Nurses & Providers Can Now Refuse Procedures That Conflict With Their Beliefs in TN

Governor Bill Lee of Tennessee signed the Medical Ethics Defense Act into law on April 24, 2025. This new legislation is shaking up the healthcare scene, especially for nurses in Tennessee. It gives healthcare providers, including nurses, the right to refuse to participate in certain medical procedures that clash with their personal beliefs. Tennessee isn’t alone in this; it’s now the 12th state to have such a law, joining the ranks of Alabama, Arkansas, and Florida, among others.

So, if you’re a nurse working in Tennessee, here’s the scoop on what this means for you and your practice.

Key Provisions of the Law

Some of the main takeaways from the Medical Ethics Defense Act are as follows:

Right to Decline Participation

Nurses and other healthcare professionals may decline involvement in medical procedures, treatments, or services that conflict with their personal beliefs. This includes protection from adverse employment actions as a result of such refusals.

Broad Scope of Coverage

The law applies to individual providers, healthcare facilities, and insurance entities across the state.

Examples of Protected Services

The law covers services including—but not limited to—abortion, gender-affirming care, contraception, and other procedures that may conflict with a provider's conscience.

No Requirement for Advance Notice to Patients

Providers are not required to notify patients in advance if they plan to decline providing a particular service. As a result, patients may only become aware of a refusal during or just before care is delivered.

Whistleblower Protections

Nurses who report violations of the law, unsafe practices, or gross mismanagement are protected from retaliation.

Legal Recourse Available

Healthcare professionals who face discrimination for exercising these rights may pursue legal action, which could include seeking damages or reinstatement of employment.

Anti-Discrimination and Emergency Care Limits

The law does not permit refusal of care based on a patient's race, sex, religion, or national origin, and does not override existing federal obligations to provide emergency care.

Implications for Nursing Practice

• Increased Autonomy in Decision-Making: Nurses have additional legal protection when declining to participate in specific procedures, helping reduce concerns over job security or disciplinary action.
  
  
• Potential for Delayed Care: Because providers are not required to notify patients in advance, refusals may result in care delays or logistical challenges, especially in time-sensitive settings.
  
  
• Need for Strong Communication: Effective coordination among team members and management may be necessary to prevent disruption in care when a provider invokes the law’s protections.
  
  
• Staffing and Workflow Adjustments: Healthcare leaders may need to create contingency plans for reassigning tasks or roles when multiple staff members object to providing the same service.
  
  
• Legal and Ethical Considerations: Nurses should stay informed about their rights under this state law, while also understanding federal care requirements and their facility’s internal policies.

Teamwork and Patient Care: The Balancing Act

The Tennessee Nurses Association is waving the caution flag, advising nurses to think carefully about how this law could change team dynamics in a healthcare setting. If multiple team members have conscious objections, scheduling could become an issue. Ensuring that all patient needs are met might require some strategic juggling.

And let’s not forget patient advocates, who are raising concerns that this law could disproportionately affect vulnerable populations. The Tennessee Equality Project, for instance, worries about the impact on transgender patients seeking gender-affirming treatments. It’s a bit like being stuck between a rock and a hard place—protecting your beliefs while ensuring all patients receive the care they need.

Dr. Zeke Taylor on TikTok shares his thoughts on the passage of the Medical Ethics Defense Act:

@drzeketayler My Oath means something. #fyp #pennsylvania #doctorsoftiktok #tennessee #oath ♬ original sound - DrZekeTayler

 

Meanwhile, Black Women’s Health Imperative shared the possible, devastating ramifications this law could have on patients from vulnerable populations:

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A post shared by BWHI (@blkwomenshealth)

 

Navigating the New Terrain

For nurses in Tennessee, the Medical Ethics Defense Act presents both opportunities and hurdles. It offers legal protection for those with strong moral objections, but it also complicates the landscape of team-based care and patient access. Nursing leaders will need to develop clear protocols to manage these conscience objections. Think of it as creating a new roadmap for patient care that respects both provider beliefs and patient needs.

As we navigate this new terrain, remember that communication is key. Keep the lines open with your team and your patients to ensure everyone is on the same page. As with any new policy, finding the right balance will take time and thoughtful implementation.

🤔What do you think of the Medical Ethics Defense Act? Share your thoughts in the discussion forum below.