HB 1127

A bill to be entitled
2An act relating to abortions; amending s. 390.0111, F.S.;
3requiring that an ultrasound be performed on a woman
4obtaining an abortion; specifying who must perform an
5ultrasound; requiring that the ultrasound be reviewed with
6the patient before the woman gives informed consent for
7the abortion procedure; specifying who must review the
8ultrasound with the patient; requiring that the woman
9certify in writing that she declined to review the
10ultrasound and did so of her own free will and without
11undue influence; providing an exemption from the
12requirement to view the ultrasound for women who are the
13victims of rape, incest, domestic violence, or human
14trafficking or for women who have a serious medical
15condition necessitating the abortion; revising
16requirements for written materials; amending s. 390.012,
17F.S.; requiring an ultrasound for all patients regardless
18of when the abortion is performed; requiring that live
19ultrasound images be reviewed and explained to the
20patient; requiring that all other provisions in s.
21390.0111, F.S., be complied with if the patient declines
22to view her live ultrasound images; providing for
23severability; providing an effective date.
25Be It Enacted by the Legislature of the State of Florida:
27     Section 1.  Subsection (3) of section 390.0111, Florida
28Statutes, is amended to read:
29     390.0111  Termination of pregnancies.-
30     (3)  CONSENTS REQUIRED.-A termination of pregnancy may not
31be performed or induced except with the voluntary and informed
32written consent of the pregnant woman or, in the case of a
33mental incompetent, the voluntary and informed written consent
34of her court-appointed guardian.
35     (a)  Except in the case of a medical emergency, consent to
36a termination of pregnancy is voluntary and informed only if:
37     1.  The physician who is to perform the procedure, or the
38referring physician, has, at a minimum, orally, in person,
39informed the woman of:
40     a.  The nature and risks of undergoing or not undergoing
41the proposed procedure that a reasonable patient would consider
42material to making a knowing and willful decision of whether to
43terminate a pregnancy.
44     b.  The probable gestational age of the fetus, verified by
45an ultrasound, at the time the termination of pregnancy is to be
47     (I)  The ultrasound must be performed by the physician who
48is to perform the abortion or by a person having documented
49evidence that he or she has completed a course in the operation
50of ultrasound equipment as prescribed by rule and who is working
51in conjunction with the physician.
52     (II)  The person performing the ultrasound must allow the
53woman to view the live ultrasound images, and a physician or a
54registered nurse, licensed practical nurse, advanced registered
55nurse practitioner, or physician assistant working in
56conjunction with the physician must contemporaneously review and
57explain the live ultrasound images to the woman before the woman
58gives informed consent to having an abortion procedure
59performed. However, this sub-sub-subparagraph does not apply if,
60at the time the woman schedules or arrives for her appointment
61to obtain an abortion, a copy of a restraining order, police
62report, medical record, or other court order or documentation is
63presented which provides evidence that the woman is obtaining
64the abortion because the woman is a victim of rape, incest,
65domestic violence, or human trafficking or that the woman has
66been diagnosed as having a condition that, on the basis of a
67physician's good faith clinical judgment, would create a serious
68risk of substantial and irreversible impairment of a major
69bodily function if the woman delayed terminating her pregnancy.
70     (III)  The woman has a right to decline to view the
71ultrasound images after she is informed of her right and offered
72an opportunity to view them. If the woman declines to view the
73ultrasound images, the woman shall complete a form acknowledging
74that she was offered an opportunity to view her ultrasound but
75that she rejected that opportunity. The form must also indicate
76that the woman's decision not to view the ultrasound was not
77based on any undue influence from any third party to discourage
78her from viewing the images and that she declined to view the
79images of her own free will.
80     c.  The medical risks to the woman and fetus of carrying
81the pregnancy to term.
82     2.  Printed materials prepared and provided by the
83department have been provided to the pregnant woman, if she
84chooses to view these materials, including:
85     a.  A description of the fetus, including a description of
86the various stages of development.
87     b.  A list of entities agencies that offer alternatives to
88terminating the pregnancy.
89     c.  Detailed information on the availability of medical
90assistance benefits for prenatal care, childbirth, and neonatal
92     3.  The woman acknowledges in writing, before the
93termination of pregnancy, that the information required to be
94provided under this subsection has been provided.
96Nothing in this paragraph is intended to prohibit a physician
97from providing any additional information which the physician
98deems material to the woman's informed decision to terminate her
100     (b)  If In the event a medical emergency exists and a
101physician cannot comply with the requirements for informed
102consent, a physician may terminate a pregnancy if he or she has
103obtained at least one corroborative medical opinion attesting to
104the medical necessity for emergency medical procedures and to
105the fact that to a reasonable degree of medical certainty the
106continuation of the pregnancy would threaten the life of the
107pregnant woman. If a In the event no second physician is not
108available for a corroborating opinion, the physician may proceed
109but shall document reasons for the medical necessity in the
110patient's medical records.
111     (c)  Violation of this subsection by a physician
112constitutes grounds for disciplinary action under s. 458.331 or
113s. 459.015. Substantial compliance or reasonable belief that
114complying with the requirements of informed consent would
115threaten the life or health of the patient is a defense to any
116action brought under this paragraph.
117     Section 2.  Paragraph (d) of subsection (3) of section
118390.012, Florida Statutes, is amended to read:
119     390.012  Powers of agency; rules; disposal of fetal
121     (3)  For clinics that perform or claim to perform abortions
122after the first trimester of pregnancy, the agency shall adopt
123rules pursuant to ss. 120.536(1) and 120.54 to implement the
124provisions of this chapter, including the following:
125     (d)  Rules relating to the medical screening and evaluation
126of each abortion clinic patient. At a minimum, these rules shall
128     1.  A medical history including reported allergies to
129medications, antiseptic solutions, or latex; past surgeries; and
130an obstetric and gynecological history.
131     2.  A physical examination, including a bimanual
132examination 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
135not performed before the abortion procedure, Urine or blood
136tests for pregnancy performed before the abortion procedure.
137     b.  A test for anemia.
138     c.  Rh typing, unless reliable written documentation of
139blood type is available.
140     d.  Other tests as indicated from the physical examination.
141     4.  An ultrasound evaluation for all patients who elect to
142have an abortion after the first trimester. The rules shall
143require that if a person who is not a physician performs an
144ultrasound examination, that person shall have documented
145evidence that he or she has completed a course in the operation
146of ultrasound equipment as prescribed in rule. The physician,
147registered nurse, licensed practical nurse, advanced registered
148nurse practitioner, or physician assistant shall review and
149explain, at the request of the patient, the live ultrasound
150images evaluation results, including an estimate of the probable
151gestational age of the fetus, with the patient before the
152abortion procedure is performed, unless the patient declines
153pursuant to s. 390.0111. If the patient declines to view the
154live ultrasound images, the rules shall require that s. 390.0111
155be complied with in all other respects.
156     5.  That the physician is responsible for estimating the
157gestational age of the fetus based on the ultrasound examination
158and obstetric standards in keeping with established standards of
159care regarding the estimation of fetal age as defined in rule
160and shall write the estimate in the patient's medical history.
161The physician shall keep original prints of each ultrasound
162examination of a patient in the patient's medical history file.
163     Section 3.  If any provision of this act or the application
164thereof to any person or circumstance is held invalid, the
165invalidity does not affect other provisions or applications of
166the act which can be given effect without the invalid provision
167or application, and to this end the provisions of this act are
169     Section 4.  This act shall take effect July 1, 2011.

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