Louisiana 2011 2011 Regular Session

Louisiana House Bill HB636 Engrossed / Bill

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Regular Session, 2011
HOUSE BILL NO. 636   (Substitute for House Bill No. 586 by Representative Hoffmann)
BY REPRESENTATIVES HOFFMANN, ANDERS, ARNOLD, AUSTIN BADON,
BOBBY BADON, BALDONE, BARRAS, BARROW, BILLIOT, BURFORD,
HENRY BURNS, BURRELL, CARTER, CHAMPAGNE, CHANDLER, CHANEY,
CONNICK, CROMER, DANAHAY, DOVE, DOWNS, EDWARDS, ELLINGTON,
FANNIN, GEYMANN, GISCLAIR, GREENE, GUILLORY, GUINN, HARDY,
HAZEL, HENDERSON, HENRY, HENSGENS, HILL, HINES, HONORE,
HOWARD, HUTTER, JOHNSON, SAM JONES, KATZ, KL ECKLEY,
LABRUZZO, LAMBERT, LANDRY, LEBAS, LIGI, LITTLE, LOPINTO,
LORUSSO, MCVEA, MONICA, NOWLIN, PEARSON, PONTI, POPE, PUGH,
RICHARD, RICHARDSON, RITCHIE, ROBIDEAUX, ROY, SCHRODER,
SEABAUGH, SMILEY, GARY SMITH, JANE SMITH, TALBOT, TEMPLET,
THIBAUT, THIERRY, WHITE, WILLIAMS, AND WILLMOTT
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
ABORTION: Provides requirements for content and delivery of information regarding
abortion in certain medical settings and revises criteria for voluntary and informed
consent to an abortion
AN ACT1
To amend and reenact R.S. 40:1299.35.6, 1299.35.9(A)(1) and (B)(2), and 1299.35.19 and2
to enact R.S. 40:1299.35.1(11) and 1299.35.5.1, relative to abortion; to require3
certain signage in abortion facilities; to provide for certain requirements of the4
Department of Health and Hospitals relative to abortion; to provide for voluntary and5
informed consent criteria; to provide for delivery of certain information under the6
Woman's Right to Know law; to provide relative to conscience in health care7
protection, including provisions relative to living human embryos; to provide for8
penalties; and to provide for related matters.9
Be it enacted by the Legislature of Louisiana:10
Section 1. R.S. 40:1299.35.6, 1299.35.9(A)(1) and (B)(2), and 1299.35.19 are11
hereby amended and reenacted and R.S. 40:1299.35.1(11) and 1299.35.5.1 are hereby12
enacted to read as follows: 13 HLS 11RS-1002	REENGROSSED
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§1299.35.1.  Definitions1
As used in R.S. 40:1299.35.0 through 1299.35.18 1299.35.19, the following2
words have the following meanings:3
*          *          *4
(11)  "Department" means the Department of Health and Hospitals.5
*          *          *6
§1299.35.5.1.  Prevention of forced abortion; signage in abortion facilities7
A.  This Section shall be known and may be cited as the "Forced Abortion8
Prevention Sign Act".9
B. Any outpatient abortion facility licensed by the department shall10
conspicuously post a sign in a location defined in Subsection D of this Section which11
is clearly visible to patients, and which features the text contained in Paragraph (1)12
of this Subsection and the information contained in Paragraph (2) of this Subsection.13
(1)  The sign shall feature the following text:14
"Notice: Women's Rights and Pregnancy Resources15
You can't be forced.16
* It is unlawful for an abortion to be forced on you without your voluntary17
and informed consent, regardless of your age.18
You and the father.19
* The father of your child is liable to assist in the support of the child, even20
if he has offered to pay for an abortion.21
You and adoption.22
*  The law permits adoptive parents to pay costs of prenatal care, childbirth23
and newborn care.24
You are not alone.25
* Many public and private agencies are willing to help you to carry your child26
to term, and to assist after your child's birth."27
(2) The sign shall feature the web address of the pregnancy resources28
website maintained by the department pursuant to R.S. 40:1299.35.6, which shall be29 HLS 11RS-1002	REENGROSSED
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shown on the sign in a large, bold font designed to be clearly visible to patients,1
along with any additional information which is deemed necessary by the department2
and is in accordance with the provisions of R.S. 40:1299.35.6.3
C. The department shall cause the sign provided for in this Section to be4
designed and produced.  All signs produced shall incorporate color graphics and5
shall be printed on durable signage material measuring sixteen inches by twenty6
inches with lettering presented in a size and style of font designed to be clearly7
visible to the patient.8
D. The sign provided for in this Section shall be conspicuously posted in9
each patient admission area, waiting room, and patient consultation room used by10
patients on whom abortions are performed, induced, prescribed for, or who are11
provided with the means for an abortion.12
§1299.35.6.  Woman's Right To Know13
A. Legislative findings and purposes.  The Legislature of Louisiana finds14
that:15
(1) Act No. 435 of the 1978 Regular Session of the Legislature required the16
obtaining of the informed consent of a pregnant woman to the performance of an17
abortion. This law was declared unconstitutional in the cases of Margaret S. v.18
Edwards, and in Margaret S. v. Treen.19
(2) By Act No. 435 of the 1978 Regular Session of the Legislature (R.S.20
40:1299.35.7) a twenty-four-hour waiting period was required between the signing21
of an informed consent and the performance of an abortion. This law was repealed22
by Act No. 418 of the 1980 Regular Session of the Legislature because of the23
decision of the federal court in Margaret S. v. Edwards.24
(3) Subsequent to the above-referenced court decisions and legislative25
enactments, the United States Supreme Court has rendered a decision in the case of26
Planned Parenthood of Pennsylvania v. Casey, which upheld the constitutionality of27
the Pennsylvania law which required informed consent, parental consent, and a28 HLS 11RS-1002	REENGROSSED
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twenty-four-hour waiting period prior to an abortion, and which decision has1
therefore impliedly overruled the decisions in the Margaret S. cases.2
(4) The judicial obstacles to such legislation now having been removed by3
virtue of the Casey decision, the legislature finds that it is in the public interest and4
in furtherance of the general health and welfare of the citizens of this state to reenact5
provisions of law similar to those heretofore either declared unconstitutional or6
repealed for the following reasons:7
(a) It is essential to the psychological and physical well-being of a woman8
considering an abortion that she receive complete and accurate information on9
regarding her alternatives.10
(b) The knowledgable exercise of a woman's decision to have an abortion11
depends on the extent to which the woman receives sufficient information to make12
an informed choice between two alternatives, giving birth or having an abortion.13
(c) The vast majority of all abortions are performed in clinics devoted solely14
to providing abortions and family planning services.  Most women who seek15
abortions at these facilities do not have any relationship with the physician who16
performs the abortion, before or after the procedure.  They do not return to the17
facility for postsurgical care.  In most instances, the woman's only actual contact18
with the physician occurs simultaneously with the abortion procedure, with little19
opportunity to receive counseling concerning her decision.20
(d) The decision to abort "is an important, and often a stressful one, and it21
is desirable and imperative that it be made with full knowledge of its nature and22
consequences", Planned Parenthood v. Danforth.23
(e) "The medical, emotional, and psychological consequences of an abortion24
are serious and can be lasting...", H. L. v. Matheson.25
(f) Abortion facilities or providers offer only limited and/or impersonal26
counseling opportunities.27
(g)  Many abortion facilities or providers hire untrained and unprofessional28
"counselors" whose primary goal is to sell abortion services.29 HLS 11RS-1002	REENGROSSED
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(5)  Based on the above findings, it is the purpose of this Act to:1
(a) Ensure that every woman considering an abortion receive complete2
information on her alternatives and that every woman submitting to an abortion do3
so only after giving her voluntary and informed consent to the abortion procedure.4
(b) Protect unborn children from a woman's uninformed decision to have an5
abortion.6
(c) Reduce "the risk that a woman may elect an abortion only to discover7
later, with devastating psychological consequences, that her decision was not fully8
informed",  Planned Parenthood v. Casey.9
(d) Ensure that every woman considering an abortion receive complete10
information regarding the availability of anesthesia or analgesics that would11
eliminate or alleviate organic pain to the unborn child that could be caused by the12
particular method of abortion to be employed.13
B. Informed consent; requirements. After a woman is determined to be14
pregnant, no abortion shall be performed or induced without the voluntary and15
informed consent of the woman upon whom the abortion is to be performed or16
induced. Except in the case of a medical emergency, consent to an abortion is17
voluntary and informed if and only if	:18
(1) the The provisions of R.S. 40:1299.35.2 requiring an ultrasound test and19
determination of viability are met	, and:.20
(2) The information required by this Section to be communicated orally and21
in person to the woman is provided to her individually and in a private room to22
protect her privacy, for the purpose of ensuring that the information focuses on her23
individual circumstances and that she has an adequate opportunity to ask questions.24
(1) (3) Oral information from the physician. At least twenty-four hours25
before the abortion, the physician who is to perform the abortion or the referring26
physician has informed the woman, orally and in person, of:27
(a)  The name of the physician who will perform the abortion.28 HLS 11RS-1002	REENGROSSED
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(b) A description of the proposed abortion method and of those risks1
(including risks to the woman's reproductive health) and alternatives to the abortion2
that a reasonable patient would consider material to the decision of whether or not3
to undergo the abortion.4
(c) The probable gestational age of the unborn child at the time the abortion5
is to be performed; and, if the unborn child is viable or has reached the gestational6
age of twenty-four weeks and the abortion may be otherwise lawfully performed7
under existing law, that:8
(i)  The unborn child may be able to survive outside the womb.9
(ii) The woman has the right to request the physician to use the method of10
abortion that is most likely to preserve the life of the unborn child.11
(iii) If the unborn child is born alive, that attending physicians have the legal12
obligation to take all reasonable steps necessary to maintain the life and health of the13
child.14
(d) The probable anatomical and physiological characteristics of the unborn15
child at the time the abortion is to be performed.16
(e)  The medical risks associated with carrying her child to term.17
(f) Any need for anti-Rh immune globulin therapy, if she is Rh negative, the18
likely consequences of refusing such therapy, and a good faith estimate of the cost19
of the therapy.20
(g)  The availability of anesthesia or analgesics to alleviate or eliminate21
organic pain to the unborn child that could be caused by the method of abortion to22
be employed.23
(h) The requirement that at least two hours prior to the woman having any24
part of an abortion performed or induced, the physician, referring physician, or25
qualified person working in conjunction with either physician must perform an26
obstetric ultrasound under the provisions of R.S. 40:1299.35.2 for the purpose of27
preserving the woman's health and determining the viability of the unborn child, and28
that neither the physician nor the woman shall be penalized should the woman29 HLS 11RS-1002	REENGROSSED
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choose not to view the obstetric ultrasound images or not to accept the photographic1
print that shall be provided offered to her in a sealed envelope.2
(i) The inclusion in her printed materials of a comprehensive list, compiled3
by the Department of Health and Hospitals department, of facilities that offer4
obstetric ultrasounds free of charge, along with an oral explanation of the provision5
that shall be included on the department's list that if the woman voluntarily chooses6
to obtain free ultrasound services, that ultrasound would likely be in addition to the7
ultrasound required by law for purposes of determining viability and preserving the8
woman's health, unless the free ultrasound is performed by the physician performing9
the abortion, the referring physician, or a qualified person working in conjunction10
with either physician. The list shall be arranged geographically and shall include the11
name, address, hours of operation, and telephone number of each entity.12
(2)(a) (4)  Oral information from a physician or qualified person.13
(a) In the initial contact with an abortion provider by any person seeking to14
schedule an abortion for a minor or adult woman or for herself, whether such initial15
contact is by telephone, by Internet communication, in person, or by any other16
means, the physician who is to perform the abortion or any person acting on behalf17
of the physician informs the person of the Internet address of the department's18
abortion alternatives and informed consent website provided for in this Section.19
(b) At least twenty-four hours before the a scheduled abortion, the physician20
who is to perform the abortion, the referring physician, or a qualified person has21
informed the woman, orally and in person, that:22
(i) Medical assistance benefits may be available for prenatal care, childbirth,23
and neonatal care, and that more detailed information on the availability of such24
assistance is contained on the department's website and in the printed materials25
which shall be given to her and described as provided in this Section.26
(ii) The department's website and printed materials describe the unborn child27
and list agencies which offer alternatives to abortion.28 HLS 11RS-1002	REENGROSSED
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(iii) The father of the unborn child is liable to assist in the support of her1
child, even in instances where he has offered to pay for the abortion. In the case of2
rape, this information may be omitted.3
(iv) She is free to withhold or withdraw her consent to the abortion at any4
time before or during the abortion without affecting her right to future care or5
treatment and without the loss of any state or federally funded benefits to which she6
might otherwise be entitled.7
(b) (c) For purposes of this Paragraph, "qualified person" shall mean an8
agent of the physician who is a psychologist, licensed social worker, licensed9
professional counselor, registered nurse, or physician.10
(3) The information required by this Section is provided to the woman11
individually and in a private room to protect her privacy and maintain the12
confidentiality of her decision, to ensure that the  information focuses on her13
individual circumstances, and that she has an adequate opportunity to ask questions.14
(4) (5) Provision of printed materials. At least twenty-four hours before the15
abortion, the woman is given a copy of the printed materials described in this Section16
by the physician who is to perform the abortion, the referring physician, or a17
qualified person as defined in Subparagraph (2)(b) (4)(c) of this Subsection. If the18
woman is unable to read the materials, they shall be read to her. If the woman asks19
questions concerning any of the information or materials, answers shall be provided20
to her in her own language.  If an interpreter is necessary, the cost of such interpreter21
shall be borne by the state of Louisiana.22
(5) (6) Certification and reporting. The woman certifies in writing on a form23
provided by the Department of Health and Hospitals department, prior to the24
abortion, that the information and materials required to be provided under this25
Section have been provided at least twenty-four hours prior to the abortion.  All26
physicians who perform abortions shall report the total number of certifications27
received monthly to the department.  The department shall make the number of28
certifications received available to the public on an annual basis.29 HLS 11RS-1002	REENGROSSED
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(6) (7) Prior to the performance of the abortion, the physician who is to1
perform the abortion or his agent receives a copy of the written certification required2
by this Section.3
(7) (8) The woman is not required to pay any amount for the abortion4
procedures until the twenty-four-hour period has expired.5
C.(1) Publication of materials abortion alternatives and informed consent6
website.7
(1) The Department of Health and Hospitals department shall cause to be8
published in English, within ninety one hundred twenty days after June 20, 19959
enactment of this Act, and shall update on an annual basis, or as needed, the10
following easily comprehensible printed materials: information on a stable Internet11
website that shall be developed and maintained by the department12
(a) Geographically indexed materials designed to inform the public of the13
inform the woman of public and private agencies and services available to assist a14
woman through pregnancy, upon childbirth, and while her child is dependent,15
including but not limited to adoption agencies. The materials shall include a16
comprehensive list of the agencies, a description of the services they offer, and the17
telephone number and addresses of the agencies, and inform the woman about18
available the following information that shall indicate the agency's or service's19
physical address, telephone number, and web address if available:20
(a) Information about public and private agencies which provide medical21
assistance benefits that may be available for prenatal care, childbirth, and neonatal22
care, and easily comprehensible information on how to apply for such benefits.23
(b)  Public and private pregnancy resource centers that provide information24
and services such as free abortion alternatives counseling, prenatal care, pantry25
services and parenting skills, and that do not refer, counsel, perform, induce,26
prescribe, or provide any means for abortion.27
(c) and Information about the support obligations of the father of a child who28
is born alive and information about the judicial enforcement of child support.29 HLS 11RS-1002	REENGROSSED
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(d) Information on a separate and featured subpage of the department's1
website that lists facilities that provide free obstetric ultrasound services under the2
provisions of R.S. 40:1299.35.2 and this Section.3
(e)  Information on public and private adoption agencies.4
(f) Information on the anatomical and physiological characteristics of the5
unborn child pursuant to the provisions of this Section, including color photographs6
or images consistent with the most current technology depicting the unborn child at7
two-week gestational increments or closer.8
(g) Information describing the various methods of abortion procedures, the9
short-term and long-term medical risks associated with abortion, and the medical10
risks associated with carrying a child to term.11
(h)  Information on the unborn child's ability to experience pain.12
(i) Video clips that convey objective and medically accurate information13
about abortion procedures, abortion risks, abortion alternative resources, and14
medically accurate information on the development of an unborn child. Video clips15
may be produced with the in-house resources of the department, or acquired for no16
cost to the state from third parties if the video is approved by the secretary as17
providing objective and medically accurate information.18
(j) Information that helps women identify unlawful abortion coercion,19
including but not limited to resources or hotlines that a minor or adult woman may20
call if she is experiencing actual or threatened physical abuse or violence, loss of21
employment or employment privileges, loss of eligible social assistance, loss of22
educational scholarship, or loss of legally protected financial support or housing.23
(k) Information to assist minors who are considering abortion, including24
parental consent information, and resources to help minors seek the protection of25
state child welfare services, temporary guardianship, or law enforcement authorities26
to report abuse as defined in Article 603 of the Children's Code.  The information27
designed to assist minors shall also include a link to pregnancy resource centers as28
defined in Subparagraph (1)(b) of this Subsection.29 HLS 11RS-1002	REENGROSSED
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(2) The home page of the department's main website shall feature a button1
or other link which accesses the department's abortion alternatives and informed2
consent website, and the home page of such website shall feature user-friendly3
buttons that link to the information required in this Section. The department shall4
ensure that the materials resources described in this Section are comprehensive and5
user-friendly, and that they do not directly or indirectly promote, exclude, or6
discourage the use of any agency or service described in this Section.7
(3) No information regarding who uses the website shall be collected or8
maintained. The department shall monitor the website to prevent and correct9
tampering and shall immediately notify abortion providers of any change of the10
website address.11
(4) The search capabilities on the department's main website shall ensure that12
entering the term "abortion" yields the website and information required by this13
Section, regardless of how the information is labeled.14
(5) The information on the department's abortion alternatives and informed15
consent website shall be printable.  The printed materials required in Subsection D16
of this Section shall be available to download from the website in a portable17
document format without cost. The download of such information shall not be18
deemed to satisfy the requirements of Subsection B of this Section.19
(6) The department's abortion alternatives and informed consent website20
shall be accessible to the public without requiring registration or use of a user name,21
a password, or any user identification.22
(7) The department's abortion alternatives and informed consent website23
shall have the capability of detecting when it is being accessed by a mobile device24
and shall have the capability of converting to a platform designed to be easily25
viewable on mobile devices.26
(8) If an abortion provider has a website, the abortion provider's Internet27
website home page shall include a prominent link to the department's abortion28
alternatives and informed consent website.29 HLS 11RS-1002	REENGROSSED
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D. Publication of printed materials.  The department shall cause to be1
published, within one hundred twenty days after enactment of this Act and shall2
update on an annual basis or as needed, the following printed materials:3
(1)  The signs provided for in the Forced Abortion Prevention Sign Act.4
(2) A list arranged geographically, including the name, address, hours of5
operation, website address if available, and telephone number of each entity which6
offers obstetric ultrasounds free of charge. The list shall not include any facility that7
counsels, refers, performs, induces, prescribes, or provides any means for abortion.8
(3) A printed booklet that features the web address of the department's9
dedicated pregnancy resource website printed in a bold large typeface. The booklet10
shall contain an outline of the various topics on the website as provided in11
Subsection C of this Section along with an explanation that more detailed12
information can be found at the department's website.  The materials shall also13
contain a separate printed listing of facilities that provide obstetric ultrasound14
services free of charge, as described in Subparagraph (B)(1)(i) of this Section. All15
materials shall include a website address where the required materials can be16
accessed on the Internet. Such website shall be maintained by the Department of17
Health and Hospitals. The printed booklet materials shall state that it is unlawful for18
any individual to coerce a minor or adult woman to undergo an abortion, that any19
physician who performs an abortion upon a woman without her informed consent20
may be liable to her for damages in a civil action at law, and that the law permits21
adoptive parents to pay costs of prenatal care, childbirth, and neonatal care.22
(a) The department's website and printed booklet materials shall include the23
following statements:24
(i) "There are many public and private agencies willing and able to help you25
to carry your child to term, and to assist you and your child after your child is born,26
whether you choose to keep your child or to place her or him for adoption. The state27
of Louisiana strongly urges you to consult an independent physician about the risks28
of abortion to your physical and psychological well-being and to contact them the29 HLS 11RS-1002	REENGROSSED
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resources provided on our website before making a final decision about abortion.1
The law requires that your physician or his agent the abortion provider give you the2
opportunity to call contact agencies like these before you undergo an abortion."3
(ii) "By twenty weeks gestation, the unborn child has the physical structures4
necessary to experience pain.  There is evidence that by twenty weeks gestation5
unborn children seek to evade certain stimuli in a manner which in an infant or an6
adult would be interpreted to be a response to pain.  Anesthesia is routinely7
administered to unborn children who are twenty weeks gestational age or older who8
undergo prenatal surgery."9
(b)  The printed booklet shall include Materials materials that inform the10
pregnant woman of the probable anatomical and physiological characteristics of the11
unborn child at a minimum of two-week gestational increments from fertilization to12
full term, including color pictures or drawings representing photographs or medical13
images consistent with the most current technology depicting the development of14
unborn children at two-week gestational increments, and any relevant information15
on the possibility of the unborn child's survival; provided that any such color pictures16
or drawings photographs or images shall contain the dimensions of the unborn child17
and shall be realistic medically accurate. The materials shall be objective,18
nonjudgmental, and designed to convey only accurate scientific information about19
the unborn child at the various gestational ages. The material shall also contain20
objective information describing the methods of abortion procedures commonly21
employed, the short-term and long-term medical risks commonly associated with22
each such procedure abortion as supported by peer-reviewed medical journals, and23
the medical risks commonly associated with carrying a child to term.24
(4) A certification form to be used by physicians or their agents as provided25
in Paragraph B(5) of this Section, which will list all the items of information which26
are to be given to women by physicians or their agents as required by this Section.27
(2) E. The materials provided for in Subsection D of this Section shall be28
printed in a typeface large enough to be clearly legible	., 29 HLS 11RS-1002	REENGROSSED
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(3) The materials required under this Section and shall be available at no cost1
from the department upon request and in appropriate number to any person, facility,2
or hospital.  The department's abortion alternatives and informed consent website3
shall contain information on ordering printed materials.4
(4) The department shall promulgate rules and regulations relative to the5
appropriate number and methods of reporting at no cost methods of distribution of6
printed materials.7
D. F. Medical emergency.  Where a medical emergency compels the8
performance of an abortion, the physician shall orally inform the woman, before the9
abortion, if possible, of the medical indications supporting his judgment that an10
abortion is necessary to avert her death or to avert substantial and irreversible11
impairment of a major bodily function.  If the informed consent requirements of this12
Section have not been met due to medical emergency, the physician shall employ a13
method of terminating the pregnancy that gives the unborn child the greatest chance14
of survival consistent with protecting the life and physical health of the mother. The15
physician shall record the medical indications supporting the necessity for an16
abortion without informed consent in the patient's medical record, which shall be17
maintained for seven years.18
E. G. Reporting requirements.  Any physician who has provided the19
information and materials to any woman in accordance with the requirements of this20
Section shall provide to the department:21
(1) With respect to a woman upon whom an abortion is performed, all22
information as required by R.S. 40:1299.35.10 as well as the date upon which the23
information and materials required to be provided under this Section were provided,24
as well as an executed copy of the certification form required by Paragraph B(5) of25
this Section.26
(2) With respect to any woman to whom the printed and oral information and27
materials have been provided in accordance with this Section, but upon whom the28
physician has not performed an abortion, the name and address of the facility where29 HLS 11RS-1002	REENGROSSED
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the required information was provided and the information as required by R.S.1
40:1299.35.10(A)(1) and (4) through (18) inclusive, and if executed by the woman,2
a copy of the certification form required by 	Paragraph B(5) of this Section.3
F. H. Criminal penalties.4
(1) Any person who intentionally, knowingly, or recklessly fails to comply5
with all the requirements of this Section shall be subject to the penalties provided in6
R.S. 40:1299.35.18 R.S. 40:1299.35.19.7
(2) No physician shall be guilty of violating this Section if he or she can8
demonstrate, by a preponderance of the evidence, that he or she reasonably believed9
that furnishing the required information would have resulted in a severely adverse10
effect on the physical or mental health of the pregnant woman.11
G. I. Civil penalties.  In addition to whatever remedies are otherwise12
available under the law of this state, failure to comply with the requirements of this13
Section shall:14
(1) Provide a basis for a civil malpractice action.  Any intentional violation15
of this Section shall be admissible in a civil suit as prima facie evidence of a failure16
to obtain an informed consent.  When requested, the court shall allow a woman to17
proceed using solely her initials or a pseudonym and may close any proceedings in18
the case and enter other protective orders to preserve the privacy of the woman upon19
whom the abortion was performed.20
(2) Provide a basis for professional disciplinary action under R.S. 37:126121
et seq.22
(3) Provide a basis for recovery for the woman for the death of her unborn23
child under Louisiana Civil Code Article 2315.2, whether or not the unborn child24
was viable at the time the abortion was performed, or was born alive.25
H. J. Limitation on civil liability.  Any physician who complies with the26
provisions of this Section may not be held civilly liable to his patient for failure to27
obtain informed consent to the abortion under this Section. Any and all other rights28
and remedies are preserved to the patient.29 HLS 11RS-1002	REENGROSSED
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
I. Severability.  The provisions of the Act which originated as House Bill1
No. 2246 of the 1995 Regular Session of the Legislature are declared to be severable,2
and if any provision, word, phrase, or clause of the Act or the application thereof to3
any person shall be held invalid, such invalidity shall not affect the validity of the4
remaining portions of the Act.5
J. K. Construction.6
(1) Nothing in this Section shall be construed as creating or recognizing a7
right to abortion.8
(2)  It is not the intention of this Section to make lawful an abortion that is9
unlawful on June 20, 1995 upon the effective date of this Act, or which later10
becomes unlawful.11
K. Right of intervention.  The author and coauthors who sponsored or12
cosponsored the Act which originated as House Bill No. 2246 of the 1995 Regular13
Session of the Legislature in his or her official standing and capacity shall intervene14
as a matter of right in any case in which the constitutionality of this Section is15
challenged.16
*          *          *17
§1299.35.9.  Conscience in health care protection; definitions18
A.(1)  Any person has the right not to participate in, and no person shall be19
required to participate in any health care service that violates his conscience. to the20
extent that In furtherance of the interest of this state in maintaining the integrity of21
the medical profession so that patient access to health care is not compromised. No,22
no person shall be held civilly or criminally liable, discriminated against, dismissed,23
demoted, or in any way prejudiced or damaged for declining to participate in any24
health care service that violates his conscience.25
*          *          *26
B.  For purposes of this Section:27
*          *          *28 HLS 11RS-1002	REENGROSSED
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are additions.
(2) "Health care service" is limited to abortion, dispensation of abortifacient1
drugs, human embryonic stem cell research, including destruction of any living2
human embryo, human embryo cloning, euthanasia, or physician-assisted suicide.3
*          *          *4
§1299.35.19.  Penalties 5
Whoever violates the provisions of this Part shall be fined not more less than6
one thousand ten thousand dollars per violation, or imprisoned for not more than two7
years, or both.8
Section 2. If any provision or item of this Act, or the application thereof, is held9
invalid, such invalidity shall not affect other provisions, items, or applications of the Act10
which can be given effect without the invalid provision, item, or application and to this end11
the provisions of this Act are hereby declared severable.12
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent.  [R.S. 1:13(B) and 24:177(E)]
Hoffmann	HB No. 636
Abstract: Provides requirements for content and delivery of information regarding abortion
in certain medical settings and revises criteria for voluntary and informed consent
to an abortion.
Proposed law provides for the Forced Abortion Prevention Sign Act.
Proposed law provides that the Forced Abortion Prevention Sign Act applies to any
outpatient abortion facility licensed by the Dept. of Health and Hospitals (DHH).
Proposed law requires such facilities to display signage which provides messages as
specified in proposed law regarding women's rights, forced abortion, fatherhood, and
adoptive parents; and provides the web address for the pregnancy resources website
maintained by the Department of Health and Hospitals (DHH).
Proposed law assigns the duty of designing and producing such signs to DHH.
Proposed law requires that information delivered personally to women per the provisions of
the Woman's Right to Know law be offered in a manner that ensures the woman's privacy,
considers the woman's individual circumstances, and allows the woman to ask questions.
Also provides that except in the case of a medical emergency, this requirement is a condition
for consent to an abortion being voluntary and informed.
Present law provides that at least 24 hours before an abortion, the physician who is to
perform the abortion or the referring physician shall provide, among other printed materials
specified in present law, a list of facilities which offer obstetric ultrasounds free of charge. HLS 11RS-1002	REENGROSSED
HB NO. 636
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
Proposed law requires that such list of facilities offering obstetric ultrasounds free of charge
not include any facility that counsels, refers, performs, induces, prescribes, or provides any
means for abortion.
Proposed law requires that in the initial contact with an abortion provider by any person
seeking to schedule an abortion for a minor or adult woman or for herself, whether such
initial contact is by telephone, by Internet communication, in person, or by any other means,
the physician who is to perform the abortion or any person acting on behalf of the physician
shall inform the person of the address of DHH abortion alternatives and informed consent
website provided for in proposed law. Also provides that except in the case of a medical
emergency, this requirement is a condition for consent to an abortion being voluntary and
informed.
Proposed law requires that at least 24 hours prior to a scheduled abortion, the physician who
is to perform the abortion, the referring physician, or a qualified person inform the woman,
orally and in person, that the DHH website:
(1)May indicate medical assistance benefits available for prenatal care, childbirth, and
neonatal care.
(2)Describes the unborn child and lists agencies which offer alternatives to abortion.
Proposed law provides that except in the case of a medical emergency, the above
requirement concerning indication of information on the DHH website is a condition for
consent to an abortion being voluntary and informed.
Proposed law deletes present law which provides that if an interpreter is necessary to
communicate certain required information to a woman, the cost of such interpreter shall be
borne by the state of La.
Present law requires that for consent to an abortion to be voluntary and informed, the
woman shall certify in writing prior to the abortion on a form provided by DHH that the
information and materials required to be provided under present law have been provided.
Proposed law adds requirement that such certification also indicate that information and
materials required to be provided under proposed law was provided at least 24 hours prior
to the abortion.
Present law requires DHH to publish certain printed materials providing information on
abortion, alternatives to abortion, and the physiology of the unborn child.
Proposed law requires that in addition to printed materials provided for in proposed law,
DHH also publish an abortion alternatives and informed consent website. Also provides that
such website shall:
(1)Be published within 120 days of enactment of 	proposed law.
(2)Provide the informed consent information required by 	proposed law.
(3)Provide information about public and private agencies that provide medical
assistance benefits that may be available for prenatal care, childbirth, and neonatal
care, and easily comprehensible information on how to apply for such benefits.
(4)Provide information about public and private pregnancy resource centers that provide
information and services that may include free abortion alternatives counseling,
prenatal care, pantry services and parenting skills, and that do not refer, counsel,
perform, induce, prescribe, or provide any means for abortion. HLS 11RS-1002	REENGROSSED
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are additions.
(5)Provide information about the support obligations of the father of a child who is born
alive and information about judicial enforcement of child support.
(6)Provide information on a separate and featured subpage of the DHH website that lists
facilities that provide free obstetric ultrasound services under the provisions of
present law and proposed law.
(7)Provide information on public and private adoption agencies.
(8)Provide information on the anatomical and physiological characteristics of the
unborn child, including color photographs or images consistent with the most current
technology depicting the unborn child at two-week gestational increments or closer.
(9)Provide information describing the various methods of abortion procedures, the
short-term and long-term medical risks associated with abortion, and the medical
risks associated with carrying a child to term.
(10)Provide information on the unborn child's ability to experience pain.
(11)Provide video clips that convey objective and medically accurate information about
abortion procedures, abortion risks, abortion alternative resources, and the
development of an unborn child. Also provides that such video clips may be
produced with the in-house resources of DHH, or acquired for no cost to the state
from third parties if the video is approved by the secretary as providing objective and
medically accurate information.
(12)Provide information that helps women identify unlawful abortion coercion, including
but not limited to resources or hotlines that a minor or adult woman may call if she
is experiencing actual or threatened physical abuse or violence, loss of employment
or employment privileges, loss of eligible social assistance, loss of educational
scholarship, or loss of legally protected financial support or housing.
(13)Provide information to assist minors who are considering abortion, including
parental consent information, and resources to help minors seek the protection of
state child welfare services, temporary guardianship, or law enforcement authorities
to report abuse as defined in Article 603 of the Children's Code.  The information
designed to assist minors shall also include a link to pregnancy resource centers as
defined in proposed law.
(14)Provide information on ordering printed materials provided for in proposed law.
Proposed law provides that no information regarding who uses the DHH website required
to be published under proposed law shall be collected or maintained, and that DHH shall
monitor the website to prevent and correct tampering and shall immediately notify abortion
providers of any change of the website address.
Proposed law provides that the search capabilities on the DHH main website shall ensure
that entering the term "abortion" yields the website and information required to be published
under proposed law regardless of how the information is labeled.
Proposed law provides that the information on the DHH website required to be published
under proposed law shall be printable, and must be available to download from the website
in a portable document format without cost.
Proposed law provides that the DHH website required to be published under proposed law
shall be accessible to the public without requiring registration or use of a user name, a
password, or any user identification. HLS 11RS-1002	REENGROSSED
HB NO. 636
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
Proposed law provides that the DHH website required to be published under proposed law
shall have the capability of detecting when it is being accessed by a mobile device and shall
have the capability of converting to a platform designed to be easily viewable on mobile
devices.
Proposed law provides that if an abortion provider has a website, then the home page of such
website must include a prominent link to the DHH website required to be published under
proposed law.
Proposed law provides that within 120 days of enactment of proposed law, DHH shall cause
to be published a printed booklet that features the web address of the DHH website required
to be published under proposed law featured in a bold large typeface.
Proposed law requires that the printed booklet provided for in proposed law include the
following:
(1)Signs required in proposed law providing for the Forced Abortion Prevention Sign
Act.
(2)A list arranged geographically, including the name, address, hours of operation,
website address if available, and telephone number of each entity which offers
obstetric ultrasounds free of charge.  Proposed law requires that this list not include
any facility that counsels, refers, performs, induces, prescribes, or provides any
means for abortion.
(3)An outline of the various topics on the DHH website required to be published under
proposed law along with an explanation that more detailed information can be found
at such website.
(4)Materials that inform the pregnant woman of the probable anatomical and
physiological characteristics of the unborn child at two-week gestational increments
from fertilization to full term, including color photographs or medical images
consistent with the most current technology depicting the development of unborn
children at two-week gestational increments or closer, and any relevant information
on the possibility of the unborn child's survival; however, any such color
photographs or images must contain the dimensions of the unborn child and must be
medically accurate.
Proposed law requires that the DHH website and printed booklet provided for in proposed
law include the following statements:
(1)"There are many public and private agencies willing and able to help you to carry
your child to term, and to assist you and your child after your child is born, whether
you choose to keep your child or to place her or him for adoption. The state of
Louisiana strongly urges you to consult an independent physician about the risks of
abortion to your physical and psychological well-being and to contact the resources
provided on our website before making a final decision about abortion.  The law
requires that the abortion provider give you the opportunity to contact agencies like
these before you undergo an abortion."
(2)"By 20 weeks gestation, the unborn child has the physical structures necessary to
experience pain. There is evidence that by 20 weeks gestation unborn children seek
to evade certain stimuli in a manner which in an infant or an adult would be
interpreted to be a response to pain. Anesthesia is routinely administered to unborn
children who are twenty weeks gestational age or older who undergo prenatal
surgery." HLS 11RS-1002	REENGROSSED
HB NO. 636
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.
Proposed law requires that the printed materials provided for in proposed law be objective,
nonjudgmental, and designed to convey only accurate scientific information about the
unborn child at the various gestational ages.
Proposed law requires that the printed materials provided for in proposed law contain
objective information describing the methods of abortion procedures and the short-term and
long-term medical risks associated with abortion, including the possible increased risk of
breast cancer associated with the loss of protective effect of a first full-term pregnancy and
any independent risk as supported by peer-reviewed medical journals, and the medical risks
associated with carrying a child to term.
Proposed law requires that the printed materials provided for in proposed law be available
at no cost from DHH upon request and in appropriate number to any person, facility, or
hospital.
Proposed law provides that DHH shall promulgate rules and regulations relative to the
methods of distribution of printed materials.
Proposed law provides that if the informed consent to abortion requirements of proposed law
have not been met due to medical emergency, the physician shall employ a method of
terminating the pregnancy that gives the unborn child the greatest chance of survival
consistent with protecting the life and physical health of the mother.  Also provides that in
such cases the physician shall record the medical indications supporting the necessity for an
abortion without informed consent in the patient's medical record, which shall be maintained
for seven years.
Proposed law deletes present law providing that no physician shall be guilty of violating
informed consent to abortion requirements if he or she can demonstrate, by a preponderance
of the evidence, that he or she reasonably believed that furnishing the required information
would have resulted in a severely adverse effect on the physical or mental health of the
pregnant woman.
Proposed law provides that it is not the intention of proposed law to make lawful an abortion
that is unlawful upon the effective date of proposed law, or which later becomes unlawful.
Present law provides that no person shall be required to participate in any health care service,
as defined in present law (R.S. 40:1299.35.9(B)(2)), that violates his conscience to the extent
that patient access to health care is not compromised.
Proposed law changes present law providing for conscience in health care protection,
deleting an exception relative to compromise of patient access to health care.  Proposed law
provides unconditionally that a person shall not be required to participate in any health care
service, as defined in present law (R.S. 40:1299.35.9(B)(2)), that violates his conscience.
Proposed law provides that the intent of present law relative to conscience in health care
protection is to further the interest of this state in maintaining the integrity of the medical
profession.
Proposed law provides that for the purposes of proposed law, "human embryonic stem cell
research" includes destruction of any living human embryo.
Present law provides that whoever violates the provisions of present law relative to abortion
shall be fined not more than $1,000, or imprisoned for not more than two years, or both.
Proposed law retains imprisonment penalty provided in present law and changes fine from
not more than $1,000 to not less than $10,000 per violation. HLS 11RS-1002	REENGROSSED
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are additions.
Proposed law provides that the sanctions and actions prescribed in proposed law shall not
displace any other applicable sanction provided by law.
Proposed law provides that its provisions shall be severable.
(Amends R.S. 40:1299.35.6, 1299.35.9(A)(1) and (B)(2), and 1299.35.19; Adds R.S.
40:1299.35.1(11) and 1299.35.5.1)
Summary of Amendments Adopted by House
House Floor Amendments to the engrossed  bill.
1. Changed a specification for the sign from requiring that the sign measure at least
16 inches by 20 inches to requiring that the sign measure 16 inches by 20 inches.
2. Added provision for the posting of the sign requiring that the sign be
conspicuously posted in the areas specified in proposed law.
3. Deleted provision of proposed law requiring that information produced and
disseminated by DHH on medical risks associated with abortion include mention
of a possible increased risk of breast cancer.
4. Added language providing for conscience in health care protection (R.S.
40:1299.35.9) stating that the intent of such conscience provisions is to further
the interest of this state in maintaining the integrity of the medical profession.
5. Made technical changes.