Iowa law protects health workers’ conscience, reports, and speech

Practitioners and health care institutions may refuse to take part in, or pay for, care that conflicts with their conscience. The rules cover medical practitioners, including students preparing to become practitioners, and organizations that provide health care. A practitioner must tell their employer the nature of the objection. The rule does not remove a duty to take part in care that does not conflict with the practitioner’s conscience. Institutions that hold themselves out as religion-based, state a religious purpose in their governing documents, and have policies that put their beliefs into practice may make related employment, staffing, contracting, and admitting privilege decisions consistent with those beliefs. Emergency medical service requirements remain in place.

Practitioners and health care institutions may not be discriminated against for reporting, testifying, or taking part in proceedings about specified concerns. The protections cover medical practitioners and health care institutions that report information, testify, or take part in proceedings. Covered concerns include suspected violations of this chapter, laws or rules, care standards or ethical guidelines, serious mismanagement or misuse of funds or authority, unsafe treatment practices, and specific dangers to public health or safety. Patient privacy and confidentiality rules still apply.

State licensing bodies may not punish protected speech, expressive activity, or association unless they meet the law’s proof and harm requirements. This applies to state agencies and boards that license or certify a medical practitioner or health care institution. The licensing body must prove by clear and convincing evidence that the speech or association directly caused physical harm. The harmed person must have had a practitioner-patient or practitioner-client relationship with the practitioner or institution within the three years immediately before the incident.

Licensing bodies must send certain complaints within 21 days or pay a daily penalty; practitioners and institutions may seek court relief for unlawful interference. These rules cover state licensing bodies, medical practitioners, and health care institutions. The complaint deadline applies when a complaint alleges protected speech or association that may result in loss of a license, certification, or registration; the penalty is $500 for each day late. A practitioner or institution alleging unlawful interference may sue. If the court finds liability, it may order an injunction, damages, and reasonable costs and attorney fees. A person may not sue someone for declining to use or buy a health care service because of a provider’s exercise of conscience. The 21-day deadline begins when the licensing body receives the complaint.