14103482D
SENATE BILL NO. 617
Offered January 15, 2014
A BILL to amend and reenact §18.2-76 of the Code of Virginia,
relating to requirement for ultrasound prior to abortion.
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Patron-- Locke
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Referred to Committee on Education and Health
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Be it enacted by the General Assembly of Virginia:
1. That §18.2-76 of the Code of Virginia is amended and
reenacted as follows:
§18.2-76. Informed written consent required; civil penalty.
A. Before performing any abortion or inducing any miscarriage
or terminating a pregnancy as provided in §18.2-72, 18.2-73, or 18.2-74, the
physician shall obtain the informed written consent of the pregnant woman.
However, if the woman has been adjudicated incapacitated by any court of
competent jurisdiction or if the physician knows or has good reason to believe
that such woman is incapacitated as adjudicated by a court of competent
jurisdiction, then only after permission is given in writing by a parent,
guardian, committee, or other person standing in loco parentis to the woman,
may the physician perform the abortion or otherwise terminate the pregnancy.
B. At least 24 hours before the performance
of an abortion, a qualified medical professional trained in sonography and
working under the supervision of a physician licensed in the Commonwealth shall
perform fetal transabdominal ultrasound imaging on the patient undergoing the
abortion for the purpose of determining gestational age. If the pregnant woman
lives at least 100 miles from the facility where the abortion is to be
performed, the fetal ultrasound imaging shall be performed at least two hours
before the abortion. The ultrasound image shall contain the dimensions of the
fetus and accurately portray the presence of external members and internal
organs of the fetus, if present or viewable. Determination of gestational age
shall be based upon measurement of the fetus in a manner consistent with
standard medical practice in the community for determining gestational age.
When only the gestational sac is visible during ultrasound imaging, gestational
age may be based upon measurement of the gestational sac. If gestational age
cannot be determined by a transabdominal ultrasound, then the patient
undergoing the abortion shall be verbally offered other ultrasound imaging to
determine gestational age, which she may refuse. A print of the ultrasound
image shall be made to document the measurements that have been taken to
determine the gestational age of the fetus.
The provisions of this
subsection shall not apply if the woman seeking an abortion is the victim of
rape or incest, if the incident was reported to law-enforcement authorities.
Nothing herein shall preclude the physician from using any ultrasound imaging
that he considers to be medically appropriate pursuant to the standard medical
practice in the community.
C. The qualified medical
professional performing fetal ultrasound imaging pursuant to subsection B shall
verbally offer the woman an opportunity to view the ultrasound image, receive a
printed copy of the ultrasound image and hear the fetal heart tones pursuant to
standard medical practice in the community, and shall obtain from the woman
written certification that this opportunity was offered and whether or not it
was accepted and, if applicable, verification that the pregnant woman lives at
least 100 miles from the facility where the abortion is to be performed. A
printed copy of the ultrasound image shall be maintained in the woman's medical
record at the facility where the abortion is to be performed for the longer of
(i) seven years or (ii) the extent required by applicable federal or state law.
D. For
purposes of this section:
"Informed written consent" means the knowing and
voluntary written consent to abortion by a pregnant woman of any age, without
undue inducement or any element of force, fraud, deceit, duress, or other form
of constraint or coercion by the physician who is to perform the abortion or
his agent. The basic information to effect such consent, as required by this
subsection, shall be provided by telephone or in person to the woman at least
24 hours before the abortion by the physician who is to perform the abortion,
by a referring physician, or by a licensed professional or practical nurse
working under the direct supervision of either the physician who is to perform
the abortion or the referring physician; however, the information in
subdivision 5 may be provided instead by a licensed health-care professional
working under the direct supervision of either the physician who is to perform
the abortion or the referring physician. This basic information shall include:
1. A full, reasonable and comprehensible medical explanation
of the nature, benefits, and risks of and alternatives to the proposed
procedures or protocols to be followed in her particular case;
2. An instruction that the woman may withdraw her consent at
any time prior to the performance of the procedure;
3. An offer for the woman to speak with the physician who is
to perform the abortion so that he may answer any questions that the woman may
have and provide further information concerning the procedures and protocols;
4. A statement of the probable gestational age of the fetus at
the time the abortion is to be performed and that fetal ultrasound
imaging shall be performed prior to the abortion to confirm the gestational age;
and
5. An offer to review the printed materials described in
subsection F D.
If the woman chooses to review such materials, they shall be provided to her in
a respectful and understandable manner, without prejudice and intended to give
the woman the opportunity to make an informed choice and shall be provided to
her at least 24 hours before the abortion or mailed to her at least 72 hours
before the abortion by first-class mail or, if the woman requests, by certified
mail, restricted delivery. This offer for the woman to review the material
shall advise her of the following: (i) the Department of Health publishes
printed materials that describe the unborn child and list agencies that offer
alternatives to abortion; (ii) medical assistance benefits may be available for
prenatal care, childbirth and neonatal care, and that more detailed information
on the availability of such assistance is contained in the printed materials
published by the Department; (iii) the father of the unborn child is liable to
assist in the support of her child, even in instances where he has offered to
pay for the abortion, that assistance in the collection of such support is
available, and that more detailed information on the availability of such
assistance is contained in the printed materials published by the Department; and (iv) she has the right to
review the materials printed by the Department and that copies will be provided
to her free of charge if she chooses to review them; and (v) a
statewide list of public and private agencies and services that provide
ultrasound imaging and auscultation of fetal heart tone services free of charge.
Where the woman has advised that the pregnancy is the result of a rape, the
information in clause (iii) may be omitted.
The information required by this subsection may be provided by
telephone or in person without conducting a physical examination of or
tests upon the woman, in which case the information required to be provided may
be based on facts supplied by the woman and whatever other relevant information
is reasonably available to the physician. If a physical examination, tests, or
the availability of other information to the physician or the nurse
subsequently indicates, in the medical judgment of the physician or the nurse,
a revision of the information previously supplied to the woman, that revised
information may be communicated to the woman at any time prior to the
performance of the abortion.
E. C. The
physician need not obtain the informed written consent of the woman when the
abortion is to be performed pursuant to a medical emergency or spontaneous
miscarriage. "Medical emergency" means any 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 a serious
risk of substantial and irreversible impairment of a major bodily function.
F. D. On or
before October 1, 2001, the Department of Health shall publish, in English and
in each language which is the primary language of two percent or more of the
population of the Commonwealth, the following printed materials in such a way
as to ensure that the information is easily comprehensible:
1. Geographically indexed materials designed to inform the
woman of public and private agencies and services available to assist a woman
through pregnancy, upon childbirth and while the child is dependent, including,
but not limited to, information on services relating to (i) adoption as a
positive alternative, (ii) information relative to counseling services,
benefits, financial assistance, medical care and contact persons or groups,
(iii) paternity establishment and child support enforcement, (iv) child
development, (v) child rearing and stress management, and (vi)
pediatric and maternal health care, and (vii)
public and private agencies and services that provide ultrasound imaging and
auscultation of fetal heart tone services free of charge.
The materials shall include a comprehensive list of the names and telephone
numbers of the agencies, or, at the option of the Department of Health, printed
materials including a toll-free, 24-hour-a-day telephone number which may be
called to obtain, orally, such a list and description of agencies in the
locality of the caller and of the services they offer;
2. Materials designed to inform the woman of the probable
anatomical and physiological characteristics of the human fetus at two-week
gestational increments from the time when a woman can be known to be pregnant
to full term, including any relevant information on the possibility of the
fetus's survival and pictures or drawings representing the development of the
human fetus at two-week gestational increments. Such pictures or drawings shall
contain the dimensions of the fetus and shall be realistic and appropriate for
the stage of pregnancy depicted. The materials shall be objective,
nonjudgmental and designed to convey only accurate scientific information about
the human fetus at the various gestational ages; and
3. Materials containing objective information describing the
methods of abortion procedures commonly employed, the medical risks commonly
associated with each such procedure, the possible detrimental psychological
effects of abortion, and the medical risks commonly associated with carrying a
child to term.
The Department of Health shall make these materials available
at each local health department and, upon request, to any person or entity, in
reasonable numbers and without cost to the requesting party.
G. E. Any physician
who fails to comply with the provisions of this section shall be subject to a
$2,500 civil penalty.
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