Finding a way through the hospital door: The role of EMTALA in public health emergencies

Document Type

Journal Article

Publication Date

Winter 2003


Journal of Law, Medicine and Ethics


Volume 31, Issue 4

Inclusive Pages



Emergency Service, Hospital--legislation & jurisprudence; Legislation, Hospital; Patient Admission--legislation & jurisprudence; Public Health--legislation & jurisprudence; United States Dept. of Health and Human Services--legislation & jurisprudence; Emergent Care; EMTALA


This article examines the Emergency Medical Treatment and Labor Act (EMTALA) in a public health emergency context. Congress enacted EMTALA in 1986 to prohibit the practice of "patient dumping," which involved hospitals' refusal to undertake emergency screening and stabilization services for individual patients who sought emergency room care, typically because of insurance status, inability to pay, or other grounds unrelated to the patient's need for the services or the hospital's ability to provide them. But in fact EMTALA, whose conceptual roots can be found in the Hospital Survey and Construction Act of 1946 (Hill Burton) as well as an evolution in both the common law and state statutes related to hospital licensure, can be viewed as having a far broader purpose than protection of individuals, and indeed, one that is related to the protection of communities and the public health. It is this broader purpose with which this article is concerned.