Legislature(1997 - 1998)

01/31/1997 09:00 AM Senate HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
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        SB  24 PARENTAL CONSENT BEFORE MINOR'S ABORTION                       
                                                                              
                                                                               
  CHAIRMAN WILKEN  called the Senate Health, Education and Social              
 Services (HESS) Committee to order at 9:00 a.m. and announced that            
 testimony and deliberations on  SB 24  would continue.                        
                                                                               
  DR. PETER NAKAMURA , Director of the Division of Public Health,              
 Department of Health and Social Services (DHSS), presented                    
 information on questions asked by committee members at the previous           
 hearing.  With regard to the number of Native American physicians             
 in Alaska, it is difficult to ascertain because statistics on                 
 physicians do not include ethnic identification.  Dr. Nakamura was            
 personally aware of five Native American physicians who work for              
 Native corporations and the Public Health Service.  Two are female            
 physicians, and of the five, two are Alaska Natives.  Other Native            
 American physicians have practiced, and may be practicing in                  
 Alaska, however an actual count is not available.  To obtain the              
 number of female physicians in Alaska, he counted the number of               
 female physicians licensed in association registers.  There are               
 126.                                                                          
                                                                               
 Number 097                                                                    
                                                                               
  DR. NAKAMURA  provided a packet of information to committee members          
 regarding the nature of counseling and counselor training.  The               
 packet included DHSS information made available to all public                 
 health nurses and nurse practitioners, as well as statements and              
 directives of the American College of OBGYN and the residency                 
 program.  Regarding the psychological impact of abortion on young             
 women, 225 cases were identified in a literature search.  The                 
 summary of the study performed using those 225 cases is included in           
 the packet.  The study dates back to the period when abortions were           
 illegal to the present, and reports trends in terms of the                    
 psychological impact on minors who delivered children compared to             
 minors who had abortions.  There has been a significant change in             
 those trends.  When abortion was illegal, the psychological impact            
 was definitely stronger on those minors who had abortions.  With              
 time, education, practice, and better knowledge, a total shift has            
 occurred so that now the stronger psychological impact is on those            
 minors who carry a pregnancy to term.                                         
                                                                               
 Number 126                                                                    
                                                                               
  SENATOR GREEN  questioned the basis upon which Dr. Nakamura's last           
 statement was made.   DR. NAKAMURA  replied that the information is           
 based on the evaluation of the studies that have been done through            
 this extended period of time.                                                 
                                                                               
  SENATOR WARD  asked what dates the 225 cases covered.   DR. NAKAMURA         
 said the cases date from the pre-war years to the present.                    
  SENATOR WARD    asked for the specific years.   DR. NAKAMURA  was una        
 to cite specific years at that moment, therefore  SENATOR WARD    note        
 he would get the information at a later time.                                 
                                                                               
  DR. NAKAMURA  responded to the remaining questions from the previous         
 committee hearing.  Regarding the risk of breast cancer following             
 an abortion, a study was published in January, 1997 in the New                
 England Journal of Medicine.  The study was conducted in Denmark,             
 where registers on abortion are kept, and included 1,500,000                  
 females.  The study demonstrated there is absolutely no correlation           
 between the practice of abortion and breast cancer.  The study                
 disputed the Harborview study and identified how it was defective.            
 In the Harborview study, a retrospective review was conducted on              
 women with cancer to find out if they had abortions.  It was                  
 determined women who already had cancer were more readily willing             
 and able to disclose they had abortions, than those who did not               
 have cancer.   The use of that group skewed the information                   
 measurably.  In the Denmark study, names were taken from the                  
 registry, which began in 1973, and from records kept prior to that            
 time.  The women were contacted to find out whether they did, or              
 did not, have cancer.  The results refuted the previous studies.              
                                                                               
 Number 176                                                                    
                                                                               
  SENATOR WARD  asked whether the American Medical Association                 
 conducted the study in Denmark.   DR. NAKAMURA  answered no, it was           
 conducted by the Danish medical association.   SENATOR WARD  asked            
 whether the study was overseen by American doctors.   DR. NAKAMURA            
 responded it was not and explained the study was done independently           
 and was reviewed by the scientific community and approved for                 
 journal publication.  That process takes about one year, sometimes            
 longer.                                                                       
                                                                               
  SENATOR WARD  questioned whether any American medical doctors                
 participated in the other one.   DR. NAKAMURA  stated he could not            
 identify them as authors but he could not say they did not                    
 participate in any way.  He offered to find out the nationalities             
 of the authors.                                                               
                                                                               
 Number 188                                                                    
                                                                               
 Regarding the question on the risk of abortions compared to the               
 risk of term deliveries,  DR. NAKAMURA  informed committee members            
 that there is no study that he is aware of that demonstrates that             
 the risk of abortion is greater than the risk of a delivery.                  
                                                                               
  SENATOR WARD  remarked the National Association of Social Workers            
 (NASW) has made the statement that in all cases it is safer to have           
 an abortion than to deliver.  He asked Dr. Nakamura if he agreed              
 with that statement.   DR. NAKAMURA  did not agree that to be true in         
 all cases.   SENATOR WARD  asked Dr. Nakamura if the NASW's statement         
 was wrong.   DR. NAKAMURA  replied that would depend on how that              
 comment was stated and what NASW's intent was, and the context in             
 which the statement was made.                                                 
                                                                               
 Number 214                                                                    
                                                                               
  SENATOR WARD  said that since he requested the packet of information         
 provided by Dr. Nakamura, he wanted to make sure it was in the                
 packet.  He appreciated Dr. Nakamura's testimony that there are two           
 Native female doctors who perform abortions.   DR. NAKAMURA                   
 clarified the question was not whether those doctors perform                  
 abortions, but what the ratio of male and female physicians is in             
 Alaska, and how many physicians are Native Americans.  No question            
 was asked regarding the number of physicians who perform abortions.           
 DHSS does not have that information, it does not know which doctors           
 participate in the practice.                                                  
                                                                               
  SENATOR WARD  apologized for not making himself clear.  He was aware         
 of several instances in the Bush where young Native girls were                
 quite intimidated by the whole process which resulted in an                   
 abortion.   DR. NAKAMURA  noted abortions are not performed anywhere          
 in the rural areas.   SENATOR WARD  indicated he understood that,             
 which is why he questioned how many peer pressures - how many women           
 or how many Natives actually perform abortions.                               
                                                                               
  SENATOR WARD  said he now understands that the answer is zero.  He           
 asked whether all doctors performing abortions in Alaska have                 
 specific training in pre and post abortion counseling, and whether            
 that information is verified in the packet of materials provided by           
 Dr. Nakamura.   DR. NAKAMURA  maintained the packet does not include          
 signed testimony by every individual physician, because he does not           
 know who they are, however any standards set by any organization              
 that deals with this practice requires practitioners to be well               
 versed in pre and post abortion counseling.  The packet contains an           
 outline of those requirements laid out by the American College of             
 OBGYN and the college for OB residency training.                              
                                                                               
  SENATOR WARD  asked whether a specific training course is required           
 prior to practice.   DR. NAKAMURA  indicated the training actually            
 begins well before physicians specialize.  All physicians are                 
 trained in counseling; maybe not specifically in depth in an issue            
 like abortion counseling, but counseling itself is a rather                   
 technical procedure that starts with an assessment process that               
 occurs.                                                                       
                                                                               
 Number 245                                                                    
                                                                               
  SENATOR WARD  asserted he was talking specifically about abortion            
 counseling because he knows of young women who did not receive it             
 in Alaska.  He is trying to determine, if in fact, the people who             
 are performing abortions are legally required to have specific                
 training for abortion counseling.   DR. NAKAMURA  answered they are           
 not required by law.                                                          
                                                                               
 Number 256                                                                    
                                                                               
  SENATOR GREEN  acknowledged she was very troubled by Dr. Nakamura's          
 previous testimony and even more troubled after she read the script           
 of his testimony.  She asked whether he is the Director of the                
 Division of Public Health.   DR. NAKAMURA  responded affirmatively.           
 She asked whether he really believed the testimony he provided to             
 the committee, and then read the following paragraph from his                 
 testimony:                                                                    
                                                                               
 Basic principles of law in society hold that parents should be               
 involved in, and responsible for, assuring appropriate medical                
 care for their children.  Parents ordinarily act in the best                  
 interests of their children, and minors benefit from the                      
 advice and emotional support of their parents.                                
                                                                               
  DR. NAKAMURA  clarified he said, "minors generally benefit" because          
 it is not 100 percent.                                                        
                                                                               
  SENATOR GREEN  asserted he must have some very compelling reasons to         
 justify ignoring the basic laws and principles mentioned.   DR.               
 NAKAMURA  said "yes."   SENATOR GREEN  asked if she could infer from          
 his testimony that he believes it is okay for a 16, 15, 14, 13, 12,           
 or 11-year-old girl to have an abortion performed on her body                 
 without the knowledge or consent of her parents.   DR. NAKAMURA               
 responded that each case is an individual case.  To answer Senator            
 Leman's question - in what kind of a situation would he recommend             
 this procedure if a minor refuses to involve her parents - he                 
 contacted physicians to request real life scenarios.  Dr. Nakamura            
 was told of a young lady who is now hospitalized in an intensive              
 care unit and will be there for about one year, who has feeding and           
 draining tubes, and is on a respirator, because she was unable to             
 obtain an abortion through the legal procedures, and as a result              
 had an illegal septic abortion.  In other situations,  minors have            
 carried fetuses without a brain or spinal chord and were therefore            
 not viable.  In counseling these individuals indicated, in no                 
 uncertain terms, they would seek illegal abortions or find some               
 other way to induce the loss of the fetus, significantly increasing           
 complications.  There are situations where a parent or custodian              
 has already demonstrated he/she is abusive.  One-third of all                 
 minors who do not seek parental consent are already in abusive or             
 coercive situations.  Over 4,000,000 undergo domestic violence                
 every year and 50 to 55 percent of the children in these families             
 have also been abused.  There are situations where it is unsafe for           
 a physician to allow a minor to leave the office.                             
                                                                               
 Number 312                                                                    
                                                                               
  SENATOR GREEN  did not think this bill would encourage that type of          
 situation.  She referred to the following statistics provided by              
 DHSS:  61 percent of unmarried minors inform one or both parents;             
 20 percent do not inform their parents but involve at least one               
 responsible adult such as clergy, another relative, teacher,                  
 counselor or professional other than the principle physician.  One-           
 third of minors who do not inform their parents have already                  
 experienced family violence and fear it will recur.  She asked                
 whether the one-third of minors who do not inform their parents               
 because of the fear of violence would comprise about 14 percent of            
 the total 40 percent who do not inform their parents.  That would             
 mean about 86 percent do not experience violence in the home.  Dr.            
 Nakamura explained he would like to go back to the articles those             
 numbers were taken from to verify the numbers.                                
                                                                               
  SENATOR GREEN  stated the inference in the testimony was that one-           
 third of minors are exposed to violence, yet the numbers breakdown            
 to 14 percent.  Although 14 percent is unfortunate, actions taken             
 for the general population should not be based on the needs of that           
 limited percent of the population.   DR. NAKAMURA  noted the 86               
 percent do not need legislation, it is the 14 percent that do not             
 have a functional relationship with their parents and will now have           
 additional court requirements and abusiveness.  That is the group             
 DHSS is concerned about.                                                      
                                                                               
  SENATOR GREEN  felt SB 24 would address the next step, a judicial            
 bypass, for the 14 percent.   DR. NAKAMURA  commented it would force          
 a relationship which could then become even more abusive or                   
 detrimental.    Dr. Nakamura remarked that the court system is an             
 intimidating process for youngsters, and is a process they are not            
 aware of.   SENATOR GREEN  doubted it would be more intimidating than         
 subjecting oneself to an abortion without a parent or guardian for            
 guidance.                                                                     
                                                                               
 Number 350                                                                    
                                                                               
  SENATOR GREEN  indicated she would be submitting more questions to           
 Dr. Nakamura in writing and noted although she has a natural                  
 respect for physicians, she was incredibly disappointed in the                
 testimony presented by Dr. Nakamura in opposition to SB 24 and in             
 his representation for DHSS.                                                  
                                                                               
  SENATOR WARD  asked Dr. Nakamura to supply to the committee the              
 number of doctors he surveyed to obtain first hand situations in              
 which parental consent would not be justified.   DR. NAKAMURA  said           
 he spoke to three doctors.   SENATOR WARD  asked how he decided which         
 doctors to call.   DR. NAKAMURA  replied he learned through                   
 colleagues, and others, these particular doctors had a familiarity            
 with these kinds of problems.                                                 
                                                                               
 Number 373                                                                    
                                                                               
  SID HEIDERSDORF  supported SB 24.  As the father of three girls, he          
 was disturbed to hear people object to a requirement ensuring that            
 abortion facilities and school counselors would respect his rights            
 and responsibilities as a parent.  SB 24 makes good policy because            
 it supports the concept of the family and recognizes that parents             
 are responsible for their children.  Minor children are not mature            
 enough to make a decision regarding serious medical matters without           
 parental advice, especially when the decision to have an abortion             
 involves a life or death decision that carries ramifications in               
 later years.  Who, better than the parents, has the best interests            
 of their children at heart.  In those extreme cases where that is             
 not true, a judicial bypass takes care of that problem.                       
 Legislation based on extreme cases is not good law.  He asked the             
 committee to support a principle in state law that finds parents to           
 be the best people to provide love and care for their children,               
 regardless of what kinds of statistics are presented.  That policy            
 protects the child.  The fact remains that a minor child who finds            
 herself pregnant may face incredible pressures from a boyfriend and           
 from abortion counselors at schools.  They need other individuals,            
 hopefully the parents, to be involved in the decision.  There are             
 plenty of individuals who have come forward and believe they were             
 pressured to have an abortion when they did not want one.  He                 
 disagreed with prior testimony which categorized pregnant teens               
 into two groups: those who go to their parents no matter what, and            
 those who do not.  He believes there is a third group in the                  
 middle.  SB 24 is for the middle group.   Regarding the dire                  
 predictions made if SB 24 passes, similar legislation is in effect            
 in many other states with no detrimental effects.  He added there             
 is a lot more to the story about the woman who will be hospitalized           
 for a year, referred to by Dr. Nakamura, that was revealed.  The              
 negative psychological impacts of abortion are well known by post             
 abortion counselors.                                                          
                                                                               
 Number 446                                                                    
                                                                               
  JOHN MONAGLE , President of Alaskans for Life, testified in favor of         
 SB 24.  He was disappointed that the Administration sends                     
 representatives to speak of gloom and doom while purporting to be             
 supporters of family, fairness, and justice.  Twenty seven states             
 have successfully passed similar legislation.                                 
                                                                               
  BETTY HALL , representing Black Americans for Life, testified in             
 support of SB 24.  As a retired nurse, she finds the lack of the              
 use of a pre-operative checklist by abortionists, to ascertain pre-           
 existing medical conditions, to be most disturbing.  She described            
 a case in which a 14-year-old girl had an abortion during which               
 complications occurred, at which point the girl's mother was called           
 to sign a consent form for follow-up treatment.  The medical costs            
 amounted to over $30,000.  She questioned a policy in which consent           
 is required for follow-up treatment, but not for the abortion.                
                                                                               
  SENATOR WARD  shared Ms. Hall's concerns about the lack of any form          
 of counseling guidelines for physicians who perform abortions.  He            
 was unsure whether the cases he referred to earlier were unusual,             
 but those women were not fully aware of what happened to them.                
 From their stories, it did not appear they were given any options             
 or counseling.                                                                
                                                                               
  MS. HALL  could not speak to counseling since she never attended any         
 abortions, however she believed most girls are told the procedure             
 involves removing a blob of tissue, not a baby, and some of the               
 girls are so young they do not know what they are getting involved            
 in.                                                                           
                                                                               
 Number 498                                                                    
                                                                               
                                                                               
  JOELLE HALL  testified in opposition to SB 24.  She disagreed with           
 Senator Green's conclusion that 14 percent of cases in which the              
 girl does not go to her parents or clergy is too small of a                   
 percentage to direct legislation, because that group is the most              
 likely to pursue illegal abortions rather than go a through                   
 judicial bypass.  It is unacceptable to deny girls their                      
 constitutional right and possibly die as a result.  Fourteen                  
 percent is enough to warrant the protection of the law.  SB 24                
 confuses parental desires with parental rights.                               
                                                                               
  SHARYLEE ZACHARY  indicated that she was leaning toward supporting           
 SB 24 because it is important to teach children that for every                
 action there is a consequence.  Family members stand together to              
 work through the happenings and consequences, learn from them, and            
 encourage each other to make wiser decisions the next time and to             
 be responsible.  It is important to teach children the great value            
 and sanctity of life and the value of abstinence until marriage.              
 One reason for the introduction of SB 24 is that many people do not           
 live their lives in such a manner and do not teach these truths to            
 their children.  There are many single parent families where there            
 was never a marriage or commitment.  There are a multitude of                 
 fatherless families living in poverty, and children are joining               
 gangs to find security and a family feeling.  Few people are                  
 accepting the consequences of their actions.  This bill drives a              
 wedge into the parent-child relationship.  Parents would not be               
 given a chance to help their child.  She questioned whether SB 24             
 allows people outside of the family to fill their children with the           
 types of lies that will cause them not to live up to their                    
 responsibilities.  She supported any legislation that does not                
 contribute to the breakdown of families.                                      
                                                                               
 Number 581                                                                    
                                                                               
  MARILYN GEORGE  testified in opposition to SB 24.  When working on           
 a crisis line in Idaho, she became aware of how scared teenagers              
 are of telling their parents about a pregnancy.                               
                                                                               
  TAPE 97-3, SIDE B                                                            
 Number 587                                                                    
                                                                               
  JOHANNA MUNSON  testified in opposition to SB 24.  Restrictive               
 bills, such as SB 24, endanger teens' health by inhibiting them               
 from seeking safe medical care early in pregnancy.  The Legislature           
 is not in the position to make personal choices for individual                
 teenage women.  If the Legislature looked at the facts and was                
 aware of what is really going on with teenage women who get                   
 pregnant, it would kill the bill.  Statistics reveal that 50                  
 percent of teenagers in the Mat-Su Valley who get pregnant live in            
 homes where they are psychologically or sexually abused.  These               
 young teenagers cannot be forced into a position that requires them           
 to consult with their parents.  If 60 percent of teenagers do                 
 consult with their parents, as statistics indicate, SB 24 will not            
 change that circumstance at all, and the Legislature should be                
 concerned about the other 40 percent.  SB 24 might be the worst               
 thing that could be done for the 40 percent.                                  
                                                                               
  SENATOR WARD  commented that he had looked into the teenage                  
 pregnancy situation in his communities and his observations differ            
 from Ms. Munson's.  He asked her to forward her statistics to the             
 committee.                                                                    
                                                                               
  ALICE JOHNSTONE  spoke on behalf of herself and for Sitkans for              
 Choice, which represents the majority of women in Sitka who are               
 pro-choice.  The real purpose of SB 24 is to prevent abortions.  SB
 24 will not prevent teen pregnancy or reduce the number of children           
 raising children.  In Minnesota, the birth rate among mothers, age            
 15-17 increased 38.4 percent after enforcement of a parental                  
 notification law.  Statistics compiled by the federal Center for              
 Disease Control and other sources indicate the risk of death from             
 pregnancy, is, on average, 24 times higher than from the risk of              
 death from abortion at up to 12 weeks of pregnancy.  Teenagers are            
 much more likely to suffer medical complications attributable to              
 childbirth, than adults.  This bill will create more teenage                  
 mothers.  There is no bill that will force unwed fathers to not               
 only support, but also participate in rearing their children.  The            
 young mother gives up nine months of her life to incubate an unborn           
 infant, then faces the wrenching decision to give it up for                   
 adoption or, if she chooses to keep the child, a life of poverty,             
 while the young man responsible gets off scott free.  She                     
 questioned why SB 24 does not have a fiscal note appropriating                
 funds to support these young mothers and their infants.  If                   
 Minnesota is an example, Alaska will have a third more unwed                  
 mothers who will be applying for welfare.  Even better would be an            
 amendment to SB 24 authorizing confidential reproductive health and           
 counseling services which could dispense candid information about             
 sexuality, reproduction, contraception, and the importance of                 
 family support and communication.  Such programs would help to                
 reduce teen pregnancy and also strengthen family bonds.  She urged            
 committee members to pass SB 24 out of committee with "do not pass"           
 recommendations or take action to supply the kind of counseling               
 services mentioned in order to prevent unwanted teenage                       
 pregnancies.                                                                  
                                                                               
 Number 518                                                                    
                                                                               
  PAT YAMAGUCHI  testified in opposition to SB 24 because not all              
 parents communicate with their children, and some teens get                   
 pregnant because they lack a social system that supports the                  
 parent-child bond.  As a pharmacist she has worked in many                    
 situations where she has counseled, by the request of the physician           
 and teenager, about choices.  Many teenagers do seek counseling               
 from various medical professionals, as well as their church groups,           
 friends, and parents.  SB 24 should not be passed until other                 
 support systems have been strengthened.                                       
                                                                               
  CHAIR WILKEN  thanked everyone for participating, and announced              
 testimony on SB 24 was closed.  He intends to vote on SB 24 as the            
 first order of business on Monday morning.  He asked committee                
 members if they preferred to discuss the bill at that time.                   
                                                                               
  SENATOR WARD  relayed that Ms. Betty Hall asked him to inform                
 committee members that there was an abused young lady who had an              
 abortion and was then sent back to the abusive situation.                     
                                                                               
  CHAIR WILKEN  announced SB 24 would be taken up as the first order           
 of business on Monday.                                                        

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