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Before 1986, the Common Law provided that physicians and hospitals had no duty to admit or treat persons who sought their care except in limited circumstances. Congress enacted The Emergency Medical Treatment and Active Labor Act (EMTALA) to curb this so-called patient-dumping problem. EMTALA provides, essentially, that Medicare-participating hospitals must treat all patients who arrive in emergency conditions.

This article first discusses the patient-dumping problem and how EMTALA has provoked many hospitals to curtail their emergency facilities in order to avoid treating indigent and uninsured patients. The Article then proceeds to analyze the specifics of EMTALA’s main statutory provision, Section 1395, and focuses on EMTALA’s particular impact on indigent elderly persons who have neither personal insurance nor Medicare. Next follows an explanation of how EMTALA may encourage, indirectly, hospitals to dump elderly patients who do not have Medicare. The argument is they presented that EMTALA’s definitional flaws and weak enforcement mechanisms make it an ineffective statute. A number of ways designed to strengthen the statute are then presented. Finally, an examination of society’s ethical obligations to treat its elderly citizens is undertaken and a conclusion reached which suggests that physicians have an affirmative obligation to treat indigent elderly patients as a condition to their licensure.



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