Florida Senate - 2011 CS for SB 1744
By the Committee on Health Regulation; and Senator Storms
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; specifying who must
5 perform an ultrasound; requiring that the ultrasound
6 be reviewed with the patient before the woman gives
7 informed consent for the abortion procedure;
8 specifying who must review the ultrasound with the
9 patient; requiring that the woman certify in writing
10 that she declined to review the ultrasound and did so
11 of her own free will and without undue influence;
12 providing an exemption from the requirement to view
13 the ultrasound for women who are the victims of rape,
14 incest, domestic violence, or human trafficking or for
15 women who have a serious medical condition
16 necessitating the abortion; revising requirements for
17 written materials; amending s. 390.012, F.S.;
18 requiring an ultrasound for all patients regardless of
19 when the abortion is performed; requiring that live
20 ultrasound images be reviewed and explained to the
21 patient; requiring that all other provisions in s.
22 390.0111, F.S., be complied with if the patient
23 declines to view her live ultrasound images; providing
24 for severability; providing an effective date.
26 Be It Enacted by the Legislature of the State of Florida:
28 Section 1. Subsection (3) of section 390.0111, Florida
29 Statutes, is amended to read:
30 390.0111 Termination of pregnancies.—
31 (3) CONSENTS REQUIRED.—A termination of pregnancy may not
32 be performed or induced except with the voluntary and informed
33 written consent of the pregnant woman or, in the case of a
34 mental incompetent, the voluntary and informed written consent
35 of her court-appointed guardian.
36 (a) Except in the case of a medical emergency, consent to a
37 termination of pregnancy is voluntary and informed only if:
38 1. The physician who is to perform the procedure, or the
39 referring physician, has, at a minimum, orally, in person,
40 informed the woman of:
41 a. The nature and risks of undergoing or not undergoing the
42 proposed procedure that a reasonable patient would consider
43 material to making a knowing and willful decision of whether to
44 terminate a pregnancy.
45 b. The probable gestational age of the fetus, verified by
46 an ultrasound, at the time the termination of pregnancy is to be
48 (I) The ultrasound must be performed by the physician who
49 is to perform the abortion or by a person having documented
50 evidence that he or she has completed a course in the operation
51 of ultrasound equipment as prescribed by rule and who is working
52 in conjunction with the physician.
53 (II) The person performing the ultrasound must allow the
54 woman to view the live ultrasound images, and a physician or a
55 registered nurse, licensed practical nurse, advanced registered
56 nurse practitioner, or physician assistant working in
57 conjunction with the physician must contemporaneously review and
58 explain the live ultrasound images to the woman before the woman
59 gives informed consent to having an abortion procedure
60 performed. However, this sub-sub-subparagraph does not apply if,
61 at the time the woman schedules or arrives for her appointment
62 to obtain an abortion, a copy of a restraining order, police
63 report, medical record, or other court order or documentation is
64 presented which provides evidence that the woman is obtaining
65 the abortion because the woman is a victim of rape, incest,
66 domestic violence, or human trafficking or that the woman has
67 been diagnosed as having a condition that, on the basis of a
68 physician’s good faith clinical judgment, would create a serious
69 risk of substantial and irreversible impairment of a major
70 bodily function if the woman delayed terminating her pregnancy.
71 (III) The woman has a right to decline to view the
72 ultrasound images after she is informed of her right and offered
73 an opportunity to view them. If the woman declines to view the
74 ultrasound images, the woman shall complete a form acknowledging
75 that she was offered an opportunity to view her ultrasound but
76 that she rejected that opportunity. The form must also indicate
77 that the woman’s decision not to view the ultrasound was not
78 based on any undue influence from any third party to discourage
79 her from viewing the images and that she declined to view the
80 images of her own free will.
81 c. The medical risks to the woman and fetus of carrying the
82 pregnancy to term.
83 2. Printed materials prepared and provided by the
84 department have been provided to the pregnant woman, if she
85 chooses to view these materials, including:
86 a. A description of the fetus, including a description of
87 the various stages of development.
88 b. A list of entities
agencies that offer alternatives to
89 terminating the pregnancy.
90 c. Detailed information on the availability of medical
91 assistance benefits for prenatal care, childbirth, and neonatal
93 3. The woman acknowledges in writing, before the
94 termination of pregnancy, that the information required to be
95 provided under this subsection has been provided.
97 Nothing in this paragraph is intended to prohibit a physician
98 from providing any additional information which the physician
99 deems material to the woman’s informed decision to terminate her
101 (b) If In the event a medical emergency exists and a
102 physician cannot comply with the requirements for informed
103 consent, a physician may terminate a pregnancy if he or she has
104 obtained at least one corroborative medical opinion attesting to
105 the medical necessity for emergency medical procedures and to
106 the fact that to a reasonable degree of medical certainty the
107 continuation of the pregnancy would threaten the life of the
108 pregnant woman. If a In the event no second physician is not
109 available for a corroborating opinion, the physician may proceed
110 but shall document reasons for the medical necessity in the
111 patient’s medical records.
112 (c) Violation of this subsection by a physician constitutes
113 grounds for disciplinary action under s. 458.331 or s. 459.015.
114 Substantial compliance or reasonable belief that complying with
115 the requirements of informed consent would threaten the life or
116 health of the patient is a defense to any action brought under
117 this paragraph.
118 Section 2. Paragraph (d) of subsection (3) of section
119 390.012, Florida Statutes, is amended to read:
120 390.012 Powers of agency; rules; disposal of fetal
122 (3) For clinics that perform or claim to perform abortions
123 after the first trimester of pregnancy, the agency shall adopt
124 rules pursuant to ss. 120.536(1) and 120.54 to implement the
125 provisions of this chapter, including the following:
126 (d) Rules relating to the medical screening and evaluation
127 of each abortion clinic patient. At a minimum, these rules shall
129 1. A medical history including reported allergies to
130 medications, antiseptic solutions, or latex; past surgeries; and
131 an obstetric and gynecological history.
132 2. A physical examination, including a bimanual examination
133 estimating uterine size and palpation of the adnexa.
134 3. The appropriate laboratory tests, including:
135 a. For an abortion in which an ultrasound examination is
136 not performed before the abortion procedure, Urine or blood
137 tests for pregnancy performed before the abortion procedure.
138 b. A test for anemia.
139 c. Rh typing, unless reliable written documentation of
140 blood type is available.
141 d. Other tests as indicated from the physical examination.
142 4. An ultrasound evaluation for all patients who elect to
143 have an abortion after the first trimester. The rules shall
144 require that if a person who is not a physician performs an
145 ultrasound examination, that person shall have documented
146 evidence that he or she has completed a course in the operation
147 of ultrasound equipment as prescribed in rule. The physician,
148 registered nurse, licensed practical nurse, advanced registered
149 nurse practitioner, or physician assistant shall review and
150 explain , at the request of the patient, the live ultrasound
151 images evaluation results, including an estimate of the probable
152 gestational age of the fetus, with the patient before the
153 abortion procedure is performed, unless the patient declines
154 pursuant to s. 390.0111. If the patient declines to view the
155 live ultrasound images, the rules shall require that s. 390.0111
156 be complied with in all other respects.
157 5. That the physician is responsible for estimating the
158 gestational age of the fetus based on the ultrasound examination
159 and obstetric standards in keeping with established standards of
160 care regarding the estimation of fetal age as defined in rule
161 and shall write the estimate in the patient’s medical history.
162 The physician shall keep original prints of each ultrasound
163 examination of a patient in the patient’s medical history file.
164 Section 3. If any provision of this act or its application
165 to any person or circumstance is held invalid, the invalidity
166 does not affect other provisions or applications of the act
167 which can be given effect without the invalid provision or
168 application, and to this end the provisions of this act are
170 Section 4. This act shall take effect July 1, 2011.