Legislature(2001 - 2002)
04/03/2002 09:14 AM Senate FIN
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
CS FOR SENATE BILL NO. 91(HES)
"An Act relating to information and services available to
pregnant women and other persons; and ensuring informed
consent before an abortion may be performed, except in cases
of medical emergency."
This was the first hearing for this bill in the Senate Finance
Committee.
Senator Ward, sponsor, testified this bill requires the Department
of Health and Social Services to develop an information booklet and
make it available to women "contemplating" an abortion. He spoke to
actions of the Senate Health Education and Social Services
Committee related to this legislation.
Senator Ward commented that Alaska's informed consent process is
not uniform. He stated this bill would provide uniform information
to those receiving services regardless of their location in the
State.
AT EASE 9:50 AM / 9:58 AM
BOB LYNN, President, Alaska Right to Life Alliance, testified via
teleconference from Anchorage to urge the Committee to pass this
legislation. He spoke of the medical procedure and the need for
informed consent. He talked about the financial benefits to
abortion providers for performing the procedures and asserted that
relying on these providers to provide information is a conflict of
interest. He used an analogy of real estate transactions and the
informed consent requirements in that industry and compared the
health of a house to the health of a woman.
VICTORIA HALCRO, Director, Public Affairs and Marketing, Planned
Parenthood of Alaska, testified via teleconference from Anchorage
that Planned Parenthood "does more every day to prevent abortions
than any other organization in the country." She stated this
legislation singles out one medical procedure, which she surmised
is unethical, and noted the medical profession has established
methods for informing patients about procedures. She asserted that
the American College of OB/GYN position is that there is no medical
basis supporting statements that a risk of adverse psychological
effects related to abortions exists. She continued that there is no
evidence that an abortion causes any long-term psychological injury
and she suggested there could be long-term psychological effects
resulting from childbirth. She opined the information that would be
contained in the proposed pamphlet would be presented in a biased
manner with the intent to discourage women from choosing to have an
abortion. She predicted the pamphlet would not contain statements
indicating that an abortion is eight times safer than carrying a
pregnancy to term, nor would it state that first-term trimester
abortion has a lower complication rate than any other surgery.
Senator Olson asked the witness if her testimony is that former US
Surgeon General, C. Everett Koop, found no psychological risk for
women who have an abortion.
Ms. Halcro affirmed.
KAREN VOSBURGH, Executive Director, Alaska Right to Life, testified
via teleconference from Anchorage that, "informed consent is not as
much an abortion issue as it is a woman's health issue." She cited
a three-year Planned Parenthood study, which found that post-
procedural trauma for abortion patients could be as high 91
percent. She disagreed that abortion providers present adequate
information about the procedure, referencing a study compiled by
David Reardon, Director, Elliot Institute for Social Services,
whereby 80 percent of surveyed women stated they were denied
informed consent or were actively misinformed prior to receiving an
abortion. She asserted that women are entitled to know the physical
and psychological risks that could be incurred from abortions as
well as information about fetal development. She listed additional
findings in Dr. Reardon's report: abortion is four times deadlier
than childbirth, and that three to five percent of women who have
had an abortion are rendered sterile. She mentioned a Japanese
report that found the rate of sterilization to be nine percent; 14
percent suffered from reoccurring miscarriages; and a 400 percent
increase in ectopic pregnancies. She also spoke of suicide attempts
and various complications from abortions, including increased risk
for breast cancer. She detailed reports of psychological trauma
related to abortions.
Co-Chair Kelly commented that one of two reporters left the room
after hearing the testimony of Planned Parenthood.
ANNE HARRISON, Registered Nurse and Nurse Practitioner of Women's
Health Care, and Member, State Board of Planned Parenthood
testified via teleconference from Fairbanks on her own behalf.
SFC 02 # 47, Side B 10:15 AM
Ms. Harrison detailed her experiences in working with pregnant
women. She asserted this legislation is unnecessary because the
health care providers give adequate information of options and
possible complications to all pregnant woman. She stated the data
cited by the Right to Life organization is inaccurate and distorted
and focuses on a small incidence. She predicted an information
packet could not be compiled to the satisfaction of groups on both
sides of the issue. She reminded this country is established on the
separation of church and state and urged the Committee not impose
it's views, especially in areas it is not proficient.
ROBIN SMITH, constituent of Senator Ward, testified via
teleconference from Anchorage in opposition to the bill. She stated
she wished efforts could be combined to prevent abortions. She
calculated that of the approximately 9,960 births in Alaska in
1999, 48 percent were funded by Medicaid, and that 42 percent of
all births are unintended births; therefore 2,100 births were paid
by the State. She referenced State information listing the average
public cost for an unintended pregnancy carried to term and infant
care for one year is $30,000 and she calculated the total cost at
$60 million annually. She emphasized the need to reduce the number
of unintended pregnancies. She spoke to the psychological problems
with childbirth and giving babies up for adoption.
JENNIFER RUTTINGER, Executive Director, Alaska Civil Liberties
Union, testified in Juneau referencing a position statement dated
April 20, 2001 [Copy on file]. She spoke of the organization's
mission "to guarantee the individual liberties that are found in
the Alaska Constitution and the US Bill of Rights," and it's
representation of Planned Parenthood of Alaska on the issue of
protecting privacy in the context of medical decision-making for
one's own body. She described the 1992 US Supreme Court decision on
Planned Parenthood of Southeastern Pennsylvania vs. Casey upholding
a Pennsylvania State law requiring physicians to provide women
state-prepared anti-choice materials prior to an abortion
procedure. She qualified that the Alaska Supreme Court, as well as
Supreme Courts in other states, gives the right to choose more
protection under their State constitution than the US Supreme Court
gives under the federal constitution, which does not contain a
right to privacy component. She told of the Alaska Supreme Court
decision in Valley Hospital Association vs. Mat-Su Coalition for
Choice finding that any restrictions on the private decision of a
woman to terminate a pregnancy or to carry a pregnancy to term,
would be "held to the highest possible standard of scrutiny." She
explained that the State must demonstrate a compelling interest for
the need for this legislation as well as demonstrate that the law
would not infringe on the right to choose. She remarked this
legislation violates the Alaska constitution under the Valley
Hospital decision. She stated the medical information required to
be included in the proposed material is scientifically and
medically "suspect" in some instances, and she noted that neither
Dr. C. Everett Koop, or the World Health Organization were able to
find psychological harm linked to abortion. She told stories of
women for whom a pregnancy would be life threatening and the
additional hardship of requiring them to be subjected to this
information. She stated this is not in women's best interest. She
talked about the higher cost of doctor's required to provide this
information rather than nurses, etc. She supported information
about all medical procedures. She cautioned against the government
making decisions about what information is appropriate.
DEB JOSLIN testified via teleconference from Delta about her
experience with an unborn child "with multiple anomalies" and the
counseling she received urging her to terminate the pregnancy. She
decided against termination and detailed her introduction to a
support group where she learned of other children with trisomy 13
disorder. She said her child was born with serious heart conditions
but was in significantly better health than anticipated and that he
was not in pain. She therefore supported this legislation as she
thought she should have received more accurate information about
the prenatal condition her son was diagnosed with. She informed her
son lived much longer than the maximum two days prognosis.
Senator Olson asked the sponsor about a witness statement that
women are aware of the availability of information on abortion
procedures. He commented that in Rural Alaska there are some people
who are "less than knowledgeable" about the procedure. He asked
what provisions in this legislation address rural residents and if
the information would be provided in languages other than English.
Senator Ward stated the information would be provided in English.
He hoped that any provider would not perform an abortion procedure
on a person who was unable to understand what was about to occur.
Co-Chair Kelly commented the number of abortions performed in rural
Alaska is low, primarily due to the limited amount of State
funding.
Senator Ward stated Senator Olson's concerns are the basis for this
legislation. He relayed the story of a girl who received an
abortion in the 1970s and was sterilized. As a result he and wife
became involved in counseling against abortion. He stated many
women did not receive adequate information.
Senator Ward asserted this legislation is about "choice". He also
compared the decision to receive medical treatment to that of a
real estate transaction, citing full disclosure requirements in
real estate.
Senator Olson spoke as a physician, that this legislation imposes
additional regulations, which he did not support because it tends
to require physicians to operate more as technicians than doctors.
He asked the consequences of a health care provider not supplying
the information proposed in this bill. He commented he assumed that
in the instance shared by Senator Ward, the sterilization was
unintended.
Senator Ward hoped so.
Senator Ward opined this legislation would provide a "safeguard",
not only for the patient making the decision, but for all involved
parties as well. He remarked, "the more information that people
have in order to make a decision, I think the better it is." He
surmised that the vast majority of patients receiving these
services would prefer to have this information.
Senator Austerman stated with due respect to moral and religious
beliefs, this issue could be divisive. He would not object to
moving the bill from Committee, however he informed that he would
not vote for passage from the Senate. He ascertained, "obviously,
it's an issue that appears to be a veiled approach" to pursue
"personal issues."
Co-Chair Kelly disagreed the legislation is "veiled" and instead
asserted, "it's a straightforward attempt to give people who are
going into a potential very dangerous medical procedure, the
information that I think has been denied them." He told of the
several miscarriages his mother experienced before his birth, and
the pressure she was under to abort him as he was not expected to
be healthy and because she was in danger of dying. He qualified
this occurred in a different time and involves only one doctor.
However, he thought this practice continues in some form.
Senator Green talked about the extensive consultation she received
before undergoing recent routine surgery. She did not think
education could be "over stressed" to allow good consumer choices,
particularly in relation to medical treatment.
Co-Chair Kelly asked about changes to the fiscal note.
KAREN PEARSON, Director, Division of Public Health, Department of
Health and Social Services, testified the fiscal note incorporates
the estimated cost of advertising and additional professional time.
At the time the original fiscal note was prepared, she stated, it
was assumed the information would be provided in the form of a
"simple pamphlet or small booklet", but in reviewing the
legislation, it was realized that a much larger publication would
be required. She explained this is partially due to the inclusion
of a geographic index of services and providers. She stated the
increase in funding for professional services is intended to
address provider inquiries regarding the publication.
Co-Chair Kelly asked the cost of the Department's statutory
requirement to advertise Planned Parenthood services.
Ms. Pearson replied the Department does not advertise Planned
Parenthood services. She clarified, "unfortunately, the terminology
that's in the statute happens to match the name of an official
organization" and stated the Department's business relates to
"planned pregnancy".
Ms. Pearson continued the Department and the Division supports the
intent of the bill to fully inform patients in any situation. She
said the contention, however, is that informed consent is already
required for any procedure. She questioned the effectiveness of
providing information in written form, given the limited literacy
of some patients. She stated that providing various forms of
information about avoiding unplanned pregnancy would be a more
appropriate approach.
Senator Hoffman clarified the witness testified that informed
consent is currently required and asked if provisions are
stipulated in regulation.
Ms. Pearson responded that before any medical procedure is
conducted, the patient must sign a consent form. She was unsure
whether this stipulation is contained in statutes or regulations.
Co-Chair Kelly stated the informed consent provision is different
in the instance of abortion procedures due to Alaska Supreme Court
decisions. He doubted if informed consent of abortion proceedings
"in practice is true." He surmised the witness is misinformed.
Ms. Pearson replied she would verify her statements.
Senator Leman asked if in light of the existing informed consent
practices, why one-half year is required annually to develop the
proposed booklet, which he assumed would utilize information
already available. He also asked why a full-time clerk position is
required to maintain a database and distribute the booklets.
SFC 02 # 48, Side A 11:03 AM
Senator Leman commented that when a department opposes legislation,
it would "inflate" the fiscal note.
Ms. Pearson responded she wanted to accurately reflect the expenses
to continually update the information. She noted the technical
information would not comprise the majority of the cost. Rather,
she stated, there would be effort required to update the frequent
changes of service providers. She qualified her interpretation of
the legislation is to document all agencies, counselors, health
care providers and other service providers, which she stated would
require constant interaction with communities. She pointed out that
if the information could be updated on an annual basis, the fiscal
note would be significantly less.
Co-Chair Kelly asserted that the content of a signed consent form
would be considerably different than the information proposed in
this legislation.
Co-Chair Kelly commented on the testimony given by the ACLU and
Planned Parenthood that there is no psychological impact of an
abortion. He pointed out that litigation regarding public funding
of abortion services is partially resulting from the argument that
medically necessary abortions include the psychological health of
the woman. He asserted, "ACLU speaks with a forked tongue."
Co-Chair Kelly requested Senator Ward address the concerns related
to the fiscal note.
Senator Green offered a motion to "move Senate Bill 91 out of
Committee with individual recommendations and flocculating fiscal
note."
Without objection, CS SB 91 (HES) MOVED from Committee with new
$110,000 fiscal note from the Department of Health and Social
Services dated 4/3/02 12:43 PM.
Co-Chair Kelly recessed 11:08 AM / 4:36 PM
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