Ky. Legislature may let workers refuse to do medical services that violate their conscience

A Kentucky Senate committee greenlit legislation Wednesday that would let doctors, nurses, pharmacists and other health workers refuse to participate in a medical service if it violates their conscience.

Patients could find it harder to access a variety of treatments if Senate Bill 239 becomes law.

Republican state Sen. Donald Douglas of Nicholasville, a doctor who is the bill’s lead sponsor, said SB 239 is a step toward addressing a shortage of physicians in Kentucky.

He said a number of colleagues over the years have told him their job was threatened if they didn’t do “what they were being asked to do,” and he said such concerns factor into doctors’ decisions about where to practice medicine.

“This law is meant to give them some recourse that they can actually depend on,” he said.

The bill would extend conscience protections to doctors, but also to other types of professionals and even to hospitals, nursing homes and other health care institutions.

SB 239 would protect workers and institutions in these circumstances from criminal or civil liability, as well as certain professional sanctions.

Democratic state Sen. Cassie Chambers Armstrong of Louisville asked Douglas at the meeting if the bill includes a guarantee that patients won’t be harmed as a result of a health care professional citing their conscience to deny a service.

“There are no guarantees in life,” Douglas replied. “Anyone in the health care space will tell you: When you get out of bed in the morning, if you have a cat, there is no guarantee that you will not trip over that cat and break your hip.”

The Kentucky Nurses Association opposes SB 239. CEO Delanor Manson told LPM News the conscience bill violates their code of ethics, which requires nurses to respect human dignity for every patient.

“The code of ethics doesn't give you leeway in terms of morals. It says you provide care to patients based on their need,” she said. “So, what the health care provider is experiencing is not the most important thing. What's the most important thing is that every patient and their family get what they need in order to have quality care.”

Nurses need to know about biases — their own and other people’s — to ensure standards of quality care are met, she said.

The Kentucky Medical Association has taken no position on SB 239, communications director Emily Schott told LPM News via email. She said the American Medical Association’s code of ethics already addresses the conscience issue for physicians.

The AMA code says doctors should have “considerable latitude,” but not unlimited freedom, to practice medicine in accordance with their conscience.

Various people opposed to SB 239 have warned that health care workers could refuse to provide antidepressants, vaccines, HIV prevention medication, addiction treatments and other necessary health care.

They also said the bill could give professionals a legal excuse to discriminate against patients based on who they are.

There’s a national, right-wing push to pass medical ‘conscience’ laws. A staffer for the influential Christian legal organization Alliance Defending Freedom was one of Douglas’ guests at a meeting last week to support SB 239.

ADF lawyers won U.S. Supreme Court rulings that overturned Roe v. Wadeand affirmed business owners’ ability to decline services to LGBTQ customers. The Southern Poverty Law Center, which “monitors and exposes the activities of the American radical right,” designates the ADF as an anti-LGBTQ+ hate group.

The Kentucky Legislature considered passing a “conscience” bill at least twice in recent years, but the proposals never made it across the finish line. Douglas is making a fresh attempt.

Senate Bill 239 made it over its first hurdle Wednesday when the Senate Health Services Committee cleared it for a future vote by the full Senate. The committee chairman, Republican state Sen. Stephen Meredith of Leitchfield, cosponsored Douglas’ bill.

An earlier version of SB 239 would’ve let health insurance companies refuse to pay for services that violated their conscience, but that provision was removed from the bill Wednesday.

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