Relating to abortions including informed consent, dispensing abortion-inducing drugs, and reporting abortion-inducing drug complications

This bill relates to abortions, including informed consent, dispensing of abortion-inducing drugs, and reporting abortion-inducing drug complications. DIVISION I —— ABORTION DEFINED. The bill excludes a spontaneous termination of pregnancy, if not all the products of conception are expelled, from the definition of abortion for the purpose of the reporting requirements and penalties on abortions under Code chapter 146B (abortion —— postfertilization age). DIVISION II —— INFORMED CONSENT. Under the bill, a physician, prior to performing or attempting to perform an abortion, is required to perform an in-person examination of the woman seeking an abortion, including screening for indicia of coercion or abuse; if necessary, the physician shall make a referral to an appropriate health care provider consistent with the examination results. The bill requires a physician who is performing or attempting to perform a chemical abortion, prior to prescribing or dispensing an abortion-inducing drug, to do all of the following: have the woman being prescribed or dispensed the drug sign a patient agreement form, obtain written confirmation that the physician has informed the woman of specific health and safety information related to abortion-inducing drugs as detailed in the bill, and advise the pregnant woman how to access emergency surgical intervention in cases of an incomplete abortion, severe bleeding, or other medical complications. The bill specifies that these requirements shall not apply to a chemical abortion performed in response to a medical emergency. The bill provides that the prohibition on dispensing of abortion-inducing drugs shall not be construed to impose civil or criminal liability on a woman upon whom a chemical abortion has been performed. Under the bill, a physician who fails to comply with the informed consent requirements is subject to licensee discipline. The bill requires the board of medicine to adopt rules to administer this division of the bill. The bill defines “abortion-inducing drug”, “chemical abortion”, “dispense”, “medical emergency”, and “pregnant” or “pregnancy”. The bill requires the department of health and human services (HHS) to publish on HHS’s internet site notice that it may be possible to reverse the effects of a chemical abortion, and information and resources on reversing the effects of a chemical abortion. DIVISION III —— DISPENSING AND REPORTING —— ABORTION-INDUCING DRUGS. The bill defines “abortion-inducing drug”, “abortion-inducing drug complication”, “chemical abortion”, “dispense”, “health care setting”, “interested party”, “medical emergency”, “physician”, “postfertilization age”, and “rural emergency hospital”.107 (drug dispensing, supplying, and prescribing —— limitations). These requirements do not apply to a medical emergency. The bill requires a hospital, rural emergency hospital, or the attending physician to file a report with HHS using a prescribed form within 30 days of discharge or death of a woman who presented with or was treated for an abortion-inducing drug complication. The form must be signed and completed by the attending physician and contain the age of the woman experiencing the abortion-inducing drug complication, the woman’s state and county of residence, the date the abortion-inducing drug was used by the woman, and the probable postfertilization age of the unborn child at the time of the abortion-inducing drug complication. The report must identify the physician who performed the chemical abortion, the facility where the chemical abortion was performed, the referring physician, agency, or service, if any, and the specific complication or complications that led to the treatment performed along with the most recent international classification of diseases code for each, if applicable. The report shall be confidential and not subject to disclosure under Code chapter 22 (open records). The bill also requires HHS to prepare annually on or before December 31 a comprehensive statistical report based upon the aggregated data gathered from the reports filed on abortion-inducing drug complications. Under the bill, the data gathered by HHS must be anonymized to prevent public disclosure of either the physician or hospital that filed a report, or the woman about whom a report is filed. HHS is required to make the anonymized data publicly available in a downloadable format on its internet site. This division of the bill imposes civil liabilities on any person who dispenses an abortion-inducing drug in violation of this division of the bill for all damages caused by the abortion-inducing drug suffered by a woman upon whom a chemical abortion was performed or was attempted or the personal representative of the woman upon whom a chemical abortion was performed or was attempted. A licensed pharmacist or physician is immune from civil liability. The bill defines “personal representative” as an administrator or an executor, or if there is no such personal representative appointed, then a person legally authorized to perform substantially the same functions. A prevailing plaintiff in an action brought under this division of the bill, in addition to compensatory and punitive damages, is entitled to court costs and reasonable attorney fees. In an action brought under this division of the bill, the name and other identifying characteristics of a woman who sought or obtained an abortion-inducing drug shall be redacted from all pleadings and documents filed in the action without a court order, and the court may make further orders as necessary to protect the identity and privacy of the woman who sought or obtained an abortion-inducing drug. This division of the bill is not to be construed to impose civil or criminal liability upon a woman upon whom a chemical abortion is performed. Under the bill, a licensed pharmacist or physician that fails to comply with this division of the bill is subject to licensee discipline. DIVISION IV —— ABORTION-RELATED PROVISIONS.29A (termination of pregnancy reporting —— legislative intent) to require a health care provider that diagnoses or induces a spontaneous termination of pregnancy to include in the required report to HHS if mifepristone or misoprostol was used to induce a spontaneous termination of pregnancy. Current law requires the health care provider to only disclose if mifepristone was used to induce a spontaneous termination of pregnancy. The bill also requires the health care provider to disclose whether mifepristone or misoprostol were ingested by the patient within 14 days prior to the spontaneous termination of pregnancy.