Hospitals and clinics can't be sued. Doctors and nurses can't lose their jobs for objecting to terminating a pregnancy.
Legislation that could be voted on as early as this week in the Republican-led Legislature would extend the same legal protections for any medical service such as providing contraception or medical marijuana, or taking someone off life support. Employers and health insurers — not just medical providers — also could opt out of paying for services as a matter of conscience.
Supporters say the legislation protects religious freedom and is needed particularly in the wake of the federal health care law mandating employer-provided birth control in their health plans. Opponents counter that the bill is an overreach that wrongly lets health workers and organizations impose their beliefs on patients, putting their treatment at risk.
"We feel like it's the right balance between patient care and the rights of individuals who work in that field to have a clear conscience," said Sen. John Moolenaar, a Midland Republican and sponsor of the bill pending on the Senate floor.
While he acknowledged the state cannot override the federal health law, Moolenaar said Michigan needs a framework to proactively safeguard health providers from possible mandates from state government or their employers.
The legislation would require health facilities, doctors and pharmacists to adopt a policy for situations in which an employee objects to a service as a matter of conscience. Employers would be prohibited from asking prospective employees about their objection to a health service unless it is a "regular or substantial" portion of the duties for the job.
To critics, the bill is too broad — inviting the potential for abuse — and unnecessary.
The American Civil Liberties Union of Michigan said it is on the front lines of protecting people's right to practice their religion and it gets few complaints from health workers about not being accommodated for their religious views.
"It's very broad in that it basically allows any person or organization or corporation to assert an objection to just about anything based on moral or principles or religious tenets," said Shelli Weisberg, the ACLU's legislative director.
Versions of the conscience-objection legislation extending to more than just abortion date back to at least 2001, but it has never reached a governor's desk. The GOP-dominated Senate passed a bill in December's lame-duck session, giving hope to backers that it can win approval if momentum builds earlier in this two-year session.
Gov. Rick Snyder, a Republican, has taken no official position on the measure, though he typically is not enthusiastic about social issues and prefers to focus on budget and economic policies. He vetoed abortion-related insurance restrictions late last year while signing requirements that abortion clinics be licensed.
Lining up against the latest measure are hospitals and insurers that say it is a solution in search of a problem. The state's main group of physicians says it has concerns and is working with Moolenaar to make sure patients' access to health care could not be hindered.
The Michigan Health and Hospital Association told senators the legislation "elevates the status of employees above the needs of patients."
Defenders counter that a moral objection could not be asserted in an emergency. In non-emergencies, providers objecting to a procedure would have to tell patients about their conditions and other options for treatment.
"Patients can be sure their needs are met," said Tom Hickson, vice president for public policy and advocacy at the Michigan Catholic Conference, a backer of the legislation. "The bill unequivocally states patient discrimination is not allowed."
Opponents, however, worry about the potential problems for rural residents who have fewer places to go for treatment. They remain concerned about potential discrimination against gays and others, and say health facilities funded in part by taxpayer-supported programs such as Medicare and Medicaid should not be able to refuse to treat people.
Legislators have heard from Jenni Polfus, a Catholic nurse in the Upper Peninsula who said she had to leave a job at a local health department rather than be trained in the family planning program. Mike Koelzer, a Grand Rapids pharmacist, also is advocating for the bill. Koelzer said he stopped selling all forms of contraception at his store and thinks others in the medical field should have legal protections for following their religious beliefs.
The legislation also would apply to universities and colleges.
Conservatives are troubled by the case of an Eastern Michigan University student who said she was removed from a graduate-level counseling program in 2009 for refusing to counsel gay clients. A separate bill protecting counseling and psychology students from discipline if they refuse to see clients for religious reasons won passage from House Republicans last year before dying in the Senate.