Ethical and Legal Concerns for Emergency Room Physicians Essay

434. Paradoxically, the Emergency Medical Treatment and Labor Act (EMTALA) requires Medicare funded hospitals provide appropriate medical treatment for individuals seeking emergency care independent of citizenship, legal status or ability to pay (Rhodes & Smith, 2016). Emergency care is costly and does not address the root cause of disease, furthermore, preventative screenings or health care is not covered under the law (Groppe, 2017). Hospitals must shift cost of providing care to the uninsured emergency care to insured individuals. Researchers in Michigan found with expanded health insurance decreased emergency room visits by 50%. Conversely, in Tennessee and Missouri had an increase in ER costs after cutting Medicaid services in 2015 (Groppe, 2017). The evidence presented suggests providing affordable health insurance for residents of the United States which is independent of citizenship could save money by reducing the need and utilization of emergency care. My follow up question is: Can law makers shift their thinking to provide residents of the country with health insurance in order to save

The Emergency Medical Treatment and Active Labor Act (EMTALA) ensures public access to emergency services, meaning stabilization and treatment, regardless of a person’s insurance status and ability to pay. Overall, the purpose of this federal law is to prevent hospitals from discriminating against patients who are uninsured or unable to pay by either refusing to treat the patient, rejecting the patient entirely, or transferring them to a lower quality hospital. Thus, it keeps medical emergency practitioners in check by looking at how they may help the patient rather looking at how much they can get out of the patient. EMTALA does apply in this situation. Further, this situation demonstrates how this act was directly violated. It is the hospital’s

Donating an organ, whether it is before or after dead, is seen by society as the right thing to do, but at what cost. Being asked to become an organ donor right before getting our license is almost always a yes. Death is one of the farthest things from our mind and when we are asked this question we would rather live life knowing our organs could be used to save someone’s life. But this simple checkmark or heart can sometimes be used against us; because there are so many people waiting for an organ, doctors have been given the ability to stretch the fine line between life and death. Not signing the donor card can gives us a few more bargaining space. Although both Crystal Lombardo and Dick Teresi speak about the effects of organ donation, Lombardo, author of “11 Major Pros And Cons Of Organ Donation”, points out the importance of becoming an organ donor, while Teresi, author of “What You Lose When You Sign That Donor Card”, describes the complications between doctor and patient.

However, most of America has also experienced the overcrowding of emergency rooms and have personally experienced the long wait times. Though no research finds a direct cause between EMTALA and overcrowding, long wait times are inevitably discussed any time the EMTALA policy is brought up. However, it certainly does not help that the U.S. has 45 million uninsured individuals who do not have access to primary care and are forced to turn to the emergency department for any kind of medical attention (Monga, Keller, & Venters, 2014). Additionally, of

Healthcare workers and the ethics board make tough decisions that impact the patient’s future, specifically related to organ allocation. Organ transplantation is extremely important in order to save lives, prolong survival, and increase the quality of life (Beyar, 2017). Each year the number of people on the waiting list continues to rise at an alarming rate. According to the U.S. Department of Health and Human Services, organ donation statistics show that more than 116,000 people are awaiting organs. The number has risen significantly every year (Health Resources & Services Administration {HRSA}, 2016). In 2016, it was reported that approximately 41,335 organ donations were made,

Hospital admissions account for the largest component of health care expenditures (Centers for Medicare and Medicaid Services (2011). In the past several decades, the critical decisions for determining need for hospitalization have been increasingly made by emergency medicine (EM) physicians (Schuur & Venkatesh, 2012). In view of the impact of hospital admissions, both hospitals and physicians are increasingly encouraged to find alternatives that are less costly. Nevertheless, perhaps wary that non-clinical factors may adversely influence EM physician decisions, in October 2015, the American College of Emergency Physicians (ACEP) published a policy statement regarding Emergency Physician Rights and Responsibilities. An important stated

Organ Donation and Transplantation continues to be an important controversial issue in healthcare ethics. The ethical principles in allocation of human organs in a pluralistic society with conflicting ideas are norms that are meant optimal for matters of a public policy, where individuals in such a society hold various conflicting, yet a reasonable position on organ allocation. Three principals have gained primary importance in allocating organs for transplantation: utility, justice and autonomy. (http://optn.transplant.hrsa.gov).

This article addresses the nationwide problem of crowding in the emergency department. Crowding in the emergency department creates delays in care and has been proven to be most prevalent in urban and teaching hospitals across the country. The authors infer that since the institution of the Emergency Medical Treatment and Active Labor Act (EMTALA) in 1986, record numbers of individuals seeking care through the emergency department has skyrocketed. Patients either use the emergency department as the first line of care or the last line of care. According to the study, uninsured members of society are most likely to utilize the emergency department for care versus their “sicker” insured counterparts. A survey conducted in 2010 by the American

Today people in America go to the Emergency Room for everything. Whether they skinned their knee, have muscle pain, or even a papercut. They don't even try to just put a band aid on it themselves, instead they go to the ER. There are people who take their kid to the ER for a cold when all they have to do is pick up some cough syrup. People don't need to go to the ER for these reason. They either need to go buy band aids, or go to their family care provider. A reason for this influx in visit to the ER is do to the EMTALA Emergency Medical Treatment and Active Labor Act. This bill made it were Emergency Departments can’t turn people away for not-payment. This is good to cover people who really need treatment that they can't offend, but also allows people who don't need to be in the ER to come because they can't get turned away. This has shifted American healthcare model to go to the ER for every bump, bruise, and stomach ache you feel, and not only do you have to wait 4-6 hours to be seen, but are taking an bed from someone who really needs it.

An option to extending one's life is the ability to replace a damaged or diseased human organ with another human's donor organ through transplantation. Transplantations have always been an option in the past, but because of the ethical hurdles, have not always been easy. With the advances in medicine, come new legal questions to ethics, and the constitutional rights of donors and the recipients. The life saving benefits of organ transplants outweigh the legal and ethical issues involved in the harvesting of cadaver organs or donations from living donors.

Recent reports of public figures receiving life-saving transplants have brought renewed attention to the scarcity of organs and the importance of organ transplants. Although more transplants are being performed in the United States each year the transplant waiting list continues to grow. It has been considered that the decrease in organ donors is due to the unsuccessful measures taken by health care professionals. This is a limited view of the matter because health care professionals are not directly responsible for the policies and other guidelines for procuring organs. The general population does not have the interest of suffering individuals at heart when it comes to donation.

A doctor obligtion is to save their patient’s life.. They are not the doctor of the recipient of the organs. The doctor of the patient is chosen because of the need/speciality of the case (mayoclinic). Along with the disagreement of the treatment that a patient is given, there is the fear of being declared dead when they are actually not. Believe it or not patients that are in this situation are ran through mulitple and intensive exams and testing to ensure that a patient is rightfully delcared dead or not (mayoclinic). On top of all the testing and examinations organ donation is only brought up when a patient is declared dead (transplants).

The need for organ donation is far greater than organ availability in todays every changing world. This has encouraged political and public support of the organ donation programme by restructuring and investing in the issue of organ donation. Today, the greater majority of organs that are able for transplant come from dying patients on an intensive care unit, or from ones who wish to donate their organs as a normal part of end-of-life care. This has put a considerable amount of pressure on physicians to accustom to the large amount of ethical and practical guidance being published to achieve this. This research paper explores some of this pressure put on physicians when it comes to making decisions on organ transplants.

Another proxy of the emergency healthcare system is the capacity of the emergency department. Initially emergency departments were created to respond to critical or life threatening conditions but are now responding to a spectrum of conditions ranging from life threatening to non-urgent conditions. This consequentially leads to higher patient volume, and operation beyond the intended capacity and an increase in LWBS. Fayyaz et al., also argues that emergency boarding of admitted patients and hospital occupancy as a cause of ED crowding rather than influx of non-urgent patients. Furthermore, lack of available beds for high acuity patients who are critically ill or intubated may remain in the ED for 24-48 hours awaiting a room. As this continues to get worse the emergency departments continue to receive an influx of critical patients that ultimately places a strain on limited resources such as nursing staff and

EMTALA affects the hospitals or providers that get reimbursed by Medicare. Almost every hospital or provider accepts Medicare in the United States. Under the EMTALA statues, the provider has a duty to render an appropriate medical screening examination to the patient in distress and necessary treatment or reasonable care to stabilize the patient’s emergency medical condition. EMTALA defines an emergency medical condition as a medical condition that presents with such acute symptoms that a patient’s health, bodily functions, or organs could be severely harmed without prompt medical attention. If the patient’s chest pain is not determined as an emergency medical condition based