Texas 2021 - 87th Regular

Texas Senate Bill SB1674 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	87R5786 SRA-D
2	2	By: Hall, et al. S.B. No. 1674
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to protection of individuals from participation in a
8	8	health care service for reasons of conscience; providing a civil
9	9	remedy; authorizing disciplinary action.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. The legislature finds that:
12	12	(1) the public policy of this state is to respect the
13	13	conscience of all health care providers and the right of each health
14	14	care provider to hold their own belief about whether certain health
15	15	care services are morally acceptable;
16	16	(2) without comprehensive protections, the conscience
17	17	of health care providers may be violated; and
18	18	(3) each health care provider must be protected from
19	19	required participation in a health care service in which the
20	20	provider has declined participation for reasons of conscience and
21	21	from discriminatory adverse action resulting from the
22	22	nonparticipation.
23	23	SECTION 2. Chapter 161, Health and Safety Code, is amended
24	24	by adding Subchapter X to read as follows:
25	25	SUBCHAPTER X. TEXAS HEALTH CARE CONSCIENCE PROTECTION ACT
26	26	Sec. 161.701. DEFINITIONS. In this subchapter:
27	27	(1) "Conscience" means a sincerely held set of moral
28	28	convictions arising from:
29	29	(A) a belief in and relation to God;
30	30	(B) a religious faith or spiritual practice; or
31	31	(C) a moral philosophy or ethical position,
32	32	without regard to whether the philosophy or position is related to a
33	33	religious faith.
34	34	(2) "Emergency care" means health care services
35	35	provided to stabilize a patient's medical condition manifesting in
36	36	acute symptoms of sufficient severity, including severe pain, that
37	37	would lead a prudent layperson possessing an average knowledge of
38	38	medicine and health to believe the patient's condition, sickness,
39	39	or injury is of sufficient severity that absence of immediate
40	40	medical care could reasonably be expected to result in:
41	41	(A) the patient's death;
42	42	(B) the patient's health being seriously
43	43	jeopardized;
44	44	(C) serious impairment of the patient's bodily
45	45	functions;
46	46	(D) serious dysfunction of a bodily organ or part
47	47	of the patient;
48	48	(E) serious disfigurement of the patient; or
49	49	(F) for a pregnant woman, serious jeopardy to the
50	50	health of the woman's unborn child.
51	51	(3) "Health care facility" means a public or private
52	52	organization, corporation, partnership, sole proprietorship,
53	53	association, agency, network, joint venture, or other entity that
54	54	provides health care services to patients. The term includes a
55	55	hospital, clinic, medical center, ambulatory surgical center,
56	56	private physician's office, pharmacy, nursing home, laboratory or
57	57	diagnostic facility, infirmary, dispensary, medical school,
58	58	nursing school, or medical training facility.
59	59	(4) "Health care provider" means a nurse, nurse aide,
60	60	medical assistant, hospital employee, clinic employee, nursing
61	61	home employee, pharmacist, pharmacy employee, researcher, medical,
62	62	pharmacy, or nursing school student, professional,
63	63	paraprofessional, or, without regard to whether the individual
64	64	holds a license, any other individual who furnishes or assists in
65	65	the furnishing of a health care service.
66	66	(5) "Health care service" means any phase of patient
67	67	health care or treatment, including any conduct that may give rise
68	68	to a health care liability claim, as that term is defined by Section
69	69	74.001, Civil Practice and Remedies Code. The term includes:
70	70	(A) testing, diagnosis, prognosis, ancillary
71	71	research, instruction, medication, therapy, treatment, and
72	72	surgery;
73	73	(B) family planning, counseling, and referrals,
74	74	and any other advice in connection with the use or procurement of
75	75	contraceptives, sterilization, or abortion; and
76	76	(C) any other care or treatment rendered by a
77	77	health care facility, physician, or health care provider.
78	78	(6) "Life-sustaining treatment" has the meaning
79	79	assigned by Section 166.002.
80	80	(7) "Participate" related to the provision of a health
81	81	care service includes an act to receive, obtain, perform, assist in
82	82	performing, give advice regarding, suggest, recommend, or refer a
83	83	health care service.
84	84	(8) "Physician" means an individual licensed to
85	85	practice medicine in this state.
86	86	(9) "Substantially prevent" related to the provision
87	87	of a health care service means to significantly delay the provision
88	88	of a health care service to a patient.
89	89	(10) "Undue delay" related to the provision of a
90	90	health care service means an unreasonable delay that impairs a
91	91	patient's health.
92	92	Sec. 161.702. RIGHT TO DECLINE PARTICIPATION IN HEALTH CARE
93	93	SERVICE FOR REASONS OF CONSCIENCE; EXCEPTIONS. (a) Except as
94	94	provided by Subsection (b), an individual may decline to
95	95	participate in a health care service for reasons of conscience.
96	96	(b) An individual may not decline to participate in the
97	97	following services:
98	98	(1) emergency care;
99	99	(2) life-sustaining treatment; or
100	100	(3) cardiopulmonary resuscitation.
101	101	(c) An individual who declines for reasons of conscience to
102	102	participate in providing life-sustaining treatment to a patient
103	103	shall continue providing life-sustaining treatment to the patient
104	104	until an accommodation is arranged under Section 161.706.
105	105	(d) This section may not be construed to allow an individual
106	106	to decline to participate in providing a health care service to a
107	107	patient because of the patient's race, color, sex, national origin,
108	108	religion, age, disability, physical condition, or economic status.
109	109	Sec. 161.703. IMMUNITY OF PHYSICIANS AND HEALTH CARE
110	110	PROVIDERS. A physician or health care provider may not be held
111	111	civilly or criminally liable because the physician or health care
112	112	provider declines to participate in a health care service wholly or
113	113	partly for reasons of conscience.
114	114	Sec. 161.704. ADVERSE ACTION. A person, including a public
115	115	official or a medical school or other institution that conducts
116	116	education or training programs for physicians or health care
117	117	providers, violates this subchapter by taking an adverse action
118	118	against an individual because the individual declines to
119	119	participate in a health care service for reasons of conscience.
120	120	Violations include taking an adverse action with regard to:
121	121	(1) licensure;
122	122	(2) certification;
123	123	(3) employment terms, benefits, seniority status,
124	124	promotion, or transfer;
125	125	(4) staff appointments or other privileges;
126	126	(5) denial of employment, admission, or participation
127	127	in a program for which the individual is eligible;
128	128	(6) reference to reasons of conscience in an
129	129	application form;
130	130	(7) questions regarding an applicant's participation
131	131	in providing a health care service for reasons of conscience;
132	132	(8) imposition of a burden in the terms or conditions
133	133	of employment;
134	134	(9) denial of aid, assistance, or benefits;
135	135	(10) conditional receipt of the aid, assistance, or
136	136	benefits; or
137	137	(11) coercion or disqualification of the individual
138	138	receiving aid, assistance, or benefits.
139	139	Sec. 161.705. PROTOCOL FOR DECLINING PARTICIPATION IN
140	140	PROVISION OF HEALTH CARE SERVICE. (a) A health care facility shall
141	141	develop a written protocol for circumstances in which an individual
142	142	declines to participate in providing a health care service, other
143	143	than a life-sustaining treatment, for reasons of conscience. The
144	144	protocol must describe a patient's access to health care services
145	145	and information to ensure the patient is not permanently or
146	146	substantially prevented from obtaining the services. The protocol
147	147	must explain the process the facility will implement to facilitate
148	148	in a timely manner the patient's access to the services.
149	149	(b) An individual who declines to participate in providing a
150	150	health care service for reasons of conscience shall:
151	151	(1) notify the health care facility of the
152	152	declination; and
153	153	(2) comply with the applicable protocol developed
154	154	under this section.
155	155	(c) This section does not require a health care facility,
156	156	physician, or health care provider to counsel a patient or refer the
157	157	patient to another physician or facility regarding a health care
158	158	service that is contrary to the conscience of the physician or
159	159	health care provider.
160	160	Sec. 161.706. PROTOCOL FOR LIFE-SUSTAINING TREATMENT. (a) A
161	161	health care facility shall develop a written protocol for
162	162	circumstances in which an individual declines to participate in
163	163	providing life-sustaining treatment for reasons of conscience. The
164	164	protocol must prohibit an individual from declining to provide
165	165	life-sustaining treatment to a patient before the patient is
166	166	transferred to another physician or health care provider at the
167	167	health care facility who is willing to provide life-sustaining
168	168	treatment to the patient. The protocol must explain the process the
169	169	health care facility will implement to facilitate the transfer in a
170	170	timely manner.
171	171	(b) An individual who declines to participate in providing
172	172	life-sustaining treatment for reasons of conscience shall notify
173	173	the health care facility and comply with the applicable protocol
174	174	developed under this section. The individual must continue to
175	175	participate in providing life-sustaining treatment until the
176	176	facility transfers the patient to another physician or health care
177	177	provider at the facility.
178	178	(c) If a transfer to another physician or health care
179	179	provider at the health care facility cannot be arranged, the
180	180	protocol at a minimum must require a health care facility,
181	181	physician, or health care provider to:
182	182	(1) timely inform the patient of the patient's
183	183	condition, prognosis, and treatment options, and the risks and
184	184	benefits of those treatment options, consistent with accepted
185	185	standards of health care;
186	186	(2) provide without undue delay copies of the
187	187	patient's medical records to the patient or another health care
188	188	facility, physician, or health care provider designated by the
189	189	patient in accordance with medical privacy laws, if requested by
190	190	the patient or the patient's legal representative; and
191	191	(3) take any other action necessary to transfer the
192	192	patient to another health care facility.
193	193	(d) This section does not require a health care facility,
194	194	physician, or health care provider to counsel a patient or refer the
195	195	patient to another physician or facility regarding a health care
196	196	service that is contrary to the conscience of the physician or
197	197	health care provider. The information required by Subsection (c)
198	198	may be provided by a health care facility, physician, or health care
199	199	provider other than the physician or health care provider who
200	200	declined to participate in providing life-sustaining treatment for
201	201	reasons of conscience.
202	202	Sec. 161.707. DISCIPLINARY ACTION; COMPLAINT. (a) A
203	203	health care facility, physician, or health care provider that holds
204	204	a license issued by a licensing agency in this state is subject to
205	205	review and disciplinary action by the licensing agency for a
206	206	violation of this subchapter as if the facility, physician, or
207	207	provider violated the applicable licensing law.
208	208	(b) An individual who is injured by a violation of this
209	209	subchapter may file a complaint with the licensing agency that
210	210	issued a license to the health care facility, physician, or health
211	211	care provider that allegedly violated this subchapter.
212	212	(c) A physician or health care provider may not file a
213	213	complaint with the appropriate licensing agency under this section
214	214	unless the physician or health care provider complies with the
215	215	health care facility's protocol developed under Section 161.705 or
216	216	161.706, as appropriate.
217	217	Sec. 161.708. CIVIL REMEDIES. A person who is injured by a
218	218	violation of this subchapter may bring a civil action against a
219	219	person who violates this subchapter. A person who brings the action
220	220	under this section may obtain:
221	221	(1) injunctive relief;
222	222	(2) damages incurred by the person, including:
223	223	(A) actual damages for all psychological,
224	224	emotional, and physical injuries resulting from the violation of
225	225	this subchapter;
226	226	(B) court costs; and
227	227	(C) reasonable attorney's fees; or
228	228	(3) both injunctive relief and damages.
229	229	SECTION 3. Not later than December 1, 2021, a health care
230	230	facility, as that term is defined by Section 161.701, Health and
231	231	Safety Code, as added by this Act, shall adopt protocols required by
232	232	Sections 161.705 and 161.706, Health and Safety Code, as added by
233	233	this Act.
234	234	SECTION 4. Section 161.703, Health and Safety Code, as
235	235	added by this Act, applies only to a cause of action that accrues on
236	236	or after the effective date of this Act.
237	237	SECTION 5. This Act takes effect September 1, 2021.