Legislature(2003 - 2004)
02/11/2004 01:09 PM House JUD
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE JUDICIARY STANDING COMMITTEE
February 11, 2004
1:09 p.m.
MEMBERS PRESENT
Representative Lesil McGuire, Chair
Representative Tom Anderson, Vice Chair
Representative Dan Ogg
Representative Ralph Samuels
Representative Les Gara
Representative Max Gruenberg
MEMBERS ABSENT
Representative Jim Holm
OTHER LEGISLATORS PRESENT
Senator Fred Dyson
COMMITTEE CALENDAR
HOUSE BILL NO. 292
"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."
- HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 292
SHORT TITLE: ABORTION: INFORMED CONSENT; INFORMATION
SPONSOR(S): REPRESENTATIVE(S) DAHLSTROM
04/30/03 (H) READ THE FIRST TIME - REFERRALS
04/30/03 (H) HES, JUD
05/06/03 (H) HES AT 3:00 PM CAPITOL 106
05/06/03 (H) Heard & Held
05/06/03 (H) MINUTE(HES)
05/08/03 (H) HES AT 3:00 PM CAPITOL 106
05/08/03 (H) Heard & Held
05/08/03 (H) MINUTE(HES)
05/13/03 (H) HES AT 3:00 PM CAPITOL 106
05/13/03 (H) -- Meeting Canceled --
05/15/03 (H) HES AT 3:00 PM CAPITOL 106
05/15/03 (H) Moved CSHB 292(HES) Out of Committee
05/15/03 (H) MINUTE(HES)
05/17/03 (H) HES RPT CS(HES) 5DP 2NR
05/17/03 (H) DP: SEATON, COGHILL, WOLF, GATTO,
05/17/03 (H) WILSON; NR: KAPSNER, CISSNA
02/11/04 (H) JUD AT 1:00 PM CAPITOL 120
WITNESS REGISTER
VANESSA TONDINI, Staff
to Representative Lesil McGuire
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As committee aide, answered questions
regarding HB 292, Version S.
REPRESENTATIVE NANCY DAHLSTROM
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Spoke as sponsor of HB 292.
THEDA PITTMAN
Anchorage, Alaska
POSITION STATEMENT: Participated in discussion of HB 292.
KAREN VOSBURGH, Executive Director
Alaska Right to Life
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 292.
COLLEEN MURPHY, M.D.
Obstetrician/Gynecologist (OB/GYN)
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to HB 292 and
answered questions.
DEBBIE JOSLIN, President
Eagle Forum Alaska
Delta Junction, Alaska
POSITION STATEMENT: Testified in support of HB 292.
REGINA MANTEUFEL, Owner
Regina's Rooming House
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition of HB 292.
ANNE HARRISON,
Fairbanks, Alaska
POSITION STATEMENT: Testified as a retired RN and nurse
practitioner in opposition to HB 292.
EILEEN BECKER, Director
Pregnancy Care Center of Homer
Homer, Alaska
POSITION STATEMENT: Testified in support of HB 292.
CAROLYN V. BROWN, M.D., Master of Public Health (M.P.H.)
Obstetrician/Gynecologist (OB/GYN)
Douglas, Alaska
POSITION STATEMENT: Her testimony in opposition to HB 292 was
read by Robin Smith.
VICKI HALCRO, Director of Public Affairs and Marketing
Planned Parenthood of Alaska
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to HB 292.
PAULINE UTTER
Anchorage, Alaska
POSITION STATEMENT: Spoke in opposition to HB 292.
CASSANDRA JOHNSON, Executive Director
Alaska Pro-Choice Alliance
Anchorage, Alaska
POSITION STATEMENT: Testified against HB 292.
RUTH ABBOTT
Delta Junction, Alaska
POSITION STATEMENT: Testified in support of HB 292.
ACTION NARRATIVE
TAPE 04-13, SIDE A
Number 0001
CHAIR LESIL McGUIRE called the House Judiciary Standing
Committee meeting to order at 1:09 p.m. Representatives
McGuire, Anderson, Ogg, Samuels, Gara, and Gruenberg were
present at the call to order. Senator Dyson was also in
attendance.
HB 292-ABORTION: INFORMED CONSENT; INFORMATION
[Contains discussion of SB 30, the companion bill]
Number 0037
CHAIR MCGUIRE announced that the only order of business would be
HOUSE BILL NO. 292, "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." [Before the committee was
CSHB 292(HES).]
CHAIR MCGUIRE, citing the emotional and sensitive issue that was
before the committee, set these ground rules: she asked that
all people participating in the meeting conduct themselves in a
professional and civil manner; she limited testimony to three
minutes, mentioning that if testifiers had more to say, they
could fax or e-mail testimony to her and the testimony would be
distributed to every person on the House Judiciary Standing
Committee; she suggested that rather than repeating a previous
point, the witnesses refer to that point to save time.
Number 0207
REPRESENTATIVE SAMUELS moved to adopt the proposed committee
substitute (CS) for HB 292, Version 23-LS0867\S, Mischel,
2/5/04, as a work draft. There being no objection, Version S
was before the committee.
CHAIR MCGUIRE said she was going to go over the changes that
Version S has that HB 292 doesn't for the benefit of those
people who don't support the changes, or do support the changes,
or want more changes. Reading from Version S, she stated that
the legislative findings are all the same in Version S, except
for paragraph (4)[which has been removed in Version S]. She
gave the reasoning behind that change, stating that she believed
the Department of Health and Social Services should have
latitude in producing the information, and she felt that it was
appropriate, that from a legislative committee perspective, the
committee should give as much discretion as they can to the
department; she believes that making the information printed,
rather than online, accomplished that.
CHAIR MCGUIRE continued to explain the deletion of paragraphs
(4) and (5) in Section 1 [of Version S] because they had an
online rather than a printed requirement, which, as she stated
before, she felt offered the department more latitude. Moving
on to Section 2 in Version S, she explained that nothing has
been changed from the former version, but she pointed out that
on page 2, line 12 [paragraph (C)], the information there was
dealing with contraception and therefore she'd deleted a section
later that she felt was covered in this section.
Number 0464
CHAIR MCGUIRE continued explaining section 2. She said that she
deleted [paragraphs] (9) and (10) from the previous version
because she believed that they had nothing to do with this
particular bill. She stated that she deleted [paragraph] (10)
because, in her opinion, the information that was being shared
had serious privacy implications.
CHAIR MCGUIRE shared that Section 3, which deals with the
requirements that must be met before performing an abortion, is
already state law. She went on to explain that she deleted
Section 4 from the previous version because she felt it was
flawed the way it was and it was unprecedented to have a cause
of action simply for failure to provide the informed consent.
She shared that she wanted to have a good committee discussion
to explore any possible way to get some other ideas on that
subject because she knows that the sponsor wants something in
the bill that deals with that subject.
Number 0638
CHAIR MCGUIRE stated that the rest of Version S is pretty much
the same, but what is different is the deletion of any reference
to the State Medical Board. She explained that she has met with
members of the State Medical Board and they expressed to her
that its main functions are the licensure, regulation of the
conduct of physicians, and dealing with malpractice cases.
Chair McGuire said that the State Medical Board doesn't have
enough time to do all the things that it is presently
responsible for, so she feels that it is appropriate that it is
deleted from this bill. She added that this deletion leaves a
very big question for the House Judiciary Standing Committee to
answer, because the bill states that the information must be
presented to a woman before an abortion is performed, but this
information must first be produced.
Number 0692
CHAIR MCGUIRE noted that the bill dictates that the Department
of Health and Social Services would produce this information.
She stated that after her meeting with two women from the
department, [it was determined that] the question of who will
actually put this information together is one that needs to be
addressed by the House Judiciary Standing Committee. Chair
McGuire noted that the state medical board told her that there
isn't an OB/GYN [obstetrician/gynecologist] on the board, so the
way the bill was originally worded would have had lay people
setting the precedents for informed consent for abortion; in her
opinion, that is a problem.
Number 0765
CHAIR MCGUIRE posed the question, should the people making those
decisions dealing with abortion be someone in the Department of
Health and Social Services? She stated that she didn't know the
answer, and the committee would have to discuss that. She then
asked for the opinion of the people who were at the meeting or
the people who were on [teleconference]. She then drew
attention to the state statutes that deal with abortion, citing
that she wasn't that familiar with the State of Alaska's stance
on abortion until recently. Chair McGuire read from existing
state statutes, emphasizing the number of regulations that
already exist in Alaska dealing with abortion, namely, Title 18
and 12 AAC 40.070. She pointed out that all the state statutes
that deal with abortion were included in the members' packets.
She also noted that the statutes should be important to all, no
matter what side they align themselves with on the issue.
CHAIR MCGUIRE then posed the question that the bill addresses,
should these regulations that already exist be made into state
law? She went on to explain that Representative Dahlstrom was
there to discuss, as sponsor, why the [State of Alaska] should
determine the type of information that a woman needs to review
before an abortion is performed, and in what manner that
information should be distributed.
Number 0958
REPRESENTATIVE GRUENBERG cited recent cases dealing with
abortion and asked for a list of those cases so that they could
be reviewed by the committee.
Number 0997
VANESSA TONDINI, Staff to Representative Lesil McGuire, Alaska
State Legislature, speaking as the committee aide, said that she
had a list of all the recent state and federal cases dealing
with abortion prepared and that she would get them for the
committee.
CHAIR MCGUIRE noted that [her office] had been going over many
cases in recent months, and she felt that it would be helpful
for the committee to see the recent jurisprudence. She then
stated that she had just received a letter from the attorney
general for the State of Alaska that raises constitutional
concerns in various sections of the bill.
REPRESENTATIVE GRUENBERG amended his last request to include any
attorney general's opinions that have been promulgated.
CHAIR MCGUIRE opened public testimony and explained that she had
no idea as to what side of the issue that the witnesses aligned
themselves, so if she called on three pro-choice witnesses in a
row, it was unintentional. She went on to explain that she was
going to take testimony from one witness from each Legislative
Information Office (LIO) and rotate every time so that every
region got its fair time to speak.
Number 1063
REPRESENTATIVE GARA inquired if every LIO had the most recent
version of the bill so everyone would be reading from the same
document.
REPRESENTATIVE MCGUIRE then pointed out what version was the
most current, [Version S], and asked if a particular LIO didn't
have that version, that the witness note it when they start
testifying.
Number 1145
REPRESENTATIVE NANCY DAHLSTROM, Alaska State Legislature, as
sponsor, thanked Representative McGuire and the House Judiciary
Standing Committee for hearing HB 292. Representative Dahlstrom
explained that HB 292 has a companion bill, SB 30, and the aim
of both of those bills is to provide pregnant women a way in
which to make informed decisions about their health care
options. She explained that HB 292 sets out to raise existing
regulations that have been in place since the early 1970s into
statute. She addressed specific regulations that require
physicians who perform or induce abortions to explain the
medical implications, as well as the possible emotional and
physical consequences, of having an abortion to the patient
before she elects to have the procedure.
REPRESENTATIVE DAHLSTROM added that HB 292 not only raises these
regulations into statute, but standardizes the information
presented [to] the patients by means of a web site maintained
and updated by the Department of Health and Social Services.
She pointed out that in the Version S that the references to the
web site have been deleted. She then voiced her request that
the Internet site be included in the bill because she believes
that the infrastructure that has been set up in rural
communities would allow people that live in those communities to
access the information before they visited a doctor. She
continued that the web site and printed material will list
accurate, objective, unbiased, and updated scientific
information that explains the resources available to a pregnant
woman and also assists her in making and implementing her own
reproductive decisions.
REPRESENTATIVE DAHLSTROM stated that her intent with HB 292 is
to enable women to make healthy, educated choices regarding
their own individual and private circumstances. She reiterated
her thanks to the House Judiciary Standing Committee and said
that she would be present throughout the meeting to answer any
questions that may arise.
CHAIR MCGUIRE referred to page 2, [lines 1-2], subsection (a)
[Version S], "The department shall produce, in printable form,
standard information that". She asked if Representative
Dahlstrom thought Internet was not included.
REPRESENTATIVE DAHLSTROM clarified that she preferred the words,
"shall maintain, on the Internet and in printable form, standard
information ...", to be added after "department".
CHAIR MCGUIRE asked that Representative Dahlstrom and her staff
consider changing that language in other parts of the bill,
where appropriate.
Number 1312
REPRESENTATIVE DAHLSTROM responded she and her staff would
attend to the language by next Wednesday, and stated that her
concerns about liabilities had already been addressed by
Representative McGuire.
Number 1357
THEDA PITTMAN discussed public policy implications of the bill.
Her testimony is as follows:
Those who testify in favor and those who testify
against such laws do have strong feelings, as I think
you've noticed. It seems to me that laws regulating
abortion must strike a balance between two things:
when is a fetus entitled to legal protection, and when
is a pregnant woman entitled to make her own decision
about terminating a pregnancy? Finding the
appropriate balance for state regulation is a complex
matter, and you have to take into account health
issues, as well as privacy issues, as well as legal
issues such as the liability issues mentioned.
In the past 5-6 years in Alaska, we have seen what
happens when lawmakers import model legislation from
elsewhere - legislation which is designed to challenge
the federal standard set out by Roe v. Wade. Time,
energy, and money is spent in court by the state as
well as those who've challenged those laws. Those who
championed such restrictions may have spent some funds
filing amicus briefs or monitoring the case, but
essentially they are free to sit back and watch
plaintiffs and the state pay the bills.
The state does have a legitimate interest in pregnancy
and the outcome of pregnancy, but the best place to
look for guidance regarding abortion, I believe, is
Roe v. Wade. This federal decision is condemned by
those who might like to see all abortion outlawed. In
some cases, those same people would condemn any birth
control as destructive of life, and I don't mean my
poor drafting to indicate that I think birth control
and abortion are synonymous or should be. But [Roe v.
Wade] is very clear. Its use would allow the state to
properly assert its position with respect to the
balance between the developing life of the fetus and
the existing person, the pregnant woman.
Under the terms of [Roe v. Wade], a state may outlaw
abortion: after fetal viability, and with exception
for rape, incest, the health, and the life of the
pregnant woman. Such a restriction would adequately
cover the myths of women aborting full-term
pregnancies moments before birth. After viability, a
pregnant woman may not want to have a child, but, if
so, should be looking at the question of adoption
rather than abortion.
Number 1483
MS. PITTMAN continued:
Using [Roe v. Wade] as your public policy standard for
legislation will not satisfy those who want the state
to insist that women be forced to carry every
pregnancy to term, regardless of gestation period or
the reason for the pregnancy. It will, however, allow
the state to assert its interest in developing life
without trampling over women. With a proposal such as
the one before you, you are put in the position of
demanding to be present in the examining room. I
can't think of anything more like Big Brother - and
Alaskans cherish their autonomy.
So, I ask you to please put a stop to this legislation
in its current form. And, I would say, thank you,
Representative Dahlstrom for knowing that we all share
the desire to allow pregnant women to make healthy,
educated choices. As long as we all remember that
that's what we're about, that's why we're talking
about this legislation, perhaps that will make the
decision-making go more smoothly.
Number 1630
KAREN VOSBURGH, Executive Director, Alaska Right to Life,
explained there were 60,000 people in her organization who agree
that women need to know exactly what [the legislature] is doing
with the most important decision of their lives. She reported
that 80 percent of women nationwide feel they are not being
given this information. She said it was very important that
this legislation be created and pointed out that most other
states already have similar legislation. She stated that it is
important that women know what can happen to them physically and
psychologically, and to know about the developing child within
them.
Number 1595
MS. VOSBURGH gave information about the breast cancer lawsuit in
Pennsylvania where a high school girl was advised by a high
school counselor to travel across state lines to have an
abortion. Afterwards, the girl did research and found out that
breast cancer is a factor after having an abortion, especially
before having a live birth. She sued the school system and the
abortionist and won. Ms. Vosburgh believed it very important
for the state to take a close look at that particular case.
MS. VOSBURGH, reflecting on the previous speaker's statement
that pro-abortion groups say that they are pro-women, stated
that she believed the following:
There are a lot of women suffering out there, from
abortions. After they have abortions, over 90 percent
of women have psychological damage, and we're not even
talking about the physical damages of infertility and
other problems.
MS. VOSBURGH emphasized that women need to know that "pro-
abortion people do not want this information to be given to
women. They're actually censoring ...." She repeated that
women can make decisions, but they need to know what can happen
to them and their developing child. She stated that this bill
was important, thanked the committee, and urged it to pass the
bill.
Number 1675
COLLEEN MURPHY, M.D., Obstetrician/Gynecologist (OB/GYN),
testified in opposition to HB 292 and answered questions. She
told the committee she has been practicing in Anchorage since
1987, is board-certified by the American College of
Obstetricians and Gynecologists (ACOG), and is an abortion
provider. She registered disagreement and non-support of HB 292
because she said it represents an anti-privacy bill. She
emphasized that the issue is neither pro-choice nor pro-life,
but rather, pro-privacy. Every medical encounter is a
personalized, individualized decision between the patient and
the provider, she said, and HB 292 interferes with this privacy
decision.
Number 1743
DR. MURPHY continued to say:
There's really a lot of discrepancy as to why this
particular procedure would warrant such invasive
informed consent when, in fact, termination of
pregnancy is safer than many of the common OB/GYN
procedures as well as many other procedures in other
specialties.
DR. MURPHY added that, at this point, when she does a
hysterectomy, where [the patient] has a 1/1,000 chance of dying,
she does not force the woman to see pictures of the blood
vessels, or the uterus, or some of the changes and damages that
can occur. The patient does not have to wait a full 24 hours
before proceeding. She emphasized that the chance of dying is
less than 1/1,000 for a safe, legal termination of pregnancy.
She stated if the legislature wanted to be consistent, then
equal protection to all informed-consent medicine should be
provided, in addition to a 24-hour wait, so that this is not
seen as an unequal protection procedure. She also stated that
the 24-hour wait period has no medical justification; rather, it
is obstructionist, and makes for higher costs and longer delays.
Number 1803
DR. MURPHY added that she has had private conversations with
medical board members. Based on what was told to her during
those conversations, she stated, the board is not supportive of
the role that it is being asked to take in HB 292. She went on
that there wasn't a OB/GYN in the state that would be willing to
participate in the program, citing that because of the standards
set by the ACOG a registered OB/GYN might get censured if he/she
participated in creating the information that was required in HB
292.
Number 1867
CHAIR MCGUIRE thanked Dr. Murphy for her testimony and explained
to her that the proposed CS before the committee addressed some
of her concerns regarding the medical board. Chair McGuire
added that the testimony brought to light some other concerns
dealing with OB/GYNs and the medical board. She asked Dr.
Murphy if she would be willing to explain to the committee the
typical steps that occur when performing an abortion.
DR. MURPHY explained that some of the larger abortion practices
use a telephone message service where the patients dial in and
receive information about informed consent while they make their
appointment. She cited two clinics that use the message service
Alaska Women's Health Services, and her own, and provided the
phone number that the patients are directed to: (907) 743-0325.
Dr. Murphy continued that a lot of women are looking on the
Internet before making decisions on their health care, she
shared that abortion has been a well-researched decision by the
time the women come into her office. Dr. Murphy added that
there are printed materials that are available for women to read
as well, and she would be happy to fax those materials to the
committee.
CHAIR MCGUIRE clarified that Dr. Murphy's main concern with HB
292 was that it was an invasion of the privacy that exists
between a doctor and a patient, not the fact that it was
providing information on potential side effects associated with
abortion or the alternatives that are available.
Number 1986
DR. MURPHY agreed absolutely that HB 292 was an invasion of
privacy, and added that many patients in Alaska do not receive
same-day or next-day appointments, and particularly for
termination services there is generally a one-week to three-week
waiting period to contemplate their decision and to research
their options. Dr. Murphy gave her opinion that adding more
time to the process only makes the women further along in their
pregnancy when they get an abortion. Dr. Murphy reiterated her
pro-privacy stance and said that HB 292 takes away from
individualized health care.
CHAIR MCGUIRE inquired about medical malpractice lawsuits and
how they are related to the informed consent, and if there were
any other medical procedures that have legal ramifications
simply because the doctor did not give informed consent.
DR. MURPHY answered that she is held to many different
guidelines and standards as a medical provider in Alaska, and
pointed out that she has to uphold state statutes and
regulations, as well as guidelines set out by the board of
certified OB/GYNs. She opined that passing this legislation was
redundant because many of the guidelines that it sets up are
already established by the state as well as the board of
OB/GYNs. Dr. Murphy explained that she can be sued on a
national level because she is held to national guidelines, and
offered to fax the guidelines to the committee. She continued
that the guidelines that are set in place already are very well
designed within the practice of medicine. She added that in
malpractice lawsuits there needs to be a link between damages to
the patient and a cause of action by the doctor and there needs
to be proof of negligence. She stated that even the most
meticulously written informed-consent contract can be micro-
examined during litigation, and she feels that requiring this
documentation does nothing to protect the doctors from
malpractice lawsuits.
CHAIR MCGUIRE asked for the copies of the informed-consent forms
that Dr. Murphy has, and for a copy of the state and national
guidelines that she has to adhere to.
DR. MURPHY agreed to fax or send that information to the
committee.
Number 2169
REPRESENTATIVE GARA asked for Dr. Murphy to validate some of the
information that he had regarding abortion, dealing with the
lack of availability of abortion services for women in Southeast
Alaska as well as other parts of the state and how that affected
their use of those services.
DR. MURPHY agreed that because the signs of pregnancy are so
variable, many women do not receive prenatal care or abortion
care until around six weeks after conception. She added that
the abortion pill that is widely used in France would help those
women in terminating their pregnancy if it were used on a wider
scale in Alaska.
REPRESENTATIVE GARA asked for a timeframe when a woman would be
able to ascertain that she is pregnant and then start to make
any decisions regarding her pregnancy.
DR. MURPHY said that it varies, depending on how a woman follows
her body signs, stating that a lot of women can tell that they
are pregnant even before they miss their period. She went on to
add that she just delivered a baby for a woman that was 36 weeks
pregnant and never missed her period. She added that in most
cases a woman will become suspicious after her first missed
period and then get a home pregnancy test, but reiterated that
these cases are very dependent on socioeconomic status, age, and
other factors. She reverted back to talk about her pro-privacy
stance and referred to other legislation that interfered with
care by delaying care and creating barriers to obtaining help.
She stated that the bottom line is that people will still get
abortions, but this legislation will result in higher fees and
more time missed from work, all the while not providing any more
service to the patient.
Number 2368
REPRESENTATIVE OGG, referring to paragraphs (6), (7), and (8) of
[Version S], asked for clarification on the way that informed
consent is handled at this time, and if the doctors provided a
consultation like the one described in the bill before
proceeding with an abortion.
TAPE 04-13, SIDE B
Number 2390
DR. MURPHY said that in the information that she was going to
fax the committee it described the processes that occur before a
woman can terminate a pregnancy. She emphasized that having a
safe, legally performed termination of pregnancy during the
first trimester - which she pointed out is 14 weeks according to
ACOG, whether it be by medical or surgical [means], is 12 times
safer than carrying a pregnancy full-term, when dealing with the
mother's risk of dying. She explained further that when
obtaining informed consent, she performs an ultrasound, shows
that ultrasound to the patient, explains to the patient how far
along the pregnancy is, explains the likelihood of miscarriage,
emphasizes that the organs in the fetus are formed and will only
be getting larger, and asks the patient at that time if she
wants to proceed with the termination of her pregnancy. She
added that after the procedure, the woman receives a picture of
the ultrasound to take with her.
REPRESENTATIVE OGG stated that his impression of the
consultation requirements, although they are not required at
this time under the Alaska Administrative Code, is that every
practitioner undergoes a similar process.
Number 2285
DR. MURPHY explained that each doctor's implementation is
different, but that they are all very thorough and provide safe
medical services in Alaska.
Number 2269
DEBBIE JOSLIN, President, Eagle Forum Alaska, told the committee
that when she was pregnant in 1999 the doctors found some fetal
anomalies and she was told by those doctors to have an abortion.
She said that she did not receive any information regarding her
alternatives or the inherent risks that would happen if she had
an abortion. She added that she doesn't feel that all doctors
are providing the consultation to women in Alaska that is needed
and commended Representative Dahlstrom for presenting HB 292.
She expressed concern about the removal of the civil liability
sections as well as removing the requirement of maintaining an
online resource that the bill originally had. She stated that
removing the online information creates a disadvantage for women
in rural Alaska who might have to travel long distances to have
an abortion. She referred to a United States Supreme Court case
that upheld state statutes relating to the disclosure of
information prior to terminating a pregnancy.
CHAIR MCGUIRE stated that it wasn't her intention to remove the
online resource, but to only require patients to receive a
printed version before having an abortion. She said that she
supports the online resource and would put the wording back into
the bill so it is required.
Number 2138
MS. JOSLIN remarked that if the wording for the online resource
isn't in the bill, the site would end up being something that
isn't required and therefore never is set up. She commented
that this is the computer age, and therefore the information
should be required to be made accessible via the computer to
better inform any woman that may undergo this procedure.
CHAIR MCGUIRE asked Ms. Joslin if she had any ideas as to who
would organize the information and make it available to the
public.
MS. JOSLIN said that she believes that it should be the
Department of Health and Social Services that arranges the
information. She said that she didn't know specifically who
within the department should be responsible, but cited that in
every other state where legislation similar to HB 292 exists,
the department of health and social services handles the
information.
Number 2087
REGINA MANTEUFEL, Owner, Regina's Rooming House, Anchorage,
stated that she was against HB 292. She emphasized the number
of cases relating to substance abuse, alcohol abuse, incest, and
rape that occur to women, especially in the Bush, stating that
they should be kept between the patient and the doctor. She
used her own personal experience working with low-income women
that have children to comment on the lack of assistance from the
state to help handle unwanted pregnancies.
MS. MANTEUFEL commented on the inability of young women to raise
babies, and said the lack of assistance from the state forces
many of these young women with their children out onto the
street. To illustrate this point, Ms. Manteufel stated that in
Anchorage, the least expensive place for a young woman to stay
is in a hotel room at $600 a month. She added that as soon as
summer comes, prices go up, and those women will be forced to
pay summer rates or be back out on the street. She commented on
the lack of follow through that the right-to-life coalition has,
stating that when a woman is pregnant the right-to-life people
promise help and support, but after the baby is delivered that
woman has two options: adoption or raising the baby on her own.
She used an example of a young woman, Betty, who was offered a
new car to keep her baby [until birth] and give it up for
adoption.
Number 1952
MS. MANTEUFEL challenged the sponsor of HB 292 to work in her
rooming house, deal with so many young mothers, and really see
what types of problems arise from unwanted pregnancies. She
then commented on the poor nutrition, lack of vitamins and
minerals, and babies with birth defects that she has seen. She
related that to the lack of social services support from the
State of Alaska.
Number 1892
ANNE HARRISON, as a retired RN and nurse practitioner, stated
that she was tired of rehashing the same issues every
legislative session. She commented that HB 292 was not
necessary and that she was a firm advocate for reproductive
choice. She stated she was pro-choice, not pro-abortion, and
her beliefs stemmed from years of professional experience
working in the women's health field. She said that if HB 292 is
passed, it would negate the work that professionals have been
doing since 1974.
MS. HARRISON stated that there are implications in this bill
that make it seem that health care professionals have denied
women facts and have encouraged abortion, when, in fact, they
have been an unbiased, science-based, source of information with
great sensitivity to the needs of a woman. She explained that
the information is presented in a non-judgmental manner and that
patients are exposed to all the different resources available
regarding their pregnancy. She added that more health care
providers would testify regarding HB 292, but they are all
working and taking care of patients. She feels that HB 292 is
another attempt to make a difficult time in a woman's life more
difficult. She stated that HB 292 would deny both the health
care provider's and the patient's privacy, and commented that
the basis of the bill didn't come from health care
professionals; it came from individuals that believe their
religious values supersede an individual's right to privacy.
She reminded the committee to separate church and state, and to
vote against HB 292.
Number 1780
EILEEN BECKER, Director, Pregnancy Care Center of Homer,
testified in support of HB 292. She commented that the
consultation that Dr. Murphy provides her patients when they
have an abortion is not typical for all health care providers.
She explained that as director of the Pregnancy Care Center she
deals with the regret and sadness that women endure after having
an abortion. She said that in her opinion, 100 percent of the
women that she's worked with who have had an abortion didn't
receive adequate information.
MS. BECKER stated that HB 292 would do nothing but good things
for women who become pregnant. She said that it is important
that a woman receive accurate information while she is deciding
how to deal with her pregnancy. She cited that when a woman is
pregnant her body, emotions, and hormones are going "helter-
skelter" and it is important that she receives the information
in a timely manner so she can make the best decision for
herself. Ms. Becker suggested forming a task force to oversee
the information that is provided and make sure it is accurate,
up to date, and accessible. She also suggested an educational
promotion that would expose a lot of people to this information
and maybe help prevent some unwanted pregnancies.
MS. BECKER spoke in support of the 24-hour waiting period that
the bill addresses, stating that for a life-changing decision,
like having an abortion, it important to have the mandatory
waiting period. She explained with regard to requiring women to
read this information that, in a sense, she feels it is speaking
for the unborn child. She agreed that there are problems with
unwanted pregnancies, but she believes that there are people
that will adopt any unwanted child.
Number 1633
CAROLYN V. BROWN, M.D., Master of Public Health (M.P.H.),
Obstetrician/Gynecologist, had her testimony read by Robin Smith
as follows [original punctuation provided]:
Having read through HB 292 and considered its contents
for legislation that might address the issues of
women's reproductive health, pregnancy, abortion, and
contraception, I have attached questions and comments
for your consideration as you deliberate these
concerns for women.
Please let me know if I can answer questions or
provide additional information or evidence-based
support for your discussions. There is ample
evidence-based support for discussion with you all.
Thank you for these considerations.
The bill speaks of pregnant women, abortion, full term
pregnancy, and informed consent. What is the bill
actually addressing? Please clarify for the public in
Alaska.
The bill appears to be discriminatory in that the
informed consent mandated for women who elect
abortions is not also mandated for all pregnant women.
It has been my professional experience as an
obstetrician-gynecologist of some 40 years in practice
that there are women who anticipate carrying a
pregnancy to term and elect a different plan when they
understand the risks/benefits of that decision. There
are women who anticipate an abortion but elect a
different plan when they understand the
risks/benefits. Please be clear on equality for all
pregnant women or change the language of the
legislation. Women deserve this.
The state indicates an interest in protecting the life
and health of pregnant women. Does health include
both physical and mental health in Alaska? Please
clarify.
In as much as the information about obstetrics is
extremely dynamic (not static), a one-time web site
will not suffice or be accurate. How will the
intervals of update be established? Who will pay for
this? Who will the ongoing experts be to provide
protection of the public's health?
Any language that proposes information must include
the risks/benefits and potential consequences of a
full term pregnancy. How will this be assured? We
know that a full term pregnancy carries a far greater
risk to death and morbidity to women than does
abortion. If you need more information on this,
please let me know.
Please clarify for Alaskans just what is "judicial
economy and resources".
Please clarify for Alaskans just what has been the
"costly and undue litigation". Where has the money
gone? Data is invaluable in decision-making.
If information is to be provided, virtually every
practice, site, agency, service, clinic, individual,
and facility would be required to be listed on the web
site. Who will keep up with this "dynamic" (and it
will be dynamic) so that Alaskan women have the
information intended in the legislation?
If all agencies, services, clinics, and facilities
that provide contraceptive options (and how did that
get here?), that would - of course include all
pharmacies and outlets where condoms and spermacides
are provided. Is the web site prepared to deal with
this in a responsible way for appropriate patient
care? Who will do this work? Who will pay for this?
It would seem appropriate and prudent to use correct
terminology when dealing with health and medical
issues. Philosophical and personal definitions have
no place in legislation. There are enormous
differences among definitions for embryo, blastocyst,
propositus, fetus, and child. Using correct
terminology in the development of parlance is
appropriate for Alaska legislation.
Would suggest that the language of the "sperm donor"
for the pregnancy be changed to "the male involved
with the pregnancy" or "sperm donor". Please call it
what it is. We do "anonymize" the woman involved with
"pregnant women (female)", don't we?
How long will it take to view this information on the
Internet? There is a limit to just how much the
average person can take in addresses, names, pictures,
disclaimers, printed forms, and a detailed
presentation of risks/benefits in the midst of a
pregnancy that may be wanted or unwanted. Please -
come let us be fair...
At what reading level will this information be? Who
will provide the oversight? At what cost to the state
of Alaska?
Would this law mandate that all physicians' offices
where pregnancy termination is done be registered?
What are the criteria? What are the medical and
surgical mandates? Who will oversee this?
What is the reason for the 30-day waiting period? It
is clear that there are more risks as the pregnancy
continues - both for abortion and for pregnancy to
term. What is the reason for this mandate? This
makes no practical sense to physicians who provide
care for women.
Who will pay for this paper work, forms to be printed,
record keeping, transmission and update of the web
site?
All pregnant women need informed consent - whether
they elect abortion or carry a pregnancy to term. To
do otherwise is to discriminate. Women must have
informed, accurate, scientific and appropriate
information.
Number 1397
VICKI HALCRO, Director of Public Affairs and Marketing, Planned
Parenthood of Alaska, asked the committee not to support HB 292.
She said that if HB 292 passed it would create an imbalance
within the legal system that would be based on the decision
whether or not to have an abortion. She pointed out that a
woman has a constitutional right to choose to have an abortion.
She conveyed that HB 292 creates this imbalance by imposing
obstacles on any woman seeking to terminate her pregnancy in
Alaska. She cited the 24-hour waiting period as one of the
obstacles, adding that it is the only medical procedure for
which a waiting period like this [is required]. She stated that
there are many faults with the bill and said that she wasn't
going to make the same points that other testifiers had made.
She closed her testimony by saying that HB 292 is a clear
attempt to restrict a woman's reproductive rights, and she urged
the committee to vote against it.
Number 1343
REPRESENTATIVE GARA inquired about what services are available
to women who want to get an abortion, where they are located,
and how the 24-hour waiting period might make it harder for a
woman to receive these services.
MS. HALCRO said that she would get that information to the
committee.
Number 1269
REPRESENTATIVE ANDERSON asked Ms. Halcro if she agrees with Dr.
Brown's statement that the state should get informed consent
from a woman who wants to carry a baby to full term.
MS. HALCRO stated that it is more dangerous to carry a baby to
full term than it is to get an abortion, so on that level it
would make sense to obtain informed consent.
Number 1194
PAULINE UTTER, Anchorage, asked the committee to kill HB 292.
She stated that 385 pieces of legislation have been passed in
the United States since 1995 that have put barriers in the way
of women who want to have an abortion. She cited that there are
no barriers for many other medical procedures, like prostate
cancer, and she doesn't feel that the state should make it its
concern what medical procedures individuals undergo. She
reiterated that she wants HB 292 killed by the committee.
REPRESENTATIVE ANDERSON pointed out that prostate cancer is a
disease.
MS. UTTER stated, "Was there any difference."
Number 1070
CASSANDRA JOHNSON, Executive Director, Alaska Pro-Choice
Alliance, gave testimony against HB 292. She addressed some
issues that had arisen during previous testimony. She first
addressed the point that Ms. Vosburgh made in her earlier
testimony that [the Alaska Pro-Choice Alliance] does not want
doctors to provide accurate, scientific-based information to
their patients, and stated that it wasn't true. She said that
[the Alaska Pro-Choice Alliance] fully supports the proposal,
but wants the doctors to provide women with accurate scientific-
based information about all their reproductive options. She
feels that Dr. Brown was going for that point when she commented
about women having informed consent when they decide to carry a
pregnancy to full term. She believes that the issue of abortion
is a private matter that a woman should only have to discuss
with her medical provider, pointing out that the medical
provider has the medical training and is the best person to give
the advice to a woman. She commented that if the sponsors of HB
292 truly felt it was the state's role to provide this type of
information, perhaps they would be willing to fund comprehensive
and accurate sexuality and reproductive health education
curricula in Alaska's public schools. She stated that HB 292
does not address this concern; rather, it targets those people
who are seeking abortion services.
MS. JOHNSON went on to give her opinion of the mandatory 24-hour
waiting period, saying it was unnecessary and discriminatory.
She cited a similar law enacted in Mississippi in 1992, noting
that after it was enacted, second-trimester abortions went up 18
percent in that state. She said that having second-trimester
abortions increases both the risk and cost of the abortion for
the woman.
MS. JOHNSON moved on to discuss the link that Ms. Vosburgh made
between having an abortion and developing breast cancer, citing
that a scientific panel appointed by the National Cancer
Institute unanimously concluded in 2003, after reviewing four
studies, that there was no evidence that having an abortion
increases the risk of developing breast cancer. She noted a
lawsuit filed in North Dakota, where a woman sued a clinic for
not getting information regarding breast cancer when she had an
abortion, and said the clinic was victorious.
Number 0935
REPRESENTATIVE GRUENBERG asked Ms. Johnson for copies of the
legal cases that she referred to in her testimony.
MS. JOHNSON said that she would get those cases for the
committee.
REPRESENTATIVE GRUENBURG stated that he was focusing on one
provision that doesn't appear in Version S, dealing with
potential litigation, and the controversy that would arise if
that provision were put back in the bill. He asked for any
information that Ms. Johnson could provide, because he is
concerned about how passing this bill would affect doctors'
malpractice rates. He cited his doctor's comments that it was
increasingly hard for doctors to obtain insurance in Alaska
because of tremendous rate increases. He stated that he doesn't
want to decrease the availability of health care in Alaska, and
asked again for any documentation that would show him the
relationship between lawsuits filed because of similar laws and
doctors' insurance rates.
Number 0795
RUTH ABBOTT, Delta Junction, read from pages 20 and 21 of the
January 10, 2004, issue of World magazine where there are state-
by-state rankings based on their abortion-related levels of
safety for women. The article was a project of the Americans
United for Life, a nonprofit, bio-ethics law firm based in
Chicago. She said that according to the report, Alaska came in
46th place out of the 50 states. She said that for this reason
[the legislature] needs to pass HB 292.
Number 0613
CHAIR McGUIRE asked if someone from the Department of Law would
be able to come to the next House Judiciary Standing Committee
meeting and discuss the letter from the attorney general.
[David Marquez, Chief Assistant Attorney General, Legislation &
Regulations Section, Office of the Attorney General, Department
of Law, nodded in assent.]
Number 0592
CHAIR McGUIRE closed public testimony and reminded the people
present that the committee would discuss the bill again at the
next committee meeting and that she would accept any faxes or e-
mails pertaining to this bill.
Number 0546
REPRESENTATIVE DAHLSTROM thanked the committee for listening to
HB 292, and she thanked the people participating in the
discussion. Representative Dahlstrom read from the Planned
Parenthood web site, quoting from its mission statement:
In order to enable the individual to make and
implement a responsible decision, there should be
access to information and services related to
sexuality, reproduction, methods of contraception,
fertility control, and parenthood.
REPRESENTATIVE DAHLSTROM quoted more from the mission
statement, regarding abortion:
Abortion services must include information on the
nature, consequences, and risks of the procedure, and
counseling on the alternatives available to the woman,
so as to assure an informed and responsible decision
concerning the continuation or termination of
pregnancy.
REPRESENTATIVE DAHLSTROM commented that those two
statements back up what she is attempting to initiate with
HB 292. She reiterated that her intent with HB 292 is to
provide accurate, updated information to the women of
Alaska so they will make informed decisions regarding their
pregnancies.
CHAIR McGUIRE commented on the open-mindedness of
Representative Dahlstrom and the hard work that she and her
staff have put into HB 292.
[HB 292 was held over.]
ADJOURNMENT
Number 0401
There being no further business before the committee, the House
Judiciary Standing Committee meeting was adjourned at 2:40 p.m.
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