Texas 2021 - 87th 1st C.S.

Texas Senate Bill SB17 Compare Versions

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

Old	New	Differences
1	1	87S10196 SRA-D
2	2	By: Hall S.B. No. 17
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:
41	41	(A) result in the patient's death;
42	42	(B) place the patient's health in serious
43	43	jeopardy;
44	44	(C) result in serious impairment of the patient's
45	45	bodily functions;
46	46	(D) result in serious dysfunction of a bodily
47	47	organ or part of the patient;
48	48	(E) result in serious disfigurement of the
49	49	patient; or
50	50	(F) for a pregnant woman, place the health of the
51	51	woman's unborn child in serious jeopardy.
52	52	(3) "Health care facility" means a public or private
53	53	organization, corporation, partnership, sole proprietorship,
54	54	association, agency, network, joint venture, or other entity that
55	55	provides health care services to patients. The term includes a
56	56	hospital, clinic, medical center, ambulatory surgical center,
57	57	private physician's office, pharmacy, nursing home, laboratory or
58	58	diagnostic facility, infirmary, dispensary, medical school,
59	59	nursing school, or medical training facility.
60	60	(4) "Health care provider" means a nurse, nurse aide,
61	61	medical assistant, hospital employee, clinic employee, nursing
62	62	home employee, pharmacist, pharmacy employee, researcher, medical,
63	63	pharmacy, or nursing school student, professional,
64	64	paraprofessional, or, without regard to whether the individual
65	65	holds a license, any other individual who furnishes or assists in
66	66	the furnishing of a health care service.
67	67	(5) "Health care service" means any phase of patient
68	68	health care or treatment, including any conduct that may give rise
69	69	to a health care liability claim, as that term is defined by Section
70	70	74.001, Civil Practice and Remedies Code. The term includes:
71	71	(A) testing, diagnosis, prognosis, ancillary
72	72	research, instruction, medication, therapy, treatment, and
73	73	surgery;
74	74	(B) family planning, counseling, and referrals,
75	75	and any other advice in connection with the use or procurement of
76	76	contraceptives, sterilization, or abortion; and
77	77	(C) any other care or treatment rendered by a
78	78	health care facility, physician, or health care provider.
79	79	(6) "Life-sustaining treatment" has the meaning
80	80	assigned by Section 166.002.
81	81	(7) "Participate" related to the provision of a health
82	82	care service includes an act to receive, obtain, perform, assist in
83	83	performing, give advice regarding, suggest, recommend, or refer a
84	84	health care service.
85	85	(8) "Physician" means an individual licensed to
86	86	practice medicine in this state.
87	87	(9) "Substantially prevent" related to the provision
88	88	of a health care service means to significantly delay the provision
89	89	of a health care service to a patient.
90	90	(10) "Undue delay" related to the provision of a
91	91	health care service means an unreasonable delay that impairs a
92	92	patient's health.
93	93	Sec. 161.702. RIGHT TO DECLINE PARTICIPATION IN HEALTH CARE
94	94	SERVICE FOR REASONS OF CONSCIENCE; EXCEPTIONS. (a) Except as
95	95	provided by Subsection (b), an individual may decline to
96	96	participate in a health care service for reasons of conscience.
97	97	(b) An individual may not decline to participate in the
98	98	following services:
99	99	(1) emergency care;
100	100	(2) life-sustaining treatment; or
101	101	(3) cardiopulmonary resuscitation.
102	102	(c) An individual who declines for reasons of conscience to
103	103	participate in providing life-sustaining treatment to a patient
104	104	shall continue providing life-sustaining treatment to the patient
105	105	until an accommodation is arranged under Section 161.706.
106	106	(d) This section may not be construed to allow an individual
107	107	to decline to participate in providing a health care service to a
108	108	patient because of the patient's race, color, sex, national origin,
109	109	religion, age, disability, physical condition, or economic status.
110	110	Sec. 161.703. IMMUNITY OF PHYSICIANS AND HEALTH CARE
111	111	PROVIDERS. A physician or health care provider may not be held
112	112	civilly or criminally liable because the physician or health care
113	113	provider declines to participate in a health care service wholly or
114	114	partly for reasons of conscience.
115	115	Sec. 161.704. ADVERSE ACTION. A person, including a public
116	116	official and a medical school or other institution that conducts
117	117	education or training programs for physicians or health care
118	118	providers, violates this subchapter by taking an adverse action
119	119	against an individual because the individual declines to
120	120	participate in a health care service for reasons of conscience.
121	121	Violations include taking an adverse action with regard to:
122	122	(1) licensure;
123	123	(2) certification;
124	124	(3) employment terms, benefits, seniority status,
125	125	promotion, or transfer;
126	126	(4) staff appointments or other privileges;
127	127	(5) denial of employment, admission, or participation
128	128	in a program for which the individual is eligible;
129	129	(6) reference to reasons of conscience in an
130	130	application form;
131	131	(7) questions regarding an applicant's participation
132	132	in providing a health care service for reasons of conscience;
133	133	(8) imposition of a burden in the terms or conditions
134	134	of employment;
135	135	(9) denial of aid, assistance, or benefits;
136	136	(10) conditional receipt of the aid, assistance, or
137	137	benefits; or
138	138	(11) coercion or disqualification of the individual
139	139	receiving aid, assistance, or benefits.
140	140	Sec. 161.705. PROTOCOL FOR DECLINING PARTICIPATION IN
141	141	PROVISION OF HEALTH CARE SERVICE. (a) A health care facility shall
142	142	develop a written protocol for circumstances in which an individual
143	143	declines to participate in providing a health care service, other
144	144	than a life-sustaining treatment, for reasons of conscience. The
145	145	protocol must describe a patient's access to health care services
146	146	and information to ensure the patient is not permanently or
147	147	substantially prevented from obtaining the services. The protocol
148	148	must explain the process the facility will implement to facilitate
149	149	in a timely manner the patient's access to the services.
150	150	(b) An individual who declines to participate in providing a
151	151	health care service for reasons of conscience shall:
152	152	(1) notify the health care facility of the
153	153	declination; and
154	154	(2) comply with the applicable protocol developed
155	155	under this section.
156	156	(c) This section does not require a health care facility,
157	157	physician, or health care provider to counsel a patient or refer the
158	158	patient to another physician or facility regarding a health care
159	159	service that is contrary to the conscience of the physician or
160	160	health care provider.
161	161	Sec. 161.706. PROTOCOL FOR LIFE-SUSTAINING TREATMENT. (a) A
162	162	health care facility shall develop a written protocol for
163	163	circumstances in which an individual declines to participate in
164	164	providing life-sustaining treatment for reasons of conscience. The
165	165	protocol must prohibit an individual from declining to provide
166	166	life-sustaining treatment to a patient before the patient is
167	167	transferred to another physician or health care provider at the
168	168	health care facility who is willing to provide life-sustaining
169	169	treatment to the patient. The protocol must explain the process the
170	170	health care facility will implement to facilitate a timely
171	171	transfer.
172	172	(b) An individual who declines to participate in providing
173	173	life-sustaining treatment for reasons of conscience shall notify
174	174	the health care facility and comply with the applicable protocol
175	175	developed under this section. The individual must continue to
176	176	participate in providing life-sustaining treatment until the
177	177	facility transfers the patient to another physician or health care
178	178	provider at the facility.
179	179	(c) If a transfer to another physician or health care
180	180	provider at the health care facility cannot be arranged, the
181	181	protocol at a minimum must require a health care facility,
182	182	physician, or health care provider to:
183	183	(1) timely inform the patient of the patient's
184	184	condition, prognosis, and treatment options, and the risks and
185	185	benefits of those treatment options, consistent with accepted
186	186	standards of health care;
187	187	(2) provide without undue delay on request of the
188	188	patient or the patient's legal representative copies of the
189	189	patient's medical records to the patient or another health care
190	190	facility, physician, or health care provider designated by the
191	191	patient in accordance with medical privacy laws; and
192	192	(3) take any other action necessary to transfer the
193	193	patient to another health care facility.
194	194	(d) This section does not require a health care facility,
195	195	physician, or health care provider to counsel a patient or refer the
196	196	patient to another physician or facility regarding a health care
197	197	service that is contrary to the conscience of the physician or
198	198	health care provider. The information required by Subsection (c)
199	199	may be provided by a health care facility, physician, or health care
200	200	provider other than the physician or health care provider who
201	201	declined to participate in providing life-sustaining treatment for
202	202	reasons of conscience.
203	203	Sec. 161.707. DISCIPLINARY ACTION; COMPLAINT. (a) A
204	204	health care facility, physician, or health care provider that holds
205	205	a license issued by a licensing agency in this state is subject to
206	206	review and disciplinary action by the licensing agency for a
207	207	violation of this subchapter as if the facility, physician, or
208	208	provider violated the applicable licensing law.
209	209	(b) An individual who is injured by a violation of this
210	210	subchapter may file a complaint with the licensing agency that
211	211	issued a license to the health care facility, physician, or health
212	212	care provider that allegedly violated this subchapter.
213	213	(c) A physician or health care provider may not file a
214	214	complaint with the appropriate licensing agency under this section
215	215	unless the physician or health care provider complies with the
216	216	health care facility's protocol developed under Section 161.705 or
217	217	161.706, as appropriate.
218	218	Sec. 161.708. CIVIL REMEDIES. A person who is injured by a
219	219	violation of this subchapter may bring a civil action against a
220	220	person who violates this subchapter. A person who brings the action
221	221	under this section may obtain:
222	222	(1) injunctive relief;
223	223	(2) damages incurred by the person, including:
224	224	(A) actual damages for all psychological,
225	225	emotional, and physical injuries resulting from the violation of
226	226	this subchapter;
227	227	(B) court costs; and
228	228	(C) reasonable attorney's fees; or
229	229	(3) both injunctive relief and damages.
230	230	SECTION 3. Not later than March 1, 2022, a health care
231	231	facility, as that term is defined by Section 161.701, Health and
232	232	Safety Code, as added by this Act, shall adopt protocols required by
233	233	Sections 161.705 and 161.706, Health and Safety Code, as added by
234	234	this Act.
235	235	SECTION 4. Section 161.703, Health and Safety Code, as
236	236	added by this Act, applies only to a cause of action that accrues on
237	237	or after the effective date of this Act.
238	238	SECTION 5. This Act takes effect January 1, 2022.