Second Regular Session
[Perfected]
House Committee Substitute for House Bill No. 1541
96TH General Assembly
AN ACT
To amend chapter 191, RSMo, by adding thereto seven new sections relating
to the conscience rights of all individuals who provide medical services.
Be it enacted by the General Assembly of the state of Missouri, as
follows:
Section A. Chapter 191, RSMo, is amended by adding thereto seven new
sections, to be known as sections 191.1150, 191.1153, 191.1156, 191.1159,
191.1162, 191.1165, and 191.1168, to read as follows:
191.1150
As used in sections 191.1150 to 191.1168, the following terms mean:
(1) "Conscience", the religious, moral, or ethical principles held by a
medical professional or a health care institution. For purposes of sections
191.1150 to 191.1168, a medical professional's conscience means a sincere
and meaningful belief in God or in relation to a supreme being, or a belief
which, though not so derived, occupies in the life of its possessor a place
parallel to that filled by God among adherents to religious faiths. A health
care institution's conscience shall be determined by reference to its
existing or proposed religious, moral, or ethical guidelines, mission
statement, constitution, bylaws, articles of incorporation, regulations, or
other relevant documents;
(2) "Health care institution", any public or private organization,
corporation, partnership, sole proprietorship, association, agency, network,
joint venture, or other entity that is involved in providing medical
services, including but not limited to, hospitals, clinics, medical centers,
ambulatory surgical centers, private physician's offices, university medical
schools and nursing schools, medical training facilities, or other
institutions or locations wherein specified medical procedures or research
are performed or provided to any person;
(3) "Medical professional", any individual who may be asked to
participate in any way in specified medical procedures or research,
including, but not limited to, the following: a physician, physician's
assistant, nurse, nurses' aide, medical assistant, hospital employee, clinic
employee, counselor, social worker, medical researcher, medical or nursing
school faculty or employee, student or applicant for studies or training in
any program in the health care professions, or any professional,
paraprofessional, or any other person who furnishes, or assists in the
furnishing of, specified medical procedures or research;
(4) "Participate in specified medical procedures or research", to
counsel, advise, provide, perform, assist in, refer for, admit for purposes
of providing, or participate in providing specified medical procedures or
research; and
(5) "Specified medical procedures or research", abortion,
abortion-inducing drugs, contraception, sterilization, assisted
reproduction, human cloning, human embryonic stem-cell research, human
somatic cell nuclear transfer, fetal tissue research, and non-therapeutic
benefit fetal experimentation, including any phase of patient medical care,
treatment, procedure, patient referral, counseling, therapy, testing,
diagnosis, prognosis, surgery, research, instruction, or the prescribing or
administering of any device, drug, or medication related to the enumerated
medical procedures or research.
191.1153
1. A medical professional has the right not to participate, and no
medical professional shall be required to participate in specified medical
procedures or research that violate his or her conscience.
2. No medical professional shall be civilly, criminally, or
administratively liable for declining to participate in specified medical
procedures or research that violate his or her conscience.
3. It shall be unlawful for any person, medical professional, health care
institution, the state of Missouri, political subdivision, public or private
institution, public official, or any board which certifies competency in
medical specialties to discriminate against any medical professional in any
manner based on his or her declining to participate in specified medical
procedures or research including but not limited to, declining to counsel,
advise, pay for, provide, perform, assist, or participate in providing or
performing specified medical procedures or research that violate his or her
conscience.
4. For purposes of this section, discrimination includes, but is not
limited to, the following: termination, suspension, refusal of staff
privileges, refusal of board certification, demotion, loss of career
specialty, reduction of wages or benefits, refusal to award any grant,
contract, or other program, refusal to provide residency training
opportunities, or any other penalty, disciplinary, or retaliatory action.
191.1156
1. A health care institution has the right not to participate, and no
health care institution shall be required to participate in specified
medical procedures or research that violate its conscience.
2. A health care institution that declines to provide or participate in
specified medical procedures or research that violate its conscience shall
not be civilly, criminally, or administratively liable if the institution
provides a consent form to be signed by a patient before admission to the
institution stating that it reserves the right to decline to provide or
participate in specified medical procedures or research that violate its
conscience.
3. It shall be unlawful for any person, the state of Missouri, a
political subdivision, a public or private institution, or a public official
to discriminate against any medical institution, or any person, association,
corporation, or other entity attempting to establish a new health care
institution or operating an existing health care institution, in any manner,
including but not limited to the following:
(1) Any denial, deprivation or disqualification with
respect to licensure;
(2) Any aid, assistance, benefit, or privilege,
including staff privileges; or
(3) Any authorization, including authorization to
create, expand, improve, acquire, or affiliate or merge with any health care
institution,
because such health care institution, or person, association, or
corporation planning, proposing, or operating a health care institution
declines to participate in specified medical procedures or research which
violate the health care institution's conscience.
4. It shall be unlawful for any public official, agency, institution, or
entity to deny any form of aid, assistance, grants, or benefits, or in any
other manner to coerce, disqualify, or discriminate against any person,
association, corporation, or other entity attempting to establish a new
health care institution or operating an existing health care institution
because the existing or proposed health care institution declines to
participate in specified medical procedures or research contrary to the
health care institution's conscience.
191.1159
Nothing contained in sections 191.1150 to 191.1168 shall be construed to
authorize any medical professional or health care institution to withhold
emergency medical treatment or services necessary to save the life of a
patient under such professional's or institution's care.
191.1162
Nothing contained in sections 191.1150 to 191.1168 shall be construed to
relieve a medical professional from any duty which may exist under the laws
and regulations of this state to inform his or her patient of the patient's
health condition, risks, and prognosis, and the medical options and health
care resources available to the patient, including compliance with the
provisions of sections 188.010 to 188.085.
191.1165
1. A cause of action for damages or injunctive relief, or both, may be
brought for the violation of any provision of sections 191.1150 to 191.1168.
It shall not be a defense to any claim arising out of the violation of
sections 191.1150 to 191.1168 that such violation was necessary to prevent
additional burden or expense on any other medical professional, health care
institution, individual, or patient.
2. Any individual, association, corporation, entity, or health care
institution injured by any public or private individual, association,
agency, entity, or corporation by reason of any conduct prohibited by
sections 191.1150 to 191.1168 may commence a civil action. Upon finding a
violation of sections 191.1150 to 191.1168, the aggrieved party shall be
entitled to recover threefold the actual damages, including pain and
suffering, sustained by such individual, association, corporation, entity,
or health care institution, the costs of the action, and reasonable
attorney's fees. In no case shall recovery be less than five thousand
dollars for each violation in addition to costs of the action and reasonable
attorney's fees. These damage remedies shall be cumulative, and not
exclusive of other remedies afforded under any other state or federal law.
3. The court in such civil action may award injunctive relief, including,
but not limited to, ordering reinstatement of a medical professional to his
or her prior employment position.
191.1168
1. It is the intent of the general assembly that sections 191.1150 to
191.1168 be severable as noted in section 1.140, except sections 191.1159
and 191.1162, which shall not be severable from those sections. In the event
that any section, subsection, subdivision, paragraph, sentence, or clause of
sections 191.1150 to 191.1168, except section 191.1159 and 191.1162, be
declared invalid under the Constitution of the United States or the
Constitution of the State of Missouri, it is the intent of the general
assembly that the remaining provisions of sections 191.1150 to 191.1168
remain in force and effect as far as capable of being carried into execution
as intended by the general assembly.
2. The general assembly may, by concurrent resolution, appoint one or
more of its members who sponsored or co-sponsored this act in his or her
official capacity, to intervene as a matter of right in any case in which
the constitutionality of this law is challenged.