| |
| |
|
|
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. |