HB 65 - PARTIAL-BIRTH ABORTIONS The first order of business to come before the House State Affairs Standing Committee was HB 65, "An Act relating to partial-birth abortions." CHAIR JAMES called on Representative Pete Kott, sponsor of HB 65, to present the bill to the committee members. Number 032 REPRESENTATIVE PETE KOTT, Alaska State Legislature, said there was not much to tell on this bill. He called it a pretty simple measure. It prohibited partial-birth abortions in the state of Alaska and if a physician performed that measure on a woman it was considered a class C felony. A copy of his sponsor statement had already been provided to the committee members. He opted not to read it into the record. Number 055 REPRESENTATIVE FRED DYSON asked Representative Kott if other states had taken similar moves? Number 057 REPRESENTATIVE KOTT replied other states had introduced similar measures. House Bill 65 was very similar to the Congressional bill that was introduced during the last Congressional session. Number 064 REPRESENTATIVE DYSON asked Representative Kott if the Congressional bill passed both houses then was vetoed by the President? Number 066 REPRESENTATIVE KOTT replied that was his understanding. Number 070 REPRESENTATIVE KIM ELTON asked Representative Kott if the state of Alaska banned any other type of medical procedure? Number 074 REPRESENTATIVE KOTT replied he was not aware of any banning; perhaps someone else knew the answer. Number 078 REPRESENTATIVE ELTON asked Representative Kott if there were doctors in the state of Alaska that practiced this procedure now? Number 081 REPRESENTATIVE KOTT replied it was questionable. He did not have any specific information on any abortionist or doctor who performed this procedure in Alaska. That did not mean preventative action was not necessary, however. There was hearsay that the procedure had been done in parts of the state. But, because it was hearsay he did not want to put on the record that it had been performed. Number 093 REPRESENTATIVE ELTON stated this was not a common procedure. In fact, the number of terminated pregnancies that occurred after 24 weeks was less than 1 percent of the total number of terminated pregnancies nation wide. He asked Representative Kott if that was his understanding as well? Number 103 REPRESENTATIVE KOTT replied he would submit himself to those numbers; Representative Elton was in the ballpark. Number 107 REPRESENTATIVE ELTON asked Representative Kott where the term "partial-birth abortion" came from? Was it considered a medical procedure? And, was the medical community familiar with this term? Number 112 REPRESENTATIVE KOTT called on his assistant, George Dozier, Jr., to answer that question. Number 115 GEORGE DOZIER, JR., Legislative Assistant to Representative Pete Kott, stated the term "partial-birth abortion" was not used in the medical literature. It was a term that was used by Congress to describe the procedure that was mentioned by Dr. Martin Haskell in medical literature. Number 128 REPRESENTATIVE ELTON asked Representative Kott if he could explain the circumstances in which this procedure was used? It was his understanding that it was only used to protect the health of the mother. Number 137 REPRESENTATIVE KOTT replied he did not believe that was the case. It was an elective procedure just like any other form of abortion. And, there were other methods in his opinion of doing that. Number 146 REPRESENTATIVE ELTON stated there were only two doctors in the United States that performed this type of procedure. And, they only performed the procedure to protect the life of the mother. He asked Representative Kott if he was correct? Number 152 REPRESENTATIVE KOTT replied there were more than two doctors, but whether or not they performed the procedure to protect the life of the mother he could not say. Dr. Haskell stated that 80 percent of the abortions performed this way were elective. Number 162 REPRESENTATIVE ELTON asked Representative Kott to provide to the committee members the details of Dr. Haskell. Number 168 REPRESENTATIVE BERKOWITZ asked Representative Kott where he got the gruesome description of the procedure used in his sponsor statement? Number 172 REPRESENTATIVE KOTT replied he obtained it from a number of sources. Number 176 REPRESENTATIVE BERKOWITZ asked Representative Kott if he obtained the information from political or medical sources? Number 178 REPRESENTATIVE KOTT replied some were published by physicians, others came from the Congressional testimony. Number 182 REPRESENTATIVE BERKOWITZ asked Representative Kott who Nurse Shafer was referenced in his sponsor statement? Where did she get her experience? Number 188 REPRESENTATIVE KOTT replied Nurse Shafer had participated in this type of an abortion and offered her testimony before the U.S. House of Representatives-Judiciary Committee in 1996. Number 194 REPRESENTATIVE BERKOWITZ asked Representative Kott if he believed the testimony of health care professionals was important? Number 197 REPRESENTATIVE KOTT replied it was important. The testimony substantiated the event because he had not witnessed it first-hand. Number 202 REPRESENTATIVE IVAN IVAN asked Representative Kott to define the term "partial-birth abortion" using layman's terms. Number 210 REPRESENTATIVE KOTT replied in layman's terms it was an abortion procedure that was used whereby the fetus was partially outside of the womb. Number 217 REPRESENTATIVE BERKOWITZ asked Representative Kott if he would object to this procedure if it was performed entirely in utero? Number 220 REPRESENTATIVE KOTT replied, "I would object to it. But then again that's just my personal belief." He called it irrelevant. He asked Representative Berkowitz what he meant by that question? Number 229 REPRESENTATIVE BERKOWITZ stated the thrust of the bill was based on the position of the fetus in the birth canal. If the procedure was to take place entirely in utero, then the bill would not cover it. Number 236 REPRESENTATIVE KOTT replied, "That's true. I don't think the procedure could be done that way." He would question the sanity of the physician if he opted to perform a procedure that way. There were other methods that were safer for the woman. Number 242 CHAIR JAMES stated she understood that if the child was entirely out of the mother and then destroyed, it would be murder. She did not know what it would be called inside the uterus because the child had no been born yet. That was the concern surrounding the abortion issue at-large. As long as a child was able to live outside of the womb then it was not right to destroy it. She did not know what other options were available to destroy the fetus at this stage, however. She agreed with Representative Kott that whether it was destroyed inside, outside or partially inside, it was not acceptable. Number 272 REPRESENTATIVE BERKOWITZ stated Representative Kott indicated that the testimony of health care professionals was important so let's ask them later when they testify. Number 276 CHAIR JAMES agreed it was important to ask about the steps of the procedure. CHAIR JAMES opened up the meeting to the teleconference network. Number 302 JANET CREPPS, Director of the State Legislative Program, The Center for Reproductive Law and Policy, was the first person to testify via teleconference in New York. She spoke in opposition to HB 65. She had been a member of the Alaska Bar since 1983 and currently represented the plaintiffs in the Mat-Su Coalition for Choice v. Valley Hospital, a case that involved the obligation of a community hospital to provide abortions. It was currently pending before the Alaska Supreme Court. The center also represented abortion providers in Ohio including Dr. Martin Haskell in a challenge to that state's 1995 law banning dilation and extraction abortions; a case that dealt with many of the same legal issues raised by HB 65. The bill was based on an unconstitutional premise-namely that the government might prohibit a method of abortion that for some women was the safest and most appropriate medical care. Since the Supreme Court's 1992 decision in Planned Parenthood v. Casey, courts evaluated statutes that restricted pre-viability abortions that HB 65 included. It was not limited to any time in the pregnancy using the "undue burden" test. The bill failed this test because in some circumstances the intact dilation and evacuation method was the safest alternative to all other methods of terminating a pregnancy. The Supreme Court had already held unconstitutional a ban on the use of an abortion procedure known as saline amniocentesis because the ban forced a woman and her physician to terminate her pregnancy by methods that were more dangerous to her health than the method outlawed. Under this reasoning, HB 65 was clearly invalid. It too would require women to terminate pregnancies by methods that posed a greater risk to their lives and health. The only court to review a ban similar to HB 65 was in 1995 in Ohio. The court invalidated the state statute because for some women the prohibited procedure would be safer than other available techniques. The Supreme Court had already made it clear that the state could not make its interest in the fetus paramount to a woman's health or require a trade-off between a woman's health and the survival of a fetus. The Alaska Supreme Court had consistently held that this guarantee provided more protection of individual rights than the Federal Constitution. While the court had not yet ruled on a case involving the right to privacy in the context of abortion, it had held that the Alaska Constitution protects an individual's right to make choices affecting his or her body in childbearing. Therefore, even if the federal courts should stray from the strong protection provided thus far, HB 65 would still be likely to fail under the Alaska Constitution. She urged the committee members to not support HB 65. Number 360 DEBRA JOSLIN was the next person to testify via teleconference in Delta Junction. She read an article from the Wall Street Journal dated, September 19, 1996, titled, "Partial-Birth Abortion Is Bad Medicine." The article can be found in the official committee file record. Number 407 BARBARA RAWALT was the next person to testify via teleconference in Delta Junction. She urged the committee members to pass the bill. She continued reading the article title, "Partial-Birth Abortion Is Bad Medicine," that Ms. Debra Joslin started. The article can be found in the official committee file record. CHAIR JAMES asked that Ms. Rawalt and Ms. Joslin fax the article to the committee. Number 454 ARTHUR HIPPLER, Executive Director, Alaska Right to Life, was the next person to testify via teleconference in Mat-Su. He represented the 9,000 members of the Alaska Right to Life organization. The organization totally opposed partial-birth abortions. A partial-birth abortion was an attempt to kill a baby in a willful way because a woman did not want to carry a baby to full term. The perusal of the medical literature failed to provide a single instance of support for a medical reason to end a pregnancy by a partial-birth abortion. In fact, a breech delivery was inherently dangerous and increased the possibility of mortality for the mother. Therefore, to kill a baby in that way was for the specific purpose to avoid criminal prosecution. Moreover, there were 1,500 partial-birth abortions performed in one clinic in the state of New Jersey. This procedure was more widespread than believed to be. He did not know how widespread it was in Alaska, however. There were two fundamental reasons to support a partial- birth abortion-to support the right to kill a baby and to make money. He reiterated the organization supported HB 65 and Representative Pete Kott and his attempt to ban this type of procedure. REPRESENTATIVE BERKOWITZ asked Chair James if he could ask a couple of questions? CHAIR JAMES replied, "No. We're just going to take testimony." REPRESENTATIVE ELTON stated, "So we're just the receptacle.... CHAIR JAMES replied, "We're just taking testimony right now. We will be able to discuss it afterwards." Number 497 ELSIE O'BRYAN was the next person to testify via teleconference in Mat-Su. The safest method to terminate a pregnancy was birth not an abortion. She questioned the inclusion of the health of the mother as an exception. The health of the mother was seldom a factor of a partial-birth abortion. If the mother was in distress or the child was in distress, what about a Cesarean she asked. "Does it have to be abortion to protect the life of the mother?" She mentioned the young couple that was prosecuted for murder for leaving their child in a dumpster. The young couple would not have been prosecuted for murder if the baby had been aborted through a partial-birth abortion. She was aware of a baby born prematurely who was now a functioning citizen, "So to say that a child can not be viable is wrong. It's flat wrong." Number 526 VIRGINIA PHILLIPS, Member, Alaska Right to Life, was the next person to testify via teleconference in Sitka. She was also the Alaskan Native spokesperson for the National Right to Life organization. She supported HB 65 because there was never a true reason for such a surgical procedure. In addition, a breech birth was avoided for the health of the mother. The only reason for a partial-birth abortion was to kill the baby, and "that is barbaric." "Why is our nation victimizing women and torturing and killing innocent human babies?" She suggested following the money trail for the answer. "Some people are getting rich on this expensive procedure," she declared. Please vote for HB 65. Number 546 DR. NELSON ISADA was the next person to testify via teleconference in Anchorage. He was a board certified perinatologist and medical geneticist. He was also a co-editor and author of numerous abstracts on problem pregnancies. He opposed HB 65. He explained, contrary to previous testimony, that problem pregnancies were common. The bill would interfere with the choices of patients regarding their pregnancies. They were difficult choices to make. Moreover, the amount of money sometimes was minimal contrary to previous testimony. "So to say that we are making hundreds of dollars, thousands of dollars is simply not the case." Furthermore, Caesareans were complicated as well. Unfortunately, the procedure could only be done by draining the fluids out of the baby's head to avoid surgery. He performed this procedure once about 12 years ago. It was unusual but it did happen, and it happened in Alaska. He reiterated he opposed HB 65 and his colleagues opposed it as well. His colleagues and he were the sole providers for high risk pregnancies in the state. They also provided consultation for obstetricians, family practitioners, M.D.s, nurse practitioners and entry mid-wives. They believed that the practice of medicine should be left to the hands of the physicians and the choices should be left to the hands of the patients. Number 600 REPRESENTATIVE BERKOWITZ stated the sponsor of the bill indicated that the baby was withdrawn from the birth canal feet first and then scissors were inserted into the baby's head. He asked Dr. Isada if this was the case? Number 604 DR. ISADA replied, "Not to the knowledge of the people that I know who occasionally do these. It's pretty bizarre if you ask me." Number 607 REPRESENTATIVE BERKOWITZ asked, "So, I just want to be clear, that you don't jab scissors into the back of a fetus's head." Number 608 DR. ISADA replied, "No." These were very, very rare. If this needed to be performed a needle could be used to drain the abnormal amount of fluid. "Now I'm speaking about abnormal fetuses. I'm not talking about the otherwise so called normal fetus." Number 613 REPRESENTATIVE BERKOWITZ asked Dr. Isada if it was his contention that this was a medical issue? DR. ISADA replied, "Yes." Number 615 CHAIR JAMES asked Dr. Isada what were the methods used once the baby was partially out of the birth canal to destroy the child? Number 617 DR. ISADA replied that once the fetus was partially out the cord was prolapsed. The cord was out and compressed so the fetus was not alive. That was the risk of a breech birth. He called it a moot issue. He was puzzled why people would stick scissors into the occipital of a fetal head; it was gruesome and difficult to do. Number 635 CHAIR JAMES wondered if the testimony from individuals that had seen a procedure such as this was not true. She asked Dr. Isada if those things did not happen? Number 638 DR. ISADA replied for an abnormal fetus that was not how it was done. Number 640 CHAIR JAMES stated that was not what you would do. But, she asked Dr. Isada, "You did not say it did not happen?" DR. ISADA replied, "No." It was a moot point and it was not that easy to do. Number 645 REPRESENTATIVE BERKOWITZ stated that the committee members had not heard any testimony from anybody that had actually seen this procedure. CHAIR JAMES stated the committee could get a copy of that testimony. But, correct, the committee had not heard that today. Number 650 ELIZABETH BARRY was the next person to testify via teleconference in Kenai. She was vehemently opposed to partial-birth abortions so she supported HB 65. The sponsor statement did give testimony of a witness to a partial-birth abortion. In addition, it was explained in a video titled, "A Doctor Explains Abortion Procedures," that the back was also split opened to remove various internal organs before evacuating the brain. The video, was available at the crisis pregnancy center in Kenai. Number 665 DR. JAN WHITEFIELD, Medical Director, Alaska Women's Health Services, was the next person to testify via teleconference in Anchorage. He had been performing first and second-trimester abortions in Alaska for 12 years now. The term "partial-birth abortion" was a legal term and not a medical term. The dilation and extraction (D&X) procedure was rare. He had never performed a D&X procedure. The bill did not describe that procedure, however. The bill described a partial-birth abortion as a procedure whereby the baby was partially delivered vaginally. That was a very broad definition. The bill did not address a viable pregnancy, a third- trimester pregnancy, a second-trimester pregnancy, or a first- trimester pregnancy, for example. It only said "a pregnancy." In his practice all second-trimester abortions that he had performed were a variation of the same story-an abnormal pregnancy. The mother was typically in her 30's who delayed childbearing because she went to school to become an attorney or a doctor, for example. "Now they have a premium pregnancy. They want to be pregnant. They want this child." When that person came to him he offered two procedures-a dilation and evacuation (D&E) or an induction of labor. In terms of the D&E procedure, sometimes part of the fetus entered the vagina before the baby died. In terms of the induction procedure, medicine was given to induce labor. The Center for Disease Control (CDC) considered the D&E procedure the safest method. TAPE 97-15, SIDE B Number 011 KAREN VOSBURGH was the next person to testify via teleconference in Mat-Su. She believed in standing for human life; those who could not speak for themselves. There were 50 million abortions being performed throughout the world. This teleconference was a "telling revelation of the steadily declining morality of this nation." The D&X procedure created the birth of a dead baby. "The result is a dead baby which is what an abortionist wants. Their worst nightmare is a live birth during an abortion." Some people call the baby a fetus, which was a latin term meaning "little one." It was not a technical term. In addition, she had a problem with an abortionist calling himself a doctor. A doctor took an oath to do no harm-abortionists kill. "I wish this nation would get a grip on its morality. We can still turn it around, but not if we have the wrong type of legislation." Number 072 TERESA LUNDY was the next person to testify via teleconference in Sitka. She was amazed that this issue needed to be debated. She strongly disagreed with HB 65. It should be eliminated or completely revised. The D&X procedure was different than a classic dilation and evacuation procedure because it did not rely on dismemberment to remove the fetus. The D&E procedure evolved as an alternative to a second-trimester abortion in the mid-1970's because of a lack of hospital facilities that allowed for a second- trimester abortion, because surgeons needed a solution to complete suction abortions, and to provide a means for an early second- trimester abortion to avoid installation methods. Most surgeons found that the classic D&E procedure was difficult because of the toughness of the fetal tissue. The D&X was never meant to be used to save the life of the mother due to a physical disorder, illness or injury as HB 65 pointed out. "I strongly disagree with HB 65. Not only because it requires a high degree of skill but also it gives legal permission to go ahead and allow another means to kill late term babies under the guise of a potentially needed medical procedure. The partial-birth abortion should be banned in the state of Alaska." Number 139 DAVID ROGERS, Representative, Alaska Women's Lobby, was the first person to testify in Juneau. He read the following statement into the record: "The Alaska Women's Lobby opposes HB 65. It is the wrong thing to do. "First, a few of our findings as we understand the situation from reviewing literature and talking to health care providers: "1. Late term abortion is used in the late second and third trimesters of pregnancy. It is a rare event: 99% of abortions occur in the first half of pregnancy; only four one hundredths of one percent (0.4%) are performed in the third trimester. "2. Doctors we have talked to tell us they have never met a patient who did to want and was not completely bonded to her baby by the third trimester, nor have they known a health care provider who was not equally concerned about the health of the baby and the mother by the third trimester. "3. There are many circumstances besides the saving of the life of a mother when delivering of a late term pregnancy are indicated. This procedure may be used when a woman's health (but not life) is seriously compromised, where there is a dead fetus with a healthy mother, where there is a healthy fetus in the body of a dead mother, and when the fetus has been diagnosed with server disorders. Factors that the doctor must consider when choosing a medical option in such cases are the length of gestation, the patient's previous obstetrical history and current presenting conditions, the facilities available and the availability and amenability of various techniques. "4. This procedure is the safest available for some women. Consider the case of Vikki Stella. At 32 weeks into her much- wanted pregnancy, she learned that her fetus had nine serious disorders. Vikki and her husband, the parents of two children, consulted a series of specialists. None of them could offer any hope. For Vikki, the safest procedure to protect her health and preserve her fertility was this later term procedure. `As a diabetic...this surgery was...safer for me than induced labor of a C-section, since diabetics don't heal as well as other people...I've been told mother like me all want perfect babies...(my son) wasn't just imperfect-he was incompatible with life. The only thing that was keeping him alive was my body.' Because Vikki's procedure preserved her family, she and her husband were able to have another child. "Last fall, Tammy Wats and her husband were elated by the news of her pregnancy. An ultrasound in the seventh month, however, revealed that the fetus was suffering from a devastating chromosomal disorder and would not live. Knowing that the fetus was going to die, the Watts made the most difficult decision of their lives, and Tammy had the type of procedure that would be banned by this bill. Commenting on her family's tragedy, Tammy said, `Until you've walked a mile in my shoes don't pretend to know what it's like for me. Everybody has a reason for what they have to do. Nobody should be forced into having to make the wrong decision...' "5. Limiting this procedure as proposed may place women's health at risk. Delays that result from having to travel outside the state for necessary treatment exacerbate this problem. "6. Finally, American Medical Association policy adamantly opposes attempts to interfere with the freedom of communication and choice between a physician and patients: `It is the policy of the AMA...to strongly condemn any interference by the government or other third parties that causes a physician to compromise his or her medical judgement as to what information or treatment is in the best interest of the patient.... "Madame Chair, these finding tell us that this rare and proper medical procedure should not be the subject of yet another restrictive law that will have a chilling effect on a physician's exercise of discretion in determining the best course of treatment and that unduly burdens a women's right to choose by unnecessarily compromising her life and health. "As is always the case in this arena, professional judgment and individual considerations must govern actions taken over the broad spectrum of medical possibilities. Families and their physicians, not politicians, must be permitted to make the difficult decisions posed by the rare and heartbreaking circumstances of wanted pregnancies gone tragically awry. "This bill is unnecessary, may result in harm to Alaskan women and only serves to further polarize concerned Alaskans. For these reasons, the Alaska Women's Lobby strongly opposes HB 65." Number 222 KRISTEN BOMENGEN, Assistant Attorney General, Human Services Section, Civil Division, Department of Law, was the next person to testify in Juneau. The major legal problem with HB 65 was the vagueness of the definition of the term "partial-birth abortion." It was not a term readily recognized by medical practitioners to mean one particular procedure. It could include two or more medical procedures including the D&E and the D&X procedures. This was a constitutional defect because due process required that individuals be given adequate notice of prohibitive conduct in order to conform their conduct to the law. "When laws are not clear in describing a prohibited activity, citizens in some uncertainty may steer far wider from the unlawful zone than is necessary." A court would scrutinize the law to determine if there was a chilling effect on the free exercise of a protected constitutional right-abortion. If it had that effect, it would not withstand a constitutional challenge at the state or federal level. Furthermore, the law imposed a criminal sanction on physicians subjecting them to a class C felony. "Where the description of prohibitive conduct is imprecise it could be found unconstitutional because if it subjects physicians to enforcement under unclear or possibly arbitrary standards, as well." In addition, the bill did not clearly distinguish pre-viability and post-viability procedures. The states could not generally regulate pre-viability abortion procedures in a way that imposed an undue burden on the woman. That was well established by the U.S. Supreme Court in the Planned Parenthood v. Casey court case. The court also found that the D&X procedure could be the safer procedure compared to others. Therefore, the state should not subject a woman to more dangerous procedures and place an undue burden. The department would anticipate a constitutional challenge. Number 288 CHAIR JAMES asked Ms. Bomengen for her testimony in writing. Number 291 REPRESENTATIVE DYSON asked Ms. Bomengen if she could assist the committee members in finding medical and legal language to deal with the vagueness of the term "partial-birth abortion." Number 296 MS. BOMENGEN replied she would be happy to work with legislative counsel to address the issue. Number 303 ANGELA SALERNO, Executive Director, National Association of Social Workers Alaska Chapter (NASW), was the next person to testify in Juneau. The NASW strongly opposed HB 65. She cited that an abortion late in a pregnancy was rare while 99 percent of abortions were performed in the first-half of the pregnancy. The bill attempted to exploit a very rare and tragic occurrence. A pregnancy that went to the second and third-trimesters were wanted and planned pregnancies only to be found that the fetus was incompatible with life. A Caesarean section or forcing labor was more damaging and dangerous to the mother. Therefore, the D&X procedure was safeguarding the mother's health and her future fertility. Testimony indicated from physicians that this bill would force them into doing a procedure that was more risky. A ban on a late-term abortion would be an unacceptable intrusion into the life of the family. These decisions had to be made by families in crisis and this bill would make that decision much more difficult for them. Again the debate was being used for a larger strategy to outlaw all abortions in this country. "Professional social workers who believe in safe and legal abortion are looking for ways to find common ground. We're looking for ways that we can all work together towards the goal of the prevention of unwanted pregnancies." Number 367 DR. PETER NAKAMURA, Director, Division of Public Health, Department of Health and Social Services, was the next person to testify in Juneau. He was a pediatrician and had not performed an abortion but was familiar with the medical practice. The problem with HB 65 was that it would preclude the use of a procedure that could be the best and the most logical choice determined by the physician and in consultation with the patient. The bill took the decision out of the hands of the physician and the patient and put it into the hands of the legislature. The bill attempted to legislate a practice. The bill was not about whether an abortion should be done or should not be done, but it was about "how" an abortion should be done. He reiterated that was a medical decision. In addition, the majority of the physicians believed that this procedure was safe. The procedure in question was for a non-viable fetus so the physician would not be charged with a crime for delivering a non-viable fetus. Dr. Nakamura wondered if the numbers would change if the physicians were informed of the specific definition of a "partial-birth abortion" described in the bill-the D&X procedure. The D&X procedure was not done in the state of Alaska. Therefore, passing a piece of legislation for a procedure that was not done seemed like an awful lot of effort to stop something that would not happen anyway. The procedure was attempted not only for the safety of the mother but to protect her future fertility as well. The physicians that performed abortions in the state were compassionate and their income was far below their peers. The average fee was around $400. This was far less than the fee for carrying a pregnancy to term, for example. He reiterated the bill was not good and he personally objected to it. Number 472 REPRESENTATIVE DYSON asked Dr. Nakamura if he spoke for the Administration? DR. NAKAMURA replied, "Yes." Number 475 REPRESENTATIVE DYSON asked Dr. Nakamura if the Administration would not support a partial-birth abortion if the fetus was viable and the mother's health and well-being was not involved? Number 480 DR. NAKAMURA reiterated the issue was not whether a partial-birth abortion should be done or it should not be done. There were other laws that applied to a viable fetus that allowed the state to decide where and how the procedure took place. Did I answer your question? he asked. Number 488 REPRESENTATIVE DYSON replied, "No you didn't, but you helped to narrow it down." The federal law allowed the state to take an interest in the abortion of a viable fetus. He asked Dr. Nakamura if the Administration favored any restrictions on abortions after viability for a healthy child and if the mother's health was not in danger? Number 494 DR. NAKAMURA replied, "I can't speak to that issue." He was only speaking today to the procedure referred to in HB 65. Number 499 REPRESENTATIVE DYSON asked Dr. Nakamura if he knew of any efforts of the Administration to protect viable, healthy, unborn children when the mother's life was not in danger? Number 504 DR. NAKAMURA replied to the best of his knowledge he did not believe that the Administration was proposing any legislation that addressed the issue of abortion. REPRESENTATIVE DYSON stated, "Or the protecting of the unborn child." DR. NAKAMURA replied there was a huge difference between protecting an unborn child and an abortion. The Administration had proposed a significant number of health related programs that related to the protection of the life of a child. Number 511 CHAIR JAMES stated she had two different pregnancies that ended with a dead fetus. During one pregnancy, the fetus died at five and one-half months, of which, it was decided by her and her doctor to "let nature take its course." At seven months the fetus was expelled. It was very, very painful, she declared. The doctor was firm to let nature take its course of action. During another pregnancy, the child stopped kicking in the womb about 10 days before she went into labor. The doctor also advised to let nature take its course. However, her labor stopped, of which, medication was taken to continue the labor in order to deliver the dead child. These experiences impressed upon her that nature would take its course. "Why should we jump in and cause the death of a child prematurely?" She asked Dr. Nakamura to respond to her particular circumstances. Number 543 DR. NAKAMURA replied he could not comment on what she should have done then, because he did not have all the information necessary to make a decision. The ability to have all the information was the issue here and it was being taken away in HB 65. Number 560 SID HEIDERSDORF was the next person to testify in Juneau. He was here today to testify in support of HB 65 not because it outlawed a gruesome procedure but because it was more infanticide than an abortion. He was opposed to killing a baby. He asked the committee members to consider if a doctor could do anything wrong or if a doctor could have a medical practice that was not acceptable to society. "All we need to do is think back 40 years- Nazi Doctors-we would say `hey' this has got to be stopped." Therefore, this was a type of procedure that the state had every legitimate right to enter into. "As far as I'm concerned the country was failing in its responsibility to protect the lives of the unborn." Moreover, the Congressional testimony indicated that this procedure was not rare. Dr. Haskell personally testified that he performed over 1,000 of these abortions, of which, the vast majority were purely elective. Dr. James McMahan personally testified that he performed 2,000 of these abortions. And, it was discovered in the one clinic in New Jersey that it performed 1,500 of these abortions. This was not his definition of rare. "I would be opposed to this procedure, and I think most of us would, for the killing of one person. That shouldn't be legal. It's just that simple." Moreover, the bill did include an exception to prevent the death of the mother so he asked the committee members to not legislate with the hard cases in mind. In conclusion, it bothered him that procedures should be allowed because they were safer. "Abortion is truly a violent, unnatural act. I don't think any of us can really dispute that. And, childbirth and the procedures related to it are normal kinds of natural things." Turning the baby around in the womb was a risky procedure which carried many risks for injury. Moreover, abortion should be a divisive issue because it was a fundamental life issue. "Yes, it should be divisive if you have a group saying they want to kill a certain category of human beings." That should not have a bearing on the decision of the bill, however. He encouraged the committee members to look at the Congressional testimony. REPRESENTATIVE BERKOWITZ stated he felt compelled to.... CHAIR JAMES stated, "You can wait until we get through.... REPRESENTATIVE BERKOWITZ stated, "I'm not going to be a potted plant while he sits here and draws a comparison.... CHAIR JAMES asked Representative Berkowitz to be quiet. You will have a chance later to voice your comments. REPRESENTATIVE BERKOWITZ stated my comments were directed at this witness. CHAIR JAMES stated she understood that, but "please hold your talk." Number 647 JOHN MONAGLE, President, Alaskans For Life, was the next person to testify in Juneau. Alaskans For Life was supported by 1,200 members locally. "My conscience tells me that partial-birth abortions is nothing short of infanticide." Alaskans For Life would support anything that protected the life of a child. Number 654 ROBIN SMITH was the next person to testify via teleconference in Anchorage. She stated abortion was not pleasant. Dead fetuses were shocking and the lives of the women involved remained unseen. She was sorry that this issue continued to weigh so heavily on this country. "I would prefer to reduce the number of abortions but our society differs on how to accomplish this task." Some would outlaw abortions. "I would rather prevent unintended pregnancies." In addition, the bill would restrict the rights of women and threaten their health. It interfered in the doctor-patient relationship. Would men accept such limitation in their medical treatment? she asked. "Can you imagine men being told prostate cancer treatment was unavailable because it interfered in potential human life?" She understood that no example was equivalent to abortion. But, pregnant women were being treated as mere vessels. The bill would interfere in late-term abortion procedures. The operation was not pretty and it was used rarely. These abortions were performed overwhelmingly due to fetal abnormalities that were incompatible with life. These were wanted pregnancies and the parents and the physicians had to make painful decisions. Frequently, the mother's life and her future reproductive capability were in danger. This method was the safest and most widely available second-trimester abortion. "Surely, you would not want the state of Alaska dictating medical procedure that would impact the life and health of your wife, daughter, sister, mother or friend. Prevent abortions by preventing unwanted pregnancies. Please vote against House Bill 65." Number 682 EDWARD WASSELL, President, Alaska Right to Life, was the next person to testify via teleconference in Anchorage. The organization had approximately 60,000 members statewide. He read a statement made by a physician. TAPE 97-16, SIDE A Number 020 CHAIR JAMES closed the House State Affairs Standing Committee meeting to public testimony. CHAIR JAMES stated that the bill needed some redrafting of the language. She believed better definitions were needed. She asked Representative Kott if he would be willing to work with her to draft a clearer statement of what would be outlawed? Number 033 REPRESENTATIVE KOTT responded he would be more than happy to work with Chair James. However, the definition in the bill mirrored the definition in the Congressional legislation. It was the result of numerous hours of experts in the medical field and their work to find an acceptable definition that was understandable to everyone involved. He reiterated, he was willing to work on another definition, but the experts had already crafted the definition in such a way that it conformed to acceptable standards. Number 049 CHAIR JAMES said she appreciated the comments made by Representative Kott, but the committee members did not have the other side of the argument as supporting documentation. She announced she would carry the bill over to Thursday, February 20, 1997. Number 064 REPRESENTATIVE KOTT replied he had supporting materials. He also explained that the bill had a House Judiciary Standing Committee referral. CHAIR JAMES replied, "I understand that." She was also a member of the House Judiciary Standing Committee. She reiterated, she would hold the bill over to Thursday, February 20, 1997. Number 072 REPRESENTATIVE KOTT further stated that HB 65 did not ban late-term abortions, contrary to the testimony. Moreover, the American Medical Association (AMA) had not taken a position on this issue. However, the AMA's counsel unanimously voted to recommend to the AMA Board of Trustees their support for this measure. Representative Kott read the following statement by C. Everett Koop, former Surgeon General, into the record: "I believe that Mr. Clinton was mislead by the medical advisors on what is fact and what is fiction in reference to late-term abortions. Because in no way can I twist my mind to see that the late-term abortions as described-you know-partial-birth and then destruction of the unborn child before the head is born is a medical necessity for the mother. It certainly can't be a necessity for the baby." REPRESENTATIVE KOTT stated the quote by C. Everett Koop captioned some of the discussion that had been surrounding this issue. CHAIR JAMES asked Representative Kott if the committee members had been supplied a copy of the quote by C. Everett Koop? REPRESENTATIVE KOTT replied there was a myriad of materials surrounding the issue as it flowed through Congress over the last two years.