These are not hypotheticals. Some pregnant people develop kidney inflammation or heart enlargement, serious health risks that may not rise to the level of death or substantial impairment of a “major bodily function.” Hospitals frequently see patients experiencing premature rupture of membranes or miscarriage. While EMTALA could require that doctors offer to terminate those pregnancies, even if fetal cardiac activity can still be detected, Texas law would demand that doctors wait until the pregnant patient risks death or loss of major bodily function.
Contrary to Texas’s claims, federal government is not using EMTALA to turn every hospital into an abortion clinic. But the federal law does require abortion in some emergency situations where the Texas law would label it a crime. And because of the shift in the anti-abortion movement’s approach to exceptions, the stage is set for a showdown between the federal government and the states. At stake is the idea that abortion can be medically necessary health care.
And if federal law doesn’t prevail, emergency physicians will continue to face the impossible task of navigating between the complexities of medicine and the vagaries of law. They will serve as de facto lawyers. And pregnant patients will pay the ultimate price.