Legislature(2003 - 2004)
04/03/2003 05:10 PM Senate HES
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* first hearing in first committee of referral
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+ teleconferenced
= bill was previously heard/scheduled
SB 30-ABORTION: INFORMED CONSENT; INFORMATION
CHAIR FRED DYSON called the Senate Health, Education and Social
Services Standing Committee meeting to order at 5:10 p.m.
Present were SENATORS GUESS and DAVIS. He announced SB 30 to be
up for consideration. He explained that the new version adds a
new section to legislative findings, recommended by the
Department of Law that explains the state's compelling interest
in regulating this issue. Section 2 of the bill directs the
Department of Health and Social Services (DHSS) to develop a
free pamphlet to assist pregnant women in their choices. Doctors
are not required to use the pamphlet, but they are offered the
option and can supply whatever other information they want to.
This version (Q) also elevates informed consent, which was in
regulation, to statute and adds to the current abortion
reporting requirement whether or not the client received the
pamphlet.
SENATOR BETTYE DAVIS moved to adopt the CS to SB 30, version Q
for purposes of discussion. There were no objections.
MS. MARI GALREAVE, Fairbanks medical professional, said that a
fetus is not an unborn child unless you subscribe to a certain
religion. In her religion, the soul enters the body 40 days
after conception. Her point is to keep religion separate from
abortion rights. She stated, "If the new pamphlet uses the words
'unborn child,' it is harassment. Don't legislate what someone
should say in the new pamphlet."
SENATOR WILKEN arrived at 5:15 p.m.
MS. RUTH ABBOTT testified on behalf of a local Delta Junction
charity and said, "Women should insist on being given the
respect of being provided with all the information necessary to
make an informed decision as is mandatory in all of their
medical procedures."
DR. BOB JOHNSON, Kodiak, said he is a retired physician and
while he was practicing, he did abortions. He has plenty of
experience talking to women about their decisions and responding
to their questions about the procedure and believes this is a
highly private matter. Women have the right to know everything
they want to know and everything they should know and that
applies to any procedure that is performed on them. He noted:
For the Legislature to make the assumption that they
know what women should ask is presumptuous. I think
they do have the right to know anything they want to
know and they should be able to ask and they should be
able to learn what they need to learn....
DR. JOHNSON explained that he scheduled four appointments for
each abortion. The first one was to help decide whether the
patient had made an appropriate decision; the second was to
answer questions about the procedure as well as its short and
long-term effects. In his experience, he found none of the short
and long term effects publicized by the Right-to-Life group to
be factual.
MS. CYNDI SAUNDERS said she wanted both men and women to know
the truth about the pain, guilt and relationship problems that a
20 to 30 minute procedure can have on the rest of a person's
life. She is sad that she had the procedure three times and no
one told her how she would feel 30 or 40 years later or how it
would affect her children that are alive today.
MS. CASSANDRA JOHNSON said the main purpose of the wording in
the proposed pamphlet is to intimidate women and make them feel
guilty for exercising their rights. Aside from being an attempt
to withdraw women's rights, there are several other problems
with the bill. First, the Legislature has no business telling
doctors the specifics of what they can tell their patients.
Doctors are already bound by standards of practice which include
complete and unbiased information about medical procedures, and
insures that any patient truly consents to the procedure they
are about to undergo. There is no need for special
information/consent for an abortion. The proposed "counseling"
material is clearly biased and includes a lot of other
information about pregnancies and possible serious
complications.
MS. AMY MENARD said she is an attorney primarily for health care
delivery, medical licensing and liability issues. She
recommended that the committee table this bill, because it is
contrary to existing Alaska law and its need has not been
demonstrated. She maintained:
As a matter of Alaska law, abortion like any other
medical treatment or procedure, always requires
informed consent under AS 09.55.556. That has been law
for 27 years. This law guarantees not only that women
have a right to information about medical care, but
that all Alaskans do. Moreover, the content of
informed consent is covered ethically by the American
Medical Association's code of ethics. Code provision
8.08 already directs physicians and their informed
consent obligation to their patient.
The so-called findings as articulated at the outset of
the bill are patently wrong. This bill does not
promote judicial economy nor will it provide
clarification for physicians. It's actually contrary
to the rubric of [indisc.]. And what this bill does,
particularly with its informed consent provisions, it
decrees a double standard for physicians who provide
abortion services contrary to those who do not. The
creation of this pamphlet and the language that's
supposed to be added to the bill, and I'm referring to
subsection (h) that would be under Title 18.16.010, is
contrary to existing law as it regards physicians and
their practices. Decreeing [indisc.] language with
regard to informed consent that is contrary to what is
already called for under Title 9.
This law is poorly written and unsupported. As far as
the findings articulated, it will not clarify anything
for physicians and it will guarantee litigation for
the state.
MS. JENNIFER ESTERL, Alaska Civil Liberties Union, opposed SB
30; one reason being the extra mandatory counseling that
includes irrelevant medical information. Mandatory extraneous
lectures do not give women accurate or meaningful medical
information; they put words in doctors' mouths and involve a
litany of conceivable pros and cons even when those alternatives
are not in the patient's best interest and, worse yet, may even
harm her. Women who are seeking prenatal care in order to carry
a pregnancy to term should not be forced to waste time and money
listening to a diatribe about their options and alternatives.
She informed them that the risk of carrying a pregnancy through
to childbirth is 20 times greater than that of a first trimester
abortion.
Second, this bill refers to possible psychological effects that
have been associated with having an abortion. Substituting
politicians' judgments to that of doctors' is misleading. A
1987-88 investigation by the attorney general of the United
States (who was not a champion of choice) and a World Health
Organization study state there is no medical evidence that shows
abortion causes psychological injury.
Third, requiring physicians to deliver extraneous lectures makes
access to quality reproductive health care much more difficult
and expensive. Informed consent is already required for medical
procedures. "This bill is designed to make a woman's very
personal decision even more difficult...."
DR. KATHY TODD said she is a practicing physician in Valdez and
opposes SB 107 for all the reasons previously stated. Women come
to her already having very carefully considered their options -
having talked to their significant others, their friends, their
pastors and another physician sometimes. They need other health
information by the time they see her. She stated that sometimes
24-hours is a long time and means an extra journey for people
who live 100 miles from her office - and this happens a lot.
Evidence shows that informed consent issues are best discussed
with social workers and specially trained nurses, not the
physician. It has also been proven that people won't read any
pamphlet that is more than two pages long.
MS. VIRGINIA PHILLIPS said that SB 30 is desperately needed in
Alaska. She explained, "Most of the time a woman is not told of
her options. A 24-hour waiting period is needed to give a woman
time to evaluate all her options along with the consequences."
She said that most women don't realize that the National
Physicians Center for Family and the [indisc.] Cancer Center
have acknowledged there is an abortion-breast cancer link. She
surmised, "The state has a compelling interest to pass this bill
to protect a woman's physical, mental and emotional health...."
MS. EILEEN BECKER said she has five children and has been
involved with the Homer Pregnancy Care Center for 15 years. She
stated that in a recent article, she read that only 24 percent
of women who have abortions don't have regrets or after effects.
About 10 million women in American regret their decision and, in
the last 30 years, 40 million babies have been aborted. One out
of every four women in American has had an abortion, very high
numbers. Post abortion syndrome is an actual feeling that she
helps women deal with at the Homer Pregnancy Care Center.
MS. JENNIE GRIMWOOD, Cordova resident, said that this informed
consent bill and pamphlet is very important. She indicated:
Often many women who are pregnant don't understand
fetal development. Many times health professionals
don't answer all the questions. A scared pregnant
women is often an uninformed one...The abortion
industry puts blinders on women. They don't want women
to really know what is happening to their bodies. Many
women today are coerced into having abortions by their
boyfriends, health professionals, their parents and
uncles. It often is not an individual choice or a pro
choice, as people would have us believe. It is often a
choice made out of fear and ignorance....
DR. COLLEEN MURPHY, Anchorage OB/GYN, said she is an abortion
provider and provides health care that is sanctioned by the
National Abortion Federation. She has a multitude of guidelines
to follow in her practice and she endeavors to provide the
highest quality care for women throughout their reproductive
health careers. She informed the committee that current levels
of care already exceed those prescribed in the bill. Birth and
abortion considerations are a private concern between her and
her patient. They talk about it and decide together what is
needed. She urged them to, "Leave medicine to doctors...."
MS. DEBBIE JOSLIN, Delta Junction, said one of her four sons,
Isaiah, was born May 10, 1999 and died 32 days later. It's
largely because of her experience with him that she supports
this bill. The bill contains:
...unbiased medical information regarding the
development of the unborn child, abortion procedure,
risks associated with abortion, alternatives to
abortions including adoption agencies and support
groups for parents and children with special needs
such as Down's Syndrome....
She explained how her husband had received a similar booklet for
his eye cataract procedure that gave him sound medical facts
that allowed him to make a good informed decision. In Planned
Parenthood of Southeast Pennsylvania v. Casey, the Supreme Court
upheld a state statute requiring disclosure of the nature of the
abortion procedure, the risks of the procedure, the alternatives
to the procedure, the gestational age of the unborn child and
the medical risks of carrying to term.
The court also said if a woman shall request, she must
be given a State Department of Health brochure
describing fetal development and a list of agencies
offering alternatives to abortion. Many states have
initiated legislation that protects the state and the
physician from liability by giving this information to
all women who are considering abortion as an
alternative....
5:43 p.m.
MS. EVA SMALL, Juneau R.N., said as a registered nurse, she
truly understands the significance of informed consent and
rational decision making for patients undergoing surgical
procedures. Informed consent laws form the foundation of medical
ethics that guarantee the patient the right to make autonomous
rational decisions free of coercion. Women's right-to-know laws
empower women to make informed decisions. Not only do they
insure knowledge of the procedure and options, but include
information on paternity establishment and child support. She
supported many of the statements made earlier.
MR. JOHN MONAGLE, President, Alaskans for Life, said he recently
had major surgery and the doctor spent three hours making sure
he understood everything about it beforehand. Doctors want to
protect themselves from liability and want to furnish as much
information as possible to their patients for their own good.
Conversely, women would want as much information as they can get
about any surgery, certainly in the case of pregnancy and
abortions.
DR. CAROLYN BROWN said she has been a physician for about 44
years and for 25 years had been in the practice of obstetric and
gynecology. She said:
This proposed bill will not mandate much of anything.
If offers a pamphlet that we're supposed to give to
some people and doesn't tell us who we have to give it
to; it doesn't tell us who has to give it to anybody;
it doesn't tell us the person we're giving it to wants
an abortion, doesn't want an abortion or hasn't made
their mind up yet. So, let's be clear on that.
DR. BROWN said she has three basic issues with the bill; the
first being that it is not equitable and has a "sincere amount
of discrimination." There are 10,000 babies born in this state
every year and some are lost through miscarriage. The bill does
not mandate this information be given to all pregnant women; it
only suggests that the pamphlet can be given out. The bill does
not say who is going to have the oversight of the distribution
of the pamphlet and who will make sure the information is
correct.
DR. BROWN said that some terms were not defined very well, like
"circumstantial criteria," "unbiased," "major bodily function"
and "major psychological function." She noted that even doctors
can't agree on what those things mean and asked how the
legislature can come up with something and put it in stone.
Third, she said the fiscal note is $42,000 for the first year
and $24,000 for the next five, but that wouldn't begin to cover
costs when they are talking about a waiting period with women
having to travel. Somebody is going to pay for them to stay over
night. Many women are on Medicaid and the oversight for policing
will cost a great deal of money.
MS. APRIL FERGUSON said, "I have had a child; I have had
miscarriages and I have had an abortion and it's all my
business. It's not your business; it's not the business of the
woman down the street...."
Further she said that anyone who bases a decision of this
magnitude on a pamphlet that someone hands them 24-hours
beforehand is absolutely ignorant.
CHAIR DYSON announced that Senator Green arrived at least a half
hour ago and that the committee would hold the bill for further
work.
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