HB 2816

relating to protection of the rights of conscience of persons from
providing and health care facilities from offering certain health
care services; providing a civil remedy; authorizing disciplinary
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1.  The legislature finds that:
(1)  the public policy of this state is to respect the
conscience of all physicians and health care providers and the
right of each physician and health care provider to hold their own
belief about whether certain health care services are morally
(2)  without comprehensive protections, the rights of
conscience of physicians, health care providers, and health care
facilities may be violated; and
(3)  each physician and health care provider must be
protected from required participation in and each health care
facility must be protected from required provision of a health care
service the physician, provider, or facility for rights of
conscience has declined participation in or provision of and from
discriminatory adverse action resulting from the nonparticipation
SECTION 2.  Chapter 161, Health and Safety Code, is amended
by adding Subchapter Z to read as follows:
SUBCHAPTER Z.  TEXAS HEALTH CARE CONSCIENCE PROTECTION ACT
Sec. 161.751.  DEFINITIONS.  In this subchapter:
(1)  "Conscience" means a sincerely held set of
religious or philosophical moral convictions.
(2)  "Health care facility" means a public or private
organization, corporation, partnership, sole proprietorship,
association, agency, network, joint venture, or other entity that
provides health care services to patients.  The term includes a
hospital, clinic, medical center, ambulatory surgical center,
private physician's office, pharmacy, nursing home, laboratory or
diagnostic facility, infirmary, dispensary, medical school,
nursing school, pharmacy school, or medical training facility.
(3)  "Health care provider" means a nurse, nurse aide,
medical assistant, hospital employee, allied health professional,
counselor, therapist, laboratory technician, clinic employee,
nursing home employee, pharmacist, pharmacy employee, researcher,
medical, pharmacy, or nursing school student, professional,
paraprofessional, or, without regard to whether the person holds a
license, any other person who furnishes or assists in the
furnishing of a health care service.
(4)  "Health care service" means any phase of patient
medical care or treatment.  The term includes:
(A)  examination, testing, diagnosis, referral,
prognosis, dispensing or administering a drug or device, ancillary
research, instruction, therapy, treatment, and preparing for or
performing a surgery or procedure;
(B)  family planning, counseling, and referrals,
and any other advice in connection with the use or procurement of
contraceptives, sterilization, or abortion; and
(C)  record-making procedures, preparation of
treatment notes, and any other care or treatment rendered by a
physician, health care provider, or health care facility.
(5)  "Physician" means an individual licensed to
practice medicine in this state.
Sec. 161.752.  RIGHT TO DECLINE PARTICIPATION IN OR OFFER
HEALTH CARE SERVICE; CONSTRUCTION OF SUBCHAPTER.  (a)  Except as
(1)  a person may decline to participate in a health
care service for reasons of conscience; and
(2)  a health care facility may decline to offer a
health care service consistent with the facility's established
beliefs and rights of conscience.
(b)  A person may not decline to participate in and a health
care facility may not decline to offer the following services:
(1)  emergency medical treatment required by 42 U.S.C.
(2)  except as provided by Chapter 166, life-sustaining
(c)  Nothing in this subchapter may be construed to:
(1)  supersede Chapter 166 governing the provision,
withholding, or withdrawing of life-sustaining treatment;
(2)  apply to emergency medical treatment required by
42 U.S.C. Section 1395dd, life-sustaining treatment, or
cardiopulmonary resuscitation; or
(3)  prevent a health care provider, health care
facility, or health care payer that holds itself out to the public
as religious, includes in its governing documents a statement of
its religious purpose or mission, and has internal operating
policies or procedures to implement its religious beliefs, from
making employment, staffing, contracting, or admitting privilege
decisions consistent with those religious beliefs.
(d)  An exercise of the rights of conscience under this
section is limited to a person's right to refuse to participate in
or a health care facility's right to refuse to offer a specific
Sec. 161.753.  IMMUNITY OF PHYSICIANS, HEALTH CARE
PROVIDERS, AND HEALTH CARE FACILITIES.  A physician, health care
provider, or health care facility may not be held civilly or
criminally liable because the physician or provider declines to
participate in or the facility declines to offer a health care
service wholly or partly for rights of conscience.
Sec. 161.754.  ADVERSE ACTION.  (a)  A person, including a
health care facility, a political subdivision of this state, the
Texas Medical Board or another agency of this state, or a medical
school or other institution that conducts education or training
programs for health care providers violates this subchapter by
taking an adverse action against another person or health care
facility because the other person or health care facility:
(1)  declines to participate in or offer a health care
service for reasons of conscience;
(2)  testifies, assists, or participates in or is
preparing to testify, assist, or participate in a proceeding to
present information about any act or omission that the person
reasonably believes relates to a violation of this subchapter; or
(3)  provides, causes to be provided, or is preparing
to provide or cause to be provided information about any act or
omission that the person reasonably believes relates to a violation
(B)  the attorney general, the Health and Human
Services Commission, or any state agency charged with protecting
health care rights of conscience; or
(C)  the United States Department of Health and
Human Services, the Office of Civil Rights of the United States
Department of State, or any other federal agency charged with
protecting health care rights of conscience.
(b)  Violations under this section include discrimination
against or taking an adverse action with regard to:
(3)  employment terms, benefits, seniority status,
(4)  staff appointments or other privileges;
(5)  denial of admission or participation in a program
for which the other person or facility is otherwise eligible;
(6)  reference to rights of conscience in an
application form for an educational or funding program;
(7)  questions regarding an educational or funding
program applicant's participation in providing a health care
service for rights of conscience;
(8)  imposition of a burden in the terms or conditions
(9)  denial of aid, assistance, or benefits;
(10)  conditional receipt of the aid, assistance, or
(11)  coercion or disqualification of the other person
or facility receiving aid, assistance, or benefits.
Sec. 161.755.  PROTOCOL FOR DECLINING PARTICIPATION IN
PROVISION OF HEALTH CARE SERVICE.  (a)  A health care facility shall
develop a written protocol for circumstances in which a person for
reasons of conscience declines to participate in providing a health
care service, other than emergency medical treatment under 42
U.S.C. Section 1395dd or life-sustaining treatment described by
Chapter 166.  The protocol must:
(1)  assist the patient in accessing the requested
health care service by providing prompt transfer or release of
medical records the patient requests; and
(2)  state the person remains responsible for providing
all other appropriate health care services to the patient other
than the specific health care service for which the person declines
participation for reasons of conscience.
(b)  A person who for reasons of conscience declines
participation in provision of a health care service shall:
(1)  notify the health care facility of the
(2)  comply with the applicable protocol developed
(c)  This section does not permit a protocol developed under
this section regarding a health care service that is contrary to the
conscience of a physician or health care provider to require a
physician, health care provider, or health care facility to counsel
a patient or refer the patient or facilitate the referral of the
patient to another physician, provider, or facility.
Sec. 161.756.  DISCIPLINARY ACTION; COMPLAINT.  (a)  A
physician, health care provider, or health care facility that holds
a license issued by a licensing agency in this state is subject to
review and disciplinary action by the licensing agency for a
violation of this subchapter as if the physician, provider, or
facility violated the applicable licensing law.
(b)  A person who is injured by a violation of this
subchapter may file a complaint with the licensing agency that
issued a license to the physician, health care provider, or health
care facility that allegedly violated this subchapter.
(c)  A physician or health care provider may not file a
complaint with the appropriate licensing agency under this section
unless the physician or health care provider complies with the
health care facility's protocol developed under Section 161.755.
Sec. 161.757.  CIVIL REMEDIES.  (a)  A person or health care
facility that is injured by a violation of this subchapter may bring
a civil action against another person, entity, or political
subdivision of this state that violates this subchapter.  A person
or facility that brings an action under this section may obtain:
(2)  damages incurred by the person or facility,
(A)  actual damages for all psychological,
emotional, and physical injuries resulting from the violation of
this subchapter, as applicable;
(C)  reasonable attorney's fees; or
(3)  both injunctive relief and damages.
(b)  Governmental immunity is waived and abolished to the
extent of liability under this section.
SECTION 3.  Not later than December 1, 2025, a health care
facility, as that term is defined by Section 161.751, Health and
Safety Code, as added by this Act, shall adopt protocols required by
Section 161.755, Health and Safety Code, as added by this Act.
SECTION 4.  Section 161.753, Health and Safety Code, as
added by this Act, applies only to a cause of action that accrues on
or after the effective date of this Act.
SECTION 5.  This Act takes effect September 1, 2025.