S.B. 80 Physician Practice Amendments: transcript

Okay. I'm all for it. Thank You Mr. Chair and members of the committee and folks who are gathered here today. This is, uh, a very simple bill that actually came out of a conversation. Well, a lot of conversations during the last session. And the gist of this bill is very simple, and it, it essentially says that a physician not willing to participate or engage in, uh, an execution is not at risk of jeopardizing their license. Um, that this is something that we would understand that would not be something some folks would be comfortable with most folks, many folks would be comfortable with. And so we would not punish them for that. There is a similar, um, application of this that was done years ago relating to provision of abortion services. Similarly, um, because, you know, in medicine we treat all, and we tend to do most everything for most everyone. But there's a line when I think when it comes to taking of a life. And so, uh, this is a very simple, someone cannot be punished or they're licensed, jeopardized for an unwillingness to participate. Uh, I do think this came into people's conversation points more with the execution that happened last year. So, um, anyway, that is the simplicity of this bill and, uh, have had multiple supporters and no one say they're against it.

Does. So let

me ask, would, uh, would a voluntary participation or even yeah, even volunteering to participate in an execution, would that violate the hypocrite oath? That's really open to a lot of, uh, interpretation. There's some subjectivity to that, right? I mean, the first do no harm concept means different things to different people.

I think that as a physician myself, we go into certain things knowing that there's high risk. Um, and you go in knowing that you may ultimately have a harmful outcome for someone. Um, but there's something different about a state sanctioned taking of life from most of the conversations I've had with folks around it.

But you, you're onto a very challenging ethical concept there. What about phys physician assisted suicide like a Dr. Korian, or what are organs doing? Does that violate the hypocrite oath? Similarly, I think there's some who would say it doesn and some who would say it doesn't. Um, and for me, ultimately, um, that's why it's important to say, we are saying it would be all right for a physician to say, I will not Like you. So, um, last question. I promise.

Yeah, I I'm having fun up here. Um, yeah, No, I love ethical stuff. So The doctor who administers the chemicals to the inmate, um, are, is the inmate their patient

At, boy, there's a whole lot of different questions there because I'm used to thinking of patients as someone that I have a relationship with providing care. They sure come to me, I've agreed to care for them. There's a charting process, there's a billing process, there's all of those pieces, right. But I do a fair amount of work out in spaces that doesn't involve a clinic or, uh, a street medicine sort of space, for lack of example. I would still consider that person my patient because they are entrusting their care to me and I am imparting some information or care to them. Um, if I were administering a medication to a person through an IV, through intravenous medication administration, I would be hard pressed to not say that, uh, there was a physician caregiver relationship there.

So on the surface, this seems reasonable, but has there ever been a case where a physician was threatened with discipline for refusing to participate in executions, uh, that you're aware of?

No, I'm not. And and I think that, um, when we had conversations around this, there was a broader co policy concept out about what a physician could or couldn't refuse to do, uh, in the provision of care. Um, and so there were deeper, um, and again, broader concepts that were going into that I am not aware of one, but I, it's amazing the kind of neck hairs that got risen on docs for them saying, what if I refuse to do that? Would there be long-term complications or consequences for me? And it's a pretty rare occurrence. It's not something tha that's, thankfully that's happening all the time. So it's a rare occurrence, the death penalty that physicians are involved with, but it's also apparently completely non-existence on any discipline that's been, um, extended for a doctor.

I, I, I'm not sure that Okay. Fair enough. I think reasonably it's on the surface, but let me just ask you kind of one, since we were talking ethics and the flip side of this and trying to make sure what this bill's actually trying to do, protect physicians, right? Um, on the flip side, you don't offer any protection of the bill if, if physician does participate, and I think that's what the chair was alluding to in participation in an execution. Um, could there not be protections designed into the bill specifically to provide protections for the ones that don't participate as well or do participate?

I, I would assume yes, that there could be built in, uh, I've not had anyone express to me that they were concerned that should they decide to participate in an execution, that they would face discipline only the concerns that should they not want to participate in it. But I think you make a valid point. There is an ethical quandary on both, uh, sides of that.

Yeah. And some of this stems from some of the other questioning, and, and I don't mean to take it into, uh, realms that are a little difficult, but, you know, there's the issue of abortion and, you know, does this, would this bill also protect a physician that refuses to perform an abortion?

Uh, there already are protections in place for, uh, we had put those in over a decade ago for, for physicians who were not willing or interested in that, they have protections for their both, I believe their license as well as protections of their job.

Yeah. Thank you. Yeah. And it is similarly that there is a line, right? That there is that line of the taking of a life piece that, yeah.

Uh, thank you, uh, Mr. Chair Kale Weston. I'm in Salt Lake County. I, I'm in support of this bill and want to thank, uh, Senator Plumb. Uh, I did a little bit of homework before my two minutes, and I believe there are 27 states that currently have the death penalty. And we ranked number 20 as far as I believe, in the last, from 1976 to, to 2024. As far as frequency, if I got my numbers right, is about eight executions. So I, I'm fully in support of, I think that the general idea behind this and whether it needs to be tweaked a bit, and I I would only add that, you know, the, the death penalty will be very much, uh, front and center in our state. And I think the more we can talk about, uh, all aspects of the death penalty, the better. So I would urge you to support this bill. And thank you Senator Plumb.

Thank you, Mr. Chair again. Mark Moffitt. I'm here on behalf of myself and, uh, the, the Defense Lawyers Association. I would urge the committee to support this bill. Uh, many of you have been in committee hearings, uh, or have seen committee hearings debating the death penalty. And I think a lot of you, um, are cognizant of the fact that when it comes to the death penalty, there's almost, I don't wanna say it's religious, but it's, it's, it's, you're either for or against it. And it, those are very, very strongly held feelings. And if a physician were to exercise their conscience and make a decision that they did not want to participate in an execution that was administered by lethal injection, I would hope that they would not be subject to sanction. I would hope that they would not be subject to some form of discipline. And for that reason, I would ask that the committee support this. Uh, bill, thank you.

I would move that we recommend favorably SB 80. We have a motion to recommend favorably Senate Bill 80, um, discussion.

No, I, I appreciate the kind of thoughts you've gotten going in my head because, um, you know, I certainly didn't try to march out with a, a flag of any sort. I think that, um, the conversations that started last session and have continued on since then, um, really just gave me that kind of desire to say, I hear you and I would like to support you, the, the clinicians that reached out to me. So, but I appreciate the, the conversations.

Yeah, I, I would just say I appreciate the, um, uh, the adherence to freedom of conscience and the ability to not have to be forced to do things that we, you know, that you may not personally believe in. I think that's important and I'm glad that it can be something that we can work on on a bipartisan basis. Thank you. Um, I just wanna say, I'll be voting for this. Um, I actually floor sponsored a bill. I believe it was last year. It was a bill by representative Mike Peterson. And it actually, um, I think it's very similar. It basically said if, if an employer asked somebody to do something that kind of violated their conscience, it didn't have to be a religious belief, but like a conscious belief, um, that if, that they could ask for another employee to be assigned to that project. And to me, this falls in that same category. It was a much broader bill than this one. So I'm not saying that they're duplicative, um, but I, I do think that, um, you know, where appropriate, um, we, we shouldn't be asking people to, um, execute a duty that they're just morally, um, opposed to, um, uh, whether, whether they have religion or not in their life. So I'll be supporting it. Alright.

Oh gosh, This room is angsty. I don't know. It's big and the es is big and yeah, Welcome to the house. Thank you. Right. Everything's bigger in the house apparently. Don't quote me on that though. Um, I appreciate the opportunity to present this bill to you all. It's, um, certainly not something that we talk about all that Often. Can you pull your mic a little closer? Yeah. Thank you. Not, not loud enough is not a comment I often get, so I'll take it. Um, thi this is a topic, we don't talk about that often, but when we do, I think it's important that we give it kind of the reverence for lack of a better term that it has. And that is, uh, executions. And I had a, a physician come to me last year when we did have this talk brewing and say, what would happen if a physician didn't want to participate in an execution? Would there be a consequence for that? Could they jeopardize their license? Uh, conversations kind of ensued. And so I had opened a bill file and, and went forward and presented it. And when I was in committee, uh, business and labor in the Senate, one of my fellow Senator Vickers said, well, what if somebody does participate? Would they have to worry similarly about their license? And so this bill, as it stands right now, amended after I think that appropriate question from one of my colleagues, makes it clear at this taking of a life very critical sort of space, that a physician cannot, um, be accused of unprofessional conduct or have a jeopardy of their license for refusing to participate in an execution. Similarly for also participating in one. And I, I actually feel really good about that amendment because I think that it, it does make it clear at this taking of a life very critical moment that this is something for each individual to decide. And that's the simplicity of this bill.

Thank you. Mr. Vice Chair. When we talk about executions, are we talking about like people on death row or Yeah, like a state sponsored execution, um, that then that would then be dictated to you as part of your job, that you would be the one ordering the medications, for example, or administering the medications if it was to be a, a lethal injection, that sort of a thing.

So yes, state sponsored execution.

So is that how it's done? They, they, it's your turn Dr. Plum to do this execution that we've had lined up for 20 years?

Yeah. In my Under or how, how do they do it? In my understanding, it, it's not random. So we wouldn't, it's not like jury duty that you would just get a, a postcard or just get a tap on the shoulder that it would be you. But that certain individuals say within corrections or possibly within our DHHS spaces, that that would be, it doesn't happen that often, but that would be if they were physician employed in that space, that would potentially be park seen as part of their, their responsibilities or their job duties.

Okay. So there is an expectation that if, if a doctor's asked it, it's considered kind of a civic duty kind of thing?

I, I don't know if I'd say civic duty. I'd say more of a, um, maybe a job expectation. And I think the conversations will go further on as this session per, uh, continues. But one of the things in medicine that we work with pretty diligently is there are areas that you're either not as good at, not as experienced in or not as comfortable with. And what we typically do is look to our colleagues, look to our, uh, other fellow practitioners and say, this is maybe not the best space for me. Is it something that you would be comfortable assisting with? I, I think back to when I was in residency, I was in Indiana and one of my fellow clinic mates that was a resident really wasn't comfortable with birth control and prescribing birth control for a variety of different reasons in her kind of makeup. And she, we just had an agreement that if there was a, a patient there that wanted birth control, that I would be the one that would take that over. And it didn't have to make anything weird about their relationship. It didn't have to make her doubt, her ability to provide care. So physicians do a lot of that I think, already. And if I were in a situation where that were asked of me, um, I suppose on either side, depending on which one it was, I would, I would tag a colleague to say, can we see if there's a better arrangement here? Um, but at the taking of a life, uh, the physician folks that I've talked to, they would like to have some coverage that they are protected, that if that they did or didn't do that, that, that we were clear with them that you're not gonna be in trouble, you're not gonna be in jeopardy.

Okay. I guess I'm just trying to, uh, understand how someone would be in a situation where this would come and, uh, apply. So if I'm a doctor mm-hmm. And, and I don't want to perform an execution, I feel like I should not have to do that.

Correct. Um, but at the same time, if I am willing to do it and I do it, I guess that's where you're at.

It's like there's gonna be no repercussions that come back because I took a life, uh, even, you know, based on our judiciary system, someone's on death row and, and it's time and Right. Is that, And likewise, if you didn't, like if you said you didn't want to, that you

Wouldn't, there'd be no repercussions for that.

Exactly. Gotcha. It's both sides.

Um, and, and I do, like I said, after I thought more about it after it was brought up to me, I was like, you know, that is such a critical decision tree point for people, um, at, at, at the thought of being asked to take a life. There should be some protections that you would not have lose your license or have professional repercussions either way that you went on that.

Thank you, Mr. Chair. I move that we favorably recommend Senate Bill 80.

I would actually, uh, this is a difficult area. I mean, there, there are expectations on healthcare providers to do no harm. And so I'm more concerned about that one, that if somebody, part of their job has to end somebody's life, that's concerning. And I also like the idea that on the other side, if they say, look, I don't, I can't do this. I have a moral objection or a, some other issue, I, they don't, they shouldn't have to do it either at the, at the peril of their license. Maybe that's a job issue or with their employer, but at least in terms of their license, it's not a license issue. So I would encourage to support the bill.

No, I, I appreciate that. And, and like I said, a lot of thought is come to my mind, so I appreciate your consideration with this. Alright.

You know, I think that the line of reasoning potentially goes into that, but this is pretty clear that it's an execution.

I'll waive. Okay.

Um, this bill has been something that touches on I think a lot of emotions and ethical kind of questions that folks in healthcare have to deal with. And it was initially brought to my attention with a bill that was being run last year, and it was a question raised about could a physician be punished or penalized for not participating in an execution or a state sponsored execution? And so this bill was drafted with the hope that we could have that discussion about what does it mean to have a line where your profession would require you to take a life? And this bill came to be, we had some, I think, thoughtful and critical discussions in committee, and it, the point was raised, well, what about if someone does participate in an execution, do they also potentially deserve need those same protections? And I actually see the point of that and agree. Um, my good colleague, Senator Musselman had, had gone forward with an amendment and, and Senator Weiler is here now to speak to that. But I, I think that this is something that when it comes to the point of taking an actual life, there should be some protections in place. We do have a protection in place for physicians, uh, who are not willing to perform an abortion, for example. And I, for me, it's that taking of a life piece that I think, um, is an important protection. With that, I'm open to questions.

You. I Rise, rise supported the bill. I actually passed a bill I think two sessions ago that, you know, um, tried to respect people's conscience in the workplace. And I think that Senator Plums Bill goes right along with that. But I agree with, uh, Senator Musselman's concern, uh, that that door should swing both ways. And so I would like to move Amendment one to Senate bill 80 that is in Senator Musselman's name. We don't know where he is and we can't find him, but I, I have confirmed we can, I can make that amendment. Um, and that would allow a doctor also not to be punished for participating in a, um, in an execution.

Like I, I really do appreciate the dialogue that has gone into this and the thoughtfulness and I see that as, as a friendly amendment and, and truly do appreciate and understand why it's important to put that there too.

No. With that I, I appreciate the, the dialogue and the improvement in the bill and, and I would call the question

A third time Roll call vote. Senator Vickers Baldy Aye. Lein Brammer Bus Kalimore Escamilla Fillmore Aye. Grover Harper Kinins Ipson Ipsen Johnson Quan McKay Mikel Milner Musselman Owens Aye. Pitcher Plum Aye. Three B. Sandal Stevenson Stratton Vicar Weiler Wilson Aye. Winterton Aye. President Adams Aye. Senate

This bill, uh, was amended I think, to be improved in our last reading and this bill makes the simple, uh, clarification that a physician can be punished for, cannot be punished. Excuse me, for either participating in an execution or not participating in an execution. I think that line at, at the taking of a life is something that's very valuable to all of us and I am certainly open to any questions if anyone would like to talk further.

Uh, thank you Mr. Uh, president Pro temp. I would call the question

Pitcher, Uh, this bill has the Department of um,

Thank you Mr. Speaker Pro Tim Senate Bill 80 representative specifies that a physician in the case of a death penalty execution on that topic, again, I knew that would perk him up, but set, set that a, that a physician does not violate the code of unprofessional conduct, does not commit unprofessional conduct by either refusing to go through with an, to participate in an execution or by, uh, completing a state order execution. This is frankly, a physician protection of matter of conscience. We're not gonna force anybody to participate that doesn't, uh, doesn't agree with that. We're also not gonna punish anyone that, uh, that does participate in that. And that's what the bill does.