Bill allowing physicians to deny services based on beliefs under consideration

LINCOLN - Doctors may have a legal way to deny services based on their personal views, under a bill considered by the Nebraska Health and Human Services Committee, March 2.

Sen. Dave Murman of Glenvil introduced LB963, the Medical Ethics and Diversity Act, which would legally state medical practitioners and healthcare institutions cannot be forced to perform procedures that go against their ethical, moral or religious beliefs. This is also commonly known as a right of conscience.

Medical practitioners include doctors, physicians assistants, nurses, nursing home employees, pharmacists, medical school faculty or students, medical researchers, psychologists and mental health professionals, among others.

Physicians would still need to provide care that does not go against their beliefs, so long as the patient consents, Murman said. Emergency medical treatment is mandated under federal law.

“I believe that this will benefit patients as they will be working with health care professionals that fully believe in what they’re doing,” Murman said.

The bill would apply only to conscience-based objections to particular health care services, Murman said, and would not allow objections to specific patients. Some services could include assisted suicide, gene editing and abortions, though Murman said more could be included.

The bill also provides a minimum $5,000 civil penalty on anyone that forces a practitioner to violate their conscience rights.

Matt Sharp, senior counsel and state government relations national director with Alliance Defending Freedom, testified that the bill would protect medical providers who may not be willing to do controversial procedures. Murman specified assisted suicide, abortion and gene editing as some of these procedures.

Sharp emphasized patients could still go to another physician who may perform the procedure.

However, Dr. Sean Figy, an assistant professor of surgery at the University of Nebraska Medical Center, testifying on behalf of the Nebraska Medical Association, said going to a second provider may not always be available.

“We must educate our patients about what the options are so that they can make a decision for themselves,” Figy said.

Objections to conscience are allowed under the American Medical Association’s Code of Ethics, Figy said, which makes the bill unnecessary.

Dr. Dale Michels, a retired family physician and a representative of the American Academy of Medical Ethics, testified in support. He said requiring providers to provide services against their beliefs leads to worse care, so patients benefit from having providers who believe in what they’re doing.

“In good conscience, I feel I must strongly support the right of the use of conscience in an appropriate way for my fellow healthcare professionals,” Michels said. “To do otherwise would be a violation of my personal conscience in this manner.”

Murman introduced an amendment that would clarify the process a practitioner must follow if they object to a particular service.

The physician would need to notify their supervisor and assist in transferring the patient to another provider at the patient’s request.

This would include promptly releasing medical records.

Julia Keown, testifying on behalf of the Nebraska Nurses Association, said Murman’s bill would place an unreasonable and unconscionable strain on minimally staffed facilities and on patients in rural areas.

She said providers can already decline service based on their competence or training, and some objections to conscience — including abortion — are already allowed.

“No patient should ever be obstructed from receiving legal healthcare based solely on a provider’s personal biases,” Keown said. “Conscience bills such as this one lead to dysfunctional health care delivery and compromise the quality of care by creating barriers to meet our patients’ needs.”

Murman said similar legislation has been passed by Illinois in 1977, Mississippi in 2005 and both Ohio and Arkansas in 2021. He said no legal challenges have been found in these states as a result of the legislation.

Sara Rips, LGBTQ legal and policy counsel for the ACLU of Nebraska, expressed concerns that she, as a Jewish and gay person, could be denied care based on someone else’s beliefs. In her view, the bill provides healthcare providers with an unbridled license to discriminate.

“This bill legitimizes unequal treatment or the denial treatment of patients by healthcare providers, organizations and insurers,” Rips said.

Abbi Swatsworth, executive director of OutNebraska, said she believes the bill could also allow employers to deny counseling to someone exploring their gender identity, blood transfusions to people recovering from COVID-19, in vitro fertilization for families struggling with infertility or HIV prevention medication for sexually active adults.

Murman said the healthcare field is facing shortages, and he hopes his bill would bring more people to medical, nursing or pharmacy schools while protecting diversity of beliefs in the field.

“A person can live out their faith in what they do and not be compelled to go against their beliefs,” Murman said. “I believe that this will bolster the supply of much needed professionals within Nebraska’s healthcare system.”