Alabama
Health Care Rights of Conscience Act
2023 Code of Alabama | Title 22 - Health, Mental Health, and Environmental Control | Title 1 - Health and Environmental Control Generally | Chapter 21B - Health Care Rights of Conscience Act
AL Code § 22-21B-1 (2023)
Short Title
Section 22-21B-1. This act may be known and cited as the Health Care Rights of Conscience Act.
Legislative findings.
Section 22-21B-2 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 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 in advance.
(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 as soon as practicable prior to being asked to perform such health care services.
Definitions
Section 22-21B-3 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 services.
(4) HEALTH CARE SERVICE. Patient medical care,treatment or procedure that is limited to abortion, human cloning, human embryonic stem cell research, and sterilization, and is related to: 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 her conscience.
(5) OBJECT IN WRITING. To provide advance notice in a signed written paper 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 act by the health care provider.
(6) PARTICIPATE. To 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 institutidn'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.
Participation in a health care service that violates the conscience of health care provider; written objection; liability.
Section 22-21B-4
(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 services.
(b) When objecting in writing in accordance with this act, no health care provider shall be civilly, criminally, or administratively liable for declining to participate in a health care service that violates his or her conscience except when failure to do so 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 health care services.
(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 or medical service, a health care provider shall provide and participate in diagnosis, medical treatment, medical care, and medical procedures until an alternate health care provider capable of providing or participating in the emergency medical treatment, medical care, or medical 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 criminal and civil liability for any damage caused by the refusal of a health care provider to participate in a health care service as defined in this act at a facility owned, operated, or controlled by the hospital or other health care entity.
Injunctive relief
Section 22-21B-5
(a) An action for injunctive relief may be brought for the violation of any provision of this act.
(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.
Construction with abortion statutes
Section 22-21B-6 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.
Abortion clinics; relation to other statutes
Section 22-21B-7 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 Alabama 1975, or the "Alabama Medical Liability Act of 1987" commencing with Section 6-5-540, Code of Alabama 1975, et seq., or the Alabama Medical Liability Act of 1996, commencing with Section 6—5-548, Code of Alabama 1975, et seq., or any amendment to any of the foregoing, or any judicial interpretation of any of the foregoing.
Severability
Section 22-21B-8 If any part, section, or subsection of this act or the application thereof to any person or circumstances is held invalid, such invalidity shall not affect parts, sections or subsections or applications of this act which can be given effect without the invalid part, section, or subsection or application and to this end, such invalid portions of this act are declared severable.