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H.B. 222 Enrolled

             1     

UNBORN CHILD PAIN PREVENTION ACT

             2     
2009 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: Carl Wimmer

             5     
Senate Sponsor: D. Chris Buttars

             6      Cosponsors:
             7      Douglas C. Aagard
             8      Roger E. Barrus
             9      Julie Fisher
             10      Craig A. Frank
             11      Keith GroverGregory H. Hughes
Eric K. Hutchings
Don L. Ipson
Michael T. Morley
Merlynn T. NewboldMichael E. Noel
Paul Ray
Stephen E. Sandstrom
Kenneth W. Sumsion
Evan J. Vickers              12     
             13      LONG TITLE
             14      General Description:
             15          This bill amends provisions of the Utah Criminal Code relating to abortion.
             16      Highlighted Provisions:
             17          This bill:
             18          .    requires that at least 24 hours before a physician performs an abortion of an unborn
             19      child who is at least 20 weeks gestational age, the woman on whom the abortion is
             20      performed shall, except when a medical emergency exists and there is not adequate
             21      time to comply with the requirements of this bill, be informed:
             22              .    that, upon the woman's request, an anesthetic or analgesic will be administered
             23      to the unborn child, through the woman, to eliminate or alleviate organic pain
             24      to the unborn child; and
             25              .    of any medical risks to the woman associated with the anesthetic or analgesic;
             26          .    provides that a person providing the information described in the preceding
             27      paragraph is not prohibited from informing the woman of the person's own opinion
             28      regarding the administration of an anesthetic or analgesic to alleviate fetal pain;
             29          .    requires the Department of Health to produce a brochure that:
             30              .    subject to certain exceptions, is to be provided to a woman seeking an abortion


             31      of an unborn child who is at least 20 weeks gestational age; and
             32              .    includes information relating to the ability of an unborn child to experience
             33      pain during an abortion procedure and the methods of alleviating or eliminating
             34      that pain;
             35          .    provides that a physician who performs an abortion of an unborn child who is at
             36      least 20 weeks gestational age shall administer an anesthetic or analgesic to the
             37      unborn child if the woman having the abortion consents to the administration of the
             38      anesthetic or analgesic, unless a medical emergency exists and there is not adequate
             39      time to comply with the requirements of this bill; and
             40          .    makes technical changes.
             41      Monies Appropriated in this Bill:
             42          None
             43      Other Special Clauses:
             44          This bill coordinates with H.B. 90 by providing substantive and technical amendments.
             45      Utah Code Sections Affected:
             46      AMENDS:
             47          76-7-305, as last amended by Laws of Utah 2008, Chapter 3
             48          76-7-305.5, as last amended by Laws of Utah 2006, Chapters 116 and 207
             49          76-7-315, as last amended by Laws of Utah 2006, Chapter 207
             50      ENACTS:
             51          76-7-308.5, Utah Code Annotated 1953
             52     
             53      Be it enacted by the Legislature of the state of Utah:
             54          Section 1. Section 76-7-305 is amended to read:
             55           76-7-305. Informed consent requirements for abortion -- 24-hour wait
             56      mandatory -- Emergency exceptions.
             57          (1) No abortion may be performed unless a voluntary and informed written consent,
             58      consistent with Section 8.08 of the American Medical Association's Code of Medical Ethics,


             59      Current Opinions, and the provisions of this section is first obtained by the attending
             60      physician from the woman upon whom the abortion is to be performed.
             61          (2) Except in the case of a medical emergency, consent to an abortion is voluntary and
             62      informed only if:
             63          (a) at least 24 hours prior to the abortion, the physician who is to perform the abortion,
             64      the referring physician, a registered nurse, nurse practitioner, advanced practice registered
             65      nurse, certified nurse midwife, or physician's assistant, in a face-to-face consultation, orally
             66      informs the woman [of]:
             67          (i) consistent with Subsection (3)(a), of the nature of the proposed abortion procedure
             68      or treatment, specifically how that procedure will affect the fetus, and the risks and
             69      alternatives to an abortion procedure or treatment that any person would consider material to
             70      the decision of whether or not to undergo an abortion;
             71          (ii) of the probable gestational age and a description of the development of the unborn
             72      child at the time the abortion would be performed; [and]
             73          (iii) of the medical risks associated with carrying her child to term; and
             74          (iv) except as provided in Subsection (3)(b), if the abortion is to be performed on an
             75      unborn child who is at least 20 weeks gestational age:
             76          (A) that, upon the woman's request, an anesthetic or analgesic will be administered to
             77      the unborn child, through the woman, to eliminate or alleviate organic pain to the unborn child
             78      that may be caused by the particular method of abortion to be employed; and
             79          (B) of any medical risks to the woman that are associated with administering the
             80      anesthetic or analgesic described in Subsection (2)(a)(iv)(A);
             81          (b) at least 24 hours prior to the abortion the physician who is to perform the abortion,
             82      the referring physician, or, as specifically delegated by either of those physicians, a registered
             83      nurse, licensed practical nurse, certified nurse-midwife, advanced practice registered nurse,
             84      clinical laboratory technologist, psychologist, marriage and family therapist, clinical social
             85      worker, or certified social worker has orally, in a face-to-face consultation, informed the
             86      pregnant woman that:


             87          (i) the Department of Health, in accordance with Section 76-7-305.5 , publishes
             88      printed material and an informational video that:
             89          (A) provides medically accurate information regarding all abortion procedures that
             90      may be used;
             91          (B) describes the gestational stages of an unborn child; and
             92          (C) includes information regarding public and private services and agencies available
             93      to assist her through pregnancy, at childbirth, and while the child is dependent, including
             94      private and agency adoption alternatives;
             95          (ii) the printed material and a viewing of or a copy of the informational video shall be
             96      provided to her free of charge;
             97          (iii) medical assistance benefits may be available for prenatal care, childbirth, and
             98      neonatal care, and that more detailed information on the availability of that assistance is
             99      contained in the printed materials and the informational video published by the Department of
             100      Health;
             101          (iv) except as provided in Subsection (3)[(b)](c), the father of the unborn child is
             102      legally required to assist in the support of her child, even in instances where he has offered to
             103      pay for the abortion, and that the Office of Recovery Services within the Department of
             104      Human Services will assist her in collecting child support; and
             105          (v) she has the right to view an ultrasound of the unborn child, at no expense to her,
             106      upon her request;
             107          (c) the information required to be provided to the pregnant woman under Subsection
             108      (2)(a) is also provided by the physician who is to perform the abortion, in a face-to-face
             109      consultation, prior to performance of the abortion, unless the attending or referring physician
             110      is the individual who provides the information required under Subsection (2)(a);
             111          (d) a copy of the printed materials published by the Department of Health has been
             112      provided to the pregnant woman;
             113          (e) the informational video, published by the Department of Health, has been provided
             114      to the pregnant woman in accordance with Subsection (4); and


             115          (f) the pregnant woman has certified in writing, prior to the abortion, that the
             116      information required to be provided under Subsections (2)(a) through (e) was provided, in
             117      accordance with the requirements of those subsections.
             118          (3) (a) The alternatives required to be provided under Subsection (2)(a)(i) shall
             119      include:
             120          (i) a description of adoption services, including private and agency adoption methods;
             121      and
             122          (ii) a statement that it is legal for adoptive parents to financially assist in pregnancy
             123      and birth expenses.
             124          (b) The information described in Subsection (2)(a)(iv) may be omitted from the
             125      information required to be provided to a pregnant woman under this section if:
             126          (i) the abortion is performed for a reason described in Subsection 76-7-302 (2)(a) or
             127      (d); and
             128          (ii) due to a serious medical emergency, time does not permit compliance with the
             129      requirement to provide the information described in Subsection (2)(a)(iv).
             130          [(b)] (c) The information described in Subsection (2)(b)(iv) may be omitted from the
             131      information required to be provided to a pregnant woman under this section if the woman is
             132      pregnant as the result of rape.
             133          (d) Nothing in this section shall be construed to prohibit a person described in
             134      Subsection (2)(a) from, when providing the information described in Subsection (2)(a)(iv),
             135      informing a woman of the person's own opinion regarding:
             136          (i) the capacity of an unborn child to experience pain;
             137          (ii) the advisability of administering an anesthetic or analgesic to an unborn child; or
             138          (iii) any other matter related to fetal pain.
             139          (4) When the informational video described in Section 76-7-305.5 is provided to a
             140      pregnant woman, the person providing the information shall first request that the woman view
             141      the video at that time or at another specifically designated time and location. If the woman
             142      chooses not to do so, a copy of the video shall be provided to her.


             143          (5) When a serious medical emergency compels the performance of an abortion, the
             144      physician shall inform the woman prior to the abortion, if possible, of the medical indications
             145      supporting the physician's judgment that an abortion is necessary.
             146          (6) Any physician who violates the provisions of this section:
             147          (a) is guilty of unprofessional conduct as defined in Section 58-67-102 or 58-68-102 ;
             148      and
             149          (b) shall be subject to:
             150          (i) suspension or revocation of the physician's license for the practice of medicine and
             151      surgery in accordance with [Sections] Section 58-67-401 [and 58-67-402 , Utah Medical
             152      Practice Act,] or [Sections] 58-68-401 [and 58-68-402 , Utah Osteopathic Medical Practice
             153      Act.]; and
             154          (ii) administrative penalties in accordance with Section 58-67-402 or 58-68-402 .
             155          (7) A physician is not guilty of violating this section for failure to furnish any of the
             156      information described in Subsection (2), if:
             157          (a) the physician can demonstrate by a preponderance of the evidence that the
             158      physician reasonably believed that furnishing the information would have resulted in a
             159      severely adverse effect on the physical or mental health of the pregnant woman;
             160          (b) in the physician's professional judgment, the abortion was necessary to save the
             161      pregnant woman's life;
             162          (c) the pregnancy was the result of rape or rape of a child, as defined in Sections
             163      76-5-402 and 76-5-402.1 ;
             164          (d) the pregnancy was the result of incest, as defined in Subsection 76-5-406 (10) and
             165      Section 76-7-102 ; or
             166          [(e) in his professional judgment the abortion was to prevent the birth of a child who
             167      would have been born with grave defects; or]
             168          [(f)] (e) the pregnant woman was 14 years of age or younger.
             169          (8) A physician who complies with the provisions of this section and Section
             170      76-7-304.5 may not be held civilly liable to the physician's patient for failure to obtain


             171      informed consent under Section 78B-3-406 .
             172          Section 2. Section 76-7-305.5 is amended to read:
             173           76-7-305.5. Requirements for printed materials and informational video --
             174      Annual report of Department of Health.
             175          (1) In order to insure that a woman's consent to an abortion is truly an informed
             176      consent, the Department of Health shall publish printed materials and produce an
             177      informational video in accordance with the requirements of this section. The department and
             178      each local health department shall make those materials and a viewing of the video available at
             179      no cost to any person. The printed material and the informational video shall be
             180      comprehensible and contain all of the following:
             181          (a) geographically indexed materials informing the woman of public and private
             182      services and agencies available to assist her, financially and otherwise, through pregnancy, at
             183      childbirth, and while the child is dependent, including services and supports available under
             184      Section 35A-3-308 . Those materials shall contain a description of available adoption services,
             185      including a comprehensive list of the names, addresses, and telephone numbers of public and
             186      private agencies and private attorneys whose practice includes adoption, and explanations of
             187      possible available financial aid during the adoption process. The information regarding
             188      adoption services shall include the fact that private adoption is legal, and that the law permits
             189      adoptive parents to pay the costs of prenatal care, childbirth, and neonatal care. The printed
             190      information and video shall present adoption as a preferred and positive choice and alternative
             191      to abortion. The department may, at its option, include printed materials that describe the
             192      availability of a toll-free 24-hour telephone number that may be called in order to obtain,
             193      orally, the list and description of services, agencies, and adoption attorneys in the locality of
             194      the caller;
             195          (b) truthful and nonmisleading descriptions of the probable anatomical and
             196      physiological characteristics of the unborn child at two-week gestational increments from
             197      fertilization to full term, accompanied by pictures or video segments representing the
             198      development of an unborn child at those gestational increments. The descriptions shall


             199      include information about brain and heart function and the presence of external members and
             200      internal organs during the applicable stages of development. Any pictures used shall contain
             201      the dimensions of the fetus and shall be realistic and appropriate for that woman's stage of
             202      pregnancy. The materials shall be designed to convey accurate scientific information about an
             203      unborn child at the various gestational ages, and to convey the state's preference for childbirth
             204      over abortion;
             205          (c) truthful, nonmisleading descriptions of abortion procedures used in current
             206      medical practice at the various stages of growth of the unborn child, the medical risks
             207      commonly associated with each procedure, including those related to subsequent childbearing,
             208      the consequences of each procedure to the fetus at various stages of fetal development, the
             209      possible detrimental psychological effects of abortion, and the medical risks associated with
             210      carrying a child to term;
             211          (d) any relevant information on the possibility of an unborn child's survival at the
             212      two-week gestational increments described in Subsection (1)(b);
             213          (e) information on the availability of medical assistance benefits for prenatal care,
             214      childbirth, and neonatal care;
             215          (f) a statement conveying that it is unlawful for any person to coerce a woman to
             216      undergo an abortion;
             217          (g) a statement conveying that any physician who performs an abortion without
             218      obtaining the woman's informed consent or without according her a private medical
             219      consultation in accordance with the requirements of this section, may be liable to her for
             220      damages in a civil action at law;
             221          (h) a statement conveying that the state prefers childbirth over abortion; and
             222          (i) information regarding the legal responsibility of the father to assist in child support,
             223      even in instances where he has agreed to pay for an abortion, including a description of the
             224      services available through the Office of Recovery Services, within the Department of Human
             225      Services, to establish and collect that support.
             226          (2) (a) The printed material described in Subsection (1) shall include a separate


             227      brochure that contains truthful, nonmisleading information regarding:
             228          (i) the ability of an unborn child to experience pain during an abortion procedure;
             229          (ii) the measures that may be taken, including the administration of an anesthetic or
             230      analgesic to an unborn child, to alleviate or eliminate pain to an unborn child during an
             231      abortion procedure;
             232          (iii) the effectiveness and advisability of taking the measures described in Subsection
             233      (2)(a)(ii); and
             234          (iv) potential medical risks to a pregnant woman that are associated with the
             235      administration of an anesthetic or analgesic to an unborn child during an abortion procedure.
             236          (b) A person or facility is not required to provide the information described in
             237      Subsection (2)(a) to a patient or potential patient, if the abortion is to be performed:
             238          (i) on an unborn child who is less than 20 weeks gestational age at the time of the
             239      abortion; or
             240          (ii) on an unborn child who is at least 20 weeks gestational age at the time of the
             241      abortion, if:
             242          (A) the abortion is being performed for a reason described in Subsection
             243      76-7-302 (2)(a) or (d); and
             244          (B) due to a serious medical emergency, time does not permit compliance with the
             245      requirement to provide the information described in Subsection (2)(a).
             246          [(2)] (3) (a) The materials described in [Subsection] Subsections (1) and (2) shall be
             247      produced and printed in a way that conveys the state's preference for childbirth over abortion.
             248          (b) The printed material described in [Subsection] Subsections (1) and (2) shall be
             249      printed in a typeface large enough to be clearly legible.
             250          [(3) Every] (4) Except as provided in Subsection (2)(b), every facility in which
             251      abortions are performed shall immediately provide the printed informed consent materials and
             252      a viewing of or a copy of the informational video described in [Subsection] Subsections (1)
             253      and (2) to any patient or potential patient prior to the performance of an abortion, unless the
             254      patient's attending or referring physician certifies in writing that he reasonably believes that


             255      provision of the materials or video to that patient would result in a severely adverse effect on
             256      her physical or mental health.
             257          [(4)] (5) The Department of Health shall produce a standardized videotape that may be
             258      used statewide, containing all of the information described in Subsection (1), in accordance
             259      with the requirements of [that subsection and Subsection (2)] Subsections (1) and (3). In
             260      preparing the video, the department may summarize and make reference to the printed
             261      comprehensive list of geographically indexed names and services described in Subsection
             262      (1)(a). The videotape shall, in addition to the information described in Subsection (1), show
             263      an ultrasound of the heart beat of an unborn child at three weeks gestational age, at six to eight
             264      weeks gestational age, and each month thereafter, until 14 weeks gestational age. That
             265      information shall be presented in a truthful, nonmisleading manner designed to convey
             266      accurate scientific information, the state's preference for childbirth over abortion, and the
             267      positive aspects of adoption.
             268          [(5)] (6) The Department of Health and local health departments shall provide
             269      ultrasounds in accordance with the provisions of Subsection 76-7-305 (2)(b), at no expense to
             270      the pregnant woman.
             271          [(6)] (7) The Department of Health shall compile and report the following information
             272      annually, preserving physician and patient anonymity:
             273          (a) the total amount of informed consent material described in [Subsection]
             274      Subsections (1) and (2) that was distributed;
             275          (b) the number of women who obtained abortions in this state without receiving those
             276      materials;
             277          (c) the number of statements signed by attending physicians certifying to [his] the
             278      physicians' opinion regarding adverse effects on the patient under Subsection [(3)] (4); and
             279          (d) any other information pertaining to protecting the informed consent of women
             280      seeking abortions.
             281          Section 3. Section 76-7-308.5 is enacted to read:
             282          76-7-308.5. Administration of anesthetic or analgesic to an unborn child.


             283          A physician who performs an abortion of an unborn child who is at least 20 weeks
             284      gestational age shall administer an anesthetic or analgesic to eliminate or alleviate organic
             285      pain to the unborn child that may be caused by the particular method of abortion to be
             286      employed, if the woman having the abortion consents to the administration of an anesthetic or
             287      analgesic to the unborn child, unless the physician is prevented from administering the
             288      anesthetic or analgesic by a medical emergency.
             289          Section 4. Section 76-7-315 is amended to read:
             290           76-7-315. Exceptions to certain requirements in serious medical emergencies.
             291          When due to a serious medical emergency, time does not permit compliance with
             292      Section 76-7-302 , 76-7-305 , 76-7-305.5 , 76-7-308.5 , or 76-7-310.5 the provisions of those
             293      sections do not apply.
             294          Section 5. Coordinating H.B. 222 with H.B. 90 -- Substantive and technical
             295      amendments.
             296          If this H.B. 222 and H.B. 90, Abortion Law Amendments, both pass, it is the intent of
             297      the Legislature that the Office of Legislative Research and General Counsel shall prepare the
             298      Utah Code database for publication by modifying:
             299          (1) Subsection 76-7-305 (3)(b)(i) to read as follows:
             300          "(i) the abortion is performed for a reason described in Subsection 76-7-302 (3)(b)(i);
             301      and"; and
             302          (2) Subsection 76-7-305.5 (2)(b)(ii)(A) to read as follows:
             303          "(A) the abortion is being performed for a reason described in Subsection
             304      76-7-302 (3)(b)(i); and".


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