1 STATE OF OKLAHOMA
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2 1st Session of the 59th Legislature (2023)
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3 SENATE BILL 887 By: Jett
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6 AS INTRODUCED
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7 An Act relating to freedom of conscience; creating
7 the Medical Ethics Defense Act; providing short
8 title; defining terms; granting certain rights to
8 certain medical practitioners, healthcare
9 institutions, or healthcare payers; limiting exercise
9 of certain rights; granting certain immunities;
10 prohibiting certain discrimination; requiring opt-in
10 for abortion; providing certain construction;
11 prohibiting and requiring certain actions by
11 licensing board under certain conditions; authorizing
12 and prohibiting certain civil actions; prohibiting
12 certain defense; providing for recovery of damages
13 and other relief; providing severability; providing
13 for codification; and providing an effective date.
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16 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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17 SECTION 1. NEW LAW A new section of law to be codified
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18 in the Oklahoma Statutes as Section 1-728g of Title 63, unless there
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19 is created a duplication in numbering, reads as follows:
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20 This act may be known and cited as the “Medical Ethics Defense
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21 Act”.
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22 SECTION 2. NEW LAW A new section of law to be codified
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23 in the Oklahoma Statutes as Section 1-728h of Title 63, unless there
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24 is created a duplication in numbering, reads as follows:
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 1 1. “Conscience” means the ethical, moral, or religious beliefs
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2 or principles held by any medical practitioner, healthcare
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3 institution, or healthcare payer. Conscience with respect to
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4 institutional entities or corporate bodies, as opposed to individual
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5 persons, is determined by reference to that entity or body’s
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6 governing documents, including but not limited to any published
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7 ethical, moral, or religious guidelines or directives; mission
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8 statements; constitutions; articles of incorporation; bylaws;
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9 policies; or regulations;
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10 2. “Disclosure” means a formal or informal communication or
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11 transmission, but does not include a communication or transmission
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12 concerning policy decisions that lawfully exercise discretionary
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13 authority unless the medical practitioner providing the disclosure
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14 or transmission reasonably believes that the disclosure or
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15 transmission evinces:
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16 a. any violation of any law, rule, or regulation,
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17 b. any violation of any ethical guidelines for the
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18 provision of any medical procedure or service, or
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19 c. gross mismanagement, a gross waste of funds, an abuse
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20 of authority, practices or methods of treatment that
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21 may put patient health at risk, or a substantial and
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22 specific danger to public health or safety;
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23 3. “Discrimination” means any adverse action taken against, or
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24 any threat of adverse action communicated to, any medical
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 1 practitioner, healthcare institution, or healthcare payer as a
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2 result of his, her, or its decision to decline to participate in a
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3 medical procedure or service on the basis of conscience.
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4 Discrimination includes, but is not limited to, termination of
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5 employment; transfer from current position; demotion from current
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6 position; adverse administrative action; reassignment to a different
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7 shift or job title; increased administrative duties; refusal of
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8 staff privileges; refusal of board certification; loss of career
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9 specialty; reduction of wages, benefits, or privileges; refusal to
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10 award a grant, contract, or other program; refusal to provide
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11 residency training opportunities; denial, deprivation, or
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12 disqualification of licensure; withholding or disqualifying from
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13 financial aid and other assistance; impediments to creating any
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14 healthcare institution or payer or expanding or improving such
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15 healthcare institution or payer; impediments to acquiring,
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16 associating with, or merging with any other healthcare institution
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17 or payer; the threat thereof with regard to any of the preceding; or
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18 any other penalty, disciplinary, or retaliatory action, whether
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19 executed or threatened. However, discrimination excludes the
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20 negotiation or purchase of insurance by a non-government entity;
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21 4. “Medical procedure or service” means medical care provided
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22 to any patient at any time over the entire course of treatment, or
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23 medical research. This includes, but is not limited to, testing;
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24 diagnosis; referral; dispensing and/or administering any drug,
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 1 medication, or device; psychological therapy or counseling;
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2 research; prognosis; therapy; record making procedures; notes
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3 related to treatment; set up or performance of a surgery or
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4 procedure; or any other care or service performed or provided by any
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5 medical practitioner including, but not limited to, physicians,
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6 nurses, allied health professionals, paraprofessionals, contractors,
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7 or employees of healthcare institutions;
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8 5. “Healthcare institution” means any organization,
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9 corporation, partnership, association, agency, network, sole
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10 proprietorship, joint venture, or other entity that provides medical
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11 procedures or services. The term includes, but is not limited to,
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12 any public or private hospital, clinic, medical center, physician
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13 organization, professional association, ambulatory surgical center,
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14 private physician’s office, pharmacy, nursing home, medical school,
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15 nursing school, medical training facility, or any other entity or
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16 location in which medical procedures or services are performed;
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17 6. “Healthcare payer” means any employer, health plan, health
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18 maintenance organization, insurance company, management services
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19 organization, or any other entity that pays for—or arranges for the
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20 payment of—any medical procedure or service provided to any patient,
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21 whether that payment is made in whole or in part;
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22 7. “Medical practitioner” means any person or individual who
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23 may be or is asked to participate in any way in any medical
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24 procedure or service. This includes, but is not limited to,
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 1 doctors, nurse practitioners, physician’s assistants, nurses,
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2 nurses’ aides, allied health professionals, medical assistants,
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3 hospital employees, clinic employees, nursing home employees,
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4 pharmacists, pharmacy technicians and employees, medical school
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5 faculty and students, nursing school faculty and students,
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6 psychology and counseling faculty and students, medical researchers,
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7 laboratory technicians, psychologists, psychiatrists, counselors,
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8 mental health professionals, social workers, or any other person who
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9 facilitates or participates in the provision of a medical procedure
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10 or service;
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11 8. “Participate” in a medical procedure or service means to
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12 provide, perform, assist with, facilitate, refer for, counsel for,
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13 advise with regard to, admit for the purposes of providing, or take
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14 part in any way in providing any medical procedure or service, or
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15 any form of such service;
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16 9. “Pay” or “payment” means to pay for, contract for, arrange
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17 for the payment of (whether in whole or in part), reimburse, or
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18 remunerate;
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19 SECTION 3. NEW LAW A new section of law to be codified
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20 in the Oklahoma Statutes as Section 1-728i of Title 63, unless there
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21 is created a duplication in numbering, reads as follows:
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22 A. Freedom of Conscience. A medical practitioner, healthcare
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23 institution, or healthcare payer has the right not to participate in
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 1 or pay for any medical procedure or service which violates his, her,
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2 or its conscience.
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3 B. Limitations. The exercise of the right of conscience is
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4 limited to conscience-based objections to a particular medical
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5 procedure or service. This section may not be construed to waive or
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6 modify any duty a health care practitioner, health care institution,
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7 or health care payer may have to provide other medical procedures or
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8 services that do not violate the practitioner’s, institution’s, or
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9 payer’s conscience.
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10 C. Immunity from Liability. No medical practitioner,
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11 healthcare institution, or healthcare payer shall be civilly,
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12 criminally, or administratively liable for exercising his, her, or
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13 its right of conscience not to participate in or pay for a medical
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14 procedure or service. No healthcare institution shall be civilly,
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15 criminally, or administratively liable for the exercise of
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16 conscience rights not to participate in a medical procedure or
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17 service by a medical practitioner employed, contracted, or granted
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18 admitting privileges by the healthcare institution.
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19 D. Discrimination. No medical practitioner, healthcare
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20 institution, or healthcare payer shall be discriminated against in
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21 any manner as a result of his, her, or its decision to decline to
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22 participate in or pay for a medical procedure or service on the
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23 basis of conscience.
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 1 E. Exception. Notwithstanding any other provision of this Act
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2 to the contrary, a religious medical practitioner, healthcare
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3 institution, or healthcare payer that holds itself out to the public
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4 as religious, states in its governing documents that it has a
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5 religious purpose or mission, and has internal operating policies or
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6 procedures that implement its religious beliefs, shall have the
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7 right to make employment, staffing, contracting, and admitting
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8 privilege decisions consistent with its religious beliefs.
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9 F. Opt-In Required. A health care practitioner may not be
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10 scheduled for, assigned, or requested to directly or indirectly
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11 perform, facilitate, refer for, or participate in an abortion unless
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12 the practitioner first affirmatively consents in writing to perform,
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13 facilitate, refer for, or participate in the abortion. This
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14 subsection does not establish a right to participate in an abortion
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15 otherwise prohibited by law.
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16 G. Emergency Medical Treatments. Nothing herein shall be
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17 construed to override the requirement to provide emergency medical
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18 treatment to all patients set forth in 42 U.S.C. Section 1395dd.
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19 Medical emergencies shall be subject to the definitions and
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20 requirements of Section 1-731.4 of Title 63 of the Oklahoma
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21 Statutes.
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22 SECTION 4. NEW LAW A new section of law to be codified
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23 in the Oklahoma Statutes as Section 1-728j of Title 63, unless there
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24 is created a duplication in numbering, reads as follows:
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 1 A. No medical practitioner shall be discriminated against in
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2 any manner because the medical practitioner:
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3 1. Provided, caused to be provided, or is about to provide or
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4 cause to be provided to his or her employer, the Attorney General,
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5 any state agency charged with protecting health care rights of
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6 conscience, the U.S. Department of Health and Human Services, Office
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7 of Civil Rights, or any other federal agency charged with protecting
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8 health care rights of conscience information relating to any
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9 violation of, or any act or omission the medical practitioner
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10 reasonably believes to be a violation of, any provision of this act;
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11 2. Testified or is about to testify in a proceeding concerning
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12 such violation; or
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13 3. Assisted or participated, or is about to assist or
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14 participate, in such a proceeding.
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15 B. Unless the disclosure is specifically prohibited by law, no
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16 medical practitioner shall be discriminated against in any manner
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17 because the medical practitioner disclosed any information that the
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18 medical practitioner reasonably believes evinces:
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19 1. Any violation of any law, rule, or regulation;
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20 2. Any violation of any ethical guidelines for the provision of
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21 any medical procedure or service; or
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22 3. Gross mismanagement, a gross waste of funds, an abuse of
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23 authority, practices or methods of treatment that may put patient
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 1 health at risk, or a substantial and specific danger to public
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2 health or safety.
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3 C. A licensing board may not reprimand, sanction, or revoke or
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4 threaten to revoke a license, certificate, or registration of a
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5 health care practitioner for engaging in speech or expressive
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6 activity protected under the First Amendment to the U.S.
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7 Constitution, unless the licensing board demonstrates beyond a
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8 reasonable doubt that the practitioner’s speech was the direct cause
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9 of physical harm to a person with whom the health care practitioner
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10 had a practitioner-patient relationship within the three (3) years
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11 immediately preceding the incident of physical harm.
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12 1. The licensing board must provide a medical practitioner with
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13 any complaints it has received which may result in the revocation of
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14 the medical practitioner’s license, certification, or registration,
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15 within seven (7) days after receipt of the complaint.
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16 2. The licensing board must pay the medical practitioner an
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17 administrative penalty of $500 for each day the complaint is not
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18 provided to the medical practitioner after the specified seven (7)
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19 days.
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20 SECTION 5. NEW LAW A new section of law to be codified
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21 in the Oklahoma Statutes as Section 1-728k of Title 63, unless there
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22 is created a duplication in numbering, reads as follows:
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23 A. Civil Action for Violation of Right of Conscience. A civil
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24 action for damages or injunctive relief—or both—may be brought by
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 1 any medical practitioner, healthcare institution, or healthcare
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2 payer for any violation of any provision of this act. Any
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3 additional burden or expense on another medical practitioner,
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4 healthcare institution, or healthcare payer arising from the
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5 exercise of the right of conscience shall not be a defense to any
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6 violation of this act. However, no civil action may be brought
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7 against an individual who declines to use or purchase medical
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8 procedure or services from a specific medical practitioner,
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9 healthcare institution, or healthcare payer for exercising the
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10 rights granted in subsection A of Section 3 of this act.
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11 B. Other Remedies. Any party aggrieved by any violation of
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12 this act may commence a civil action and shall be entitled—upon the
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13 finding of a violation—to recover threefold his, her, or its actual
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14 damages sustained, along with the costs of the action and reasonable
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15 attorney fees. Such damages shall be cumulative and in no way
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16 limited by any other remedies which may be available under any other
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17 federal, state, or municipal law. A court considering such civil
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18 action may also award injunctive relief, which may include, but is
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19 not limited to, reinstatement of a medical practitioner to his or
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20 her previous position, reinstatement of board certification, and re-
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21 licensure of a healthcare institution or healthcare payer.
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22 SECTION 6. NEW LAW A new section of law to be codifi