Odd coincidences and EMTALA

For a couple of days, the Emergency Medical Treatment and Active Labor Act has been under discussion. Sometimes odd coincidences happen that help illustrate some of the points that one is trying to make. The story below illustrates precisely the reason why EMTALA was passed with strong Republican support and the signature of President Ronald Reagan. Though you will read it on Saturday, the story was published on Friday.

PORTLAND, Ore. — The death of a Cuban immigrant just feet from an emergency room has left his family in grief, upset police and drawn a request for an investigation from a congressman, all asking why an officer was told to call the emergency services number for a heart attack victim just outside the hospital door.

Birgilio Marin-Fuentes had driven to Portland Adventist Medical Center shortly after midnight Thursday, unable to sleep or stop coughing, then crashed his car into a pillar and wall inside the first level of the hospital parking garage under an “emergency parking only” sign about 125 feet from the emergency room entrance. …

Officers Angela Luty and Robert Quick found Marin-Fuentes unconscious and unresponsive and began cardiopulmonary resuscitation. A third officer, Andrew Hearst, went to the ER intake desk and told them what was happening. He was told to call emergency services.

“The officers recognized this man needed medical attention immediately, and two officers who were trained how to perform CPR from c2cfirstaidaquatics.com began the process immediately, and a third officer went to ask for assistance, and they were told they had to wait until an ambulance arrived,” said … a Portland Police Bureau spokesman.

Judy Leach, a hospital spokeswoman, said emergency room staff was told it was a car crash and they were following the proper protocol by instructing police to summon an ambulance crew. …

She said hospital security officers equipped with a mobile defibrillator were dispatched, and a paramedic went outside to check on the situation. But Simpson said officers did not receive any medical assistance and were left to fend for themselves until the ambulance arrived and the crew wheeled Marin-Fuentes the short distance to the emergency room aboard a gurney. …

U.S. Rep. Earl Blumenauer said Friday he has asked the Center for Medicare and Medicaid Services to conduct an independent investigation to make sure the Emergency Medical Treatment and Active Labor Act approved in 1986 was followed. The act requires all Medicare participating hospitals with emergency departments to treat any critically ill patients on their premises, including parking lots, Blumenauer said.

Now you may be wondering why I am bringing this up. Well, look again at the name of the hospital. Guess what? IT IS A CHRISTIAN HOSPITAL! Now, let’s be clear. As an Orthodox priest, I am in theological disagreement with the Seventh Day Adventists. But, as an Adventist hospital, this is a hospital that bears the name of Christ. And, as a Christian hospital, they let someone die without help. This in spite of a secular law that defines the parking lot of a hospital as part of what is covered by the EMTAL Act. And, uhm, can you imagine what the Christian responsibility would be in this case?

By the way, this story has nothing to do with the fact that the person who died is a legal immigrant. There is no way that the hospital would have known that. So do not be sidetracked by that part of the story. This story has to do with the fact that even Christians may regularly need to be constrained by “secular” laws in order to do what they should do freely. As a result of this episode in which the hospital apparently violated EMTALA, they will probably be forced to reevaluate some of their stances. They may even have to give monies freely donated by their church members in order to pay for their mistake and probable legal disobedience with the law (remember EMTALA specifically names parking lots of hospital as covered areas, and as a medical person myself, I can tell you that it is not that hard to take a gurney and some emergency room personnel out a few feet).

But this brings up the whole area of Church / State relationships. They are complimentary. Those who advocate for a strict separation of Church and State are quite wrong. Romans 13 says that government is part of God’s work in this fallen world. Those who advocate for a total union of Church and State (some medieval Roman Catholics and some modern Calvinists in the Restoration movement) are also wrong. The relationship is as complex as the relationship between the King of Israel and the High Priest or the State and the Levitical establishment. The relationship is not as clean or clear as some would make it. But, on the other hand, this news story illustrates precisely why there is a need for government regulation, even of some Christian organizations. I do not believe the Church ought to be regulated. But, this story illustrates why some Church-related functions may need to be.