Members of the public and media listen during the Texas Medical Board Full Board Meeting in the George H.W. Bush Building in Austin, Texas on Mar. 22, 2024. All the seats in the room were filled as everyone listened while they talked about agenda item number 28, Consideration and possible action on rules regarding exceptions to the ban on abortions.
In addition to requiring doctors to document how they diagnosed the patient as needing an abortion, the board’s proposal requires them to note whether there was “adequate time to transfer the patient, by any means available to a facility or physician with a higher level of care or expertise to avoid performing an abortion.”
“How can a physician feel protected enough to provide good medical care when the ultimate decision is going to be made by the court, and they may not support the physician?” said Dr. Todd Ivey, a Houston OB/GYN and officer with the Texas chapter of the American College of Obstetricians and Gynecologists.
Doctors, health lawyers and women denied medical care for complicated pregnancies decried the guidance as both insufficiently clarifying and additionally burdensome on providers. “If you’re at Baylor, and there’s a physician at who says they would have tried a different treatment, or taken a more invasive approach … are they going to be under heightened scrutiny that they should have transferred?”
“If I've got a patient dying in front of me, I'm not going to sit there and start talking about why I didn't transfer the patient,” he said. “The patient is unstable, and I had to act quickly to save the patient's life … You don't have to say anything else.” “I think there’s concern that … even if they do everything right, this is a political battle versus a medical one,” Gearing said. “If an official wants to make an example, some of my clients don’t feel very confident that their choices would be viewed in a medical context, rather than a more political context.”As this guidance is being debated, Texas is in court arguing against a federal law that requires hospitals to screen and stabilize any patient experiencing a medical emergency.
But Sara Rosenbaum, an EMTALA legal expert at the Milken School of Public Health at the George Washington University, said the guidance to try to transfer a patient “by any means available,” as the proposal says, has the potential to further confuse doctors about their obligations under state and federal laws.
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