Hundreds of thousands of people have already voted in Florida’s November General Election by mail. One of the constitutional initiatives on the ballot this year has to do with reproductive rights.
Pro-choice advocates, such as Floridians Protecting Freedom, have been working to educate the public on Amendment 4 prior to election day, Nov. 5. The group was responsible for collecting the 900,000 necessary signatures to get the amendment on the November ballot. Now, in order to pass, 60% of voters must say yes.
Opponents of the proposed amendment, groups like Physicians Against Amendment 4, have been pushing back, arguing that if passed, there would be unintended consequences. The amendment is 49 words long and is stirring a lot of disagreement on what it would do.
Here are the basics.
What is Amendment 4?
The official name for Amendment 4 is “the Amendment to Limit Government Interference With Abortion.”.
It states: “No law shall prohibit, penalize, delay, or restrict abortion before viability or when necessary to protect the patient’s health, as determined by the patient’s healthcare provider. This amendment does not change the Legislature's constitutional authority to require notification to a parent or guardian before a minor has an abortion."
How did we get here?
In 2022, the U.S. Supreme Court stripped away the constitutional right to an abortion, returning that power to the states in a case known as Dobbs v Jackson’s Women’s Health Organization.
That same year, Florida Gov. Ron DeSantis signed into law a 15-week abortion ban. The next year he signed a bill for a 6-week ban, however, that didn’t become law until earlier this year after the Florida Supreme Court ruled the 15-week ban was constitutionally sound.
What would Amendment 4 change?
Amendment 4 would make abortion a constitutional right meaning legislative bans on abortion would be removed.
What does the term “viability” mean?
Opponents of the amendment argue that viability is a vague word and would allow for abortions in all stages of fetal development.
However, viability does have a legal definition in Florida. According to a state statute “viable” or “viability” means the stage of fetal development when the life of a fetus is sustainable outside the womb through standard medical measures.
According to research by the American College of Obstetricians and Gynecologists, the majority of experts agree that 24 weeks is the earliest that a fetus is potentially viable. However, the ACOG states there is no formally recognized clinical definition of “viability” and discourages the use of the word in laws and regulations.
What do opponents not like about Amendment 4?
Dr. Angeli Akey is an MD from Gainesville and a member of Florida Physicians Against Amendment 4. The group states it has 500 physicians of varying specialties who stand against the amendment. The group opposes the portion of the amendment that they say would allow more people to conduct abortions. The wording in question reads:
“as determined by the patient’s healthcare provider.”
According to Dr. Akey, that vague terminology eliminates the need for a doctor to perform an abortion.
“A doctor needs to be involved, not only for complicated pregnancies but especially for second and third-trimester abortions, which are high-risk surgeries and would be allowed under this amendment,” she said. “So even people who aren't licensed in our field, or perhaps aren't even licensed at all, could provide an abortion.”
Abortions after 21 weeks do happen but are difficult to obtain and make up 1% of all abortions, according to a study by KFF. The most common reasons for an abortion to happen so late is because of fetal anomalies or maternal life endangerment.
While the proposed amendment doesn’t define what a healthcare provider is, Florida laws do. A 2016 statute defines a “provider” as a “person that furnishes health care services and is licensed or otherwise authorized to practice in the state,” and a 2024 statute list of providers includes: “a physician assistant, a registered nurse, a nurse midwife, a licensed practical nurse, or advanced practice registered nurse licensed.”
Currently, it is legally necessary in Florida for a physician to be present for an abortion, and Amendment 4 would open up the possibilities of who could perform an abortion. Some legal experts, like Dr. Robyn Powell who is a professor of public health law at Stetson University, say due to the advancement of medicine, medical professionals such as nursing practitioners or physician assistants could step in place of a physician for some abortion procedures.
“More than half of abortions are not done through surgical mechanisms. And we still have a slew of laws related to the healthcare profession as a whole that act as guardrails and would remain in place,” Powell said.
According to a 2022 analysis by the Guttmacher Institute, 54% of all abortions are carried out through medication.
Does it eliminate parental consent?
In Florida, it is legally required for the parent or guardian of a minor to receive parental notification and give consent 48 hours before an abortion can take place. Amendment 4 would eliminate parental consent, but the last line of the amendment does retain the necessity for parental notification prior to the abortion procedure.
Most medical procedures in Florida require parental approval prior to treatment, however, the state did pass a law in 2022 outlining emergency medical care that could be provided to a minor without consent. Exceptions can be when a minor “is suffering from an acute illness, disease, or condition and delaying treatment would endanger the health or physical well-being of the minor.” However, this is considered only for emergency situations.
How similar is this measure to others that have passed?
It is fairly similar. None that have passed are identical to each other but Amendment 4’s language was partially shaped by looking at states that have passed similar constitutional protections in the last two years like Ohio, Vermont, and Oregon. However, the last two states allow for an abortion during all stages of pregnancy. Ohio allows for abortions up to viability, as the Florida measure proposes.
Florida’s ballot measure isn’t alone this November. There are nine other states taking up similar measures. Eight of them made it onto the November ballot thanks to citizen-led efforts, like Florida’s Amendment 4. However, Florida is the only state with a six-week abortion ban and the only state that requires 60% approval from voters in order to pass. The others require 50% or 55%.
