Christian Legal Society
The following draft Federal statute is proposed for discussion purposes
only by the Christian Legal Society's Center for Law and Religious
Please send comments to
Samuel B. Casey,
4208 Evergreen Lane, Suite 222,
Annandale, VA 22003
Tel: 703-642-1070; Fax: 703-642-1075; E-mail:
The Health Care Freedom of Conscience Act of 2000
(Placed on the Calendar in the House)
Calendar No. ____
Entitled the "Health Care Freedom of Conscience Act of 2000"
IN THE HOUSE OF REPRESENTATIVES OF THE UNITED STATES ___, 2000
Mr. __________(joined by co-cosponsors ___________________) introduced
the following bill; which was read the first time ____, 2000
Read the second time and placed on the calendar
A BILL Related to Health Care
Entitled the "Health Care Freedom of Conscience Act of 2000"
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the Health Care Freedom of Conscience Act.
SEC. 2. FEDERAL JURISDICTION
This Act applies to -
a) Any person required to perform or assist in the
performance of any part of a health care service or research activity funded
in whole or in part under a program administered by the Secretary of Health
and Human Services.
b) Any health care provider who receives a grant,
contract, loan, or loan guarantee under the Public Health Service Act [42
U.S.C.A. ' 201 et seq.], the Community Mental Health Centers Act [42
U.S.C.A. ' 2689 et seq.], the Developmental Disabilities Services and
Facilities Construction Act [42 U.S.C.A. ' 6000 et seq.], or the Bill of
Rights Act [42 U.S.C.A ' 6000 et seq.]
c) Any health care payer who directly or indirectly
pays for or arranges for the payment of any health care service or research
activity by any person or health care provider, funded in whole or in part
under any program, grant, contract, loan or loan guarantee defined in
sub-sections (a) and (b) above
SEC. 3. POLICY AND PURPOSES
It is the public policy of United States to respect and protect the
rights of conscience of all persons, health care providers and health care
payers subject to this Act when they are involved directly or indirectly in
performing, providing or paying for health care services. It is the purpose
of this Act to protect the civil right of all such individuals, persons,
health care providers and health care payers to refuse to counsel, advise,
pay for, provide, perform, assist, or participate in directly or indirectly
providing or performing health services that violate such persons' religious
or moral convictions; and to prohibit all forms of discrimination,
disqualification, coercion, disability, or liability upon such persons by
reason of such refusal.
SEC. 3: DEFINITIONS
As used in this Act, unless the context clearly otherwise requires:
(a) "Health care institution" means any public or
private corporation, partnership, association, organization, agency or other
legal entity that is involved directly or indirectly in providing health
care services, including, without limitation, any public or private
hospital, clinic, medical center, medical school, nursing school or other
medical training institution, laboratory or diagnostic facility, physician's
office, infirmary, dispensary, ambulatory surgical treatment center,
physician organizations and associations, insurance organizations, and other
financing organizations, networks, joint ventures, and all other
combinations of those organizations.
(b) "Health care provider" means any health care
institution and any individual involved directly or indirectly in providing
(c) "Health care services" means any phase of patient
care, including but not limited to, testing; diagnosis; prognosis; ancillary
research; instructions; family planning, counseling, referrals, or any other
advice in connection with the use or procurement of contraceptives and
sterilization or abortion procedures; medication; or surgery or other care
or treatment rendered by a physician or physicians, nurses,
paraprofessionals or health care provider, intended for the physical,
emotional, and mental well-being of persons;
(d) "Physician" means any person who is duly licensed to
practice the medical arts as a physician under the laws of the several
(e) "Health care personnel" means any nurse, nurses'
aide, medical school student, professional, paraprofessional or any other
person who furnishes, or assists in the furnishing of, health care services;
(f) "Health care payer" means a health maintenance
organization, insurance company, management services organization, or any
other entity that pays for or arranges for the payment of any health care or
medical care service, procedure, or product.
(g) "Medical emergency procedure" means any health
service necessary to save the life of a human being in any stage or
condition of existence from imminent death, requiring for its success the
immediate assistance of a person asserting religious or moral objections,
that must be performed before a replacement for the objecting person can be
obtained or reasonably could have been obtained.
(h) "Individual" means any human being or group of human
(i) "Person" includes all juridical persons, including
but not limited to health care providers, physicians, health care personnel,
and health care payers, and all other public and private individuals,
institutions, entities, organizations, associations, and agencies.
(j) "Religious or moral convictions" means the religious
or moral mandates sincerely believed by an individual, and the policies
adopted by the governing body of a health care institution that are based on
sincerely held religious or moral mandates.
(k) "Conscience" means a sincerely held set of religious
or moral convictions arising from belief in and relation to God, or which,
though not so derived, arises from a place in the life of its possessor
parallel to that filled by God among adherents to religious faiths.
SEC. 4: CIVIL RIGHTS OF CONSCIENCE
(a) All persons have the right not to counsel, advise, pay for, provide,
perform, assist, or participate in directly or indirectly providing or
performing health care services that would be contrary to their religious or
(b) No person shall be required to counsel, advise, pay for, provide,
perform, assist, or participate directly or indirectly in providing or
performing health services that violate his or her or its religious or moral
SEC 5: INDIVIDUAL FREEDOM OF CONSCIENCE
(a) No individual shall be required to counsel, advise, pay for, provide,
assist, or participate directly or indirectly in providing health services
that violate his or her religious or moral convictions.
(b) No individual shall be civilly, criminally, or administratively
liable to any person for any refusal, to counsel, advise, pay for, provide,
assist, or participate directly or indirectly in providing or performing
health services that violate his or her religious or moral convictions if
(i) prior to the request or assignment he or she
notified the person making the request or assignment of his or her general
refusal and, if asked, certified such general refusal in writing, or
(ii) he or she notified the person making the request
or assignment of his or her refusal within 24 hours after being asked or
(c) No person shall discriminate against, penalize, discipline, or
retaliate against any individual in employment, privileges, benefits,
remuneration, promotion, termination of employment; or in eligibility for,
admission to, renewal or participation in, or graduation from any
educational, study, or training program; or in any grant, contract, or other
program because of his or her refusal or unwillingness to counsel, advise,
pay for, provide, perform, assist, or participate directly or indirectly in
providing or performing health services that violate his or her religious or
SEC 6: INSTITUTIONAL RIGHTS OF CONSCIENCE
(a) No health care institution or health care payer shall be required to
recommend, advise, pay for, provide, assist, perform, or participate in
providing or performing (including, without limitation, to admit for the
purpose of providing, provide facilities, equipment, or personnel for, or
maintain as a patient for) any health care service that violates its
religious or moral convictions.
(b) No health care institution or health care payer shall be civilly,
criminally, or administratively liable to any person for any such refusal if
(i) the institution posted notice of its refusal
policy in plain sight in the admission area(s) of the institution prior to
the request or assignment, or
(ii) the institution notified the person requesting
such health service of its refusal within 24 hours of the request, and there
has been no irreversible change in the circumstances of the patient or
person making the request or assignment during the time between making the
request and the institution's refusal that would render it unjust for the
institution to refuse the request or assignment.
(c) No person shall discriminate or retaliate against any health care
institution or health care payer in any grant, contract, or program because
of its refusal to counsel, advise, pay for, provide, perform, assist, or
participate in providing or performing health services that violate its
religious or moral convictions.
(d) It shall be unlawful for any person, public or private institution,
or public official to discriminate against any person, association, or
corporation (i) attempting to establish a new health care payer or (ii)
operating an existing health care payer, in any manner, including but not
limited to, denial, deprivation, or disqualification in licensing; granting
of authorizations, aids, assistance, benefits, or any other privileges; and
granting authorization to expand, improve, or create any health care payer,
because the person, association, or corporation planning, proposing, or
operating a health care payer refuses to pay for or arrange for the payment
of any particular form of health care services that violates the health care
payer's conscience as documented in the existing or proposed ethical
guidelines, mission statement, constitution, bylaws, articles of
incorporation, regulations or other governing documents.
SEC. 7: EXCEPTIONS
(a) The foregoing provisions do not apply to medical emergency
(b) Nothing herein shall relieve any person from liability to pay for a
health service for which he, she or it freely and knowingly contracted to
pay, which was performed before a timely conscientious objection was
asserted, or from liability to pay lawful taxes.
(c) Any health care institution, or department or division thereof,
established for the sole or primary purpose of providing specific health
care services to which some individuals may object may exclude persons who
object to such services from employment in a position for which the
performance of such services is a necessary and substantial responsibility,
if such person's moral or conscience rights cannot be reasonably
accommodated by diligent effort.
SEC. 8: ACTION FOR VIOLATION OF RIGHTS OF CONSCIENCE
(a) Any person insured by any behavior, act, or omission prohibited in
this Act shall recover three-fold the actual damages sustained (but in no
case shall the recovery be less than $3,000 damages for each violation),
plus costs and reasonable attorney's fees.
(b) Any person threatened with injury or injured by any other person by
reason of action prohibited in this Act may obtain an injunction against the
illegal activity, plus costs and reasonable attorney's fees.
(c) AUTHORITY OF UNITED STATES TO ENFORCE THIS ACT
The United States may bring an action for injunctive or declaratory
relief to enforce compliance with this Act.
(d) These remedies shall be cumulative and not exclusive of other
remedies afforded under any other federal or state law.
SEC. 9: RESPECT FOR RIGHTS OF CONSCIENCE TO BE REGULATED
(a) Within one year from the effective date of this Act, the Secretary of
Health and Human Services shall adopt such regulations as will ensure the
protection of the rights of conscience of any person subject to this Act by
and in all public agencies, entities, institutions, contracts, grants, and
(b) No rule or regulation shall impair or delay any person who believes
that his or her or its rights under this Act have been threatened or
violated from bringing an action in any state or federal court, except that
reasonable methods of alternative dispute resolution which postpone or delay
proceedings by not more than 45 days may be required.
SEC.10. SOVEREIGN IMMUNITY
Nothing in this Act shall be construed to abrogate the sovereign immunity
of a State.