86R9840 SRA-D
By: Kolkhorst S.B. No. 1107
A BILL TO BE ENTITLED
AN ACT
relating to the right of conscientious refusal of a health care
service.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 161, Health and Safety Code, is amended
by adding Subchapter X to read as follows:
SUBCHAPTER X. TEXAS HEALTH CARE RIGHT OF CONSCIENCE ACT
Sec. 161.701. DEFINITIONS. In this subchapter:
(1) "Conscience" means a sincerely held set of moral
convictions arising from:
(A) a belief in and relation to God;
(B) a religious faith or spiritual practice; or
(C) a moral philosophy or ethical position,
without regard to whether the philosophy or position is related to a
religious faith.
(2) "Health care facility" means a public or private
organization, corporation, partnership, sole proprietorship,
association, agency, network, joint venture, or other entity that
provides health care services, including a hospital, clinic,
medical center, ambulatory surgical center, private physician's
office, pharmacy, nursing home, laboratory or diagnostic facility,
infirmary, dispensary, medical school, nursing school, or medical
training facility.
(3) "Health care provider" means a nurse, nurse aide,
medical assistant, hospital employee, clinic employee, nursing
home employee, pharmacist, pharmacy employee, researcher, medical
or nursing school student, professional, paraprofessional, or,
without regard to whether the individual holds a license, any other
individual who furnishes or assists in the furnishing of a health
care service.
(4) "Health care service" means any phase of patient
health care or treatment, including any conduct that may give rise
to a health care liability claim, as that term is defined by Section
74.001, Civil Practice and Remedies Code. The term includes:
(A) testing, diagnosis, prognosis, ancillary
research, instruction, medication, and surgery;
(B) family planning, counseling, and referrals,
and any other advice in connection with the use or procurement of
contraceptives, sterilization, or abortion; and
(C) any other care or treatment rendered by a
health care facility, physician, or health care provider.
(5) "Physician" means an individual licensed to
practice medicine in this state.
(6) "Undue delay" means an unreasonable delay that
impairs a patient's health.
Sec. 161.702. CONSCIENTIOUS REFUSAL OF HEALTH CARE SERVICE
DEFINED; LIFE-SUSTAINING TREATMENT; HEALTH CARE OR TREATMENT
DECISION. (a) Subject to Subsection (b), in this chapter,
"conscientious refusal of a health care service" means an
individual's refusal to receive, obtain, perform, assist in
performing, give advice regarding, suggest, recommend, refer, or
participate in a health care service that is contrary to the
individual's conscience.
(b) Chapter 166 governs the required provision of, and the
withholding or withdrawing of, life-sustaining treatment, as that
term is defined by Section 166.002. A conscientious refusal of a
health care service does not include, and may not be construed to
include:
(1) an individual's refusal to provide or refusal to
assist in providing life-sustaining treatment subject to Chapter
166; or
(2) a patient's advance directive or a health care or
treatment decision made by or on behalf of a patient that is subject
to Section 166.046.
Sec. 161.703. IMMUNITY OF PHYSICIANS AND HEALTH CARE
PROVIDERS. A physician or health care provider may not be held
civilly or criminally liable in part because of the physician's or
health care provider's conscientious refusal of a health care
service.
Sec. 161.704. ADVERSE ACTION RELATED TO LICENSING. A
person violates this subchapter by taking an adverse action against
an individual because of the individual's conscientious refusal of
a health care service, including taking an adverse action with
regard to:
(1) licensing;
(2) employment terms or status or hiring, promoting,
or transferring; and
(3) granting of staff appointments or other
privileges.
Sec. 161.705. ADVERSE ACTION RELATED TO EMPLOYMENT. A
person, including a medical school or other institution that
conducts education or training programs for physicians or health
care providers, violates this subchapter by taking an adverse
action against an applicant because of the applicant's
conscientious refusal of a health care service, including taking an
adverse action by:
(1) denying employment, admission, or participation
in a program for which an applicant is eligible;
(2) referring to conscientious refusal in an
application form;
(3) questioning an applicant regarding the applicant's
conscientious refusal of a health care service; and
(4) imposing a burden in the terms or conditions of
employment.
Sec. 161.706. ADVERSE ACTION RELATED TO BENEFITS. A
person, including a public official, violates this subchapter by
taking an adverse action against a recipient entitled to any type of
aid, assistance, or benefits because of the recipient's
conscientious refusal of a health care service, including taking an
adverse action by:
(1) denying aid, assistance, or benefits;
(2) conditioning receipt of the aid, assistance, or
benefits; or
(3) coercing or disqualifying the recipient.
Sec. 161.707. CONSCIENTIOUS REFUSAL PROTOCOL. (a) A
health care facility shall develop a written conscientious refusal
protocol describing a patient's access to care and information to
ensure that a conscientious refusal of a health care service does
not permanently or substantially prevent a patient from obtaining
the health care service. The protocol must explain the process the
health care facility will implement to address a conscientious
refusal of a health care service in a timely manner to facilitate
the patient's health care service through the health care facility
or another health care facility. The protocol must, at a minimum,
require a health care facility, physician, or health care provider
to:
(1) timely inform a patient of the patient's
condition, prognosis, legal treatment options, and risks and
benefits of treatment options, consistent with accepted standards
of health care;
(2) provide copies of the patient's medical records to
the patient or to another health care facility, physician, or
health care provider designated by the patient in accordance with
medical privacy laws, without undue delay, if requested by the
patient or the patient's legal representative; and
(3) take any other action necessary to transfer the
patient to another health care facility.
(b) The protocol must clearly differentiate between a
health care service to which this chapter applies and a
life-sustaining treatment governed by Chapter 166.
(c) This section does not require a health care facility,
physician, or health care provider to counsel a patient regarding a
health care service that is contrary to the conscience of the
physician or health care provider. The information required by
Subsection (a)(1) may be provided by a health care facility,
physician, or health care provider other than the physician or
health care provider with a conscientious refusal of a health care
service.
(d) A physician or health care provider may not file a
complaint with the appropriate licensing agency under Section
161.708 unless the physician or health care provider, as
applicable, complies with the applicable health care facility's
conscientious refusal protocol developed under this section.
Sec. 161.708. DISCIPLINARY ACTION; COMPLAINT. (a) A
health care facility, physician, or health care provider that holds
a license issued by a licensing agency in this state is subject to
review and disciplinary action by the licensing agency for a
violation of this subchapter.
(b) A person who is injured by a violation of this
subchapter may file a complaint with the licensing agency that
issued a license to the health care facility, physician, or health
care provider that allegedly violated this subchapter.
SECTION 2. Not later than December 1, 2019, a health care
facility, as that term is defined by Section 161.701, Health and
Safety Code, as added by this Act, shall adopt a conscientious
refusal protocol required by Section 161.707, Health and Safety
Code, as added by this Act.
SECTION 3. Section 161.703, Health and Safety Code, as
added by this Act, applies only to a cause of action that accrues on
or after the effective date of this Act.
SECTION 4. This Act takes effect September 1, 2019.