HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE March 15, 1993 3:00 p.m. MEMBERS PRESENT Rep. Cynthia Toohey, Co-Chair Rep. Con Bunde, Co-Chair Rep. Gary Davis, Vice Chair Rep. Al Vezey Rep. Pete Kott Rep. Harley Olberg Rep. Bettye Davis Rep. Irene Nicholia Rep. Tom Brice MEMBERS ABSENT None COMMITTEE CALENDAR *HB 154: "An Act establishing a woman's right to know certain medical facts related to the woman's safety before an abortion is performed." HEARD AND HELD *HB 128: "An Act relating to early acknowledgement of paternity for the child of an unmarried mother." NOT HEARD HB 30: "An Act amending the definition of `municipality' for purposes of the human services matching grant program." NOT HEARD (* First public hearing.) WITNESS REGISTER LAURIE CHRISTENSON P.O. Box 4123 Homer, Alaska 99603 Phone: (907) 235-5915 Position Statement: Testified in favor of HB 154 MEL PUCKETT, Pastor Tok First Baptist Church P.O. Box 37 Tok, Alaska 99780 Phone: (907) 883-2953 Position Statement: Testified in favor of HB 154 DR. CLARICE DUKEMINIER 1905 Cowles Fairbanks, Alaska 99701 Phone: (907) 456-3139 Position Statement: Testified in opposition to HB 154 MARTHA CLARK 3030 Bettles Bay Loop Anchorage, Alaska 99515 Phone: (907) 344-1323 Position Statement: Testified in favor of HB 154 SANDOR MANYOKY 3900 E. 112th Ave. Anchorage, Alaska 99516 Phone: (907) 344-4108 Position Statement: Testified in favor of HB 154 LEANN MCCAUGHEY P.O. Box 8642 Nikiski, Alaska 99635 Phone: (907) 776-5687 Position Statement: Testified in favor of HB 154 JOYCE MOLDENHAUER P.O. Box 595 Sterling, Alaska 99672 Phone: (907) 262-9319 Position Statement: Testified in favor of HB 154 MARY SOLTIS 615 Degroff Sitka, Alaska 99835 Phone: (907) 747-5624 Position Statement: Testified in favor of HB 154 ALICE YOUNG Respect for Human Life P.O. Box 6161 Sitka, Alaska 99835 Phone: (907) 747-5155 Position Statement: Testified in favor of HB 154 DANIEL J. DAVIS P.O. Box 1285 Delta Junction, Alaska 99737 Phone: (907) 895-4190 Position Statement: Testified in favor of HB 154 MICHAEL RAWALT P.O. Box 823 Delta Junction, Alaska 99737 Phone: (907) 895-1946 Position Statement: Testified in favor of HB 154 DEBRA JOSLIN P.O. Box 138 Delta Junction, Alaska 99737 Phone: (907) 895-4565 Position Statement: Testified in favor of HB 154 DEBORAH MORRIS P.O. Box 304 Kenai, Alaska 99611 Phone: (907) 283-8459 Position Statement: Testified in favor of HB 154 BETTIE L. DAVIS P.O. Box 395 Clam Gulch, Alaska 99568 Phone: (907) 262-5124 Position Statement: Testified in favor of HB 154 GLENDA STRAUBE 1318 N St. Anchorage, Alaska 99501 Phone: (907) 278-0840 Position Statement: Testified in opposition to HB 154 ELIZABETH CURREY P.O. Box 90909 Anchorage, Alaska 99509 Phone: (907) 258-0123 Position Statement: Testified in favor of HB 154 EILEEN BECKER P.O. Box 109 Homer, Alaska 99603 Phone: (907) 235-7526 Position Statement: Testified in favor of HB 154 MARTHA RESETARITS P.O. Box 3063 Homer, Alaska 99603 Phone: (907) 235-6413 Position Statement: Testified in favor of HB 154 STEPHANIE VIERIA 611 Biorka St. Sitka, Alaska 99835 Phone: (907) 747-3698 Position Statement: Testified in favor of HB 154 SUSAN MANYOKY 3900 E 112th Ave. Anchorage, Alaska 99516 Phone: (907) 344-4108 Position Statement: Testified in favor of HB 154 REP. TERRY MARTIN Alaska State Legislature State Capitol, Room 411 Juneau, Alaska 99801 Phone: (907) 465-3783 Position Statement: Testified in favor of HB 154 RUTH LISTER, Member Interior Alaska Women's Political Caucus 1290 Jones Road Fairbanks, Alaska 99709 Phone: (907) 455-6886 Position Statement: Testified in opposition to HB 154 KRIS GROSE Interior Alaska Right to Life 1111 Elizabeth St. Fairbanks, Alaska 99709 Phone: (907) 455-6886 Position Statement: Testified in favor of HB 154 DUANE CHRISTENSON P.O. Box 4123 Homer, Alaska 99603 Phone: (907) 235-5915 Position Statement: Testified in favor of HB 154 IDA BARNACK, President Alaskans for Life, Inc. 8292 Garnet St. Juneau, Alaska 99801 Phone: (907) 465-4531 work Phone: (907) 789-9622 home Position Statement: Testified in favor of HB 154 JOAN HEIDERSDORF P.O. Box 020658 Juneau, Alaska 99802 Phone: (907) 789-9858 Position Statement: Testified in favor of HB 154 JUDY CAVANAUGH Juneau Coalition for Pro-Choice 510 Third St. Juneau, Alaska 99801 Phone: (907) 586-8447 work Phone: (907) 463-3367 Position Statement: Testified in opposition to HB 154 SANDY SPARGO 965 Goldbelt Juneau, Alaska 99801 Position Statement: Testified in favor of HB 154 PREVIOUS ACTION BILL: HB 154 SHORT TITLE: INFORMED CONSENT BEFORE ABORTIONS BILL VERSION: SPONSOR(S): REPRESENTATIVE(S) KOTT,Green,Martin,Sanders TITLE: "An Act establishing a woman's right to know certain medical facts related to the woman's safety before an abortion is performed." JRN-DATE JRN-PG ACTION 02/15/93 345 (H) READ THE FIRST TIME/REFERRAL(S) 02/15/93 346 (H) HES, JUDICIARY 02/17/93 372 (H) COSPONSOR(S): SANDERS 03/15/93 (H) HES AT 03:00 PM CAPITOL 106 BILL: HB 128 SHORT TITLE: EARLY ACKNOWLEDGEMENT OF PATERNITY BILL VERSION: SSHB 128 SPONSOR(S): REPRESENTATIVE(S) B.DAVIS,Toohey TITLE: "An Act relating to early acknowledgement of paternity for the child of an unmarried mother." JRN-DATE JRN-PG ACTION 02/05/93 235 (H) READ THE FIRST TIME/REFERRAL(S) 02/05/93 235 (H) HES, JUDICIARY, FINANCE 03/08/93 569 (H) SPONSOR SUBSTITUTE INTRODUCED-REFERRALS 03/08/93 569 (H) HES, JUDICIARY, FINANCE 03/15/93 (H) HES AT 03:00 PM CAPITOL 106 BILL: HB 30 SHORT TITLE: HUMAN SERVICES MATCHING GRANTS BILL VERSION: SPONSOR(S): REPRESENTATIVE(S)BRICE, Sitton, Therriault, Davies, James TITLE: "An Act amending the definition of `municipality' for purposes of the human services community matching grant program." JRN-DATE JRN-PG ACTION 01/04/93 32 (H) PREFILE RELEASED 01/11/93 32 (H) READ THE FIRST TIME/REFERRAL(S) 01/11/93 32 (H) CRA, HES, FINANCE 01/15/93 92 (H) COSPONSOR(S): DAVIES, JAMES 02/09/93 (H) CRA AT 01:00 PM CAPITOL 124 02/09/93 (H) MINUTE(CRA) 02/10/93 284 (H) CRA RPT CS(CRA) 5DP 2NR 02/10/93 284 (H) DP: BUNDE,DAVIES,WILLIS, TOOHEY,OLBERG 02/10/93 284 (H) NR: SANDERS, WILLIAMS 02/10/93 284 (H) -2 ZERO FNS (DCRA,DHSS) 2/10/93 02/10/93 285 (H) REFERRED TO HES 02/22/93 (H) HES AT 03:00 PM CAPITOL 106 03/15/93 (H) HES AT 03:00 PM CAPITOL 106 ACTION NARRATIVE TAPE 93-35, SIDE A Number 000 CHAIR TOOHEY called the meeting to order at 3:08 p.m., noted members present, and announced the calendar. She said the meeting was being teleconferenced to Kenai-Soldotna, Tok, Delta Junction, and Homer. She also noted that testimony would be limited to two minutes in order to accommodate the large number of people hoping to testify. (Rep. Nicholia arrived at 3:10 p.m.) HB 154 - INFORMED CONSENT BEFORE ABORTION Number 055 REP. PETE KOTT spoke as PRIME SPONSOR of HB 154. He said the bill was not an anti-abortion bill and asked members to lay aside any preconceptions about the bill they might have had. He said HB 154 was a pro-woman, women-empowering bill designed to protect women when they are most vulnerable, in crisis pregnancies. He said the state has an interest in making sure that women make informed decisions on abortion, and to receive their information from physicians. REP. KOTT said the bill should please the pro-choice camp, because it assures that decisions on a potentially dangerous operation are made with full understanding of their implications. He said that possibly as many as 90 percent of abortions in Alaska are done in clinics, which rely financially on the practice and which therefore might not provide full information on the procedures. He said the bill would enhance the physician-patient relationship by requiring a doctor to meet at least once to discuss abortion with a woman patient. He noted a 1987 American Medical Association (AMA) policy statement supporting informed consent for medical procedures. He said the Alaska administrative codes' requirement for informed consent before abortion are inadequate because they are not in statute, and because they do not require the actual physician performing the procedure to provide the information. REP. KOTT stated, "The decision to abort is an important one, a decision that is very often stressful for the patient. This makes it all the more desirable that the decision be made with the full knowledge of both the nature of abortion and its consequences, so a potentially life changing decision is not made in haste. It is simply essential to the psychological and physical well-being of a woman considering an abortion that she receive complete and accurate information from her doctor. This bill asserts this imperative and makes it a matter of law. In closing, I would like to again reiterate that this is not an anti- abortion bill; there is no period of reflection. It is a woman's empowerment bill." REP. KOTT noted that 25 states have laws requiring informed consent before abortions. Number 165 REP. VEZEY questioned whether it was proper, given the Department of Corrections' problems with prison overcrowding, to make failure to comply with the informed consent a misdemeanor, punishable by a year in prison and/or a fine of $5,000. REP. KOTT said that the penalty was meant as a deterrent to encourage physicians to follow the law. He pointed out results of a national survey he provided to members, which claimed to show that 50 percent of women receiving abortions had not been adequately informed about the abortion procedure. Number 193 REP. BUNDE noted the initials W.E.B.Y. on the survey, and asked the source of the survey. A WOMAN IN THE COMMITTEE ROOM answered that W.E.B.Y. stood for "Women Exploited By Abortion." Number 204 REP. BUNDE observed that the survey was not conducted by an unbiased organization. He also noted the zero fiscal note from the Department of Law and asked whether there would not be an additional cost to the Department of Health and Social Services, through Medicaid services, for the additional time physicians would have to spend advising patients under the bill. REP. KOTT said that the funding of abortions through Medicaid was still up in the air, and he did not believe the bill would require doctors to spend more than five more minutes with their patients. He said the bill was aimed at preventing a "barbershop style of conducting business" in which clinics dealt with women patients not as individuals, but as numbers. Number 220 REP. BUNDE asked whether HB 154 required a second visit to a clinic. REP. KOTT said, "We're talking about a woman coming to a clinic seeking an abortion, and allowing for about five minutes, I would imagine it wouldn't take any longer than five minutes, to explain the circumstances surrounding abortion as well as some alternatives." REP. BUNDE said he would be surprised if it could be discussed in five minutes, but said he understood Rep. Kott's point about any fiscal note. REP. KOTT said the Department of Health and Social Services was asked about a fiscal note, but had responded that none was necessary. Number 232 REP. BRICE noted that HB 154 required a doctor to discuss alternative treatments or procedures before the abortion, and asked Rep. Kott if he was thereby implicitly supporting the introduction of the abortifacient RU-486 into Alaska. REP. KOTT said he neither supported nor opposed the introduction of RU-486, but he would comment if and when it became legal in the United States. Number 244 CHAIR TOOHEY announced she would begin taking public testimony. LAURIE CHRISTENSON testified via teleconference from Homer in support of HB 154. She said she had made a mistake in getting an abortion, did not receive adequate information beforehand, and hoped to discourage other women from making an uninformed decision about abortion. Number 274 MEL PUCKETT, PASTOR OF THE TOK FIRST BAPTIST CHURCH, testified via teleconference from Tok in support of HB 154. He asked that the bill be amended to require warnings to women of the psychological harm they might experience through an abortion. He said he has seen such harm in his work as a counselor and therapist. Number 292 DR. CLARICE DUKEMINIER, a physician who performs abortions, testified via teleconference from Fairbanks in opposition to HB 154. She said, "The proposed legislation is not only an affront to my profession, but is also harassment and unnecessary. Informed consent is the dialogue that a physician or another health care professional and a patient participate in prior to medical or surgical treatment. I find it offensive and impossible indeed that legislation would presume to outline that dialogue and then dictate misdemeanor charges for failure to comply. Medical informed consent, as already practiced, includes disclosure to the patient of the nature, the alternatives and relevant risks of any proposed procedure." DR. DUKEMINIER took exception with the requirement that physicians themselves deliver information orally. She said that as most patients remember only 10 percent of oral instructions, most physicians rely on written information. She said doctors use nurses to counsel patients as a way to save money and allow more time for patient questions. She said the bill's reference to a fetus as an "unborn child" was as inappropriate as referring to an adult person as an "un-dead corpse." She said HB 154 required delineation of the risks of carrying a child to term without stating those risks, and that a doctor could conceivably face misdemeanor charges for failure to mention all of the myriad of possible risks. In summary, she said HB 154 was offensive and unnecessary. Number 332 REP. BUNDE asked Dr. Dukeminier to describe the procedure a woman undergoing an abortion would follow at the doctor's clinic. DR. DUKEMINIER said such a woman would be given half an hour to review written information about the procedure. She would then spend 30 minutes to 45 minutes undergoing a medical examination, medical history review, and counseling with the doctor or a nurse practitioner concerning all the issues required under informed consent. While the actual abortion procedure takes an hour or more, she said, she encouraged patients to return at least a day later for the procedure. She said that more than 95 percent of her patients returned the next day for the abortion procedure. Number 369 REP. KOTT observed that Dr. Dukeminier was following prudent and rational practice and was not a target of the bill. He asked whether she would object to a bill requiring other physicians, possibly not so conscientious, to meet minimum standards. He also asked her to comment on the case of a woman who entered an abortion clinic and left 45 minutes later, the procedure completed. DR. DUKEMINIER said she found that difficult to believe, as it was improper to rush such a difficult decision. She said she was insulted by the assumption that physicians performing abortions were not professionals who did not obtain informed consent. She also challenged Rep. Kott's assertion that half of women were not adequately counseled before their abortions, saying studies show patients do not retain much of the information they are given. Number 393 CHAIR TOOHEY noted for the record that Rep. Davidson had arrived in the committee room and invited him to the committee table; which he declined. MARTHA CLARK testified via teleconference from Anchorage in support of HB 154. She expressed disbelief at the lack of mandatory full disclosure about abortion, and said women have the right to full information. She said abortion entails several risks, including sterilization or death, and a doctor withholding any information about them from a woman patient is guilty of sexual abuse. She favored the legal penalties in the bill. Number 424 SANDOR MANYOKY testified via teleconference from Anchorage in support of HB 154. He said his mother had an abortion and later cried about it. His said he supported doctors who provided full information about surgical procedures, and that women deserve informed consent to abortion. LEANN MCCAUGHEY testified via teleconference from Nikiski in support of HB 154, saying it will give women the tools necessary to make an informed decision about abortion. She wanted doctors to give patients information, both oral and written, about abortion. Number 455 JOYCE MOLDENHAUER testified via teleconference from Sterling in support of HB 154. She read a news release from a doctor at a New York college claiming women younger than 33 years who had aborted their first pregnancy were at a greater risk of breast cancer than other women. Her written testimony is on file in the committee room. Number 471 REP. BUNDE asked whether the cancer statistics included women who later had live births. MS. MOLDENHAUER answered yes. MARY SOLTIS, a psychiatric nurse, testified via teleconference from Kodiak in support of HB 154. She called abortion a mechanical rape, after which the legislators and care-givers go free, but the woman goes to an emotional hell. Number 503 REP. BUNDE asked Ms. Soltis if she felt that a women who had received sufficient information before an abortion would then choose not to go through with the procedure. MS. SOLTIS she said her testimony was based on her experience with mentally ill people who often have a history of sexual abuse. She said 75 to 90 percent of her female patients who had been sexually abused had had abortions. She said she did not know if informed consent would discourage abortion, but women suffer emotional pain after realizing what they had done in getting an abortion. Number 523 REP. BUNDE asked Ms. Soltis if she had counseled women who gave informed consent but still suffered the regret of which she spoke. MS. SOLTIS said she could not answer as she had dealt only with women who had not been informed and who felt guilty. Number 530 ALICE YOUNG, of Respect for Human Life, testified via teleconference from Sitka in support of HB 154. Number 535 DANIEL J. DAVIS testified via teleconference from Delta Junction in support of HB 154. He said all medical procedures require informed consent, and the bill was a women's safety and right-to-know bill that would protect women from unethical treatment. Number 560 REP. BUNDE asked Mr. Davis if he knew of clinics in Alaska that encouraged women to have abortions but did not inform women about the procedure. MR. DAVIS answered that he did not know of any in Alaska. Number 572 MICHAEL RAWALT testified via teleconference from Delta Junction in support of HB 154. He said he could not conceive of undergoing a medical procedure without knowing the risks; that women have a right to know medical facts and circumstances relating to procedures as serious as abortions; and that the information should be available both in writing and orally. TAPE 93-35, SIDE A Number 000 DEBRA JOSLIN testified via teleconference from Delta Junction in support of HB 154, saying she had been treated like a number when she went to an abortion clinic to terminate her pregnancy. While the clinic was not in Alaska, it could have been. She said women have a right to know that abortion kills a baby. She said she was not told how the abortion would affect her 20 years later, or that a family would have adopted her baby. Number 060 DEBORAH MORRIS testified via teleconference from Kenai in support of HB 154. She stated, "Many women and people do not know that the person in their womb is alive; they believe it is a glob of tissue. They have a right to know what the baby is, looks like, and what it's doing and how it's growing. The risks involved to their bodies, minds and their lives." She said she received medical information before getting her wisdom teeth pulled, and believed women needed such information before abortions. BETTIE L. DAVIS testified via teleconference from Kenai in support of HB 154, saying women needed information on abortion before deciding whether to abort a pregnancy. Number 112 GLENDA STRAUBE testified via teleconference from Anchorage opposing HB 154, but supporting the principle of informed consent prior to any medical procedure. She asked why the sponsor of the bill had not recommended informed consent for all potentially dangerous medical procedures, not just abortion. She said she had an abortion and was told of the possible repercussions, but had not experienced long-term emotional problems. While not doubting the pain expressed by women who had had abortions, she said she had also experienced pain after giving up a child of hers for adoption. She said no one had informed her prior to the adoption that her child would later be sexually and emotionally abused, and that it would cause her pain for years. She asked why no one had proposed informed consent before adoption. She questioned the real objective of HB 154. Number 145 REP. KOTT asked what other medical procedure performed in clinics, where standards are lower than in hospitals, might be more life-threatening than abortion. Number 154 MS. STRAUBE said she had never seen proof that clinics are more dangerous than hospitals. She said it was inconceivable to put warnings into statute for all the hundreds of procedures that might be more dangerous than abortions, which she could not list, as she was not a doctor. Number 170 ELIZABETH CURREY testified via teleconference from Anchorage in support of HB 154. She said she had had an abortion, and described it as a frightening and lonely experience that left her depressed. She said that God had forgiven her and that her baby was in heaven. (Rep. Brice departed at approximately 4:00 p.m.) Number 226 EILEEN BECKER testified via teleconference from Homer in support of HB 154. She said she had counseled women with crisis pregnancies and said abortion creates problems for women that take years to manifest themselves. She said doctors make money from treating infertility brought on by scarring caused by abortions. She said a state that enacted a 24-hour waiting period saw a 50 percent drop in abortions. She stated that the "selective bullying" going on across the nation was bad and needed to stop, and that HB 154 was a step in that procedure. She said women having abortions are in denial about the nature of their fetuses, and that once they knew more information, they change their opinions. CHAIR TOOHEY reminded Ms. Becker of the two-minute limit on testimony and asked her to conclude her testimony. Number 277 REP. BUNDE asked Ms. Becker if she believed that informed consent would reduce the trauma of abortion. He also asked what she had meant by HB 154 being a step in the right direction, and what else she would want to happen. MS. BECKER responded, "Well, this is the beginning, I think, of some other things that we need to see established, but I really feel like this bill, as far as dealing with informed consent, is really important." She went on to say that 80 percent of the women she had counseled and who had had abortions were not given all the facts they needed to make a good decision. She said that if women who were feeling lost and alone were given the proper information before having an abortion, they would "make the decision for life." Number 311 MARTHA RESETARITS, A VOLUNTEER AT THE CRISIS PREGNANCY CENTER IN HOMER, testified via teleconference from Homer in support of HB 154. She said she had an abortion, got minimum information, and still grieved over it. She said many abortions would be averted if women were properly informed. CHAIR TOOHEY announced that there would not be enough time to consider bills on the calendar other than HB 154. Number 338 STEPHANIE VIERIA testified via teleconference from Sitka in support of HB 154. She read a statement from VIRGINIA PHILLIPS, an American Indian and Alaska Native spokesman for the National Right to Life organization, which is on file in the committee room. The statement described a woman's pain during and after an abortion. Number 354 CHAIR TOOHEY announced that the committee would hear testimony by teleconference until 4:30 p.m., then take testimony from those attending the meeting in person in Juneau. SUSAN MANYOKY testified via teleconference from Anchorage in support of HB 154. Number 379 REP. TERRY MARTIN testified in Juneau in support of HB 154. He said that doctors should explain medical procedures to women undergoing abortions, just as doctors explain the possible long-term risks of other medical procedures. He said he could not believe that Alaska women did not want to be informed. Number 412 REP. B. DAVIS asked Rep. Martin for supporting information to buttress his claim that abortion was the only medical procedure before which physicians were not required to obtain informed consent. REP. MARTIN offered to go to his office to get supporting documents. Number 429 REP. VEZEY asked for Rep. Martin to comment on the elements in the bill making failure to comply a class A misdemeanor. REP. MARTIN said he did not worry about the ramifications of the punishment as much as the need to provide people with information on the medical procedures they were about to undergo. Number 449 CHAIR TOOHEY invited those testifying to mail in their testimony to the committee. Number 453 RUTH LISTER, OF THE INTERIOR ALASKA WOMEN'S POLITICAL CAUCUS, testified via teleconference from Fairbanks in opposition to HB 154. She noted that abortion is a legal right and HB 154 would make exercise of that right more difficult and expensive. She said abortion opponents were using informed consent as a ruse to dissuade women from having abortions. She said the decision to abort or not is a personal choice, and women can already ask for help or information from whatever sources they choose. She said doctors already provide information to their patients on any medical procedure, and a new law just for abortion was unnecessary. Number 468 KRIS GROSE, OF THE INTERIOR ALASKA CHAPTER OF RIGHT TO LIFE, testified via teleconference from Fairbanks in support of HB 154. She suggested amendments to require doctors to provide information on agencies providing alternatives to abortion to require a 48-hour waiting period before abortions, and to require parental notification and consent for abortion with a court-mandated judicial bypass. She said that someone other than a doctor should be required to provide information to women seeking abortions, as the physician performing an abortion has a conflict of interest. (Rep. Vezey departed at 4:26 p.m.) Number 485 DUANE CHRISTENSON testified via teleconference from Homer in support of HB 154. CHAIR TOOHEY closed off testimony from the teleconference sites and asked people who had not had the chance to testify to send their written testimony to the committee. He then invited those in Juneau to testify. Number 508 IDA BARNACK, PRESIDENT OF ALASKANS FOR LIFE, INC., testified in Juneau in support of HB 154. She read a statement, which is on file in the committee room, saying that women deserve the same advance notice of the risks of an abortion as in any medical procedure. (Rep. Olberg departed at 4:30 p.m. Remaining committee members at 4:30 p.m. were Reps. Nicholia, B. Davis, and Toohey.) JOAN HEIDERSDORF testified in Juneau in support of HB 154. She said generic consent to a medical procedure is insufficient in dealing with abortion, which can have grave physical, psychological and emotional effects on a woman, about which she must be informed before she can give informed consent. She said women must be given information about the age of their fetus and about alternatives to abortion. She read from the survey conducted by Women Exploited By Abortion. TAPE 93-36, SIDE A Number 000 JOAN HEIDERSDORF continued, saying pro-choice women should all support HB 154. She added that she felt the committee should hold additional hearings on the bill, given the number of people testifying. REP. BUNDE asked if the subjects of the survey had had their abortions before the procedure was made legal. MS. HEIDERSDORF said she believed that was the case. JUDY CAVANAUGH, OF THE JUNEAU COALITION FOR PRO-CHOICE, testified in Juneau in opposition to HB 154, saying the coalition opposed the bill and urged the committee to oppose it as well. REP. KOTT asked Ms. Cavanaugh why her coalition did not support the bill, as the American Medical Association and Alaska code both supported informed consent. MS. CAVANAUGH, speaking as a registered nurse, said information was already given to women before their consent to an abortion. She said informed consent is already a standard practice. Number 061 REP. KOTT asked if she would change her mind if a clinic was not giving information prior to obtaining consent for an abortion. MS. CAVANAUGH said the issue was between a woman and her physician. She said that if informed consent was not obtained, then the physician involved would be the subject of lawsuits, and she did not know of any such lawsuits. Number 071 REP. KOTT said he knew that a great number of Alaska Natives were flown into cities for abortions in clinics, and they were not provided such information. MS. CAVANAUGH repeated that this was a legal issue between the women and the physicians. Number 080 REP. NICHOLIA expressed disagreement with Rep. Kott's previous comment, saying that Alaska Natives would not undergo abortions without finding out what was happening to them. SANDY SPARGO testified in Juneau in support of HB 154, saying she had not heard good reasons during testimony why the bill should not be passed and why a woman would not want to know the age of a fetus and her own dangers. She stated, "I feel that there are women who feel themselves in a crisis, and when you're under a mode of crisis, you do not take into consideration at times your full mental power to ask a doctor what the legal applications could be to an abortion." Number 120 REP. BUNDE supported the idea that a woman should have all knowledge and information available to her. He asked if Ms. Spargo believed that women did not have such information available. Number 130 MS. SPARGO said yes, and that Reps. Martin, Kott and Hanley had information backing up that assertion. REP. BUNDE asked whether Ms. Spargo believed that if women had more information they would not choose abortion. MS. SPARGO said she did not know, but she suspected that the pro-choice camp might fear that fewer women would chose abortion if provided more information about it. Number 141 REP. BUNDE asked if there was any way of knowing whether such information might make a woman who chose an abortion feel better about the decision in 10 or 15 years. MS. SPARGO said no. She added that a doctor was ideally suited to providing information to a woman about the medical risks of the procedure. Number 160 CHAIR TOOHEY closed public testimony on the bill and invited Rep. Kott to make a final statement. REP. KOTT said that he had been challenged by those on both sides of the abortion issue. He repeated his request to the committee not to consider the bill as an impediment to a woman's right to an abortion. He said it was an effort to address the concerns of constituents that they had not gotten enough information before undergoing abortions. He said it was not an anti-woman bill at all. Number 190 REP. B. DAVIS asked whether women had told him they had not received enough information, or no information at all, prior to their abortions. REP. KOTT answered that there seemed to be no guidelines for providing information at all, and a doctor had recommended the guidelines contained in the bill as a minimum amount of information to provide. He said he was appalled that nurses, not doctors, provided important information to women considering an abortion. Number 210 REP. BUNDE said he understood the bill's intent, but did not believe that the committee would "get there." He observed that some women experience long-term psychological ill effects from abortion, while others did not. He said he wondered whether having been provided more information on abortion would really make a difference in the level of suffering some women felt years after their abortions. He stated he did not know whether women could or could not honestly disavow responsibility for choosing to have an abortion, whether fully informed or not. Number 241 REP. KOTT agreed that the legislators could not speculate on such questions. He said they did have an obligation to provide information to women, then leave it up to the women to make what decision they will, and suffer whatever ill feeling or psychological damage might occur. He said the bill would neither restrict women nor advocate, but simply provide information. Number 249 REP. B. DAVIS asked Rep. Kott how the provisions in HB 154 would be enforced, how it would affect doctors, and why the informed consent provision applied only to abortion and not to other surgical procedures. Number 262 REP. KOTT said the bill set out plainly the uniform information that doctors had to provide. He said it would be up to each physician to carry out the bill's provisions, and if they did not, then it would be up to the patient to report any failure to do so to the State Medical Board. Number 271 CHAIR TOOHEY announced that testimony on HB 154 was closed, and asked the will of the committee. REP. G. DAVIS moved for adjournment. CHAIR TOOHEY then ADJOURNED the meeting at approximately 5:05 p.m. The following bills were not heard: HB 128 and HB 30.