Legislature(2001 - 2002)

03/16/2001 12:00 PM Senate HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
          SB  91-ABORTION: INFORMED CONSENT;INFORMATION                                                                     
CHAIRWOMAN GREEN announced SB 91 to be up for consideration.                                                                    
MS. SANDY ALTLAND, staff to Senator  Ward, sponsor, explained that                                                              
SB 91 provides  more information to people who  are considering an                                                              
abortion. It asks  the Department of Health to  prepare a handbook                                                              
with the  information that is  needed. Some people  have emotional                                                              
problems after a  procedure and more information  in the beginning                                                              
might help them.                                                                                                                
MS. NANCY DAVIS, Acting Director,  Division of Public Health, said                                                              
she  was  presenting  the prepared  testimony  of  Karen  Pearson,                                                              
Director as follows:                                                                                                            
     The Division  of Public Health supports what  appears to                                                                   
     be  the intent  of  this bill  insuring  that all  women                                                                   
     seeking a  abortion are fully informed prior  to signing                                                                   
     consent  for the  procedure to  be done.  Since this  is                                                                   
     currently  required  to  any  surgical  procedure  being                                                                   
     performed  and is  considered essential  by the  medical                                                                   
     provider and  the advocate communities, we  question the                                                                   
     need for a law specific to the abortion procedure.                                                                         
     I believe  we are in  agreement that each  woman seeking                                                                   
     an  abortion  needs  information   about  the  physical,                                                                   
     emotional, psychological and  medical risks and benefits                                                                   
     of  the procedure  them personally.  This bill seeks  to                                                                   
     address this need by requiring  each women be provided a                                                                   
     detailed   and   lengthy  informational   document   and                                                                   
     requiring  that the  provider  have the  patient sign  a                                                                   
     form  indicating  she  has   read  and  understands  the                                                                   
     information in the document and its relevance to her.                                                                      
     Some  women would  find such  material information,  but                                                                   
     many who  are of  low literacy,  illiterate or for  whom                                                                   
     English is  a second language  would not be  served well                                                                   
     by  this  process.  Many individuals  who  have  reading                                                                   
     problems are very skilled at  hiding those problems from                                                                   
     those with  whom they interact.  Thus, it could  be very                                                                   
     difficult  for a provider  to ascertain  surely or  with                                                                   
     any  degree  of  certainty  that  a woman  to  whom  the                                                                   
     written  materials were  provided was  actually able  to                                                                   
     read and comprehend the information.                                                                                       
     Providers  are  accustomed   to  explaining  procedures,                                                                   
     risks,  and  benefits relative  to  medication  options,                                                                   
     treatment options of all kinds  and being able to follow                                                                   
     up on  questions and  concerns as  they arise. They  are                                                                   
     used  to tailoring  the information  given  to meet  the                                                                   
     specific  needs of  the patient  being  seen. There  are                                                                   
     many  individual  health issues  that  a physician  must                                                                   
     address with  each patient no matter what  the procedure                                                                   
     that will be performed. These  needs are not well served                                                                   
     when large  volumes of written  information that  may or                                                                   
     may  not be  relevant to  that  individual are  required                                                                   
     first in order to verify that  a person is informed. The                                                                   
     language,  culture, age  and other  relevant factors  of                                                                   
     the  woman  must  be considered  when  deciding  how  to                                                                   
     provide information  in the most usable form  and manner                                                                   
     and  only  the provider  working  with the  patient  can                                                                   
     determine those individual needs.  There are substantial                                                                   
     costs  as reflected in  the fiscal  note related to  the                                                                   
     Department   of  Health   and   Social  Services   staff                                                                   
     compiling  and  keeping  current   lists  of  providers,                                                                   
     agencies  and  organizations   in  each  community  that                                                                   
     provides  support,  aid  or  other  services  for  women                                                                   
     contemplating  parenting,  adoption or  abortion.  Local                                                                   
     communities are  well-versed in local resources  and are                                                                   
     better   able  to  keep   the  information  current   at                                                                   
     significantly  lower costs. Thus,  if these booklets  do                                                                   
     not significantly  improve the process of  informing the                                                                   
     patient, and  we believe they will not, then  this money                                                                   
     could  perhaps be  used to  fund needed  services or  to                                                                   
     educate  women  about  avoiding  unintended  pregnancies                                                                   
     and, thus, avoiding contemplating having an abortion.                                                                      
TAPE 01-24, SIDE A                                                                                                            
CHAIRWOMAN  GREEN  asked  if  they generally  refer  people  to  a                                                              
physician, if possible.                                                                                                         
MS.  DAVIS  answered  that the  Public  Health  Division,  through                                                              
several different divisions, encounters  women who are pregnant or                                                              
seeking a  pregnancy test.  Through some  of their grantees,  that                                                              
encounter is  made through public  health nurses in  public health                                                              
centers  at the  local level.  They  do not  provide any  abortion                                                              
services at public health centers  or by public health staff. They                                                              
refer clients  to whatever  services they need  or seek.  She said                                                              
further that  public health services  are primarily  preventive in                                                              
nature and for on-going prenatal  care or other things, they refer                                                              
them to an on-going provider.                                                                                                   
MS. IDA  BARNICK, Alaskans  for Life, Inc.,  supported SB  91. She                                                              
said, "Medical  and scientific  fact have  proven that  human life                                                              
begins at conception."                                                                                                          
This is extremely  important for a woman who is  contemplating the                                                              
life of her unborn child to understand what she is doing.                                                                       
     Therefore,  she  deserves to  know  the age,  the  fetal                                                                   
     development of her unborn child,  possible psychological                                                                   
     effects that  she might experience if she  ends the life                                                                   
     of  this child  and she  needs  to know  what the  other                                                                   
     options  to abortion  or other  community services  that                                                                   
     can  help her if  she decides  to let  her unborn  child                                                                   
     live.  She  should  never  be  coerced  into  having  an                                                                   
     abortion.  She should  be required  to sign a  statement                                                                   
     that she was given the information…                                                                                        
MS. BARNICK said  this is the same procedure she  would have to go                                                              
through  if she  were  going  to have  any  other major  or  minor                                                              
medical procedure.  If English is  the second language,  she would                                                              
usually  have  an  interpreter  with  her  who  will  explain  the                                                              
information.  She also  didn't think  it was unusual  for a  state                                                              
agency  to have to  provide brochures  to the  public for  various                                                              
things and she didn't believe it would cost that much.                                                                          
Number 460                                                                                                                      
MS.  KAREN VOSBURGH,  Executive Director,  Alaska  Right to  Life,                                                              
said she didn't  understand the opposition by  pro-abortion forces                                                              
to allow  women to have full  and informed consent. She  has found                                                              
that  when women  are considering  abortion,  very little  factual                                                              
information  is  actually  given.  She  said there  are  over  100                                                              
potential  physical complications  associated  with abortion.  She                                                              
presented some  abortion statistics for Great Britain  saying that                                                              
she new women were not aware of these.  She said that many studies                                                              
have connected breast cancer and  abortion and have also connected                                                              
it with the pill.                                                                                                               
     According   to  Calinborn  (ph),   based  on  the   most                                                                   
     comprehensive   medical  evidence   available,   induced                                                                   
     abortion   and  the   birth   control   pill  are   both                                                                   
     independent  root  factors  for  development  of  breast                                                                   
     cancer. This risk is especially  great if the women have                                                                   
     participated in either of these  factors at a young age…                                                                   
She said  that despite  evidence of the  dangers of breast  cancer                                                              
from abortions  and contraceptive use, "abortion  clinics continue                                                              
to  promote  abortion  on  demand."  She  said  that  evidence  of                                                              
psychological damage from having abortion is overwhelming.                                                                      
Number 825                                                                                                                      
MR.  BOB  LYNN,  President,  Alaskans  Right to  Life,  said  that                                                              
passing a statute mandating informed  consent is not about whether                                                              
abortion should or should not be  legal or available or who should                                                              
pay  for it.  "My concern  today is  nothing more  than a  woman's                                                              
right to know  the facts about any medical procedure  including an                                                              
abortion procedure before consenting to it."                                                                                    
He said that  informed consent is  routine. If women knew  some of                                                              
the  risks of  abortion,  she might  not  consent.  He noted  that                                                              
abortion providers only get paid when a woman decides to abort.                                                                 
MR. LYNN  said that  he sells  real estate  and that everyone  who                                                              
sells a house must provide a disclosure statement to buyers.                                                                    
     Likewise, Alaska  Right to Life  thinks that  anyone who                                                                   
     sells  an  abortion should  provide  the buyer  of  that                                                                   
     abortion with  a full disclosure of facts.  So there was                                                                   
     informed consent  before the woman buys the  abortion. I                                                                   
     hope the legislature  thinks that the health  of a woman                                                                   
     is more important than the health of a house.                                                                              
DR. COLLEN MURHPY,  Anchorage Obstetric Gynecologist,  said she is                                                              
Board certified  by the American  College of OBGYN. She  wanted to                                                              
reassure the audience and said:                                                                                                 
     The  standard  procedure  for  medical  practice  is  to                                                                   
     provide  informed  consent.   It  currently  constitutes                                                                   
     excellent patient care. It is  currently required by all                                                                   
     professional  organizations under  all circumstances  be                                                                   
     it for a medical or a surgical  procedure of any nature.                                                                   
     Likewise, our professional ethical  standards require it                                                                   
     and  furthermore  the  lawyers  demand it.  I  will  say                                                                   
     repeatedly  again   and  again,  that   this  particular                                                                   
     attempt at informed consent  is not required under state                                                                   
     law. This  is something that  is done in the  privacy of                                                                   
     the  office  with  an  individual   patient  and  client                                                                   
     talking about  the serious nature  of a condition  be it                                                                   
     related to  abortion, a hysterectomy, a colposcopy  or a                                                                   
     gall  bladder surgery.  For the legislature  to step  in                                                                   
     between  the  privacy  of  a patient  and  a  doctor  is                                                                   
     inappropriate. We are practicing  medicine and this does                                                                   
     not need to be legislated.                                                                                                 
DR. MURPHY disagreed with the preceding  scientific information by                                                              
someone describing breast cancer.  That is not scientific fact and                                                              
is a subjective  evaluation. She also wanted to  discuss what they                                                              
could do about the tragedy of unintended pregnancy in Alaska.                                                                   
     Currently, 60  percent of pregnancies are  unintended in                                                                   
     Alaska. It  is estimated that half of  those pregnancies                                                                   
     will go to termination of pregnancy.  The other half may                                                                   
     miscarry or become  live born. Some women  will elect to                                                                   
     adopt them  out. If we truly  want to decrease  the need                                                                   
     or the request  for abortion, we should be  directly our                                                                   
     attention  towards  decreasing  the  reasons  unintended                                                                   
     pregnancy occurs  in Alaska. Rather than  fighting about                                                                   
     informed  consent,  which  is  something  that  is  done                                                                   
     privately  between  a trained  medical  provider when  a                                                                   
     surgical condition  is being considered with  a patient.                                                                   
     I would suggest that we direct  our attention, just like                                                                   
     the World  Health Organization has suggested  elsewhere.                                                                   
     The best  way to  decrease the  need for termination  of                                                                   
     pregnancy   is   to   increase   the   availability   of                                                                   
     contraception. I would challenge  this committee to look                                                                   
     at a  bill that has  currently been proposed  by Senator                                                                   
     Johnny Ellis,  SB 15,  called the prescriptive  fairness                                                                   
     act.  This is  a step  in the  right  direction that  is                                                                   
     concrete, that  everyone can agree  on - that  women who                                                                   
     use contraception  that is reliable and approved  by the                                                                   
     FDA - have a lower risk of unintended  pregnancy and the                                                                   
     need for termination.                                                                                                      
DR. MURHPY said they should spend time doing something that they                                                                
know works rather  than putting women and providers  in additional                                                              
difficulties and expense based on the proposals in this bill.                                                                   
CHAIRWOMAN GREEN said  she had a question from someone  who had to                                                              
leave  earlier,  but  they  refer  to  the term  in  the  bill  of                                                              
"gestational  age",  which is  neither  a medical  nor  scientific                                                              
concept and asked if there was better phrasing.                                                                                 
DR. MURPHY replied that gestational age varies. She explained:                                                                  
     There is  something called Migel's  Rule. It's  when you                                                                   
     find out when the woman's last  menstrual period is. You                                                                   
     add  nine months  plus one  calendar week  and it's  the                                                                   
     estimated date  of confinement. From that,  we calculate                                                                   
     the  supposed  gestational age.  The  average  pregnancy                                                                   
     will  be approximately  40 weeks in  duration. A  normal                                                                   
     term pregnancy will deliver  between 37 and 42 weeks. To                                                                   
     make   a  long   story   short,  menstrual   dating   is                                                                   
     notoriously    inaccurate.   If    you   go   ahead    a                                                                   
     retrospectively  date a  pregnancy based  on the  baby's                                                                   
     size and weight  and appearance at birth,  25 percent of                                                                   
     menstrual  dates  are inaccurate  for  gestational  aged                                                                   
     dating. In  modern obstetrics,  we will often  alter the                                                                   
     dating  of  the  pregnancy   based  on  ultrasonigraphic                                                                   
     findings  in which  we might  go ahead  and measure  the                                                                   
     gestational  sack  size.  We  might  measure  the  crown                                                                   
     growth  points, the fetal  fold, different  measurements                                                                   
     of the  skull or the femur  length. This will  alter the                                                                   
     gestational age such that we  no longer rely on the last                                                                   
     menstrual  period  because a  bleeding  episode did  not                                                                   
     occur  exactly  two  weeks  prior  before  the  egg  was                                                                   
     released from the ovary.                                                                                                   
CHAIRWOMAN GREEN asked if the method  of computing the gestational                                                              
age has been refined through time.                                                                                              
DR. MURPHY  responded that  it no longer  relies on just  the last                                                              
menstrual    period.    "It's   invariably    complemented    with                                                              
ultrasonigraphic and physical exam."                                                                                            
CHAIRWOMAN GREEN asked  if using those methods, was  there a range                                                              
in  which she  could identify  at  what point  of development  the                                                              
unborn child is.                                                                                                                
DR. MURHPY  replied, "I  don't know what  an unborn child  is. I'm                                                              
not familiar  with the term unborn  child. She is a  physician and                                                              
medically trained  and has  never come across  unborn child  in my                                                              
medical training."                                                                                                              
CHAIRWOMAN GREEN  asked what phrase  would she use for  the before                                                              
delivery time.                                                                                                                  
DR. MURHPY said they don't use that phraseology. She explained:                                                                 
     When  a  fertilized  egg  divides,  it  changes  into  a                                                                   
     blastocyst and then it will  implant into the uterus and                                                                   
     be called  an embryo until  eight weeks gestation.  From                                                                   
     eight weeks gestation until  the time of delivery, it is                                                                   
     called a fetus.  There is no such thing as  unborn child                                                                   
     in medical literature.                                                                                                     
CHAIRWOMAN GREEN asked  how she identified the number  of weeks or                                                              
what the  stage of  development is.  She asked,  "If when  you are                                                              
making those assumptions,  are you basing that on  a range of time                                                              
versus this is  a specific day in the development  versus it could                                                              
be within two weeks."                                                                                                           
DR. MURHPY replied:                                                                                                             
     It  gets  pretty  interesting.  If  you  look  at  first                                                                   
     trimester,  which  according  the  American  College  of                                                                   
     OBGYN  is up  to 14  weeks in  pregnancy,  and then  the                                                                   
     second  trimester is  14  weeks to  28  weeks and  third                                                                   
     trimester is  28 weeks to  birth. Basically, we  know if                                                                   
     we do ultrasound  measurements of the fetus,  that world                                                                   
     wide based  on large statistical studies  [indisc.] that                                                                   
     fetuses pretty  much grow at a very similar  rate in the                                                                   
     first trimester,  through 14 weeks  - such that  you can                                                                   
     date  the  pregnancy within  several  days  to about  10                                                                   
     days. Between  14 weeks [and  28 weeks] we start  to get                                                                   
     such  variation  that  it's two  weeks  difference.  So,                                                                   
     we're not accurate. I think  a lot of lay people give us                                                                   
     too  much  credit for  being  terribly accurate  and  we                                                                   
     really aren't. We guess pretty well.                                                                                       
Number 1486                                                                                                                     
MS. SHERRY  GOLL, Alaska  Pro Choice  Alliance, Haines,  said they                                                              
are  a state  wide coalition  of  diverse nonprofit  organizations                                                              
with a  mission of protecting  reproductive rights and  to promote                                                              
reproductive  health  services  through  education,  advocacy  and                                                              
community   organizing.   Although   the  group   promoting   this                                                              
legislation think it is informational,  her organization thinks it                                                              
is trying to intimidate and harass  women who are choosing to have                                                              
an abortion. She said:                                                                                                          
     Apparently, people  are under the impression  that women                                                                   
     take this  kind of decision lightly instead  of thinking                                                                   
     about it  and dealing  with it in  the privacy of  their                                                                   
     own lives, making their own  constitutionally protected,                                                                   
     private pregnancy decision with  their physician. As Dr.                                                                   
     Murphy   just  stated,  physicians   for  all   surgical                                                                   
     procedures  provide informed  consent.  To suggest  that                                                                   
     women  in  this particular  instance  have  to be  shown                                                                   
     photographs -  I mean photographs of a  developing fetus                                                                   
     would  be more  appropriate to  show to a  woman who  is                                                                   
     planning to  have a pregnancy  and there are  many books                                                                   
     in the library to help you understand  child development                                                                   
     if you're going to have a baby.                                                                                            
     If  a  man  needs  to  have  a  cyst  removed  from  his                                                                   
     testicles,  do you  think it would  appropriate for  the                                                                   
     legislature to put in law that  this man should be shown                                                                   
     pictures of  how that cyst would  grow over a  period of                                                                   
     time if he fails to remove it.                                                                                             
     I think the bill is flawed in  ways using terms that are                                                                   
     so charged,  like unborn child,  when as you know  it is                                                                   
     not a medical term. If it's  meant to be educational, if                                                                   
     you want to  provide information, don't tell  women that                                                                   
     the father  of their child  will be under  obligation to                                                                   
     provide child  support unless you're also going  to tell                                                                   
     her  what the  statistics are  that  obligors pay  their                                                                   
     child  support.   I  am  very   much  opposed   to  this                                                                   
     legislation. I  think that it's just intended  to harass                                                                   
     women who  choose to  have an abortion  and it is  clear                                                                   
     that  it is  that type  of bill  by the  folks who  have                                                                   
     shown up to  testify on it. I appreciate  your taking my                                                                   
     testimony. Thank you very much.                                                                                            
Number 1620                                                                                                                     
MS. ANNA  FRANKS, Fairbanks, said  she would be  reading testimony                                                              
from Alicia  Wells, Anchorage  resident, who  was home  caring for                                                              
her children.  The letter said  preventing pregnancy  sometimes is                                                              
just based  on luck  and that a  woman can  get pregnant  using an                                                              
IUD. She said  that she was never  forced to have sex  against her                                                              
will  and that  her  parents  shared  with her  information  about                                                              
responsible sexual behavior. She read:                                                                                          
     Not  all women  are  that lucky,  however,  and for  one                                                                   
     reason or  another, many women find themselves  pregnant                                                                   
     when  they  don't  want  to be.  For  these  women,  the                                                                   
     decision  about what  to do  is  not easy.  I know  from                                                                   
     having  counseled  several friends  with  this  decision                                                                   
     that it is  not one that any woman takes  lightly. Women                                                                   
     who are  in this situation  need access to  good quality                                                                   
     information  and  supportive  non-judgmental  counseling                                                                   
     about their actions.                                                                                                       
She read further that:                                                                                                          
     SB  91 masquerades  as something  that  will help  women                                                                   
     make a  decision at this  critical time in  their lives,                                                                   
     its main  purpose is to  intimidate women and  make them                                                                   
     feel guilty  for exercising their right to  make choices                                                                   
     about  their  bodies and  their  lives. In  addition  to                                                                   
     being a blatant anti-choice  attempt to restrict women's                                                                   
     rights, there are several major  problems with the bill.                                                                   
     First, the  legislature has no business  telling doctors                                                                   
     the specifics of  what they can and should  be saying to                                                                   
     their  patients.  Doctors  are   already  bound  by  the                                                                   
     standards of  practice which include providing  complete                                                                   
     and unbiased  information and  counseling about  medical                                                                   
     procedures  as well  as  insuring that  a  woman or  any                                                                   
     patient  freely  consents  to  the  procedure  she  will                                                                   
     undergo.  These  systems  are  already  established  and                                                                   
     working.  There  is  not need  for  special  information                                                                   
     consent forms just for abortion.                                                                                           
     Second,   the   purposed  intent   of   this   so-called                                                                   
     counseling  material is clearly  biased and intended  to                                                                   
     dissuade women.                                                                                                            
     Third, the proposed content  of the so-called counseling                                                                   
     materials  related  to  the   psychological  affects  of                                                                   
     abortion   is  simply   not   supported  by   scientific                                                                   
     Finally,  SB 91 shows  a lack of  respect for women.  It                                                                   
     assumes  that  women  will not  make  the  right  choice                                                                   
     without an  extra push in  the right direction  from the                                                                   
     state.  Well, as  a  woman myself  and  someone who  has                                                                   
     talked to  many women,  I can assure  you that women  do                                                                   
     have the ability to make thoughtful  and moral decisions                                                                   
     about their lives.  We need to respect that  ability and                                                                   
     provide women  with quality information and  services so                                                                   
     that they  may have the  best possible outcome  whatever                                                                   
     their  choice. I  urge you  to  vote against  SB 91  and                                                                   
     allow  women  to  make  their  own  decisions  with  the                                                                   
     assistance and medical expertise of their own doctors.                                                                     
MS. JENNIFER RUDINGER, Executive  Director, Alaska Civil Liberties                                                              
Union  (ACLU), opposed  SB  91. She  asked  if  the committee  had                                                              
received testimony from  Dr. Sharon Smith, Dr. Cathy  Todd and Dr.                                                              
Jan Whitefield regarding this bill.                                                                                             
CHAIRWOMAN GREEN replied that they did receive it.                                                                              
MS. RUDINGER summarized her testimony:                                                                                          
     I want to  first of all point out something  that hasn't                                                                   
     been mentioned  yet and that's that SB 91  requires that                                                                   
     the physician, him or herself,  be the person delivering                                                                   
     these extraneous lectures to  the patient. This is going                                                                   
     to have the  effect of not only forcing doctors  to give                                                                   
     information that may not be  relevant to that particular                                                                   
     patient's circumstances, but  also by using the doctor's                                                                   
     time  to do  this, is  making access  to quality  health                                                                   
     care more difficult  and more expensive. SB  91 will not                                                                   
     allow  a trained counselor,  a nurse  or another  health                                                                   
     care  practitioner  to  provide  the  state's  mandatory                                                                   
     lecture to  the patient and  there are very  few doctors                                                                   
     already  available. There's a  shortage of doctors  able                                                                   
     to  help women  in these  circumstances.  By taking  the                                                                   
     doctors time and forcing them  to deliver these lectures                                                                   
     when  other  healthcare  practitioners  could do  it  is                                                                   
     going  to  drive up  the  cost  of healthcare  and  make                                                                   
     access more difficult.                                                                                                     
     Finally,  I just  want to  address some  of the  medical                                                                   
     misinformation,   actually,  that's  been  put   on  the                                                                   
     record, to kind  of correct the record. SB  91 refers to                                                                   
     possible   psychological   affects    that   have   been                                                                   
     associated  with having  an abortion  and as Dr.  Murphy                                                                   
     testified,  this is really  substituting lay people  and                                                                   
     politician's  judgment for that  of doctors.  Practicing                                                                   
     medicine is something  that should be left  up to people                                                                   
     with  a  medical license.  This  reference  to  possible                                                                   
     psychological  effects  is misleading  because  no  such                                                                   
     psychological  harms have  been proved  to exist and  in                                                                   
     fact  to  corroborate  that,   according  to  a  1987-88                                                                   
     investigation  by  former  Surgeon  General  C.  Everett                                                                   
     Coup, who  is of course no  champion of choice,  as well                                                                   
     as  another  study  by the  World  Health  Organization,                                                                   
     there  is  no  medical  evidence  that  abortion  causes                                                                   
     psychological  injury. On  the contrary,  relief is  the                                                                   
     most  common reaction  to a  voluntary abortion  whereas                                                                   
     women who  are forced  to continue unwanted  pregnancies                                                                   
     suffer  adverse   and  sometimes  severe   psychological                                                                   
     consequences. So, again this  is where it should be left                                                                   
     to  doctors  to  decide  based  on  their  best  medical                                                                   
     judgment, based on the specifics  of their patient, what                                                                   
     risks and  benefits are relevant  to that patient,  what                                                                   
     medical information is scientifically sound.                                                                               
     And finally,  I hadn't  planned to  discuss this,  but I                                                                   
     must just  briefly rebut the  allegation that  there's a                                                                   
     link  shown  between  abortion and  breast  cancer.  The                                                                   
     latest scare  tactic initiated by anti-choice  groups is                                                                   
     to link abortion with breast  cancer. Ceasing upon scant                                                                   
     evidence in a  1994 research study, they  have mounted a                                                                   
     bigger   advertising   and  legislative   campaigns   to                                                                   
     convince the public that having  an abortion increases a                                                                   
     woman's  chance of contracting  breast cancer.  In fact,                                                                   
     this  study  they  are referring  to  published  in  the                                                                   
     Journal  of the  National  Cancer Institute  reported  a                                                                   
     small  statistical   connection  between   abortion  and                                                                   
     breast  cancer. Although  cancer  research experts  have                                                                   
     characterized    this   study   as   inconclusive    and                                                                   
     methodolically   problematic,    anti-choice   activists                                                                   
     eagerly  wield it  as a new  way to  frighten women  and                                                                   
     restrict  their   choices.  Opponents  of   choice  have                                                                   
     persuaded  legislators in several  states that  there is                                                                   
     this link,  that this  is part  of the information  that                                                                   
     needs  to be  conveyed. It's  not clear  from this  bill                                                                   
     whether,  in fact,  that's the  case, but  if anyone  is                                                                   
     under the impression that there  is such a link and that                                                                   
     this  information is  needed for  informed consent,  I'd                                                                   
     like to  mention, and  I can get  this for you  later, a                                                                   
     couple  points that  illustrate just  the opposite.  The                                                                   
     Natural Cancer Institute has  charged that the study has                                                                   
     been   interpreted  inaccurately   and,  "There  is   no                                                                   
     evidence of a direct relationship  between breast cancer                                                                   
     and either induced or spontaneous abortion."                                                                               
     Second, the American Cancer  Society has concluded, "The                                                                   
     inconsistencies  of  existing  research  do  not  permit                                                                   
     definitive scientific conclusions."                                                                                        
     Third, on the day this study  was published, the Journal                                                                   
     of National  Cancer Institute, the source of  the study,                                                                   
     printed an editorial stating  that, "The overall results                                                                   
     of the  study as  well as the  particulars are far  from                                                                   
     conclusive and  it's difficult to  see how they  will be                                                                   
     informative to the public.                                                                                                 
     The  study was  particularly criticized  because of  the                                                                   
     methodological problem of possible  inaccurate reporting                                                                   
     of a history of abortion by participants.                                                                                  
     Fourth,  four  recent reviews  published  in  scientific                                                                   
     journals  have   assessed  more  than  30   studies  and                                                                   
     concluded  that the available  data on the  relationship                                                                   
     between  induced  or  spontaneous   abortion  in  breast                                                                   
     cancer  are  inconclusive.  Fifth,  a  1995  article  in                                                                   
     Cancer  Causes  and  Controls  reported  in  an  article                                                                   
     entitled  Abortion  and Breast  Cancer  Causes in  Seven                                                                 
     Countries  the study of  these countries concluded,  "In                                                                 
     Summary,  these data suggest  that any overall  relation                                                                   
     between abortion and risk of  breast cancer is likely to                                                                   
     be weak at the most."                                                                                                      
     This list goes on and on and  finally, one more point, a                                                                   
     widely noted  1997 study of more than 1.5  million women                                                                   
     in Denmark where abortion histories  are corroborated by                                                                   
     a government  sponsored medical registry, so  there's no                                                                   
     chance  of  reporting  bias,  concluded  that,  "Induced                                                                   
     abortions have  no overall affect on the  risk of breast                                                                   
     In  a  New  England Journal  of  Medicine  editorial,  a                                                                   
     company  in  the  Danish research  I  just  quoted,  Dr.                                                                   
     Patricia  Harkey (ph) of  the National Cancer  Institute                                                                   
     said, "It  provides important new evidence  to resolve a                                                                   
     controversy  that  previous   investigations  have  been                                                                   
     unable  to settle."  In short,  a woman  need not  worry                                                                   
     about  the  risk  of  breast   cancer  when  facing  the                                                                   
     difficult decision of whether  to terminate a pregnancy.                                                                   
MS. GOLL said she appreciated the opportunity to read these                                                                     
articles into the record and offered to provide them with further                                                               
information they might find helpful.                                                                                            
MS. DIETRICK SITLER, Anchorage resident, opposed SB 91. She                                                                     
wanted to share with them why a bill like this could be very                                                                    
detrimental to many women like her as follows:                                                                                  
     At  the age of  14 I  was diagnosed  with hemophilia,  a                                                                   
     disease  affecting  the  blood.  As  a  result  of  this                                                                   
     condition, it  is medically dangerous for me  to carry a                                                                   
     pregnancy  to term,  because  the loss  of blood  during                                                                   
     delivery  could be potentially  fatal to  me. I am  in a                                                                   
     long-term  committed relationship and  my partner  and I                                                                   
     are  very careful,  but as you  know, no  form of  birth                                                                   
     control  is  100 percent  effective.  Were  I to  become                                                                   
     accidentally  pregnant, it would  be in my best  medical                                                                   
     interests to  terminate the pregnancy rather  than carry                                                                   
     the  pregnancy  to  term.  I strongly  feel  this  is  a                                                                   
     decision between  my partner and  I with the  advice and                                                                   
     consultation of my doctor. The  government I feel has no                                                                   
     place in this personal painful  choice that I would have                                                                   
     to make.  Furthermore, my  partner and  I would find  it                                                                   
     very  painful   to  have  to  listen  to   a  litany  of                                                                   
     alternatives to abortion - alternatives  that are not in                                                                   
     our best  interest and that  could actually  threaten my                                                                   
     life before we would be deemed  capable of consenting to                                                                   
     an abortion.                                                                                                               
     My  greatest  objection  is  in  your  definition  of  a                                                                   
     medical emergency.  I would  not fall under  the medical                                                                   
     necessity  exception  to  SB   91,  because  having  the                                                                   
     abortion  at that very  moment would  probably not  be a                                                                   
     life   saving  measure   or   an  emergency   situation.                                                                   
     Therefore, I  would be subject to this  extra counseling                                                                   
     which  would  be  wholly  irrelevant  in  my  individual                                                                   
     circumstances.  I have  also  heard a  lot of  testimony                                                                   
     today stating  that if many women knew more  facts about                                                                   
     abortion, they  would probably  choose not to  have this                                                                   
     procedure. This  is not entirely true, especially  in my                                                                   
     situation.  Not every woman  that is having  an abortion                                                                   
     is having this  procedure just because they  do not want                                                                   
     to have  the child. What about  women like me?  There is                                                                   
     no exception for women like  me. I would remind you that                                                                   
     this decision  would already be very painful  for me and                                                                   
     I would  be terminating  this pregnancy  to save my  own                                                                   
     life. Why  should these extra  hurdles be placed  on me,                                                                   
     especially  when they  are not placed  before any  other                                                                   
     patient  seeking any  other medical  treatment. We  urge                                                                   
     you  to oppose  this bill and  thank you  very much  for                                                                   
     your time.                                                                                                                 
Number 2224                                                                                                                     
MS. MARY DYE, citizen of Alaska, supported SB 91 and read a                                                                     
definition of informed consent that she got off the Internet:                                                                   
     In medicine  a patient's written  consent to  a surgical                                                                   
     or medical procedure or other  course of treatment given                                                                   
     after  the physician  has told  the patient  all of  the                                                                   
     potential benefits, risks and alternatives involved.                                                                       
She used an analogy  of deciding whether or not to  put gutters on                                                              
her home and gathering all the information  available and deciding                                                              
if  it  was the  thing  to  do.  She  said they  could  offer  the                                                              
information to women and do the best you can.                                                                                   
MR. SID HEIDERSDORF, Juneau resident, supported SB 91.                                                                          
TAPE 01-24, SIDE B                                                                                                            
He said  that informed  consent is  needed to  protect women  from                                                              
unscrupulous  abortion practices.  He pointed  out this bill  does                                                              
not attempt to outlaw abortion or  place restrictions on a woman's                                                              
right to  an abortion. He said,  "Abortion is not an  honorable or                                                              
an innocent medical  procedure and those who are  involved with it                                                              
are not  likely to  be very  open and  free about the  information                                                              
when they are talking to their patient."                                                                                        
MR. HEIDERSDORF asked, "Why is abortion  the only invasive medical                                                              
procedure  for which  full information  is not  given? It is  well                                                              
known that abortion counseling is a sham."                                                                                      
Further he said:                                                                                                                
     If biased information results  in an attitude of viewing                                                                   
     it  as being anti  abortion, I  think there's  something                                                                   
     there to look  at. The fact is that  scientific unbiased                                                                   
     information, which is required  by this legislation, may                                                                   
     in fact  speak against  abortion and  that's the way  it                                                                   
     is. It's  true if the  child in  the womb, which  is the                                                                   
     crux  of the  issue, is  what's  discussed. That's  what                                                                   
     women really must know.                                                                                                    
     We hear a  lot said about RU486. In August  of this past                                                                   
     year, Serle, the company that  produces one of the drugs                                                                   
     used in the RU486 abortion procedure,  wrote a letter to                                                                   
     200,000  medical practitioners  in this country  telling                                                                   
     them,  "Don't use  cytotech  for abortions."  They  said                                                                   
     don't use  it because it's dangerous. They  didn't study                                                                   
     it  for  that purpose;  this  is  a  drug used  to  cure                                                                   
     ulcers, not to be used for producing  contractions for a                                                                   
     woman to expel a dead baby.                                                                                                
He passed out an  article to the committee on cytotech  in which a                                                              
woman died  who used  it. He  disagreed that  there wasn't  a link                                                              
between abortion  and breast  cancer. He said  there are  over two                                                              
dozen  scientific articles  that  do show  a  strong link  between                                                              
abortion and breast cancer, especially  first pregnancy abortions.                                                              
He said, "The evidence is building."                                                                                            
Specifically, SB 91 does not include  a waiting period. He thought                                                              
a 24-hour  waiting period  was critical because  a woman  needs to                                                              
get the information  and get away  from the doctor and  the clinic                                                              
personnel, because they are out to  sell an abortion. "They are in                                                              
the business of selling these abortions."                                                                                       
One final thing was on page 5, line  3. He was concerned that this                                                              
language did not  require that the woman be given  the information                                                              
produced by the Department of Health and Social Services.                                                                       
CHAIRWOMAN GREEN  said she thought  page 5, line 8,  addressed his                                                              
MR. HEIDERSDORF responded  that he was concerned  with language in                                                              
AS 18.05.032.                                                                                                                   
Number 1853                                                                                                                     
MS. MARY  HORTON, Juneau resident,  supported SB 91, because  of a                                                              
recent  experience she  had bringing  healing to  two men and  six                                                              
women who had  experienced abortion in Juneau. Their  ages were 17                                                              
-  over 50  years. She  said that  a man  begins to  deal with  an                                                              
abortion 5 - 7 years after it's happened.  She said, "When we talk                                                              
about  the abortion,  it's  not only  the  woman  who carries  the                                                              
child,  the fetus,  it's also  the grandparents,  the sisters  and                                                              
brothers  that  come  before  or  are still  there,  the  man  who                                                              
fathered the child."                                                                                                            
She said  there will  be another opportunity  for healing  that is                                                              
called  Project Rachael,  Rachael's Vineyard.  In her  experience,                                                              
she found  that women were very  surprised to hear the  other side                                                              
of the  story, that  men were  carrying the  guilt and what  could                                                              
they have done about it. "Women need  to know, but so do the men…"                                                              
She  said that  people who  can't read  can see  pictures and  can                                                              
understand clearly what's  going on. It's hard for  her to express                                                              
all the  healing that happened  and SB 91  would go a long  way in                                                              
helping people think about it a little bit more clearly.                                                                        
CHAIRWOMAN GREEN said  she was chagrined at some  of the comments.                                                              
She had undergone various surgeries  and had seen pictures of body                                                              
parts on  the doctor's office  wall and  what might be  wrong with                                                              
them and  how they could be  corrected. She received a  great deal                                                              
of information and  the consent forms and waivers  she signed were                                                              
all inclusive. She continues:                                                                                                   
     On the other  hand, I would say that those  who say that                                                                   
     government  should  not  be involved  in  this  decision                                                                   
     making  and certainly in  regulating and/or  prohibiting                                                                   
     or allowing are  the very same people who  spend a great                                                                   
     deal of  time challenging the  fact that state  Medicaid                                                                   
     money should  indeed be used to fund abortions.  So, I'm                                                                   
     a little conflicted on those.                                                                                              
SENATOR  DAVIS  asked if  there  would  be  time for  more  public                                                              
SENATOR WARD  said he had  a lot of  people who wanted  to testify                                                              
and  wanted  to  know  if  any  state  money  had  been  spent  on                                                              
psychological follow-ups or abortions; if so, how much. He was                                                                  
trying to figure out if the state is liable.                                                                                    
CHAIRWOMAN GREEN adjourned the meeting at 2:55 p.m.                                                                             

Document Name Date/Time Subjects