Arizona Arkansas California Colorado Summary of State Laws Protecting Rights of Conscience-July 8, 2002-Continued Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana lowa Kansas Kentucky Maine Maryland Massachusetts Michigan Missouri A.R.S. § 36-2151 Hospital, physician or other medical personnel may refuse to perform an abortion for moral or religious reasons. A.C.A. § 20-16-304, 601 (2001) No person or hospital has to participate in an abortion. Medical personnel may refuse to give contraceptives or information about such things if it is against their religious beliefs. Cal. Health & Safety Code 123420 A physician, nurse or other hospital employee may refuse to participate in an abortion for moral or religious reasons. Admission to a school may not be denied due to applicant's unwillingness to participate in an abortion. Non-profit facility or religious hospitals do not have to perform abortions. C.R.S. 18-6-104 (2001) Hospital does not have to admit a person for the purpose of performing an abortion. A person who is an employee at a hospital does not have to perform an abortion if it is against his morals or religious principles. C.R.S. 25-6-102, 207 (2001) No private institution or physician is required to give out contraceptive. A county or city employee may refuse the duty to supply contraceptives. Conn. Gen. Stat. § 19a-580a (2001) Any physician who does not wish to comply with a living will must transfer the patient. 24 Del. Code Ann. 1791 No person is required to participate in an abortion. No hospital has to participate. Fla. Stat. § 390.0111 (2001) Hospital and person do not have to participate in abortion if it against moral or religious principles. Fla. Stat. § 381.0051 (2001) Physician or other person may refuse to give contraceptives for medical or religious purposes. O.C.G.A. § 16-12-142 (2001) No person or hospital shall be required to perform an abortion when it is against his moral or religious principles. O.C.G.A. § 49-7-6 (2001) Any employee can refuse to provide family planning services if it is contrary to his religious beliefs H.R.S. §453-16 Nothing in this section shall require any hospital or any person to participate in such abortion nor shall any hospital or any person be liable for such refusal. Idaho Code § 18-612 (2002) No hospital or person shall be required to perform an abortion if it is ob- 745 ILCS 70-Rights of Conscience are protected for all procedures. Sec. 11.2-Health Care Payers are lowa Code § 146.1&2 (2002) No person shall be required to perform an abortion if it against his moral K.S.A. § 65-443, 444 (2001) No person or hospital is required to perform an abortion. Refusal to do so is not grounds for civil liability against any person. KRS § 311.800 (2001) No public funds shall be used to perform an abortion. No private hospital or person shall be required to perform an abortion. La. R.S. 40:1299.31 to 32 (2002) No person in the medical field can be liable for refusing to participate in abortion. No social service worker is liable for refusing to recommend abortions. No hospital shall be required to perform an abortion. 22 M.R.S. § 1591-2 (2001) no person or hospital is required to perform an abortion. No hospital, firm, or education institution can discriminate for a person's refusal to perform an abortion. 22 M.R.S. § 1903 (2001) A private institution or physician or their agent may refuse to provide family planning services if it is against their religious or moral beliefs. Md. Health-General Code Ann. § 20-214 No person or hospital has to participate in an abortion, artificial insemination, or sterilization. There is no immunity if a person's referring the patient to a source of pregnancy termination would have prevented death or long lasting injury. Mass. Ann. Laws ch. 112, § 121 (2002) Any person who objects to abortion or sterilization will not be required to participate. Such an objection will not be used against a person to keep him out of medical school, social work, etc. MCLS § 333.20181, 20182 (2002) No hospital, teaching institution or person connected with such a facility is required to perform an abortion if objected to on professional, moral, or religious grounds. Minn. Stat. Ann. 145.414, 145.42 No hospital or person is liable if they refuse to participate in an abortion. No health Plan company will be held liable for not providing abortions. Miss. Code Ann. § 41-41-215 "A health-care provider may decline to comply with an individual instruction or health-care decision for reasons of conscience." §197.032 R.S.Mo. No person or public or private hospital shall be required to treat a person for abortion. § 188.110 R.S. Mo. (2001) No employer can discriminate against employees for their refusal to participate in an abortion. § 188.110 R.S.Mo. (2001) No school can deny admittance for a person's refusal to participate in an abortion Montana Nebraska Nevada Summary of State Laws Protecting Rights of Conscience-July 8, 2002-Continued New Hampshire New Jersey New Mexico New York Mont. Code Anno., § 50-20-111 (2001) No private hospital need provide abortion. All persons have the right to refuse or participate in an abortion. Person can mean individual or corporations. Mont. Code Anno. § 50-5-502 to 505 No hospital or medical facility or persons shall have to perform sterilization. Person has the right to injunctive relief or monetary damages. Hospital or medical facility shall not loose any privileges or immunities. Neb. Rev. Stat. 28-337 No hospital in the state, public or private, must perform an abortion, but it must inform the patient of this policy. Nev. Rev. Stat. 632.475-Nurse or somebody providing direct assistance to a patient does not have to assist in an abortion if it is against her morals RSA 137-H:6 (2002) A physician who, for conscience sake, cannot comply with a living will shall without delay transfer the patient to another physician. N.J. Stat. § 2A:65A-1 "No person shall be required to perform or assist in the performance of an abortion or sterilization." N.J. Stat. § 2A.65A-2 "No hospital or other health care facility shall be required to provide abortion or sterilization services or procedures. N.J. Stat. § 2A:65A-2 No civil liability for those who refuse to perform abortion or sterilization. N.M. Stat. Ann. § 30-5-2 (2001) No person or hospital has to participate in abortion for moral or religious reasons N.M. Stat. Ann. § 24-8-6 (2001) No hospital is required to admit a patient for sterilization if done so on religious grounds. NY CLS Civ R § 79-i (2002) No person shall be required to perform an abortion if it is against his conscience or religious beliefs. North Carolina N.C. Gen. Stat. § 14-45.1 Physician or nurse do not have to perform abortion if it is against their religious principles. A hospital or healthcare institution does not have to offer abortions. North Dakota Ohio Oklahoma Pennsylvania Rhode Island South Carolina Tennessee Texas Utah Virginia N.D. Cent. Code, § 23-16-14 (2002) NO hospital or person shall be required to perform an abortion. ORC Ann. 4731.91 (Anderson 2002) No public or private hospital or person has to participate in an 63 Okl. St. § 1-741 No Private hospital or person has to participate in an abortion. Or. Rev. Stat. 435.485 (2001) No physician must give advice to a patient concerning abortion, but he must advise the patient. No hospital employee is required to participate in an abortion. Or. Rev. Stat. § 435.225 (2001) "Any employee of the Department of Human Services may refuse to accept the duty of offering family planning and birth control services" if it conflicts with religious principles. 18 Pa. C. S. § 3202 (2002) Right of Conscience is protected for all person who desires to not provide an abortion. 18 Pa. C.S. § 3213. Except for a facility devoted to abortions, no facility is required to perform abortions, 43 P.S. $955.2 (2002) No hospital or person is required to perform an abortion or sterilization. No S.C. Code Ann. § 44-41-40 (2001) No private institution is required to perform an abortion. Tenn. Code Ann. § 39-15-204, 205 (2001) No hospital or person need provide an abortion. Tenn. Code Ann. § 68-34-104 No private institution or physician is required to provide contraceptive procedures or supplies if refusal is based on conscientious or religious objections. Tex. Occ. Code § 103.001, 002 (2002) No physician, nurse or employee of a hospital maybe required to participate in an abortion. Tex. Occ. Code § 103.003 (2002) A person whose rights are violated may sue the hospital, medical facility or educational institution for an injunction plus affirmative relief, including reinstatement, backpay plus 10% Tex. Occ. Code § 103.004 Hospital need not provide abortions. Tex. Ins. Code Ann. art. 20A.09(m)—No, HMO, physician, or provider is required to recommend or provide services that violate religious convictions. Utah Code Ann. § 76-7-306 (2001) No person shall be required to perform an abortion if it is against his moral or religious beliefs. No private or denominational hospital shall be required to perform abortions. Va. St. § 18.2-75 A hospital, medical facility or physician do not have to perform abortion. Summary of State Laws Protecting Rights of Conscience-July 8, 2002-Continued Washington Wash. Rev. Code Ann. 70.47.160 (2002) No HMO need provide or pay for services that are religiously objectionable. Wash. Rev. Code Ann. § 70.122.060 (2002). No nurse, physician, or other health care practitioner may be required by law or contract in any circumstances to participate in the withholding or withdrawal of life-sustaining treatment if such person objects to so doing West Virginia... W. Va. Code § 16-2F-7 (2001)-No person need participate in and abortion if they refuse for medical reasons or any others. Wisconsin W. Va. Code § 16-2B-4 (2001) Any employee of the state may refuse the duty of providing family planning services. W. Va. Code § 16-30-12 A health care facility does not need to change it policies that are grounded in A health care provider need not provide service that is contrary to its religious beliefs. (Living Wills etc.) Wyo. Stat. § 42-5-101 (2001) Any person may refuse the duty of providing family planning or birth con- Mr. BILIRAKIS. Thank you, Mr. Wardle. I felt compelled to introduce the legislation that we are discussing today, because the intent of the legislature has always meant an awful lot to me. And in trying to determine what was intended, I reach to these additional views signed by Senators Bill Frist, McConnell, Gregg, Hutchinson, Coats and DeWine, where they said, "We believe that the term 'health care entity," "and I don't know how anyone can, in my opinion, look at it logically and come to the conclusion that a health care entity could exclude a hospital. But we believe that the term, "health care entity," was intended to be read in the straightforward manner of including not only the specific entities mentioned but also those which are routinely seen as health care entities in common usage and other Federal laws, such as a hospital, provider-sponsored entity, health maintenance organization, health plan, et cetera, et cetera. So that is why I felt compelled to do this, because, as Mr. Wardle said, there is a gap there I am not sure if you used that exact word—and we have got to try to fill that gap. Ms. Vosburgh Ms. VOSBURGH. Yes. Mr. BILIRAKIS. [continuing] You have indicated that, if I understood you correctly, there is a provider across the street from the hospital Ms. VOSBURGH. Yes. Mr. BILIRAKIS. [continuing] who performs Ms. VOSBURGH. Yes, that is abortions. Mr. BILIRAKIS. [continuing] elective abortions. Ms. VOSBURGH. Abortionist lamage, yes. Mr. BILIRAKIS. So if Valley Hospital were afforded conscience protection, then it is likely that women would still have access to elective abortions, correct? Ms. VOSBURGH. Yes, they would. In fact, she does her first term trimester abortions in her own clinic. Mr. BILIRAKIS. In her own clinic. Ms. VOSBURGH. She uses the hospital for second trimester abortions. Mr. BILIRAKIS. Well, could she perform the second trimester abortions in her own clinic? Ms. VOSBURGH. No. Mr. BILIRAKIS. She could not. Ms. VOSBURGH. No. It is a State law; she has to use the hospital. Mr. BILIRAKIS. Okay. Ms. VOSBURGH. But, you know, why should we be forced to Mr. BILIRAKIS. How many-I don't know the answer to this, and I guess it is always dangerous to ask a question you don't know the answer to but how many hospitals are there in the valley? Ms. VOSBURGH. Just one. Mr. BILIRAKIS. Just one. Ms. VOSBURGH. Anchorage is about 50 miles away. Mr. BILIRAKIS. About 50 miles away. Are there hospitals there where there may not be a problem regarding their conscience in terms of performing abortions? Ms. VOSBURGH. Providence is a Catholic hospital; it will not allow abortions there either. But there is always a regional-there is the Vets Hospital, so I am not sure if she would do her second trimester abortions there. My suggestion would be to her to build her own facility if she wants to do second trimester abortions. Mr. BILIRAKIS. Okay. Do you feel then that your experience in Alaska-you obviously feel very strongly about this point, but do you feel that that experience presents a compelling argument for clarifying Congress' original intent in providing Federal conscience protections? Ms. VOSBURGH. Yes. I believe if this had been in place solidly, that this probably would not have happened. Mr. BILIRAKIS. Yes. It is just unfortunate. Sometimes you can't see the forest for the trees up here, and you are just so overloaded with so many things on your plate that the intent of the Congress at the time was not played out accurately in terms of what was meant by "health care entity." Ms. VOSBURGH. One thing I did want to mention is the cases that I brought up here are hard cases the rape, incest and life of the mother-which are you know, those are the ones that are tearwrenching and things. But the fact of the matter is even Planned Parenthood admits that 95 percent and more some people say only 1 percent-are for life, incest and rape. So 95, 96, 97 percent of all abortions are for nearly birth control purposes. Why should we Mr. BILIRAKIS. Well, let us not—yes. I don't disagree with you. Let us not go into that. Ms. VOSBURGH. All right. Mr. BILIRAKIS. Mr. Weiss, you mention in your testimony that you oppose extending conscience clause protections to other health care entities because, using your words, "Its burdens fall primarily on those who do not share the beliefs that motivate the refusal." Would you agree that forcing a Catholic hospital, which is based on a faith that finds abortion objectionable, and I think you would agree with that, to perform abortions would also place a burden on that entity based on a belief that this institution does not share if we are talking about placing a burden? MS. WEISS. Chairman, it is a matter of balancing the rights involved. The question there is what kind of institution is it? Let us just take for a minute Valley Hospital as against an institution that I think would be entitled in many cases to exemptions from the public health laws, which would be a privately funded Christian Science Sanitorium. Valley Hospital, just by way of example, was held to be a quasi-public entity by the Alaska Supreme Court for three reasons. First, because it was built on public land, 5 acres donated by the city, with over $10 million in public funds. It operated on very significant public funds. It had been granted a certificate of need by the State through a regulatory process which gave it a health care monopoly in the valley, in return for which it promised to meet the health care needs of the valley. It is the only hospital in the valley in which second trimester procedures can be performed. Mr. BILIRAKIS. Well, how would you feel about it if it were a Catholic hospital? MS. WEISS. Well, then it would depend for me on whether the Catholic hospital met these same kinds of criteria. Is it a hospital that was built with or on public land? Is it operated significantly with public dollars? Does it treat the general public? Does it employ the general public? If so, then I submit it should abide by public health laws. If not, as is the case, for example, with the Christian Science Sanitorium, built with private funds, operated with private funds, it employs Christian scientists, it serves Christian scientists, it heals exclusively through prayer, that kind of pervasively sectarian health care institution ought, in general, to be out from under public health laws that are repugnant to its beliefs, because it is serving a population of believers. Mr. BILIRAKIS. Thank you, Ms. Weiss. My time has expired. Ms. Capps? Ms. CAPPS. Thank you very much, Mr. Chairman. And, Ms. Weiss, I will give you a chance to continue. I want to start with the premise that I understand from colleagues who have proposed this legislation that H.R. 4691 is a small technical change in the law and give you an opportunity to agree or disagree and then expand on that. MS. WEISS. I think that really it is clear from the comparison of the Coats Amendment with the comparison of the chairman's bill that it is by no means a small technical change in the law. The Coats Amendment defines the term, "health care entity," in this way. The term, "health care entity," includes an individual physician, a post-graduate physician training program or a participant in a program of training in the health professions. The Coats Amendment was passed to address what this body, Congress, viewed as a problem with mandatory-with a professional standard that the Accreditation Council for Graduate Medical Education had issued to require residency programs either to offer or to arrange abortion training for residents. Just to correct the record here, that professional standard at all times, when it was first promulgated and now, has provided an opt-out for any individual resident or physician who does not want to participate in abortions. It has never, by its terms, forced any doctor who had an objection personally to perform any abortion. So this body responded to address the problem in residency programs. This new bill, as I think you know, applies not simply to fit individual physicians and residency programs but to hospitals, |