Florida Senate - 2009 SB 1854
By Senator Gardiner
9-00796-09 20091854__
1 A bill to be entitled
2 An act relating to abortion; amending s. 390.0111,
3 F.S.; requiring that an ultrasound be performed on any
4 woman obtaining an abortion; specifying who must
5 perform an ultrasound; requiring that the ultrasound
6 be reviewed with the patient prior to the woman giving
7 informed consent; specifying who must review the
8 ultrasound with the patient; requiring that the woman
9 certify in writing that she declined to review the
10 ultrasound and did so of her own free will and without
11 undue influence; providing an exemption from the
12 requirement to view the ultrasound for women who are
13 the victims of rape, incest, domestic violence, or
14 human trafficking or for women who have a serious
15 medical condition necessitating the abortion; revising
16 requirements for written materials; amending s.
17 390.012, F.S.; requiring ultrasounds for all patients;
18 requiring that live ultrasound images be reviewed and
19 explained to the patient; requiring that all other
20 provisions in s. 390.0111, F.S., be complied with if
21 the patient declines to view her live ultrasound
22 images; providing for severability; providing an
23 effective date.
24
25 Be It Enacted by the Legislature of the State of Florida:
26
27 Section 1. Subsection (3) of section 390.0111, Florida
28 Statutes, is amended to read:
29 390.0111 Termination of pregnancies.—
30 (3) CONSENTS REQUIRED.—A termination of pregnancy may not
31 be performed or induced except with the voluntary and informed
32 written consent of the pregnant woman or, in the case of a
33 mental incompetent, the voluntary and informed written consent
34 of her court-appointed guardian.
35 (a) Except in the case of a medical emergency, consent to a
36 termination of pregnancy is voluntary and informed only if:
37 1. The physician who is to perform the procedure, or the
38 referring physician, has, at a minimum, orally, in person,
39 informed the woman of:
40 a. The nature and risks of undergoing or not undergoing the
41 proposed procedure that a reasonable patient would consider
42 material to making a knowing and willful decision of whether to
43 terminate a pregnancy.
44 b. The probable gestational age of the fetus, verified by
45 an ultrasound, at the time the termination of pregnancy is to be
46 performed.
47 (I) The ultrasound must be performed by the physician who
48 is to perform the abortion or by a person having documented
49 evidence that he or she has completed a course in the operation
50 of ultrasound equipment as prescribed by rule and who is working
51 in conjunction with the physician.
52 (II) The person performing the ultrasound must allow the
53 woman to view the live ultrasound images, and a physician or a
54 registered nurse, licensed practical nurse, advanced registered
55 nurse practitioner, or physician assistant working in
56 conjunction with the physician must contemporaneously review and
57 explain the live ultrasound images to the woman prior to the
58 woman giving informed consent to having an abortion procedure
59 performed. However, this sub-sub-subparagraph does not apply if,
60 at the time the woman schedules or arrives for her appointment
61 to obtain an abortion, a copy of a restraining order, police
62 report, medical record, or other court order or documentation is
63 presented that evidences that the woman is obtaining the
64 abortion because the woman is a victim of rape, incest, domestic
65 violence, or human trafficking or that the woman has been
66 diagnosed as having a condition that, on the basis of a
67 physician's good faith clinical judgment, would create a serious
68 risk of substantial and irreversible impairment of a major
69 bodily function if the woman delayed terminating her pregnancy.
70 (III) The woman has a right to decline to view the
71 ultrasound images after she is informed of her right and offered
72 an opportunity to view them. If the woman declines to view the
73 ultrasound images, the woman shall complete a form acknowledging
74 that she was offered an opportunity to view her ultrasound but
75 that she rejected that opportunity. The form must also indicate
76 that the woman's decision not to view the ultrasound was not
77 based on any undue influence from any third party to discourage
78 her from viewing the images and that she declined to view the
79 images of her own free will.
80 c. The medical risks to the woman and fetus of carrying the
81 pregnancy to term.
82 2. Printed materials prepared and provided by the
83 department have been provided to the pregnant woman, if she
84 chooses to view these materials, including:
85 a. A description of the fetus, including a description of
86 the various stages of development.
87 b. A list of entities agencies that offer alternatives to
88 terminating the pregnancy.
89 c. Detailed information on the availability of medical
90 assistance benefits for prenatal care, childbirth, and neonatal
91 care.
92 3. The woman acknowledges in writing, before the
93 termination of pregnancy, that the information required to be
94 provided under this subsection has been provided.
95 Nothing in this paragraph is intended to prohibit a physician
96 from providing any additional information which the physician
97 deems material to the woman's informed decision to terminate her
98 pregnancy.
99 (b) In the event a medical emergency exists and a physician
100 cannot comply with the requirements for informed consent, a
101 physician may terminate a pregnancy if he or she has obtained at
102 least one corroborative medical opinion attesting to the medical
103 necessity for emergency medical procedures and to the fact that
104 to a reasonable degree of medical certainty the continuation of
105 the pregnancy would threaten the life of the pregnant woman. In
106 the event no second physician is available for a corroborating
107 opinion, the physician may proceed but shall document reasons
108 for the medical necessity in the patient's medical records.
109 (c) Violation of this subsection by a physician constitutes
110 grounds for disciplinary action under s. 458.331 or s. 459.015.
111 Substantial compliance or reasonable belief that complying with
112 the requirements of informed consent would threaten the life or
113 health of the patient is a defense to any action brought under
114 this paragraph.
115 Section 2. Paragraph (d) of subsection (3) of section
116 390.012, Florida Statutes, is amended to read:
117 390.012 Powers of agency; rules; disposal of fetal
118 remains.—
119 (3) For clinics that perform or claim to perform abortions
120 after the first trimester of pregnancy, the agency shall adopt
121 rules pursuant to ss. 120.536(1) and 120.54 to implement the
122 provisions of this chapter, including the following:
123 (d) Rules relating to the medical screening and evaluation
124 of each abortion clinic patient. At a minimum, these rules shall
125 require:
126 1. A medical history including reported allergies to
127 medications, antiseptic solutions, or latex; past surgeries; and
128 an obstetric and gynecological history.
129 2. A physical examination, including a bimanual examination
130 estimating uterine size and palpation of the adnexa.
131 3. The appropriate laboratory tests, including:
132 a. For an abortion in which an ultrasound examination is
133 not performed before the abortion procedure, Urine or blood
134 tests for pregnancy performed before the abortion procedure.
135 b. A test for anemia.
136 c. Rh typing, unless reliable written documentation of
137 blood type is available.
138 d. Other tests as indicated from the physical examination.
139 4. An ultrasound evaluation for all patients who elect to
140 have an abortion after the first trimester. The rules shall
141 require that if a person who is not a physician performs an
142 ultrasound examination, that person shall have documented
143 evidence that he or she has completed a course in the operation
144 of ultrasound equipment as prescribed in rule. The physician,
145 registered nurse, licensed practical nurse, advanced registered
146 nurse practitioner, or physician assistant shall review and
147 explain, at the request of the patient, the live ultrasound
148 images evaluation results, including an estimate of the probable
149 gestational age of the fetus, with the patient before the
150 abortion procedure is performed, unless the patient declines
151 pursuant to s. 390.0111. If the patient declines to view the
152 live ultrasound images, the rules shall require that s. 390.0111
153 be complied with in all other respects.
154 5. That the physician is responsible for estimating the
155 gestational age of the fetus based on the ultrasound examination
156 and obstetric standards in keeping with established standards of
157 care regarding the estimation of fetal age as defined in rule
158 and shall write the estimate in the patient's medical history.
159 The physician shall keep original prints of each ultrasound
160 examination of a patient in the patient's medical history file.
161 Section 3. If any provision of this act or the application
162 thereof to any person or circumstance is held invalid, the
163 invalidity does not affect other provisions or applications of
164 the act which can be given effect without the invalid provision
165 or application, and to this end the provisions of this act are
166 severable.
167 Section 4. This act shall take effect July 1, 2009.