The South Dakota House rejected legislation that would have protected healthcare providers from being required to participate in medical services that violate their ethical, moral, or religious beliefs.
House Bill 1153 failed on a 25-41 vote on Tuesday. The measure, sponsored by Rep. Les Heinemann, R-Flandreau, would have prohibited healthcare providers from being discriminated against for declining to participate in procedures that conflict with their conscience.
Heinemann said the bill addresses real concerns from South Dakota healthcare workers. He read a letter from Dr. David Johnson of Rapid City, whose son was completing medical school at USD and selecting a residency. One of the son’s criteria in deciding where to go was the likelihood that he would have to participate in a procedure that violated his conscience.
“No one should be forced to choose between their faith and their profession,” Heinemann said during floor debate. “That is absolutely wrong.”
It would have protected providers from administrative, civil, or criminal liability for exercising conscience rights. Providers would also have been shielded from liability when another healthcare provider they contract with, employ or grant admitting privileges to exercises those rights.
Heinemann cited a recent federal appeals court case in which Dr. Alan Josephson won $1.6 million after the University of Louisville terminated his contract following comments about delaying treatments for childhood gender dysphoria. He said nine other states have enacted similar protections without problems.
But opponents said the bill’s broad language could compromise patient care, especially in rural areas with limited providers.
Rep. Nick Fosness, R-Britton, thr CEO of Marshall County Healthcare Center Avera, said the legislation would create unintended consequences for healthcare systems already struggling with staffing.
“What is that compromise?” Fosness asked. “How does an employer who’s staffing an EMS crew in rural South Dakota define who do we put on the ambulance crew tonight and what may they or may they not have a compromise with a patient transfer?”
Fosness said his small critical access hospital lacks the resources to maintain extra on-call staff for ethical or moral situations.
Rep. Taylor Rehfeldt, R-Sioux Falls, a nurse anesthetist, argued the bill’s definition of “medical service” was too expansive and could allow providers to refuse essential care based on personal ideology.
“The intentions of this bill are good, but we need to think about the patients first,” Rehfeldt said. “What I get sad about with these bills is that the patient gets put in the corner and we’re talking about providers who should be caring and put the patient first.”
Rehfeldt provided examples of how the bill could affect care, from refusing to dispense ivermectin to declining to provide respiratory treatments based on vaccination status.
Rep. Jana Hunt, R-Minnehaha County, supported the bill based on her healthcare experience. She said she had quit a job over ethical principles and warned that discouraging ethical practitioners from analyzing their values would drive qualified people away from healthcare careers.
Heinemann said federal emergency treatment laws would still apply in emergency situations. He urged colleagues to consider the five healthcare providers who testified in committee that they feel their beliefs aren’t respected in their professions.
The bill failed final passage, effectively killing it for this session.
