Safety preempted: When EMTALA and restraining orders collide

      A patient has been stalking Dr. Smith, an emergency physician at St. Mary's Hospital, for months. His stalking behavior has included frequent phone calls and e-mails. The patient has come to the emergency department at Saint Mary's during shifts worked by Dr. Smith several times. He has been in the emergency department 15 times in the last six months for vague complaints. Extensive medical work-ups have been negative. The patient frequently leaves against medical advice. He has been seen by multiple consultants including psychiatry, who diagnosed him with malingering and gave no other psychiatric diagnosis. When seen by Dr. Smith, he is frequently verbally aggressive and threatening. At the last ED visit, the patient assaulted Dr. Smith. Given the behavior, Dr. Smith obtained a restraining order against the patient, who continues to regularly go to the emergency department and continues to make threatening statements to staff members about Dr. Smith. Should Dr. Smith have to treat this patient?
      To read this article in full you will need to make a payment
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Katz M.H.
        • Wei E.K.
        EMTALA—a noble policy that needs improvement.
        JAMA Intern Med. April 01, 2019; (Published online)
      1. 42 USC §1395dd.
        • Patsner Bruce
        Refusing to treat: are there limits to physician “conscience” claims? Houst. J. Health Law Policy: Health Law Perspectives.
        (Published online August 18, 2008)
        • Marketing General Incorporated
        ACEP emergency department violence poll.
        (Retrieved from) ([on April 9, 2019])
        • Omar H.
        • et al.
        Reassessment of violence against emergency physicians.
        Ann Emerg Med. 2018; 72 (October)
        • Occupational Safety and Health Administration (OSHA)
        Guidelines for preventing workplace violence for healthcare and social service workers. No. 3148-04R.
        • Goggins Becki
        • Gallegos Anne
        State progress in record reporting for firearm-related background checks: protection order submissions.
        SEARCH and the National Center for State Courts, April 2016
        • American College of Emergency Physicians
        EMTALA fact sheet.
        (Retrieved from) ([on April 6, 2019])
      2. 131 Cal.App.3d 38.
        • Dietrich Damon
        EMTALA: a lesson in the inevitable futility of forced ethics.
        (Retrieved from)
        Date: November 20, 2008
        ([on April 6, 2019])