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H.B. 222

             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     
             7      LONG TITLE
             8      General Description:
             9          This bill amends provisions of the Utah Criminal Code relating to abortion.
             10      Highlighted Provisions:
             11          This bill:
             12          .    requires that at least 24 hours before a physician performs an abortion of an unborn
             13      child who is at least 20 weeks gestational age, the woman on whom the abortion is
             14      performed shall be informed of any anesthetic or analgesic that would eliminate or
             15      alleviate organic pain to the unborn child and any medical risks associated with the
             16      anesthetic or analgesic, unless:
             17              .    a medical emergency exists; or
             18              .    the abortion is being performed to save the life of the woman or to prevent grave
             19      damage to her medical health;
             20          .    provides that a person providing the information described in the preceding
             21      paragraph is not prohibited from informing the woman of the person's own opinion
             22      regarding the administration of an anesthetic or analgesic to alleviate fetal pain;
             23          .    requires the Department of Health to produce a brochure that:
             24              .    subject to certain exceptions, is to be provided to a woman seeking an abortion
             25      of an unborn child who is at least 20 weeks gestational age; and
             26              .    includes information, from both sides of the issue, relating to the ability of an
             27      unborn child to experience pain during an abortion procedure and the methods


             28      of alleviating or eliminating that pain;
             29          .    provides that a physician who performs an abortion of an unborn child who is at
             30      least 20 weeks gestational age shall administer an anesthetic or analgesic to the
             31      unborn child if the woman having the abortion consents to the administration of the
             32      anesthetic or analgesic, unless:
             33              .    a medical emergency exists; or
             34              .    the physician informs the woman that the physician, or the facility at which the
             35      abortion is to be performed, cannot or does not provide the service of
             36      administering an anesthetic or analgesic to an unborn child; and
             37          .    makes technical changes.
             38      Monies Appropriated in this Bill:
             39          None
             40      Other Special Clauses:
             41          None
             42      Utah Code Sections Affected:
             43      AMENDS:
             44          76-7-305, as last amended by Laws of Utah 2008, Chapter 3
             45          76-7-305.5, as last amended by Laws of Utah 2006, Chapters 116 and 207
             46          76-7-315, as last amended by Laws of Utah 2006, Chapter 207
             47      ENACTS:
             48          76-7-308.5, Utah Code Annotated 1953
             49     
             50      Be it enacted by the Legislature of the state of Utah:
             51          Section 1. Section 76-7-305 is amended to read:
             52           76-7-305. Informed consent requirements for abortion -- 24-hour wait mandatory
             53      -- Emergency exceptions.
             54          (1) No abortion may be performed unless a voluntary and informed written consent,
             55      consistent with Section 8.08 of the American Medical Association's Code of Medical Ethics,
             56      Current Opinions, and the provisions of this section is first obtained by the attending physician
             57      from the woman upon whom the abortion is to be performed.
             58          (2) Except in the case of a medical emergency, consent to an abortion is voluntary and


             59      informed only if:
             60          (a) at least 24 hours prior to the abortion, the physician who is to perform the abortion,
             61      the referring physician, a registered nurse, nurse practitioner, advanced practice registered
             62      nurse, certified nurse midwife, or physician's assistant, in a face-to-face consultation, orally
             63      informs the woman of:
             64          (i) consistent with Subsection (3)(a), the nature of the proposed abortion procedure or
             65      treatment, specifically how that procedure will affect the fetus, and the risks and alternatives to
             66      an abortion procedure or treatment that any person would consider material to the decision of
             67      whether or not to undergo an abortion;
             68          (ii) the probable gestational age and a description of the development of the unborn
             69      child at the time the abortion would be performed; [and]
             70          (iii) the medical risks associated with carrying her child to term; and
             71          (iv) except as provided in Subsection (3)(b), if the abortion is to be performed on an
             72      unborn child who is at least 20 weeks gestational age:
             73          (A) any anesthetic or analgesic that would eliminate or alleviate organic pain to the
             74      unborn child that may be caused by the particular method of abortion to be employed; and
             75          (B) any medical risks associated with the anesthetic or analgesic described in
             76      Subsection (2)(a)(iv)(A);
             77          (b) at least 24 hours prior to the abortion the physician who is to perform the abortion,
             78      the referring physician, or, as specifically delegated by either of those physicians, a registered
             79      nurse, licensed practical nurse, certified nurse-midwife, advanced practice registered nurse,
             80      clinical laboratory technologist, psychologist, marriage and family therapist, clinical social
             81      worker, or certified social worker has orally, in a face-to-face consultation, informed the
             82      pregnant woman that:
             83          (i) the Department of Health, in accordance with Section 76-7-305.5 , publishes printed
             84      material and an informational video that:
             85          (A) provides medically accurate information regarding all abortion procedures that may
             86      be used;
             87          (B) describes the gestational stages of an unborn child; and
             88          (C) includes information regarding public and private services and agencies available
             89      to assist her through pregnancy, at childbirth, and while the child is dependent, including


             90      private and agency adoption alternatives;
             91          (ii) the printed material and a viewing of or a copy of the informational video shall be
             92      provided to her free of charge;
             93          (iii) medical assistance benefits may be available for prenatal care, childbirth, and
             94      neonatal care, and that more detailed information on the availability of that assistance is
             95      contained in the printed materials and the informational video published by the Department of
             96      Health;
             97          (iv) except as provided in Subsection (3)[(b)](c), the father of the unborn child is
             98      legally required to assist in the support of her child, even in instances where he has offered to
             99      pay for the abortion, and that the Office of Recovery Services within the Department of Human
             100      Services will assist her in collecting child support; and
             101          (v) she has the right to view an ultrasound of the unborn child, at no expense to her,
             102      upon her request;
             103          (c) the information required to be provided to the pregnant woman under Subsection
             104      (2)(a) is also provided by the physician who is to perform the abortion, in a face-to-face
             105      consultation, prior to performance of the abortion, unless the attending or referring physician is
             106      the individual who provides the information required under Subsection (2)(a);
             107          (d) a copy of the printed materials published by the Department of Health has been
             108      provided to the pregnant woman;
             109          (e) the informational video, published by the Department of Health, has been provided
             110      to the pregnant woman in accordance with Subsection (4); and
             111          (f) the pregnant woman has certified in writing, prior to the abortion, that the
             112      information required to be provided under Subsections (2)(a) through (e) was provided, in
             113      accordance with the requirements of those subsections.
             114          (3) (a) The alternatives required to be provided under Subsection (2)(a)(i) shall include:
             115          (i) a description of adoption services, including private and agency adoption methods;
             116      and
             117          (ii) a statement that it is legal for adoptive parents to financially assist in pregnancy and
             118      birth expenses.
             119          (b) The information described in Subsection (2)(a)(iv) may be omitted from the
             120      information required to be provided to a pregnant woman under this section if the abortion is


             121      performed for a reason described in Subsection 76-7-302 (2)(a) or (d).
             122          [(b)] (c) The information described in Subsection (2)(b)(iv) may be omitted from the
             123      information required to be provided to a pregnant woman under this section if the woman is
             124      pregnant as the result of rape.
             125          (d) Nothing in this section shall be construed to prohibit a person described in
             126      Subsection (2)(a) from, when providing the information described in Subsection (2)(a)(iv),
             127      informing a woman of the person's own opinion regarding:
             128          (i) the capacity of an unborn child to experience pain;
             129          (ii) the advisability of administering an anesthetic or analgesic to an unborn child; or
             130          (iii) any other matter related to fetal pain.
             131          (4) When the informational video described in Section 76-7-305.5 is provided to a
             132      pregnant woman, the person providing the information shall first request that the woman view
             133      the video at that time or at another specifically designated time and location. If the woman
             134      chooses not to do so, a copy of the video shall be provided to her.
             135          (5) When a serious medical emergency compels the performance of an abortion, the
             136      physician shall inform the woman prior to the abortion, if possible, of the medical indications
             137      supporting the physician's judgment that an abortion is necessary.
             138          (6) Any physician who violates the provisions of this section:
             139          (a) is guilty of unprofessional conduct as defined in Section 58-67-102 or 58-68-102 ;
             140      and
             141          (b) shall be subject to:
             142          (i) suspension or revocation of the physician's license for the practice of medicine and
             143      surgery in accordance with [Sections] Section 58-67-401 [and 58-67-402 , Utah Medical
             144      Practice Act,] or [Sections] 58-68-401 [and 58-68-402 , Utah Osteopathic Medical Practice
             145      Act.]; and
             146          (ii) administrative penalties in accordance with Section 58-67-402 or 58-68-402 .
             147          (7) A physician is not guilty of violating this section for failure to furnish any of the
             148      information described in Subsection (2), if:
             149          (a) the physician can demonstrate by a preponderance of the evidence that the physician
             150      reasonably believed that furnishing the information would have resulted in a severely adverse
             151      effect on the physical or mental health of the pregnant woman;


             152          (b) in the physician's professional judgment, the abortion was necessary to save the
             153      pregnant woman's life;
             154          (c) the pregnancy was the result of rape or rape of a child, as defined in Sections
             155      76-5-402 and 76-5-402.1 ;
             156          (d) the pregnancy was the result of incest, as defined in Subsection 76-5-406 (10) and
             157      Section 76-7-102 ; or
             158          [(e) in his professional judgment the abortion was to prevent the birth of a child who
             159      would have been born with grave defects; or]
             160          [(f)] (e) the pregnant woman was 14 years of age or younger.
             161          (8) A physician is not guilty of violating this section for failure to furnish any of the
             162      information described in Subsections (2)(a)(i) through (iii) or (2)(b) through (f), if, in the
             163      physician's professional judgment, the abortion was to prevent the birth of a child who would
             164      have been born with grave defects.
             165          [(8)] (9) A physician who complies with the provisions of this section and Section
             166      76-7-304.5 may not be held civilly liable to the physician's patient for failure to obtain
             167      informed consent under Section 78B-3-406 .
             168          Section 2. Section 76-7-305.5 is amended to read:
             169           76-7-305.5. Requirements for printed materials and informational video --
             170      Annual report of Department of Health.
             171          (1) In order to insure that a woman's consent to an abortion is truly an informed
             172      consent, the Department of Health shall publish printed materials and produce an informational
             173      video in accordance with the requirements of this section. The department and each local
             174      health department shall make those materials and a viewing of the video available at no cost to
             175      any person. The printed material and the informational video shall be comprehensible and
             176      contain all of the following:
             177          (a) geographically indexed materials informing the woman of public and private
             178      services and agencies available to assist her, financially and otherwise, through pregnancy, at
             179      childbirth, and while the child is dependent, including services and supports available under
             180      Section 35A-3-308 . Those materials shall contain a description of available adoption services,
             181      including a comprehensive list of the names, addresses, and telephone numbers of public and
             182      private agencies and private attorneys whose practice includes adoption, and explanations of


             183      possible available financial aid during the adoption process. The information regarding
             184      adoption services shall include the fact that private adoption is legal, and that the law permits
             185      adoptive parents to pay the costs of prenatal care, childbirth, and neonatal care. The printed
             186      information and video shall present adoption as a preferred and positive choice and alternative
             187      to abortion. The department may, at its option, include printed materials that describe the
             188      availability of a toll-free 24-hour telephone number that may be called in order to obtain,
             189      orally, the list and description of services, agencies, and adoption attorneys in the locality of the
             190      caller;
             191          (b) truthful and nonmisleading descriptions of the probable anatomical and
             192      physiological characteristics of the unborn child at two-week gestational increments from
             193      fertilization to full term, accompanied by pictures or video segments representing the
             194      development of an unborn child at those gestational increments. The descriptions shall include
             195      information about brain and heart function and the presence of external members and internal
             196      organs during the applicable stages of development. Any pictures used shall contain the
             197      dimensions of the fetus and shall be realistic and appropriate for that woman's stage of
             198      pregnancy. The materials shall be designed to convey accurate scientific information about an
             199      unborn child at the various gestational ages, and to convey the state's preference for childbirth
             200      over abortion;
             201          (c) truthful, nonmisleading descriptions of abortion procedures used in current medical
             202      practice at the various stages of growth of the unborn child, the medical risks commonly
             203      associated with each procedure, including those related to subsequent childbearing, the
             204      consequences of each procedure to the fetus at various stages of fetal development, the possible
             205      detrimental psychological effects of abortion, and the medical risks associated with carrying a
             206      child to term;
             207          (d) any relevant information on the possibility of an unborn child's survival at the
             208      two-week gestational increments described in Subsection (1)(b);
             209          (e) information on the availability of medical assistance benefits for prenatal care,
             210      childbirth, and neonatal care;
             211          (f) a statement conveying that it is unlawful for any person to coerce a woman to
             212      undergo an abortion;
             213          (g) a statement conveying that any physician who performs an abortion without


             214      obtaining the woman's informed consent or without according her a private medical
             215      consultation in accordance with the requirements of this section, may be liable to her for
             216      damages in a civil action at law;
             217          (h) a statement conveying that the state prefers childbirth over abortion; and
             218          (i) information regarding the legal responsibility of the father to assist in child support,
             219      even in instances where he has agreed to pay for an abortion, including a description of the
             220      services available through the Office of Recovery Services, within the Department of Human
             221      Services, to establish and collect that support.
             222          (2) (a) The printed material described in Subsection (1) shall include a separate
             223      brochure that contains truthful, nonmisleading information on both sides of the issue regarding:
             224          (i) the ability of an unborn child to experience pain during an abortion procedure;
             225          (ii) the measures that may be taken, including the administration of an anesthetic or
             226      analgesic to an unborn child, to alleviate or eliminate pain to an unborn child during an
             227      abortion procedure;
             228          (iii) the effectiveness and advisability of taking the measures described in Subsection
             229      (2)(a)(ii); and
             230          (iv) potential medical risks associated with the administration of an anesthetic or
             231      analgesic to an unborn child during an abortion procedure.
             232          (b) A person or facility is not required to provide the information described in
             233      Subsection (2)(a) to a patient or potential patient, unless the abortion is to be performed:
             234          (i) on an unborn child who is at least 20 weeks gestational age at the time of the
             235      abortion; and
             236          (ii) for a reason other than a reason described in Subsection 76-7-302 (2)(a) or (d).
             237          [(2)] (3) (a) The materials described in [Subsection] Subsections (1) and (2) shall be
             238      produced and printed in a way that conveys the state's preference for childbirth over abortion.
             239          (b) The printed material described in [Subsection] Subsections (1) and (2) shall be
             240      printed in a typeface large enough to be clearly legible.
             241          [(3) Every] (4) Except as provided in Subsection (2)(b), every facility in which
             242      abortions are performed shall immediately provide the printed informed consent materials and
             243      a viewing of or a copy of the informational video described in [Subsection] Subsections (1) and
             244      (2) to any patient or potential patient prior to the performance of an abortion, unless the


             245      patient's attending or referring physician certifies in writing that he reasonably believes that
             246      provision of the materials or video to that patient would result in a severely adverse effect on
             247      her physical or mental health.
             248          [(4)] (5) The Department of Health shall produce a standardized videotape that may be
             249      used statewide, containing all of the information described in Subsection (1), in accordance
             250      with the requirements of [that subsection and Subsection (2)] Subsections (1) and (3). In
             251      preparing the video, the department may summarize and make reference to the printed
             252      comprehensive list of geographically indexed names and services described in Subsection
             253      (1)(a). The videotape shall, in addition to the information described in Subsection (1), show an
             254      ultrasound of the heart beat of an unborn child at three weeks gestational age, at six to eight
             255      weeks gestational age, and each month thereafter, until 14 weeks gestational age. That
             256      information shall be presented in a truthful, nonmisleading manner designed to convey accurate
             257      scientific information, the state's preference for childbirth over abortion, and the positive
             258      aspects of adoption.
             259          [(5)] (6) The Department of Health and local health departments shall provide
             260      ultrasounds in accordance with the provisions of Subsection 76-7-305 (2)(b), at no expense to
             261      the pregnant woman.
             262          [(6)] (7) The Department of Health shall compile and report the following information
             263      annually, preserving physician and patient anonymity:
             264          (a) the total amount of informed consent material described in [Subsection]
             265      Subsections (1) and (2) that was distributed;
             266          (b) the number of women who obtained abortions in this state without receiving those
             267      materials;
             268          (c) the number of statements signed by attending physicians certifying to [his] the
             269      physicians' opinion regarding adverse effects on the patient under Subsection [(3)] (4); and
             270          (d) any other information pertaining to protecting the informed consent of women
             271      seeking abortions.
             272          Section 3. Section 76-7-308.5 is enacted to read:
             273          76-7-308.5. Administration of anesthetic or analgesic to an unborn child.
             274          A physician who performs an abortion of an unborn child who is at least 20 weeks
             275      gestational age shall administer an anesthetic or analgesic to eliminate or alleviate organic pain


             276      to the unborn child that may be caused by the particular method of abortion to be employed, if
             277      the woman having the abortion consents to the administration of an anesthetic or analgesic to
             278      the unborn child, unless:
             279          (1) the physician is prevented from administering the anesthetic or analgesic by a
             280      medical emergency; or
             281          (2) prior to performing the abortion, the physician informs the woman that the
             282      physician, or the facility at which the abortion is to be performed, cannot or does not provide
             283      the service of administering an anesthetic or analgesic to an unborn child.
             284          Section 4. Section 76-7-315 is amended to read:
             285           76-7-315. Exceptions to certain requirements in serious medical emergencies.
             286          When due to a serious medical emergency, time does not permit compliance with
             287      Section 76-7-302 , 76-7-305 , 76-7-305.5 , 76-7-308.5 , or 76-7-310.5 the provisions of those
             288      sections do not apply.




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