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STATE OF OKLAHOMA
1st Session of the 59th Legislature (2023)
SENATE BILL 887 By: Jett
AS INTRODUCED
An Act relating to freedom of conscience; creating
the Medical Ethics Defense Act; provi ding short
title; defining terms; granting certain rights to
certain medical practitioner s, healthcare
institutions, or healthcare payer s; limiting exercise
of certain rights; granting certain immunities;
prohibiting certain discrimination; requiring opt-in
for abortion; providing certain construction;
prohibiting and requiring certain act ions 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 THE 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 codifi ed
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 resp ect 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 directives; 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 communicati on or transmission
concerning policy decisions 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 e thical 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 paye r as a
result of his, her, or its decision to decli ne 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 cur rent
position; adverse administrative action; reass ignment 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 privilege s; refusal to
award a grant, contract, or other pro gram; refusal to provide
residency training opportunities; denial, deprivation, or
disqualification of licensure; withholding or disqualifying from
financial aid and ot her assistance; impediments to creati ng any
healthcare institution or payer or expanding 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 prece ding; or
any other penalty, disciplinary, or retali atory 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 pr ovided
to any patient at any time over the entire c ourse 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 couns eling;
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, physic ians,
nurses, allied health professionals, paraprof essionals, contractors,
or employees of healthcare institutions ;
5. “Healthcare institution” means any organization,
corporation, partnership, association, agency, ne twork, sole
proprietorship, joint vent ure, 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, medical sch ool,
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, management se rvices
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 individual 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 fac ulty 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 or 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 service , or
any form of such service ;
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. Freedom of Conscience. A medical practitioner, healthcare
institution, or healthcare payer has the right not to participate in
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or pay for any medical procedure or service which violat es his, her,
or its conscience.
B. Limitations. The exercise of the right of conscience is
limited to conscience -based objections to a particular medical
procedure or service. This section may not be co nstrued to waive or
modify any duty a health care p ractitioner, 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. Immunity from Liability. No medical practitioner,
healthcare institution, or healthcare payer shall be civilly,
criminally, or administratively liable for exercising his, her, or
its right of conscience not to participate in or pay for a medical
procedure or service. No healthcare institution shall be civilly,
criminally, or administratively liable for the exercise of
conscience rights not to participate in a medical procedure or
service by a medical practitioner employed, c ontracted, or granted
admitting privileges by the healthcare institution.
D. Discrimination. No medical practitioner, healthcare
institution, or healthcare 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 me dical procedure or service on the
basis of conscience.
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E. Exception. Notwithstanding any other provision of this Act
to the contrary, a religious medical practitioner, health care
institution, or healthcare 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. Opt-In Required. 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 participate in the abortion. This
subsection does not establish a right to participate in an abo rtion
otherwise prohibited by law.
G. Emergency Medical Treatments. Nothing herein shall be
construed to override the req uirement to provide emergency medical
treatment to all patients set forth in 42 U.S.C. Section 1395dd.
Medical emergencies shal l 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:
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A. No medical practitioner shall be discriminated against in
any manner because the medical practitioner:
1. Provided, caused to be provided, or is about to provide or
cause to be provided to his or her empl oyer, 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 federal 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 testify 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 against in any manner
because the medical practitioner 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
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health at risk, or a s ubstantial and specific danger to public
health or safety.
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 U.S.
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 incident of physical harm.
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 complaint.
2. The licensing board must pay the medical practitioner an
administrative penalty of $500 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. Civil Action for Violation of Right of Conscience. A civil
action for damages or injunctive relief —or both—may be brought by
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any medical practitioner, healthcare institutio n, or healthcare
payer for any violation of any provision of this act. Any
additional burden or expense on another medical practitioner,
healthcare institution, or healthcare payer arising fro m the
exercise of the right of co nscience 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 from a specific medical practition er,
healthcare institution, or heal thcare payer for exercising th e
rights granted in subsection A of Section 3 of this act .
B. Other Remedies. Any party aggrieved by any violation of
this act may commence a civil action and shall be entitled —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 be available under any other
federal, state, or munici pal 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 healthcare institution or hea lthcare 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 follows:
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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,
unless such holding shall be one of utter invalidity or
unenforceability, in which event such prov ision shall be deemed
severable herefrom 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 effecti ve November 1, 2023.
59-1-1458 DC 1/19/2023 10:12:57 PM