By: Patrick, et al.  S.B. No. 16
         (In the Senate - Filed January 14, 2011; January 31, 2011,
  read first time and referred to Committee on State Affairs;
  February 14, 2011, reported adversely, with favorable Committee
  Substitute by the following vote:  Yeas 7, Nays 2;
  February 14, 2011, sent to printer.)
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 16 By:  Deuell
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to informed consent to an abortion.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 171.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 171.002.  DEFINITIONS [DEFINITION].  In this chapter:
               (1)  "Abortion"[, "abortion"] means the use of any
  means to terminate the pregnancy of a female known by the attending
  physician to be pregnant with the intention that the termination of
  the pregnancy by those means will, with reasonable likelihood,
  cause the death of the fetus.
               (2)  "Medical emergency" means a condition exists that,
  in a physician's good faith clinical judgment, complicates the
  medical condition of the pregnant woman and necessitates the
  immediate abortion of her pregnancy to avert her death or to avoid a
  serious risk of substantial impairment of a major bodily function.
         SECTION 2.  Subsections (a), (b), and (c), Section 171.012,
  Health and Safety Code, are amended to read as follows:
         (a)  Consent [Except in the case of a medical emergency,
  consent] to an abortion is voluntary and informed only if:
               (1)  the physician who is to perform the abortion [or
  the referring physician] informs the pregnant woman on whom the
  abortion is to be performed of:
                     (A)  the physician's name [of the physician who
  will perform the abortion];
                     (B)  the particular medical risks associated with
  the particular abortion procedure to be employed, including, when
  medically accurate:
                           (i)  the risks of infection and hemorrhage;
                           (ii)  the potential danger to a subsequent
  pregnancy and of infertility; and
                           (iii)  the possibility of increased risk of
  breast cancer following an induced abortion and the natural
  protective effect of a completed pregnancy in avoiding breast
  cancer;
                     (C)  the probable gestational age of the unborn
  child at the time the abortion is to be performed; and
                     (D)  the medical risks associated with carrying
  the child to term;
               (2)  the physician who is to perform the abortion or the
  physician's agent informs the pregnant woman that:
                     (A)  medical assistance benefits may be available
  for prenatal care, childbirth, and neonatal care;
                     (B)  the father is liable for assistance in the
  support of the child without regard to whether the father has
  offered to pay for the abortion; and
                     (C)  public and private agencies provide
  pregnancy prevention counseling and medical referrals for
  obtaining pregnancy prevention medications or devices, including
  emergency contraception for victims of rape or incest; [and]
               (3)  the physician who is to perform the abortion or the
  physician's agent:
                     (A)  provides [(D)]  the pregnant woman with [has
  the right to review] the printed materials described by Section
  171.014; and
                     (B)  informs the pregnant woman[,] that those
  materials:
                           (i)  have been provided by the [Texas]
  Department of State Health Services;
                           (ii) [and]  are accessible on an Internet
  website sponsored by the department;
                           (iii) [, and that the materials]  describe
  the unborn child and list agencies that offer alternatives to
  abortion; and
                           (iv)  include a list of agencies that offer
  sonogram services at no cost to the pregnant woman;
               (4)  at least 24 hours before the abortion:
                     (A)  the physician who is to perform the abortion
  or an agent of the physician who is also a sonographer certified by
  a national registry of medical sonographers performs a sonogram on
  the pregnant woman on whom the abortion is to be performed;
                     (B)  the physician who is to perform the abortion
  displays the sonogram images in a quality consistent with current
  medical practice in a manner that the pregnant woman may view them;
                     (C)  the physician who is to perform the abortion
  provides, in a manner understandable to a layperson, a verbal
  explanation of the results of the sonogram images, including a
  medical description of the dimensions of the embryo or fetus, the
  presence of cardiac activity, and the presence of external members
  and internal organs; and
                     (D)  makes audible the heart auscultation for the
  pregnant woman to hear, if present, in a quality consistent with
  current medical practice and provides, in a manner understandable
  to a layperson, a simultaneous verbal explanation of the heart
  auscultation;
               (5) [(3)]  the pregnant woman certifies in a signed,
  written statement [writing] before the abortion is performed that:
                     (A)  the information and the printed materials 
  described by Subdivisions (1), [and] (2), and (3) have [has] been
  provided and explained to her [and that she has been informed of her
  opportunity to review the information described by Section
  171.014];
                     (B)  she has been provided with and has had the
  opportunity to review the sonogram images and hear the heart
  auscultation required by Subdivision (4); and
                     (C)  she understands the nature and consequences
  of an abortion;
               (6) [(4)]  before the abortion is performed, the
  physician who is to perform the abortion receives a copy of the
  signed, written certification required by Subdivision (5); and
               (7)  the pregnant woman is provided the name of each
  person who provides or explains the information required under this
  subsection [(3)].
         (b)  The information required to be provided under
  Subsections (a)(1) and (2) may not be provided by audio or video
  recording and must be provided:
               (1)  orally and [by telephone or] in person; and
               (2)  at least 24 hours before the abortion is to be
  performed.
         (c)  When providing the information under Subsection (a)(3) 
  [(a)(2)(D)], the physician or the physician's agent must provide
  the pregnant woman with the address of the Internet website on which
  the printed materials described by Section 171.014 may be viewed as
  required by Section 171.014(e).
         SECTION 3.  Subchapter B, Chapter 171, Health and Safety
  Code, is amended by adding Sections 171.0121 and 171.0122 to read as
  follows:
         Sec. 171.0121.  VIEWING PRINTED MATERIALS AND SONOGRAM
  IMAGE; HEARING HEART AUSCULTATION OR VERBAL EXPLANATION. (a)  A
  pregnant woman may choose not to view the printed materials
  provided under Section 171.012(a)(3) after she has been provided
  the materials.
         (b)  A pregnant woman may choose not to view the sonogram
  images required to be provided to and reviewed with the pregnant
  woman under Section 171.012(a)(4).
         (c)  A pregnant woman may choose not to hear the heart
  auscultation required to be provided to and reviewed with the
  pregnant woman under Section 171.012(a)(4).
         (d)  A pregnant woman may choose not to receive the verbal
  explanation of the results of the sonogram images under Section
  171.012(a)(4)(C) if:
               (1)  the woman's pregnancy is a result of a sexual
  assault, as defined by Section 22.011, Penal Code, that has been
  reported to law enforcement authorities;
               (2)  the woman's pregnancy is a result of incest; or
               (3)  the fetus has an irreversible medical condition or
  abnormality, as previously identified by reliable diagnostic
  procedures and documented in the woman's medical file.
         (e)  The physician and the pregnant woman are not subject to
  a penalty under this chapter solely because the pregnant woman
  chooses not to view the printed materials or the sonogram images,
  hear the heart auscultation, or receive the verbal explanation, as
  described by this section.
         Sec. 171.0122.  EXCEPTION FOR MEDICAL EMERGENCY. A
  physician may perform an abortion without obtaining informed
  consent under this subchapter in a medical emergency.  A physician
  who performs an abortion in a medical emergency shall:
               (1)  include in the patient's medical records a
  statement signed by the physician certifying the nature of the
  medical emergency; and
               (2)  not later than the 30th day after the date the
  abortion is performed, certify to the Department of State Health
  Services the specific medical condition that constituted the
  emergency.
         SECTION 4.  Subsection (a), Section 171.013, Health and
  Safety Code, is amended to read as follows:
         (a)  The [If the woman chooses to view the materials
  described by Section 171.014, the] physician or the physician's
  agent shall furnish copies of the materials described by Section
  171.014 to the pregnant woman [her] at least 24 hours before the
  abortion is to be performed and shall direct the pregnant woman to
  the Internet website required to be published under Section
  171.014(e). The [A] physician or the physician's agent may furnish
  the materials to the pregnant woman by mail if the materials are
  mailed, restricted delivery to addressee, at least 72 hours before
  the abortion is to be performed.
         SECTION 5.  Section 171.015, Health and Safety Code, is
  amended to read as follows:
         Sec. 171.015.  INFORMATION RELATING TO PUBLIC AND PRIVATE
  AGENCIES.  The informational materials must include [either]:
               (1)  geographically indexed materials designed to
  inform the pregnant woman of public and private agencies and
  services that:
                     (A)  are available to assist a woman through
  pregnancy, childbirth, and the child's dependency, including:
                           (i)  a comprehensive list of adoption
  agencies;
                           (ii)  a description of the services the
  adoption agencies offer; [and]
                           (iii)  a description of the manner,
  including telephone numbers, in which an adoption agency may be
  contacted; and
                           (iv)  a comprehensive list of agencies and
  organizations that offer sonogram services at no cost to the
  pregnant woman;
                     (B)  do not provide abortions or abortion-related
  services or make referrals to abortion providers; and
                     (C)  are not affiliated with organizations that
  provide abortions or abortion-related services or make referrals to
  abortion providers; and [or]
               (2)  a toll-free, 24-hour telephone number that may be
  called to obtain an oral list and description of agencies described
  by Subdivision (1) that are located near the caller and of the
  services the agencies offer.
         SECTION 6.  Subsection (a), Section 164.055, Occupations
  Code, is amended to read as follows:
         (a)  The board may take an appropriate disciplinary action
  against a physician who violates Section 170.002 or Chapter 171,
  Health and Safety Code. The board may refuse to admit to
  examination or refuse to issue a license or renewal license to a
  person who violates that section or chapter.
         SECTION 7.  The purposes of this Act include, but are not
  limited to:
               (1)  protecting the physical and psychological health
  and well-being of pregnant women;
               (2)  providing pregnant women access to information
  that would allow her to consider the impact an abortion would have
  on her unborn child; and
               (3)  protecting the integrity and ethical standards of
  the medical profession.
         SECTION 8.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution.  If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2011.
 
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