The Washington Post reports today on the tensions between doctors and hospital administrators in states with strict abortion bans, and the University of Arkansas for Medical Sciences comes out looking none too principled.
Even the most fanatically anti-abortion states, such as Arkansas, have exceptions for life-threatening medical emergencies written into statute. But what exactly counts as an emergency is open to interpretation, and risk-averse administrators are often reluctant to provide doctors with concrete guidance.
The stakes are high: Doctors could face criminal liability for performing an abortion illegally, while delaying an emergency abortion for a pregnant patient can be a matter of life or death. Horror stories abound of women with unviable pregnancies being forced by hospitals to wait to receive an abortion until the risk to their health increases.
Then there are the political considerations for public institutions in red states. Stephen “Steppe” Mette, the former chief executive officer of UAMS Medical Center, told the Post that hospital leaders “opted for a narrow interpretation of the medical exception in Arkansas’s abortion law” when it weighed in on the issue after the U.S. Supreme Court’s decision overturning Roe v. Wade:
The hospital issued June 2022 guidance that forbids abortions in certain cases, according to records, even though some hospitals in states with similar bans permit the procedure in identical situations. Stephen Mette, who was chief executive officer for the Arkansas hospital before stepping down in September 2022, said the staff made that decision because they feared retribution from the state’s antiabortion legislators.
“You won’t find a document saying [it], but the leaders at UAMS were perennially afraid of funding cuts,” said Mette, adding that legislators routinely threatened to withdraw funding from the hospital. “I have no doubt it was subliminally or actually was overtly influencing the conservatism in the guidelines.”
UAMS officials disputed Mette’s account. The attorney who crafted the guidance said she was “not influenced by any political pressure,” Leslie Taylor, a spokesperson for the hospital, wrote in an email.
Mette now works as a senior advisor at BDC Advisors, a Miami-based health care consultancy, according to LinkedIn.
Hospitals and doctor also have federal law to consider, which has long required hospitals to provide emergency medical care to anyone who needs it under the Emergency Medical Treatment and Labor Act, or EMTALA. The Biden administration is now suing Idaho because the state’s abortion ban — just as strictly worded as Arkansas’s, if not more so — doesn’t provide adequate room for doctors to perform emergency procedures. The federal government is also investigating hospitals in Missouri and Kansas and is “privately reviewing dozens of reports” of other potential violations of EMTALA, the Post reports.
Might Arkansas hospitals be among them? Time will tell. But the Supreme Court has yet to weigh in on the limits of EMTALA vis-à -vis state abortion bans; the Idaho case is now before the Ninth Circuit Court of Appeals. And, the Post adds, the government’s willingness to invoke the federal emergency care law depends on who controls the White House beyond 2024. If a Republican wins the presidency, red states can expect an even freer hand to regulate abortion however they see fit.