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Idaho’s Abortion Ban Seriously Harms the Health of Patients: PHR Amicus Brief to U.S. Supreme Court

In amicus curiae brief filed in Idaho v. United States, PHR documents how Idaho’s abortion ban dangerously overrides U.S. government protections in the Emergency Medical Treatment & Labor Act (EMTALA), fueling a health and human rights crisis for patients and physicians

An Idaho state law (“The Idaho Act”) that bans pregnancy termination except to prevent the death of a pregnant patient is “demonstrably in conflict” with the federal Emergency Medical Treatment & Labor Act (EMTALA), which requires that health facilities offer stabilizing treatment – including pregnancy termination – when clinically indicated to preserve the health of a pregnant patient, Physicians for Human Rights (PHR) argues in a new amicus curiae brief filed today in Idaho v. United States. Oral arguments in the U.S. Supreme Court case are scheduled for April 24, 2024. 

“Idaho’s abortion ban results in grave health harms to patients and is causing clinicians to leave the state as they are blocked from upholding basic medical standards and ethics. The Supreme Court should affirm the judgment of the District Court and ensure enforcement of EMTALA so that patients can access medically necessary care,” said amicus brief co-author Payal K. Shah, JD, director of PHR’s Program on Sexual Violence.

A PHR fact-finding brief cited in the amicus documents accounts of what physicians practicing in and around Idaho have experienced since the Idaho law went into effect. The brief sheds light on how the Idaho statute has significantly delayed necessary medical care for pregnant patients and has forced them to undergo dangerous, costly journeys for care that further threaten their health, undermining the goals of EMTALA. An Idaho clinician told PHR researchers:

“We know, as physicians and health care providers, we don’t wait until somebody’s in kidney failure. We want to do the things to prevent them from ever getting there and to fix things, if we can, or treat it appropriately. It’s not how medicine is practiced to wait till somebody’s having the worst case scenario situation. And so that’s the main issue with these bans, is that they’re so strict that they’re in conflict with our EMTALA obligations.” 

Idaho v. United States presents the Supreme Court with a crucial question regarding access to reproductive health care for pregnant patients in the U.S. following its June 2022 Dobbs v. Jackson Women’s Health Organization decision overturning the right to abortion enshrined by Roe v. Wade. The case addresses whether the severe restrictions on access to abortion in Idaho preempt the federal requirement to provide medically mandated emergency care under EMTALA.

“Idaho’s abortion ban puts essential health care in jeopardy and forces medical professionals to decide between jail and their medical ethics. The earlier holding issued by the District Court is essential to ensuring that clinicians can treat patients in a way that is consistent with medical standards of care and adheres to professional ethical principles, as well as the requirements of EMTALA,” said Counsel of Record Gerson H. Smoger, JD, PhD, who also serves as Chair of PHR’s Board of Directors.

PHR’s amicus brief calls for the judgment of the District Court to be upheld, which would block enforcement of Idaho’s abortion ban in emergency rooms, as it directly overrides the federal protections of EMTALA for pregnant patients in need of emergency treatment. The PHR brief states:

“Diligent emergency room physicians face an impossible choice of either following the Idaho Act, but jeopardizing their patients’ health, or acting in accordance with basic medical standards of care and professional ethics. The difficulties of this choice are only exacerbated by the harsh civil, criminal, and professional penalties clinicians may face for violating the Idaho Act, while they are placed in a ‘double bind’ where they may face a medical malpractice suit if they follow the law by delaying treatment or not treating at all.”

PHR argues that the conflicting laws and civil, criminal, and professional penalties for violating the Idaho abortion ban place physicians in untenable positions that ultimately endanger the health of pregnant patients to whom they have an ethical duty to provide care. 

“In Idaho, medical professionals are grappling with an impossible choice, torn between a state law that criminalizes the care that is legally required by federal legislation. This contradiction creates an environment of fear for medical professionals and pregnant patients alike,” said Shah. 

Clinicians in Idaho face an “abortion double bind” due to the conflicting legal risks under the state’s abortion ban, which mandates denial of care even where medically indicated to preserve patient health. As maternity mortality and morbidity rates rise in Idaho and in other states that have criminalized abortion, the blocking of EMTALA in the state will only increase the numbers of “maternity deserts” in Idaho, putting reproductive care completely out of reach for many patients across the state. The amicus states: 

“The Idaho statute has led to delays in necessary medical care and resulted in the material deterioration of the health of pregnant patients. Patients in desperate and urgent need of health care have been forced to undergo long-distance and dangerous journeys for treatment that further jeopardizes their health, which is contrary to the core purpose of EMTALA. Such delays and denials of care have already caused health harms to pregnant patients, and risks causing maternal death. Pregnant patients diagnosed with fatal fetal impairments may be forced to continue their pregnancies and denied the care necessary to prevent deterioration of their condition, adversely impacting their physical and mental health and violating their human rights.”

Since the reversal of Roe, PHR has mobilized its medical and legal networks to investigate, document, and spotlight the impacts of state-level abortion bans. PHR has worked alongside local and national partners to research and highlight the consequences of abortion criminalization on health care in Louisiana, Oklahoma, Texas, and Idaho.

The amicus brief filed by PHR was written by Gerson H. Smoger, JD, PhD, Payal K. Shah, JD, and Christian De Vos, JD, PhD.

Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.

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