SENATE JUDICIARY COMMITTEE April 5, 2000 1:56 p.m. MEMBERS PRESENT Senator Robin Taylor, Chairman Senator Rick Halford, Vice-Chairman Senator Dave Donley Senator Johnny Ellis MEMBERS ABSENT Senator John Torgerson COMMITTEE CALENDAR SENATE BILL NO. 300 "An Act relating to services and information available to pregnant women and other persons; and requiring informed consent and a 24-hour waiting period before an abortion may be performed unless there is a medical emergency." -MOVED CSSB 300(JUD) OUT OF COMMITTEE CS FOR SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 275(JUD) "An Act relating to the Uniform Probate Code, including trusts and governing instruments; relating to trustees; relating to under productive trust property; and relating to conveyances of real property and interests in real property by or to trusts." -MOVED CSSSHB 275(JUD) OUT OF COMMITTEE CS FOR HOUSE BILL NO. 318(JUD) "An Act relating to property disposal by law enforcement agencies." -MOVED CSHB 318(JUD) OUT OF COMMITTEE PREVIOUS SENATE COMMITTEE ACTION SB 300 - No previous action to report. HB 275 - See Judiciary minutes dated 3/22/00. HB 318 - No previous action to report. WITNESS REGISTER Mr. Mike Pauley Staff to Senator Leman Alaska State Capitol Juneau, Alaska 99801 POSITION STATEMENT: Testified on SB 300 Dr. Peter Nakamura Department of Health and Social Services PO Box 110601 Juneau, Alaska 99811-0601 POSITION STATEMENT: Opposes SB 300 Ms. Kirsten Bomengen Assistant Attorney General Department of Law PO Box 110300 Juneau, Alaska 99811-0300 POSITION STATEMENT: Opposes SB 300 Ms. Caren Robinson Alaska Women's Lobby Juneau, Alaska POSITION STATEMENT: Opposes SB 300 Mrs. Debbie Joslin Delta Junction, Alaska 99737 POSITION STATEMENT: Supports SB 300 Ms. Regina Manteufel 1128 East 10th Avenue Anchorage, Alaska 99501 POSITION STATEMENT: Opposes SB 300 Ms. Anne Harrison 3270 Rosie Creek Road Fairbanks, Alaska 99709 POSITION STATEMENT: Opposes SB 300 Ms. Donna Rae Faulkner PO Box 2742 Homer, Alaska 99709 POSITION STATEMENT: Opposes SB 300 Ms. Robin Smith 14100 Jarvi Anchorage, Alaska 99515 POSITION STATEMENT: Opposes SB 300 Ms. Jennifer Rudinger AKCLU PO Box 201844 Anchorage, Alaska 99520 POSITION STATEMENT: Opposes SB 300 Dr. Whitefield No address furnished POSITION STATEMENT: Opposes SB 300 Ms. Rose Medeiros No address furnished Juneau, Alaska POSITION STATEMENT: Testified on SB 300 Ms. Leila Wise PO Box 244034 Anchorage, Alaska 99524 POSITION STATEMENT: Opposes SB 300 Ms. Amy Bollenbach PO Box 3429 Homer, Alaska 99603 POSITION STATEMENT: Opposes SB 300 Representative Con Bunde Alaska State Capitol Juneau, Alaska 99801 POSITION STATEMENT: Sponsor of HB 318 ACTION NARRATIVE    TAPE 00-19, SIDE A Number 001 CHAIRMAN ROBIN TAYLOR called the Senate Judiciary Committee meeting to order at 1:56 p.m. Present were SENATOR ELLIS, SENATOR HALFORD and CHAIRMAN TAYLOR. The first order of business to come before the committee was SB 300. SB 300-INFO AND INFORMED CONSENT FOR ABORTION SENATOR HALFORD stated that he introduced SB 300 as a companion bill to HB 329 but, because it was past the deadline for submitting personal bills, SB 300 was submitted by the Senate Resources Committee. MR. MIKE PAULEY, staff to Senator Leman, said that SB 300 is similar to HB 329. It requires Alaska physicians to provide women seeking an elected abortion with information regarding the potential physical and psychological risks of the procedure, as well as information about the alternatives to abortion. The U.S. Supreme Court noted in H.L. v Matheson in 1981 that the medical, emotional and psychological consequences of abortion are serious and can be lasting. MR. PAULEY said, with regard to informed consent, the U.S. Supreme Court observed in Planned Parenthood v Danforth in 1976 that a decision to have an abortion is "an important and often a stressful one, and it is desirable and imperative that it be made with full knowledge of it's nature and the consequences." Alaska regulation requires that physicians advise patients seeking abortions of the "medical implications and possible emotional and physical sequela of the procedure." However, Alaska's informed consent provision lags behind other states because it exists only in regulation and not in statute. It also lacks specificity and is not uniform in its application. More than 25 other states have laws requiring informed consent before abortions are performed. States with some of the most comprehensive informed consent statutes include Indiana, Kansas, Kentucky, Michigan, Mississippi, Nebraska, North Dakota, Ohio, Pennsylvania, South Dakota, Utah and Wisconsin. MR. PAULEY said SB 300 will elevate the informed consent requirement from regulation to statute, and it will require the Department of Health and Social Services (DHSS) to develop a standard information brochure which physicians will make available to women considering an abortion. The brochure will include information on public and private agencies that provide services to assist pregnant women, including adoption services. The brochure will include objective information and photographs depicting the anatomical and physiological characteristics of a typical unborn child at two week gestational increments. The brochure will also describe specific potential health risks of abortion including infection, hemorrhage, breast cancer, danger to subsequent pregnancies and infertility. Number 310 DR. PETER NAKAMURA, DHSS, stated that, as a physician for 39 years and an administrator for three of those years, he has a high level of discomfort with SB 300. One of his major concerns is that the bill attempts to define terms, not on the basis of medical or surgical necessity or even logic, but in terms of meeting a philosophical need. The bill is an attempt to determine how the medical profession will intervene in the issue of abortion. Definitions of "conception," "fertilization," "pregnancy," "gestation" and "unborn child" are critical. In SB 300 a pregnancy means the fusion of an egg and a sperm - that is not a pregnancy. A pregnancy starts when an ovum and sperm begin to develop and actually implant in the body, causing a reaction that triggers hormone production. Changing definitions to meet philosophical needs frightens people who deal with medical issues. DR. NAKAMURA said the language of SB 300 also gives the impression that physicians do not give informed consent - this is untrue. Physicians, for legal reasons and for health reasons, do give informed consent information. Another problem is that the bill has the tendency to direct the kind of information the provider will give. By not including information on the complications of taking a pregnancy to term or the complications of an illegal abortion, SB 300 is not requiring full information. DR. NAKAMURA said there is also the issue of requiring a woman to wait 24 hours after signing a consent form. Experience shows a 53 percent increase in second term abortions after this type of restriction is applied and complications arise significantly the longer a woman waits. DR. NAKAMURA said there is also language in the bill that gives a false impression about the complications of surgical intervention. SB 300 suggests there may be an increased cancer risk, increased fertilization and a number of other complications, which is not true. There are many studies that demonstrate that complications are no greater without surgical intervention than with surgical intervention. As a state health officer and the director of the Division of Public Health, DR. NAKAMURA strongly objected to SB 300 and recommended that it not go any further. MS. KIRSTEN BOMENGEN, Assistant Attorney General with the Department of Law (DOL), said that a previous testifier stated the requirements in SB 300 are similar to those in other states and those requirements have withstood legal challenge. However, DOL believes the requirements in SB 300 will not withstand a legal challenge in Alaska because the Alaska Supreme Court has different standards. The 1997 Valley Hospital v Matsu Coalition case established that any restraints on abortion will be tested by viewing abortion as a fundamental right and will only be constrained when it is legally justified. DOL believes that some of the provisions in SB 300 will not withstand this kind of scrutiny because they will be viewed as employing excessive means to accomplish the ends of assuring that a patient is given informed medical consent before receiving an abortion. MS. BOMENGEN said, with regard to the brochure, section 1(3) reads, "states that a person may not lawfully coerce a woman to undergo an abortion;." This statement, in itself, is not legally accurate. There are many ways to apply coercive pressure to a woman, and there is no law against a person acting in this manner. DOL urges that this subsection be rewritten so that medical providers can place information in the brochure that is accurate and will not be subject to this type of scrutiny. MS. BOMENGEN noted that section 1(5) reads, states that the father of a child is liable to assist in the support of the child even in instances where the father has offered to pay for an abortion, and that the law permits adoptive parents to pay costs of prenatal care, childbirth, and neonatal care;. This wording may mislead a woman into believing that she can actually obtain that support. This section should contain a provision that addresses the need for a woman to take legal action in order to gain this support, and there should be something that addresses the frequency with which support is not obtained. MS. BOMENGEN said section 1(B)(b) reads, "The information required under (a) of this section must be written in easily comprehensible language and must be printed in a typeface that is large enough to be clearly legible." This subsection does not sufficiently address people who have limited English proficiency. The Departments of Health and Social Services in many states have been coming under scrutiny for providing information where other languages are spoken. MS. BOMENGEN noted the definitions that appear in section 1(B)(d) and in section 4(c) are not medically accurate. They create confusion and this confusion is addressed in the context of section 2. Section 2(a)(5) requires that the applicable requirements of AS 18.16.060 have been satisfied, and this involves the 24-hour waiting period before any action may be initiated by a doctor to address the request for an abortion. This subsection needs to be read in conjunction with the definition of abortion in AS 18.16.090. In this provision, an abortion is the use or prescription of an instrument, medicine or drug or other substance or device to terminate the pregnancy of a woman known to be pregnant. The definition of conception in SB 300, the mere fusion of a human sperm and ovum, can be construed with the other definitions to impose a prohibition upon the administration of emergency contraception. It should be clear that emergency contraception will not be counter to this provision because it will most certainly be found to be unconstitutional since emergency contraception is only effective in the first 24 hours - when the waiting period is being imposed. MS. BOMENGEN said section 3 imposes physician liability that includes both compensatory and punitive damages without any limit on what the damages might be. Looking at other states, this seems to have had a chilling effect on the availability of abortions. The indefinite level of damages needs to be examined. MS. BOMENGEN stated the 24-hour waiting period in section 4 presents problems regarding equal protection and privacy. Abortion is a medical procedure sought only by women and it is the only medical procedure in which a 24-hour delay is imposed. As a matter of law, if SB 300 is enacted, the intrusion into the physician-patient relationship for this sole procedure may fail to meet a constitutional challenge. MS. BOMENGEN added that for rural Alaskan women, the 24-hour delay could be viewed as imposing unnecessary costs. It will place a burden on them that will not meet the test of being the least restrictive means of assuring a woman is informed and has given her consent. MS. BOMENGEN noted that section 4(b)(1) says, "(F) that medical assistance benefits may be available for prenatal care, childbirth, and neonatal care; and (G) that the father is liable to assist in the support of the woman's child, even in instances where the father has offered to pay for the abortion." For a woman who is pregnant as the result of rape or incest, requiring a doctor to say that the rapist can be held liable for the support of the child can be seen to cause psychological harm and to not serve a medical purpose. An amendment has been made to HB 329 that addresses this issue, which allows the doctor to use discretion in whether to raise this particular issue. It was also determined that some psychological harm can be caused by a physician spending time addressing medical assistance benefits with parents whose unborn child has been diagnosed with a lethal fetal anomaly. These issues should be addressed in a way that will give some discretion to a physician who has to impart this information. Number 1207 Ms. Bomengen also called attention to section 4(3), "a copy of the information described in (2)(A) of this subsection has been given to the woman; and." This subsection means that the information does not have to be provided 24 hours in advance but it requires the pamphlet be given to the woman. In some instances, this will have to happen whether the woman wants it or not. This can also be considered to do psychological harm. MS. BOMENGEN addressed section 4(c)(3), "'medical emergency' means a condition that, on the basis of the physician's good faith clinical judgment, so complicates the medical condition of a pregnant woman that the immediate termination of a woman's pregnancy is necessary to avert the woman's death or that a delay in providing an abortion will create serious risk of substantial and irreversible impairment of a major bodily function of the woman;." Because this section does not address potential psychological harm, DOL believes it will be subject to constitutional problems. Number 1333 MS. CAREN ROBINSON, Alaska Women's Lobby (AWL), stated the Lobby has a membership of about 1,000 men and women across the state. It was established in 1983 and its purpose is to preserve hard- won statutory and budgetary gains for women and children of this state. MS. ROBINSON made the following statement: Inserting a political directive in a medical decision is an intrusion of privacy of the worst kind. No other surgical procedure involves the Alaska legislature insinuating itself between the patient and the doctor to determine informed consent. Will the legislature concurrently require women who decide to take a pregnancy to term to be educated about the hazards and costs of parenthood and counseled about the options of abortion? AWL thinks not, for the same reason--one's right to privacy. Or will the legislature require a man who wishes to have a vasectomy be reminded of the consequences of his actions and require him to wait to make sure he knows what he is doing? Again, it is a right, not a privilege that the legislature can make optional at its desire. In 1983 the U. S. Supreme Court struck down a local ordinance from Akron, Ohio that required doctors to give patients seeking abortions anti-abortion literature and impose a 24 hour waiting period. AWL suspects that the Alaska Supreme Court will come to a similar conclusion about this bill if it is to become law. Number 1465 CHAIRMAN TAYLOR commented that the main thrust of this legislation is informed consent and Ms. Robinson's testimony is in opposition to informed consent. MS. ROBINSON said that it is important that people advocate for themselves and work with their doctors to get as much information as they can on any medical procedure. AWL is against informed consent being inserted by the legislature, by law. CHAIRMAN TAYLOR commented that the legislature passed a licensure bill on tattooing and body piercing, and with the bill was a provision for informed consent that said a parent had to be informed and a consent form had to be signed before the procedure could be done. Where was the Women's Lobby on this legislation? MS. ROBINSON responded she was not asked to monitor that legislation. CHAIRMAN TAYLOR said, "Then it's okay to get parental consent for body piercing but it's wrong to ask for parental consent for an abortion procedure?" MS. ROBINSON responded that because she has not read or paid attention to this legislation she cannot speak to it. SENATOR ELLIS asked if SB 300 speaks to parental consent. CHAIRMAN TAYLOR responded yes, it refers to existing law on parental consent. Number 1580 MS. DEBBIE JOSLIN, representing herself, said she has been appointed to be an expert on this subject, she is not willingly doing this or testifying by her choice, but she is an expert on the subject. Ms. Joslin made the following statement: On January 15, 1999, I was 22 weeks pregnant when we drove to Fairbanks for an ultrasound on our child. After a lengthy examination of the baby, I was told we were expecting a male child with multiple anomalies. The baby we named Isaiah John had a brain cyst, a missing or unconnected stomach and a hypoplastic left heart. We were given the name of a Perinatologist in Anchorage,. A perinatologist, as I understand it, is a doctor who specializes in unborn babies who have serious health complications. I spoke to this specialist over the phone and made arrangements to go to Anchorage and have another ultrasound. During that phone conversation she urged me to have the pregnancy terminated. The reasons she listed were that the baby would probably die anyway, the medical expenses would be too great and that my own life was probably in danger. Keep in mind, she had not examined me at this point. I made an appointment with this doctor, since I was told she was the only perinatologist in the state. My husband and I drove 350 miles to keep that appointment, leaving Delta at 40 below zero. When we arrived for our appointment we first saw a genetic counselor who went over some family history with us and explained that they thought Isaiah had Trisomy 18, a chromosomal abnormality (an extra number 18 chromosome). She expressed surprise that we were not considering terminating the pregnancy and asked several times whether we wanted to consider terminating the pregnancy. Another ultrasound was performed by a technician and then the perinatologist took over the exam and listed the following anomalies: Brain cyst, missing or unconnected stomach, hypoplastic left heart, eyes not properly spaced, underdeveloped chin, something wrong with spinal development, something wrong with his penis, rocker bottom feet, possibly an extra toe and fluid in the abdominal cavity and lungs. We were told the fluid indicated that Isaiah was already in congestive heart failure and that he would never make it to his due date in May. We were also told that all Trisomy infants were severely mentally retarded. The perinatologist told us that Isaiah would never respond to us if he were to live. She described a somewhat vegetative state but more probably he would be stillborn any day. She said that if he were to be born alive he would only live for a few hours or maybe a day at most. We agreed to an amniocentesis to determine whether Isaiah did actually have Trisomy 18. Our hope was that he would not, and we could begin to make plans for heart surgery. She told us doctors will not operate on Trisomy infants since they ALL die in infancy anyway. You can imagine what heavy hearts we had as we drove back to Delta. The plans and dreams I had had for my son were shelved as we instead discussed his funeral. Within a few days I got a call from the genetic counselor with the preliminary test results which showed Isaiah had Trisomy 13. I asked how that differed from Trisomy 18 and she said it was worse. She asked again about termination and I told her again that we were not interested in that. Almost immediately I got a call from my doctor in Fairbanks who asked me about termination. I told here (again) I was not interested in that. She told me that since my life was in danger and I had chosen to continue with the pregnancy, she could no longer be my doctor as she was a general practitioner and not qualified to handle such a case. I began seeing the osteopath doctor in Delta and an OB/GYN in Fairbanks. I told them what I had been told about the baby and about my own health. The OB/GYN doctor told me he could not understand why I had been told my life was in danger. He treated me during the remainder of the pregnancy and I never had any complications or problems. Only the usual complaints pregnant women suffer from. A couple of weeks after the preliminary results, the genetic counselor called with the final results from Isaiah's amniocentesis. It was final - Isaiah had Trisomy 13. She asked me again about termination and I told her no again. I then asked her out of curiosity what she would do if I did say yes. She got very excited and told me that "there is the most wonderful clinic in Kansas." I asked if she meant Tiller's and she said "yes, do you know him?" "No, I told her, but I know about him." She offered to have other women who had had abortions call me but I declined. Sensing that I was not interested in pursuing this any further she told me in a very apologetic voice that "there is a parent support group, but well ... they are rather positive." She made it sound as though positive was a bad thing to be. She then went on to tell me that she had information on the group including an 800 number as well as pamphlets and books in her office that gave detailed information about Trisomy 18, 13 and related disorders including pictures. I called S.O.F.T. (Support Organization for Trisomy 18, 13 and Related Disorders) right away and found that they were indeed positive - but realistic. I told the woman over the phone about Isaiah's diagnosis and she told me that probably they were right but there was a chance he could live. She talked to me about the other "parents" and I remember asking her, "parents, you mean they have children?" "Yes, some did," she said. "How old?" I was told that they varied but there were a few children who were teenagers and even a couple of adults. The lady took my name and address and told me she would send me a family packet right away. I also requested the books they had available: Trisomy 13, a Guideline for Families and Care of the Infant, and Child with Trisomy 18 or 13. These were the books the genetic counselor had described, the very ones she had in her office. While the information was heartbreaking, it also offered some hope and some help--two things we had not had much of. Not only did some of these children live, they played and smiled and laughed and talked and learned things and showed affection and responded to love and affection. We located a wonderful pediatrician in Fairbanks who agreed that Isaiah's chances were not good but she was willing to do what she could to help him. We made the decision to hire her, and then we made plans to deliver our baby in Fairbanks. On May 10, only 11 days before his due date, Isaiah John Joslin was born at Fairbanks Memorial Hospital. He weighed six pounds one ounce and was 18 1/4 inches long. Isaiah was a pretty baby with lots of bright red hair. Isaiah had difficulty breathing when first born, but as the doctors and nurses checked him over they could find no sign of the problems seen earlier on the three different ultrasounds. The brain cyst, stomach problem and hypoplastic heart were all missing, as were all of the other problems earlier noted. However, Isaiah suffered from a ventricular septal defect (VSD), a hole in his heart. Although very serious, it was a far cry from the problems he had earlier. Isaiah required oxygen and a nasal gastric tube for feeding. Because of the hole in his heart, he was too weak to nurse and had to be fed with a tube. Isaiah looked so normal that even the nursing staff agreed we should retest him. Test results again showed Isaiah to have Trisomy 13. He stayed in the hospital for 12 days and then came home where we cared for him for 20 days before he left us to go to be with the Lord in heaven. Those were some of the hardest but sweetest days of my life. I am telling you this story so you will understand why I stand before you today and ask that you pass SB 300. After talking to other doctors and doing a great deal of research and reading about Trisomy infants and because of my own personal experience, I believe my life was never in any danger. Yet, this undue burden was placed on me at a time when I already had plenty to worry about. I was told that all trisomy infants die. I now know that somewhere between 90 and 95% of all trisomy infants die before one year of age. That does not leave much room for hope I realize, but it is quite different than saying they all die. I was not told about the parent support group for over two weeks. Well, you may say they were not sure my child had Trisomy until the final results were in. Perhaps, but they were sure enough that they continually brought up termination. I drove 350 miles to see the doctor and was never shown the written information about this disorder, that they had right there. Though they were careful to tell me every negative thing they could about the baby, I was never told of any of the risks of having an abortion. There was never any mention made of the risk to my health, either physical or emotional. I believe the doctors who repeatedly brought up termination probably meant well. The problem comes in where they apparently believed that their professional status, or their medical degrees placed them in a position to know better than me what was best for me, my family and my baby--that simply was not true. Giving life to Isaiah was hard on our family but it was not too hard. It was expensive but it was not too expensive. It was hard on the other children but it was not too hard. Giving life to Isaiah blessed our family, including the other children. Because of his heart condition, Isaiah was always lethargic, sleepy and tired-acting, but he was never in pain. The equipment, which monitored his oxygen saturation rate, showed that whenever we held him or showed affection to him, Isaiah was aware of it. His saturation levels would soar when he was being loved on. There seems to be a feeling out there that a successful life is one that is free from pain or suffering or trials, and that is not true. Isaiah's life was successful. We loved him and he loved us. Of course, I would like for every mother to make the same decision I did but I realize that will not happen. But every mother deserves to have all of the information pertinent to her situation so that she can make an intelligent informed decision. I stand before you today and say that if you vote against SB 300 you are saying, in effect, that women are not competent enough to be trusted with the facts regarding the health of their own bodies and that of their unborn children. A no vote says that you have no compassion for families and believe that doctors are better suited to make decisions for women and their unborn babies. A yes vote for SB 300 sends an entirely different message. A vote for informed consent says that you have respect for the intelligence of a women and believe that they have the right to be trusted with the information necessary to make decisions for themselves. I trust and hope that this body of legislators will prove themselves to be in favor of women's rights. Number 2177 MS. REGINA MANTEUFEL, speaking on her own behalf, said that in regard to section 1 of SB 300, she called the Right to Life Coalition and said she was a pregnant woman who needed a place to stay. She was told that they had homes for teenagers but no place for older women. She said it is frustrating for her because at the Fairview Compass meeting about a year ago she had a woman beg her to help build a place to house women with babies because there were not enough beds at pregnancy shelters. MS. MANTEUFEL said section 6 does not make sense because she deals with pregnant women and women who have babies. Costs associated with raising a child need to be discussed. There is not enough of a support network with the agencies that are available to take care of babies. There is not enough of a network of people to collect money from dead beat fathers. A woman from rural Alaska cannot afford hotel rates when coming to town for a medical appointment, and then wait through the required 24-hour waiting period. A woman should have the right to decide what to do with her body, regardless of the amount of money she makes. There would be fewer abortions if there was a system that provided birth control pills at a lower cost for women. If pamphlets are given out with pictures of unborn babies and gestation periods, then there should also be a pamphlet telling women what the cost of apartments, cabs, hotels, the latest number on the waiting list for section 8 and what litigation fees will cost in trying to recover money from dead beat dads. The costs should be listed for having a baby and of raising a child. Ms. Manteufel stated she is pro-choice. Tape 00-19, Side B    MS. ANNE HARRISON, a semi-retired nurse practitioner from Fairbanks, said that Mrs. Joslin's testimony underlines the need for professional, compassionate and sensitive counseling. She suggested that nurses, rather than physicians, are often the best people to provide this. MS. HARRISON said she is strongly opposed to SB 300 and, even with the amendment, it is nothing more than a blatant anti- choice, anti-abortion piece of legislation. By regulation, women are now receiving professional, unbiased information about the risks of pregnancy and about the benefits of the choices they make in regard to pregnancy. Ms. Harrison asked that the committee members listen to and talk with public health nurses, clinic and office nurses, nurse practitioners, physicians assistants and physicians who work in reproductive health. These people know the risk of pregnancy, abortion and even adoption based on science, research and experience. Individuals or groups who have personal and or religious agendas to promote have a biased mind set. Their information is often based on one-sided information gleaned from very select and often incorrect resources. "We are a country based on the separation of church and state, do not forget this, and do not torment women at an often trying time with this bill of anti-choice bias." Number 2197 MS. DONNA RAE FAULKNER, representing 12 Homer residents, said she is against SB 300. It has been nearly 30 years since American women were granted the right to choose an abortion for an unwanted pregnancy. Roe v Wade was crafted in such a way to make abortion legally possible, accessible and practical and since 1971 there have been countless attempts to erode this right--HB 329 and SB 300 are perfect examples of this. This bill incorporates additional shame, pain and guilt into a woman's decision to have an abortion. MS. FAULKNER said the proposal for a 24-hour waiting period after informed consent seems as if it was designed to place a woman into purgatory while she waits for a procedure that is allowed by law. Ms. Faulkner does not know of anyone who has casually dropped into her physician's office for an abortion without intensive decision making and without considering it to be a last resort. This decision process is totally disrespected and disregarded by SB 300. MS. FAULKNER stated it is additionally disrespectful to use propaganda tactics such as forcing women to view and study various anatomical and physiological characteristics of the fetus from conception on, and then to sign a statement saying she has done this before her abortion can be performed--more guilt and shame. MS. FAULKNER said the bill also requires women to understand the various abortion procedures. Will this include information on later term abortions that may not even be applicable to that woman? Informed consent as proposed in SB 300 goes far beyond a woman being educated about the procedure she is about to undertake and the medical risks involved. MS. FAULKNER commented that SB 300 proposes that women should be given lists of resources available that can help her carry her child to term, and to inform the father of his responsibilities. If the state's goal is to restrict a woman's right to an abortion, then one is to assume that it wants all pregnancies to be carried to term, but where is the help with the rest of the child's parenting? This bill is likely to decrease the number of abortions but it will not decrease the number of unwanted children. MS. FAULKNER said Alaska women have the right to choose an abortion just like all American women, and the state has no business trying to hurt a woman who has made this difficult choice or to scare her with tactics, propaganda and road blocks. MS. FAULKNER said the 12 Homer residents she is representing are: Karey Thurman, Jane Albert, Judy Flora, Melon Purcell, Jim Meesis, Kathy Steberl, Terry Thurman, Michelle Waneka, Laura Wilke, Kate Finn and Heidi Glotfelty. Number 2083 MS. ROBIN SMITH, representing herself, stated she is pro-choice. She disagrees with the people who oppose abortion but, just as she does not want a woman coerced into having an abortion, she also does not want a woman coerced into carrying a pregnancy to term. This bill attempts to inflict one person's religious beliefs onto another's and questions a woman's intelligence and moral values. MS. SMITH said there is already a waiting period longer than the required 24 hour waiting period--it takes three weeks past a missed menstruation to perform the earliest surgical abortion and this is because a physician must be able to visually see the fetal tissue. MS. SMITH noted there is also the consideration that an abortion costs $550.00 and this is only if a woman lives within the three communities where surgical abortion is offered--Anchorage, Palmer and Kenai. MS. SMITH said that because of the advances in technology, everyone has seen pictures of a fetus and there is no need to go back and educate women about the fetus. MS. SMITH noted that C. Everett Koop, the pro-life surgeon general, could not find any adverse psychological effects from an abortion. However, for the past 16 years Alaska has had the highest rape rate per capita in the United States--what type of trauma will this legislation inflict on a rape victim? MS. SMITH said that if the legislature wants to make sure a woman knows what she is doing, a better way would be to require responsible sex education in the schools--having an impact on both men and women. Ms. Smith urged the committee to vote against SB 300. Number 1941 MS. JENNIFER RUDINGER, Executive Director for the Alaska Civil Liberties Union (ACLU), said she speaks in opposition to SB 300 on behalf of the 1,000 members of the ACLU and for other people who have contacted her in opposition to SB 300. MS. RUDINGER addressed the question that Chairman Taylor asked Ms. Robinson in regard to the difference between SB 300 and the tattooing bill concerning informed consent. First of all, a 24 hour waiting period is not required, which causes extra expense and delay. But more importantly, people who want a tattoo are not being given biased propaganda by the state and forced to sign off that they have received it. People are not forced to incur the extra expense of consulting with a physician before getting a tattoo, and abortion is a constitutional right. The U.S. Supreme Court and the Alaska Supreme Court have decided that the right to choose an abortion is a woman's fundamental constitutional right. CHAIRMAN TAYLOR thanked her and said that he was not addressing the unique differences between the two bills, he was talking about the concept of whether or not there should be informed consent for a female child who is pregnant. MS. RUDINGER stated that no one will argue that informed consent is not important. Doctors are now required to obtain informed consent for any medical procedure and they are required to spend time counseling women. MS. RUDINGER said that SB 300 is unconstitutional and the ACLU agrees with Ms. Bomengen's earlier testimony. SB 300 violates a woman's right and endangers her health. It also imposes extra cost and great burdens on women who are seeking to exercise these fundamental rights. The ACLU hopes the committee will stop the progress of SB 300. Number 1733 DR. WHITEFIELD, an OB/GYN practicing in Alaska and representing women of Alaska, said that he has maintained a data base on abortion in Alaska for many years. Frequently, people who come to Anchorage for an abortion come from the Bush and, the Bush, in most cases, represents Alaska Natives. The 24-hour waiting period will incur additional costs for Alaskan Natives who choose to come to Anchorage, or any other city, for a pregnancy termination--increasing the cost. DR. WHITEFIELD said that redefining the word "conception" opens up a number of issues. What will happen to the standard forms of birth control, such as intrauterine devises, emergency contraception and birth control pills--all of which can cause a pregnancy to slough from the side of the uterus before it implants? Do these types of birth control become abortions and, if so, how will physicians counsel women who want an IUD, birth control pills or need emergency contraception? If people have eggs that have been fertilized for in vitro fertilization and decide not to use all of them and want them destroyed, is this abortion? The word "conception" has to be dealt with in medical terms, in terms of implantation in the uterus and not fertilization of an egg. DR. WHITEFIELD said he has done abortions based on lethal fetal anomalies, and he has asked patients how they would have felt if he had provided a pamphlet demonstrating a pregnancy at two week intervals before the abortion. The response has been that this would not have been helpful and that it would have caused emotional trauma. MS. ROSE MEDEIROS, representing herself, said that she has a virus called HSV which causes cold sores--painful blisters. For Ms. Medeiros, HSV creates recurrent and very painful sores and without treatment she can get as many as two or three blisters a month. HSV is treatable with antiviral drugs but it is not curable. Unfortunately, these antiviral drugs cannot be prescribed to pregnant women because they tend to cause fetal birth defects. With the definition of pregnancy in SB 300 and HB 329, her doctor will not be able to legally certify that she is not pregnant, therefore he will not be able to prescribe the antiviral drugs. SB 300 will take away the only way she has to control an extremely painful disorder and she asks the committee to help fix this problem. Number 1471 MS. LEILA WISE, resident of Anchorage, said she opposes SB 300. She believes that the decision to have an abortion is personal and private and should be left to a woman. The provisions of SB 300 are invasive and punitive and are based on inaccurate information about medical practices and terminology. She is concerned that the bill will make certain contraceptives illegal. Since the whole goal of SB 300 is to prevent abortions, she does not think the committee wants to make contraceptives illegal or more difficult to obtain. MS. WISE stated the bill is also intrusive, no other medical procedure requires a 24-hour waiting period for women and no other bill punishes women exclusively. All surgical procedures now require informed consent--abortion included. Informed consent is not required for the consequences of not choosing an abortion. Pregnancy is far more dangerous than choosing an abortion, and if informed consent is required for an abortion it should then be required for carrying a pregnancy to term so that women and their families know exactly what will happen or could happen. People should be educated on all the physical and emotional consequences of having a baby and they should also be educated on maternal death as the direct result of continuing a pregnancy. MS. WISE said that SB 300 is dangerous. Women in Alaska already face enormous burdens and challenges in locating abortion services and having to leave their home to obtain a first trimester procedure. It is expensive and hard and imposing a 24- hour waiting period can make it even harder. The waiting period is a deliberate strategy that has allowed anti-choice extremists to harass women in other states. They will write down license plate numbers, follow women home, barrage them and violate their privacy for the 24 hours before they can go back to the clinic. MS. WISE claimed this bill dehumanizes women, it patronizes women and it shames them about a decision they have made. Ms. Wise strongly urged the committee to vote against this bill because women are smart enough, responsible enough and capable enough to make their own choices. Number 1328 MS. AMY BOLLENBACH, representing herself, asked if information about the risks of pregnancy and childbirth were included in HB 329. MR. PAULEY stated that the House did not include any additional information on this issue when they reported the CS from committee but the original bill includes reference to this. MS. BOLLENBACH asked if the language "carrying the unborn child to term" includes child birth itself. She said it would only be fair for the bill to include information for both. The bill talks about photographs of the fetus--there should also be photographs of women birthing a child. It would also be correct and fair to show a picture of a woman who has died at child birth. MS. BOLLENBACH said that Dr. Nakamura, Ms. Rudinger and Dr. Whitefield have made all the points she wanted to make. She stated she is against SB 300, and it is important to remember that a person has the right to decide what happens to his or her own body. Number 1183 SENATOR HALFORD moved to replace the word "conception" on page 5, line 21 and page 3, line 8 with the word "fertilization." There being no objection, amendment 1 was adopted. SENATOR DONLEY said he was concerned with the fact that women have to be certified that they are not pregnant before they can receive certain medications. DR. NAKAMURA stated that the committee has made the bill even worse by replacing the word conception with the word fertilization. Fertilization is not a definition of pregnancy. SB 300 tends to equate conception, fertilization and pregnancy-- this is impossible to do. SENATOR HALFORD suggested replacing the word "contraception" with "implantation" instead of with "fertilization." DR. NAKAMURA responded that "implantation" would be a more correct term, at least that is when pregnancy is considered to be initiated. Number 978 SENATOR HALFORD moved to rescind the action in adopting the previous amendment. There being no objection, amendment 1 was withdrawn. SENATOR HALFORD moved to include the words "when combined with implantation" on page 3, line 8 and page 5, line 22. The new language will read, "'conception' when combined with implantation means the fusion of a human spermatozoan with a human ovum:." DR. NAKAMURA said that if the bill was left the way it was, no woman could undergo any sexual act with a male without total artificial contraception because there will always be a point at which a sperm and an egg get together. This will also eliminate any possibility of taking any medication as precluded in the event of a pregnancy. SENATOR HALFORD asked if using the word implantation will allow a woman to use medication when needed. DR. NAKAMURA said yes, assuming the woman has the ability to get a pregnancy test done early, but not everyone has access to early pregnancy testing. CHAIRMAN TAYLOR said that from what Ms. Medeiros said, her physician would be unwilling to prescribe medication to her if he was aware of her being pregnant. So, for a woman of child bearing age facing this sort of difficulty and the doctor knowing the adverse effects that the medication may have on such a person--how is it done today without doing a test? DR. NAKAMURA said that missing a period is an indication that a pregnancy has been initiated, which at least gives the woman an opportunity to seek the test. Number 698 CHAIRMAN TAYLOR asked if there was an objection to the earlier amendment. There being no objection, amendment 1 was adopted. SENATOR HALFORD moved CSSB 300(JUD) out of committee with individual recommendations. There being no objection, the motion carried. HB 275-UNIFORM PROBATE CODE/TRUSTS/PROPERTY CHAIRMAN TAYLOR reminded the committee that testimony was taken on HB 275 during the March 22 Judiciary Committee meeting. SENATOR HALFORD moved CSHB 275 with individual recommendations from committee. With no objection, the motion carried. HB 318-LAW ENFORCEMENT AGENCY PROPERTY DISPOSAL REPRESENTATIVE CON BUNDE, sponsor of HB 318, said the state does not have a law regarding lost property and the return of that property to the finder. If property is not claimed in one year the person who found it should be able to claim it. SENATOR HALFORD moved CSHB 318 with individual recommendations from committee. With no objection, the motion carried. There being no further business to come before the committee, CHAIRMAN TAYLOR adjourned the meeting at 3:15 p.m.