House Bill 31 (2013)
Health Care Rights of Conscience Act
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A BILL TO BE ENTITLED AN ACT
Relating to health care, to allow health care providers to decline to
perform any health care service that violates their conscience and provide
remedies for persons who exercise that right and suffer consequences as a
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
This act may be known and cited as the Health Care Rights of Conscience
The Legislature finds and declares:
(1) It is the public policy of the State of Alabama to respect and
protect the fundamental right of conscience of individuals who provide
health care services.
(2) Without comprehensive protection, health care rights of conscience
may be violated in various ways, such as harassment, demotion, salary
reduction, termination, loss of privileges, denial of aid or benefits, and
refusal to license, or refusal to certify.
(3) It is the purpose of this act to protect religious or ethical rights
of all health care providers to decline to counsel, advise, provide,
perform, assist, or participate in providing or performing certain health
care services that violate their consciences, where they have made their
objections known in writing.
(4) It is the purpose of this act to prohibit discrimination,
disqualification, or coercion upon such health care providers who decline to
perform any health care service that violates their conscience and who
object in writing prior to being asked to perform such health care services.
The following words and terms shall have the meanings ascribed to them in
this section, unless otherwise required by their respective context:
(1) CONSCIENCE. The religious, moral, or ethical principles held by a
health care provider.
(2) DISCRIMINATION. Discrimination includes, but is not limited to:
Hiring, termination, refusal of staff privileges, refusal of board
certification, demotion, loss of career specialty, reduction of wages or
benefits, adverse treatment in the terms and conditions of employment,
refusal to award any grant, contract, or other program, or refusal to
provide residency training opportunities.
(3) HEALTH CARE PROVIDER. Any individual who may be asked to participate
in any way in a health care service, including, but not limited to: A
physician, physician's assistant, nurse, nurse's aide, medical assistant,
hospital employee, clinic employee, nursing home employee, pharmacist,
researcher, medical or nursing school faculty, student, or employee,
counselor, social worker, or any professional, paraprofessional, or any
other person who furnishes or assists in the furnishing of health care
(4) HEALTH CARE SERVICE. Any phase of patient medical care, treatment or
procedure that is limited to abortion, human cloning, human embryonic stem
cell research, and sterilization, and is related to: Patient referrals,
counseling, therapy, testing, diagnosis or prognosis, research, instruction,
prescribing, dispensing or administering any device, drug, or medication,
surgery, or any other care or treatment rendered or provided by health care
providers. Health care service does not include notifying a member of a
health care institution's management of a patient inquiry about obtaining a
health care service that a health care provider believes may violate his or
(5) OBJECT IN WRITING. To provide advance notice in a signed written
document to an authorized agent of his or her employer, board, or other
oversight agency of a particular health care provider. The notice shall be
provided within a reasonable time, but in no case less than twenty-four (24)
hours prior to any service or procedure objected to under this section by
the health care provider.
(6) PARTICIPATE. To counsel, advise, provide, perform, assist in, refer
for, admit for purposes of providing, or participate in providing, any
health care service or any form of such service. Participate does not
include compliance with a health care institution's policy and procedure
which states that a health care provider must notify a member of the health
care institution's management of a patient's inquiry about obtaining a
health care service that the health care provider believes may violate his
or her conscience.
(a) A health care provider has the right not to participate, and no
health care provider shall be required to participate, in a health care
service that violates his or her conscience when the health care provider
has objected in writing prior to being asked to provide such health care
(b) No health care provider shall be civilly, criminally, or
administratively liable for declining toparticipate in a health care
service that violates his or her conscience except when failure to do would
immediately endanger the life of a patient.
(c) It shall be unlawful for any person, health care provider, health
care institution, public or private institution, public official, or any
board which certifies competency in medical or health care specialties to
discriminate against any health care provider in any manner based on his or
her declining to participate in a health care service that violates his or
her conscience, where the health care provider has made his or her
objections known in writing. Provided further, students may be evaluated
based on their understanding of course materials, but no student shall be
required to perform a health care service or be penalized because he or she
subscribes to a particular position on one or more of the four health care
(d) Notwithstanding any other provision in this act, in a
life-threatening situation where no other health care provider is available
or capable of providing or participating in a health care service, a health
care provider shall provide and participate in treatment, care, or
procedures until an alternate health care provider capable of providing or
participating in the emergency treatment, care, or procedures is found or
otherwise becomes available.
(e) Except as otherwise provided in this section, a hospital, as defined
in Section 22-21-20, Code of Alabama 1975, or other health care entity, and
any employee, physician, member, or person associated with the hospital or
other health care entity is immune from liability for anydamage caused
by the refusal of a health care provider to participate in a health care
service defined in this act at a facility owned, operated, or controlled by
the hospital or other health care entity.
(a) An action for injunctive relief may be brought for the violation of
any provision of this act. It shall not be a defense to any claim arising
out of the violation of this act that such violation was necessary to
prevent additional burden or expense on any other health care provider or
health care institution.
(b) The court in such action may award injunctive relief, including
ordering reinstatement of a health care provider to his or her prior job
position, back pay and costs of the action.
Nothing in this act shall be construed to permit or require the violation
of any Alabama statute,regulation, or other provision of law that
regulates or provides rights, duties, obligations, or limitations related in
any way to abortion.
The provisions of this act shall not apply to health care institutions or
employers who are licensed by the State of Board of Health as abortion
clinics. Further, nothing in this act shall modify, amend, repeal, or
supersede any provision of Section 6-5-333 of the Code of 13 Alabama
1975, or any judicial interpretation thereof.
If any part of this act or the application thereof to any person or
circumstances is held invalid, such invalidity shall not affect parts or
applications of this act which can be given effect without the invalid part
or application and to this end, such invalid portions of this act are
This act shall become effective on the first day of the third month
following its passage and approval by the Governor, or its otherwise