1| STATE OF OKLAHOMA | | | 2| 1st Session of the 60th Legislature (2025) | | | 3|SENATE BILL 665 By: Jett | | | 4| | | | 5| | | | 6| AS INTRODUCED | | | 7| An Act relating to freedom of conscience; creating | | the Medical Ethics Defense Act; providing short | 8| title; defining terms; granting certain rights to | | certain medical practitioners, healthcare | 9| institutions, or healthcare payers; limiting exercise | | of certain rights; granting certain immunities; | 10| prohibiting certain discrimination; requiring opt-in | | for abortion; providing certain construction; | 11| prohibiting and requiring certain actions by | | licensing board under certain conditions; authorizing | 12| and prohibiting certain civil actions; prohibiting | | certain defense; providing for recovery of damages | 13| and other relief; providing severability; providing | | for codification; and providing an effective date. | 14| | | | 15| | | | 16|BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: | | | 17| SECTION 1. NEW LAW A new section of law to be codified | | | 18|in the Oklahoma Statutes as Section 1-728g of Title 63, unless there | | | 19|is created a duplication in numbering, reads as follows: | | | 20| This act may be known and cited as the "Medical Ethics Defense | | | 21|Act". | | | 22| SECTION 2. NEW LAW A new section of law to be codified | | | 23|in the Oklahoma Statutes as Section 1-728h of Title 63, unless there | | | 24|is created a duplication in numbering, reads as follows: | | | Req. No. 1567 Page 1 ___________________________________________________________________________
1| 1. "Conscience" means the ethical, moral, or religious beliefs | | | 2|or principles held by any medical practitioner, healthcare | | | 3|institution, or healthcare payer. Conscience with respect to | | | 4|institutional entities or corporate bodies, as opposed to individual | | | 5|persons, is determined by reference to that entity or body's | | | 6|governing documents including, but not limited to, any published | | | 7|ethical, moral, or religious guidelines or directives; mission | | | 8|statements; constitutions; articles of incorporation; bylaws; | | | 9|policies; or regulations; | | | 10| 2. "Disclosure" means a formal or informal communication or | | | 11|transmission, but does not include a communication or transmission | | | 12|concerning policy decisions that lawfully exercise discretionary | | | 13|authority unless the medical practitioner providing the disclosure | | | 14|or transmission reasonably believes that the disclosure or | | | 15|transmission evinces: | | | 16| a. any violation of any law, rule, or regulation, | | | 17| b. any violation of any ethical guidelines for the | | | 18| provision of any medical procedure or service, or | | | 19| c. gross mismanagement, a gross waste of funds, an abuse | | | 20| of authority, practices or methods of treatment that | | | 21| may put patient health at risk, or a substantial and | | | 22| specific danger to public health or safety; | | | 23| 3. "Discrimination" means any adverse action taken against, or | | | 24|any threat of adverse action communicated to, any medical | | | Req. No. 1567 Page 2 ___________________________________________________________________________
1|practitioner, healthcare institution, or healthcare payer as a | | | 2|result of his, her, or its decision to decline to participate in a | | | 3|medical procedure or service on the basis of conscience. | | | 4|Discrimination includes, but is not limited to, termination of | | | 5|employment; transfer from current position; demotion from current | | | 6|position; adverse administrative action; reassignment to a different | | | 7|shift or job title; increased administrative duties; refusal of | | | 8|staff privileges; refusal of board certification; loss of career | | | 9|specialty; reduction of wages, benefits, or privileges; refusal to | | | 10|award a grant, contract, or other program; refusal to provide | | | 11|residency training opportunities; denial, deprivation, or | | | 12|disqualification of licensure; withholding or disqualifying from | | | 13|financial aid and other assistance; impediments to creating any | | | 14|healthcare institution or payer or expanding or improving such | | | 15|healthcare institution or payer; impediments to acquiring, | | | 16|associating with, or merging with any other healthcare institution | | | 17|or payer; the threat thereof with regard to any of the preceding; or | | | 18|any other penalty, disciplinary, or retaliatory action, whether | | | 19|executed or threatened. However, discrimination excludes the | | | 20|negotiation or purchase of insurance by a nongovernment entity; | | | 21| 4. "Medical procedure or service" means medical care provided | | | 22|to any patient at any time over the entire course of treatment, or | | | 23|medical research. This includes, but is not limited to, testing; | | | 24|diagnosis; referral; dispensing and/or administering any drug, | | | Req. No. 1567 Page 3 ___________________________________________________________________________
1|medication, or device; psychological therapy or counseling; | | | 2|research; prognosis; therapy; record-making procedures; notes | | | 3|related to treatment; set up or performance of a surgery or | | | 4|procedure; or any other care or service performed or provided by any | | | 5|medical practitioner including, but not limited to, physicians, | | | 6|nurses, allied health professionals, paraprofessionals, contractors, | | | 7|or employees of healthcare institutions; | | | 8| 5. "Healthcare institution" means any organization, | | | 9|corporation, partnership, association, agency, network, sole | | | 10|proprietorship, joint venture, or other entity that provides medical | | | 11|procedures or services. The term includes, but is not limited to, | | | 12|any public or private hospital, clinic, medical center, physician | | | 13|organization, professional association, ambulatory surgical center, | | | 14|private physician's office, pharmacy, nursing home, medical school, | | | 15|nursing school, medical training facility, or any other entity or | | | 16|location in which medical procedures or services are performed; | | | 17| 6. "Healthcare payer" means any employer, health plan, health | | | 18|maintenance organization, insurance company, management services | | | 19|organization, or any other entity that pays for, or arranges for the | | | 20|payment of, any medical procedure or service provided to any | | | 21|patient, whether that payment is made in whole or in part; | | | 22| 7. "Medical practitioner" means any person or individual who | | | 23|may be or is asked to participate in any way in any medical | | | 24|procedure or service. This includes, but is not limited to, | | | Req. No. 1567 Page 4 ___________________________________________________________________________
1|doctors, nurse practitioners, physician's assistants, nurses, | | | 2|nurses' aides, allied health professionals, medical assistants, | | | 3|hospital employees, clinic employees, nursing home employees, | | | 4|pharmacists, pharmacy technicians and employees, medical school | | | 5|faculty and students, nursing school faculty and students, | | | 6|psychology and counseling faculty and students, medical researchers, | | | 7|laboratory technicians, psychologists, psychiatrists, counselors, | | | 8|mental health professionals, social workers, or any other person who | | | 9|facilitates or participates in the provision of a medical procedure | | | 10|or service; | | | 11| 8. "Participate" in a medical procedure or service means to | | | 12|provide, perform, assist with, facilitate, refer for, counsel for, | | | 13|advise with regard to, admit for the purposes of providing, or take | | | 14|part in any way in providing any medical procedure or service, or | | | 15|any form of such service; and | | | 16| 9. "Pay" or "payment" means to pay for, contract for, arrange | | | 17|for the payment of (whether in whole or in part), reimburse, or | | | 18|remunerate. | | | 19| SECTION 3. NEW LAW A new section of law to be codified | | | 20|in the Oklahoma Statutes as Section 1-728i of Title 63, unless there | | | 21|is created a duplication in numbering, reads as follows: | | | 22| A. Freedom of Conscience. A medical practitioner, healthcare | | | 23|institution, or healthcare payer has the right not to participate in | | | 24| | | | Req. No. 1567 Page 5 ___________________________________________________________________________
1|or pay for any medical procedure or service which violates his, her, | | | 2|or its conscience. | | | 3| B. Limitations. The exercise of the right of conscience is | | | 4|limited to conscience-based objections to a particular medical | | | 5|procedure or service. This section may not be construed to waive or | | | 6|modify any duty a health care practitioner, health care institution, | | | 7|or health care payer may have to provide other medical procedures or | | | 8|services that do not violate the practitioner's, institution's, or | | | 9|payer's conscience. | | | 10| C. Immunity from Liability. No medical practitioner, | | | 11|healthcare institution, or healthcare payer shall be civilly, | | | 12|criminally, or administratively liable for exercising his, her, or | | | 13|its right of conscience not to participate in or pay for a medical | | | 14|procedure or service. No healthcare institution shall be civilly, | | | 15|criminally, or administratively liable for the exercise of | | | 16|conscience rights not to participate in a medical procedure or | | | 17|service by a medical practitioner employed, contracted, or granted | | | 18|admitting privileges by the healthcare institution. | | | 19| D. Discrimination. No medical practitioner, healthcare | | | 20|institution, or healthcare payer shall be discriminated against in | | | 21|any manner as a result of his, her, or its decision to decline to | | | 22|participate in or pay for a medical procedure or service on the | | | 23|basis of conscience. | | | 24| | | | Req. No. 1567 Page 6 ___________________________________________________________________________
1| E. Exception. Notwithstanding any other provision of this act | | | 2|to the contrary, a religious medical practitioner, healthcare | | | 3|institution, or healthcare payer that holds itself out to the public | | | 4|as religious, states in its governing documents that it has a | | | 5|religious purpose or mission, and has internal operating policies or | | | 6|procedures that implement its religious beliefs shall have the right | | | 7|to make employment, staffing, contracting, and admitting privilege | | | 8|decisions consistent with its religious beliefs. | | | 9| F. Opt-In Required. A health care practitioner may not be | | | 10|scheduled for, assigned, or requested to directly or indirectly | | | 11|perform, facilitate, refer for, or participate in an abortion unless | | | 12|the practitioner first affirmatively consents in writing to perform, | | | 13|facilitate, refer for, or participate in the abortion. This | | | 14|subsection does not establish a right to participate in an abortion | | | 15|otherwise prohibited by law. | | | 16| G. Emergency Medical Treatments. Nothing herein shall be | | | 17|construed to override the requirement to provide emergency medical | | | 18|treatment to all patients set forth in 42 U.S.C., Section 1395dd. | | | 19|Medical emergencies shall be subject to the definitions and | | | 20|requirements of Section 1-731.4 of Title 63 of the Oklahoma | | | 21|Statutes. | | | 22| SECTION 4. NEW LAW A new section of law to be codified | | | 23|in the Oklahoma Statutes as Section 1-728j of Title 63, unless there | | | 24|is created a duplication in numbering, reads as follows: | | | Req. No. 1567 Page 7 ___________________________________________________________________________
1| A. No medical practitioner shall be discriminated against in | | | 2|any manner because the medical practitioner: | | | 3| 1. Provided, caused to be provided, or is about to provide or | | | 4|cause to be provided to his or her employer, the Attorney General, | | | 5|any state agency charged with protecting healthcare rights of | | | 6|conscience, the U.S. Department of Health and Human Services, Office | | | 7|for Civil Rights, or any other federal agency charged with | | | 8|protecting healthcare rights of conscience information relating to | | | 9|any violation of, or any act or omission the medical practitioner | | | 10|reasonably believes to be a violation of, any provision of this act; | | | 11| 2. Testified or is about to testify in a proceeding concerning | | | 12|such violation; or | | | 13| 3. Assisted or participated, or is about to assist or | | | 14|participate, in such a proceeding. | | | 15| B. Unless the disclosure is specifically prohibited by law, no | | | 16|medical practitioner shall be discriminated against in any manner | | | 17|because the medical practitioner disclosed any information that the | | | 18|medical practitioner reasonably believes evinces: | | | 19| 1. Any violation of any law, rule, or regulation; | | | 20| 2. Any violation of any ethical guidelines for the provision of | | | 21|any medical procedure or service; or | | | 22| 3. Gross mismanagement, a gross waste of funds, an abuse of | | | 23|authority, practices or methods of treatment that may put patient | | | 24| | | | Req. No. 1567 Page 8 ___________________________________________________________________________
1|health at risk, or a substantial and specific danger to public | | | 2|health or safety. | | | 3| C. A licensing board may not reprimand, sanction, or revoke or | | | 4|threaten to revoke a license, certificate, or registration of a | | | 5|healthcare practitioner for engaging in speech or expressive | | | 6|activity protected under the First Amendment to the United States | | | 7|Constitution, unless the licensing board demonstrates beyond a | | | 8|reasonable doubt that the practitioner's speech was the direct cause | | | 9|of physical harm to a person with whom the healthcare practitioner | | | 10|had a practitioner-patient relationship within the three (3) years | | | 11|immediately preceding the incident of physical harm. | | | 12| 1. The licensing board must provide a medical practitioner with | | | 13|any complaints it has received which may result in the revocation of | | | 14|the medical practitioner's license, certification, or registration, | | | 15|within seven (7) days after receipt of the complaint. | | | 16| 2. The licensing board must pay the medical practitioner an | | | 17|administrative penalty of Five Hundred Dollars ($500.00) for each | | | 18|day the complaint is not provided to the medical practitioner after | | | 19|the specified seven (7) days. | | | 20| SECTION 5. NEW LAW A new section of law to be codified | | | 21|in the Oklahoma Statutes as Section 1-728k of Title 63, unless there | | | 22|is created a duplication in numbering, reads as follows: | | | 23| A. Civil Action for Violation of Right of Conscience. A civil | | | 24|action for damages or injunctive relief, or both, may be brought by | | | Req. No. 1567 Page 9 ___________________________________________________________________________
1|any medical practitioner, healthcare institution, or healthcare | | | 2|payer for any violation of any provision of this act. Any | | | 3|additional burden or expense on another medical practitioner, | | | 4|healthcare institution, or healthcare payer arising from the | | | 5|exercise of the right of conscience shall not be a defense to any | | | 6|violation of this act. However, no civil action may be brought | | | 7|against an individual who declines to use or purchase medical | | | 8|procedure or services from a specific medical practitioner, | | | 9|healthcare institution, or healthcare payer for exercising the | | | 10|rights granted in subsection A of Section 3 of this act. | | | 11| B. Other Remedies. Any party aggrieved by any violation of | | | 12|this act may commence a civil action and shall be entitled, upon the | | | 13|finding of a violation, to recover threefold his, her, or its actual | | | 14|damages sustained, along with the costs of the action and reasonable | | | 15|attorney fees. Such damages shall be cumulative and in no way | | | 16|limited by any other remedies which may be available under any other | | | 17|federal, state, or municipal law. A court considering such civil | | | 18|action may also award injunctive relief, which may include, but is | | | 19|not limited to, reinstatement of a medical practitioner to his or | | | 20|her previous position, reinstatement of board certification, and | | | 21|re-licensure of a healthcare institution or healthcare payer. | | | 22| SECTION 6. NEW LAW A new section of law to be codified | | | 23|in the Oklahoma Statutes as Section 1-728l of Title 63, unless there | | | 24|is created a duplication in numbering, reads as follows: | | | Req. No. 1567 Page 10 ___________________________________________________________________________
1| Any provision of this act held to be invalid or unenforceable by | | | 2|its terms, or as applied to any person or circumstance, shall be | | | 3|construed so as to give it the maximum effect permitted by law, | | | 4|unless such holding shall be one of utter invalidity or | | | 5|unenforceability, in which event such provision shall be deemed | | | 6|severable herefrom and shall not affect the remainder hereof or the | | | 7|application of such provision to other persons not similarly | | | 8|situated or to other, dissimilar circumstances. | | | 9| SECTION 7. This act shall become effective November 1, 2025. | | | 10| | | | 11| 60-1-1567 DC 1/14/2025 6:02:20 PM | | | 12| | | | 13| | | | 14| | | | 15| | | | 16| | | | 17| | | | 18| | | | 19| | | | 20| | | | 21| | | | 22| | | | 23| | | | 24| | | | Req. No. 1567 Page 11