Indiana

Ranking: 7

In 2012, litigation continued over Indiana’s landmark 2011 law defunding Planned Parenthood and other abortion providers. In October, the Seventh Circuit Court of Appeals affirmed a preliminary injunction against the enforcement of the law, but conceded that, absent federal regulations to the contrary, a state is free to determine what entities are qualified – and, equally importantly, which entities (such as abortion providers) are not qualified – to receive Medicaid and other federal healthcare funding. Abortion:

Abortions may be performed at or after 20 weeks gestation only for “medical necessity.”
Indiana prohibits partial-birth abortion.
Indiana law requires that, at least 18 hours before an abortion, a woman receive information about the type of abortion procedure to be used, the risks of and alternatives to that particular procedure, the probable gestational age of the unborn child, the risks associated with carrying the pregnancy to term, and the name of the physician who will perform the abortion. Further, the woman must be told about state medical assistance benefits, the father’s liability for child support, and abortion alternatives.
A 2011 law requires that informed consent information include the fact that human physical life begins when a human ovum is fertilized by a human sperm. Further, women must be informed before abortion that “objective scientific information shows that a fetus can feel pain” at or before 20 weeks. This law is currently in litigation.
Physicians must notify a pregnant woman of the availability of fetal ultrasound and fetal heart tone auscultation services at least 18 hours before a scheduled abortion and advise her that she may view the images or listen to the heart tone. A woman must certify that she has been offered this opportunity to view the fetal ultrasound imaging and hear the auscultation of the fetal heart tone (if the fetal heart tone is audible).
A physician may not perform an abortion on a minor under the age of 18 without the written consent of one parent unless there is a medical emergency or the minor obtains a court order.
All facilities performing surgical abortions must be licensed by the state Department of Health and meet comprehensive health and safety standards. Indiana also requires that post-first-trimester abortions be performed in a hospital or ambulatory outpatient surgical center.
Only physicians licensed to practice medicine in Indiana may perform abortions. Abortion providers must have admitting privileges in the county where abortions are provided or in a contiguous county.
The state has an enforceable abortion reporting law, but does not require the reporting of information to the Centers for Disease Control (CDC). The measure pertains to both surgical and nonsurgical abortions and requires abortion providers to report short-term complications.
Every medical facility where abortions may be performed must be supplied with reporting forms provided by the state that require the reporting of, among other things, the post-fertilization age (of the pregnancy) and, if an abortion is performed at or after 20 weeks gestation, the medical reason for the abortion. Further, if an abortion is performed on a female who is less than 14 years of age, the physician who performed the abortion must transmit an information form to the state Department of Health and the state Department of Child Services within a specified time period.
Indiana funds abortions for women eligible for public assistance when necessary to preserve the woman’s life or physical health or the pregnancy is the result of rape or incest, but otherwise provides that neither the state nor any political subdivision of the state may make a payment from any fund under its control for the performance of an abortion unless the abortion is necessary to preserve the life of the pregnant woman.
The Office of Women's Health director and employees are not permitted to advocate, promote, refer to, or otherwise advance abortion or abortion-inducing drugs.
Indiana’s law prohibiting state agencies from contracting with or making grants (of state or state-administered federal funds) to entities that perform abortions or maintain or operate facilities where abortions are performed, and cancelling current contracts with such entities, is in litigation.
The state prohibits insurance companies from offering abortion coverage within the state insurance Exchanges established pursuant to the federal healthcare law (required to be operational by 2014), except in cases of life endangerment, substantial and irreversible impairment of a major bodily function, rape, or incest.
Indiana offers “Choose Life” license plates, the proceeds of which benefit pregnancy care centers and/or other organizations providing abortion alternatives.
Indiana has a “contraceptive equity” law, requiring health insurance coverage for contraception. No exemption is provided for employers or insurers with a moral or religious objection to contraception.

Legal Recognition of Unborn and newly Born:

Under Indiana criminal law, the killing of an unborn child after viability is defined as a form of homicide.
A person who causes the death of a child in utero while committing murder or felony murder may be sentenced to an additional fixed term of imprisonment that is equal to the advisory sentence for murder. This provision applies at any stage of gestation.
An assault on a viable unborn child is a prosecutable crime. In addition, Indiana defines criminal assaults on a pregnant woman that result in miscarriage, stillbirth, or “damage to pregnancy” as an enhanced offense for sentencing purposes.
The state allows a wrongful death (civil) action only when an unborn child is born alive following a negligent or criminal act and dies thereafter.
The state has created a specific affirmative duty of physicians to provide medical care and treatment to infants born alive at any stage of development.
The state defines substance abuse during pregnancy as “child abuse” under civil child welfare statutes.
The state Department of Health has been directed to develop a system of registry for stillbirth information.

Bioethics Laws:

Indiana bans human cloning for any purpose and prohibits funding of human cloning.
While the state does not explicitly ban destructive embryo research, it does prohibit research on embryos created from ova initially provided for in vitro fertilization (IVF) purposes as well as experimentation on aborted fetuses. However, the state’s prohibition on experimentation on embryos created for IVF purposes explicitly excludes fetal stem cell research from its application.
Indiana has established a public umbilical cord blood bank and an educational initiative to promote public awareness of the importance of donating. Participating facilities must offer patients the option of donating cord blood following delivery.
The state has also directed the Board of Trustees at Indiana University to establish an adult stem cell research center.
Indiana also prohibits the purchase or sale of human ova, but does not prohibit certain transactions between a woman and a qualified IVF clinic for certain expenses (e.g., earnings lost, travel expenses, medical expenses, or recovery time).
The state does not regulate assisted reproductive technologies, but does prohibit gestational surrogacy contracts.

End of Life Laws:

Assisting a suicide constitutes a felony.
The state maintains a Physicians Order for Life Sustaining Treatment (POLST) Paradigm Program.

Healthcare Rights of Conscience Laws: Participation in Abortion:

A physician, hospital, facility employee, or staff member who objects on religious, moral, or ethical grounds is not required to participate in abortions.
A private or religiously-afﬁliated hospital is not required to permit the use of its facilities for the performance of an abortion.

Participation in Research Harmful to Human Life:

Indiana currently provides no protection for the rights of healthcare providers who conscientiously object to participation in human cloning, destructive embryo research, or other forms of immoral medical research.

What Happened in 2012:

In Planned Parenthood of Indiana v. Comm'r of the Ind. State Dep't of Health, the Seventh Circuit Court of Appeals upheld the grant of a preliminary injunction against a 2011 Indiana law defunding Planned Parenthood and other abortion providers. However, the court also acknowledged that, absent federal rules to the contrary, a state may preclude certain providers (such as Planned Parenthood) from receiving certain healthcare funds.
Indiana enacted a bioethics measure with multiple implications. The measure prohibits destructive research on embryos created with ova provided to a “qualified third part[ies].” In other words, the state prohibits research on embryos created from ova initially provided for in vitro fertilization purposes. The measure also prohibits the purchase or sale of human ova, but does not prohibit certain transactions between a woman and a qualified IVF clinic for certain expenses (e.g., earnings lost, travel expenses, medical expenses, or recovery time). Further, the measure’s prohibition on experimentation explicitly excludes fetal stem cell research from its application.

Recommendations for Indiana Top Priorities:

Abortion-Inducing Drugs Safety Act
Child Protection Act
Unborn Wrongful Death Act

Other Priorities: Abortion

Joint Resolution Commending Pregnancy Centers

Legal Recognition and Protection for the Unborn:

Law criminalizing assaults on the unborn regardless of viability
Unborn Wrongful Death Act
Pregnant Woman’s Protection Act

Bioethics:

Promotion of ethical research alternatives

Healthcare Freedom of Conscience:

Healthcare Freedom of Conscience Act

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