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A BILL TO BE ENTITLED
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AN ACT
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relating to protection of individuals from participation in a |
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health care service for reasons of conscience; providing a civil |
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remedy; authorizing disciplinary action. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The legislature finds that: |
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(1) the public policy of this state is to respect the |
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conscience of all health care providers and the right of each health |
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care provider to hold their own belief about whether certain health |
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care services are morally acceptable; |
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(2) without comprehensive protections, the conscience |
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of health care providers may be violated; and |
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(3) each health care provider must be protected from |
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required participation in a health care service in which the |
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provider has declined participation for reasons of conscience and |
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from discriminatory adverse action resulting from the |
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nonparticipation. |
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SECTION 2. Chapter 161, Health and Safety Code, is amended |
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by adding Subchapter X to read as follows: |
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SUBCHAPTER X. TEXAS HEALTH CARE CONSCIENCE PROTECTION ACT |
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Sec. 161.701. DEFINITIONS. In this subchapter: |
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(1) "Conscience" means a sincerely held set of moral |
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convictions arising from: |
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(A) a belief in and relation to God; |
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(B) a religious faith or spiritual practice; or |
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(C) a moral philosophy or ethical position, |
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without regard to whether the philosophy or position is related to a |
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religious faith. |
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(2) "Emergency care" means health care services |
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provided to stabilize a patient's medical condition manifesting in |
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acute symptoms of sufficient severity, including severe pain, that |
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would lead a prudent layperson possessing an average knowledge of |
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medicine and health to believe the patient's condition, sickness, |
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or injury is of sufficient severity that absence of immediate |
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medical care could reasonably be expected to: |
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(A) result in the patient's death; |
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(B) place the patient's health in serious |
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jeopardy; |
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(C) result in serious impairment of the patient's |
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bodily functions; |
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(D) result in serious dysfunction of a bodily |
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organ or part of the patient; |
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(E) result in serious disfigurement of the |
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patient; or |
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(F) for a pregnant woman, place the health of the |
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woman's unborn child in serious jeopardy. |
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(3) "Health care facility" means a public or private |
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organization, corporation, partnership, sole proprietorship, |
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association, agency, network, joint venture, or other entity that |
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provides health care services to patients. The term includes a |
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hospital, clinic, medical center, ambulatory surgical center, |
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private physician's office, pharmacy, nursing home, laboratory or |
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diagnostic facility, infirmary, dispensary, medical school, |
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nursing school, or medical training facility. |
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(4) "Health care provider" means a nurse, nurse aide, |
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medical assistant, hospital employee, clinic employee, nursing |
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home employee, pharmacist, pharmacy employee, researcher, medical, |
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pharmacy, or nursing school student, professional, |
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paraprofessional, or, without regard to whether the individual |
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holds a license, any other individual who furnishes or assists in |
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the furnishing of a health care service. |
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(5) "Health care service" means any phase of patient |
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health care or treatment, including any conduct that may give rise |
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to a health care liability claim, as that term is defined by Section |
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74.001, Civil Practice and Remedies Code. The term includes: |
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(A) testing, diagnosis, prognosis, ancillary |
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research, instruction, medication, therapy, treatment, and |
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surgery; |
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(B) family planning, counseling, and referrals, |
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and any other advice in connection with the use or procurement of |
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contraceptives, sterilization, or abortion; and |
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(C) any other care or treatment rendered by a |
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health care facility, physician, or health care provider. |
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(6) "Life-sustaining treatment" has the meaning |
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assigned by Section 166.002. |
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(7) "Participate" related to the provision of a health |
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care service includes an act to receive, obtain, perform, assist in |
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performing, give advice regarding, suggest, recommend, or refer a |
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health care service. |
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(8) "Physician" means an individual licensed to |
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practice medicine in this state. |
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(9) "Substantially prevent" related to the provision |
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of a health care service means to significantly delay the provision |
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of a health care service to a patient. |
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(10) "Undue delay" related to the provision of a |
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health care service means an unreasonable delay that impairs a |
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patient's health. |
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Sec. 161.702. RIGHT TO DECLINE PARTICIPATION IN HEALTH CARE |
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SERVICE FOR REASONS OF CONSCIENCE; EXCEPTIONS. (a) Except as |
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provided by Subsection (b), an individual may decline to |
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participate in a health care service for reasons of conscience. |
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(b) An individual may not decline to participate in the |
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following services: |
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(1) emergency care; |
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(2) life-sustaining treatment; or |
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(3) cardiopulmonary resuscitation. |
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(c) An individual who declines for reasons of conscience to |
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participate in providing life-sustaining treatment to a patient |
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shall continue providing life-sustaining treatment to the patient |
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until an accommodation is arranged under Section 161.706. |
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(d) This section may not be construed to allow an individual |
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to decline to participate in providing a health care service to a |
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patient because of the patient's race, color, sex, national origin, |
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religion, age, disability, physical condition, or economic status. |
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Sec. 161.703. IMMUNITY OF PHYSICIANS AND HEALTH CARE |
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PROVIDERS. A physician or health care provider may not be held |
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civilly or criminally liable because the physician or health care |
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provider declines to participate in a health care service wholly or |
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partly for reasons of conscience. |
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Sec. 161.704. ADVERSE ACTION. A person, including a public |
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official and a medical school or other institution that conducts |
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education or training programs for physicians or health care |
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providers, violates this subchapter by taking an adverse action |
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against an individual because the individual declines to |
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participate in a health care service for reasons of conscience. |
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Violations include taking an adverse action with regard to: |
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(1) licensure; |
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(2) certification; |
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(3) employment terms, benefits, seniority status, |
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promotion, or transfer; |
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(4) staff appointments or other privileges; |
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(5) denial of employment, admission, or participation |
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in a program for which the individual is eligible; |
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(6) reference to reasons of conscience in an |
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application form; |
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(7) questions regarding an applicant's participation |
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in providing a health care service for reasons of conscience; |
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(8) imposition of a burden in the terms or conditions |
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of employment; |
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(9) denial of aid, assistance, or benefits; |
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(10) conditional receipt of the aid, assistance, or |
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benefits; or |
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(11) coercion or disqualification of the individual |
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receiving aid, assistance, or benefits. |
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Sec. 161.705. PROTOCOL FOR DECLINING PARTICIPATION IN |
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PROVISION OF HEALTH CARE SERVICE. (a) A health care facility shall |
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develop a written protocol for circumstances in which an individual |
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declines to participate in providing a health care service, other |
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than a life-sustaining treatment, for reasons of conscience. The |
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protocol must describe a patient's access to health care services |
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and information to ensure the patient is not permanently or |
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substantially prevented from obtaining the services. The protocol |
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must explain the process the facility will implement to facilitate |
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in a timely manner the patient's access to the services. |
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(b) An individual who declines to participate in providing a |
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health care service for reasons of conscience shall: |
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(1) notify the health care facility of the |
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declination; and |
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(2) comply with the applicable protocol developed |
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under this section. |
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(c) This section does not require a health care facility, |
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physician, or health care provider to counsel a patient or refer the |
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patient to another physician or facility regarding a health care |
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service that is contrary to the conscience of the physician or |
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health care provider. |
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Sec. 161.706. PROTOCOL FOR LIFE-SUSTAINING TREATMENT. (a) A |
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health care facility shall develop a written protocol for |
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circumstances in which an individual declines to participate in |
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providing life-sustaining treatment for reasons of conscience. The |
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protocol must prohibit an individual from declining to provide |
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life-sustaining treatment to a patient before the patient is |
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transferred to another physician or health care provider at the |
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health care facility who is willing to provide life-sustaining |
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treatment to the patient. The protocol must explain the process the |
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health care facility will implement to facilitate a timely |
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transfer. |
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(b) An individual who declines to participate in providing |
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life-sustaining treatment for reasons of conscience shall notify |
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the health care facility and comply with the applicable protocol |
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developed under this section. The individual must continue to |
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participate in providing life-sustaining treatment until the |
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facility transfers the patient to another physician or health care |
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provider at the facility. |
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(c) If a transfer to another physician or health care |
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provider at the health care facility cannot be arranged, the |
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protocol at a minimum must require a health care facility, |
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physician, or health care provider to: |
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(1) timely inform the patient of the patient's |
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condition, prognosis, and treatment options, and the risks and |
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benefits of those treatment options, consistent with accepted |
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standards of health care; |
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(2) provide without undue delay on request of the |
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patient or the patient's legal representative copies of the |
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patient's medical records to the patient or another health care |
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facility, physician, or health care provider designated by the |
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patient in accordance with medical privacy laws; and |
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(3) take any other action necessary to transfer the |
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patient to another health care facility. |
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(d) This section does not require a health care facility, |
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physician, or health care provider to counsel a patient or refer the |
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patient to another physician or facility regarding a health care |
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service that is contrary to the conscience of the physician or |
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health care provider. The information required by Subsection (c) |
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may be provided by a health care facility, physician, or health care |
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provider other than the physician or health care provider who |
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declined to participate in providing life-sustaining treatment for |
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reasons of conscience. |
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Sec. 161.707. DISCIPLINARY ACTION; COMPLAINT. (a) A |
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health care facility, physician, or health care provider that holds |
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a license issued by a licensing agency in this state is subject to |
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review and disciplinary action by the licensing agency for a |
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violation of this subchapter as if the facility, physician, or |
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provider violated the applicable licensing law. |
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(b) An individual who is injured by a violation of this |
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subchapter may file a complaint with the licensing agency that |
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issued a license to the health care facility, physician, or health |
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care provider that allegedly violated this subchapter. |
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(c) A physician or health care provider may not file a |
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complaint with the appropriate licensing agency under this section |
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unless the physician or health care provider complies with the |
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health care facility's protocol developed under Section 161.705 or |
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161.706, as appropriate. |
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Sec. 161.708. CIVIL REMEDIES. A person who is injured by a |
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violation of this subchapter may bring a civil action against a |
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person who violates this subchapter. A person who brings the action |
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under this section may obtain: |
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(1) injunctive relief; |
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(2) damages incurred by the person, including: |
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(A) actual damages for all psychological, |
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emotional, and physical injuries resulting from the violation of |
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this subchapter; |
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(B) court costs; and |
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(C) reasonable attorney's fees; or |
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(3) both injunctive relief and damages. |
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SECTION 3. Not later than March 1, 2022, a health care |
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facility, as that term is defined by Section 161.701, Health and |
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Safety Code, as added by this Act, shall adopt protocols required by |
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Sections 161.705 and 161.706, Health and Safety Code, as added by |
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this Act. |
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SECTION 4. Section 161.703, Health and Safety Code, as |
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added by this Act, applies only to a cause of action that accrues on |
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or after the effective date of this Act. |
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SECTION 5. This Act takes effect January 1, 2022. |