House File 2140 - Introduced HOUSE FILE 2140 BY SALMON , NUNN , HEARTSILL , FISHER , HOLT , GUSTAFSON , WINDSCHITL , PETTENGILL , KOOIKER , GASSMAN , WATTS , SHEETS , BAXTER , ROGERS , and FRY A BILL FOR An Act relating to fetal deaths, prohibitions against the 1 buying, selling, or experimentation on an unborn infant or 2 bodily remains, providing penalties, and including effective 3 date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 5131YH (14) 86 pf/nh

H.F. 2140 Section 1. Section 144.1, subsections 7 and 9, Code 2016, 1 are amended to read as follows: 2 7. “Fetal death” means death prior to the complete 3 expulsion or extraction from its mother of a product of human 4 conception an unborn infant , irrespective of the duration of 5 pregnancy. Death is indicated by the fact that after expulsion 6 or extraction the fetus unborn infant does not breathe or 7 show any other evidence of life such as beating of the heart, 8 pulsation of the umbilical cord, or definite movement of 9 voluntary muscles. In determining a fetal death, heartbeats 10 shall be distinguished from transient cardiac contractions, and 11 respirations shall be distinguished from fleeting respiratory 12 efforts or gasps. 13 9. “Final disposition” means the burial, interment, 14 cremation, removal from the state, or other disposition of a 15 dead body or fetus unborn infant . 16 Sec. 2. Section 144.1, Code 2016, is amended by adding the 17 following new subsections: 18 NEW SUBSECTION . 1A. “Bodily remains” means the physical 19 remains, corpse, or body parts of a dead unborn infant that 20 has reached the stage of development in which there are 21 cartilaginous structures or fetal or skeletal parts, which 22 remains were extracted or expelled following a fetal death. 23 “Bodily remains” does not include medical waste. 24 NEW SUBSECTION . 9A. “Health care provider” means an 25 individual licensed or registered under chapter 148, 148C, 26 148D, or 152, or any individual who provides medical services 27 under the authorization of the licensee. 28 NEW SUBSECTION . 9B. “Inducing of a termination of pregnancy” 29 means the use of any means to terminate the pregnancy of a 30 woman known to be pregnant with the intent other than to 31 produce a live birth or to remove a dead unborn infant. 32 NEW SUBSECTION . 11A. “Medical waste” means discarded 33 biologic product such as blood, tissue, or body parts removed 34 from medical facilities as well as bedding, bandages, syringes, 35 -1- LSB 5131YH (14) 86 pf/nh 1/ 12

H.F. 2140 and similar materials that have been used in treating patients, 1 but does not include bodily remains. 2 NEW SUBSECTION . 12A. “Spontaneous termination of pregnancy” 3 means the occurrence of an unintended termination of pregnancy 4 at any time during the period from conception to twenty weeks 5 gestation. 6 NEW SUBSECTION . 13A. “Stillbirth” means an unintended fetal 7 death occurring after a gestation period of twenty completed 8 weeks, or an unintended fetal death of an unborn infant with a 9 weight of three hundred fifty or more grams. 10 NEW SUBSECTION . 14A. “Unborn infant” means the offspring of 11 a human being from conception until birth. 12 Sec. 3. Section 144.29, Code 2016, is amended to read as 13 follows: 14 144.29 Fetal deaths. 15 1. A fetal death certificate for each fetal death of an 16 unborn infant that has reached the stage of development at 17 which bodily remains are evident which occurs in this state 18 after a gestation period of twenty completed weeks or greater, 19 or for a fetus with a weight of three hundred fifty grams or 20 more shall be filed as directed by the state registrar within 21 three days after delivery and prior to final disposition of the 22 fetus dead unborn infant . The certificate shall be registered 23 if it has been completed and filed in accordance with this 24 chapter . 25 2. The county in which a dead fetus unborn infant is found 26 is the county of death. The certificate shall be filed within 27 three days after the fetus dead unborn infant is found. If 28 a fetal death occurs in a moving conveyance, the county in 29 which the fetus dead unborn infant is first removed from the 30 conveyance is the county of death. 31 Sec. 4. Section 144.29A, subsection 7, Code 2016, is amended 32 by striking the subsection. 33 Sec. 5. NEW SECTION . 144.29B Final disposition of bodily 34 remains after fetal death —— release to mother or authorized 35 -2- LSB 5131YH (14) 86 pf/nh 2/ 12

H.F. 2140 representative —— alternative authorization. 1 1. a. When a fetal death occurs, the individual in charge 2 of the institution where the bodily remains were expulsed 3 or extracted from the mother shall release to the mother or 4 the mother’s authorized representative, upon the request of 5 the mother, the bodily remains for final disposition in the 6 following manner: 7 (1) When the bodily remains are not the result of a 8 spontaneous termination of pregnancy or a stillbirth, only by 9 burial, interment, or cremation. 10 (2) In addition to the means specified in subparagraph 11 (1), when the bodily remains are the result of a spontaneous 12 termination of pregnancy or a stillbirth, by means in 13 compliance with chapter 142C. 14 b. A request by the mother or her authorized representative 15 under paragraph “a” may be made prior to or within seventy-two 16 hours after the expulsion or extraction of the bodily remains. 17 c. A release of bodily remains to a mother or the mother’s 18 authorized representative made under this subsection shall 19 comply with section 144.32. 20 2. a. When a fetal death occurs, if the mother or her 21 authorized representative does not request the release of 22 the bodily remains under subsection 1, the funeral director, 23 the individual in charge of the institution where the bodily 24 remains were expulsed or extracted, or a person assuming 25 responsibility for the final disposition of the bodily remains 26 shall obtain from the mother or her authorized representative 27 a written authorization for final disposition on a form 28 prescribed and furnished or approved by the department. 29 (1) The authorization may allow final disposition to be by 30 a funeral director, the individual in charge of the institution 31 where the bodily remains were expulsed or extracted, or another 32 person assuming responsibility for the final disposition of the 33 bodily remains. 34 (2) The mother or her authorized representative may direct, 35 -3- LSB 5131YH (14) 86 pf/nh 3/ 12

H.F. 2140 in the written authorization, that the final disposition of the 1 bodily remains be by one of the following: 2 (a) When the bodily remains are not the result of a 3 spontaneous termination of pregnancy or a stillbirth, only by 4 burial, interment, or cremation. 5 (b) In addition to the means specified in subparagraph 6 division (a), when the bodily remains are the result of a 7 spontaneous termination of pregnancy or a stillbirth, by means 8 in compliance with chapter 142C. 9 b. The funeral director, the individual in charge of 10 the institution where the bodily remains were expulsed or 11 extracted, or the person assuming responsibility for the final 12 disposition of the bodily remains shall ensure that the final 13 disposition of the bodily remains is performed in compliance 14 with the authorization for final disposition. 15 c. After final disposition, the funeral director, the 16 individual in charge of the institution where the bodily 17 remains were expulsed or extracted, or the person assuming 18 responsibility for the final disposition of the bodily remains, 19 shall retain the authorization for not less than seven years. 20 3. The final disposition of the bodily remains shall not be 21 by incineration. 22 4. If the final disposition of the bodily remains is by 23 cremation, the medical examiner of the county in which the 24 fetal death occurred shall sign the authorization for final 25 disposition. 26 5. Bodily remains may be moved from the place of death to be 27 prepared for final disposition with the consent of the person 28 who certified the death. 29 6. A permit for final disposition issued under the laws of 30 another state that accompanies bodily remains brought into Iowa 31 is authorization for final disposition of the bodily remains 32 in Iowa. 33 Sec. 6. Section 144.30, Code 2016, is amended to read as 34 follows: 35 -4- LSB 5131YH (14) 86 pf/nh 4/ 12

H.F. 2140 144.30 Funeral director’s duty —— fetal death certificate. 1 The funeral director who first assumes custody of a fetus 2 dead unborn infant shall file the fetal death certificate. In 3 the absence of such a person, the physician or other person in 4 attendance at or after the delivery shall file the certificate 5 of fetal death. The person filing the certificate shall obtain 6 the personal data from the next of kin or the best qualified 7 person or source available and shall obtain the medical 8 certification of cause of death from the person responsible 9 for completing the certification. When a person other than a 10 funeral director assumes custody of a fetus dead unborn infant , 11 the person shall be responsible for carrying out the provisions 12 of this section . 13 Sec. 7. Section 144.31A, subsection 1, Code 2016, is amended 14 to read as follows: 15 1. As used in this section : 16 a. “Certificate , “certificate of birth resulting in 17 stillbirth” means a document issued based upon a properly filed 18 fetal death certificate to record the birth of a stillborn 19 fetus unborn infant . 20 b. “Stillbirth” means stillbirth as defined in section 21 136A.2 . 22 Sec. 8. Section 144.32, subsections 1, 2, and 3, Code 2016, 23 are amended to read as follows: 24 1. If a person other than a funeral director, medical 25 examiner, or emergency medical service assumes custody of a 26 dead body or fetus dead unborn infant , the person shall secure 27 a burial transit permit. To be valid, the burial transit 28 permit must be issued by the county medical examiner, a funeral 29 director, or the state registrar. The permit shall be obtained 30 prior to the removal of the body or fetus dead unborn infant 31 from the place of death and the permit shall accompany the body 32 or fetus dead unborn infant to the place of final disposition. 33 2. To transfer a dead body or fetus dead unborn infant 34 outside of this state, the funeral director who first assumes 35 -5- LSB 5131YH (14) 86 pf/nh 5/ 12

H.F. 2140 custody of the dead body or fetus dead unborn infant shall 1 obtain a burial transit permit prior to the transfer. The 2 permit shall accompany the dead body or fetus dead unborn 3 infant to the place of final disposition. 4 3. A dead body or fetus dead unborn infant brought into this 5 state for final disposition shall be accompanied by a burial 6 transit permit under the law of the state in which the death 7 occurred. 8 Sec. 9. Section 144.33, Code 2016, is amended to read as 9 follows: 10 144.33 Bodies brought into state. 11 A burial transit permit issued under the law of another 12 state which accompanies a dead body or fetus dead unborn 13 infant brought into this state shall be authority for final 14 disposition of the body or fetus dead unborn infant in this 15 state. 16 Sec. 10. Section 144.49, Code 2016, is amended to read as 17 follows: 18 144.49 Additional record by funeral director. 19 A funeral director or other person who removes from the place 20 of death or transports or finally disposes of a dead body or 21 fetus dead unborn infant , in addition to filing any certificate 22 or other form required by this chapter , shall keep a record 23 which shall identify the body, and information pertaining to 24 the funeral director’s or other person’s receipt, removal, and 25 delivery of the body as prescribed by the department. 26 Sec. 11. Section 144.52, subsection 7, Code 2016, is amended 27 to read as follows: 28 7. Knowingly violates a provision of section 144.29A or 29 144.29B . 30 Sec. 12. NEW SECTION . 146B.1 Prohibitions on buying, 31 selling, or experimentation relating to an unborn infant or the 32 bodily remains resulting from an abortion —— criminal and civil 33 penalties —— state funding prohibited. 34 1. A person shall not experiment upon an unborn infant 35 -6- LSB 5131YH (14) 86 pf/nh 6/ 12

H.F. 2140 intended to be aborted unless the experimentation is 1 therapeutic to the unborn infant. 2 2. A person shall not perform or offer to perform an 3 abortion if the justification or reason for the abortion 4 is that the bodily remains may be used for animal or human 5 research, experimentation, or transplantation. 6 3. A person shall not knowingly sell, transfer, distribute, 7 give away, accept, use, or attempt to use an unborn infant or 8 the bodily remains resulting from an abortion. 9 4. A person shall not aid or abet any prohibited action 10 specified in subsection 3. 11 5. A person shall not use an unborn infant or the bodily 12 remains resulting from an abortion in animal or human research, 13 experimentation, or study, or for transplantation, except under 14 any of the following circumstances: 15 a. For diagnostic or remedial tests, procedures, or 16 observations which have the purpose of determining the life or 17 health of the unborn infant, or preserving the life or health 18 of the unborn infant or pregnant woman. 19 b. For pathological study. 20 6. In addition to other remedies available, failure to 21 comply with the requirements of this section shall provide 22 a basis for recovery for the pregnant woman, or the parent 23 or guardian of the pregnant woman if the pregnant woman is a 24 minor, for the unlawful disposition of or experimentation upon 25 an unborn infant or bodily remains. Such relief may include 26 all of the following: 27 a. Monetary damages for all psychological injuries 28 occasioned by such violation. 29 b. Statutory damages equal to three times the cost of the 30 pregnant woman’s delivery or abortion. 31 c. A basis for professional disciplinary action under 32 chapter 148. 33 d. Upon conviction of a violation of this section, the 34 automatic suspension of the license of the physician for at 35 -7- LSB 5131YH (14) 86 pf/nh 7/ 12

H.F. 2140 least one year. 1 7. A person who violates this section is guilty of a class 2 “C” felony for each violation. 3 8. State funding shall not be appropriated to or expended by 4 any state agency, state institution, or program administered by 5 the state including but not limited to the medical assistance 6 program if such entity or program is found in violation of this 7 section. 8 9. For purposes of this section: 9 a. “Abortion” means abortion as defined in section 146.1. 10 b. “Bodily remains” means bodily remains as defined in 11 section 144.1. 12 c. “Experiment” or “experimentation” means the use of bodily 13 remains in any trial, test, procedure, or observation carried 14 out with the goal of verifying, refuting, or establishing the 15 validity of a hypothesis, but does not include diagnostic or 16 remedial tests, procedures, or observations which have the 17 purpose of determining the life or health of the unborn infant, 18 preserving the life or health of the unborn infant or the 19 pregnant woman, or pathological study. 20 d. “Pathological study” means the examination of body tissue 21 for diagnostic or forensic purposes. 22 e. “Therapeutic” means intended to treat or cure a disease 23 or disorder by remedial agents or methods. 24 f. “Unborn infant” means unborn infant as defined in section 25 144.1. 26 Sec. 13. STATUTORY CONSTRUCTION. 27 1. Nothing in this Act shall be construed to affect existing 28 federal or state law regarding abortion. 29 2. Nothing in this Act shall be construed as creating or 30 recognizing a right to abortion. 31 3. Nothing in this Act shall be construed to alter generally 32 accepted medical standards. 33 Sec. 14. SEVERABILITY. If any provision of this Act or 34 the application thereof to any person or circumstances is held 35 -8- LSB 5131YH (14) 86 pf/nh 8/ 12

H.F. 2140 invalid, the invalidity shall not affect other provisions or 1 applications of the Act which can be given effect without 2 the invalid provisions or application and, to this end, the 3 provisions of this Act are severable. 4 Sec. 15. RIGHT OF INTERVENTION. The general assembly, 5 by joint resolution, may appoint one or more of its members, 6 who sponsored or cosponsored this Act in the member’s official 7 capacity to intervene as a matter of right in any case in which 8 the constitutionality of this Act is challenged. 9 Sec. 16. EFFECTIVE UPON ENACTMENT. This Act, being deemed 10 of immediate importance, takes effect upon enactment. 11 EXPLANATION 12 The inclusion of this explanation does not constitute agreement with 13 the explanation’s substance by the members of the general assembly. 14 This bill relates to fetal deaths and prohibitions against 15 the buying or selling of or experimentation on an unborn infant 16 or bodily remains. The bill includes definitions used in the 17 bill. 18 The bill amends provisions in Code chapter 144 (vital 19 statistics) relating to fetal deaths, and provides that a fetal 20 death certificate is to be filed for all fetal deaths occurring 21 at the stage of an unborn infant’s development at which bodily 22 remains are evident, not only for those after a gestation 23 period of 20 completed weeks or greater, or for a dead unborn 24 infant with a weight of 350 grams or more. 25 The bill also establishes a process for the release to a 26 mother or her authorized representative of fetal bodily remains 27 following a fetal death, or in the alternative, provides 28 for the disposition of fetal bodily remains by the funeral 29 director, the individual in charge of the institution where 30 the bodily remains were expulsed or extracted, or by a person 31 assuming responsibility for the bodily remains, in the manner 32 authorized by the woman or her authorized representative. 33 If the fetal death is not a spontaneous termination of 34 pregnancy or a stillbirth, disposition may only be by burial, 35 -9- LSB 5131YH (14) 86 pf/nh 9/ 12

H.F. 2140 interment, or cremation. If the fetal death is a spontaneous 1 termination of pregnancy or a stillbirth, disposition may 2 also be made in accordance with the uniform anatomical gift 3 Act (Code chapter 142C). Final disposition shall not be by 4 incineration. If final disposition of the bodily remains is 5 by cremation, the medical examiner of the county in which the 6 fetal death occurred is required to sign the authorization 7 for final disposition. If bodily remains are assumed by the 8 mother or her authorized representative, they must secure 9 a burial transit permit as provided in current law under 10 Code section 144.32. Bodily remains may be moved from the 11 place of death to be prepared for final disposition with the 12 consent of the person who certified the death. A permit for 13 final disposition issued under the laws of another state that 14 accompanies bodily remains brought into Iowa is authorization 15 for final disposition of the bodily remains in Iowa. A 16 person who knowingly violates these provisions is guilty of a 17 serious misdemeanor. A serious misdemeanor is punishable by 18 confinement for no more than one year and a fine of at least 19 $315 but not more than $1,875. 20 The bill also establishes prohibitions on the buying or 21 selling of or experimentation on an unborn infant or the bodily 22 remains resulting from an abortion. The bill prohibits a 23 person from experimenting upon an unborn infant intended to 24 be aborted unless the experimentation is therapeutic to the 25 unborn infant; performing or offering to perform an abortion 26 if the justification or reason for the abortion is that the 27 bodily remains may be used for animal or human research, 28 experimentation, or transplantation; knowingly selling, 29 transferring, distributing, giving away, accepting, using, 30 or attempting to use an unborn infant or the bodily remains 31 resulting from an abortion; or aiding or abetting any of these 32 prohibited actions. 33 Additionally, under the bill a person is prohibited from 34 using an unborn infant or the bodily remains resulting from 35 -10- LSB 5131YH (14) 86 pf/nh 10/ 12

H.F. 2140 an abortion in animal or human research, experimentation, 1 or study, or for transplantation, unless an exception is 2 met. The exceptions include for diagnostic or remedial 3 tests, procedures, or observations which have the purpose 4 of determining the life or health of the unborn infant, or 5 preserving the life or health of the unborn infant or pregnant 6 woman; and for pathological study. 7 The bill provides for civil relief in the form of monetary 8 and statutory damages, professional disciplinary action 9 against a physician, and criminal penalties for failure to 10 comply with the prohibitions relating to buying, selling, 11 or experimentation in regard to an unborn infant or bodily 12 remains. 13 The bill provides that upon conviction of a violation of 14 these prohibitions, a person is guilty of a class “C” felony. 15 A class “C” felony is punishable by confinement of no more 16 than 10 years and a fine of at least $1,000 but not more than 17 $10,000. 18 The bill provides that state funding shall not be 19 appropriated to or expended by a state institution, state 20 agency, or program administered by the state if the entity or 21 program is found in violation of the prohibitions. 22 The bill provides that nothing in the bill shall be construed 23 to affect existing federal or state law regarding abortion, 24 as creating or recognizing a right to abortion, or to alter 25 generally accepted medical standards. 26 The provisions of the bill are severable and the bill also 27 provides for the right of intervention by members of the 28 general assembly who sponsored or cosponsored the bill in their 29 official capacity, appointed by joint resolution, to intervene 30 as a matter of right in any case in which the constitutionality 31 of the bill is challenged. 32 The bill makes conforming changes in Code chapter 144 to 33 replace the term “fetus” with the term “unborn infant” and 34 defines “unborn infant” as the offspring of a human being from 35 -11- LSB 5131YH (14) 86 pf/nh 11/ 12