In a recent decision, the fifth US Circuit Court of Appeals unanimously ruled that the US government cannot enforce federal guidance in Texas mandating emergency room doctors to perform abortions in cases necessary to stabilize patients. This verdict, delivered on Tuesday, aligns with the state's position in a lawsuit asserting that the Biden administration overstepped its authority.
The legal dispute revolves around the interpretation of the Emergency Medical Treatment and Active Labor Act (Emtala), a federal law governing emergency rooms. The Biden administration, in July 2022, issued guidance asserting that Emtala could require abortion to stabilize a patient with a medical emergency, even in states where abortion is restricted. This guidance followed the US Supreme Court's decision to overturn the historic Roe v. Wade ruling, which had guaranteed the right to abortion nationwide since 1973.
Texas, along with anti-abortion medical associations—the American Association of Pro-Life Obstetricians & Gynecologists and the Christian Medical & Dental Associations—promptly filed a lawsuit challenging the administration's guidance, claiming interference with the state's right to regulate abortion. In August 2022, a lower court judge sided with Texas, arguing that Emtala did not specify what actions a doctor should take in a conflict between the health of the mother and the unborn child. The judge contended that the Texas abortion ban filled this void by including narrow exceptions to save the mother's life or prevent serious bodily injury in certain cases.
Circuit Judge Kurt Engelhardt, writing for the fifth circuit panel, concurred with the lower court's decision. He emphasized that Emtala includes a requirement to deliver an unborn child and placed the responsibility on doctors to balance the medical needs of both the mother and the fetus, all while adhering to state abortion laws. The ruling underscored that Emtala does not grant an unequivocal right for a pregnant mother to abort her child.
This decision not only upheld the lower court's order blocking the enforcement of the guidance in Texas but also prevented the administration from enforcing it against members of the two anti-abortion medical associations nationwide.
This development follows a recent ruling by Texas's highest state court against a woman seeking an emergency abortion for her non-viable pregnancy. The court is currently deliberating another lawsuit involving 22 women, addressing the scope of the emergency medical exception to Texas's abortion ban.
Contrastingly, a federal judge reached an opposite conclusion in a similar lawsuit in Idaho last year, blocking the state's abortion ban after finding it conflicted with Emtala. As legal battles unfold across different states, the question of when and under what circumstances abortions can be provided in cases of medical emergencies remains a focal point in the ongoing debate over reproductive rights in the United States.