Bill Text: FL S0792 | 2019 | Regular Session | Introduced
Bill Title: Abortion
Spectrum: Partisan Bill (Republican 10-0)
Status: (Failed) 2019-05-03 - Died in Health Policy [S0792 Detail]
Download: Florida-2019-S0792-Introduced.html
Florida Senate - 2019 SB 792 By Senator Baxley 12-01265-19 2019792__ 1 A bill to be entitled 2 An act relating to abortion; amending s. 390.011, 3 F.S.; providing and revising definitions; amending s. 4 390.0111, F.S.; requiring a physician to perform an 5 examination for, and inform a woman obtaining an 6 abortion of the presence of, a detectable fetal 7 heartbeat; requiring the physician to review the 8 results of such examination with the patient before 9 the woman gives informed consent for the abortion 10 procedure; requiring that a woman who declines to 11 review the results certify in writing that she did so 12 of her own free will and without undue influence; 13 providing criminal penalties; amending s. 390.01112, 14 F.S.; prohibiting the termination of a pregnancy when 15 a fetal heartbeat is detected; providing exceptions; 16 requiring a physician to perform certain examinations 17 to detect a fetal heartbeat; requiring the physician 18 to document such findings in the woman’s medical file; 19 providing the standard of care for the termination of 20 a pregnancy when a fetal heartbeat exists; amending s. 21 390.012, F.S.; conforming terminology; providing an 22 effective date. 23 24 WHEREAS, as many as 30 percent of natural pregnancies end 25 in spontaneous miscarriage, and 26 WHEREAS, fewer than 5 percent of all natural pregnancies 27 end in spontaneous miscarriage after the detection of fetal 28 cardiac activity, and 29 WHEREAS, more than 90 percent of in vitro pregnancies do 30 not survive the first trimester when cardiac activity is not 31 detected in the gestational sac, and 32 WHEREAS, a fetal heartbeat, therefore, is a key medical 33 predictor that an unborn human being will reach live birth, and 34 WHEREAS, cardiac activity begins at a biologically 35 identifiable moment in time, normally when the fetal heart is 36 formed in the gestational sac, and 37 WHEREAS, the State of Florida has a legitimate interest 38 from the outset of a pregnancy in protecting the health of the 39 woman and the life of the unborn human being who may be born, 40 and 41 WHEREAS, in order to make an informed choice about whether 42 to continue her pregnancy, the pregnant woman has a legitimate 43 interest in knowing the likelihood of the unborn human being 44 surviving to full-term birth based upon the presence of cardiac 45 activity, NOW, THEREFORE, 46 47 Be It Enacted by the Legislature of the State of Florida: 48 49 Section 1. Present subsections (6), (7), (8), (9), (10), 50 (11), (12), and (13) of section 390.011, Florida Statutes, are 51 renumbered as subsections (7), (9), (10), (11), (12), (13), 52 (14), and (16), respectively, present subsections (1), (6), (8), 53 (11), and (13) are amended, and new subsections (6), (8), and 54 (15) are added to that section, to read: 55 390.011 Definitions.—As used in this chapter, the term: 56 (1) “Abortion” means the termination of human pregnancy 57 with an intention other than to produce a live birth or to 58 remove a dead unborn human beingfetus. 59 (6) “Fetal heartbeat” means cardiac activity or the steady 60 and repetitive rhythmic contraction of the fetal heart within 61 the gestational sac. 62 (7)(6)“Gestation” means the development of a human embryo 63 or an unborn human beingfetusbetween fertilization and birth. 64 (8) “Gestational sac” means the structure that comprises 65 the extraembryonic membranes that envelop the unborn human being 66 and that is typically visible by ultrasound after the fourth 67 week of pregnancy. 68 (10)(8)“Partial-birth abortion” means a termination of 69 pregnancy in which the physician performing the termination of 70 pregnancy partially vaginally delivers a living unborn human 71 beingfetusbefore killing the unborn human beingfetusand 72 completing the delivery. 73 (13)(11)“Standard medical measure” means the medical care 74 that a physician would provide based on the particular facts of 75 the pregnancy, the information available to the physician, and 76 the technology reasonably available in a hospital, as defined in 77 s. 395.002, with an obstetrical department, to preserve the life 78 and health of the unborn human beingfetus, with or without 79 temporary artificial life-sustaining support, if the unborn 80 human beingfetuswere born at the same stage of gestational 81fetaldevelopment. 82 (15) “Unborn human being” means an individual organism of 83 the species Homo sapiens from fertilization until live birth. 84 (16)(13)“Viable” or “viability” means the stage offetal85 development when the life of an unborn human beinga fetusis 86 sustainable outside the womb through standard medical measures. 87 Section 2. Paragraph (a) of subsection (3), subsections 88 (4), (6), and (10), paragraph (a) of subsection (11), and 89 paragraph (a) of subsection (15) of section 390.0111, Florida 90 Statutes, are amended to read: 91 390.0111 Termination of pregnancies.— 92 (3) CONSENTS REQUIRED.—A termination of pregnancy may not 93 be performed or induced except with the voluntary and informed 94 written consent of the pregnant woman or, in the case of a 95 mental incompetent, the voluntary and informed written consent 96 of her court-appointed guardian. 97 (a) Except in the case of a medical emergency, consent to a 98 termination of pregnancy is voluntary and informed only if: 99 1. The physician who is to perform the procedure, or the 100 referring physician, has, at a minimum, orally, while physically 101 present in the same room, and at least 24 hours before the 102 procedure, informed the woman of: 103 a. The nature and risks of undergoing or not undergoing the 104 proposed procedure that a reasonable patient would consider 105 material to making a knowing and willful decision of whether to 106 terminate a pregnancy. 107 b. The probable gestational age of the unborn human being 108fetus, verified by an ultrasound, at the time the termination of 109 pregnancy is to be performed. 110 (I) The ultrasound must be performed by the physician who 111 is to perform the abortion or by a person having documented 112 evidence that he or she has completed a course in the operation 113 of ultrasound equipment as prescribed by rule and who is working 114 in conjunction with the physician. 115 (II) The person performing the ultrasound must offer the 116 woman the opportunity to view the live ultrasound images and 117 hear an explanation of them. If the woman accepts the 118 opportunity to view the images and hear the explanation, a 119 physician or a registered nurse, licensed practical nurse, 120 advanced practice registered nurse, or physician assistant 121 working in conjunction with the physician must contemporaneously 122 review and explain the images to the woman before the woman 123 gives informed consent to having an abortion procedure 124 performed. 125 (III) The woman has a right to decline to view and hear the 126 explanation of the live ultrasound images after she is informed 127 of her right and offered an opportunity to view the images and 128 hear the explanation. If the woman declines, the woman shall 129 complete a form acknowledging that she was offered an 130 opportunity to view and hear the explanation of the images but 131 that she declined that opportunity. The form must also indicate 132 that the woman’s decision was not based on any undue influence 133 from any person to discourage her from viewing the images or 134 hearing the explanation and that she declined of her own free 135 will. 136 (IV) Unless requested by the woman, the person performing 137 the ultrasound may not offer the opportunity to view the images 138 and hear the explanation and the explanation may not be given 139 if, at the time the woman schedules or arrives for her 140 appointment to obtain an abortion, a copy of a restraining 141 order, police report, medical record, or other court order or 142 documentation is presented which provides evidence that the 143 woman is obtaining the abortion because the woman is a victim of 144 rape, incest, domestic violence, or human trafficking or that 145 the woman has been diagnosed as having a condition that, on the 146 basis of a physician’s good faith clinical judgment, would 147 create a serious risk of substantial and irreversible impairment 148 of a major bodily function if the woman delayed terminating her 149 pregnancy. 150 c. Whether the unborn human being has a detectable fetal 151 heartbeat. The physician who performs the examination for the 152 presence of a fetal heartbeat must offer the woman the 153 opportunity to view or hear the fetal heartbeat and present the 154 statistical data regarding the probability of survival. If the 155 woman declines, the woman shall complete a form acknowledging 156 that she was offered an opportunity to view and hear the fetal 157 heartbeat but that she declined that opportunity. The form must 158 also indicate that the woman’s decision was not based on any 159 undue influence from any person to discourage her from viewing 160 or hearing the fetal heartbeat and that she declined of her own 161 free will. 162 d.c.The medical risks to the woman and the unborn human 163 beingfetusof carrying the pregnancy to term. 164 165 The physician may provide the information required in this 166 subparagraph within 24 hours before the procedure if requested 167 by the woman at the time she schedules or arrives for her 168 appointment to obtain an abortion and if she presents to the 169 physician a copy of a restraining order, police report, medical 170 record, or other court order or documentation evidencing that 171 she is obtaining the abortion because she is a victim of rape, 172 incest, domestic violence, or human trafficking. 173 2. Printed materials prepared and provided by the 174 department have been provided to the pregnant woman, if she 175 chooses to view these materials, including: 176 a. A description of the unborn human beingfetus, including 177 a description of the various stages of development. 178 b. A list of entities that offer alternatives to 179 terminating the pregnancy. 180 c. Detailed information on the availability of medical 181 assistance benefits for prenatal care, childbirth, and neonatal 182 care. 183 3. The woman acknowledges in writing, before the 184 termination of pregnancy, that the information required to be 185 provided under this subsection has been provided. 186 187 Nothing in this paragraph is intended to prohibit a physician 188 from providing any additional information which the physician 189 deems material to the woman’s informed decision to terminate her 190 pregnancy. 191 (4) STANDARD OF MEDICAL CARE TO BE USED IN THIRD 192 TRIMESTER.—If a termination of pregnancy is performed in the 193 third trimester, the physician performing the termination of 194 pregnancy must exercise the same degree of professional skill, 195 care, and diligence to preserve the life and health of the 196 unborn human beingfetuswhich the physician would be required 197 to exercise in order to preserve the life and health of an 198 unborn human beinga fetusintended to be born and not aborted. 199 However, if preserving the life and health of the unborn human 200 beingfetusconflicts with preserving the life and health of the 201 pregnant woman, the physician must consider preserving the 202 woman’s life and health the overriding and superior concern. 203 (6) EXPERIMENTATION ON UNBORN HUMAN BEINGFETUSPROHIBITED; 204 EXCEPTION.—No person shall use any live unborn human beingfetus205 or live, premature infant for any type of scientific, research, 206 laboratory, or other kind of experimentation either prior to or 207 subsequent to any termination of pregnancy procedure except as 208 necessary to protect or preserve the life and health of such 209 unborn human beingfetusor premature infant. 210 (10) PENALTIES FOR VIOLATION.—Except as provided in 211 subsections (3), (7), and (12): 212 (a) Any person who willfully performs, or actively 213 participates in, a termination of pregnancy in violation of the 214 requirements of this section or s. 390.01112 commits a felony of 215 the third degree, punishable as provided in s. 775.082, s. 216 775.083, or s. 775.084. 217 (b) Any person who knowingly or purposefully performs or 218 induces an abortion on a pregnant woman with the specific intent 219 of causing or abetting the termination of the life of the unborn 220 human being whose fetal heartbeat has been detected pursuant to 221 sub-subparagraph (3)(a)1.c. commits a felony of the third 222 degree, punishable as provided in s. 775.082, s. 775.083, or s. 223 775.084. 224 (c)(b)Any person who performs, or actively participates 225 in, a termination of pregnancy in violation of this section or 226 s. 390.01112 which results in the death of the woman commits a 227 felony of the second degree, punishable as provided in s. 228 775.082, s. 775.083, or s. 775.084. 229 (11) CIVIL ACTION PURSUANT TO PARTIAL-BIRTH ABORTION; 230 RELIEF.— 231 (a) The father, if married to the mother at the time she 232 receives a partial-birth abortion, and, if the mother has not 233 attained the age of 18 years at the time she receives a partial 234 birth abortion, the maternal grandparents of the unborn human 235 beingfetusmay, in a civil action, obtain appropriate relief, 236 unless the pregnancy resulted from the plaintiff’s criminal 237 conduct or the plaintiff consented to the abortion. 238 (15) USE OF PUBLIC FUNDS RESTRICTED.—A state agency, a 239 local governmental entity, or a managed care plan providing 240 services under part IV of chapter 409 may not expend funds for 241 the benefit of, pay funds to, or initiate or renew a contract 242 with an organization that owns, operates, or is affiliated with 243 one or more clinics that are licensed under this chapter and 244 perform abortions unless one or more of the following applies: 245 (a) All abortions performed by such clinics are: 246 1. On unborn human beingsfetusesthat are conceived 247 through rape or incest; or 248 2. Are medically necessary to preserve the life of the 249 pregnant woman or to avert a serious risk of substantial and 250 irreversible physical impairment of a major bodily function of 251 the pregnant woman, other than a psychological condition. 252 Section 3. Section 390.01112, Florida Statutes, is amended 253 to read: 254 390.01112 Termination of pregnancies during viability or 255 after fetal heartbeat is detected.— 256 (1) No termination of pregnancy shall be performed on any 257 womanhuman beingif the physician determines that, in 258 reasonable medical judgment, the unborn human beingfetushas 259 achieved viability or has a detectable fetal heartbeat, unless: 260 (a) Two physicians certify in writing that, in reasonable 261 medical judgment, the termination of the pregnancy is necessary 262 to save the pregnant woman’s life or avert a serious risk of 263 substantial and irreversible physical impairment of a major 264 bodily function of the pregnant woman other than a psychological 265 condition; or 266 (b) The physician certifies in writing that, in reasonable 267 medical judgment, there is a medical necessity for legitimate 268 emergency medical procedures for termination of the pregnancy to 269 save the pregnant woman’s life or avert a serious risk of 270 imminent substantial and irreversible physical impairment of a 271 major bodily function of the pregnant woman other than a 272 psychological condition, and another physician is not available 273 for consultation. 274 (2) Before performing a termination of pregnancy, a 275 physician must determine whetherifthe unborn human being: 276 (a)fetusIs viable by, at a minimum, performing a medical 277 examination of the pregnant woman and, to the maximum extent 278 possible through reasonably available tests and the ultrasound 279 required under s. 390.0111(3), an examination of the unborn 280 human beingfetus. 281 (b) Has a detectable fetal heartbeat. 282 283 The physician must document in the pregnant woman’s medical file 284 the physician’s determination and the method, equipment,fetal285 measurements, and any other information used to determine the 286 viability of the unborn human being and whether the unborn human 287 being has a detectable fetal heartbeatfetus. 288 (3) If a termination of pregnancy is performed during 289 viability or after a fetal heartbeat has been detected, the 290 physician performing the termination of pregnancy must exercise 291 the same degree of professional skill, care, and diligence to 292 preserve the life and health of the unborn human beingfetus293 that the physician would be required to exercise in order to 294 preserve the life and health of an unborn human beinga fetus295 intended to be born and not aborted. However, if preserving the 296 life and health of the unborn human beingfetusconflicts with 297 preserving the life and health of the woman, the physician must 298 consider preserving the woman’s life and health the overriding 299 and superior concern. 300 Section 4. Paragraphs (d), (e), (f), and (h) of subsection 301 (3) and subsections (6) and (7) of section 390.012, Florida 302 Statutes, are amended to read: 303 390.012 Powers of agency; rules; disposal offetal304 remains.— 305 (3) For clinics that perform or claim to perform abortions 306 after the first trimester of pregnancy, the agency shall adopt 307 rules pursuant to ss. 120.536(1) and 120.54 to implement the 308 provisions of this chapter, including the following: 309 (d) Rules relating to the medical screening and evaluation 310 of each abortion clinic patient. At a minimum, these rules shall 311 require: 312 1. A medical history including reported allergies to 313 medications, antiseptic solutions, or latex; past surgeries; and 314 an obstetric and gynecological history. 315 2. A physical examination, including a bimanual examination 316 estimating uterine size and palpation of the adnexa. 317 3. The appropriate laboratory tests, including: 318 a. Urine or blood tests for pregnancy performed before the 319 abortion procedure. 320 b. A test for anemia. 321 c. Rh typing, unless reliable written documentation of 322 blood type is available. 323 d. Other tests as indicated from the physical examination. 324 4. An ultrasound evaluation for all patients. The rules 325 shall require that if a person who is not a physician performs 326 an ultrasound examination, that person shall have documented 327 evidence that he or she has completed a course in the operation 328 of ultrasound equipment as prescribed in rule. The rules shall 329 require clinics to be in compliance with s. 390.0111. 330 5. That the physician is responsible for estimating the 331 gestational age of the unborn human beingfetusbased on the 332 ultrasound examination and obstetric standards in keeping with 333 established standards of care regarding the estimation of the 334 gestationalfetalage of the unborn human being as defined in 335 rule and shall write the estimate in the patient’s medical 336 history. The physician shall keep original prints of each 337 ultrasound examination of a patient in the patient’s medical 338 history file. 339 (e) Rules relating to the abortion procedure. At a minimum, 340 these rules shall require: 341 1. That a physician, registered nurse, licensed practical 342 nurse, advanced practice registered nurse, or physician 343 assistant is available to all patients throughout the abortion 344 procedure. 345 2. Standards for the safe conduct of abortion procedures 346 that conform to obstetric standards in keeping with established 347 standards of care regarding the estimation of the gestational 348fetalage of the unborn human being as defined in rule. 349 3. Appropriate use of general and local anesthesia, 350 analgesia, and sedation if ordered by the physician. 351 4. Appropriate precautions, such as the establishment of 352 intravenous access at least for patients undergoing post-first 353 trimester abortions. 354 5. Appropriate monitoring of the vital signs and other 355 defined signs and markers of the patient’s status throughout the 356 abortion procedure and during the recovery period until the 357 patient’s condition is deemed to be stable in the recovery room. 358 (f) Rules that prescribe minimum recovery room standards. 359 At a minimum, these rules must require that: 360 1. Postprocedure recovery rooms be supervised and staffed 361 to meet the patients’ needs. 362 2. Immediate postprocedure care consist of observation in a 363 supervised recovery room for as long as the patient’s condition 364 warrants. 365 3. A registered nurse, licensed practical nurse, advanced 366 practice registered nurse, or physician assistant who is trained 367 in the management of the recovery area and is capable of 368 providing basic cardiopulmonary resuscitation and related 369 emergency procedures remain on the premises of the abortion 370 clinic until all patients are discharged. 371 4. A physician sign the discharge order and be readily 372 accessible and available until the last patient is discharged to 373 facilitate the transfer of emergency cases if hospitalization of 374 the patient or the unborn human beingviable fetusis necessary. 375 5. A physician discuss Rho(D) immune globulin with each 376 patient for whom it is indicated and ensure that it is offered 377 to the patient in the immediate postoperative period or will be 378 available to her within 72 hours after completion of the 379 abortion procedure. If the patient refuses the Rho(D) immune 380 globulin, she and a witness must sign a refusal form approved by 381 the agency which must be included in the medical record. 382 6. Written instructions with regard to postabortion coitus, 383 signs of possible problems, and general aftercare which are 384 specific to the patient be given to each patient. The 385 instructions must include information regarding access to 386 medical care for complications, including a telephone number for 387 use in the event of a medical emergency. 388 7. A minimum length of time be specified, by type of 389 abortion procedure and duration of gestation, during which a 390 patient must remain in the recovery room. 391 8. The physician ensure that, with the patient’s consent, a 392 registered nurse, licensed practical nurse, advanced practice 393 registered nurse, or physician assistant from the abortion 394 clinic makes a good faith effort to contact the patient by 395 telephone within 24 hours after surgery to assess the patient’s 396 recovery. 397 9. Equipment and services be readily accessible to provide 398 appropriate emergency resuscitative and life support procedures 399 pending the transfer of the patient or the unborn human being 400viable fetusto the hospital. 401 (h) Rules to prescribe minimum abortion clinic incident 402 reporting. At a minimum, these rules shall require that: 403 1. The abortion clinic records each incident that results 404 in serious injury to a patient or an unborn human beinga viable405fetusat an abortion clinic and shall report an incident in 406 writing to the agency within 10 days after the incident occurs. 407 For the purposes of this paragraph, “serious injury” means an 408 injury that occurs at an abortion clinic and that creates a 409 serious risk of substantial impairment of a major bodily organ. 410 2. If a patient’s death occurs, other than thea fetal411 death of an unborn human being properly reported pursuant to 412 law, the abortion clinic reports it to the department not later 413 than the next department workday. 414 (6) The agency may adopt and enforce rules, in the interest 415 of protecting the public health, to ensure the prompt and proper 416 disposal offetalremains and tissue resulting from pregnancy 417 termination. 418 (7) If an owner, operator, or employee of an abortion 419 clinic fails to dispose offetalremains and tissue in a 420 sanitary manner pursuant to s. 381.0098, rules adopted 421 thereunder, and rules adopted by the agency pursuant to this 422 section, the license of such clinic may be suspended or revoked, 423 and such person commits a misdemeanor of the first degree, 424 punishable as provided in s. 775.082 or s. 775.083. 425 Section 5. This act shall take effect July 1, 2019.