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Hi, everybody. Welcome to week 10.

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The majority of hospital admissions come

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through the emergency department.

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And obviously, the emergency
department is important

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to patients and families
and communities it serves.

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So the law relating to emergency care

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should be well understood by
all those in public health

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and in health fields.

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EMTALA stands for

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the Emergency Medical
Treatment and Labor Act.

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It's a federal law in the US

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that requires hospitals
to participate in Medicare

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to provide emergency treatment
to anyone who seeks it,

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regardless of their ability to pay

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or their legal status.

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EMTALA was enacted in about 1986,

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and it was meant to address the concerns

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that hospitals had
refused to help patients

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who didn't have health insurance

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or were unable to pay for medical care

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even in an emergency situation.

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The law requires

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that hospitals provide
medical screening examination

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to anyone who presents in
an emergency department

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with any kind of emergency
medical condition.

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If a patient is found

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to have an emergency medical condition,

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the hospital's required

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to either stabilize
the patient's condition

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or transfer that patient
to another hospital

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that can provide the
necessary medical care

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if they can't do it there.

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Hospitals that violate EMTALA

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can face pretty significant fines.

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You might see a couple examples of that

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in the reading this week.

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They can be excluded from
participating in Medicare, which,

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for all intents and purposes,

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would bankrupt most hospitals.

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EMTALA has played a pretty
important role ensuring

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that all hospitals,

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regardless of their
financial or legal status,

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participate in this process,

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and it ensures that individuals

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receive emergency medical care
in the US when they need it.

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Thinking back historically,

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the idea behind helping others

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in emergency room involves
really interesting questions

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about morals, values,
ethics, and legalities.

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We have to begin with the realization

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that there is no general duty

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to come to another person's
aid here in the US.

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It's not the same everywhere.

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Even if the danger to another
is obvious, immediate,

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or easily avoided,

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the idea is that I don't
have to save another

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from their poor decisions.

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Thus, it's been said
that no one has a duty

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to keep a blind man from
walking off a cliff.

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Now, this is all an oversimplification,

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and you can have different regions,

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different states have
different rules regarding this.

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And in general, we should
always come to another's aid

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whenever we have the ability

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and resources to do so,

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as long as that intervention

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is likely to improve the situation,

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and as well prioritize
our own safety if we do.

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We always wanna reach out
to trained professionals

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when it's appropriate.

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Under the common law,

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someone who voluntarily
came to another's aid,

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and in doing so but caused an
injury could be held liable

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if that rescue involved
some kind of negligence.

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So not just physicians,

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but everyday folks, like you and me,

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became afraid to render aid
at the scene of an accident.

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And that also ties into the ideas

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behind emergency rooms

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and fear of negligence in
an emergency situation.

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Most people would agree
that we have a moral

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and legal duty to help others

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if we're in a position to do that.

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We call this in the
law, the duty to rescue.

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It's based on this ethical principle

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of sharing a community

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which requires us to act in ways

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that promote the well-being of others.

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There are various legals duties to rescue

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that vary from country to country,

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and again, from state to state.

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I'll put some of that information

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in the announcement section.

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In many jurisdictions,

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there is a legal responsibility

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to require some individuals
take reasonable steps

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to assist someone in need,

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maybe calling for emergency services,

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administering first aid,

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or providing transportation
to a medical facility.

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But this is not a

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consistent rule or law

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that is across the whole US.

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And in addition to possible legal duties,

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most people recognize there's
a moral duty to help others,

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especially if we're the only
ones in a position to do so.

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That comes from this idea of solidarity,

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which holds we have this
shared community responsibility

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to help those in need,

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to work together to
promote the common good.

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Failing to fulfill our
duty to help others,

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often can have serious
consequences as well

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for both victim, for ourselves.

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You know, delaying care
or not responding quickly

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to an emergency means that,

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you know, victims can
have more severe injuries,

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can even result in death.

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And it also has moral
repercussions for us.

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Therefore, if we find ourselves

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in a position to help someone who needs it

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at an important time,

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you know, there's these questions of like,

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what do we need to do?

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Do we need to do
everything we possibly can

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to provide assistance,

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to help seek assistance
as quickly as possible?

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That has just not been the general rule

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in the United States.

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So do we fall back on kind of a moral rule

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that promotes, encourages us to act?

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So this is tied into historically

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how emergency rooms operated

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and where that idea came from.

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So this week, we're gonna
consider our duties to others,

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that duty to rescue.

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We're gonna think about
what duties we have,

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where do they come from?

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Are they legal? Are they moral?

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What duties should we have?

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US is out of line with
many other countries.

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And then, you know, something goes wrong,

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what about the liabilities
for hurting others negligently

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if we do try to help?

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So a lot of things to think about.

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As always, there's not a
lot of easy answers here.

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I'll see you in the discussion forum.