Table of Contents

 

2007 State Legislative Sessions in Review

 

by Denise M. Burke

Vice President & Legal Director

 

Introduction

In 2007, the overall level of legislative activity was fairly consistent with that seen in 2006, but significantly less than levels seen in 2004 and 2005. There was a greater than 50% increase in abortion-related bills, but there was also a nearly 50% decline in legislation related to biotechnologies.

 

Oklahoma emerged as the most improved state, enacting an omnibus measure that, among other things, amended its definition of "medical emergency" as applied to abortions; funded crisis pregnancy centers (CPCs); prohibited the use of public funds for abortion counseling and the use of public facilities for abortions; strengthened its parental consent law; and instituted a comprehensive system of abortion reporting.

 

Arkansas, Louisiana and Missouri also had very successful legislative sessions, enacting a number of measures designed to protect and defend human life.

 

Conversely, New York emerged as the most notable threat to the sanctity of life. At the instigation of Governor Spitzer, New York lawmakers introduced a state version of the Freedom of Choice Act or FOCA (that would enshrine abortion-on-demand in NY law and overturn any existing protection for women and the unborn). New York lawmakers also considered measures that would violate the rights of conscience of healthcare providers; force hospitals to train certain residents in abortion; target CPCs for hostile state oversight; force clinics at state universities to provide "emergency contraception"; and fund destructive embryo research.

 

In 2007, "usual suspects" like California and New Jersey continued their pursuit of anti-life agendas, while threats also surfaced in normally pro-life states like Kansas, where the Governor Sebelius continued to thwart efforts by legislators to limit late-term abortions and subject the practice of notorious abortionist George Tiller to meaningful oversight.

 

Nearly 900 life-related measures were considered by the states in 2007, reaffirming the importance of the states in re-establishing a culture of life in America and in the coming state-by-state battle after Roe v. Wade is overturned.

 

This year, 44 pro-life laws were enacted (as compared to 34 in 2006) and 2 pro-life laws were vetoed (as compared to 11 vetoes in 2006). Conversely, 14 anti-life measures were enacted (as compared to 7 in 2006).1

 

The following is a more detailed summary of this year"s state legislative activity:

 

 

 

Overall Trends and Analysis

 

 

Abortion

Approximately 400 bills related to abortion were considered by the states in 2007, a more than 50% increase from 2006.

 

Amendments to General Abortion Statutes

Definition of "Abortion":
OK3 enacted an omnibus measure that, among many reforms, changed the definition of "abortion" to include the use of abortifacients (e.g. RU-486, so called "medical abortions"). At least three other states considered similar measures.

 

Definition of "Medical Emergency":
Two states, MO and OK, amended the definition of "medical emergency" as applied to all their abortion-related laws, narrowing the exception.

 

In MO4 , the exception now applies to situations where the woman"s life or a "major bodily function" is at risk.

 

Meanwhile, in OK, the enacted measure eliminated a "mental health" exception and now allows exceptions only in cases where a physical condition could cause major impairment of a bodily function or death.

 

Abortion Bans/Constitutional Amendments

At least, 27 measures seeking to ban abortions were introduced in 20 states including AL, CO, FL, GA, HI, IL, IA, LA, MA, MI, MS, MO, NJ, ND, SD, TX, UT, VA, WI, and WV.

 

Delayed Enforcement Law ("Trigger Laws"):
Several states including MS, ND, SD, UT, VA, and WV introduced measures to ban abortion should Roe v. Wade be overturned.

 

MS enacted a measure that would ban abortion except in cases of life endangerment or rape if Roe v. Wade is overturned.

 

ND enacted a measure that would make performing an abortion a felony if Roe v. Wade is overturned. Although the measure does not purport to include any exceptions, it would explicitly permit a physician to avoid conviction if the procedure is performed because the woman"s life was endangered or if the pregnancy was the result of rape or incest.

 

Additionally, similar measures in SD, UT, and VA passed one chamber of the legislature.

 

Partial Birth Abortion:
At least 9 states including IA, LA, MI, MO, UT, and WI considered bans on partial birth abortion. Many of these measures were introduced and debated in the wake of the U.S. Supreme Court"s decision in Gonzales v. Carhart and contained language virtually identical to the federal law.

 

LA enacted a state ban on partial birth abortion, banning the same procedure as proscribed in the federal law. The measure provides that the banned procedure can only be used when necessary to save the life of the woman and creates civil cause of action for violations of the ban. Notably, the measure contains more stringent criminal penalties than the federal law and would impose a sentence of hard labor or imprisonment of 1-10 years; a fine of $10,000-$100,000; or both on any person who knowingly performs the banned abortion procedure.

 

Late-term and Post-Viability Bans:
Several states including FL, HI, IL, ND, and WV considered measures banning abortions after the first trimester (or post-viability in some cases).

 

Bans on Sex Selection:
WV considered a measure prohibiting abortions for "gender selection."

 

Constitutional Amendments:
GA considered a constitutional amendment declaring that life begins at conception. Meanwhile, at least 6 states, including KY, MN, MS, NJ, TN, and WV, considered constitutional amendments establishing that the state constitution does not provide a right to abortion.

 

Abortion Clinic Regulations

At least 15 states considered measures regulating abortion facilities including FL, HI, IL, IN, MA, MS, MO, NY, OR, SC, SD, TX, VT, VA, and WV.

 

FL amended its abortion clinic licensing laws to revise the rule-making authority of the state department of health over abortion clinics to permit rulemaking under the general health facility and the abortion clinic licensing laws; to repeal a provision that gave clinics "reasonable time" to comply with any rule applicable to abortion clinic licensing; and to increase the licensing fee paid by abortion clinics. MO enacted a measure classifying facilities that provide five or more first-trimester abortions a year or any second- or third-trimester abortions in any given year as "ambulatory surgical centers" and subjecting them to regulation as such.

 

Clinic Access/FACE

At least 4 states including NJ and RI considered measures "protecting" access to clinic entrances.

 

Coerced Abortions

Several states including AR, SD, and VA considered measures prohibiting any person from coercing a woman to undergo an abortion. In VA, the proposed measure would have made it a felony to coerce a woman into undergoing an abortion.

 

Crisis Pregnancy Centers

Approximately a third of the states considered measures to provide funding to organizations providing abortion alternatives.

 

"Choose Life" License Plates:
Measures related to "Choose Life" license plates were introduced in at least five states: AR, NJ, NC, TX, and WV.

 

AR enacted a measure implementing the program and directing the proceeds to organizations providing abortion alternatives.

 

Direct Funding:
At least 14 states considered measures providing direct taxpayer funds to organizations and entities providing abortion alternatives including AZ, KS, LA, MO, ND, OH, OK, PA, and TX.

 

AZ enacted a measure allocating $20,000 to organizations that provide "medically accurate alternatives-to-abortion services" during pregnancy and for one year following birth. The funds may not be used by organizations that provide abortions or make abortion referrals.

 

LA appropriated $1 million to the Department of Social Services, Office of Family Support for abortion alternatives. The funds cannot go to entities that promote, refer for, or perform abortions.

 

Pursuant to the Missouri Alternatives to Abortion Services Program, MO appropriated $1.7 million dollars to promote alternatives to abortion for women at or below 200 percent of the Federal Poverty Level. Specifically, the measure allocates funds for services and counseling to assist a woman in carrying her pregnancy to term, in caring for her dependant child, or in placing her child for adoption. Funded services will be available during pregnancy and for up to one year after childbirth and can include prenatal care, medical and mental health care, drug and alcohol testing and treatment, adoption assistance, child care, and other services relating to pregnancy and parenting. None of the funds allocated can be used to fund family planning services or organizations that perform, induce, or refer for abortions.

 

ND enacted a measure funding alternatives-to-abortion services and related public education activities.

 

OH allocated $150,000 over the next two years to a Choose Life fund.

 

OK directed the Department of Health to disburse $40,000 to an alternatives-to-abortion fund.

 

PA enacted two measures allocating $4,655,000 to abortion alternative programs. The measures specifically prohibit the entities receiving the funds from performing abortions or providing abortion counseling and require that the entities maintain a strict separation from organizations that provide abortion services.

 

TX allocated $2.5 million to fund abortion alternative programs. The measure also strengthened restrictions on family planning funds by requiring organizations to maintain strict separation from abortion providers.

 

Regulation of CPCs:
In an ominous development, at least 5 states (NJ, NY, OR, TX, and WV) considered measures directly attacking or seeking to regulate CPCs. This reflects a 50% increase in such efforts (as compared to 2006).

 

NJ considered a measure to limit the sale of ultrasound machines to qualified professionals (potentially precluding CPCs from purchasing this mission-essential equipment).

 

In the most direct attack on the mission of CPCs, OR considered a measure establishing a study committee to "review" the policies and procedures of state CPCs. The alleged impetus for establishing the committee (as delineated in the preamble to the bill) was that CPCs are providing women with misleading and/or false information.

 

Meanwhile, NY, TX, and WV considered measures to directly regulate CPCs.

 

Freedom of Choice Act (FOCA)

NY introduced a measure that would enshrine abortion-on-demand in state law and wipe out all incremental protections (including protection for unborn victims of violence and the right of healthcare providers to refuse to participate in abortions).

 

RI also considered measures to ensure continued, unfettered access to abortion if Roe v. Wade is overturned.

 

Informed Consent/Women's Right to Know

General:
Informed consent measures were introduced in at least 23 states including AR, CT, FL, GA, ID, KS, KY, LA, MS, MO, NH, NY, NC, OK, OR, SC, SD, TX, VA, WV, and WY.

 

AR enacted a measure amending the state"s abortion counseling materials to include a statement that a woman"s consent to have an abortion should be given voluntarily and not as the result of coercion.

 

Fetal Pain:
Measures related to fetal pain were considered by at least 8 states including KY, LA, MO, NY, OK, OR, SC, and VA.

 

LA enacted a measure requiring that a woman considering abortion receive information about fetal pain and also be given the option to undergo and review an ultrasound prior to an abortion. Specifically, the woman must be told about the availability of anesthesia or analgesics to prevent pain to the unborn child that could be caused by the abortion. Moreover, the Department of Health and Hospitals will revise the mandatory informed consent materials to state that, by 20 weeks gestation, an unborn child can experience and respond to pain and that anesthesia is routinely administered to unborn children for prenatal surgery at 20 weeks gestation or later.

 

Ultrasound Requirements:
At least 15 states including CT, FL, GA, ID, KS, MS, MO, NH, NY, NC, SC, SD, TX, VA, and WV considered ultrasound requirements.

 

In addition to LA, three other states (GA, ID, and MS) enacted measures related to the provision of ultrasounds for women considering abortion.

 

GA enacted a measure requiring that a woman seeking an abortion be offered the opportunity to view any ultrasound performed as part of the preparation for the procedure. Further, state-developed counseling materials will also include resource information on organizations that provide ultrasounds.

 

ID now requires abortion providers to offer a woman seeking an abortion the opportunity to view any ultrasound that is conducted in preparation for the procedure. The measure also gives women the right to ask for an ultrasound, even if the provider does not routinely conduct them.

 

MS enacted a measure requiring abortion providers to perform an ultrasound on a woman seeking an abortion. Additionally, the woman will be offered the opportunity to view the ultrasound image, receive a copy of the image, and listen to the unborn child"s heartbeat. The measure also requires that facilities performing abortions purchase ultrasound equipment.

 

Insurance Coverage

At least 7 states including NJ, NY, NC, OH, OK, PA, and WV considered measures limiting or expanding public and/or private health insurance coverage for abortion.

 

NJ amended its State Health Benefits plan for state employees, requiring that any contracts entered into by the State Health Benefits Commission include coverage for "obstetrical services including . . . abortion."

 

OH enacted a measure prohibiting abortion coverage for government employees.

 

OK enacted a measure prohibiting health insurance coverage for elective abortions.

 

Legislative Declarations

VT considered measures announcing its support for abortion.

 

Parental Involvement

A number of states considered measures strengthening their existing parental consent or parental notice laws.

 

Parental Consent:
At least 13 states including AZ, ID, MS, NY, NC, ND, OK, RI, TX, and VT considered measures related to parental consent for abortion. In a notable development, several states sought to delineate standards for courts to use in deciding judicial bypass petitions.

 

ID enacted a measure requiring parental consent for an abortion. Specifically, the law now requires written consent from one parent before an abortion is performed on a minor. The consent requirement can be waived because of a medical emergency, if the pregnancy is the result of rape or incest, or if a judicial order is obtained.

 

MS imposed stricter standard for judges to use when deciding judicial bypass petitions.

 

OK amended its existing law to require a parent or guardian to sign a consent form and to provide photo identification. The abortion provider must also sign a document attesting to the quality of the identification provided. The measure also requires that, in case of a medical emergency, abortion providers notify a parent or guardian of a minor"s abortion no less than 24 hours after the procedure, unless the minor obtains a judicial waiver. Finally, the measure also imposes stricter standards for courts to use in evaluating judicial bypass petitions.

 

Parental Notice:
At least 16 states including AZ, CT, FL, ID, KS, MT, NH, NM, NY, OK, OR, TX, UT, VT, WA, and WV considered measures related to parental notification for abortion.

 

NH repealed its parental notification statute (the subject of litigation in Ayotte v. Planned Parenthood and a 2006 U.S. Supreme Court decision, remanding the case for further action).

 

Transportation of Minors:
At least two states (MS and WV) considered measures criminalizing a third party transporting a minor over state lines to obtain an abortion.

 

Provider Requirements/Limitations

At least 6 states including AL, IN, MN, MS, OK, and WV considered measures requiring hospital admitting privileges for abortion providers.

 

Public Funding for Abortion

In 2007, numerous states considered measures limiting the use of public funds for abortion.

 

Public Funding for Abortions for Low-Income Women:
Measures either limiting or expanding taxpayer funding of abortion for low-income women were considered in at least 15 states including CO, IA, ME, MD, MN, MO, NC, NJ, NY, ND, OK, RI, TX, VA, and WV. Three states (IA, MD, and NC) simply reaffirmed existing limitations:

 

IA continues to prohibit public funding except in cases of life endangerment, rape, incest, or fetal defect.

 

MD continues to prohibit public funding except when the pregnancy is the result of incest or rape, the woman"s life is at risk, the fetus is affected by a serious abnormality, or the women"s physical and mental health is at "grave risk."

 

NC continues to prohibit public funding unless the pregnancy is the result of incest or rape or the woman"s life is at risk.

 

Meanwhile, TX enacted a measure strengthening limitations on organizations" eligibility for state family planning funds. Under the measure, organizations must maintain incorporation, governing structure, and bookkeeping that are separate from abortion providers.

 

NJ specifically considered a measure to prohibit state funding of abortifacients.

 

Limitations on the Use of Public Funds for Abortion Counseling and the Use of Public Facilities to Perform Abortions:
CO"s legislature overrode the Governor"s veto of a prohibition on state family planning funds going to organizations that provide abortion services, safeguarding a long-standing pro-life policy.

 

At least 10 states considered measures prohibiting state funds from being used to counsel for abortions including KY, MS, MO, NH, NJ, OH, OK, RI, TX, and WV.

 

OH enacted a measure that prohibits both the use of public funds for abortion counseling and the use of public facilities to perform abortions.

 

OK enacted a measure prohibiting any state or federal funds disbursed by the state from being used to provide abortion counseling unless the abortion is necessary to save a woman"s life. Physicians may, however, provide nondirective counseling on "reproductive health options."

 

Meanwhile, NH considered a measure prohibiting the state from entering into contracts with Planned Parenthood, along with general prohibitions against the use of state funds for abortion counseling or referrals.

 

RU- 486

OK considered measures to regulate the use of RU-486.

 

Reporting

A significant number of states considered measures requiring that abortion providers report certain information to state agencies (such as complications, reasons for late-term abortions, and the number of minors applying for judicial bypass).

 

General:
At least 11 states including AZ, HI, ME, MI, OK, KS, TN, TX, VA, WV, and WY considered measures related to abortion reporting. Moreover, several states specifically targeted the reporting of abortion complications including MI, TX, VA, and WV.

 

In KS, the Governor vetoed a provision requiring abortion providers to report the diagnosis or nature of the condition which necessitates a post-viability abortion

 

OK now requires abortion providers to report specific and detailed information, including information on the number of women receiving state abortion counseling materials and the number of abortions exempted from the counseling requirement because of a "medical emergency."

 

Minors:
At least 8 states considered measures requiring additional reporting to state agencies regarding minors seeking abortions including ID, OK, TX, and WY.

 

ID enacted a measure requiring abortion providers to report information on abortions performed on minors and requiring courts to report information on waivers of the state"s parental consent requirement.

 

OK now requires abortion providers to report specific and detailed information regarding minors" abortions, including whether physicians received the mandatory parental consent, whether minors sought judicial bypass, and whether or not such bypass was granted.

 

Reporting of Sexual Abuse:
At least four states (CT, FL, ME, and WV) considered measures defining abortion clinic employees as "mandatory reporters" of suspected child sexual abuse. Meanwhile, TX considered a measure requiring DNA testing on the remains of the unborn child after an abortion on a minor girl 13 years of age or younger.

 

Spousal Notification

At least 2 states (RI and WV) considered measures requiring notification of the woman"s spouse or father of the unborn child prior to an abortion.

 

 

 

Contraception

"Contraceptive Equity"

At least 9 states including KY, MI, NY, OH, OK, OR, PA, TX, and UT introduced measures to require any entity or organization providing prescription coverage to its employees to also provide coverage for contraception and/or "emergency contraception."

 

OR enacted a measure requiring health plans that provide coverage for prescription drugs to also cover prescription contraceptives. Under the provision, religious employers may refuse coverage if their primary purpose is the inculcation of religious values; they primarily employ and serve people with the same values; and are nonprofit entities under federal law.

 

Emergency Contraception/Plan B

Despite of the FDA"s approval of Plan B (or "emergency contraception") for over-the-counter sale and use, the level of state activity related to the drug continued to be high.

 

General Access:
Seven states including HI, MN, NM, NY, OH, OR, and WV introduced measures designed to increase access to "emergency contraception." These measures sought to, among other things, provide financial resources to low income women or those receiving Medicaid assistance; require insurance coverage for abortifacients; or require a state university system to provide "emergency contraception" in its campus clinics (NY).

 

Access for Sexual Assault Victims:
At least 18 states considered measures requiring that emergency rooms provide sexual assault victims with information about and/or access to "emergency contraception" including AR, AZ, CO, CT, FL, HI, MN, MO, NC, NY, OK, OR, PA, SD, TN, TX, WI, and WV. Only measures in TN would have provided a broad exception for religious hospitals.

 

AR enacted a measure requiring hospitals to provide sexual assault victims with information about "emergency contraception." The measure also permits an individual provider to assert objections based on religious or moral beliefs.

 

CO enacted a measure requiring hospitals to provide sexual assault victims with information about "emergency contraception." However, they are not required to provide the medication itself. The measure also permits an individual provider to assert objections based on religious or moral beliefs.

 

CT enacted a measure requiring hospitals to inform sexual assault victims about "emergency contraception" and to provide the medication upon request, unless there is a positive pregnancy test. Moreover, to meet these requirements, the hospital may contract with an independent medical professional to provide services related to "emergency contraception."

 

MN enacted a measure requiring a hospital to inform sexual assault victims about "emergency contraception" and to provide the drug upon request. Hospitals are not required to provide "emergency contraception" if the medication is contraindicated or the woman has a positive pregnancy test.

 

OR enacted a measure requiring hospitals to inform sexual assault victims about "emergency contraception" and to provide the medication upon request. Further, OR enacted a second measure requiring the state department of justice to pay for medical assessments of sexual assault victims (including the provision of "emergency contraception") and to provide a prescription for "emergency contraception" if the victim is under 18.

 

Collaborative Agreements with Physicians in Lieu of Prescriptions:
A few states including NY introduced measures to allow certain healthcare providers (typically, nurses and pharmacists) to dispense "emergency contraception" without a prescription.

 

Other Related Measures:
CO enacted a measure requiring pharmacies to post a notice when non-prescription "emergency contraception" is out of stock.

 

 

 

Protection for Unborn Victims of Violence and Newly-Born

More than 100 measures seeking to protect the unborn or newly-born or recognizing the legal status of a stillborn child were considered in 2007.

 

Protection of Unborn Victims of Violence

At least 21 states including AZ, CO, CT, FL, HI, IN, KS, MA, MS, NV, NH, NY, NC, OR, PA, RI, SC, VA, WV, and WY considered measures to protect unborn victims from homicide and/or assault.

 

KS enacted a measure including an "unborn child" (from fertilization to birth) as a possible victim of murder, manslaughter, vehicular manslaughter, and battery laws.

 

Conversely, in WY, the Governor vetoed a measure that would have created the crime of "homicide of an unborn child or fetus." This new crime would have applied only when the mother was killed as well.

 

Born-Alive Infant Protection

At least 3 states (NC, SC, and WV) considered measures protecting infants who are born alive following an attempted abortion.

 

"Baby Moses" Laws

A number of states including AK, CA, HI, IL, and NM considered measures providing "safe havens" for legal infant abandonment.

 

HI"s legislature overrode the Governor"s veto to enact a measure allowing a person to leave an unharmed infant no more than 72 hours old at a hospital, fire station, or police station and be immune from prosecution for child abandonment. The professional receiving the infant will be required to inquire about the child"s medical history and to provide information on social services to the person relinquishing the infant.

 

Stillbirth Certificates

A number of states including AR, CA, MT, NM, NY, RI, and SD considered measures providing for death certificates in the case of stillborn infants (typically, at or after 20 weeks gestation). Such measures were enacted in AR, MT, RI, and SD.

 

AR, MT, and SD enacted measures allowing a woman who loses a child after 20 weeks" gestation to obtain a "Certificate of Birth Resulting in a Stillbirth." The certificates will not be used in any form of statistical reporting.

 

RI enacted a measure allowing a woman who loses a child after 20 weeks" gestation to seek a "Certificate of Birth Resulting in a Stillbirth." The certificate will also be filed with the state registrar.

 

Substance Abuse During Pregnancy/Child Endangerment

Several states including AR, LA, MD, MN, MT, NM, and WY considered measures protecting unborn children from their mothers" substance use/abuse. Such measures were enacted in AR, LA, MD, MN, and MT.

 

AR allocated $5 million over two years to expand substance abuse treatment services for pregnant women and women with children.

 

LA expanded the definition of "prenatal neglect" to include (1) "exposure to chronic or severe use of alcohol"; (2) the use of any controlled dangerous substance "in a manner not lawfully prescribed" that results in symptoms of withdrawal to the newborn; (3) the presence of a controlled substance or related metabolite in the newborn; or (4) observable and harmful effects in the newborn's appearance or functioning. The measure also requires physicians to issue reports to the local child protection agencies if there are symptoms of withdrawal in a newborn child or other observable effects that the physician believes are due to chronic or severe alcohol use during pregnancy or if a toxicology test on the newborn child returns positive.

 

MD enacted a measure amending current policy to provide that a child is "not receiving proper care" if he or she is born exposed to methamphetamine or if the mother tests positive for methamphetamine upon admission to the hospital for delivery of that infant.

 

MN enacted a measure allowing a court to order a pregnant woman into an early intervention treatment program for substance abuse. The bill also requires professionals, such as health care providers and law enforcement officers, to report suspected abuse of a controlled substance by a pregnant woman. However, MN"s Governor vetoed a measure that sought to establish an intervention and advocacy program to provide a range of services for women who give birth to children affected by alcohol or drugs.

 

MT enacted a measure requiring specific professionals to report any infant affected by drug exposure to the health department.

 

 

 

Bioethics

Approximately 120 measures were considered in 32 states relating to cloning, destructive embryo research, and/or ethical alternatives to destructive research such as research using adult stem cells or umbilical cord blood. This reflects a drop of approximately 50% from 2006. Anti-life measures, such as measures funding destructive embryo research, continued to significantly outpace life-affirming measures (as they did in 2005 and 2006).

 

Constitutional Amendments

MO, OK, and TX considered constitutional amendments related to human cloning. MO"s amendment sought to prohibit human cloning.

 

OK sought to authorize any form of stem cell research permitted under federal law and would have prohibited cloning-to-produce children, while TX"s amendment would have prohibited cloning-to-produce children in state institutions of higher education.
 

 

Human Cloning

At least 18 states considered measures related to human cloning including AL, CT, DE, FL, KS, LA, MD, MI, MO, MT, NE, NM, NY, NC, OH, OR, SC, and TX. In large part, these measures sought to ban human cloning.

 

IL and IA enacted a measure banning reproductive cloning, but permitting cloning for research (and destructive embryo research).

 

Destructive Embryo Research ("DER")/Embryonic Stem Cell Research ("ESCR")

At least 34 states including CA, CT, DE, FL, HI, IL, IA, LA, MD, MN, MO, MT, NE, NJ, NM, NY, NC, OK, OR, RI, SC, TX, VA, and WA considered measures permitting or otherwise promoting destructive and immoral research.

 

IL enacted a measure setting up an institute under the Illinois Department of Public Health to award grants for embryonic stem cell research.

 

IA enacted a measure permitting embryonic stem cell research, the Iowa Stem Cell Research and Cures Initiative.

 

NJ enacted a measure allocating $5.5 million for embryonic stem cell research.

 

NY enacted a measure establishing an institute to disburse state monies for embryonic stem cell research. However, no funds can be used for human reproductive cloning.

 

Meanwhile, a smaller number of states such as IN, KS, MI, MT, and NJ considered bans on destructive embryo research. For example, MI considered measures to prohibit research on a live or aborted embryo, fetus, or neonate after elective abortions.

 

Similarly, NE enacted a measure prohibiting monies from a state-supported biomedical research fund from being used for research on fetal tissue obtained from induced abortions or for research using embryonic stem cells.

 

Ethical Alternatives to DER/ESCR

At least 11 states (CA, GA, IL, KS, ME, MI, MO, NV, NJ, NY, and OK) considered measures promoting and/or funding ethical alternatives such as adult stem cells and umbilical cord blood.

 

Adult Stem Cells:
At least 4 states including IL, ME, MI, and NV considered measures promoting the use of adult stem cells.

 

Umbilical Cord Blood:
At least 8 states including CA, GA, IL, KS, ME, MI, MO, and NY considered measures promoting research using umbilical cord blood.

 

GA created the Newborn Umbilical Cord Blood Bank for postnatal tissue and fluid.

 

The NJ measure funding destructive embryo research also provides for the collection of umbilical cord blood to support stem cell research and related activities

 

Meanwhile, NY enacted a measure facilitating the donation of umbilical cord blood for stem cell collection, preservation, and storage for public or private use.

 

Chimeras

MD considered a ban on the creation of chimeras.

 

 

 

Regulation of Assisted Reproductive Technologies/In-Vitro Fertilization

At least 27 states including AZ, CA, CT, DE, IL, IN, IA, KS, ME, MD, MA, MI, MS, MO, NH, NJ, NY, ND, OK, OR, PA, RI, SC, TN, TX, VA, and WV considered measures related to assisted reproductive technologies, principally in vitro fertilization.

 

Insurance Coverage

At least 15 states including AZ, DE, IA, KS, MA, ME, MI, MS, NH, NJ, ND, OR, OK, RI, and TN considered measures requiring insurance companies to provide coverage for infertility treatments.

 

RI enacted a measure providing for insurance coverage for infertility treatments regardless of marital status and up to the age of 45 years.

 

Regulation

A variety of regulations for assisted reproductive technologies were considered in 2007 including advance directives for the disposition of embryos (NY); regulations for egg procurement (CA, MD, and NJ); embryo adoption (IN and TX); informed consent (NY, SC, VA, and WA); laws related to parentage of embryos and/or children created using assisted reproductive technologies (CT, NY, OK, and TX); a ban on sex selection (MO); and an omnibus Reproductive Privacy Act (IL).

 

CT enacted a measure providing that an identified or anonymous donor of sperm or human eggs shall not have any right or interest in any child born as a result of artificial insemination.

 

 

 

Healthcare Rights of Conscience

Approximately 104 measures related to healthcare rights of conscience were considered in 36 states including AR, AZ, CO, CT, DE, FL, GA, HI, IA, IL, IN, KS, KY, MA, ME, MI, MN, MO, MS, NC, NH, NJ, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, WI, and WV.

 

Abortion

At least 4 states including IL, NC, NJ, and WV considered measures allowing healthcare providers to refuse to participate in abortions.

 

Broad ROC Protection

At least 5 states including MI, MO, RI, SC, and VT considered measures protecting healthcare providers in all circumstances.

 

Contraception

IN considered a measure allowing healthcare providers to refuse to prescribe or dispense contraception.

 

Protection for Pharmacists

At least 4 states including MO, SC, TX, and WV considered measures to allow pharmacists and/or pharmacies to refuse to dispense contraception. However, TX"s measure stipulated that objecting pharmacists and pharmacies must enact measures to ensure patient access.

 

"Compulsion" Bills

Abortion:
NY considered two measures that, in practice, would force healthcare providers and payers to participate in, refer for, and facilitate abortions. One measure requires hospitals receiving funds under the public health law and providing resident training in obstetrics, gynecology, internal medicine, or women's health to provide training in abortion, either on-site or off-site. It also sought to require training in all methods of contraception and sterilization. While failing to grant affirmative protection for any programs or facilities, the measure admits that some residency programs might have a conscience objection and requires those programs to ensure that its students receive training in abortion complications and that its non-objecting students can receive abortion training at another institution. The bill did provide conscience protection for medical residents.

 

A second measure sought to require all managed-care providers to provide or arrange for "reproductive services," including abortion, for all enrollees.

 

Pharmacists and Pharmacies:
Eleven states including AZ, MO, NJ, NY, OK, PA, TX, VA, and WV introduced measures forcing pharmacists and/or pharmacies to dispense contraception and/0r "emergency contraception" without regard to conscience concerns or objections.

 

Measures in NJ, OK, and TX specifically purported to require pharmacists and/or pharmacies to dispense "emergency contraception" (and were, in large part, modeled after the 2005 IL executive order currently in litigation).

 

In GA and MI, measures calling on the U.S. Congress to pass the Prevention First Act, including a national contraceptive mandate and a national "emergency contraception" for sexual assault mandate, were debated.

 

 

 

End-of-Life

Nearly 100 measures concerning end-of-life issues were considered in 34 states: AZ, CA, CT, FL, GA, HI, ID, IL, IA, KS, MD, MA, MN, MS, MO, MT, NC, NE, NH, NJ, NM, NV, NY, OK, OR, PA, SC, TN, TX, UT, VT, WI, WV, and WY. Most of these measures concerned advance directives for healthcare, "do not resuscitate orders," and "living wills."

 

Assisted Suicide/Euthanasia

Four states (AZ, CA, HI, and VT) considered measures legalizing assisted suicide in specified circumstances and under delineated conditions.

 

Conversely, at least four states (HI, IL, KS, and NY) considered measures strengthening prosecutor"s options and/or punishment options in cases involving assisted suicide. HI"s measure would define assisting in a suicide as "manslaughter."

 

Advance Directives

At least 20 states including FL, GA, IA, MD, MA, MN, MO, NC, NV, NH, NJ, NM, NY, OK, PA, TN, TX, UT, WV, and WY considered measures related to advance directives and other healthcare documents (such a "living wills" and "do not resuscitate" orders). Related measures were enacted in GA, ID, MD, MT, PA, UT, and WY. Meanwhile, in MN, the Governor vetoed a measure defining the responsibility of healthcare facilities to contact and coordinate with designated patient representatives.

 

GA enacted a measure providing for an advance directive for healthcare that combines provisions of a living will and a durable power of attorney for healthcare.

 

ID enacted legislation to replace "do not resuscitate" ("DNR") orders used at hospitals and other healthcare institutions within the State of Idaho with a standardized form.

 

MD enacted four measures concerning the responsibility of healthcare providers to comply with a patient"s wishes as expressed in advance directives or DNR orders, two of which dealt with the expressed wishes of mental health patients.

 

MT enacted a measure limiting the ability of guardians to consent to the withdrawal of life-sustaining treatment or to DNR orders. The guardians are limited by the provisions of the Montana Rights of the Terminally-Ill Act.

 

PA enacted an omnibus measure dealing with healthcare powers of attorney; who may be appointed as a patient representative; what the patient"s rights are; and what a provider who refuses to comply with a patient"s wishes as to treatment is required to do.

 

UT repealed the Personal Choice and Living Will Act and enacted the Advance Health Care Directive Act.

 

WY enacted an omnibus measure providing standards for the preparation, content, and execution of healthcare powers of attorney.

 

Conversely, MN"s Governor vetoed a measure delineating the responsibilities of healthcare facilities to contact designated patient representatives and involve them in healthcare and treatment decisions.

 

Pain Control and Palliative Care

HI considered a measure providing financial and other resources for palliative care programs.

 

GA considered a measure protecting physicians from prosecution when they administer drugs to terminally-ill patients to relieve pain (but which could result in a patient"s death).

 

MT debated a measure establishing a bill of rights for terminally-ill patients.

 

Prevention of Dehydration and Starvation

At least four states (MS, NH, OK, and WI) considered measures related to the removal of nutrition and hydration.

 

OK enacted a measure providing that (under no circumstances) shall a court authorize the Department of Human Services to consent or deny consent to a DNR Order, to the withdrawal of hydration or nutrition, or to other life-sustaining treatment, although the court retains jurisdiction to hear such matters under applicable law.

 

 

Endnotes

1 While the total number of bills for 2007 includes information on state bills related to advance directives, the totals given for life-affirming and anti-life bills enacted and vetoed do not include any enacted legislation related to advance directives.  I purposely did not include these bills because the impact of many of these advance directive bills is unclear; some contain both life-affirming and anti-life elements; and because AUL has not taken an official position on the advisability and desirability of advance directives (and what terms they should or should not contain).

 

2 The noted increase in abortion-related legislation compares 2007 activity to 2006 levels.  Notably, 2007 levels for abortion-related legislation approached those seen in 2004 and 2005.

 

3 Unless otherwise noted, new laws enacted in OK specifically refer to multiple sections in an omnibus bill that dealt with many reforms.

 

4 Unless otherwise noted, new laws enacted in MO specifically refer to multiple sections in an omnibus bill that dealt with many reforms.