德克萨斯州司法部长肯·帕克斯顿周四首次向总统乔·拜登提出法律挑战关于堕胎的行政命令-指责政府将紧急医疗服务提供者变成“未经预约的堕胎诊所”，并开始了白宫和红州之间预计将是一场旷日持久的法律战。
争论的焦点是拜登对一项要求医生在医疗紧急情况下治疗病人，即使他们没有保险，并提供必要的“稳定治疗”
根据周一发布的指导意见，健康和人类服务部表示，法律将要求医生在医疗紧急情况下实施堕胎，如果他们的临床判断认为这样的程序有助于稳定怀孕患者。
该指导是总统本月早些时候签署的一项更广泛的行政命令的结果，该命令呼吁HHS保护生殖服务，并在最高法院之后扩大药物流产的可及性推翻罗伊诉韦德案。
周四，帕克斯顿表示，政府走得太远，并向美国德克萨斯州北区地方法院提起诉讼。
帕克斯顿在一份声明中说:“本届政府很难遵守法律，现在他们正试图让他们任命的官员授权医院和急诊医生实施堕胎手术。”
白宫回应称帕克斯顿的立场是“激进的”。
2021年11月1日，在华盛顿特区，德克萨斯州司法部长肯·帕克斯顿在美国最高法院外对反堕胎支持者发表讲话
Evelyn Hockstein/路透社，文件
“这是又一个极端和激进的共和党当选官员的例子。新闻秘书郭佳欣·让-皮埃尔说:“这位政府官员起诉阻止妇女在急诊室接受救生护理是不可思议的，这是受美国法律保护的权利。”。
拜登的命令和随后的HHS指导意见预计不会对限制堕胎的州产生重大影响，因为孕妇面临威胁生命的紧急医疗情况相对较少。
尽管如此，该命令旨在解决许多医学专家的担忧，即允许堕胎以“拯救母亲的生命”的州法律含糊不清。医生说，他们不确定在提供者采取行动之前，死亡必须迫在眉睫。
在周一对医院的指导中，卫生部长泽维尔·韦塞拉说，联邦法律《紧急医疗处理和积极劳动法案》应该授权医生使用他们最好的临床判断。韦塞拉指出，由于EMTALA是一项联邦法规，它将优先于任何限制堕胎的州法律。
“作为一线医疗保健提供者，联邦EMTALA法令保护你的临床判断和你为怀孕患者提供稳定医疗治疗的行动，不管你执业所在州的限制，”韦塞拉写道。
根据HHS指南，涉及怀孕患者的紧急医疗状况可能包括“宫外孕、流产并发症或紧急高血压疾病，如具有严重特征的先兆子痫。”
EMTALA通过投诉强制执行。如果一家医院通过联邦调查被发现违反法律，它可能会失去医疗保险计划或面临罚款。
一个主要的反堕胎组织，苏珊·b·安东尼反堕胎美国组织，周四表示同意德克萨斯州对拜登紧急医疗指导的诉讼。
在提供给美国广播公司新闻的一份声明中，该组织表示，拜登引用的联邦法律从未专门规定稳定病人的特定方法。如果孕妇的健康处于危险之中，应该“尽一切努力”来稳定母亲和孩子，即使这意味着早产。
“新的指导方针是对(法律)EMTALA的完全歪曲，我们坚定地站在德州AG Paxton一边，”该组织表示
Texas AG sues Biden for telling doctors to perform abortions as needed in emergencies
Texas Attorney General Ken Paxton on Thursday filed the first legal challenge to President Joe Biden’sexecutive order on abortion-- accusing the administration of turning emergency health care providers into "walk-in abortion clinics" and kicking off what is expected to be a protracted legal battle between the White House and red states.
At issue is Biden’s interpretation of a federal law that requires doctorsto treat patients in medical emergencies, even if they do not have insurance, and provide the necessary “stabilizing treatment."
Under guidance issued Monday, the Health and Human Services Department said the law would require doctors to perform abortions in medical emergencies if their clinical judgement finds such a procedure would help stabilize a pregnant patient.
The guidance was the result of a broader executive order signed by the president earlier this month that called on HHS to to protect reproductive services and expand access to medication abortion in the wake of the Supreme Courtoverturning Roe v. Wade.
On Thursday, Paxton said the administration went too far and filed a complaint in the U.S. District Court for the Northern District of Texas.
“This administration has a hard time following the law, and now they are trying to have their appointed bureaucrats mandate that hospitals and emergency medicine physicians perform abortions,” Paxton said in a statement.
The White House responded by calling Paxton's position "radical."
"This is yet another example of an extreme and radical Republican elected official. It is unthinkable that this public official would sue to block women from receiving life-saving care in emergency rooms, a right protected under US law," press secretary Karine Jean-Pierre said.
Biden’s order and the subsequent HHS guidance were not expected to have a major impact on abortion access in states that restrict it as life-threatening medical emergencies facing pregnant patients are relatively rare.
Still, the order was aimed at addressing concerns by many medical experts that state laws allowing abortion to “save the life of a mother” were vague. Doctors said they weren’t sure how imminent death must be before a provider could act.
In guidance to hospitals on Monday, Health Secretary Xavier Becerra said the federal law -- the Emergency Medical Treatment and Active Labor Act -- should empower doctors to use their best clinical judgement. Becerra noted that because EMTALA is a federal statute, it would take precedence over any state laws restricting abortion.
“As frontline health care providers, the federal EMTALA statute protects your clinical judgment and the action that you take to provide stabilizing medical treatment to your pregnant patients, regardless of the restrictions in the state where you practice,” Becerra wrote.
According to the HHS guidance, emergency medical conditions involving pregnant patients may include “ectopic pregnancy, complications of pregnancy loss, or emergent hypertensive disorders, such as preeclampsia with severe features.”
EMTALA is enforced through complaints. If a hospital is found to violate the law through a federal investigation, it could lose access to the Medicare program or face fines.
A major anti-abortion group, Susan B. Anthony Pro-Life America, said Thursday it agreed with Texas on its suit over Biden’s emergency medical guidance.
In a statement provided to ABC News, the organization said the federal law cited by Biden has never specialized a particular method of stabilizing a patient. And if a pregnant person’s health is in danger “every attempt” should be made to stabilize both the mother and child, even if that means premature delivery.
“The new guidance is a complete distortion of [the law] EMTALA and we firmly stand with AG Paxton in Texas,” the group said.
