Based on my reading of that block from the article, she did get a second opinion. Once you've got two more credentialed professionals agreeing on something, it's a lot harder to justify going against their opinion.
No, because we don’t live in a world where only one person has to be responsible for every outcome.
Multiple people can share responsibility (and legal liability) for an outcome. In this case, the NP may bear some responsibility for the reasons you outlined. In fact the NP and her organization were sued and settled out of court already:
> At some point prior to that date, Justin Warren “sued Essentia Health for the alleged malpractice of its employees, Simon and Baldwin.” (p. 6) That case was settled out of court.
So, the NP may bear some responsibility, but there’s no reason why that should be the end of the investigation as to who else may bear some responsibility.
Either they are trained well enough to make the decision on their own (which would mean the NP shouldn't need permission for this patient to be admitted) or the doctor is actually the person who is responsible for the patient's well-being.
In fact, let's make the refusal even more explicit.
Let's suppose that he flat-out said, "I don't think she needs emergency care, and if you send this patient to the ER, I will refuse to treat her."
Even so ... isn't it ultimately on the NP -- who seemed to grasp that he was blowing her off -- to either get a second opinion or (ideally) use her own medical training to determine that the patient really should go to the ER, no matter what he says, knowing that he can't actually refuse to treat her?
Stating that you intend not to do something, after all, is not always the same as actually refusing to do it.
That's not the most compelling argument, I know.
But I do worry about the broader implications of this ruling. Should physicians fear malpractice claims arising out of consultations with colleagues? In what cases can you feel free to give your opinion "off the record," with the understanding that the person who has consulted you will bear ultimate responsibility for the treatment they are providing?