Legislature(2003 - 2004)
04/09/2003 01:31 PM Senate HES
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* first hearing in first committee of referral
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= bill was previously heard/scheduled
SB 30-ABORTION: INFORMED CONSENT; INFORMATION
CHAIR FRED DYSON announced SB 30 to be up for consideration and
called an at-ease from 1:36 to 1:38 p.m. He said the Department
of Health and Social Services (DHSS) and the Department of Law
(DOL) provided conceptual notes about the amendments to SB 30.
The first two notes concern typos. DHSS suggested that it create
a website to keep the pamphlet information updated with access
by agencies to update their particular information as it became
available. That approach decreases the fiscal note from $120,000
to $10,000 and he had not heard a good argument against it.
The DOL suggested offering immunity from prosecution to
providers who distribute the pamphlet or a printout as incentive
for fulfilling the requirements for getting information to the
patient/client.
MS. JANICE DELAND supported SB 30. She related her experience 27
years ago when a doctor told her she had to have an abortion
because she was miscarrying.
MR. SID HEIDERSDORF, Juneau resident, said, "This is much needed
legislation to protect women from unscrupulous abortion
practices."
He thought that abortion counseling was a sham and that most
women are not adequately informed. Many states already require
informed consent of this type. He also added that the 24-hour
waiting period is important because a woman needs some breathing
room from the intimidating atmosphere of a clinic after getting
their information.
MS. KARLEEN JACKSON, Deputy Commissioner, Department of Health
and Social Services, supported SB 30. DHSS is particularly
excited about making the information available on its website.
That would not only allow physicians to download and print out
the information, but it would allow women who have access to an
Internet connection to get the information as they try to figure
out what to do regarding a pregnancy. The fiscal note would be
much lower if the information was on a website.
MS. LINDA BOWDRE, Delta Junction resident, supported SB 30 and
commented that she can't understand why the state has to have a
bill to require doctors to explain a very serious medical
procedure to their patients.
MS. KARI THOMAS, Delta Junction resident, supported SB 30 and
thought the website was a great idea, except that providers need
to be held accountable to make sure they give the information to
the patient.
MS. ROSEANNE CURRAN, Cordova resident, supported SB 30. She
noted, "It just makes sense to have as many facts as possible
before any type of surgery or medical procedure, especially one
as life changing as an abortion."
MS. KAREN VOSBURGH, Mat-Su resident, supported SB 30 saying,
"It's always a good idea to have more information rather than
none or less."
DR. COLEEN MURPHY, OB-GYN, said she has been practicing in
Alaska since 1987 and is an active abortion provider. She has
undergone credentialing and review by the National Abortion
Federation to provide such services. She is currently undergoing
her annual board certification for the American College of OB-
GYN to provide many high quality services, including menopausal
care, gynecologic services, contraceptive services, abortion and
others. She noted that she just paid $10,000 on a premium for
malpractice coverage to practice here. She is accountable to the
American Medical Association's code of ethics for providing
appropriate informed consent and she is held to a preexisting
statute, AS 05.09.555, which discusses informed consent for all
surgical and invasive medical procedures. She concluded by
saying this bill is unnecessary and meddles with private
discussions between a patient and a doctor. She said this would
place obstructions to health care, as many women in Alaska have
to travel from remote places to get abortion services; requiring
a 24-hour wait only raises the cost of the care.
CHAIR DYSON appreciated her mentioning that the Legislature is
putting the language now in the Alaska Administrative Code about
informed consent into statute.
DR. MURPHY interrupted to say that she had just done a vaginal
hysterectomy on a Jehovah's Witness who didn't want blood
products. She suggested if the Legislature is going to
specifically include abortion in statute, it should put all
procedures, like that one, in as well.
CHAIR DYSON replied the difference is that the human rights
issue makes abortion different from other surgical procedures.
He said he might agree that the 24-hour waiting period is an
unfortunate choice and asked whether doctors still inject
laminaria and then wait for a couple of hours as a procedure.
DR. MURPHY replied that the National Abortion Federation does
not recommend the use of cervical dilatation. She explained
that the moment a foreign body is put in the cervix, basically,
the abortion starts. The informed consent for people who use
laminaria actually states that the minute laminaria is used, the
abortion starts.
CHAIR DYSON asked the standard length of time a patient stays
for observation after the procedure.
DR. MURPHY replied that the majority of patients are immediately
observed for excessive blood loss. She explained that there are
two different types of abortions now available - medical and
surgical. The medical procedure involves giving a patient
medicine. The patient can then safely deliver at home as an
abortion. That procedure is growing in usage. The surgical
procedure is done in the office and the patient is observed for
signs of blood loss for approximately a half to one hour
afterwards. She also said that more and more non-obstetrician
gynecologists are getting trained in the use of medical abortion
so they can offer it, if they haven't been surgically trained.
She pointed out, "So, more and more women are actually doing
this at home and it's going to be really hard for you to
regulate that."
CHAIR DYSON said he appreciated her information. He asked if a
patient who flies in from rural Alaska would be able to fly home
on the same day.
DR. MURPHY replied if it's a surgical procedure, patients can
generally fly home the same day. If they have to wait 24-hours
and are using a laminaria procedure, they can return home 48
hours later. She noted that Medicaid pays for a minority of the
abortions done in her office because most women pay for them out
of pocket to avoid creating a paper trail.
MS. THEA PITMANN, Anchorage resident, opposed SB 30, but was not
opposed to trying to reduce the number of abortions that take
place. She said the bad thing about this bill is that it
addresses the issue after a woman is pregnant, instead of
providing opportunities to prevent unwanted pregnancies in the
first place. She urged the committee to do more research on this
issue.
MS. DIETRICH STITLER, Anchorage resident, opposed SB 30. She
related how she was diagnosed with hemophilia at the age of 14
and it is medically dangerous for her to carry a pregnancy to
term because a loss of blood during delivery could potentially
be fatal. She didn't think the government should have a place in
any pregnancy decision she might have to make. Her biggest
concern is with their definition of medical necessity. She might
not fall under that section, because having an abortion at the
very moment would probably not be a life saving measure or an
emergency situation. Her doctor would probably say that a delay
in abortion could create a serious risk or that there is a
significant chance that a delay may create a serious risk. She
said this bill would add costs for additional office visits and
create a waiting period that could increase the risk of
complication.
MS. ROBIN SMITH opposed SB 30. She said it is far more than an
informed consent bill. The 24-hour waiting period makes it
totally biased against rural women by increasing the cost of
whatever stay they have to make in the city. Abortions cost more
than $500 and one of the main reasons second trimester abortions
occur is that women are trying to get funds together to pay for
them. She pointed out the parental consent requirement has
already been struck down by Alaska courts (although it is now in
the Supreme Court, but she thought it would be struck down
again).
MS. SMITH also pointed out that this bill requires the facility
to be state and federally approved and at this point the only
facility that fits that description is Valley hospital. Most
abortions are now conducted in a doctor's office.
MS. PAULINE UDDER opposed SB 30 saying they should not place any
more impediments in front of women who, according to our Supreme
Court, still have the right to choose. She related how her 43-
year old friend will have to fly to Seattle to get an abortion
if it turns out that she is carrying a Downs-syndrome fetus.
TAPE 03-18, SIDE B
CHAIR DYSON thanked all participants for their testimony and set
SB 30 aside.
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