OK bill would allow providers to deny care that violates their conscience
S E E D E D C O N T E N T
Alexia Aston - The Oklahoman
- AI-assisted summary
- Oklahoma House Bill 1224, which would allow medical practitioners to refuse service based on conscience, passed with a 70-28 vote.
- The bill's author, Rep. Kevin West, R-Moore, said the bill's language is modeled after a similar law passed in Montana in 2023.
- The bill now moves to the Oklahoma Senate for consideration, where a similar bill, SB 959, failed in committee earlier this year.
Health care institutions and payors in Oklahoma may soon be granted the right to deny services that violate their conscience after a bill from Rep. Kevin West, R-Moore, saw recent success on the House floor.
House Bill 1224 passed on the House floor in a 70-28 vote and could allow medical practitioners to refuse health care to a patient if the service violates their conscience. Critics say the proposed law would adversely affect LGBTQ+ Oklahomans seeking gender-affirming care, along with women needing an abortion.
"With this in place, a provider would be able to have that right of refusal unless it's an emergency situation," West said about the bill on Wednesday.
The Moore representative has routinely authored bills targeting LGBTQ+ Oklahomans and access to abortion. This year, he authored a bill that sought to ban government agencies from displaying Pride flags and another that would bar Oklahomans from amending the sex designation on their birth certificates. Neither met requirements for passage.
Last year, West authored a controversial bill that ultimately went dormant, but would have allowed for civil lawsuits against those who help women obtain an abortion, and required physicians to report each provided abortion. The bill would have seemingly created a database, assigning each woman who obtained an abortion a "unique patient identifier" that would allow them to be identified by the Oklahoma State Department of Health.
On Wednesday, West said he received support for HB 1224 from several conservative and religious health care organizations, including the Association of American Physicians and Surgeons, American College of Pediatricians, Christian Medical and Dental Associations, Catholic Medical Association, American Association of Pro-Life OBGYNs and National Association of Pro-Life Nurses.
West added that the bill comes from the Alliance Defending Freedom (ADF), an American conservative Christian legal advocacy group. Rep. Arturo Alonso-Sandoval, D-Oklahoma City, asked West if he knew the ADF was considered a hate group by the Southern Poverty Law Center.
"I was not aware of that," West answered. "We've had two different versions of this bill. This particular language is mirrored after the Montana language that was passed a few years ago. But Alliance Defending Freedom does support this language."
The law in Montana was passed in 2023 and provides legal protections to health care practitioners who refuse to prescribe marijuana or participate in procedures and treatments such as abortion, medically assisted death, gender-affirming care, or others that run afoul of their ethical, moral, or religious beliefs or principles.
The Oklahoma Senate saw a partner bill to HB 1224, authored by Sen. Julie McIntosh, R-Porter. Senate Bill 959 largely mirrors HB 1224's language, and failed in committee with bipartisan disapproval.
"Do you think this is the best use of our time today considering the fact that the Senate has determined that they're not going to move forward with their version, and they have rules that say if a bill has the same effect covering the same specifics or substantially similar subject matter that they can't consider in the same legislature?" Rep. Forrest Bennett, D-Oklahoma City, asked West on Wednesday. "Do you share my concern that we're wasting time because this isn't going to go anywhere?"
West replied, "We don't know exactly what they're going to do with this bill."
Bennett also asked whether West is concerned that his bill might place further restrictions on providers having to determine if they can provide an abortion for someone facing a medical emergency.
"Do you share my concern that people are going to be at greater risk of serious, permanent health issues or death because of this legislation?" Bennett asked.
West answered by pointing to a section in his bill that prevents medical professionals from refusing to provide emergency medical treatment.
Anti-abortion laws have already created confusion for Oklahoma doctors
But Oklahoma's restrictive abortion laws have already created confusion for doctors. In 2023, a woman from Meeker was turned away from several hospitals while her pregnancy was causing vaginal bleeding and high blood pressure along with other symptoms defined by a partial molor pregnancy.
Similar cases have been documented across the country in states with restrictive abortion bans, some resulting in deaths.
If passed by the Senate and signed by Gov. Kevin Stitt, HB 1224 would require health care payors to list services they may refuse to pay for on the basis of conscience. The bill would exempt practitioners, institutions and payors from legal liability for refusal to participate in such services.
"If you are a hospital or a facility that provides treatment, in order for that facility to claim the right of conscience, and this is in the bill, it has to be part of their governing documents, including but not limited to published ethical or religious guidelines or directives, mission statements, constitutions, articles of incorporation, bylaws, policies or regulations," West explained.
In a statement, Nicole McAfee, executive director of LGBTQ+ advocacy group Freedom Oklahoma, said bills like HB 1224 are cloaked in language about ethics and morality, but they're ultimately a license to discriminate against groups who already face disproportionate barriers to accessing health care.
"It's disappointing to see the House again ignore the best interest of constituents across the state and advance this policy that we know will create further medical mistrust rooted in real fear and potential for harm all while making care less accessible in a state where accessibility is already a barrier at the expense of people's quality of life," she said. "2SLGBTQ+ community members know too well that religious refusal in practice comes in the form of discrimination against marginalized and excluded communities, and the inability to access medically necessary care."
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MAGA!
God help OK if they have a large number of doctors that follow the Jehovah's Witness beliefs.
I’m wondering if this is a problem that actually comes up a lot. From what I’ve seen with most bills like this, I’d guess not. Outside of an emergency, are you likely to try to get a doctor to do some treatment or procedure on you that they are uncomfortable with? Who has been forcing doctors to operate on them? Anyone?
I’m sure conservatives are only thinking about abortion or gender affirming care with this bill, but what if some liberal doctor decides he doesn’t want to treat cancer or heart disease in a conservative patient because he considers their politics immoral? Or maybe it’s not even political and he just disagrees with the patient’s lifestyle in some way.
I mean, you kinda just hope doctors generally are better people than their legislators clearly are, so hopefully this unnecessary legislation never ends up being enforced for anything.
This is the internal strife that threatens a sense of Community. Conservatives don't want to do anything for "others" in a sense of fair play. Their 'bent' is always cut to their particular biases.
Their argument is Americans should be legally free to associate and disassociate from anybody they choose to not serve. (Yes, that is reasonable in one sense.)
Whereas, liberals have a mindset that largely says we are willing to help all that 'come' into and have a sense of the Community. Being part of the whole. For liberals it is a consciousness of inclusion. For conservatives, it remains (a freedom to) exclusion.
All of this is rooted in our constitution. A truly conservative document written for the conservative times at its appearing. Today's conservatives take advantage of the document's lack of scientific knowledge and inspiration to try to hold this country down to 'old-fashioned' standards of conduct and character.
BTW, there is no truth "originalism" inherent in our constitution. Conservatives made it up and popularized the. . . idea. . . on an ignorant public either too weak to confront and question it or just don't care enough (sense the notion does not disturb them personally) that it checks the progress of this country.
So this is what conservatives do. They sit around obsessing on how to 'defeat' our conservatively written constitution where it liberates the underserved minorities. Can anything be more frustrating to honest, sincere, and decent people?
It is basically a "We reserve the right to refuse service to anyone" law for doctors. Which is not legal for restaurants or department stores...
No it isn't. They can't pick and choose who they provide service to.
It protects doctors from being forced by the state to perform procedures that violate their conscience. I know progressives loves authoritarianism and forcing people to comply with their moral beliefs, but even progressives should see the problem with forcing doctors to perform procedures against their will.
The fact is, no one should want an emotionally crippled doctor or team with such a physician involved in their healthcare. He or she will be distracted and accordingly will have to compel oneself to return to the task at hand while lacking a single-minded focus. (A double-minded physician.)
Of course, the clause, "emergency treatment' is in the moment and most professionals don't have time for their biases to kick-in; as training takes over immediately.
I will agree with that comment in one regard: Liberals would fare better in these types of discussions if they simply understand that there are conservatives that really despise the inclusion of certain groups and classes of people under their sense of community. And will wage political warfare continually to exclude those groups and classes at great cost of dividing the community in quarters, halves, or whole.
Lol. It's about procedures. Not people. Doctors can't refuse to treat someone because of their race creed etc...
The state cannot force a lawyer to defend a client the lawyer doesn't want to, nor even provide type of service if a lawyer the doesn't want to.
I am not sure what distinction you are making that is relevant to my comment. Of course this is about a procedure or several listed procedures determined by any doctor to be against his or her conscience. . . and since conservative evangelicals have a litany of medical procedures for which they can choose to be offended. . . apart from whether the procedure is sanctioned by the medical/scientific/legal professions of the state. . . Oklahoma's conservative physicians are requesting state approval to be set apart from those procedures except in the rare occasion where it is life or death (emergency medical) and then it would have to be determined to what extent are they up to date in professional training and certification/s on said procedures.
Like what? What state is forcing doctors to do procedures? What doctor knows how to do a procedure that violates their conscience? Doctors tend to specialize. Why would you go into a field where you don't want to do the work? Why would the state force a doctor to something he has no experience with?
Every doctor I know belongs to a group or an association that can find someone to cover just about anything on the occasion. Whenever I need a procedure done, they consult one another. I have made it quite clear that wearing MAGA or similar buttons in a healthcare workplace is wrong. All of those people get to tell me they are "booked" or otherwise not available and I don't care; we both avoid having to work with assholes. /s
Except the colonoscopy guy, he apparently doesn't mind assholes.
Are they required to post what procedures they will not perform so patients can see them before seeing that doctor?
It's an objection to the procedure, not the patient. For instance, an abortionist, who as an ode to Margaret Sanger would only provide abortions to black women, would not be protected. But a doctor who didn't want to provide abortions to anyone would be.
You went from “abortionist” to “doctor.” So, we’re having one of those apples and oranges comparisons?
Not every doctor performs abortions because not every doctor is in that field of medicine. If a doctor is in that field, why would he object? If he’s not in that field, why would anyone go to him for the procedure?
This bill appears to be a solution in search of a problem.
Playing devil's advocate here...
It is Oklahoma. It has half as many people as DFW. I can imagine a possibility where there is some pediatrician in Nowhere, Oklahoma (real place) has somebody come in to transition their child. The doc objects morally, but he's the only doc for 50 miles in any direction, so a fight ensues.
I admit it's a stretch. But it's Oklahoma. These are the people who brought you anti Sharia Law legislation, to protect themselves from the Muslims... both of them.
Just following your example. Though the law deals with a doctor refusing to perform a specific procedure, you subsituited an example of a Doctor refusing to treat a patient on the basis of a patient's politics, rather than a general objection to the procedure. So I provided an example of your mistaken example , an abortionist (who is also a doctor for your information) who is perfectly happy providing abortions, but refuses to provide abortions to certain classes of patients to show how that is, and will still be illegal under this law.
I hope that clears up your confusion.
No, they’re different things, and trying to just echo my argument structure only confuses things. I’d appreciate it if you just made your own argument on your own point. I’ll clarify mine.
I was showing that if a doctor could refuse to do a procedure on moral grounds (related to the procedure or the patient), he could refuse to treat someone for all sorts of reasons. If you’re confused, I’ll tell you why it’s about more than the procedure, and the patient is also relevant.
Consider a plastic surgeon who does breast augmentation. As a specialist in the field, he obviously doesn’t object to the procedure. He chose to do this work.
He enhances women who want larger breasts, does reductions for women who want smaller breasts, and does reconstruction for women who have had mastectomies. But he won’t do any of those procedures on a man. Here, the patient is what makes the difference. The doctor has no objection to the procedure, in and of itself.
And so a heart surgeon might be unwilling to do a bypass on a guy who won’t quit eating too much or won’t quit smoking. Or maybe he just refuses service of any kind because he doesn’t like his politics.
I really think almost every doctor is going to feel free to say “I don’t do that.” Because he probably doesn’t. It’s really niche stuff. Your average pediatrician isn’t going to have much, if any, training or experience with it. It would likely be malpractice for anyone but a specialist to treat such a patient. I doubt the doctor even gets as far as morality in his decision process.
You're correct on this.
Physicians are expected to recognize and practice within their abilities. When my sister ruptured a disk, her insurance only had one surgeon at the hospital where she worked who was in-network, and insisted that she see him. He didn't do any surgeries involving the spine. Period. Was it legal for him to do so? Yes. He was a general surgeon, and technically could do any surgery. But he had no interest in doing spinal surgeries, did no updated training on those particular surgeries, and refused to do hers. Nor did she want him to. You don't want the guy who hasn't done spinal surgery since his residency, if he even did one then, mucking around with your spine.
As a dentist, it is legal for me to do any oral and maxillofacial surgery, up to and including orthognathic surgery to move people's jaws around or reconstructive surgeries after, for example, trauma or cancer treatment. I don't do those because I recognize that I do not have the training to do so. Not even now that the only oral surgeon in our rural area who does them, so far as I know, is nearing retirement and the nearest place to have it done is several hours' drive away. It would be malpractice for me to even attempt it.
And she is very good at what she does
Thank you!
OK. Probably.
But the law isn't about what the doc would feel free to do, it's about what the crazy parent would try to take to court.
Well... let's be honest... the law is about political grandstanding and pandering to the members of First Baptist Church of *insert your tiny town here*.... but in theory it's supposed to protect medical providers from that kind of thing.
It does sort of seem like a "solution" looking for a problem.
Jinx!
If one has an issue with their conscience, perhaps they should be in a profession where their conscience would not be challenged. Performing a medical procedure should be based on a practitioners ability, certifications, and the risk/benefit to the patient.
Right or wrong, some people are their ethos. Case in point: Zealots of all stripes.
And so, here is this state representative bringing to the front the concerns of those members of Oklahoma society whom are passionate against certain groups inside their state. It's sad that we can't all get along. On the other-hand, for many others in Oklahoma it can be a 'blessing' and a good thing to know who to watch out for when it comes to the laying on of hands for healing. So s/he can be disqualified and removed from consideration of care.
That's the problem. People become irrational and let emotion overrule reason.
Politicians like the one discussed in the article, would like to state that they are reasonably dispassionate on these matters of freedom and liberty for religious people, but they are caught on the horns of a dilemma. The lie is easily exposed, when one realizes that 'everything' about the Christian-Right (and every other religion) is based on emotional regard for what a Deity is thought to 'want' from them- reason notwithstanding.
(Strange coming from me, eh? No it is not. I have always stood for what is right and wholesome in any given situation. Never agreeing with anything or anybody just because is customary to do so.)
When politicians say anything, I'm immediately skeptical.
That would be my position on the issue. If one is so religious they should work for the church, but then again RCC does own a fuck ton of medical providers.
Perhaps outlawing religious groups from owning and operating secular business will bring the country forward? If Congress can pass a law making one particular foreign entity (China/TikTok) then can't Congress pass another making the Catholic Church close their businesses?
That would probably lead to a legal constitutional issue.
How so? No one would be interfering with religious practices unless they are claiming hospitals are religious institutions on par with churches and doctors hold the same ranks as Priests. Then forbid them from charging any fees.
I have little doubt some would make that claim. Or at the very least vociferously whine and complain.