Feminism: Filibuster Transcript (Part 3)

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Texas Senate Session on June 25, 2013.
The Wendy Davis filibuster of Senate Bill 5.

Part 003
Testimony of Texas Medical Association.

Public Domain video from Texas Senate public archives.
Transcript is the work of Ana Mardoll.



File Links:
Texas Senate Archive (Full) (.rm)
SB5-003-Testimony of Texas Medical Association (.mp4)
SB5-003-Testimony of Texas Medical Association (.mp3)
Transcript from Google Docs


Senator Wendy Davis: The 20-week ban on abortion. We’ve heard a great deal of testimony about that particular provision, and I want to hit a few highlights of what has been shared with us. Number one, and most importantly, from our medical community we’ve heard the concern that this interferes with the practice of medicine. As important, we know that concerns have been raised that this ban interferes with a woman’s health care decision before she and her doctor may have important health information about her own health and the health of the pregnancy.

The ban will have devastating consequences when a woman is experiencing medical complications. And unfortunately, it bans abortion before a woman may receive important information about her own health and the health of her pregnancy. Fewer than 2% of abortions occur after 20 weeks, and while they are uncommon, it is important that a woman and her doctor have every medical option available.

On the abortion-inducing drugs restriction, some of the key concerns that we’ve heard about that: one, that it requires that the physician-preferred course of treatment be replaced with a treatment that is potentially more physically harmful to the patient. And again, though asked, no one on this senate floor was able to provide information to us that demonstrated any other incidents where the legislature had taken it upon itself to interfere in such a dramatic way in a physician’s decision-making as it pertains to the administration of treatment.

The bill would require physicians to follow an out-dated protocol, limiting women’s access to safe effective medication abortion. It directly contradicts a physician’s ability to provide the highest level of care for their patients, by requiring a government-prescribed course of treatment. It prohibits physicians in Texas from providing the standard of care to their patients, subjecting physicians to disciplinary action for providing the nationally-recognized standard of care endorsed by the leading medical professional association of obstetricians and gynecologists: ACOG.


Senator Wendy Davis: On the ambulatory surgical center standards: additional state government regulations on an already heavily regulated practice of medicine was one of the primary concerns raised there. Healthcare providers comply with all federal, state, and local laws and regulations, and they strongly opposed regulations that failed to make healthcare more cost-effective, safer, efficient, or accessible. Texas already requires abortions performed after 16 weeks to be performed in ambulatory surgical centers. And we know, and I’ll read some information in a little while about the fact, that there is a reason for that because the incidents of problems that arise prior to that period of time, at existing clinical settings, is extremely low. Much lower, in fact, than any complications that arise from the live birth, of which we are not subjecting to the same standards.

When these facilities close, and they will, women will lose access to their trusted provider. These closed facilities cannot offer any other services that they may have been providing. And we know that in Texas sometimes these facilities are shared facilities where family planning services are also provided.

What is required of reproductive healthcare centers today? Today in the United States, reproductive healthcare services are among the safest and most commonly sought forms of care in the United States. Placing unreasonable requirements on healthcare centers that provide safe, legal abortion today is uncalled for and again not a hint of evidence has been offered as to why it’s needed. And we know why. Governor Dewhurst’s tweet told us why.

[EDITOR’S NOTE: This is a reference to a tweet sent from Lt. Gov. Dewhurst’s official twitter account. The tweet said “We fought to pass SB5 thru the Senate last night, & this is why! #StandWithTXChildren #txlege pic.twitter.com/fJbQSJur7i”. The accompanying picture was one that had been circulated by opponents of the bill, and stated:

"Keep Abortion Safe & Legal
If SB5 passes, it would essentially ban abortion statewide:
* Abortion providers that may be forced to close [red color-coded pins on a map showing 37 of 42 Texas clinics]
* One of only 5 providers that will be able to provide sage and legal abortion [white color-coded pins on a map]"

Dewhurst’s tweet is essentially implying that the reason for the SB5 bill is explicitly to shut down Texas clinics and make abortion unsafe and legally banned in the state of Texas. LINK: Lt. Gov. Dewhurst says in tweet that abortion bill all about shutting down accessibility]

Senator Wendy Davis: It is because the real aim of this bill is not to make women safer, but it is to force the closure of multiple facilities across the state of Texas without a single care or concern for the women whose lives will be impacted by that decision. Not a single care or concern. Because our leadership has demonstrated that it is prioritizing its own political possibilities over potential and devastating consequences for individual women.


Senator Wendy Davis: Let’s talk about the parts of the bill that are medically unnecessary. First of all, I think each of us would agree that as patients we trust our doctors, not the government, to determine what medical equipment and what size rooms is necessary to provide us with good care. It is medically unnecessary to require health centers to build a hospital-grade operating room for an abortion procedure when one is not required for this type of procedure. And in fact we know there are many out-patient clinical procedures that are more invasive, have higher incidences of problems, that today are allowed to take place in clinical settings such as a doctor’s office, without the standards that are being required in this bill.

Texas, of course as a said a minute ago, already requires that abortions performed after 16 weeks be performed at ambulatory surgical centers. This provision, the provision in these bills, goes further by requiring that all health centers that provide abortions comply with regulations that are equivalent to those governing places where surgery takes place. The vast majority of abortions, however, are out-patient procedures that can be performed in a health center, making those requirements inappropriate, unnecessary, and not at all about the health of women.


Senator Wendy Davis: I want to read into the record written testimony that we were provided by a variety of groups on the measures that are before us today. This from the Texas medical association. It was addressed to the House committee on State Affairs, on House Bill 16 and 60 by Representative Jodie Laubenberg. And it’s dated June the 20th, 2013.

“The Texas Medical Association is a private, voluntary, non-profit association of more than 47,000 member physicians and medical students. TMA was founded in 1853 to serve the people of Texas in matters of medical care, prevention, and cure of disease, and improvement of public health. Today our maxim continues in the same direction: physicians caring for Texans. TMA’s diverse physician members practice in all fields of medical specialization. Our member physicians fall on both sides of any debate on abortion. Our concerns with House Bills [13] and 60 are not based on any position on abortion. Rather, our concerns are with legislative intrusion into the patient-physician relationship, and the details of the practice of medicine, and with a legislatively creative standard of care.

“Example of concerns that these proposed bills are:

“House Bill 60, Section 3, Sub-Chapter D directs physicians to take specific actions related to the prescription of an abortion-inducing drug approved by the U.S. Food and Drug Administration for use by women who seek an abortion. The bill prescribes details and the practice of medicine, such as the requirements for the examination, patient-physician communication, and protocols. As previously outlined in our written statement on Senate Bill 97 in the 83rd Texas legislature, TMA is concerned this legislation sets a dangerous precedent of the legislature prescribing the details of the practice of medicine. The medical community, based on science, must make these determinations. Not the legislature.

“Sections 171.0031 and 171.063c in HB60 would require a physician or other healthcare personnel to be available by phone 24 hours a day indefinitely. Although the intent of these provisions may be to allow the patient access to the provider for assistance with complications, as written they are overly broad and could require 24-7 access for years. Furthermore, these sections are vague and they appear to require access to medical records 24 hours a day, which is an overly broad and unprecedented requirement.

“House Bill 16, Section 2, Sub-Chapter C and House Bill 60, Section 3, Sub-Chapter C include a definition of profound and irremediable congenital anomalies based on the amount of time a physician reasonably believes the infant would survive after birth. The definition places that time at minutes-to-hours, which TMA opposes because it is arbitrary and would be impossible for a physician to predict. The bill may seek to allow an exception for conditions in which death after birth would be imminent, and in that regard use of the word ‘imminent’ would be more appropriate than minutes-to-hours.

“Additionally, this proposed definition does not take into account fetal trauma, which in severe situations could result in imminent death after birth. The following definition for severe fetal abnormalities currently exists in Section 285.202 Health and Safety Code and may be an appropriate definition to replace the proposed definition for profound and irremediable congenital anomalies to severe fetal abnormalities, meaning ‘a life-threatening physical condition that in reasonable medical judgment, regardless of the provision of life-saving medical treatment is incompatible with life outside the womb.

“The patient-physician relationship is one of mutuality and trust. Patients must be able to trust their physicians are always acting in each patient’s individual best interest, and must be assured of candid communication with their physicians so they may effectively evaluate their medical care options. TMA strongly opposes any legislation that interferes in this relationship. TMA appreciates the opportunity to provide you our concerns regarding HBs 16 and 60 and urges you to take these comments in serious consideration. We are happy to provide any additional information, or assistance you may request.”

And it is signed by Stephen Brotherton, M.D., the president of TMA.


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