HB-5276, As Passed House, April 21, 2004                                    

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                              SUBSTITUTE FOR                                    

                                                                                

                           HOUSE BILL NO. 5276                                  

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 A bill to allow certain health facilities to object to                            

                                                                                

    providing or participating in certain procedures under certain              

                                                                                

    circumstances; and to provide for protection from certain                   

                                                                                

    liability.                                                                  

                                                                                

                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      

                                                                                

1       Sec. 1.  As used in this act:                                               

                                                                                

2       (a) "Health care service" means the provision or withdrawal                 

                                                                                

3   of, or research or experimentation involving, a medical                     

                                                                                

4   diagnosis, treatment, procedure, diagnostic test, device,                   

                                                                                

5   medication, drug, or other substance intended to affect the                 

                                                                                

6   physical or mental condition of an individual.                              

                                                                                

7       (b) "Health facility" means any of the following:                           

                                                                                

8                                                                                (i) A clinical laboratory.                                                          

                                                                                

9       (ii) A county medical care facility.                                         

                                                                                

10      (iii) A freestanding surgical outpatient facility.                           

                                                                                


                                                                                

1       (iv) A home for the aged.                                                    

                                                                                

2       (v) A hospital.                                                             

                                                                                

3       (vi) A nursing home.                                                         

                                                                                

4       (vii) A hospice.                                                             

                                                                                

5       (viii) A hospice residence.                                                   

                                                                                

6       (ix) A facility or agency listed in subparagraphs (i) to (vi)                 

                                                                                

7   located in a university, college, or other educational                      

                                                                                

8   institution.                                                                

                                                                                

9       (x) A private physician's office.                                           

                                                                                

10      (xi) A medical clinic.                                                       

                                                                                

11      (xii) A public or private institution that provides health                   

                                                                                

12  care services to an individual.                                             

                                                                                

13      (xiii) A teaching institution that provides health care                       

                                                                                

14  services to an individual.                                                  

                                                                                

15      (xiv) A pharmacy that provides health care services to an                    

                                                                                

16  individual.                                                                 

                                                                                

17      (xv) A corporation, partnership, sole proprietorship, limited               

                                                                                

18  liability company, or other legal entity that provides health               

                                                                                

19  care services to an individual.                                             

                                                                                

20      (c) "Health profession" means a vocation, calling,                          

                                                                                

21  occupation, or employment performed by individuals acting                   

                                                                                

22  pursuant to a license or registration issued under article 15 of            

                                                                                

23  the public health code, 1978 PA 368, MCL 333.16101 to 333.18838.            

                                                                                

24  However, health profession does not include a vocation, calling,            

                                                                                

25  occupation, or employment performed by an individual licensed or            

                                                                                

26  registered as a sanitarian or a veterinarian.                               

                                                                                

27      (d) "Participate" or "participating" means, at a minimum, to                


     House Bill 5276 (H-2) as amended April 21, 2004     (1 of 2)

   

1   counsel, refer, perform, administer, prescribe, dispense, treat,            

                                                                                

2   withhold, withdraw, diagnose, test, evaluate, train, research,              

                                                                                

3   prepare, or provide medical advice or material or physical                  

                                                                                

4   assistance in a health care service.                                        

                                                                                

5       (e) "Public health emergency" means a condition or situation                

                                                                                

6   that presents an immediate threat to the public health, safety,             

                                                                                

7   or welfare and requires immediate action to preserve the public             

                                                                                

8   health, safety, or welfare.                                                 

                                                                                

9       Sec. 2.  (1) Notwithstanding any other provision of law, a                  

                                                                                

10  health facility may withdraw or withhold from providing a health            

                                                                                

11  care service, or may refuse to provide or participate in a health           

                                                                                

12  care service, on [             ] ethical, moral, or religious               

                                                                                

13  grounds as reflected in its organizational documents, charter,              

                                                                                

14  bylaws, or an adopted mission statement.                                    

                                                                                

15      (2) A health facility shall not assert an objection described               

                                                                                

16  in subsection (1) under any of the following circumstances:                 

                                                                                

17      (a) The objection is to a health care service the health                    

                                                                                

18  facility routinely provides or participates in and is based on a            

                                                                                

19  disagreement with a member of a health profession employed by,              

                                                                                

20  under contract to, or granted privileges by the health facility             

                                                                                

21  regarding the medical appropriateness of a health care service              

                                                                                

22  for a specific patient if the patient has consented to the                  

                                                                                

23  provision of the health care service.                                       

                                                                                

24      (b) In the event of a public health emergency.                              

         [(c) In the event of an emergency where a patient's condition, in the reasonable medical judgment of an attending physician or medical director, requires immediate action to avert serious injury, harm, impairment, or death or is such that a delay would create a serious risk of substantial and irreversible impairment of a major bodily function to that patient.

     (3) This act does not relieve a health care facility from a duty that exists under another statute or other law pertaining to medical standards of acceptable health care practice and procedures.                                            

25      (4)] A health facility's objection as described in subsection               

                                                                                

26  (1) to providing or participating in a health care service shall            

                                                                                

27  not be a basis for 1 or more of the following:                              


                                                                                

1       (a) Civil, criminal, or administrative liability.                           

                                                                                

2       (b) Eligibility discrimination against the health facility in               

                                                                                

3   a grant, contract, or program, unless providing or participating            

                                                                                

4   in the health care service is the exclusive purpose for the                 

                                                                                

5   grant, contract, or program.