. Physicians' refusal of requested treatment: the case of baby L . N Engl J Med . 1990;322:1012-1015.Crossref 10. Paris JJ, Schreiber MD, Statter M, Arensman R, Seigler M. Beyond autonomy: physicians' refusal to use life-prolonging extracorporeal membrane oxygenation . N Engl J Med . 1993;329:354-357.Crossref 11. Ramos T, Reagan JE. 'No' when the family says 'go': resisting families' requests for futile CPR . Ann Emerg Med . 1989;18:898-899.Crossref 12. Truog RD, Brett AS, Frader J. The problem with futility . N Engl J Med . 1992;326:1560-1564.Crossref 13. Schneiderman LJ, Jecker NS, Jonsen AR. Medical futility: its meaning and ethical implications . Ann Intern Med . 1990;112:949-954.Crossref 14. Solomon MZ. How physicians talk about futility: making words mean too many things . J Law Med Ethics . 1993:21:231-237.Crossref 15. Fleischman AR, Nolan K, Dubler NN, et al. Caring for gravely ill children . Pediatrics . 1994;94: 433-439. 16. Spielman B. Collective decisions about medical futility . J Law Med Ethics . 1994;22:152-160.Crossref 17. Department of Health and Human Services. Child abuse and neglect prevention and treatment program . Federal Register . 1985;50:14887-14892. 18. Helton v Phelps County Regional Medical Center. 794 FSupp 332 (ED Mo 1992). 19. Smith v Richmond Memorial Hospital. 416 SE 2nd 689 (Va 1992). 20. Thornton v Southwest Detroit Hospital. 895 F2d 1131 (6th Cir 1990).

Journal

Archives of Pediatrics & Adolescent MedicineAmerican Medical Association

Published: Oct 1, 1995

References