Bill Text: MI SB1283 | 2009-2010 | 95th Legislature | Introduced
Bill Title: Health; abortion; ultrasound equipment used on woman seeking an abortion; require use of most technologically advanced equipment on site. Amends sec. 17015 of 1978 PA 368 (MCL 333.17015).
Spectrum: Moderate Partisan Bill (Republican 4-1)
Status: (Engrossed - Dead) 2010-09-29 - Referred To Committee On Judiciary [SB1283 Detail]
Download: Michigan-2009-SB1283-Introduced.html
SENATE BILL No. 1283
April 22, 2010, Introduced by Senators KUIPERS, CROPSEY, BROWN, JANSEN and GLEASON and referred to the Committee on Judiciary.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending section 17015 (MCL 333.17015), as amended by 2006 PA
77.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 17015. (1) Subject to subsection (10), a physician shall
not perform an abortion otherwise permitted by law without the
patient's informed written consent, given freely and without
coercion.
(2) For purposes of this section:
(a) "Abortion" means the intentional use of an instrument,
drug, or other substance or device to terminate a woman's pregnancy
for a purpose other than to increase the probability of a live
birth, to preserve the life or health of the child after live
birth, or to remove a dead fetus. Abortion does not include the use
or prescription of a drug or device intended as a contraceptive.
(b) "Fetus" means an individual organism of the species homo
sapiens in utero.
(c) "Local health department representative" means a person,
who meets 1 or more of the licensing requirements listed in
subdivision (f) and who is employed by, or under contract to
provide services on behalf of, a local health department.
(d) "Medical emergency" means that condition which, on the
basis of the physician's good faith clinical judgment, so
complicates the medical condition of a pregnant woman as to
necessitate the immediate abortion of her pregnancy to avert her
death or for which a delay will create serious risk of substantial
and irreversible impairment of a major bodily function.
(e) "Medical service" means the provision of a treatment,
procedure, medication, examination, diagnostic test, assessment, or
counseling, including, but not limited to, a pregnancy test,
ultrasound, pelvic examination, or an abortion.
(f) "Qualified person assisting the physician" means another
physician or a physician's assistant licensed under this part or
part 175, a fully licensed or limited licensed psychologist
licensed under part 182, a professional counselor licensed under
part 181, a registered professional nurse or a licensed practical
nurse licensed under part 172, or a social worker licensed under
part 185.
(g) "Probable gestational age of the fetus" means the
gestational age of the fetus at the time an abortion is planned to
be performed.
(h) "Provide the patient with a physical copy" means
confirming that the patient accessed the internet website described
in subsection (5) and received a printed valid confirmation form
from the website and including that form in the patient's medical
record or giving a patient a copy of a required document by 1 or
more of the following means:
(i) In person.
(ii) By registered mail, return receipt requested.
(iii) By parcel delivery service that requires the recipient to
provide a signature in order to receive delivery of a parcel.
(iv) By facsimile transmission.
(3) Subject to subsection (10), a physician or a qualified
person assisting the physician shall do all of the following not
less than 24 hours before that physician performs an abortion upon
a patient who is a pregnant woman:
(a) Confirm that, according to the best medical judgment of a
physician, the patient is pregnant, and determine the probable
gestational age of the fetus.
(b) Orally describe, in language designed to be understood by
the patient, taking into account her age, level of maturity, and
intellectual capability, each of the following:
(i) The probable gestational age of the fetus she is carrying.
(ii) Information about what to do and whom to contact should
medical complications arise from the abortion.
(iii) Information about how to obtain pregnancy prevention
information through the department of community health.
(c) Provide the patient with a physical copy of the written
summary described in subsection (11)(b) that corresponds to the
procedure the patient will undergo and is provided by the
department of community health. If the procedure has not been
recognized by the department, but is otherwise allowed under
Michigan law, and the department has not provided a written summary
for that procedure, the physician shall develop and provide a
written summary that describes the procedure, any known risks or
complications of the procedure, and risks associated with live
birth and meets the requirements of subsection (11)(b)(iii) through
(vii).
(d) Provide the patient with a physical copy of a medically
accurate depiction, illustration, or photograph and description of
a fetus supplied by the department of community health pursuant to
subsection (11)(a) at the gestational age nearest the probable
gestational age of the patient's fetus.
(e) Provide the patient with a physical copy of the prenatal
care and parenting information pamphlet distributed by the
department of community health under section 9161.
(4) The requirements of subsection (3) may be fulfilled by the
physician or a qualified person assisting the physician at a
location other than the health facility where the abortion is to be
performed. The requirement of subsection (3)(a) that a patient's
pregnancy be confirmed may be fulfilled by a local health
department under subsection (18). The requirements of subsection
(3) cannot be fulfilled by the patient accessing an internet
website other than the internet website described in subsection (5)
that is maintained through the department.
(5) The requirements of subsection (3)(c) through (e) may be
fulfilled by a patient accessing the internet website maintained
and operated through the department and receiving a printed, valid
confirmation form from the website that the patient has reviewed
the information required in subsection (3)(c) through (e) at least
24 hours before an abortion being performed on the patient. The
website shall not require any information be supplied by the
patient. The department shall not track, compile, or otherwise keep
a record of information that would identify a patient who accesses
this website. The patient shall supply the valid confirmation form
to the physician or qualified person assisting the physician to be
included in the patient's medical record to comply with this
subsection.
(6) Subject to subsection (10), before obtaining the patient's
signature on the acknowledgment and consent form, a physician
personally and in the presence of the patient shall do all of the
following:
(a) Provide the patient with the physician's name and inform
the patient of her right to withhold or withdraw her consent to the
abortion at any time before performance of the abortion.
(b) Orally describe, in language designed to be understood by
the patient, taking into account her age, level of maturity, and
intellectual capability, each of the following:
(i) The specific risk, if any, to the patient of the
complications that have been associated with the procedure the
patient will undergo, based on the patient's particular medical
condition and history as determined by the physician.
(ii) The specific risk of complications, if any, to the patient
if she chooses to continue the pregnancy based on the patient's
particular medical condition and history as determined by a
physician.
(7) To protect a patient's privacy, the information set forth
in subsection (3) and subsection (6) shall not be disclosed to the
patient in the presence of another patient.
(8) If at any time prior to the performance of an abortion, a
patient undergoes an ultrasound examination, or a physician
determines that ultrasound imaging will be used during the course
of a patient's abortion, the physician or qualified person
assisting the physician shall provide the patient with the
opportunity to view or decline to view an active ultrasound image
of the fetus, and offer to provide the patient with a physical
picture of the ultrasound image of the fetus prior to the
performance of the abortion. In complying with this subsection, the
physician or person assisting the physician shall ensure that the
most technologically advanced ultrasound equipment available at
that location is used for the ultrasound examination, for viewing
an active ultrasound image, and for creating the physical picture
of the ultrasound image. Before performing an abortion on a patient
who is a pregnant woman, a physician or a qualified person
assisting the physician shall do all of the following:
(a) Obtain the patient's signature on the acknowledgment and
consent form described in subsection (11)(c) confirming that she
has received the information required under subsection (3).
(b) Provide the patient with a physical copy of the signed
acknowledgment and consent form described in subsection (11)(c).
(c) Retain a copy of the signed acknowledgment and consent
form described in subsection (11)(c) and, if applicable, a copy of
the pregnancy certification form completed under subsection
(18)(b), in the patient's medical record.
(9) This subsection does not prohibit notifying the patient
that payment for medical services will be required or that
collection of payment in full for all medical services provided or
planned may be demanded after the 24-hour period described in this
subsection has expired. A physician or an agent of the physician
shall not collect payment, in whole or in part, for a medical
service provided to or planned for a patient before the expiration
of 24 hours from the time the patient has done either or both of
the following, except in the case of a physician or an agent of a
physician receiving capitated payments or under a salary
arrangement for providing those medical services:
(a) Inquired about obtaining an abortion after her pregnancy
is confirmed and she has received from that physician or a
qualified person assisting the physician the information required
under subsection (3)(c) and (d).
(b) Scheduled an abortion to be performed by that physician.
(10) If the attending physician, utilizing his or her
experience, judgment, and professional competence, determines that
a medical emergency exists and necessitates performance of an
abortion before the requirements of subsections (1), (3), and (6)
can be met, the physician is exempt from the requirements of
subsections (1), (3), and (6), may perform the abortion, and shall
maintain a written record identifying with specificity the medical
factors upon which the determination of the medical emergency is
based.
(11) The department of community health shall do each of the
following:
(a) Produce medically accurate depictions, illustrations, or
photographs of the development of a human fetus that indicate by
scale the actual size of the fetus at 2-week intervals from the
fourth week through the twenty-eighth week of gestation. Each
depiction, illustration, or photograph shall be accompanied by a
printed description, in nontechnical English, Arabic, and Spanish,
of the probable anatomical and physiological characteristics of the
fetus at that particular state of gestational development.
(b) Subject to subdivision (g), develop, draft, and print, in
nontechnical English, Arabic, and Spanish, written standardized
summaries, based upon the various medical procedures used to abort
pregnancies, that do each of the following:
(i) Describe, individually and on separate documents, those
medical procedures used to perform abortions in this state that are
recognized by the department.
(ii) Identify the physical complications that have been
associated with each procedure described in subparagraph (i) and
with live birth, as determined by the department. In identifying
these complications, the department shall consider the annual
statistical
report required under section 2835(6) 2835, and shall
consider studies concerning complications that have been published
in a peer review medical journal, with particular attention paid to
the design of the study, and shall consult with the federal centers
for
disease control and
prevention, the American college congress
of obstetricians and gynecologists, the Michigan state medical
society, or any other source that the department determines
appropriate for the purpose.
(iii) State that as the result of an abortion, some women may
experience depression, feelings of guilt, sleep disturbance, loss
of interest in work or sex, or anger, and that if these symptoms
occur and are intense or persistent, professional help is
recommended.
(iv) State that not all of the complications listed in
subparagraph (ii) may pertain to that particular patient and refer
the patient to her physician for more personalized information.
(v) Identify services available through public agencies to
assist the patient during her pregnancy and after the birth of her
child, should she choose to give birth and maintain custody of her
child.
(vi) Identify services available through public agencies to
assist the patient in placing her child in an adoptive or foster
home, should she choose to give birth but not maintain custody of
her child.
(vii) Identify services available through public agencies to
assist the patient and provide counseling should she experience
subsequent adverse psychological effects from the abortion.
(c) Develop, draft, and print, in nontechnical English,
Arabic, and Spanish, an acknowledgment and consent form that
includes only the following language above a signature line for the
patient:
"I, _____________________________ , hereby authorize Dr.
__________________ ("the physician") and any assistant designated
by the physician to perform upon me the following operation(s) or
procedure(s):
______________________________________________________________
(Name of operation(s) or procedure(s))
______________________________________________________________
I understand that I am approximately _____ weeks pregnant. I
consent to an abortion procedure to terminate my pregnancy. I
understand that I have the right to withdraw my consent to the
abortion procedure at any time prior to performance of that
procedure. I acknowledge that at least 24 hours before the
scheduled abortion I have received a physical copy of each of the
following:
(a) A medically accurate depiction, illustration, or
photograph of a fetus at the probable gestational age of the fetus
I am carrying.
(b) A written description of the medical procedure that will
be used to perform the abortion.
(c) A prenatal care and parenting information pamphlet. If any
of the above listed documents were transmitted by facsimile, I
certify that the documents were clear and legible. I acknowledge
that the physician who will perform the abortion has orally
described all of the following to me:
(i) The specific risk to me, if any, of the complications that
have been associated with the procedure I am scheduled to undergo.
(ii) The specific risk to me, if any, of the complications if I
choose to continue the pregnancy.
I acknowledge that I have received all of the following
information:
(d) Information about what to do and whom to contact in the
event that complications arise from the abortion.
(e) Information pertaining to available pregnancy related
services.
I have been given an opportunity to ask questions about the
operation(s) or procedure(s). I certify that I have not been
required to make any payments for an abortion or any medical
service before the expiration of 24 hours after I received the
written materials listed in paragraphs (a), (b), and (c) above, or
24 hours after the time and date listed on the confirmation form if
paragraphs (a), (b), and (c) were viewed from the state of Michigan
internet website.".
(d) Make available to physicians through the Michigan board of
medicine and the Michigan board of osteopathic medicine and
surgery, and any person upon request the copies of medically
accurate depictions, illustrations, or photographs described in
subdivision (a), the standardized written summaries described in
subdivision (b), the acknowledgment and consent form described in
subdivision (c), the prenatal care and parenting information
pamphlet described in section 9161, and the pregnancy certification
form described in subdivision (f).
(e) The department shall not develop written summaries for
abortion procedures under subdivision (b) that utilize medication
that has not been approved by the United States food and drug
administration for use in performing an abortion.
(f) Develop, draft, and print a certification form to be
signed by a local health department representative at the time and
place a patient has a pregnancy confirmed, as requested by the
patient, verifying the date and time the pregnancy is confirmed.
(g) Develop and maintain an internet website that allows a
patient considering an abortion to review the information required
in subsection (3)(c) through (e). After the patient reviews the
required information, the department shall assure that a
confirmation form can be printed by the patient from the internet
website that will verify the time and date the information was
reviewed. A confirmation form printed under this subdivision
becomes invalid 14 days after the date and time printed on the
confirmation form.
(h) Include on the informed consent website developed under
subdivision (g) a list of health care providers, facilities, and
clinics that offer to perform ultrasounds free of charge. The list
shall be organized geographically and shall include the name,
address, and telephone number of each health care provider,
facility, and clinic.
(12) A physician's duty to inform the patient under this
section does not require disclosure of information beyond what a
reasonably well-qualified physician licensed under this article
would possess.
(13) A written consent form meeting the requirements set forth
in this section and signed by the patient is presumed valid. The
presumption created by this subsection may be rebutted by evidence
that establishes, by a preponderance of the evidence, that consent
was obtained through fraud, negligence, deception,
misrepresentation, coercion, or duress.
(14) A completed certification form described in subsection
(11)(f) that is signed by a local health department representative
is presumed valid. The presumption created by this subsection may
be rebutted by evidence that establishes, by a preponderance of the
evidence, that the physician who relied upon the certification had
actual knowledge that the certificate contained a false or
misleading statement or signature.
(15) This section does not create a right to abortion.
(16) Notwithstanding any other provision of this section, a
person shall not perform an abortion that is prohibited by law.
(17) If any portion of this act or the application of this act
to any person or circumstances is found invalid by a court, that
invalidity does not affect the remaining portions or applications
of the act that can be given effect without the invalid portion or
application, if those remaining portions are not determined by the
court to be inoperable.
(18) Upon a patient's request, each local health department
shall:
(a) Provide a pregnancy test for that patient to confirm the
pregnancy as required under subsection (3)(a) and determine the
probable gestational stage of the fetus. The local health
department need not comply with this subdivision if the
requirements of subsection (3)(a) have already been met.
(b) If a pregnancy is confirmed, ensure that the patient is
provided with a completed pregnancy certification form described in
subsection (11)(f) at the time the information is provided.
(19) The identity and address of a patient who is provided
information or who consents to an abortion pursuant to this section
is confidential and is subject to disclosure only with the consent
of the patient or by judicial process.
(20) A local health department with a file containing the
identity and address of a patient described in subsection (19) who
has been assisted by the local health department under this section
shall do both of the following:
(a) Only release the identity and address of the patient to a
physician or qualified person assisting the physician in order to
verify the receipt of the information required under this section.
(b) Destroy the information containing the identity and
address of the patient within 30 days after assisting the patient
under this section.
