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EMTALA and Deferred Care

As physicians, we have the inherent duty to care for all patients, and as emergency physicians, we have the ability to stabilize and treat myriad problems that present to us in our emergency departments. A patient’s ability to pay should not matter. This ethical obligation was enshrined into law when US President Ronald Reagan signed the Emergency Medical Treatment and Active Labor Act (EMTALA). This law, however, has undergone several clarifications over the three decades since it went into effect, and the application of it in the clinical arena can sometimes be nuanced. The need to address emergency medical treatment and active labor may occur. One must always perform a medical screening exam (MSE) and arrange for appropriate transfer when indicated.