Florida Senate - 2011                                    SB 1744
       By Senator Storms
       10-00409B-11                                          20111744__
    1                        A bill to be entitled                      
    2         An act relating to abortions; amending s. 390.0111,
    3         F.S.; requiring that an ultrasound be performed on a
    4         woman obtaining an abortion; providing exceptions;
    5         specifying who may perform an ultrasound; requiring
    6         that the ultrasound be reviewed with the patient
    7         before the woman gives informed consent for the
    8         abortion procedure; specifying who may review the
    9         ultrasound with the patient; requiring that the woman
   10         certify in writing that she declined to review the
   11         ultrasound and did so of her own free will and without
   12         undue influence; providing an exemption from the
   13         requirement to view the ultrasound for women who have
   14         a serious medical condition necessitating the
   15         abortion; revising requirements for written materials;
   16         amending s. 390.012, F.S.; requiring an ultrasound for
   17         all patients regardless of when the abortion is
   18         performed; providing exceptions; requiring that live
   19         ultrasound images be reviewed and explained to the
   20         patient; requiring compliance with all other
   21         provisions in s. 390.0111, F.S., if the patient
   22         declines to view the live ultrasound images; providing
   23         for severability; providing an effective date.
   25  Be It Enacted by the Legislature of the State of Florida:
   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 a
   36  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 the
   41  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 who has 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. Such person or the physician
   52  may not perform the ultrasound if, at the time the woman
   53  schedules or arrives for her appointment to obtain an abortion,
   54  a copy of a restraining order, police report, medical record, or
   55  other court order or documentation is presented which provides
   56  evidence that the woman is obtaining the abortion because she is
   57  a victim of rape, incest, domestic violence, or human
   58  trafficking.
   59         (II)The person performing the ultrasound must allow the
   60  woman to view the live ultrasound images, and a physician,
   61  registered nurse, licensed practical nurse, advanced registered
   62  nurse practitioner, or physician assistant working in
   63  conjunction with the physician must contemporaneously review and
   64  explain the live ultrasound images to the woman before the woman
   65  gives informed consent to having an abortion procedure
   66  performed. However, this sub-sub-subparagraph does not apply if,
   67  at the time the woman schedules or arrives for her appointment
   68  to obtain an abortion, a copy of a medical record or
   69  documentation is presented which provides evidence that the
   70  woman has been diagnosed as having a condition that, on the
   71  basis of a physician’s good faith clinical judgment, would
   72  create a serious risk of substantial and irreversible impairment
   73  of a major bodily function if the woman delayed terminating her
   74  pregnancy.
   75         (III)The woman has a right to decline to view the
   76  ultrasound images after she is informed of her right and offered
   77  an opportunity to view them. If the woman declines to view the
   78  ultrasound images, the woman shall complete a form acknowledging
   79  that she was offered an opportunity to view her ultrasound but
   80  that she rejected that opportunity. The form must also indicate
   81  that the woman’s decision not to view the ultrasound was not
   82  based on any undue influence from any third party to discourage
   83  her from viewing the images and that she declined to view the
   84  images of her own free will.
   85         c. The medical risks to the woman and fetus of carrying the
   86  pregnancy to term.
   87         2. Printed materials prepared and provided by the
   88  department have been provided to the pregnant woman, if she
   89  chooses to view these materials, including:
   90         a. A description of the fetus, including a description of
   91  the various stages of development.
   92         b. A list of entities agencies that offer alternatives to
   93  terminating the pregnancy.
   94         c. Detailed information on the availability of medical
   95  assistance benefits for prenatal care, childbirth, and neonatal
   96  care.
   97         3. The woman acknowledges in writing, before the
   98  termination of pregnancy, that the information required to be
   99  provided under this subsection has been provided.
  101  Nothing in This paragraph does not is intended to prohibit a
  102  physician from providing any additional information that which
  103  the physician deems material to the woman’s informed decision to
  104  terminate her pregnancy.
  105         (b) If In the event a medical emergency exists and a
  106  physician cannot comply with the requirements for informed
  107  consent, a physician may terminate a pregnancy if he or she has
  108  obtained at least one corroborative medical opinion attesting to
  109  the medical necessity for emergency medical procedures and to
  110  the fact that to a reasonable degree of medical certainty the
  111  continuation of the pregnancy would threaten the life of the
  112  pregnant woman. If a In the event no second physician is not
  113  available for a corroborating opinion, the physician may proceed
  114  but shall document reasons for the medical necessity in the
  115  patient’s medical records.
  116         (c) Violation of this subsection by a physician constitutes
  117  grounds for disciplinary action under s. 458.331 or s. 459.015.
  118  Substantial compliance or reasonable belief that complying with
  119  the requirements of informed consent would threaten the life or
  120  health of the patient is a defense to any action brought under
  121  this paragraph.
  122         Section 2. Paragraph (d) of subsection (3) of section
  123  390.012, Florida Statutes, is amended to read:
  124         390.012 Powers of agency; rules; disposal of fetal
  125  remains.—
  126         (3) For clinics that perform or claim to perform abortions
  127  after the first trimester of pregnancy, the agency shall adopt
  128  rules pursuant to ss. 120.536(1) and 120.54 to implement the
  129  provisions of this chapter, including the following:
  130         (d) Rules relating to the medical screening and evaluation
  131  of each abortion clinic patient. At a minimum, these rules shall
  132  require:
  133         1. A medical history including reported allergies to
  134  medications, antiseptic solutions, or latex; past surgeries; and
  135  an obstetric and gynecological history.
  136         2. A physical examination, including a bimanual examination
  137  estimating uterine size and palpation of the adnexa.
  138         3. The appropriate laboratory tests, including:
  139         a. For an abortion in which an ultrasound examination is
  140  not performed before the abortion procedure, Urine or blood
  141  tests for pregnancy performed before the abortion procedure.
  142         b. A test for anemia.
  143         c. Rh typing, unless reliable written documentation of
  144  blood type is available.
  145         d. Other tests as indicated from the physical examination.
  146         4. An ultrasound evaluation for each patient, except for a
  147  patient who, at the time the patient schedules or arrives for
  148  her appointment to obtain an abortion, presents a copy of a
  149  restraining order, police report, medical record, or other court
  150  order or documentation as evidence that the patient is obtaining
  151  the abortion because she is a victim of rape, incest, domestic
  152  violence, or human trafficking all patients who elect to have an
  153  abortion after the first trimester. The rules shall require that
  154  if a person who is not a physician performs an ultrasound
  155  examination, that person must shall have documented evidence
  156  that he or she has completed a course in the operation of
  157  ultrasound equipment as prescribed in rule. The physician,
  158  registered nurse, licensed practical nurse, advanced registered
  159  nurse practitioner, or physician assistant shall review and
  160  explain, at the request of the patient, the live ultrasound
  161  images evaluation results, including an estimate of the probable
  162  gestational age of the fetus, with the patient before the
  163  abortion procedure is performed, unless the patient declines to
  164  view the live ultrasound images pursuant to s. 390.0111, in
  165  which case the rules shall require compliance with s. 390.0111
  166  in all other respects.
  167         5. That the physician is responsible for estimating the
  168  gestational age of the fetus based on the ultrasound examination
  169  and obstetric standards in keeping with established standards of
  170  care regarding the estimation of fetal age as defined in rule
  171  and shall write the estimate in the patient’s medical history.
  172  The physician shall keep original prints of each ultrasound
  173  examination of a patient in the patient’s medical history file.
  174         Section 3. If any provision of this act or its application
  175  to any person or circumstance is held invalid, the invalidity
  176  does not affect other provisions or applications of the act
  177  which can be given effect without the invalid provision or
  178  application, and to this end the provisions of this act are
  179  severable.
  180         Section 4. This act shall take effect July 1, 2011.