BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Deborah V. Ortiz, Chair


          BILL NO:       SB 1487                                      
          S
          AUTHOR:        Hollingsworth                                
          B
          AMENDED:       As Introduced 
          HEARING DATE:  April 19, 2006                               
          1
          FISCAL:        Judiciary / Appropriations                   
          4
                                                                      
          8
          CONSULTANT:                                                 
          7
          Vazquez / ak
                                        
                      RECONSIDERATION GRANTED - VOTE ONLY
                                        
                                     SUBJECT
                                         
                                Coerced abortion

                                     SUMMARY  

          This bill would prohibit a physician or surgeon from  
          performing an abortion unless he or she has obtained the  
          written assurance from the patient that she understands  
          that she may not be coerced into having an abortion, and  
          that her decision to have an abortion is voluntary.  The  
          bill would require a signed form to that effect be placed  
          in the patient's chart.  

                                     ABSTRACT  
          
          Existing law: 
          1.The Reproductive Privacy Act, makes a surgical abortion  
            unauthorized unless it complies with provisions of the  
            Medical Practice Act that makes performance of an  
            abortion by a person without a physician and surgeon's  
            certificate subject to the provisions relating to the  
            unauthorized practice of medicine.  Violation of these  
            provisions constitutes unprofessional conduct and is a  
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            crime. 

          This bill: 
          1.Prohibits a physician or surgeon from performing an  
            abortion unless he or she has obtained the written  
            assurance from the patient that she understands that she  
            may not be forced into having an abortion, and that her  
            decision to have an abortion was made voluntarily,  
            without duress or intimidation.  

          2.Requires that the patient's chart contain a copy of a  
            form signed by the patient assuring that the abortion was  
            obtained without force, coercion, or intimidation. 

          3.Specifies that the form shall be in bold capital letters  
            and state: "It is against the law for anyone to force,  
            intimidate, or coerce you into having an abortion." 

          4.States that no reimbursement is required by this act  
            pursuant to the California Constitution.  

                                  FISCAL IMPACT  

          Unknown.  

                            BACKGROUND AND DISCUSSION  

          Purpose of the bill 
          This bill prohibits a physician or surgeon from performing  
          an abortion unless he or she has obtained the written  
          assurance from the patient that she understands that she  
          may not be coerced into having an abortion, and that her  
          decision to have an abortion is voluntary and requires that  
          a signed form to this effect be placed in the patient's  
          chart.  

          The author states that there are everyday cases of coerced  
          abortion, where husbands, boyfriends, or patients insist on  
          abortions.  "Children and women are often at a great  
          disadvantage when it comes to protecting themselves from  
          numerous threats.  Many women do not even know their rights  
          and it is important that women and children understand that  
          they have the right to choose life."  

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          The author further states that the bill does not attempt to  
          prohibit legal abortions, but that it merely prevents a  
          physician from either knowingly or unknowingly influencing  
          a woman's choice.  The author contests that this is a  
          common sense measure that will take steps to guarantee that  
          many women are not preyed upon by disreputable individuals  
          who would take advantage of their condition to manipulate  
          or coerce them as they face an important moral decision. 

          Current law on informed consent 
          Informed consent is a process of education and  
          communication intended to enhance the doctor-patient  
          relationship and prepare the patient for a procedure or  
          treatment.  Under current law, a physician has a duty to  
          obtain the informed consent of a patient before providing  
          or declining to provide complex treatment.  In Cobbs v.  
          Grant,  8 Cal. 3d 229, the California Supreme Court held  
          that it is a requirement "for divulgence by the physician  
          to his patient of all information relevant to a meaningful  
          decisional process," and that, "as an integral part of the  
          physician's overall obligation to the patient there is a  
          duty of reasonable disclosure of the available choices with  
          respect to proposed therapy and of the dangers inherently  
          and potentially involved in each."  There are very few  
          cases where written consent is required by law for a  
          specific treatment, as is the case before a patient  
          receives a hysterectomy or sterilization.  However, many  
          practitioners document the consent process in writing to  
          protect them against liability.  















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          Prior legislation 
          SB 1593 (Hollingsworth) of 2004 sought to require that  
          providers giving an abortion to a Medi-Cal patient obtain  
          specified written assurance from the patient that she  
          understands that she may not be forced into an abortion and  
          that her decision was made voluntarily.  The bill failed  
          passage in the Senate Health and Human Services Committee  
          on April 21, 2004.  AB 2291 (Haynes) of 2004 contained  
          identical language to that in SB 1593 and failed passage in  
          the Assembly Health Committee on April 13, 2004.  

          Arguments in support 
          The California Catholic Conference writes in support of the  
          measure and states that this is a common sense approach to  
          a sensitive issue.  The Conference states that this bill  
          will assist women both in protecting themselves from any  
          coercion to undergo abortion and with one of the most  
          important decisions of their lives without undue pressure  
          from others.  

          Arguments in opposition 
          Opponents state that the California Supreme Court has  
          established the guidelines for informed consent regarding  
          the provider's duty of disclosure in Cobbs v. Grant  .  The  
          American Civil Liberties Union and the American College of  
          Obstetricians and Gynecologists (ACOG), District IX state  
          that if the treatment involves the performance of a complex  
          procedure, a physician must explain the nature of the  
          procedure, the risks, possible complications, and expected  
          effects of the treatment.  The opponents state that failure  
          to obtain informed consent may result in a malpractice  
          charge.  They assert that it is unnecessary and unduly  
          cumbersome to single out a legal and constitutionally  
          protected medical procedure for an additional layer of  
          administrative burden.  

          ACOG argues that patients sign a written document, based on  
          their individual situation, stating that they are giving  
          their consent for the abortion, and it is their choice to  
          have the procedure.  The document is signed by both the  
          physician and her clinician.  Planned Parenthood Affiliates  
          of California states that currently abortion patients must  
          receive "options counseling" prior to receiving an abortion  
          and that this counseling involves the provision of  
          information and a discussion of potential assistance  
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          available for continuing the pregnancy, the possibilities  
          and referrals for adoption, as well as abortion.  

                                    POSITIONS  

          Support:       California Catholic Conference
                         California Family Council
                         Capitol Resource Institute

          Oppose:   American Association of University Women
                         American Civil Liberties Union 
                         American College of Obstetricians and  
          Gynecologists, District IX
                         California Commission on the Status of Women  

                         California Family Health Council
                         California Medical Association 
                         California Women Lawyers
                         Kaiser Permanente Medical Care Program
                         NARAL Pro-Choice California 
                         Planned Parenthood Affiliates of California 
                         Planned Parenthood Mar Monte
                         Planned Parenthood of San Diego and  
          Riverside Counties

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