On Tuesday, a federal appeals court ruled that the US government cannot compel emergency room doctors in Texas to perform abortions as mandated by federal guidance, even if it is deemed necessary to stabilize patients. The court, siding with Texas, supported the state in a lawsuit accusing the Biden administration of exceeding its authority.
This unanimous decision by the fifth US circuit court of appeals is part of a broader legal landscape where lawsuits are challenging the timing of abortion provision in states with bans that include exceptions for medical emergencies.
The lawsuit arose after the Biden administration, in July 2022, issued guidance asserting that the Emergency Medical Treatment and Active Labor Act (Emtala), a federal law governing emergency rooms, could require abortions to stabilize patients in medical emergencies, even in states where abortion is prohibited.
This guidance followed the US Supreme Court’s overturning of the landmark Roe v Wade decision, which had guaranteed a nationwide right to abortion since 1973.
Texas, along with two anti-abortion medical associations—the American Association of Pro-Life Obstetricians & Gynecologists and the Christian Medical & Dental Associations—immediately filed a lawsuit, arguing that the guidance infringed on the state’s authority to restrict abortion.
In August 2022, a lower court judge agreed, stating that Emtala was silent on handling conflicts between the health of the mother and the unborn child and that the Texas abortion ban addressed this by allowing narrow exceptions to save the mother’s life or prevent serious bodily injury in certain cases.
The 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 while adhering to state abortion laws.
The ruling maintains the lower court order blocking the enforcement of the guidance in Texas and preventing the administration from enforcing it against members of the two anti-abortion medical associations nationwide.
This federal court decision follows a recent ruling by Texas’s highest state court against a woman seeking an emergency abortion for a non-viable pregnancy. The court is currently reviewing another lawsuit by 22 women regarding the scope of the emergency medical exception to Texas’s abortion ban.
In a contrasting decision last year, a federal judge in Idaho blocked the state’s abortion ban, finding it conflicted with Emtala; the ninth US circuit court of appeals is expected to hear the state’s appeal later this month.