Chemical abortion

AN ACT Relating to chemical abortion; amending RCW 9.02.120; 1
reenacting and amending RCW 9.02.170; adding new sections to chapter 2
9.02 RCW; creating a new section; and prescribing penalties.3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:4
NEW SECTION. Sec. 1. A new section is added to chapter 9.02 RCW 5
to read as follows: 6
(1) In every civil, criminal, or administrative proceeding or 7
action brought under this act, the court shall rule whether the 8
anonymity of any patient upon whom an abortion has been performed or 9
attempted shall be preserved from public disclosure if the patient 10
does not consent to such disclosure. The court, upon motion or sua 11
sponte, shall make such a ruling and, upon determining that the 12
patient's anonymity should be preserved, shall issue orders to the 13
parties, witnesses, and counsel and shall direct the sealing of the 14
record and exclusion of individuals from courtrooms or hearing rooms 15
to the extent necessary to safeguard the patient's identity from 16
public disclosure. 17
(2) Each such order shall be accompanied by specific written 18
findings explaining why the anonymity of the patient should be 19
preserved from public disclosure, why the order is essential to that 20
S-1261.1
SENATE BILL 5713
State of Washington 69th Legislature 2025 Regular Session
By Senator Fortunato
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end, how the order is narrowly tailored to serve that interest, and 1
why no reasonable less restrictive alternative exists.2
(3) In the absence of written consent of the patient upon whom an 3
abortion has been performed or attempted, anyone other than the 4
public official who brings an action under this act shall do so under 5
a pseudonym. 6
(4) This section may not be construed to conceal the identity of 7
the plaintiff or of witnesses from the defendant or from attorneys 8
for the defendant. 9
Sec. 2. RCW 9.02.120 and 2022 c 65 s 8 are each amended to read 10
as follows: 11
(1) Unless authorized by RCW 9.02.110, any person who performs an 12
abortion on another person shall be guilty of a class C felony 13
punishable under chapter 9A.20 RCW. ((The state shall not penalize, 14
prosecute, or otherwise take adverse action against an individual 15
based on their actual, potential, perceived, or alleged pregnancy 16
outcomes. Nor shall the state penalize, prosecute, or otherwise take 17
adverse action against someone for aiding or assisting a pregnant 18
individual in exercising their right to reproductive freedom with 19
their voluntary consent.))20
(2) A cause of action for civil damages against a person who has 21
performed or prescribed a chemical abortion in violation of section 4 22
of this act may be maintained by:23
(a) Any patient upon whom a chemical abortion has been performed 24
or prescribed in violation of section 4 of this act;25
(b) The spouse of the patient, if married to the patient at the 26
time the chemical abortion was performed or prescribed;27
(c) If the patient had not attained the age of 18 when the 28
chemical abortion was performed or prescribed or has died as a result 29
of the abortion, then the maternal grandparents of the unborn child; 30
or31
(d) If the patient has died from the complications, then the 32
patient's next of kin.33
(3) No damages may be awarded to a plaintiff if the pregnancy 34
resulted from the plaintiff's criminal conduct.35
(4) Damages awarded in such action shall include:36
(a) Money damages for all injuries, psychological and physical, 37
caused by the chemical abortion; and38
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(b) Statutory damages equal to three times the cost of the 1
chemical abortion.2
(5) No criminal or civil penalty may be assessed against the 3
patient upon whom the abortion is performed, induced, or attempted.4
(6) The attorney general or a district attorney with appropriate 5
jurisdiction may investigate the alleged violation of section 4 of 6
this act and initiate a civil action on behalf of the state to assess 7
civil penalties.8
(7) Prior to asserting a cause of action, the attorney general or 9
a district attorney with appropriate jurisdiction shall provide the 10
abortion pill provider, physician, physician assistant, advanced 11
practice registered nurse, or other health care provider with at 12
least 30 days to comply with section 4 of this act.13
(8) Any abortion pill provider, physician, physician assistant, 14
advanced practice registered nurse, or other health care provider 15
that violates section 4 of this act may be liable for a civil 16
penalty, to be assessed by the court, of not more than $5,000 for 17
each day in violation to be paid to the state to fund pregnancy 18
resource centers that do not perform or refer for abortions.19
(9) In addition to the remedies provided in this section, the 20
attorney general or a district attorney with appropriate jurisdiction 21
may request, and the court may impose, an additional civil penalty 22
not to exceed $10,000 for each violation of section 4 of this act 23
against any abortion pill provider, physician, physician assistant, 24
advanced practice registered nurse, or other health care professional 25
found by the court to have knowingly failed to conduct reasonable 26
informed consent prior to a chemical abortion. The civil penalty 27
shall be paid to the state to fund pregnancy resource centers that do 28
not perform or refer for abortions.29
(10) Each violation may be treated as a separate violation or may 30
be combined into one violation at the option of the attorney general 31
or a district attorney with appropriate jurisdiction.32
(11) Any commercial entity that violates this section may be 33
liable to the attorney general or a district attorney with 34
appropriate jurisdiction for all costs, expenses, and fees related to 35
investigations and proceedings associated with the violation, 36
including attorneys' fees.37
(12) If the court assesses a civil penalty pursuant to this 38
section, the state shall be entitled to the statutory legal interest 39
from the date of imposition of the penalty until paid in full.40
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(13) If judgment is rendered in favor of the plaintiff, the court 1
shall also render judgment for reasonable attorneys' fees in favor of 2
the plaintiff.3
(14) If judgment is rendered in favor of the defendant and the 4
court finds that the plaintiff's suit was frivolous and brought in 5
bad faith, the court shall render judgment for reasonable attorneys' 6
fees in favor of the defendant.7
(15) No attorneys' fees may be assessed against the patient upon 8
whom an abortion was performed or attempted except in accordance with 9
subsection (14) of this section.10
(16) Any person who violates section 4 of this act shall be fined 11
$10,000 or is guilty of a class B misdemeanor. No criminal or civil 12
penalty may be assessed against the patient upon whom the abortion is 13
performed or attempted.14
Sec. 3. RCW 9.02.170 and 2022 c 65 s 7 are each reenacted and 15
amended to read as follows: 16
For purposes of this chapter: 17
(1) "Abortion" means any medical treatment intended to induce the 18
termination of a pregnancy except for the purpose of producing a live 19
birth. 20
(2) "Abortion-inducing drug" means a medicine, drug, or substance 21
prescribed or dispensed with the intent of terminating a clinically 22
diagnosable pregnancy with the knowledge that the termination will, 23
with reasonable likelihood, cause the death of the fetus. The term 24
includes the off-label use of a drug known to have abortion-inducing 25
properties if the drug is prescribed with the intent of causing an 26
abortion.27
(3) "Abortion pill provider" means any person, regardless of 28
whether they are authorized or licensed by the state, who provides in 29
any capacity the means to deliver, arrange, offer, or give the 30
abortion pill to a woman with the intention of terminating the 31
woman's pregnancy.32
(4) "Advanced practice registered nurse ((practitioner))" means 33
an advanced practice registered nurse ((practitioner)) licensed under 34
chapter 18.79 RCW. 35
(((3))) (5) "Agent" means any person who acts for another at the 36
request or with the knowledge of the other in dealing with third 37
parties.38
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(6) "Attempt to perform an abortion" means to do anything that, 1
under the circumstances as the actor believes them to be, is an act 2
constituting a substantial step in a course of conduct planned to 3
culminate in performing an abortion. Such substantial steps include, 4
but are not limited to:5
(a) Agreeing with an individual to perform an abortion on that 6
individual or on another individual, regardless of whether the term 7
"abortion" is used in the agreement and whether the agreement is 8
contingent on another factor such as receipt of payment or a 9
determination of pregnancy; and10
(b) Scheduling or planning a time to perform an abortion on an 11
individual, regardless of whether the term "abortion" is used and 12
whether the performance is contingent on another factor such as 13
receipt of payment or a determination of pregnancy.14
(7) "Chemical abortion" means the use or prescription of an 15
abortion-inducing drug dispensed with the intent to cause the death 16
of the unborn child.17
(8) "Complication" means any harmful event or adverse outcome 18
with respect to a patient related to chemical abortion that is 19
performed on the patient and that is diagnosed or treated by a health 20
care practitioner or at a health care facility. "Complications" 21
include, but are not limited to:22
(a) Shock;23
(b) Hemorrhage;24
(c) Aspiration or allergic response;25
(d) Infection;26
(e) Sepsis;27
(f) Death of the patient;28
(g) Incomplete chemical abortion requiring additional treatment;29
(h) Incomplete chemical abortion requiring further surgical 30
procedures that include risks such as uterine perforation, cervical 31
laceration, or scarring;32
(i) Damage to the uterus;33
(j) The continuation of the pregnancy;34
(k) Psychological or emotional trauma; and35
(l) Excessive pain, discomfort, or nausea.36
(9) "Health care provider" means a person regulated under Title 37
18 RCW to practice health or health-related services or otherwise 38
practicing health care services in this state consistent with state 39
law. 40
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(((4))) (10) "Medical emergency" means a condition which, in 1
reasonable medical judgment, so complicates the medical condition of 2
the patient as to necessitate the immediate abortion of the pregnancy 3
to avert the patient's death or for which a delay will create serious 4
risk of substantial and irreversible physical impairment of a major 5
bodily function of the patient, not including psychological or 6
emotional conditions. If, based on a claim by the patient or a 7
diagnosis by a medical provider, the patient will engage in conduct 8
the patient intends to result in the patient's death or in 9
substantial and irreversible physical impairment of a major bodily 10
function of the patient, then this shall not be deemed a medical 11
emergency.12
(11) "Physician" means a physician licensed to practice under 13
chapter 18.57 or 18.71 RCW in the state of Washington.14
(((5))) (12) "Physician assistant" means a physician assistant 15
licensed to practice under chapter 18.71A RCW in the state of 16
Washington. 17
(((6))) (13) "Pregnancy" means the reproductive process beginning 18
with the implantation of an embryo. 19
(((7))) (14) "Private medical facility" means any medical 20
facility that is not owned or operated by the state.21
(((8))) (15) "State" means the state of Washington and counties, 22
cities, towns, municipal corporations, and quasi-municipal 23
corporations in the state of Washington. 24
(((9))) (16) "Viability" means the point in the pregnancy when, 25
in the judgment of the physician, physician assistant, advanced 26
practice registered nurse ((practitioner)), or other health care 27
provider acting within the provider's scope of practice on the 28
particular facts of the case before such physician, physician 29
assistant, advanced practice registered nurse ((practitioner)), or 30
other health care provider acting within the provider's scope of 31
practice, there is a reasonable likelihood of the fetus's sustained 32
survival outside the uterus without the application of extraordinary 33
medical measures. 34
NEW SECTION. Sec. 4. A new section is added to chapter 9.02 RCW 35
to read as follows: 36
(1) Except in the case of a medical emergency, a chemical 37
abortion may not be provided, performed, induced, or attempted, and 38
an abortion-inducing drug may not be prescribed with the intent to 39
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terminate a pregnancy, unless, prior to any chemical abortion 1
provided, performed, or attempted using any abortion-inducing drug 2
with the intent to terminate a pregnancy, the abortion pill provider, 3
physician, physician assistant, advanced practice registered nurse, 4
other health care provider, or their agents shall provide written 5
information to accompany any instructions along with a list of 6
complications given to the patient, which must include the following 7
statement: 8
"If you decide to take any abortion-inducing drug to end your 9
pregnancy, the state of Washington informs you that either you or 10
your family may hold the manufacturer, distributor, or your 11
prescriber financially liable should you die, suffer injury or 12
complication, or any debilitating side effects (e.g. infection, 13
excessive bleeding, the rupture of a previously undiscovered ectopic 14
pregnancy, etc.) from the chemical abortion. Additionally, should the 15
manufacturer, distributor, or your prescriber fail to address side 16
effects or if the abortion-inducing drug fails and the pregnancy 17
continues so that you have an incomplete abortion or require surgical 18
intervention, you may hold them financially liable. You or your 19
family may also hold the abortion pill provider, physician, physician 20
assistant, advanced practice registered nurse, other health care 21
provider, or their agents financially liable for failing to inform 22
you of complications. 23
If you experience complications and are in need of emergency care 24
or a hospital visit, then you have the right to inform the health 25
care provider treating the complications that you have had a chemical 26
abortion. Providing this information will not subject you to any 27
criminal or civil penalty and will further help save your life."28
(2) Certification of the statement in subsection (1) of this 29
section is required. The patient shall certify in writing, prior to 30
the chemical abortion, that the information described in subsection 31
(1) of this section has been provided to the patient and that the 32
patient has been informed of the opportunity to review the 33
information referred to in subsection (1) of this section.34
(3) Prior to performance of the chemical abortion, the abortion 35
pill provider, physician, physician assistant, advanced practice 36
registered nurse, other health care provider performing the chemical 37
abortion, or their agents shall receive a copy of the written 38
certification outlined in subsection (2) of this section.39
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(4) The abortion pill provider, physician, physician assistant, 1
advanced practice registered nurse, other health care provider, or 2
their agents shall retain a copy of the written certification 3
outlined in subsection (2) of this section. 4
NEW SECTION. Sec. 5. A new section is added to chapter 9.02 RCW 5
to read as follows: 6
(1) Within 90 days after the effective date of this section, the 7
department of health shall prepare a reporting form for all abortion 8
pill providers and facilities providing, performing, or prescribing 9
chemical abortions containing a copy of this chapter and providing 10
for the listing of the following: 11
(a) The number of individuals to whom the abortion pill provider 12
gave the information described in section 4 (1) of this act; of that 13
number, the number provided by telephone, electronically, and in-14
person; and, of each of those numbers, the number provided 15
specifically by abortion pill providers, physicians, physicians 16
assistants, advanced practice registered nurses, or other health care 17
providers by provider type, and their agents. 18
(b) The number of chemical abortions performed by the abortion 19
pill provider, physician, physician assistant, advanced practice 20
registered nurse, other health care provider, or their agents whereby 21
information otherwise required to be provided before the chemical 22
abortion was not provided because an immediate abortion was necessary 23
to avert the patient's death or injury, along with the number of 24
chemical abortions in which such information was not provided because 25
a delay would create a medical emergency. 26
(2) Within 90 days after the effective date of this section, the 27
department of health shall prepare a reporting form for all 28
physicians or facilities that treat any adverse event or complication 29
arising from a known chemical abortion that has been performed, 30
attempted, or prescribed containing a copy of this chapter and 31
providing a listing of the following: 32
(a) The date the patient presented for treatment for the chemical 33
abortion complication; 34
(b) The age of the patient; 35
(c) The race of the patient; 36
(d) The county and state of the patient's residence;37
(e) The name of the abortion-inducing drug obtained by the 38
patient; 39
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(f) The date of the abortion; 1
(g) The name of the physician or health care facility where the 2
procedures were performed; 3
(h) Whether the patient obtained the abortion-inducing medication 4
via mail order or a website, including information identifying the 5
online source of the medication; 6
(i) Whether the complication was previously managed by the 7
abortion pill provider or the abortion pill provider's relief health 8
care provider; 9
(j) A list of each diagnosed complication; 10
(k) A description of the treatment provided for each complication 11
requiring treatment; 12
(l) Whether the patient's visit to treat the complications was 13
the original visit or a follow-up visit; 14
(m) The date of each follow-up visit, if any; and15
(n) A list of each complication diagnosed or treated at a follow-16
up visit, if any. 17
(3) The reporting requirements of subsection (2) of this section 18
apply only to: 19
(a) A physician, physician assistant, advanced practice 20
registered nurse, or other health care provider who:21
(i) Provides, performs, or induces a chemical abortion that 22
results in an abortion complication diagnosed or treated by that 23
physician, physician assistant, advanced practice registered nurse, 24
or other health care provider; or 25
(ii) Diagnoses or treats an abortion complication arising from an 26
abortion-inducing drug that is the result of an abortion performed by 27
another physician, physician assistant, advanced practice registered 28
nurse, or other health care provider; and 29
(b) A hospital, clinic, or health care facility providing 30
emergency services as defined in RCW 48.43.005. 31
(4) An abortion pill provider, physician, physician assistant, 32
advanced practice registered nurse, or other health care provider 33
shall electronically submit to the department of health a report on 34
each abortion complication diagnosed or treated by the abortion pill 35
provider, physician, physician assistant, advanced practice 36
registered nurse, or other health care provider no later than the end 37
of the third business day after the date the abortion complication 38
was diagnosed or treated. 39
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(5) The department of health shall ensure that no personally 1
identifiable health information of any patient is included in the 2
report. 3
(6) No later than July 1st of each year, the department of health 4
shall issue a public annual abortion report on its website providing 5
statistics for the previous calendar year compiled from all the 6
reports covering that year submitted in accordance with subsections 7
(1) and (2) of this section. 8
(7) Any abortion pill provider, physician, physician assistant, 9
advanced practice registered nurse, or other health care provider 10
that knowingly violates this section and fails to complete a report 11
detailed in subsections (1) or (2) of this section is subject to a 12
civil penalty of $500 for each violation. 13
NEW SECTION. Sec. 6. If any provision of this act or its 14
application to any person or circumstance is held invalid, the 15
remainder of the act or the application of the provision to other 16
persons or circumstances is not affected.17
NEW SECTION. Sec. 7. This act may be known and cited as the 18
abortion pill provider liability education (APPLE) act.19
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