HB 1127

1	A bill to be entitled
2	An act relating to abortions; amending s. 390.0111, F.S.;
3	requiring that an ultrasound be performed on a woman
4	obtaining an abortion; specifying who must perform an
5	ultrasound; requiring that the ultrasound be reviewed with
6	the patient before the woman gives informed consent for
7	the abortion procedure; 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 the
13	victims of rape, incest, domestic violence, or human
14	trafficking or for women who have a serious medical
15	condition necessitating the abortion; revising
16	requirements for written materials; amending s. 390.012,
17	F.S.; requiring an ultrasound for all patients regardless
18	of when the abortion is performed; requiring that live
19	ultrasound images be reviewed and explained to the
20	patient; requiring that all other provisions in s.
21	390.0111, F.S., be complied with if the patient declines
22	to view her live ultrasound images; providing for
23	severability; providing an 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
36	a 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
41	the 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 before the woman
58	gives 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 which provides evidence that the woman is obtaining
64	the abortion because the woman is a victim of rape, incest,
65	domestic violence, or human trafficking or that the woman has
66	been 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
81	the 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
96	Nothing in this paragraph is intended to prohibit a physician
97	from providing any additional information which the physician
98	deems material to the woman's informed decision to terminate her
99	pregnancy.
100	(b)  If In the event a medical emergency exists and a
101	physician cannot comply with the requirements for informed
102	consent, a physician may terminate a pregnancy if he or she has
103	obtained at least one corroborative medical opinion attesting to
104	the medical necessity for emergency medical procedures and to
105	the fact that to a reasonable degree of medical certainty the
106	continuation of the pregnancy would threaten the life of the
107	pregnant woman. If a In the event no second physician is not
108	available for a corroborating opinion, the physician may proceed
109	but shall document reasons for the medical necessity in the
110	patient's medical records.
111	(c)  Violation of this subsection by a physician
112	constitutes grounds for disciplinary action under s. 458.331 or
113	s. 459.015. Substantial compliance or reasonable belief that
114	complying with the requirements of informed consent would
115	threaten the life or health of the patient is a defense to any
116	action brought under this paragraph.
117	Section 2.  Paragraph (d) of subsection (3) of section
118	390.012, Florida Statutes, is amended to read:
119	390.012  Powers of agency; rules; disposal of fetal
120	remains.-
121	(3)  For clinics that perform or claim to perform abortions
122	after the first trimester of pregnancy, the agency shall adopt
123	rules pursuant to ss. 120.536(1) and 120.54 to implement the
124	provisions of this chapter, including the following:
125	(d)  Rules relating to the medical screening and evaluation
126	of each abortion clinic patient. At a minimum, these rules shall
127	require:
128	1.  A medical history including reported allergies to
129	medications, antiseptic solutions, or latex; past surgeries; and
130	an obstetric and gynecological history.
131	2.  A physical examination, including a bimanual
132	examination estimating uterine size and palpation of the adnexa.
133	3.  The appropriate laboratory tests, including:
134	a.  For an abortion in which an ultrasound examination is
135	not performed before the abortion procedure, Urine or blood
136	tests for pregnancy performed before the abortion procedure.
137	b.  A test for anemia.
138	c.  Rh typing, unless reliable written documentation of
139	blood type is available.
140	d.  Other tests as indicated from the physical examination.
141	4.  An ultrasound evaluation for all patients who elect to
142	have an abortion after the first trimester. The rules shall
143	require that if a person who is not a physician performs an
144	ultrasound examination, that person shall have documented
145	evidence that he or she has completed a course in the operation
146	of ultrasound equipment as prescribed in rule. The physician,
147	registered nurse, licensed practical nurse, advanced registered
148	nurse practitioner, or physician assistant shall review and
149	explain, at the request of the patient, the live ultrasound
150	images evaluation results, including an estimate of the probable
151	gestational age of the fetus, with the patient before the
152	abortion procedure is performed, unless the patient declines
153	pursuant to s. 390.0111. If the patient declines to view the
154	live ultrasound images, the rules shall require that s. 390.0111
155	be complied with in all other respects.
156	5.  That the physician is responsible for estimating the
157	gestational age of the fetus based on the ultrasound examination
158	and obstetric standards in keeping with established standards of
159	care regarding the estimation of fetal age as defined in rule
160	and shall write the estimate in the patient's medical history.
161	The physician shall keep original prints of each ultrasound
162	examination of a patient in the patient's medical history file.
163	Section 3.  If any provision of this act or the application
164	thereof to any person or circumstance is held invalid, the
165	invalidity does not affect other provisions or applications of
166	the act which can be given effect without the invalid provision
167	or application, and to this end the provisions of this act are
168	severable.
169	Section 4.  This act shall take effect July 1, 2011.

CODING: Words stricken are deletions; words underlined are additions.