川普总统保护保护弱势新生儿和婴儿的行政命令(2020/09/25)

图片来源:https://www.whitehouse.gov/presidential-actions/executive-order-protecting-vulnerable-newborn-infant-children/

Executive Order on Protecting Vulnerable Newborn and Infant Children

保护弱势新生儿和婴儿的行政命令

Issued on: September 25, 2020

2020年9月25日发布

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:

根据美国宪法和美利坚合众国法律赋予我的总统授权,现命令如下: 

Section 1.  Purpose.  Every infant born alive, no matter the circumstances of his or her birth, has the same dignity and the same rights as every other individual and is entitled to the same protections under Federal law.  Such laws include the Emergency Medical Treatment and Labor Act (EMTALA), 42 U.S.C. 1395dd, which guarantees, in hospitals that have an emergency department, each individual’s right to an appropriate medical screening examination and to either stabilizing treatment or an appropriate transfer.  They also include section 504 of the Rehabilitation Act (Rehab Act), 29 U.S.C. 794, which prohibits discrimination against individuals with disabilities by programs and activities receiving Federal funding.  In addition, the Born-Alive Infants Protection Act, 1 U.S.C. 8, makes clear that all infants born alive are individuals for purposes of these and other Federal laws and are therefore afforded the same legal protections as any other person.  Together, these laws help protect infants born alive from discrimination in the provision of medical treatment, including infants who require emergency medical treatment, who are premature, or who are born with disabilities.  Such infants are entitled to meaningful and non-discriminatory access to medical examination and services, with the consent of a parent or guardian, when they present at hospitals receiving Federal funds.

第一节  目的:每一个活着出生的婴儿,不管他或她出生的情况如何,都享有与其他人同样的尊严和权利,并有权享受联邦法律规定的同样的保护。

这些法律包括《紧急医疗和劳工法》(EMTALA),《美国法典》第42卷第1395dd节,该法保障在设有急诊科的医院里,每个人都有权接受适当的医学筛查检查,以及稳定治疗或适当转院。其中还包括《康复法》(第504节,即《美国法典》第29卷第794节,该节禁止通过接受联邦资助的计划和活动歧视残疾人。此外,《活产婴儿保护法》, 也就是《美国法典》第1卷第8节明确规定,所有活产婴儿都是本联邦法律和其它联邦法律所规定的个人,因此享有与任何其他人相同的法律保护。这些法律加在一起,有助于保护活产婴儿在提供医疗方面不受歧视,包括需要紧急治疗的婴儿、早产儿或先天残疾的婴儿。这些婴儿在接受联邦资金的医院就诊时,经父母或监护人同意,有权获得有意义和无歧视的体检和服务。

Despite these laws, some hospitals refuse the required medical screening examination and stabilizing treatment or otherwise do not provide potentially lifesaving medical treatment to extremely premature or disabled infants, even when parents plead for such treatment.  Hospitals might refuse to provide treatment to extremely premature infants — born alive before 24 weeks of gestation — because they believe these infants may not survive, may have to live with long-term disabilities, or may have a quality-of-life deemed to be inadequate.  Active treatment of extremely premature infants has, however, been shown to improve their survival rates.  And the denial of such treatment, or discouragement of parents from seeking such treatment for their children, devalues the lives of these children and may violate Federal law.

尽管有这些法律,即使父母要求这样做,一些医院仍拒绝进行必要的医学筛查检查和稳定治疗,或者不向极早产或残疾婴儿提供可能挽救生命的医疗。医院可能拒绝为极早产婴儿(怀孕24周前出生的婴儿)提供治疗,因为他们认为这些婴儿可能无法存活,可能不得不长期生活在残疾中,或者生活质量被视为不足。然而,对极早产婴儿进行积极治疗可以提高他们的存活率。拒绝这种治疗,或阻止父母为孩子寻求这种治疗,会使这些孩子的生命遭受损失,同时也触犯了联邦法律。

Sec. 2.  Policy.  It is the policy of the United States to recognize the human dignity and inherent worth of every newborn or other infant child, regardless of prematurity or disability, and to ensure for each child due protection under the law.

第二节  政策:美国的政策是承认每一个新生儿或其他婴儿的人的尊严和固有价值,不论其是否早产或残疾,并确保每个儿童都得到法律的适当保护。

Sec. 3.  (a)  The Secretary of Health and Human Services (Secretary) shall ensure that individuals responsible for all programs and activities under his jurisdiction that receive Federal funding are aware of their obligations toward infants, including premature infants or infants with disabilities, who have an emergency medical condition in need of stabilizing treatment, under EMTALA and section 504 of the Rehab Act, as interpreted consistent with the Born-Alive Infants Protection Act.  In particular, the Secretary shall ensure that individuals responsible for such programs and activities are aware that they are not excused from complying with these obligations, including the obligation to provide an appropriate medical screening examination and stabilizing treatment or transfer, when extremely premature infants are born alive or infants are born with disabilities.  The Secretary shall also ensure that individuals responsible for such programs and activities are aware that they may not unlawfully discourage parents from seeking medical treatment for their infant child solely because of their infant child’s disability.  The Secretary shall further ensure that individuals responsible for such programs and activities are aware of their obligations to provide stabilizing treatment that will allow the infant patients to be transferred to a more suitable facility if appropriate treatment is not possible at the initial location.

第三节  (a)  : 卫生与公众服务部部长(简称:部长)应确保负责其管辖范围内接受联邦资助的所有项目和活动的个人了解其对婴儿(包括早产儿或残疾婴儿)的义务,根据EMTALA和《康复法案》第504条,有需要稳定治疗的紧急医疗状况的人,其解释与《出生婴儿保护法》一致。特别是,部长应确保负责此类计划和活动的个人意识到,当极早产婴儿活着出生或婴儿出生时就有残疾。部长还应确保负责此类计划和活动的个人意识到,他们不能仅仅因为婴儿的残疾而非法阻止父母为其婴儿寻求治疗。部长应进一步确保负责此类计划和活动的个人意识到他们有义务提供稳定的治疗,如果在最初的医院无法进行适当的治疗,可以将婴儿患者转移到更合适的其它医院。

(b)  The Secretary shall, as appropriate and consistent with applicable law, ensure that Federal funding disbursed by the Department of Health and Human Services is expended in full compliance with EMTALA and section 504 of the Rehab Act, as interpreted consistent with the Born-Alive Infants Protection Act, as reflected in the policy set forth in section 2 of this order.

(b)  部长应根据适用法律,确保卫生和公共服务部支付的联邦资金完全符合EMTALA和《康复法案》第504节的规定,并根据《未出生婴儿保护法》进行解释,如本命令第2节所述政策所述。

(i)   The Secretary shall, as appropriate and to the fullest extent permitted by law, investigate complaints of violations of applicable Federal laws with respect to infants born alive, including infants who have an emergency medical condition in need of stabilizing treatment or infants with disabilities whose parents seek medical treatment for their infants.  The Secretary shall also clarify, in an easily understandable format, the process by which parents and hospital staff may submit such complaints for investigation under applicable Federal laws.

(i)    部长应在适当的情况下,在法律允许的最大范围内,调查有关违反适用联邦法律有关活产婴儿的投诉,包括有急症需要稳定治疗的婴儿或父母寻找治疗的残疾婴儿。部长还应以通俗易懂的形式向父母和医院工作人员阐明此类投诉的程序,根据适用的联邦法律进行调查。

(ii)  The Secretary shall take all appropriate enforcement action against individuals and organizations found through investigation to have violated applicable Federal laws, up to and including terminating Federal funding for non-compliant programs and activities.

(ii)  部长应针对经调查发现违反联邦法律的个人和组织采取一切强制措施,直至并包括终止联邦对不合规计划和活动的资助。

(c)  The Secretary shall, as appropriate and consistent with applicable law, prioritize the allocation of Department of Health and Human Services discretionary grant funding and National Institutes of Health research dollars for programs and activities conducting research to develop treatments that may improve survival — especially survival without impairment — of infants born alive, including premature infants or infants with disabilities, who have an emergency medical condition in need of stabilizing treatment.

(c)   部长应在符合适用法律的前提下,优先分配卫生及公众服务署酌情拨款和国家卫生研究院的研究资金,用于开展研究以开发可提高活产婴儿存活率(尤其是无损伤存活率)的治疗方案和活动,包括早产儿或残疾婴儿,有急症需要稳定治疗的。

(d)  The Secretary shall, as appropriate and consistent with applicable law, prioritize the allocation of Department of Health and Human Services discretionary grant funding to programs and activities, including hospitals, that provide training to medical personnel regarding the provision of life-saving medical treatment to all infants born alive, including premature infants or infants with disabilities, who have an emergency medical condition in need of stabilizing treatment.

(d) 部长应在符合适用法律的前提下,优先将卫生及公众服务署酌情拨款分配给有关联的项目和活动,包括那些向医务人员提供活产婴儿救生医疗培训的医院,包括那些有急症需要稳定治疗的早产儿或残疾婴儿。

(e)  The Secretary shall, as necessary and consistent with applicable law, issue such regulations or guidance as may be necessary to implement this order.

(e)  必要时,部长应根据适用法律发布实施本命令所需的法规或指南。

Sec. 4.  General Provisions.  

(a)  Nothing in this order shall be construed to impair or otherwise affect:

(i)   the authority granted by law to an executive department or agency, or the head thereof; or

(ii)  the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

(b)  This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

(c)  This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

第四节  一般规定:

(a)  本命令中的任何内容不得解释为损害或以其他方式影响:

(i)  法律赋予行政部门或机构或其负责人的权力;或

(ii)  管理和预算办公室职能以及与预算、行政或立法提案有关的职能。

(b)  本命令应按照适用法律执行,并视拨款情况而定。

(c)  本命令无意也不会针对美国及其部门、机构或实体、官员、雇员或代理人或任何其他人,产生任何实质性或程序性权利或利益。

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翻译:【沙漠红蚂蚁】校对&编辑:【Isaiah4031】

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“but those who hope in the Lord will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint” 【Isaiah 40:31】 9月 26日