What is left of futility? The convergence of anencephaly and the Emergency Medical Treatment and Active Labor Act
D. S. Diekema
Department of Pediatrics, University of Washington School of Medicine, Seattle, USA.
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). 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.
