JEFFERSON CITY, Mo. (AP) — Missouri health care workers could refuse to participate in procedures and research that run afoul of their religious, moral or ethical beliefs under legislation given first-round approval Monday by the House.

Physicians, nurses, medical researchers, and certain others involved in health care could not be discriminated against for refusing. Objections could be raised for specified medical procedures and research, including abortion, sterilization that is not medically necessary, assisted reproduction, human embryonic stem-cell research and contraception. Health care institutions such as hospitals, clinics and medical or nursing schools also could refuse to perform procedures or conduct research with which it has moral objections.

House Speaker Tim Jones, who is sponsoring the legislation, said conscience rights are a bedrock principle that has been applied for a long time in the U.S. He said the legislation protects workers’ rights and claimed support from both political parties and men and women.

“It’s a shield. They don’t have to use,” said Jones, R-Eureka, “It’s not a sword.”

The House endorsed the legislation 118-42, and it needs another vote before moving to the state Senate. Similar legislation was approved in the House last year.

Vocal opposition Monday came from Democratic lawmakers who argued that the bill could inhibit access to health care for some Missourians.

Rep. Stacey Newman said the measure could affect couples seeking fertility treatment and rape victims who might want emergency contraception. She said the measure would discriminate against women.

“This bill is wrong. It hurts people. It hurts women and families,” said Newman, D-St. Louis.

The conscious objections for medical workers would protect employees from termination, suspension, demotion and the loss of wages if they invoke it. Employees asserting the right not to participate would need to provide reasonable notice.

Reassigning employees to positions where they would not need to participate in the objectionable research or procedure would not be allowed, and if a worker files a lawsuit alleging their conscious rights were violated, the employer could claim the specific procedure or research is so integral to the position’s duties that a reasonable person would understand participation would be a requirement.

The opt-out rights would not allow health care workers or facilities to withhold emergency medical treatment needed to save a patients’ life. It also would not excuse caregivers from a duty to inform patients about their health conditions, risks and medical options. However, health care workers would not be required to refer for or promote certain procedures.

In addition, if a lawsuit were to be filed challenging the constitutionality of the conscious objections measure, the Legislature could approve a resolution appointing some of its members to intervene in the case.