Hi, everybody. Welcome to week 10.
The majority of hospital admissions come
through the emergency department.
And obviously, the emergency department is important
to patients and families and communities it serves.
So the law relating to emergency care
should be well understood by all those in public health
and in health fields.
EMTALA stands for
the Emergency Medical Treatment and Labor Act.
It's a federal law in the US
that requires hospitals to participate in Medicare
to provide emergency treatment to anyone who seeks it,
regardless of their ability to pay
or their legal status.
EMTALA was enacted in about 1986,
and it was meant to address the concerns
that hospitals had refused to help patients
who didn't have health insurance
or were unable to pay for medical care
even in an emergency situation.
The law requires
that hospitals provide medical screening examination
to anyone who presents in an emergency department
with any kind of emergency medical condition.
If a patient is found
to have an emergency medical condition,
the hospital's required
to either stabilize the patient's condition
or transfer that patient to another hospital
that can provide the necessary medical care
if they can't do it there.
Hospitals that violate EMTALA
can face pretty significant fines.
You might see a couple examples of that
in the reading this week.
They can be excluded from participating in Medicare, which,
for all intents and purposes,
would bankrupt most hospitals.
EMTALA has played a pretty important role ensuring
that all hospitals,
regardless of their financial or legal status,
participate in this process,
and it ensures that individuals
receive emergency medical care in the US when they need it.
Thinking back historically,
the idea behind helping others
in emergency room involves really interesting questions
about morals, values, ethics, and legalities.
We have to begin with the realization
that there is no general duty
to come to another person's aid here in the US.
It's not the same everywhere.
Even if the danger to another is obvious, immediate,
or easily avoided,
the idea is that I don't have to save another
from their poor decisions.
Thus, it's been said that no one has a duty
to keep a blind man from walking off a cliff.
Now, this is all an oversimplification,
and you can have different regions,
different states have different rules regarding this.
And in general, we should always come to another's aid
whenever we have the ability
and resources to do so,
as long as that intervention
is likely to improve the situation,
and as well prioritize our own safety if we do.
We always wanna reach out to trained professionals
when it's appropriate.
Under the common law,
someone who voluntarily came to another's aid,
and in doing so but caused an injury could be held liable
if that rescue involved some kind of negligence.
So not just physicians,
but everyday folks, like you and me,
became afraid to render aid at the scene of an accident.
And that also ties into the ideas
behind emergency rooms
and fear of negligence in an emergency situation.
Most people would agree that we have a moral
and legal duty to help others
if we're in a position to do that.
We call this in the law, the duty to rescue.
It's based on this ethical principle
of sharing a community
which requires us to act in ways
that promote the well-being of others.
There are various legals duties to rescue
that vary from country to country,
and again, from state to state.
I'll put some of that information
in the announcement section.
In many jurisdictions,
there is a legal responsibility
to require some individuals take reasonable steps
to assist someone in need,
maybe calling for emergency services,
administering first aid,
or providing transportation to a medical facility.
But this is not a
consistent rule or law
that is across the whole US.
And in addition to possible legal duties,
most people recognize there's a moral duty to help others,
especially if we're the only ones in a position to do so.
That comes from this idea of solidarity,
which holds we have this shared community responsibility
to help those in need,
to work together to promote the common good.
Failing to fulfill our duty to help others,
often can have serious consequences as well
for both victim, for ourselves.
You know, delaying care or not responding quickly
to an emergency means that,
you know, victims can have more severe injuries,
can even result in death.
And it also has moral repercussions for us.
Therefore, if we find ourselves
in a position to help someone who needs it
at an important time,
you know, there's these questions of like,
what do we need to do?
Do we need to do everything we possibly can
to provide assistance,
to help seek assistance as quickly as possible?
That has just not been the general rule
in the United States.
So do we fall back on kind of a moral rule
that promotes, encourages us to act?
So this is tied into historically
how emergency rooms operated
and where that idea came from.
So this week, we're gonna consider our duties to others,
that duty to rescue.
We're gonna think about what duties we have,
where do they come from?
Are they legal? Are they moral?
What duties should we have?
US is out of line with many other countries.
And then, you know, something goes wrong,
what about the liabilities for hurting others negligently
if we do try to help?
So a lot of things to think about.
As always, there's not a lot of easy answers here.
I'll see you in the discussion forum.