A diabetic patient suffering from ketoacidosis was taken from his hospital bed, removed from the hospital, and left in the parking lot without shoes or a shirt because the patient did not have health insurance and had not paid for prior services (Fedas, Alexander, and Chase-Lubitz 1991). The patient died at home the following day. A man with a steak knife in his back, wedged against his spine, was transferred from an emergency room because he was uninsured and could not pay $1,000 cash in advance to remove the knife (Annas 1986). A woman who was mistakenly identified as uninsured was turned away by two hospitals during the early stages of birth despite indications of fetal distress, and once she reached a hospital that would provide the necessary care the fetus had died (Gionis, Camargo, and Zito 2002). After a pregnant woman’s water broke at 14 weeks, she was denied services at a hospital and sent on an 80-mile cab ride to receive the procedure her physician declared medically necessary (Clark 2003). A woman whose water broke at 18 weeks was sent home twice from a hospital without receiving treatment or accurate information on the status of her fetus, denying her the medical services that would most ensure her safety (NeJaime and Siegel 2015).The first three cases represent examples that led to the passing of the Emergency Medical Treatment and Active Labor Act (EMTALA), which sought to end patient dumping, where hospitals would deny service or transfer patients, typically poor individuals, whom they did not want to care for. The last two cases were enabled by the government through the passage of the conscientious objection statutes that Nelson (2018) references, which allow providers, including large for-profit hospital systems, to deny medically necessary, potentially lifesaving care due to religious or moral beliefs.
Michael R. Ulrich,
Pregnant Women and Equitable Access to Emergency Medical Care,
American Journal of Bioethics
Available at: https://scholarship.law.bu.edu/faculty_scholarship/1205