Michigan
House Bill 5158 (2001)
This bill supersedes HB 5290,
which died in committee. Check the status of this bill at the
Michigan Legislature
Introduced on October 9, 2001 by Reps. Ehardt,
Raczkowski, Vander Veen, Koetje, Rocca, Birkholz, Tabor, Sanborn, Middaugh,
Patterson, Pumford, Mans, DeVuyst, Cassis, Bisbee, Pestka, Sheltrown,
O'Neil, Neumann, Callahan, Wojno, Bishop, Richardville, Basham, Drolet,
Cameron Brown, Faunce, George, Kowall, Van Woerkom, Stamas, Jansen,
Voorhees, Hart, Hager, Allen, Pappageorge, Jelinek, Newell, DeRossett,
Howell, Vander Roest and Kuipers and referred to the Committee on Health
Policy.
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.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
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
physicalor 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
asdefined 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, orother 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
anindividual.
(e) "Life threatening condition" means a condition that
inthe 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
section20906.
(g) "Participate or participating" means, at a minimum,
tocounsel, refer, perform, administer, prescribe, dispense, treat,withhold,
withdraw, diagnose, test, evaluate, train, research,
prepare, or provide material or physical assistance in a healthcare 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 healthcare 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
disciplinaryactions taken against him or her by a health facility within
aconsecutive 5-year period, 3 of which are related to the health
service to which the objection applies, that result in a changeof
employment status or that adversely affect the health careprovider'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 whichare 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 orother medical
condition, marital status, economic status, orsexual 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 specificpatient 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 hasan objection
described in subsection (1), the health careprovider, 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 whois employed on the effective date
of this act shall notify his orher employer in writing of an objection
described in subsection(1) as soon as practicable after learning that he or
she may haveto participate in the health care service to which the
objectionapplies 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 thehealth care provider's
employment. The written objection isvalid for the duration of the health
care provider's employmentor until rescinded by the health care provider in
writing.
(5) If a health care provider has not submitted a writtenobjection under
subsection (3) before being asked to participatein a health care service,
the health care provider shall notifythe 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 notnotify 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 healthcare provider from
participating in the health care service or tofind a replacement for the
health care provider if the healthcare provider still claims to have, either
orally or in writing,an objection to participating in the health care
service asdescribed 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'sdaily or weekly duties
consist of participating in that healthcare service, the employer may give
the health care provideremployee not less than 6 months' notice of the
termination of theemployee'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 ahealth care
service as described in subsection (1) shall not bethe 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 lawpertaining to
current standards of acceptable health care practice and
procedure to inform a patient of the patient'scondition, prognosis, and
risks of receiving health care servicesfor the condition. However, this
subsection does not impose aduty on a health care provider to counsel,
recommend, or refer ahealth 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 mayassert 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 ofpatients' 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
healthcare 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 thepatient has consented to the provision
of the health care service.
(3) A health facility shall provide notice of an objectiondescribed in
subsection (1) to providing a health care service through
written public notice or personally in writing at thetime an individual
seeks to obtain that health care service fromthe 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 1or more of the
following:
(a) Civil, criminal, or administrative liability.
(b) Eligibility discrimination against the health
facilityin a grant, contract, or program, where providing the health
careservice is not expressly required as a condition of eligibilityfor the
grant, contract, or program.
(5) A person including, but not limited to, a governmentalagency shall
not refuse employment or staff privileges to a health care
provider or impose an involuntary change in terms orconditions of employment
or other disciplinary action, including,but not limited to, termination of
employment, on a health careprovider 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 ofthe
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 educationor training of
a health care provider shall not refuse admissionto 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 asdescribed in section 5(1).
(7) Except as otherwise provided in this section and section5, a civil
action for damages or reinstatement of employment, orboth, may be brought
against a person including, but not limitedto, a governmental agency, health
facility, or other employer forpenalizing 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 ofproven
damages and attorney fees. A civil action filed underthis subsection may
include a petition for injunctive relief.
Sec. 9. A person who violates this act is responsible for astate civil
infraction and may be ordered to pay a civil fine ofnot more than $1,000.00
for each day the violation continues or acivil fine of not more than
$1,000.00 for each occurrence.