Florida Senate - 2008 SB 2400
By Senator Webster
9-03169B-08 20082400__
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A bill to be entitled
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An act relating to abortion; amending s. 390.0111, F.S.;
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requiring that an ultrasound be performed on any woman
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obtaining an abortion; specifying who must perform an
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ultrasound; requiring that the ultrasound be reviewed with
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the patient prior to the woman giving informed consent;
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specifying who must review the ultrasound with the
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patient; requiring that the woman certify in writing that
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she declined to review the ultrasound and did so of her
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own free will and without undue influence; providing an
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exemption from the requirement to view the ultrasound for
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women who are the victims of rape, incest, domestic
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violence, or human trafficking or for women who have a
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serious medical condition necessitating the abortion;
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revising requirements for written materials; amending s.
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390.012, F.S.; conforming cross-references; requiring
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ultrasounds for all patients; requiring that live
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ultrasound images be reviewed and explained to the
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patient; requiring that all other provisions in s.
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390.0111, F.S., be complied with if the patient declines
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to view her live ultrasound images; providing for
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severability; providing an effective date.
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Be It Enacted by the Legislature of the State of Florida:
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Section 1. Subsection (3) of section 390.0111, Florida
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Statutes, is amended to read:
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390.0111 Termination of pregnancies.--
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(3) CONSENTS REQUIRED.--A termination of pregnancy may not
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be performed or induced except with the voluntary and informed
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written consent of the pregnant woman or, in the case of a mental
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incompetent, the voluntary and informed written consent of her
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court-appointed guardian.
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(a) Except in the case of a medical emergency, consent to a
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termination of pregnancy is voluntary and informed only if:
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1. The physician who is to perform the procedure, or the
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referring physician, has, at a minimum, orally, in person,
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informed the woman of:
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a. The nature and risks of undergoing or not undergoing the
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proposed procedure that a reasonable patient would consider
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material to making a knowing and willful decision of whether to
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terminate a pregnancy.
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b. The probable gestational age of the fetus, verified by
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an ultrasound, at the time the termination of pregnancy is to be
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performed.
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(I) The ultrasound must be performed by the physician who
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is to perform the abortion or by a person having documented
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evidence that he or she has completed a course in the operation
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of ultrasound equipment as prescribed by rule and who is working
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in conjunction with the physician.
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(II) The person performing the ultrasound must allow the
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woman to view the live ultrasound images, and a physician or a
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registered nurse, licensed practical nurse, advanced registered
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nurse practitioner, or physician assistant working in conjunction
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with the physician must contemporaneously review and explain the
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live ultrasound images to the woman prior to the woman giving
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informed consent to having an abortion procedure performed.
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However, this sub-sub-subparagraph does not apply if, at the time
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the woman schedules or arrives for her appointment to obtain an
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abortion, a copy of a restraining order, police report, medical
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record, or other court order or documentation is presented that
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evidences that the woman is obtaining the abortion because the
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woman is a victim of rape, incest, domestic violence, or human
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trafficking or that the woman has been diagnosed with a condition
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that, on the basis of a physician's good faith clinical judgment,
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would create a serious risk of substantial and irreversible
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impairment of a major bodily function if the woman delayed
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terminating her pregnancy.
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(III) The woman has a right to decline to view the
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ultrasound images after she is informed of her right and offered
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an opportunity to view them. If the woman declines to view the
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ultrasound images, the woman shall complete a form acknowledging
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that she was offered an opportunity to view her ultrasound but
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that she rejected that opportunity. The form must also indicate
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that the woman's decision not to view the ultrasound was not
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based on any undue influence from any third party to discourage
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her from viewing the images and that she declined to view the
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images of her own free will.
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c. The medical risks to the woman and fetus of carrying the
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pregnancy to term.
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2. Printed materials prepared and provided by the
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department have been provided to the pregnant woman, if she
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chooses to view these materials, including:
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a. A description of the fetus, including a description of
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the various stages of development.
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b. A list of entities agencies that offer alternatives to
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terminating the pregnancy.
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c. Detailed information on the availability of medical
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assistance benefits for prenatal care, childbirth, and neonatal
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care.
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3. The woman acknowledges in writing, before the
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termination of pregnancy, that the information required to be
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provided under this subsection has been provided.
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Nothing in this paragraph is intended to prohibit a physician
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from providing any additional information which the physician
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deems material to the woman's informed decision to terminate her
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pregnancy.
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(b) In the event a medical emergency exists and a physician
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cannot comply with the requirements for informed consent, a
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physician may terminate a pregnancy if he or she has obtained at
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least one corroborative medical opinion attesting to the medical
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necessity for emergency medical procedures and to the fact that
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to a reasonable degree of medical certainty the continuation of
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the pregnancy would threaten the life of the pregnant woman. In
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the event no second physician is available for a corroborating
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opinion, the physician may proceed but shall document reasons for
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the medical necessity in the patient's medical records.
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(c) Violation of this subsection by a physician constitutes
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Substantial compliance or reasonable belief that complying with
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the requirements of informed consent would threaten the life or
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health of the patient is a defense to any action brought under
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this paragraph.
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Section 2. Subsection (1) and paragraph (d) of subsection
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(3) of section 390.012, Florida Statutes, are amended to read:
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390.012 Powers of agency; rules; disposal of fetal
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remains.--
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(1) The agency may develop and enforce rules pursuant to
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for the health, care, and treatment of persons in abortion
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clinics and for the safe operation of such clinics.
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(a) The rules shall be reasonably related to the
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preservation of maternal health of the clients.
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(b) The rules shall be in accordance with s. 797.03 and may
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not impose an unconstitutional burden on a woman's freedom to
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decide whether to terminate her pregnancy.
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(c) The rules shall provide for:
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1. The performance of pregnancy termination procedures only
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by a licensed physician.
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2. The making, protection, and preservation of patient
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records, which shall be treated as medical records under chapter
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458.
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(3) For clinics that perform or claim to perform abortions
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after the first trimester of pregnancy, the agency shall adopt
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provisions of this chapter, including the following:
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(d) Rules relating to the medical screening and evaluation
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of each abortion clinic patient. At a minimum, these rules shall
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require:
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1. A medical history including reported allergies to
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medications, antiseptic solutions, or latex; past surgeries; and
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an obstetric and gynecological history.
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2. A physical examination, including a bimanual examination
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estimating uterine size and palpation of the adnexa.
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3. The appropriate laboratory tests, including:
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a. For an abortion in which an ultrasound examination is
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not performed before the abortion procedure, Urine or blood tests
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for pregnancy performed before the abortion procedure.
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b. A test for anemia.
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c. Rh typing, unless reliable written documentation of
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blood type is available.
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d. Other tests as indicated from the physical examination.
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4. An ultrasound evaluation for all patients who elect to
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have an abortion after the first trimester. The rules shall
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require that if a person who is not a physician performs an
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ultrasound examination, that person shall have documented
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evidence that he or she has completed a course in the operation
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of ultrasound equipment as prescribed in rule. The physician,
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registered nurse, licensed practical nurse, advanced registered
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nurse practitioner, or physician assistant shall review and
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explain , at the request of the patient, the live ultrasound
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images evaluation results, including an estimate of the probable
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gestational age of the fetus, with the patient before the
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abortion procedure is performed, unless the patient declines
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pursuant to s. 390.0111. If the patient declines to view the live
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ultrasound images, the rules shall require that s. 390.0111 be
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complied with in all other respects.
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5. That the physician is responsible for estimating the
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gestational age of the fetus based on the ultrasound examination
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and obstetric standards in keeping with established standards of
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care regarding the estimation of fetal age as defined in rule and
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shall write the estimate in the patient's medical history. The
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physician shall keep original prints of each ultrasound
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examination of a patient in the patient's medical history file.
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Section 3. If any provision of this act or the application
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thereof to any person or circumstance is held invalid, the
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invalidity does not affect other provisions or applications of
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the act which can be given effect without the invalid provision
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or application, and to this end the provisions of this act are
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severable.
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Section 4. This act shall take effect July 1, 2008.
CODING: Words stricken are deletions; words underlined are additions.