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AN ACT relating to protecting the exercise of medical ethics within the medical 1
profession. 2
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 3
SECTION 1. A NEW SECTION OF KRS CHAPTER 344 IS CREATED TO 4
READ AS FOLLOWS: 5
As used in Sections 1 to 4 of this Act: 6
(1) "Conscience" means the religious, moral or ethical principles held by a medical 7
practitioner, a health care institution, or a health care payer. For purposes of 8
Sections 1 to 4 of this act, a health care institution or health care payer's 9
conscience shall be determined by reference to its existing or proposed religious, 10
moral or ethical guidelines, mission statement, constitution, bylaws, articles of 11
incorporation, regulations or other relevant documents; 12
(2) "Disclosure" means a formal or informal communication or transmission, but 13
does not include a communication or transmission concerning policy decisions 14
that lawfully exercise discretionary authority, unless the medical practitioner 15
providing the disclosure or transmission reasonably believes that the disclosure 16
or transmission evinces: 17
(a) A violation of any law, rule, or regulation; 18
(b) A violation of any standard of care or other ethical guidelines for the 19
provision of any health care service; or 20
(c) Gross mismanagement, a gross waste of funds, an abuse of authority, or a 21
substantial and specific danger to public health or safety; 22
(3) "Discrimination" means any adverse action taken against, or any threat of 23
adverse action communicated to, a medical practitioner, health care institution, 24
or health care payer as a result of his, her, or its decision to decline to participate 25
in a health care service on the basis of conscience. Discrimination includes but is 26
not limited to termination of employment; transfer from current position; 27 UNOFFICIAL COPY 23 RS BR 869
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demotion from current position; adverse administrative action; reassignment to a 1
different shift or job title; increased administrative duties; refusal of staff 2
privileges; refusal of board certification; loss of career specialty; reduction of 3
wages, benefits, or privileges; refusal to award a grant, contract, or other 4
program; refusal to provide residency training opportunities; denial, deprivation, 5
or disqualification of licensure; withholding or disqualifying from financial aid 6
and other assistance; reducing, excluding, terminating, materially altering the 7
terms of conditions of, or otherwise making unavailable or denying, any grant, 8
contract, subcontract, cooperative agreement, guarantee, loan, or other similar 9
program or benefit; impediments to creating any health care institution or payer 10
or expanding or improving that health care institution or payer; impediments to 11
acquiring, associating with, or merging with any other health care institution or 12
payer; the threat thereof with regard to any of the preceding; or any other 13
penalty, disciplinary, or retaliatory action, whether executed or threatened; 14
(4) "Health care service" means medical care provided to any patient at any time 15
over the entire course of treatment. This includes but is not limited to initial 16
examination; testing; diagnosis; referral; dispensing or administering any drug, 17
medication, or device; psychological therapy or counseling; research; prognosis; 18
therapy; any other care or necessary services performed or provided by any 19
medical practitioner, including but not limited to allied health professionals, 20
paraprofessionals, or employees of health care institutions; 21
(5) "Health care institution" means any public or private hospital, clinic, medical 22
center, professional association, ambulatory surgical center, private physician's 23
office, pharmacy, nursing home, medical school, nursing school, medical 24
training facility, or any other entity or location in which health care services are 25
performed on behalf of any person. Health care institutions may include but are 26
not limited to organizations, corporations, partnerships, associations, agencies, 27 UNOFFICIAL COPY 23 RS BR 869
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networks, sole proprietorships, joint ventures, or any other entity that provides 1
health care services; 2
(6) "Health care payer" means any employer, health care plan, health maintenance 3
organization, insurance company, management services organization, or any 4
other entity that pays for or arranges for the payment of any health care service 5
provided to any patient, whether that payment is made in whole or in part; 6
(7) "Medical practitioner" means any person or individual who may be or is asked to 7
participate in a health care service. This includes but is not limited to doctors, 8
nurses, practitioners, physician's assistants, nurses, nurse's aides, allied health 9
professionals, medical assistants, hospital employees, clinic employees, nursing 10
home employees, pharmacists, pharmacy technicians and employees, medical 11
school faculty and students, nursing home faculty and students, psychology and 12
counseling faculty and students, medical researchers, laboratory technicians, 13
counselors, social workers, or any other person who facilitates or participates in 14
the provision of health care to any person; 15
(8) "Participate in a health care service" means to provide, perform, assist with, 16
facilitate, refer for, counsel for, consult with regard to, admit for the purposes of 17
providing, or take part in any way in providing, any health care service or any 18
form of such a service; and 19
(9) "Pay" or "payment" means to pay for, contract for, arrange for the payment of 20
(whether in whole or in part), reimburse, or remunerate. 21
SECTION 2. A NEW SECTION OF KRS CHAPTER 344 IS CREATED TO 22
READ AS FOLLOWS: 23
(1) A medical practitioner, health care institution, or health care payer shall have the 24
right not to participate in or pay for any health care service which violates his, 25
her, or its conscience. 26
(2) A medical practitioner, health care institution, or health care payer shall not be 27 UNOFFICIAL COPY 23 RS BR 869
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liable civilly, criminally, or administratively for exercising his, her, or its right or 1
conscience with respect to a health care service. 2
(3) No medical practitioner, health care institution, or health care payer shall be 3
subject to discrimination in any manner as a result of his, her, or its decision to 4
decline to participate in a health care service on the basis of conscience. 5
(4) Nothing in Sections 1 to 4 of this Act shall be construed to override the 6
requirement to provide emergency medical treatment to all patients as set forth in 7
42 U.S.C. sec. 1395dd or any other federal law governing emergency medical 8
treatments. 9
SECTION 3. A NEW SECTION OF KRS CHAPTER 344 IS CREATED TO 10
READ AS FOLLOWS: 11
(1) No medical practitioner shall be discriminated against because he or she: 12
(a) Provided, caused to be provided, or is about to provide to his or her 13
employer, the Attorney General, any agency of the Commonwealth charged 14
with protecting health care rights of conscience, the United States 15
Department of Health and Human Services, Office for Civil Rights, or any 16
other federal agency charged with protecting health care rights of 17
conscience with information relating to any violation, act, or omission the 18
medical practitioner reasonably believes to be a violation of any provision of 19
Sections 1 to 4 of this Act; 20
(b) Testified or is about to testify in a proceeding concerning a violation; or 21
(c) Assisted, participated, or is about to assist or participate in related 22
proceedings. 23
(2) Unless the disclosure is prohibited by law, no medical practitioner shall be 24
discriminated against because he or she disclosed information that he or she 25
reasonably believe evinces: 26
(a) A violation of a relevant law, rule, or regulation; 27 UNOFFICIAL COPY 23 RS BR 869
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(b) A violation of a standard of care or other ethical guideline for the provision 1
of health care services; or 2
(c) Gross mismanagement, gross waste of funds, abuse of authority, or 3
substantial and specific danger to public health or safety. 4
SECTION 4. A NEW SECTION OF KRS CHAPTER 344 IS CREATED TO 5
READ AS FOLLOWS: 6
Any person injured by a violation of Sections 1 to 4 of this Act shall have a civil cause 7
of action in the Circuit Court of appropriate jurisdiction to enjoin further violations, to 8
recover the actual damages sustained, and to recover the costs of the lawsuit and to 9
provide any other appropriate relief, which may include reinstatement of a medical 10
practitioner to his or her previous position, reinstatement of board certification, and 11
relicensure of a health care institution or health care payer. If a violation is found to 12
have occurred, the court's order or judgment shall include a reasonable fee for the 13
plaintiff's attorney of record. Any additional burden or expense on another medical 14
practitioner, health care institution, or health care payer arising from the exercise of 15
the right of conscience shall not be a defense to any violation of Sections 1 to 4 of this 16
Act. 17
Section 5. Whereas it is crucial that the Commonwealth's regulatory policies 18
reflect the statutory intent of the General assembly, an emergency is declared to exist, and 19
this Act takes effect upon its passage and approval by the Governor or upon its otherwise 20
becoming a law. 21