Skip to main content
S 2483Medical Services

Health and Safety - Medical Ethics Defense Act

Allows healthcare providers and insurers to refuse medical services or payments based on personal conscience without facing punishment or liability.

Introduced
Population
Affected
65
Email Legislator
Introduced Feb 6, 2026Committee Senate Judiciary

Plain-English Summary

This legislation, titled the "Medical Ethics Defense Act," grants medical practitioners, healthcare institutions, and insurance payers the right to refuse to participate in, pay for, or refer patients for medical services that violate their moral, ethical, or religious beliefs. It defines "participation" broadly to include counseling and record-keeping. The bill prohibits employers or licensing boards from discriminating against or punishing those who exercise this right. It also limits the ability of the state medical board to discipline practitioners for speech unless it directly causes physical harm. Emergency medical treatment required by federal law is exempt.

For younger readers

This bill creates a new rule for doctors, nurses, and hospitals. It says that if a medical worker believes a certain treatment is wrong because of their personal or religious beliefs, they do not have to do it. For example, if a doctor thinks a specific surgery is bad, they can say no to performing it or helping with it. The bill also says that their bosses cannot fire them or get them in trouble for saying no. However, they must still help if a patient is in immediate danger and needs emergency help.

Who & Where It Applies

Impacted groups
Medical Practitioners (Doctors, Nurses, Pharmacists)Healthcare Institutions (Hospitals, Clinics)Healthcare Payers (Insurers, Employers)Patients seeking reproductive healthcareLGBTQ+ Community
Impacted communities
All

Constitutional & Fiscal Check

High. The bill's broad protection for refusal of service may conflict with state and federal anti-discrimination laws and the constitutional obligation to ensure equal protection. Furthermore, the provision restricting the Board of Medical Licensure from disciplining speech unless "beyond a reasonable doubt" of direct physical harm likely infringes on the state's police power to regulate professional standards and protect public health, potentially violating separation of powers.

Estimated cost
Amount unknown
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Includes whistleblower protections that prohibit discrimination against medical practitioners who report violations of law, ethical guidelines, or gross mismanagement, potentially safeguarding public health standards.
  • Restricts licensing boards from punishing practitioners for speech unless it causes direct physical harm, which could be viewed as a strong defense of First Amendment free speech rights.
  • Ensures that emergency medical treatments required by federal law are not overridden, preserving a baseline safety net for critical care regardless of provider objections.
  • Allows healthcare providers and institutions to deny essential medical care, including reproductive health and gender-affirming care, to patients based on personal beliefs, disproportionately harming women and LGBTQ+ individuals.
  • Permits insurance companies and employers to refuse payment for medical services they object to, weakening the social safety net and limiting access to healthcare for low-income workers.
  • Broad definitions allow refusal of referrals and counseling, potentially leaving patients without knowledge of or access to legal medical options, undermining the welfare of the community.
For Conservatives
  • Protects the fundamental right of medical professionals and institutions to operate according to their moral and religious convictions without fear of government punishment or loss of employment.
  • Reinforces corporate freedom by allowing private healthcare institutions and payers to establish policies and coverage consistent with their organizational mission and values.
  • Limits the power of regulatory boards to police the speech of medical practitioners, protecting individuals from bureaucratic overreach and weaponized licensing procedures.
  • Creates a "triple damages" civil remedy that could encourage frivolous lawsuits against employers and hospitals, potentially increasing costs for businesses and clogging the court system.
  • Broad definitions of "conscience" could lead to unpredictable refusals of service by employees, undermining the ability of business owners to manage their staff and ensure consistent service delivery.
  • The high burden of proof ("beyond a reasonable doubt") required for licensing boards to discipline practitioners could protect incompetent doctors, threatening public safety and the reputation of the profession.

Votes

Loading votes...

Full Bill Text

Changes to existing Rhode Island law · 152 additions

SECTION 1. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby amended by adding thereto the following chapter: 23-106-1. Short title. This chapter shall be known and may be cited as the "Medical Ethics Defense Act". 23-106-2. Definitions. As used in this chapter:

(1) "Conscience" means the ethical, moral, or religious belief or principles held by any medical practitioner, healthcare institution, or healthcare payer. Conscience with respect to institutional entities or corporate bodies, as opposed to individual persons, is determined by reference to that entity or body’s governing documents, including, but not limited to, any published ethical, moral or religious guidelines or directives, mission statements, constitutions, articles of incorporation, bylaws, policies, or regulations.

(2) "Disclosure" means a formal or informal communication or transmission, but does not include a communication or transmission concerning policy decisions that lawfully exercise discretionary authority unless the medical practitioner providing the disclosure or transmission reasonably believes that the disclosure or transmission evinces:

(i) Any violation of any law, rule, or regulation;

(ii) Any violation of any ethical guidelines for the provision of any medical procedure or service; or

(iii) Gross mismanagement, a gross waste of funds, an abuse of authority, practices or methods of treatment that may put patient health at risk, or a substantial and specific danger to public health or safety.

(3) "Discrimination" means any adverse action taken against, or any threat of adverse action communicated to, any medical practitioner, healthcare institution, or healthcare payer as a result of their decision to decline to participate in a medical procedure or service on the basis of conscience. Discrimination includes, but is not limited to, termination of employment; transfer from current position; demotion from current position; adverse administrative action; reassignment to a different shift or job title; increased administrative duties; refusal of staff privileges; refusal of board certification; loss of career specialty; reduction of wages, benefits or privileges; refusal to award a grant, contract or other program; refusal to provide residency training opportunities; denial, deprivation, or disqualification of licensure; withholding or disqualifying from financial aid and other assistance; impediments to creating any healthcare institution or payer or expanding or improving said healthcare institution or payer; impediments to acquiring, associating with, or merging with any other healthcare institution or payer; the threat thereof with regard to any of the preceding; or any other penalty, disciplinary, or retaliatory action, whether executed or threatened. Discrimination excludes the negotiation or purchase of insurance by a non-government entity.

(4) "Healthcare institution" means any organization, corporation, partnership, association, agency, network, sole proprietorship, joint venture, or other entity that provides medical procedures or services. The term includes, but is not limited to, any public or private hospital, clinic, medical center, physician organization, professional association, ambulatory surgical center, private physician’s office, pharmacy, nursing home, medical school, nursing school, medical training facility, or any other entity or location in which medical procedures or services are performed.

(5) "Healthcare payer" means any employer, health plan, health maintenance organization, insurance company, management services organization, or any other entity that pays for or arranges for the payment of any medical procedure or service provided to any patient, whether that payment is made in whole or in part.

(6) "Medical practitioner" means any person or individual who may be or is asked to participate in any way in any medical procedure or service. This includes, but is not limited to, doctors, nurse practitioners, physician’s assistants, nurses, nurses’ aides, allied health professionals, medical assistants, hospital employees, clinic employees, nursing home employees, pharmacists, pharmacy technicians and employees, medical school faculty and students, nursing school faculty and students, psychology and counseling faculty and students, medical researchers, laboratory technicians, psychologists, psychiatrists, counselors, mental health professionals, social workers, or any other person who facilitates or participates in the provision of a medical procedure or service.

(7) "Medical procedure or service" means medical care provided to any patient at any time over the entire course of treatment, or medical research. This includes, but is not limited to, testing; diagnosis; referral; dispensing and/or administering any drug, medication, or device; psychological therapy or counseling; research; prognosis; therapy; record making procedures; notes related to treatment; set up or performance of a surgery or procedure; or any other care or services performed or provided by any medical practitioner including, but not limited to, physicians, nurses, allied health professionals, paraprofessionals, contractors, or employees of healthcare institutions.

(8) "Participate" in a medical procedure or service means to provide, perform, assist with, facilitate, refer for, counsel for, advise with regard to, admit for the purposes of providing, or take part in any way in providing any medical procedure or service, or any form of such service.

(9) "Pay" or "payment" means to pay for, contract for, arrange for the payment of, whether in whole or in part, reimburse or remunerate. 23-106-3. Rights of conscience of medical practitioners, healthcare institutions and healthcare payers.

(a) Freedom of conscience. A medical practitioner, healthcare institution, or healthcare payer has the right not to participate in or pay for any medical procedure or service which violates their conscience.

(b) Limitations. The exercise of the right of conscience is limited to conscience-based objections to a particular medical procedure or service. This section shall not be construed to waive or modify any duty a health care practitioner, health care institution, or health care payer may have to provide other medical procedures or services that do not violate the practitioner’s, institution’s or payer’s conscience.

(c) Immunity from liability. No medical practitioner, healthcare institution, or healthcare payer shall be civilly, criminally, or administratively liable for exercising their right of conscience not to participate in or pay for a medical procedure or service. No healthcare institution shall be civilly, criminally, or administratively liable for the exercise of conscience rights not to participate in a medical procedure or service by a medical practitioner employed, contracted, or granted admitting privileges by the healthcare institution.

(d) Discrimination. No medical practitioner, healthcare institution, or healthcare payer shall be discriminated against in any manner as a result of their decision to decline to participate in or pay for a medical procedure or service on the basis of conscience.

(e) Exception. Notwithstanding any other provision of this chapter to the contrary, a religious medical practitioner, healthcare institution, or healthcare payer that holds itself out to the public as religious, states in its governing documents that it has a religious purpose or mission, and has internal operating policies or procedures that implement its religious beliefs, shall have the right to make employment, staffing, contracting, and admitting privilege decisions consistent with its religious beliefs.

(f) Opt-in required. A health care practitioner may not be scheduled for, assigned, or requested to directly or indirectly perform, facilitate, refer for, or participate in an abortion unless the practitioner first affirmatively consents in writing to perform, facilitate, refer for, or participate in the abortion.

(g) Emergency medical treatments. This chapter shall not be construed to override the requirement to provide emergency medical treatment to all patients as set forth in 42 U.S.C. § 1395dd. 23-106-4. Whistleblower protection.

(a) No medical practitioner shall be discriminated against in any manner because the medical practitioner:

(1) Provided, caused to be provided, or is about to provide or cause to be provided to their employer, the attorney general, department of health, any state agency charged with protecting health care rights of conscience, the U.S. Department of Health and Human Services, Office of Civil Rights, or any other federal agency charged with protecting health care rights of conscience information relating to any violation of, or any act or omission the medical practitioner reasonably believes to be a violation of, any provision of this chapter;

(2) Testified or is about to testify in a proceeding concerning such violation; or

(3) Assisted or participated, or is about to assist or participate, in such a proceeding.

(b) Unless the disclosure is specifically prohibited by law, no medical practitioner shall be discriminated against in any manner because the medical practitioner disclosed any information that the medical practitioner reasonably believes evinces:

(1) Any violation of any law, rule, or regulation;

(2) Any violation of any ethical guidelines for the provisions of any medical procedure or service; or

(3) Gross mismanagement, a gross waste of funds, an abuse of authority, practices or methods of treatment that may put patient health at risk, or a substantial and specific danger to public health or safety.

(c) The board of medical licensure and discipline shall not reprimand, sanction, or revoke or threaten to revoke a license, certificate, or registration of a health care practitioner for engaging in speech or expressive activity protected under the first amendment of the U.S. Constitution, unless the board demonstrates beyond a reasonable doubt that the practitioner’s speech was the direct cause of physical harm to a person with whom the health care practitioner had a practitioner-patient relationship within the three (3) years immediately preceding the incident of physical harm.

(1) The board of medical licensure and discipline shall provide a medical practitioner with any complaints it has received which may result in the revocation of the medical practitioner’s license, certification, or registration, within seven (7) days after receipt of the complaint.

(2) The board of medical licensure and discipline shall pay the medical practitioner an administrative penalty of five hundred dollars ($500) for each day the complaint is not provided to the medical practitioner after the seven (7) day period set forth in subsection (c)(1) of this section. 23-106-5. Civil remedies.

(a) Civil action for violation of right of conscience. A civil action for damages or injunctive relief, or both, may be brought by any medical practitioner, healthcare institution, or healthcare payer for any violation of this chapter. Any additional burden or expense on another medical practitioner, healthcare institution, or healthcare payer arising from the exercise of the right of conscience shall not be a defense to any violation of this chapter. However, no civil action may be brought against an individual who declines to use or purchase medical procedure or services from a specific medical practitioner, healthcare institution, or healthcare payer for exercising the rights set forth in § 23-106-3.

(b) Other remedies. Any party aggrieved by any violation of this chapter may commence a civil action and upon a finding of a violation, shall be entitled to recover threefold their actual damages sustained, along with the costs of the action and reasonable attorneys' fees. Such damages shall be cumulative and in no way limited by any other remedies which may be available under any other federal, state, or municipal law. A court considering such civil action may also award injunction relief, which may include, but is not limited to, reinstatement of a medical practitioner to their previous position, reinstatement of board certification, and re-licensure of a healthcare institution or healthcare payer. 23-106-6. Severability. Any provision of this chapter held to be invalid or unenforceable by its terms, or as applied to any person or circumstance, shall be construed so as to give it the maximum effect permitted by law, unless such holding shall be one of utter invalidity or unenforceability, in which event such provision shall be deemed severable herefrom and shall not affect the remainder hereof or the application of such provision to other persons not similarly situated or to other, dissimilar circumstances.

SECTION 2. This act shall take effect upon passage.