Washington, D.C. – Yesterday, the American College of Obstetricians and Gynecologists (ACOG), together with the American Medical Association, the American College of Emergency Physicians, and seven other medical societies, filed an amicus brief in support of the Department of Justice's challenge to Idaho's abortion ban, which was recently upheld by the state's supreme court. The Department of Justice has argued that the law conflicts with the Emergency Medical Treatment and Labor Act (EMTALA).
ACOG's brief states that "[t]he Idaho Law is inconsistent with bedrock principles of medical ethics, the safe and medically indicated provision of emergency care, and federal law ensuring that all patients in emergency settings receive medical treatment based on their individual health care needs." In the case of complications of pregnancy, ACOG notes, this may and sometimes does include lifesaving abortion care.
Banning physicians from providing safe, necessary, medically indicated care, including abortion, in an emergency setting will cost lives, the brief states. "The law disregards standard medical practice and purports to force physicians to delay care until a patient's medical condition deteriorates to the point of becoming life-threatening," the brief states. The Idaho abortion ban criminalizes care in the face of common pregnancy complications that can threaten lives if not treated immediately—including ectopic pregnancies, septic infection, and uterine hemorrhage.
People who are pregnant already face the risks inherent in pregnancy, and abortion bans like Idaho's will exacerbate the ongoing maternal mortality crisis in the United States. "When those risks create emergency situations that jeopardize the patient's health and life, the patient is entitled to and should receive health- and life-saving medical care like anyone else in this country, and the physicians who provide that care consistent with clinical best practices and longstanding federal law should not be criminally sanctioned," the brief states.
Iffath Abbasi Hoskins, MD, FACOG, president of ACOG, said: "Our amicus brief in support of the Department of Justice says what obstetrician–gynecologists have already known: that abortion bans are not just bad law—they are bad, nonscientific, nonevidence-based medicine. When pregnancy complications become crises, doctors need to be able to use their training, judgment, expertise, and experience to intervene on behalf of their patients; their decision making should not have to be clouded by the threat of arrest simply for providing medically indicated, evidence-based care."
Molly Meegan, JD, chief legal officer and general counsel at ACOG, said: "For nearly 40 years, EMTALA has protected all of us by ensuring that in an emergency, we can get the treatment that we need to protect our health. EMTALA codified into law what physicians already viewed as their ethical and professional responsibility: to take care of patients in need. By criminalizing emergency physicians and obstetrician–gynecologists for providing lifesaving abortion care, Idaho's abortion ban is in direct conflict with this critical federal law."
The amicus brief also addresses the inadequacy of the "to save the life of the mother" exception, which cannot be applied to real-life medical crises. It states: "No clinical bright line defines when a patient's condition becomes life-threatening. At what point does the condition of a pregnant woman with a uterine hemorrhage deteriorate from health-threatening to life-threatening?... It is physicians in the room with the patient, not lawmakers or courts, who are uniquely equipped to make these decisions. There is simply no viable way to apply a 'life-threatening' test in emergency medicine.
"Life and health exist on a fragile and shifting continuum and in emergent situations physicians must and do act quickly to preserve it. They cannot be expected, and should not be compelled, to delay stabilizing treatment until a legislatively imagined but medically nonexistent line has been crossed."
Federal EMTALA law was intended to advance equity by ensuring that all people have access to emergency medical care. In contrast, the Idaho law will have a disproportionately harmful impact on people of color, people in rural areas, and those without robust financial resources—many of whom are more likely to experience health-threatening and life-threatening health complications and to have those complications treated in an emergency treatment setting—thus increasing existing health inequities and intensifying the maternal mortality crisis already existing in the United States.