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A BILL TO BE ENTITLED
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AN ACT
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relating to protection of persons from participation in a health |
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care service for reasons of conscience; providing a civil remedy; |
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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 bona fide emergency |
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services provided after a sudden onset of a medical or traumatic |
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condition manifested by acute symptoms of sufficient severity, |
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including severe pain, such that the absence of immediate medical |
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attention could reasonably be expected to: |
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(A) place the patient's health in serious |
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jeopardy; |
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(B) result in serious impairment to the patient's |
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bodily functions; or |
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(C) result in serious dysfunction of any bodily |
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organ or body part of the patient. |
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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, pharmacy 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, allied health professional, |
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laboratory technician, clinic employee, nursing home employee, |
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pharmacist, pharmacy employee, researcher, medical, pharmacy, or |
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nursing school student, professional, paraprofessional, or, |
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without regard to whether the person holds a license, any other |
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person who furnishes or assists in the furnishing of a health care |
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service. |
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(5) "Health care service" means any phase of patient |
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health care or treatment. The term includes: |
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(A) examination, testing, diagnosis, referral, |
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prognosis, dispensing or administering a drug or device, ancillary |
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research, instruction, therapy, treatment, and preparing for or |
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performing a surgery or procedure; |
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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) record-making procedures, preparation of |
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treatment notes, and 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) "Physician" means an individual licensed to |
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practice medicine in this state. |
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Sec. 161.702. RIGHT TO DECLINE PARTICIPATION IN HEALTH CARE |
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SERVICE FOR REASONS OF CONSCIENCE; CONSTRUCTION OF SUBCHAPTER. (a) |
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Except as provided by Subsection (b), a person may decline to |
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participate in a health care service for reasons of conscience. |
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(b) A person may not decline to participate in the following |
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services: |
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(1) emergency care; or |
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(2) except as provided by Chapter 166, life-sustaining |
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treatment. |
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(c) Nothing in this subchapter may be construed to: |
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(1) supersede Chapter 166 governing the provision, |
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withholding, or withdrawing of life-sustaining treatment; or |
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(2) apply to emergency care, life-sustaining |
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treatment, or cardiopulmonary resuscitation. |
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(d) An exercise of the right of conscience under this |
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section is limited to a person's right to refuse to participate in a |
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specific health care service. |
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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 another person because the other person declines to |
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participate in a health care service for reasons of conscience. |
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Violations include discrimination against or taking an adverse |
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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 other person 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 other person |
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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 a person |
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declines to participate in providing a health care service, other |
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than emergency care or life-sustaining treatment, for reasons of |
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conscience. The protocol must: |
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(1) describe a patient's access to health care |
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services and information to ensure the patient is not permanently |
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or substantially prevented from obtaining the services; and |
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(2) explain the process the facility will implement to |
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facilitate in a timely manner the patient's access to the services. |
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(b) A person 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 permit a protocol developed under |
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this section to require a health care facility, physician, or |
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health care provider to counsel a patient or refer the patient to |
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another physician or facility regarding a health care service that |
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is contrary to the conscience of the physician or health care |
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provider. |
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Sec. 161.706. 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) A person 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. |
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Sec. 161.707. 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 an 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 December 1, 2023, 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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Section 161.705, Health and Safety Code, as added by 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 September 1, 2023. |