BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2512
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          Date of Hearing:   April 25, 2006

                            ASSEMBLY COMMITTEE ON HEALTH
                                  Wilma Chan, Chair
                 AB 2512 (Runner) - As Introduced:  February 23, 2006
           
          SUBJECT  :   Fetal pain prevention.

           SUMMARY  :   Enacts the Unborn Child Pain Awareness Act of 2006.   
          Specifically,  this bill  :  

          1)Contains a number of findings and declarations related to  
            fetal pain, abortion methods, the federal Humane Slaughter Act  
            of 1958, the federal Animal Welfare Act, and the federal  
            Public Health Service Act.

          2)Defines "abortion" as the intentional use or prescription of  
            any instrument, medicine, drug, or any other substance or  
            device to terminate the pregnancy of a woman known to be  
            pregnant with an intention 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.

          3)Defines "abortion provider" as any person legally qualified to  
            perform an abortion under applicable federal and state laws.

          4)Defines "pain-capable unborn child" as an unborn child who has  
            reached a probable stage of development of 20 weeks after  
            fertilization.  Prohibits this bill from being construed as a  
            determination or finding by the Legislature that pain may not  
            in fact be experienced by an unborn child at stages of  
            development prior to 20 weeks after fertilization.

          5)Defines "probable age of development" as the duration of  
            development after fertilization of the unborn child at the  
            time an abortion is performed, as determined in the good faith  
            judgment of the abortion provider on the basis of examination  
            of the unborn child using ultrasound or other imaging  
            technology, in addition to information obtained by  
            interviewing the pregnant woman.

          6)Defines "unborn child" as a member of the species homo  
            sapiens, at any stage of development, who is carried in the  
            womb.









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          7)Defines "medical emergency" as a condition which, in the  
            reasonable medical judgment of the abortion provider, so  
            complicates the medical condition of the pregnant woman that a  
            delay in commencing an abortion procedure would impose a  
            serious risk of causing grave and irreversible physical health  
            damage entailing substantial impairment of a major bodily  
            function.

          8)Defines "reasonable medical judgment" as a medical judgment  
            that would be made by a reasonably prudent physician,  
            knowledgeable about the case and the treatment possibilities  
            with respect to the medical conditions involved.

          9)Prohibits an abortion provider performing any abortion, of a  
            pain-capable unborn child, from complying with the  
            requirements of this bill.

          10)Requires the abortion provider or his or her agent, before  
            any part of an abortion involving a pain-capable unborn child  
            begins and by telephone or in person, to:

             a)   Make an oral statement, as specified, to the pregnant  
               woman, or in the case of a deaf or non-English speaking  
               woman, provide the statement in a manner that she can  
               easily understand.  Permits the abortion provider, after  
               making the statement, to provide the woman involved with  
               his or her best medical judgment on the risks of  
               administering the anesthesia or analgesic, if any, and the  
               associated costs.

             b)   If the abortion provider is not qualified or willing to  
               administer anesthesia or other pain-reducing drug, arrange  
               for a qualified specialist to administer or advise the  
               pregnant woman of in response to the request;  advise the  
               woman where she may obtain the anesthesia or other  
               pain-reducing drugs for the unborn child in the course of  
               an abortion; or, advise the woman that the abortion  
               provider is unable to perform the abortion if the woman  
               elects to receive anesthesia or other pain-reducing drug  
               for her unborn child.

             c)   Provide the pregnant woman with the Unborn Child Pain  
               Awareness Brochure developed by the Department of Health  
               Services (DHS) pursuant to this bill and provide  
               information on accessing the brochure on the department's  








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               Web site, as specified.

             d)   Provide the pregnant woman with the Unborn Child Pain  
               Awareness Decision Form developed by DHS pursuant to this  
               bill and obtain the appropriate signature of the woman on  
               the form.

          11)Requires DHS, by April 1, 2007, to develop an Unborn Child  
            Pain Awareness Brochure, to be written in English and Spanish  
            and contain the same information as required under the  
            statement specified in a) above, including greater detail on  
            her option of having a pain-reducing drug or drugs  
            administered to the unborn child to reduce the experience of  
            pain by the unborn child during the abortion.

          12)Requires the information to be written in an objective and  
            nonjudgmental manner and be printed in a typeface large enough  
            to be clearly legible.  Requires the brochure to be made  
            available by DHS at no cost to any abortion provider.

          13)Requires the brochure to be available on the Web site of the  
            department at a minimum resolution of 70 dots per inch.   
            Requires all pictures appearing on the Web site to be a  
            minimum of 200x300 pixels and all letters to be a minimum of  
            12 point font.  Requires all the information and pictures to  
            be accessible with an industry standard browser, requiring no  
            additional plug-ins.

          14)Requires an abortion provider or his or her agent to offer to  
            provide a pregnant woman with the brochure, before any part of  
            an abortion of a pain-capable unborn child begins through an  
            in-person visit by the pregnant woman, an e-mail attachment,  
            from the abortion provider or his or her agent, or a request  
            to have the brochure mailed, by certified mail, to the woman  
            at least 72 hours before any part of the abortion begins.

          15)Requires DHS, by March 2, 2007, to develop an Unborn Child  
            Pain Awareness Decision Form.

          16)Permits a pregnant woman, after the abortion provider or his  
            or her agent offers to provide a pregnant woman the brochure,  
            to waive receipt of the brochure by signing the waiver form  
            contained in the Unborn Child Pain Awareness Decision Form.

          17)Requires the form, to be valid and with respect to the  








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            pregnant woman, to: contain a statement that affirms that the  
            woman has received or been offered all of the information  
            required in this bill; require the woman to explicitly either  
            request or refuse the administration of pain-reducing drugs to  
            the unborn child; and be signed by a pregnant woman prior to  
            the performance of an abortion involving a pain-capable unborn  
            child.

          18)Requires the form, to be valid and with respect to the  
            abortion provider, to: contain a statement that the provider  
            has provided the woman with all of the information required  
            under this bill; contain, if applicable, a certification by  
            the provider that an exception described in this bill applies  
            and the detailed reasons for the certification; and, be signed  
            by the provider prior to the performance of the abortion  
            procedure.

          19)Requires DHS to adopt regulations relating to the period of  
            time during which copies of the forms under this subdivision  
            are required to be maintained by abortion providers.

          20)Prohibits anything in this bill from being construed to  
            impede an abortion provider or the abortion provider's agent  
            from offering their own evaluation on the capacity of the  
            unborn child to experience pain, the advisability of  
            administering pain-reducing drugs to the unborn child, or any  
            other matter, as long as the provider or agent provides the  
            required information, obtains the woman's signature on the  
            decision form, and otherwise complies with the affirmative  
            requirements of the law.

          21)Prohibits the notice and advisement requirements of this bill  
            from applying to an abortion provider in the case of a medical  
            emergency.

          22)Requires the abortion provider, upon his or her determination  
            that a medical emergency exists with respect to a pregnant  
            woman, to certify the specific medical conditions that  
            constitutes the emergency.

          23)Requires an abortion provider who willfully falsifies a  
            certification of emergency to be subject to all the penalties  
            for violation of this bill.

          24)Requires an abortion provider who willfully violates this  








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            bill to be subject to civil penalties in a civil action  
            commenced by the Attorney General (AG) in accordance with this  
            bill in an appropriate court.  Permits the AG to commence a  
            civil action under this bill.

          25)Requires the AG, at the time of the commencement of an action  
            under this bill, to certify to the court involved that, at  
            least 30 calendar days prior to the filing of the action, the  
            AG has:

             a)   Provided notice of the alleged violation of this bill,  
               in writing, to the district attorney who has jurisdiction,  
               the California Medical Board, and DHS; and,

             b)   Believes that the action by the State of California is  
               in the public interest and necessary to secure substantial  
               justice.

          26)Permits the California Medical Board, with respect to an  
            action under this article, to hold a hearing to determine the  
            penalty to be imposed under this bill.

          27)Permits a woman upon whom an abortion has been performed in  
            violation of this article, or the parent or legal guardian of  
            the woman if she is an unemancipated minor, to commence a  
            civil action against the abortion provider for any knowing or  
            reckless violation of this article for actual and punitive  
            damages.

          28)Requires the California Medical Board, in consultation with  
            DHS, to adopt regulations and procedures for the revocation or  
            suspension of the medical license of an abortion provider upon  
            a finding by a court that the provider has violated this bill.

           EXISTING LAW  :

          1)Provides for the performance of abortions under the  
            Therapeutic Abortion Act by licensed physicians or surgeons. 

          2)Requires physicians and surgeons to obtain written consent  
            from patients prior to various procedures and treatments, not  
            including abortion. 

           FISCAL EFFECT  :   Unknown









                                                                  AB 2512
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           COMMENTS  :   

           1)PURPOSE OF THIS BILL  .  According to the author, there is  
            substantial evidence that an unborn child has the physical  
            structure necessary to experience pain 20 weeks after  
            fertilization.  There is no specification for the  
            administration of anesthesia to unborn children when they are  
            aborted 20 weeks after fertilization.  Because of the nature  
            of the abortion procedure, it is apparent that it causes pain  
            to the unborn child in absence of any anesthesia.  One  
            procedure, the dilation and evacuation method, uses a clamp to  
            grasp the unborn child's body parts at random and pull them  
            out, finishing with the head after it is crushed.  In order to  
            prevent the pain suffered by an unborn child in an abortion  
            procedure, it is vital to provide women undergoing an abortion  
            with the option of anesthesia.  For this reason current law  
            protects these children from experiencing pain in prenatal  
            surgery by injecting the unborn child with anesthesia. 

           2)PREVIOUS LEGISLATION  .  In 2004, AB 2331 (Mountjoy) would have  
            required a physician performing an abortion in the 3rd  
            trimester of pregnancy to offer to the pregnant woman  
            information and counseling on fetal pain and offer to the  
            pregnant woman anesthesia for the fetus.  AB 2331 would have  
            also required the physician to arrange for anesthesia to be  
            administered if the pregnant woman voluntarily consents to  
            administration of anesthesia for the fetus and would have  
            required the pregnant woman to sign a document that  
            information and counseling on fetal pain was provided and that  
            the physician offered anesthesia for the fetus.  AB 2331  
            failed passage in the Assembly Committee on Health by a vote  
            of 4-14.  In 1997, AB 1758 (Runner) contained the exact  
            language found in AB 2331 and failed passage in the Assembly  
            Committee on Health by a vote of 8-11.  

           3)TECHNICAL AMENDMENTS  .  

             a)   On page 9, line 30: delete "appropriate" and on line 31  
               delete "be heard at" and insert "hold"
             b)   On page 9, lines 26, 31, and 39 should read "Medical  
               Board of California" rather than "California Medical Board"

           4)DOUBLE REFERRAL  .  This bill is double referred. Should it pass  
            out of this Committee, it will be heard in the Assembly  
            Committee on Judiciary.








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           5)SUPPORT  .  The California Catholic Conference writes that this  
            bill exhibits both compassion and common sense.  Capitol  
            Resource Institute states that it has been well documented  
            that unborn children experience pain, among other emotions,  
            during abortion and when making a choice, women deserve to  
            have all the facts so they can make an informed choice.  The  
            California Family Alliance writes that this bill makes the  
            valid point that current laws protect animals from pain and  
            that unborn children deserve no less compassion. 
           
          6)OPPOSITION  .  The American College of Obstetricians and  
            Gynecologists (ACOG), District IX, asserts that just over 1%  
            of all abortions occur after 20 weeks gestation and many of  
            these abortions occur for highly unusual circumstances such as  
            a severe fetal anomaly and/or lack of viability or the health  
            or life of the mother.  ACOG also writes that informed consent  
            is a unique and personalized process between the physician and  
            the patient, where all aspects of the procedure are discussed,  
            including risks, alternatives and anesthesia and that the  
            mandated discussion and treatment outlined in this bill are  
            inappropriate intrusions into the practice of medicine.   
            Finally, ACOG contends that there are factual and medical  
            inaccuracies throughout this bill, such as defining a 20-week  
            fetus as a "pain-capable unborn child."  The California  
            Medical Association writes that this bill is a troubling  
            governmental intrusion into the physician-patient  
            relationship, even delineating the exact words a physician  
            must say to his or her patient.  The California Family Health  
            Council contends that the mandated discussion and treatment  
            options as outlined in this bill are inappropriate intrusions  
            into the practice of medicine.  Planned Parenthood Affiliates  
            of California opposes this bill because it is not based on  
            conclusive medical evidence, it does not take into account  
            women's health, and it tries to set legal precedent by  
            recognizing in statute the term "unborn child."  Planned  
            Parenthood Golden Gate asserts that this bill puts political  
            philosophy before sciences and is a shameless attack on women  
            who are already making a difficult choice. American  
            Association of University Women writes that the mandated  
            script required in this bill intrudes upon a woman's  
            relationship with her physician and ignores her needs and  
            circumstances with misinformation.

           REGISTERED SUPPORT / OPPOSITION  :   








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           Support 
           
          California Catholic Conference 
          California Family Alliance
          California Family Council
          Capitol Resource Institute

           Opposition 
           
          American Association of University Women
          American College of Obstetricians and Gynecologists, District IX
          California Family Health Council
          California Medical Association
          California National Organization for Women
          California Women Lawyers
          National Association of Social Workers, California Chapter
          Planned Parenthood Affiliates of California
          Planned Parenthood Golden Gate

           
          Analysis Prepared by  :    Melanie Moreno / HEALTH / (916)  
          319-2097