CS/HB 983

1
A bill to be entitled
2An act relating to abortion; amending s. 390.0111, F.S.;
3requiring that an ultrasound be performed on any woman
4obtaining an abortion; specifying who must perform an
5ultrasound; requiring that the ultrasound be reviewed with
6the patient prior to the woman giving informed consent;
7specifying who must review the ultrasound with the
8patient; requiring that the woman certify in writing that
9she declined to review the ultrasound and did so of her
10own free will and without undue influence; providing an
11exemption from the requirement to view the ultrasound for
12women who are the victims of rape, incest, domestic
13violence, or human trafficking or for women who have a
14serious medical condition necessitating the abortion;
15revising requirements for written materials; amending s.
16390.012, F.S.; requiring ultrasounds for all patients;
17requiring that live ultrasound images be reviewed and
18explained to the patient; requiring that all other
19provisions in s. 390.0111, F.S., be complied with if the
20patient declines to view her live ultrasound images;
21providing for severability; providing an effective date.
22
23Be It Enacted by the Legislature of the State of Florida:
24
25     Section 1.  Subsection (3) of section 390.0111, Florida
26Statutes, is amended to read:
27     390.0111  Termination of pregnancies.--
28     (3)  CONSENTS REQUIRED.--A termination of pregnancy may not
29be performed or induced except with the voluntary and informed
30written consent of the pregnant woman or, in the case of a
31mental incompetent, the voluntary and informed written consent
32of her court-appointed guardian.
33     (a)  Except in the case of a medical emergency, consent to
34a termination of pregnancy is voluntary and informed only if:
35     1.  The physician who is to perform the procedure, or the
36referring physician, has, at a minimum, orally, in person,
37informed the woman of:
38     a.  The nature and risks of undergoing or not undergoing
39the proposed procedure that a reasonable patient would consider
40material to making a knowing and willful decision of whether to
41terminate a pregnancy.
42     b.  The probable gestational age of the fetus, verified by
43an ultrasound, at the time the termination of pregnancy is to be
44performed.
45     (I)  The ultrasound must be performed by the physician who
46is to perform the abortion or by a person having documented
47evidence that he or she has completed a course in the operation
48of ultrasound equipment as prescribed by rule and who is working
49in conjunction with the physician.
50     (II)  The person performing the ultrasound must allow the
51woman to view the live ultrasound images, and a physician or a
52registered nurse, licensed practical nurse, advanced registered
53nurse practitioner, or physician assistant working in
54conjunction with the physician must contemporaneously review and
55explain the live ultrasound images to the woman prior to the
56woman giving informed consent to having an abortion procedure
57performed. However, this sub-sub-subparagraph does not apply if,
58at the time the woman schedules or arrives for her appointment
59to obtain an abortion, a copy of a restraining order, police
60report, medical record, or other court order or documentation is
61presented that evidences that the woman is obtaining the
62abortion because the woman is a victim of rape, incest, domestic
63violence, or human trafficking or that the woman has been
64diagnosed as having a condition that, on the basis of a
65physician's good faith clinical judgment, would create a serious
66risk of substantial and irreversible impairment of a major
67bodily function if the woman delayed terminating her pregnancy.
68     (III)  The woman has a right to decline to view the
69ultrasound images after she is informed of her right and offered
70an opportunity to view them. If the woman declines to view the
71ultrasound images, the woman shall complete a form acknowledging
72that she was offered an opportunity to view her ultrasound but
73that she declined. The form must also indicate that the woman's
74decision not to view the ultrasound was not based on any undue
75influence from any third party to discourage her from viewing
76the images and that she declined to view the images of her own
77free will.
78     c.  The medical risks to the woman and fetus of carrying
79the pregnancy to term.
80     2.  Printed materials prepared and provided by the
81department have been provided to the pregnant woman, if she
82chooses to view these materials, including:
83     a.  A description of the fetus, including a description of
84the various stages of development.
85     b.  A list of entities agencies that offer alternatives to
86terminating the pregnancy.
87     c.  Detailed information on the availability of medical
88assistance benefits for prenatal care, childbirth, and neonatal
89care.
90     3.  The woman acknowledges in writing, before the
91termination of pregnancy, that the information required to be
92provided under this subsection has been provided.
93
94Nothing in this paragraph is intended to prohibit a physician
95from providing any additional information which the physician
96deems material to the woman's informed decision to terminate her
97pregnancy.
98     (b)  In the event a medical emergency exists and a
99physician cannot comply with the requirements for informed
100consent, a physician may terminate a pregnancy if he or she has
101obtained at least one corroborative medical opinion attesting to
102the medical necessity for emergency medical procedures and to
103the fact that to a reasonable degree of medical certainty the
104continuation of the pregnancy would threaten the life of the
105pregnant woman. In the event no second physician is available
106for a corroborating opinion, the physician may proceed but shall
107document reasons for the medical necessity in the patient's
108medical records.
109     (c)  Violation of this subsection by a physician
110constitutes grounds for disciplinary action under s. 458.331 or
111s. 459.015. Substantial compliance or reasonable belief that
112complying with the requirements of informed consent would
113threaten the life or health of the patient is a defense to any
114action brought under this paragraph.
115     Section 2.  Paragraph (d) of subsection (3) of section
116390.012, Florida Statutes, is amended to read:
117     390.012  Powers of agency; rules; disposal of fetal
118remains.--
119     (3)  For clinics that perform or claim to perform abortions
120after the first trimester of pregnancy, the agency shall adopt
121rules pursuant to ss. 120.536(1) and 120.54 to implement the
122provisions of this chapter, including the following:
123     (d)  Rules relating to the medical screening and evaluation
124of each abortion clinic patient. At a minimum, these rules shall
125require:
126     1.  A medical history including reported allergies to
127medications, antiseptic solutions, or latex; past surgeries; and
128an obstetric and gynecological history.
129     2.  A physical examination, including a bimanual
130examination 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
133not performed before the abortion procedure, Urine or blood
134tests for pregnancy performed before the abortion procedure.
135     b.  A test for anemia.
136     c.  Rh typing, unless reliable written documentation of
137blood type is available.
138     d.  Other tests as indicated from the physical examination.
139     4.  An ultrasound evaluation for all patients who elect to
140have an abortion after the first trimester. The rules shall
141require that if a person who is not a physician performs an
142ultrasound examination, that person shall have documented
143evidence that he or she has completed a course in the operation
144of ultrasound equipment as prescribed in rule. The physician,
145registered nurse, licensed practical nurse, advanced registered
146nurse practitioner, or physician assistant shall review and
147explain, at the request of the patient, the live ultrasound
148images evaluation results, including an estimate of the probable
149gestational age of the fetus, with the patient before the
150abortion procedure is performed, unless the patient declines
151pursuant to s. 390.0111. If the patient declines to view the
152live ultrasound images, the rules shall require that s. 390.0111
153be complied with in all other respects.
154     5.  That the physician is responsible for estimating the
155gestational age of the fetus based on the ultrasound examination
156and obstetric standards in keeping with established standards of
157care regarding the estimation of fetal age as defined in rule
158and shall write the estimate in the patient's medical history.
159The physician shall keep original prints of each ultrasound
160examination of a patient in the patient's medical history file.
161     Section 3.  If any provision of this act or the application
162thereof to any person or circumstance is held invalid, the
163invalidity does not affect other provisions or applications of
164the act which can be given effect without the invalid provision
165or application, and to this end the provisions of this act are
166severable.
167     Section 4.  This act shall take effect July 1, 2009.


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