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.