87S10196 SRA-D
 
  By: Hall S.B. No. 17
 
 
 
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:
                     (A)  result in the patient's death;
                     (B)  place the patient's health in serious
  jeopardy;
                     (C)  result in serious impairment of the patient's
  bodily functions;
                     (D)  result in serious dysfunction of a bodily
  organ or part of the patient;
                     (E)  result in serious disfigurement of the
  patient; or
                     (F)  for a pregnant woman, place the health of the
  woman's unborn child in serious jeopardy.
               (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 and 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 a timely
  transfer.
         (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 on request of the
  patient or the patient's legal representative 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; 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 March 1, 2022, 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 January 1, 2022.