87R5786 SRA-D
By: Hall, et al. S.B. No. 1674
A BILL TO BE ENTITLED
AN ACT
relating to protection of individuals from participation in a
health care service for reasons of conscience; providing a civil
remedy; authorizing disciplinary action.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. The legislature finds that:
(1) the public policy of this state is to respect the
conscience of all health care providers and the right of each health
care provider to hold their own belief about whether certain health
care services are morally acceptable;
(2) without comprehensive protections, the conscience
of health care providers may be violated; and
(3) each health care provider must be protected from
required participation in a health care service in which the
provider has declined participation for reasons of conscience and
from discriminatory adverse action resulting from the
nonparticipation.
SECTION 2. Chapter 161, Health and Safety Code, is amended
by adding Subchapter X to read as follows:
SUBCHAPTER X. TEXAS HEALTH CARE CONSCIENCE PROTECTION 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) "Emergency care" means health care services
provided to stabilize a patient's medical condition manifesting in
acute symptoms of sufficient severity, including severe pain, that
would lead a prudent layperson possessing an average knowledge of
medicine and health to believe the patient's condition, sickness,
or injury is of sufficient severity that absence of immediate
medical care could reasonably be expected to result in:
(A) the patient's death;
(B) the patient's health being seriously
jeopardized;
(C) serious impairment of the patient's bodily
functions;
(D) serious dysfunction of a bodily organ or part
of the patient;
(E) serious disfigurement of the patient; or
(F) for a pregnant woman, serious jeopardy to the
health of the woman's unborn child.
(3) "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 to patients. The term includes 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.
(4) "Health care provider" means a nurse, nurse aide,
medical assistant, hospital employee, clinic employee, nursing
home employee, pharmacist, pharmacy employee, researcher, medical,
pharmacy, 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.
(5) "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, therapy, treatment, 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.
(6) "Life-sustaining treatment" has the meaning
assigned by Section 166.002.
(7) "Participate" related to the provision of a health
care service includes an act to receive, obtain, perform, assist in
performing, give advice regarding, suggest, recommend, or refer a
health care service.
(8) "Physician" means an individual licensed to
practice medicine in this state.
(9) "Substantially prevent" related to the provision
of a health care service means to significantly delay the provision
of a health care service to a patient.
(10) "Undue delay" related to the provision of a
health care service means an unreasonable delay that impairs a
patient's health.
Sec. 161.702. RIGHT TO DECLINE PARTICIPATION IN HEALTH CARE
SERVICE FOR REASONS OF CONSCIENCE; EXCEPTIONS. (a) Except as
provided by Subsection (b), an individual may decline to
participate in a health care service for reasons of conscience.
(b) An individual may not decline to participate in the
following services:
(1) emergency care;
(2) life-sustaining treatment; or
(3) cardiopulmonary resuscitation.
(c) An individual who declines for reasons of conscience to
participate in providing life-sustaining treatment to a patient
shall continue providing life-sustaining treatment to the patient
until an accommodation is arranged under Section 161.706.
(d) This section may not be construed to allow an individual
to decline to participate in providing a health care service to a
patient because of the patient's race, color, sex, national origin,
religion, age, disability, physical condition, or economic status.
Sec. 161.703. IMMUNITY OF PHYSICIANS AND HEALTH CARE
PROVIDERS. A physician or health care provider may not be held
civilly or criminally liable because the physician or health care
provider declines to participate in a health care service wholly or
partly for reasons of conscience.
Sec. 161.704. ADVERSE ACTION. A person, including a public
official or 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 individual because the individual declines to
participate in a health care service for reasons of conscience.
Violations include taking an adverse action with regard to:
(1) licensure;
(2) certification;
(3) employment terms, benefits, seniority status,
promotion, or transfer;
(4) staff appointments or other privileges;
(5) denial of employment, admission, or participation
in a program for which the individual is eligible;
(6) reference to reasons of conscience in an
application form;
(7) questions regarding an applicant's participation
in providing a health care service for reasons of conscience;
(8) imposition of a burden in the terms or conditions
of employment;
(9) denial of aid, assistance, or benefits;
(10) conditional receipt of the aid, assistance, or
benefits; or
(11) coercion or disqualification of the individual
receiving aid, assistance, or benefits.
Sec. 161.705. PROTOCOL FOR DECLINING PARTICIPATION IN
PROVISION OF HEALTH CARE SERVICE. (a) A health care facility shall
develop a written protocol for circumstances in which an individual
declines to participate in providing a health care service, other
than a life-sustaining treatment, for reasons of conscience. The
protocol must describe a patient's access to health care services
and information to ensure the patient is not permanently or
substantially prevented from obtaining the services. The protocol
must explain the process the facility will implement to facilitate
in a timely manner the patient's access to the services.
(b) An individual who declines to participate in providing a
health care service for reasons of conscience shall:
(1) notify the health care facility of the
declination; and
(2) comply with the applicable protocol developed
under this section.
(c) This section does not require a health care facility,
physician, or health care provider to counsel a patient or refer the
patient to another physician or facility regarding a health care
service that is contrary to the conscience of the physician or
health care provider.
Sec. 161.706. PROTOCOL FOR LIFE-SUSTAINING TREATMENT. (a) A
health care facility shall develop a written protocol for
circumstances in which an individual declines to participate in
providing life-sustaining treatment for reasons of conscience. The
protocol must prohibit an individual from declining to provide
life-sustaining treatment to a patient before the patient is
transferred to another physician or health care provider at the
health care facility who is willing to provide life-sustaining
treatment to the patient. The protocol must explain the process the
health care facility will implement to facilitate the transfer in a
timely manner.
(b) An individual who declines to participate in providing
life-sustaining treatment for reasons of conscience shall notify
the health care facility and comply with the applicable protocol
developed under this section. The individual must continue to
participate in providing life-sustaining treatment until the
facility transfers the patient to another physician or health care
provider at the facility.
(c) If a transfer to another physician or health care
provider at the health care facility cannot be arranged, the
protocol at a minimum must require a health care facility,
physician, or health care provider to:
(1) timely inform the patient of the patient's
condition, prognosis, and treatment options, and the risks and
benefits of those treatment options, consistent with accepted
standards of health care;
(2) provide without undue delay copies of the
patient's medical records to the patient or another health care
facility, physician, or health care provider designated by the
patient in accordance with medical privacy laws, 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.
(d) This section does not require a health care facility,
physician, or health care provider to counsel a patient or refer the
patient to another physician or facility regarding a health care
service that is contrary to the conscience of the physician or
health care provider. The information required by Subsection (c)
may be provided by a health care facility, physician, or health care
provider other than the physician or health care provider who
declined to participate in providing life-sustaining treatment for
reasons of conscience.
Sec. 161.707. 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 as if the facility, physician, or
provider violated the applicable licensing law.
(b) An individual 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.
(c) A physician or health care provider may not file a
complaint with the appropriate licensing agency under this section
unless the physician or health care provider complies with the
health care facility's protocol developed under Section 161.705 or
161.706, as appropriate.
Sec. 161.708. CIVIL REMEDIES. A person who is injured by a
violation of this subchapter may bring a civil action against a
person who violates this subchapter. A person who brings the action
under this section may obtain:
(1) injunctive relief;
(2) damages incurred by the person, including:
(A) actual damages for all psychological,
emotional, and physical injuries resulting from the violation of
this subchapter;
(B) court costs; and
(C) reasonable attorney's fees; or
(3) both injunctive relief and damages.
SECTION 3. Not later than December 1, 2021, a health care
facility, as that term is defined by Section 161.701, Health and
Safety Code, as added by this Act, shall adopt protocols required by
Sections 161.705 and 161.706, Health and Safety Code, as added by
this Act.
SECTION 4. 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 5. This Act takes effect September 1, 2021.