HB 983

1	A bill to be entitled
2	An act relating to abortion; amending s. 390.0111, F.S.;
3	requiring that an ultrasound be performed on any woman
4	obtaining an abortion; specifying who must perform an
5	ultrasound; requiring that the ultrasound be reviewed with
6	the patient prior to the woman giving informed consent;
7	specifying who must review the ultrasound with the
8	patient; requiring that the woman certify in writing that
9	she declined to review the ultrasound and did so of her
10	own free will and without undue influence; providing an
11	exemption from the requirement to view the ultrasound for
12	women who are the victims of rape, incest, domestic
13	violence, or human trafficking or for women who have a
14	serious medical condition necessitating the abortion;
15	revising requirements for written materials; amending s.
16	390.012, F.S.; requiring ultrasounds for all patients;
17	requiring that live ultrasound images be reviewed and
18	explained to the patient; requiring that all other
19	provisions in s. 390.0111, F.S., be complied with if the
20	patient declines to view her live ultrasound images;
21	providing for severability; providing an effective date.
22
23	Be It Enacted by the Legislature of the State of Florida:
24
25	Section 1.  Subsection (3) of section 390.0111, Florida
26	Statutes, is amended to read:
27	390.0111  Termination of pregnancies.--
28	(3)  CONSENTS REQUIRED.--A termination of pregnancy may not
29	be performed or induced except with the voluntary and informed
30	written consent of the pregnant woman or, in the case of a
31	mental incompetent, the voluntary and informed written consent
32	of her court-appointed guardian.
33	(a)  Except in the case of a medical emergency, consent to
34	a termination of pregnancy is voluntary and informed only if:
35	1.  The physician who is to perform the procedure, or the
36	referring physician, has, at a minimum, orally, in person,
37	informed the woman of:
38	a.  The nature and risks of undergoing or not undergoing
39	the proposed procedure that a reasonable patient would consider
40	material to making a knowing and willful decision of whether to
41	terminate a pregnancy.
42	b.  The probable gestational age of the fetus, verified by
43	an ultrasound, at the time the termination of pregnancy is to be
44	performed.
45	(I)  The ultrasound must be performed by the physician who
46	is to perform the abortion or by a person having documented
47	evidence that he or she has completed a course in the operation
48	of ultrasound equipment as prescribed by rule and who is working
49	in conjunction with the physician.
50	(II)  The person performing the ultrasound must allow the
51	woman to view the live ultrasound images, and a physician or a
52	registered nurse, licensed practical nurse, advanced registered
53	nurse practitioner, or physician assistant working in
54	conjunction with the physician must contemporaneously review and
55	explain the live ultrasound images to the woman prior to the
56	woman giving informed consent to having an abortion procedure
57	performed. However, this sub-sub-subparagraph does not apply if,
58	at the time the woman schedules or arrives for her appointment
59	to obtain an abortion, a copy of a restraining order, police
60	report, medical record, or other court order or documentation is
61	presented that evidences that the woman is obtaining the
62	abortion because the woman is a victim of rape, incest, domestic
63	violence, or human trafficking or that the woman has been
64	diagnosed as having a condition that, on the basis of a
65	physician's good faith clinical judgment, would create a serious
66	risk of substantial and irreversible impairment of a major
67	bodily function if the woman delayed terminating her pregnancy.
68	(III)  The woman has a right to decline to view the
69	ultrasound images after she is informed of her right and offered
70	an opportunity to view them. If the woman declines to view the
71	ultrasound images, the woman shall complete a form acknowledging
72	that she was offered an opportunity to view her ultrasound but
73	that she rejected that opportunity. The form must also indicate
74	that the woman's decision not to view the ultrasound was not
75	based on any undue influence from any third party to discourage
76	her from viewing the images and that she declined to view the
77	images of her own free will.
78	c.  The medical risks to the woman and fetus of carrying
79	the pregnancy to term.
80	2.  Printed materials prepared and provided by the
81	department have been provided to the pregnant woman, if she
82	chooses to view these materials, including:
83	a.  A description of the fetus, including a description of
84	the various stages of development.
85	b.  A list of entities agencies that offer alternatives to
86	terminating the pregnancy.
87	c.  Detailed information on the availability of medical
88	assistance benefits for prenatal care, childbirth, and neonatal
89	care.
90	3.  The woman acknowledges in writing, before the
91	termination of pregnancy, that the information required to be
92	provided under this subsection has been provided.
93
94	Nothing in this paragraph is intended to prohibit a physician
95	from providing any additional information which the physician
96	deems material to the woman's informed decision to terminate her
97	pregnancy.
98	(b)  In the event a medical emergency exists and a
99	physician cannot comply with the requirements for informed
100	consent, a physician may terminate a pregnancy if he or she has
101	obtained at least one corroborative medical opinion attesting to
102	the medical necessity for emergency medical procedures and to
103	the fact that to a reasonable degree of medical certainty the
104	continuation of the pregnancy would threaten the life of the
105	pregnant woman. In the event no second physician is available
106	for a corroborating opinion, the physician may proceed but shall
107	document reasons for the medical necessity in the patient's
108	medical records.
109	(c)  Violation of this subsection by a physician
110	constitutes grounds for disciplinary action under s. 458.331 or
111	s. 459.015. Substantial compliance or reasonable belief that
112	complying with the requirements of informed consent would
113	threaten the life or health of the patient is a defense to any
114	action brought under 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
130	examination 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.

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