川普總統保護保護弱勢新生兒和嬰兒的行政命令(2020/09/25)

圖片來源:https://www.whitehouse.gov/presidential-actions/executive-order-protecting-vulnerable-newborn-infant-children/

Executive Order on Protecting Vulnerable Newborn and Infant Children

保護弱勢新生兒和嬰兒的行政命令

Issued on: September 25, 2020

2020年9月25日發佈

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:

根據美國憲法和美利堅合眾國法律賦予我的總統授權,現命令如下: 

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.

第一節  目的:每一個活著出生的嬰兒,不管他或她出生的情況如何,都享有與其他人同樣的尊嚴和權利,並有權享受聯邦法律規定的同樣的保護。

這些法律包括《緊急醫療和勞工法》(EMTALA),《美國法典》第42卷第1395dd節,該法保障在設有急診科的醫院裡,每個人都有權接受適當的醫學篩查檢查,以及穩定治療或適當轉院。其中還包括《康復法》(第504節,即《美國法典》第29卷第794節,該節禁止通過接受聯邦資助的計劃和活動歧視殘疾人。此外,《活產嬰兒保護法》, 也就是《美國法典》第1卷第8節明確規定,所有活產嬰兒都是本聯邦法律和其它聯邦法律所規定的個人,因此享有與任何其他人相同的法律保護。這些法律加在一起,有助於保護活產嬰兒在提供醫療方面不受歧視,包括需要緊急治療的嬰兒、早產兒或先天殘疾的嬰兒。這些嬰兒在接受聯邦資金的醫院就診時,經父母或監護人同意,有權獲得有意義和無歧視的體檢和服務。

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.

儘管有這些法律,即使父母要求這樣做,一些醫院仍拒絕進行必要的醫學篩查檢查和穩定治療,或者不向極早產或殘疾嬰兒提供可能輓救生命的醫療。醫院可能拒絕為極早產嬰兒(懷孕24周前出生的嬰兒)提供治療,因為他們認為這些嬰兒可能無法存活,可能不得不長期生活在殘疾中,或者生活質量被視為不足。然而,對極早產嬰兒進行積極治療可以提高他們的存活率。拒絕這種治療,或阻止父母為孩子尋求這種治療,會使這些孩子的生命遭受損失,同時也觸犯了聯邦法律。

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:美國的政策是承認每一個新生兒或其他嬰兒的人的尊嚴和固有價值,不論其是否早產或殘疾,並確保每個兒童都得到法律的適當保護。

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)  : 衛生與公眾服務部部長(簡稱:部長)應確保負責其管轄範圍內接受聯邦資助的所有項目和活動的個人瞭解其對嬰兒(包括早產兒或殘疾嬰兒)的義務,根據EMTALA和《康復法案》第504條,有需要穩定治療的緊急醫療狀況的人,其解釋與《出生嬰兒保護法》一致。特別是,部長應確保負責此類計劃和活動的個人意識到,當極早產嬰兒活著出生或嬰兒出生時就有殘疾。部長還應確保負責此類計劃和活動的個人意識到,他們不能僅僅因為嬰兒的殘疾而非法阻止父母為其嬰兒尋求治療。部長應進一步確保負責此類計劃和活動的個人意識到他們有義務提供穩定的治療,如果在最初的醫院無法進行適當的治療,可以將嬰兒患者轉移到更合適的其它醫院。

(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)  部長應根據適用法律,確保衛生和公共服務部支付的聯邦資金完全符合EMTALA和《康復法案》第504節的規定,並根據《未出生嬰兒保護法》進行解釋,如本命令第2節所述政策所述。

(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)    部長應在適當的情況下,在法律允許的最大範圍內,調查有關違反適用聯邦法律有關活產嬰兒的投訴,包括有急症需要穩定治療的嬰兒或父母尋找治療的殘疾嬰兒。部長還應以通俗易懂的形式向父母和醫院工作人員闡明此類投訴的程序,根據適用的聯邦法律進行調查。

(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)  部長應針對經調查發現違反聯邦法律的個人和組織採取一切強制措施,直至並包括終止聯邦對不合規計劃和活動的資助。

(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)   部長應在符合適用法律的前提下,優先分配衛生及公眾服務署酌情撥款和國家衛生研究院的研究資金,用於開展研究以開發可提高活產嬰兒存活率(尤其是無損傷存活率)的治療方案和活動,包括早產兒或殘疾嬰兒,有急症需要穩定治療的。

(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) 部長應在符合適用法律的前提下,優先將衛生及公眾服務署酌情撥款分配給有關聯的項目和活動,包括那些向醫務人員提供活產嬰兒救生醫療培訓的醫院,包括那些有急症需要穩定治療的早產兒或殘疾嬰兒。

(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)  必要時,部長應根據適用法律發佈實施本命令所需的法規或指南。

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.

第四節  一般規定:

(a)  本命令中的任何內容不得解釋為損害或以其他方式影響:

(i)  法律賦予行政部門或機構或其負責人的權力;或

(ii)  管理和預算辦公室職能以及與預算、行政或立法提案有關的職能。

(b)  本命令應按照適用法律執行,並視撥款情況而定。

(c)  本命令無意也不會針對美國及其部門、機構或實體、官員、僱員或代理人或任何其他人,產生任何實質性或程序性權利或利益。

翻譯:【沙漠紅螞蟻】校對&編輯:【Isaiah4031】

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Himalaya Rose Garden Team

“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