There are unique ethical and legal obligations of the Emergency Room Physician. Commonly faced issues include patient “dumping”, organ donation, and Do-Not Resuscitate orders. These issues have ethical and legal considerations for the Emergency Room Physician in regards to their responsibilities and actions.
The ethical right for individuals to have access to health care already has a form of legal binding within the United States as seen in the Emergency Medical Treatment and Active Labor Act. “In 1986, Congress passed the Emergency Medical Treatment and Active Labor Act (EMTALA), which forbids Medicare-participating hospitals from “dumping” patients out of emergency departments” (Pozgar, 2010, p. 221). The act provides that:
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The ethical question arises for the Emergency Room Physician “about whether organ preservation and removal might begin before patients are technically dead, and because of fears that doctors might not do everything possible to save patients and may even hasten their deaths, to increase the chance of obtaining organs” (Stein, 2010). The complexity of the ethical concerns of this issue extends to the Do-Not-Resuscitate orders, “particularly with controlled donors who have a constitutionally protected right to withdraw life-sustaining care” (Harrington, 2009).
The final issue being addressed which holds both ethical and legal conditions, is the Do-Not-Resucitate (DNR) order. “A DNR order is a written medical order that documents the patient's wishes regarding resuscitation and, more specifically, the patient's desire to avoid CPR” (Payne & Thornlow, 2008). An Emergency Room Physician may be unaware of a DNR order, or the DNR order may not be in the hospital’s medical record. Also, during emergency care, an Emergency Room Physician most likely will not have the time to review the existence of a DNR order. “This example highlights the challenges in communicating vital information across health care sites and among health care providers. To meet these challenges, several states have enacted legislation requiring the portability of do-not-resuscitate (DNR) orders” (Payne &