Montana’s Republican-led state House has approved a so-called “medical conscience bill” that would allow medical providers to refuse services based on “ethical, moral, or religious beliefs or principles,” even in emergencies. The bill now requires a third House vote before proceeding to the state’s Republican-led Senate.
The bill’s sponsor, state Rep. Amy Regier (R), has specifically said she authored it to allow medical professionals to refuse abortions, medical marijuana, physician-assisted euthanasia, and gender-affirming care for transgender people, all things that Regier called “lifestyle and elective procedures,” according to the Montana Free Press.
Regier promises that her bill, known as H.B. 303: Implement Medical Ethics and Diversity Act, would only apply to “narrow circumstances” and wouldn’t lead to large-scale discrimination against LGBTQ+ patients.
However, the bill’s text says that it would allow basically any individual involved in healthcare to refuse services. These individuals include any healthcare employees, doctors, nurses, aides, pharmacy workers, medical and mental health school members, lab techs, board members, insurers, other payers, “or any other person who facilitates or participates in a healthcare service.”
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In short, this means that anyone involved in the chain of care could refuse to provide services for anyone or anything they object to. This means that any marginalized person will have to worry that any part of their care could be interrupted at any point by anybody, based on an undefined notion of “conscious.”
The bill says that objecting individuals cannot be disciplined for “engaging in speech or expressive activity protected under the First Amendment to the U.S. Constitution” unless a health department or board proves “beyond a reasonable doubt that the medical practitioner’s speech was the direct cause of physical harm to a person.”
Put another way, any medical-related worker could possibly express discriminated viewpoints to patients, and the groups that work with those workers couldn’t reprimand them for it without undergoing a long and arduous process.
If anyone tries to interfere with a person’s discriminatory speech or refusal to provide care, the interfering person will be subject to a lawsuit by the discriminating person or their supportive institution.
Furthermore, if any institution is sued over a worker’s refusal to provide care, the institution can neither penalize nor pass legal liability onto that individual. Bizarrely, the bill also states that this provision doesn’t apply to any state-owned healthcare institutions or healthcare payers.
The bill also says that no medical practitioner may be required to help facilitate an abortion unless they first consent in writing.
During the bill’s 20 minutes of debate in the state house, Democrats emphasized that it contains no discrimination protection for patients nor does guarantee a patient’s right to access health care otherwise if workers refuse to provide care.
Transgender state Rep. Zooey Zephyr (D) said that the bill would allow people like her to be refused necessary medical services.
“What is actually going to happen is it will be a denial based on diagnosis. Something like, I am diagnosed with gender dysphoria,” Zephyr said. “And… to deny me based on my diagnosis of gender dysphoria is to deny me based on my being a trans woman.”
State Rep. Laura Smith (D) said, “This is just one of many examples that I receive where medical teams have tried to deny parents’ rights to choose procedures for their children. If the bill passes, it will take away parental rights, and your constituents’ parental rights, to make these life-and-death procedural and medical decisions for our own children.”
In a January hearing, 10 conservative and religious groups spoke in favor of the bill, including Alliance Defending Freedom, a legal group that opposes any expansion of LGBTQ+ civil rights; the Montana Family Foundation, a group that opposes LGBTQ+ non-discrimination ordinances; and the Montana Catholic Conference, a group that opposes the legal recognition of married same-sex couples.
In the same hearing, 22 opponents spoke against the bill, including the Montana Medical Association, Montana Hospital Association, Montana chapter of the American Academy of Pediatrics, the Montana Nurses Association, the Montana Primary Care Association, Planned Parenthood of Montana, Blue Mountain Clinic, the ACLU of Montana, and the Montana Human Rights Network.
Dr. Nathan Allen, an emergency physician at Billings Clinic, said of the bill, “This creates a discrimination loophole, which would allow health care workers, organizations and payers to decline to provide care to a patient because they are a man, a Native American, have HIV, committed a crime or a member of a different religious faith.”
