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STATE OF OKLAHOMA
2nd Session of the 59th Legislature (2024)
HOUSE BILL 3214 By: West (Kevin)
AS INTRODUCED
An Act relating to freedom of conscience; creating
the Medical Ethics Defense Act; prov iding short
title; defining terms; granting certain rights to
certain medical practitioner s, health care
institutions, or health care payers; limiting
exercise of certain rights; granting certain
immunities; prohibiting certain discrimination;
requiring opt-in for abortion; providing certain
construction; prohibiting and requiring certain
actions by licensing board under certain c onditions;
authorizing and prohibiting certain civil action s;
prohibiting certain defense; providing for recovery
of damages and other relief; providing severability;
providing for codification; and providing an
effective date.
BE IT ENACTED BY THE PEOPLE OF T HE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-728g of Title 63, unless there
is created a duplication in numbering, reads as follows:
This act may be known and cited as the "Medical Ethics Defense
Act".
SECTION 2. NEW LAW A new section of law to be codif ied
in the Oklahoma Statutes as Section 1-728h of Title 63, unless there
is created a duplication in numbering, reads as follows:
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1. "Conscience" means the ethical, moral, or religious beliefs
or principles held by any medical practitioner, healthcare
institution, or healthcare payer. Conscience with respect to
institutional entities or corporate bodies, as opposed to individual
persons, is determined by reference to that entity or body 's
governing documents, including but not limited to any published
ethical, moral, or religious guidelines or dire ctives; mission
statements; constitutions; articles of incorporation; bylaws;
policies; or regulations;
2. "Disclosure" means a formal or informal communication or
transmission, but does not include a communicat ion or transmission
concerning policy decisi ons that lawfully exercise discretionary
authority unless the medical practitioner provid ing the disclosure
or transmission reasonably believes that the disclosure or
transmission evinces:
a. any violation of any law, rule, or regulation ,
b. any violation of any ethical guidelines for the
provision of any medical procedure or service , or
c. gross mismanagement, a gross waste of funds, an abuse
of authority, practices or methods of treatment that
may put patient health at risk, or a substantial and
specific danger to public health or safety ;
3. "Discrimination" means any adverse action taken ag ainst, or
any threat of adverse action communicated to, any medical
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practitioner, healthcare institution, or healthcare pay er as a
result of his, her, or its decision to decline to participate in a
medical procedure or service on the basis of conscience.
Discrimination includes, but is not limited to, termination of
employment; transfer fro m current position; demotion from cu rrent
position; adverse administrative actio n; reassignment to a different
shift or job title; increased administrative duties; refusa l of
staff privileges; refusal of board certification; loss of career
specialty; reduction of wages, benefits, or privileg es; refusal to
award a grant, contract, or o ther program; refusal to provide
residency training opportunities; denial, deprivation, or
disqualification of licensure; withholding or disqualifying from
financial aid and ot her assistance; impediments to creat ing any
healthcare institution or payer or e xpanding or improving such
healthcare institution or payer; impediments to acquiring,
associating with, or merging with any other healthcare institution
or payer; the threat th ereof with regard to any of the prec eding; or
any other penalty, disciplinary, o r retaliatory action, whether
executed or threatened. However, discrimination excludes th e
negotiation or purchase of insurance by a non -government entity;
4. "Medical procedure or service" means medical care p rovided
to any patient at any time over the entire course of treatment, or
medical research. This includes, but is not limited to, te sting;
diagnosis; referral; dispensing and/or administering any drug,
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medication, or device; psychological therapy or coun seling;
research; prognosis; therapy; record making procedures; notes
related to treatment; set up or performance of a surgery or
procedure; or any other care or service performed or provided by any
medical practitioner including, but not limited to, physi cians,
nurses, allied health professionals, paraprofessionals, contractors,
or employees of healthcare institutions ;
5. "Healthcare institution" means any organization,
corporation, partnership, association, agency, ne twork, sole
proprietorship, joint ven ture, or other entity that provides medical
procedures or services. The term includes, but is not limited to,
any public or private h ospital, clinic, medical center, physician
organization, professional association, am bulatory surgical center,
private physician's office, pharmacy, nursing home, med ical school,
nursing school, medical training facility, or any other entity or
location in which medical procedures or services are performed ;
6. "Healthcare payer" means any employer, health plan, health
maintenance organization, insurance company, manag ement services
organization, or any other entity that pays for , or arranges for the
payment of, any medical procedure or service provided to any
patient, whether that payment is made in whole or in part ;
7. "Medical practitioner" means any person or indiv idual who
may be or is asked to participate in any way in any medical
procedure or service. This includes, but is not limited to,
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doctors, nurse practitioners, physician 's assistants, nurses,
nurses' aides, allied health professionals, medical assistants,
hospital employees, clinic employees, nursing home employees,
pharmacists, pharmacy technician s and employees, medical school
faculty and students, nursing school faculty and s tudents,
psychology and counseling faculty and students, medical researchers,
laboratory technicians, psychologists, psychiatrists, counselors,
mental health professionals, s ocial workers, or any other person who
facilitates or participates in the provisio n of a medical procedure
or service;
8. "Participate" in a medical procedure o r service means to
provide, perform, assist with, facilitate, refer for, counsel for,
advise with regard to, admit for the purposes of providing, or take
part in any way in prov iding any medical procedure or serv ice, or
any form of such service ; and
9. "Pay" or "payment" means to pay for, contract for, arrange
for the payment of (whether in whole or in p art), reimburse, or
remunerate.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-728i of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. A medical practitioner, healthcare institution, or
healthcare payer has the right not to participate in or pa y for any
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medical procedure or service which violat es his, her, or its
conscience.
B. The exercise of the right of conscience is limited to
conscience-based objections to a particular medical procedure o r
service. This section may not be co nstrued to waive or modify any
duty a health care practitioner, health care institution, or health
care payer may have to provide other medical procedures or services
that do not violate the practitioner 's, institution's, or payer's
conscience.
C. No medical practitioner, health care institution, or health
care payer shall be ci villy, criminally, or administratively liable
for exercising his, her, or it s right of conscience not to
participate in or pay for a medical procedure or ser vice. No health
care institution shall be civilly, criminally, or administratively
liable for the exercise of conscience rights not to participate in a
medical procedure or ser vice by a medical practitioner employed,
contracted, or granted admitting privil eges by the health care
institution.
D. No medical practitioner, health care institution, or heal th
care payer shall be discriminated against in any manner as a result
of his, her, or its decision to dec line to participate in or pay for
a medical procedure or service on the basis of conscien ce.
E. Notwithstanding any other provision of this act to the
contrary, a religious medical practitioner, health care institution,
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or health care payer that holds itself out to the public as
religious, states in its governing documents that it h as a religious
purpose or mission, and has internal operating policies or
procedures that implement its religious beliefs, sh all have the
right to make employment, sta ffing, contracting, and admitting
privilege decisions consistent with its religious belie fs.
F. A health care practitioner may not be scheduled for,
assigned, or requested to directly or indirect ly perform,
facilitate, refer for, or part icipate in an abortion unless the
practitioner first affirmatively consents in writing to perform,
facilitate, refer for, or participa te in the abortion. This
subsection does not establish a right to participate in an abo rtion
otherwise prohibited by law.
G. Nothing herein shall be co nstrued to override the
requirement to provide emergency medical treatment to a ll patients
set forth in 42 U.S.C. Section 1395dd. Medical emergencies shall be
subject to the definitions and requirements of Section 1 -731.4 of
Title 63 of the Oklahoma Statutes.
SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-728j of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. No medical practitioner shall be discriminated against in
any manner because the medical practitioner:
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1. Provided, caused to be provided, or is about to provide or
cause to be provided to his or her employer, the Attorney General,
any state agency charged with protecting health care rights of
conscience, the U.S. Departme nt of Health and Human Services, Office
of Civil Rights, or any other federa l agency charged with protecting
health care rights of conscience informati on relating to any
violation of, or any act or omissio n the medical practitioner
reasonably believes to b e a violation of, any provision of this act;
2. Testified or is about to te stify in a proceeding concerning
such violation; or
3. Assisted or participated, or is about to assist or
participate, in such a proceeding.
B. Unless the disclosure is specifica lly prohibited by law, no
medical practitioner shall be discriminated agains t in any manner
because the medical practiti oner disclosed any information that the
medical practitioner re asonably believes evin ces:
1. Any violation of any law, rule, or regulat ion;
2. Any violation of any ethical guidelines for the provision of
any medical procedure or service; or
3. Gross mismanagement, a gross waste of fu nds, an abuse of
authority, practices or methods of tr eatment that may put patient
health at risk, or a s ubstantial and specific danger to public
health or safety.
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C. A licensing board may not reprimand, sanction, or revoke or
threaten to revoke a license , certificate, or registration o f a
health care practitioner for engaging in sp eech or expressive
activity protected under the First Amendment to the United States
Constitution, unless the licensing board demonstrates beyond a
reasonable doubt that the practitioner 's speech was the direct cause
of physical harm to a person with whom the health care practitioner
had a practitioner-patient relationship within the three (3) years
immediately preceding the in cident of physical har m.
1. The licensing board must provide a medical practitioner with
any complaints it has rece ived which may result in the revocation of
the medical practitioner's license, certification, or registration,
within seven (7) days after receipt of the complain t.
2. The licensing board must pay the medical practitioner an
administrative penalty of Five Hundred Dollars ($500.00) for each
day the complaint is not provided to the medical practitioner after
the specified seven (7) days.
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-728k of Title 63, unless there
is created a duplication in numbering, reads as fol lows:
A. A civil action for damages or i njunctive relief, or both,
may be brought by any medical practitioner, health care institution,
or health care payer for any violation of any provision of this act.
Any additional burden or expense on another medical practitioner,
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health care institution, or health care payer arising fro m the
exercise of the right of conscience shall not be a defens e to any
violation of this act. However, no civil action may be brought
against an individual who declines to use or purchase medical
procedure or services fro m a specific medical practition er, health
care institution, or health care payer for exercising th e rights
granted in subsection A of Section 3 of this act .
B. Any party aggrieved by any violation of this act may
commence a civil action and shall be entit led, upon the finding of a
violation, to recover threefold his, her, or its actual damages
sustained, along with the costs of the action and reasonable
attorney fees. Such damages shall be cumulative and in no way
limited by any other remedies which may b e available under any other
federal, state, or municipal law. A court considering such civil
action may also award injunctive relief, which may include, bu t is
not limited to, reinstatement of a medical practitioner to his or
her previous position, reinstatement of board certification, and re -
licensure of a health care institution or hea lth care payer.
SECTION 6. NEW LAW A new section o f law to be codified
in the Oklahoma Statutes as Section 1-728l of Title 63, unless there
is created a duplication in numbering, reads as foll ows:
Any provision of this act held to be invalid or unenforcea ble by
its terms, or as applied to any person or ci rcumstance, shall be
construed so as to give it the maximum effect permitted by law,
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unless such holding shall be one of utter invalidity or
unenforceability, in which event such prov ision shall be deemed
severable here from and shall not affect the remaind er hereof or the
application of such provision t o other persons not similarly
situated or to other, dissimilar circumstances.
SECTION 7. This act shall become effective November 1, 2024.
59-2-8531 TJ 11/06/23