Protection of Conscience Project
Proposed Legislation
United States (States & Territories)

HB 5158

HB 5277

HB 5278

HB 6326

HB5006

SB 894

SB 895

SB 896

SB 972

This bill died in committee and has been superseded by HB 5158.

HOUSE BILL No. 5290

A bill to amend 1978 PA 368, entitled "Public health code," by amending section 20199 (MCL 333.20199) and by adding sections 16282 and 20185.

(1)   Pursuant to this section, a health care provider may assert, on a professional, ethical, moral, or religious ground, a conscientious objection to participating in a health care service.

(2) A health care provider shall notify his or her employer in writing of a conscientious objection described in subsection (1) that the individual has to participating in a health care service upon learning that he or she may have to participate in that health care service or at any other time that the health care provider considers necessary to submit an objection.

(3) A health care provider's written conscientious objection filed under subsection (2) shall be retained by the health care provider's employer and is valid for the duration of the health care provider's employment or until rescinded by the health care provider in writing.

(4) If a health care provider has not submitted a written conscientious objection under subsection (2) before being asked to participate in a health care service, the health care provider shall notify the employer in writing if he or she has a conscientious objection to participating in the health care service at least 24 hours before the health care service is scheduled. If a health care provider does not notify the employer at least 24 hours before the health care service is scheduled, the employer shall make a reasonable effort to exclude the health care provider from participating or find a replacement for the health care provider if the health care provider still claims to have, either orally or in writing, a conscientious objection to participation.

(5) A health care provider's conscientious objection to participating in a health care service shall not be the basis for 1 or more of the following:

(A) civil liability to another person.

(B) criminal action.

(C) refusal of staff privileges at a health facility or agency.

(D) administrative or licensure action.

(E) an involuntary change in terms or conditions of employment or other disciplinary action by the health care provider's employer.

(6) As used in this section, "health care provider", "health care service", and "participate or participating" mean those terms as defined in section 20185.

Sec. 20185.
(1) Pursuant to this section, a health facility may assert, on a professional, ethical, moral, or religious ground, a conscientious objection to a health care service.

(2) A health facility shall provide notice of a conscientious objection described in subsection (1) to a health care service through written notice, written postings, or in writing at the time an individual seeks to obtain that health care service from the health facility.

(3) A health facility's conscientious objection to a health care service shall not be a basis for 1 or more of the following:

(A) civil, criminal, or administrative liability.

(B) eligibility discrimination against the health facility in a grant, contract, or program, where providing the objectionable health care service is not expressly required as a condition of eligibility for the grant, contract, or program.

(4) A person including, but not limited to, a governmental agency shall not refuse employment or staff privileges to a health care provider who has previously asserted, or is presently asserting, a conscientious objection to participating in a health care service under section 16282, unless participation in that health care service is indicated as a part of the normal course of duties in the posting of the availability of the position for employment or staff privileges.

(5) 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 a conscientious objection to participating in a health care service under section 16282.

(6) 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 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, because that health care provider has filed a conscientious objection to participating in a health care service. Civil damages may be awarded equal to 3 times the amount of proven damages and attorney fees. A civil action may include a petition for injunctive relief against a person including, but not limited to, a governmental agency alleged to have penalized or discriminated against a health care provider as described in this subsection.

(7) As used in this section and section 16282:

(A) "health facility" means a health facility or agency as defined in section 20106, a private physician office, or a public or private institution, teaching institution, pharmacy, corporation, partnership, or sole proprietorship that provides a health care service to an individual.

(B) "health care provider" means a person licensed or registered under article 15, a student of a health facility, or other person employed by a health care institution who either directly or indirectly participates in a health care service.

(C) "health care service" means an action intended to maintain, improve, or restore the health or physical comfort of an individual.

(D) "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 material or physical assistance in a health care service.

Sec. 20199.
(1) Except as provided in subsection (2) or section 20142, a person who violates this article or a rule promulgated or an order issued under this article is guilty of a misdemeanor, punishable by fine of not more than $1,000.00 for each day the violation continues or, in case of a violation of sections 20551 to 20554, a fine of not more than $1,000.00 for each occurrence.

(2) A person who violates sections 20181 to 20185 is guilty of a misdemeanor, punishable by imprisonment for not more than 6 months, or a fine of not more than $2,000.00, or both.

Related Links
HB5290

HB 6326

HB6336

HB5006

HB 5277

HB 5278

SB 894

SB 895

SB 896

SB 972

This bill supersedes HB 5290, which died in committee.

A bill to provide for certain health care professionals and providers to object to participating in certain procedures under certain circumstances; to provide for protection from certain liability; and to provide for penalties and remedies.

Sec. 1. This act shall be known and may be cited as the "health care conscience clause act".

Sec. 3. As used in this act:

(a) "Emergency patient" means an individual whose physical or mental condition is such that, in the reasonable medical judgment of an attending physician or medical director, the individual is, or may reasonably be suspected or known to be, in imminent danger of loss of life or of significant health impairment.

(b) "Health facility" means a health facility or agency as defined in section 20106 of the public health code, 1978 PA 368,00141'01 MCL 333.20106, a private physician office, or a public or private institution, teaching institution, pharmacy, corporation, partnership, or sole proprietorship that provides a health care service to an individual.

(c) "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 other person employed by a health care institution who either directly or indirectly participates in a health care service.

(d) "Health care service" means an action intended to maintain, improve, or restore the health or physical comfort of an individual.

(e) "Life threatening condition" means a condition that in the reasonable medical judgment of an attending physician or medical director will result in a patient's death.

(f) "Medical director" means that term as defined in section 20906.

(g) "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 material or physical assistance in a health care service.

Sec. 5. (1) Pursuant to this section, a health care provider may assert as a matter of conscience, on an ethical, moral, or religious ground, an objection to participating in a health care service.00141'01

(2) A health care provider shall not assert an objection described in subsection (1) under 1 or more of the following circumstances:

(a) The health care provider has had 5 or more disciplinary actions taken against him or her by a health facility within a consecutive 5-year period, 3 of which are related to the health service to which the objection applies, that result in a change of employment status or that adversely affect the health care provider's clinical privileges for a period of more than 15 days.

(b) The health care provider has had 3 or more complaints issued by the department of consumer and industry services against him or her within a consecutive 5-year period, 2 of which are related to the health service to which the objection applies.

(c) The objection to participating in the health care service is based on the patient's or a group of patients' race, religion, color, national origin, sex, age, disability, disease or other medical condition, marital status, economic status, or sexual preference.

(d) The objection is based on a disagreement with the clinical judgment of another health care provider regarding the medical appropriateness of a health care service for a specific patient if the patient has consented to the provision of the health care service.

(3) If a health care provider is not employed on the effective date of this act, and if the health care provider has an objection described in subsection (1), the health care provider, upon being offered employment, shall notify the employer at that time in writing of the objection. Except as otherwise provided in subsection (5), a health care provider who is employed on the effective date of this act shall notify his or her employer in writing of an objection described in subsection (1) as soon as practicable after learning that he or she may have to participate in the health care service to which the objection applies or at any other time that the health care provider considers necessary to submit an objection described in subsection (1).

(4) An employer shall retain a health care provider's written objection filed under subsection (3) 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.

(5) If a health care provider has not submitted a written objection under subsection (3) before being asked to participate in a health care service, the health care provider shall notify the employer in writing if he or she has an objection to participating in the health care service described in subsection (1) within 24 hours after receiving notice that the health care service has been scheduled. If a health care provider does not notify the employer of the objection within 24 hours after receiving notice that the health care service has been scheduled, the employer shall make a reasonable effort to exclude the health care provider from participating in the health care service or to find a replacement for the health care provider if the health care provider still claims to have, either orally or in writing, an objection to participating in the health care service as described in subsection (1).

(6) If a health care provider employee has submitted an objection to participating in a health care service under subsection (3) or (5), and if 5% or more of the health care provider's daily or weekly duties consist of participating in that health care service, the employer may give the health care provider employee not less than 6 months' notice of the termination of the employee's employment. This subsection does not apply to an employer who employs 5 or fewer health care providers.

(7) A health care provider's objection to participating in a health care service as described in subsection (1) shall not be the basis for 1 or more of the following:

(a) Civil liability to another person.

(b) Criminal action.

(c) Except as otherwise provided in section 7, refusal of staff privileges at a health facility.

(d) Administrative or licensure action.

(e) Except as otherwise provided in subsection (6), an involuntary change in terms or conditions of employment or other disciplinary action, including, but not limited to, termination of employment, by the health care provider's employer.

(8) This section does not relieve a health care provider from a duty that exists under another statute or other law pertaining to current standards of acceptable health care practice and procedure to inform a patient of the patient's condition, prognosis, and risks of receiving health care services for the condition. However, this subsection does not impose a duty on a health care provider to counsel, recommend, or refer a health care service to which the health care provider has asserted an objection as described in subsection (1).

Sec. 7. (1) Pursuant to this section, a health facility may assert as a matter of conscience, on an ethical, moral, or religious ground, an objection to providing a health care service.

(2) A health facility shall not assert an objection described in subsection (1) under either of the following circumstances:

(a) If the objection is based on a patient's or a group of patients' race, religion, color, national origin, sex, age, disability, disease or other medical condition, marital status, economic status, or sexual preference.

(b) The objection is based on a disagreement with a health care provider employed by, under contract to, or granted privileges by the health facility regarding the medical appropriateness of a health care service for a specific patient if the patient has consented to the provision of the health care service.

(3) A health facility shall provide notice of an objection described in subsection (1) to providing a health care service through written public notice or personally in writing at the time an individual seeks to obtain that health care service from the health facility.

(4) A health facility's objection as described in subsection (1) to providing a health care service shall not be a basis for 1 or more of the following:

(a) Civil, criminal, or administrative liability.

(b) Eligibility discrimination against the health facility in a grant, contract, or program, where providing the health care service is not expressly required as a condition of eligibility for the grant, contract, or program.

(5) A person including, but not limited to, a governmental agency shall not refuse employment or staff privileges to a health care provider or impose an involuntary change in terms or conditions of employment or other disciplinary action, including, but not limited to, termination of employment, on a health care provider who has previously asserted, or is presently asserting, an objection to participating in a health care service under section 5, unless participation in that health care service is indicated as a part of the normal course of duties in the posting of the availability of the position for employment or staff privileges and except as otherwise provided in section 5(6).

(6) 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 an objection to participating in a health care service as described in section 5(1).

(7) Except as otherwise provided in this section and section 5, 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, because that health care provider has filed an objection to participating in a health care service under section 5(3) or (5).  Civil damages may be awarded equal to 3 times the amount of proven damages and attorney fees. A civil action filed under this subsection may include a petition for injunctive relief.

Sec. 9. A person who violates this act is responsible for a state civil infraction and may be ordered to pay a civil fine of not more than $1,000.00 for each day the violation continues or a civil fine of not more than $1,000.00 for each occurrence.