HOUSE BILL No. 4660

 

April 25, 2007, Introduced by Rep. Palmer and referred to the Committee on Judiciary.

 

     A bill to provide standards for personnel policies to protect

 

and accommodate the right of conscience of health care providers

 

who conscientiously object to providing or participating in certain

 

health care services under certain circumstances; to provide for

 

protection from certain liability; and to provide for penalties and

 

remedies.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 1. This act shall be known and may be cited as the

 

"conscientious objector accommodation act".

 

     Sec. 3. As used in this act:

 

     (a) "Health care provider" means a person licensed or

 

registered under article 15 of the public health code, 1978 PA 368,

 

MCL 333.16101 to 333.18838, a student of a health facility, or

 

another person who is employed by or under contract to a health


 

facility and directly participates in the provision of a health

 

care service. Health care provider does not include a sanitarian or

 

a veterinarian.

 

     (b) "Health care service" means the provision or withdrawal

 

of, or research or experimentation involving, a medical diagnosis,

 

treatment, procedure, diagnostic test, device, medication, drug, or

 

other substance intended to affect the physical or mental condition

 

of an individual.

 

     (c) "Health facility" means any of the following:

 

     (i) A clinical laboratory.

 

     (ii) A county medical care facility.

 

     (iii) A freestanding surgical outpatient facility.

 

     (iv) A home for the aged.

 

     (v) A hospital.

 

     (vi) A nursing home.

 

     (vii) A hospice.

 

     (viii) A hospice residence.

 

     (ix) A facility or agency listed in subparagraphs (i) to (vi)

 

located in a university, college, or other educational institution.

 

     (x) A private physician's office.

 

     (xi) A medical clinic.

 

     (xii) A public or private institution that provides health care

 

services to an individual.

 

     (xiii) A teaching institution that provides health care services

 

to an individual.

 

     (xiv) A pharmacy that provides health care services to an

 

individual.


 

     (xv) A corporation, partnership, sole proprietorship, limited

 

liability company, or other legal entity that provides health care

 

services to an individual.

 

     (d) "Medical director" means that term as defined in section

 

20906 of the public health code, 1978 PA 368, MCL 333.20906.

 

     (e) "Participate" or "participating" means, at a minimum, to

 

counsel, refer, perform, administer, prescribe, dispense, treat,

 

withhold, withdraw, diagnose, test, evaluate, train, research,

 

prepare, or provide medical advice or material or physical

 

assistance in a health care service.

 

     (f) "Person" means a person as defined in section 1106 of the

 

public health code, 1978 PA 368, MCL 333.1106, or a governmental

 

entity.

 

     (g) "Public health emergency" means a condition or situation

 

that presents an immediate threat to the public health, safety, or

 

welfare and requires immediate action to preserve the public

 

health, safety, or welfare.

 

     (h) "Refer" means to make a recommendation or give information

 

to a patient regarding a specific health care provider or health

 

facility that provides health care services.

 

     (i) "Regular or substantial portion" means that 10% or more of

 

the health care provider's daily or weekly hours of duty consist of

 

providing or participating in that health care service.

 

     Sec. 5. (1) A health care provider may object as a matter of

 

conscience to providing or participating in a health care service

 

on ethical, moral, or religious grounds.

 

     (2) A health care provider shall notify his or her employer in


 

writing of a conscientious objection described in subsection (1).

 

The written notice shall be given directly to his or her supervisor

 

and shall include a statement explaining his or her conscientious

 

objection and the health care service or services to which he or

 

she specifically objects to providing or participating in under

 

this act.

 

     (3) A health care provider may assert his or her conscientious

 

objection under any of the following conditions:

 

     (a) Upon being offered employment.

 

     (b) At the time the health care provider adopts an ethical,

 

moral, or religious belief system that conflicts with participation

 

in a health care service.

 

     (c) Within 24 hours after he or she is asked or has received

 

notice that he or she is scheduled to participate in a health care

 

service to which he or she conscientiously objects.

 

     Sec. 7. (1) An employer shall retain a health care provider's

 

written objection filed under section 5 for the duration of the

 

health care provider's employment. The written objection is valid

 

for the duration of the health care provider's employment or until

 

rescinded by the health care provider in writing.

 

     (2) Within 7 days after receiving a written objection pursuant

 

to section 5, an employer shall develop an accommodation plan with

 

the health care provider to ensure that the health care provider

 

will not be scheduled or requested to participate in a health care

 

service to which he or she specifically objects.

 

     (3) An employer shall not refuse employment or staff

 

privileges to a health care provider who has exercised his or her


 

right to assert an objection to providing or participating in a

 

health care service under section 5, unless participation in that

 

health care service is indicated as a regular or substantial

 

portion of the normal course of duties in the posting of the

 

availability of the position for employment or staff privileges.

 

     (4) A medical school or other institution for the education or

 

training of a health care provider shall not refuse admission to an

 

individual or penalize that individual because the individual has

 

filed in writing with the medical school or other institution a

 

conscientious objection to participating in a health care service

 

under this act.

 

     Sec. 9. (1) The protections afforded to a health care provider

 

under this act do not apply to a health care provider who has

 

asserted to his or her supervisor a written objection to providing

 

or participating in a certain health care service under any of the

 

following circumstances:

 

     (a) A patient's condition, in the reasonable medical judgment

 

of an attending physician or medical director, requires immediate

 

action and no other qualified health care provider is available to

 

provide that health care service.

 

     (b) In the event of a public health emergency.

 

     (c) If a health care provider first asserts an objection

 

contemporaneously to a patient's requiring or requesting the

 

objectionable health care service and no other health care provider

 

is available to provide the health care service.

 

     (d) If the objection is based on the status of the patient,

 

including, but not limited to, the patient's religion, race, color,


 

national origin, age, gender, height, weight, familial status,

 

marital status, participation in high-risk activities, past or

 

present medical disease or condition, sexual orientation,

 

employment status, insurance coverage, ability to pay, or method of

 

payment.

 

     (2) This act does not relieve a health care provider from a

 

duty that exists under any other law pertaining to current

 

standards of acceptable health care practice and procedure to

 

inform a patient of the patient's condition, prognosis, risk of

 

receiving or forgoing relevant health care services for the

 

condition, including the availability of a health care service to

 

which the health care provider conscientiously objects.

 

     (3) Subject to a collective bargaining agreement, if a health

 

care provider asserts an objection to a health care service that at

 

the time the objection is asserted constitutes a regular or

 

substantial portion of the health care provider's current and

 

defined position, the employer may give the health care provider

 

not less than 60 days' notice of the termination of his or her

 

employment.

 

     Sec. 11. (1) Except as provided in section 9, a health care

 

provider's objection to providing or participating in a health care

 

service as described in section 5 shall not be the basis for 1 or

 

more of the following:

 

     (a) Civil liability to another person.

 

     (b) Criminal action.

 

     (c) Administrative or licensure action.

 

     (2) If a health care provider is required by his or her


 

employer to participate in a health care service more than 7 days

 

after the health care provider has asserted a written objection to

 

that health care service, the health care provider is immune from

 

civil liability in an action arising from his or her participation

 

in that health care service.

 

     Sec. 13. (1) A civil action for damages or reinstatement of

 

employment, or both, may be brought against a person, including,

 

but not limited to, a governmental agency, health facility, or

 

other employer, for penalizing or discriminating against a health

 

care provider, including, but not limited to, penalizing or

 

discriminating in hiring, promotion, transfer, a term or condition

 

of employment, licensing, or granting of staff privileges or

 

appointments, solely because that health care provider has asserted

 

an objection to participating in a health care service under

 

section 5. Civil damages may be awarded equal to the amount of

 

proven damages and attorney fees. A civil action filed under this

 

subsection may include a petition for injunctive relief against a

 

person alleged to have penalized or discriminated against a health

 

care provider as described in this subsection.

 

     (2) A person who violates this act is responsible for a state

 

civil infraction and may be ordered to pay a fine of not more than

 

$1,000.00 for each day the violation continues or a fine of not

 

more than $1,000.00 for each occurrence.