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Texas emergency rooms not bound by Biden admin’s guidance on emergency abortion, federal court rules

A federal court of appeals ruled this week that emergency rooms in Texas cannot be forced to perform abortions to stabilize a patient, when abortion is considered illegal.

A federal appeals court ruled on Tuesday that the U.S. government does not have the authority to force Texas emergency room doctors to perform abortions if necessary to stabilize emergency room patients.

Reuters reported that the ruling sided with Texas in a lawsuit claiming the Biden administration was overstepping its authority on abortion.

A panel with the 5th Circuit Court of Appeals ruled unanimously on the matter as several lawsuits pertaining to when abortions can be performed in states with abortion ban exceptions for medical emergencies make their way through the courts.


In July 2022, the Biden administration issued guidance saying the Emergency Medical Treatment and Active Labor Act (EMTALA), which is a federal law that governs emergency rooms, can require abortion if it is necessary to stabilize a patient with a medical emergency, despite abortion being required in the state where the emergency room is located.

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The guidance was issued shortly after the U.S. Supreme Court overturned the landmark Roe v. Wade ruling in June 2022.

The overturning of Roe v. Wade turned power over to the states to allow, limit or ban abortion altogether.

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The ruling came in the court’s opinion in Dobbs v. Jackson Women’s Health Organization, which centered on a Mississippi law that banned abortion after 15 weeks of pregnancy.

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A lower court agreed, in August 2022, that there was no mention in EMTALA on what a doctor should do if there is a conflict between the health of a mother and the unborn child. The court also agreed that the Texas abortion ban “fills that void” by including narrow exceptions to save a mother’s life or prevent serious bodily injury in some cases.

Writing for the 5th Circuit Court panel, Judge Kurt Engelhardt said EMTALA includes a requirement to deliver an unborn child, and it was up to doctors to balance the mother’s medical needs, as well as those for the fetus, while complying with state abortion laws.

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What the law does not provide, Engelhardt wrote, is an “unqualified right for the pregnant mother to abort her child.”

The 5th Circuit Court’s ruling upholds a lower court order that blocked enforcement of the Biden administration’s guidance in Texas, and against members of two anti-abortion medical associations anywhere in the U.S.

In December, a pregnant Texas woman whose baby had a fatal diagnosis asked a court to let her have an abortion, bringing what her attorneys said was the first lawsuit of its kind in the U.S. since Roe v. Wade was overturned.

The Texas Supreme Court denied the woman’s request. She ended up leaving the state to get the procedure.

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Texas is one of 13 states that ban abortion at nearly all stages of pregnancy, and although Texas allows exceptions, doctors and women have argued in court that the state’s law is so restrictive and vaguely worded that physicians are fearful of providing abortions because they could face criminal charges.

Reuters contributed to this report.

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