On Why I Do Not Support The RH Bill

I finally got down and wrote my thoughts about the RH Bill on my Facebook page.  Since I already talked about this last year, I decided to copy the note here too.

There is a lot of conflict going on today regarding the the RH Bill and so many people pro and con talk about it, asks my opinion, that I felt I should put on record where I stand.  First, I want to be clear that I am for family planning and responsible parenthood. I agree that reproductive health, especially maternal and child care are important.  But I do not agree with the way the RH Bill is worded and made.  So simply put, I do not support the RH Bill...which one?...frankly, I don't know anymore which RH bill people are talking about because there are so many.  So I will just limit myself to the one I am familiar with and that is RH Bill No. 5043, 2008 version.  As someone coming from the health sector and familiar with the DOH programs on reproductive, maternal and child health, one does not need to read further to see and understand the real purpose of this so called "new" bill.  I could take it apart point by point.

From it's very title...AN ACT PROVIDING FOR A NATIONAL POLICY ON REPRODUCTIVE HEALTH, RESPONSIBLE PARENTHOOD AND POPULATION DEVELOPMENT, AND FOR OTHER PURPOSES.  The other purposes here being: to promote gender equality, women empowerment and human rights, specifically reproductive health rights.

But what about Republic Act 6365 which is AN ACT ESTABLISHING A NATIONAL POLICY ON POPULATION, CREATING THE COMMISSION ON POPULATION AND FOR OTHER PURPOSES ... doesn't it state that it is a "national policy" as well? and there's PRESIDENTIAL DECREE No. 79 December 8, 1972 REVISING THE POPULATION ACT OF NINETEEN HUNDRED AND SEVENTY-ONE. There is also Republic Act 7600 which is The Rooming-In and Breastfeeding Act of 1992 and Executive Order 209 or THE FAMILY CODE OF THE PHILIPPINES as well.  Plus the RA 9710 or The Magna Carta for Women, as well as the Violence against Women and Children laws.

Is there a difference between these laws and the RH Bill?  If you read through all of them, I would say not much and fact is, the RH bill more less just summarizes them all.  All the above previous laws addresses population, gender equality and equity, reproductive health care, et al.  Now I am not a lawyer, nor do I profess to know the law but in my layman's opinion, this RH Bill actually reads more like an inadequate and ambiguous IRR of all of the above laws rather than a law itself! It is redundant to say the least.

I find the following sections coercive and dictatorial. Are we not allowed conscientious objection here?

SEC. 9 of the RH Bill states: Hospital-Based Family Planning. -Tubal ligation, vasectomy, intrauterine device insertion and other family planning methods requiring hospital services shall be available in all national and local government hospitals, except: in specialty hospitals which may render such services on an optional basis. For indigent patients, such services shall be fully covered by PhilHealth insurance and/or government financial assistance. 

So, what happens if there doctorsdo not want to do these procedures?

And SEC. 10 states: Contraceptives as Essential Medicines. – Hormonal contraceptives, intrauterine devices, injectables and other allied reproductive health products and supplies shall be considered under the category of essential medicines and supplies which shall form part of the National Drug Formulary and the same shall be included in the regular purchase of essential medicines and supplies of all national and local hospitals and other government health units.

This one does not even need to be included here.  WHO has already listed contraceptives, IUDs, injectable hormonal contraceptives in their model list of essential drugs. My issue on this is simple.  Why in heavens name should hospitals include contraceptives in their regular procurement of essential drugs when they cannot even provide the complete course of antibiotics and other life-saving medicines?  Why should our taxes pay for contraceptive use which is basically cheap and available over the counter when our hospitals are in dire need of upgrading their facilities and services?  Why should I, a taxpayer pay for other people's birth control?

And then, this...

SEC. 21. Prohibited Acts. – The following acts are prohibited:

a) Any health care service provider, whether public or private, who shall:

1. Knowingly withhold information or impede the dissemination thereof, and/or intentionally provide incorrect information regarding programs and services on reproductive health including the right to informed choice and access to a full range of legal, medically-safe and effective family planning methods;

I interpret this as meaning that if I advise the patient on family planning/ responsible parenthood programs that I adhere to and not on other methods, then I am violating this law. Whatever happened to my rights?

2. Refuse to perform voluntary ligation and vasectomy and other legal and medically-safe reproductive health care services on any person of legal age on the ground of lack of spousal consent or authorization.

Very indiscriminate and random!  So, if a 21 year old with 2 children whose ages are 1 and 3 wants to undergo tubal ligation, this should be done just because?

3. Refuse to provide reproductive health care services to an abused minor, whose abused condition is certified by the proper official or personnel of the Department of Social Welfare and Development (DSWD) or to duly DSWD-certified abused pregnant minor on whose case no parental consent is necessary.

What exactly does "reproductive health services" constitute here?

4. Fail to provide, either deliberately or through gross or inexcusable negligence, reproductive health care services as mandated under this Act, the Local Government Code of 1991, the Labor Code, and Presidential Decree 79, as amended; and

What can I say....we cannot provide what we do not have in terms of skills, manpower and facilities. Does that constitute deliberate, gross or inexcusable negligence on our part or the government's?

5. Refuse to extend reproductive health care services and information on account of the patient’s civil status, gender or sexual orientation, age, religion, personal circumstances, and nature of work; Provided, That all conscientious objections of health care service providers based on religious grounds shall be respected: Provided, further, That the conscientious objector shall immediately refer the person seeking such care and services to another health care service provider within the same facility or one which is conveniently accessible: Provided, finally, That the patient is not in an emergency or serious case as defined in RA 8344 penalizing the refusal of hospitals and medical clinics to administer appropriate initial medical treatment and support in emergency and serious cases.

Ask ko lang....since when did contraception fall under emergency medicine?  Meron ba?  Has there ever been a case of "contraceptive emergency"? SO WHAT FALLS UNDER "EMERGENCY AND SERIOUS CASES"?  Maybe in cases of bleeding due to an IUD but otherwise, seeking reproductive health service specifically for tubal ligation, IUD insertion, et al... are all classified under elective procedures. There are already laws addressing emergency cases and penalties for doctors and hospitals refusing to treat such cases. This provision will only result in arbitrary interpretations and only create confusion.

b) Any public official who prohibits or restricts personally or through a subordinate the delivery of legal and medically-safe reproductive health care services, including family planning;

c) Any employer who shall fail to comply with his obligation under Section 17 of this Act or an employer who requires a female applicant or employee, as a condition for employment or continued employment, to involuntarily undergo sterilization, tubal ligation or any other form of contraceptive method;

d) Any person who shall falsify a certificate of compliance as required in Section 14 of this Act; and

e) Any person who maliciously engages in disinformation about the intent or provisions of this Act.

SEC. 22. Penalties. – The proper city or municipal court shall exercise jurisdiction over violations of this Act and the accused who is found guilty shall be sentenced to an imprisonment ranging from one (1) month to six (6) months or a fine ranging from Ten Thousand Pesos (P10,000.00) to Fifty Thousand Pesos (P50,000.00) or both such fine and imprisonment at the discretion of the court. If the offender is a juridical person, the penalty shall be imposed upon the president, treasurer, secretary or any responsible officer. An offender who is an alien shall, after service of sentence, be deported immediately without further proceedings by the Bureau of Immigration. An offender who is a public officer or employee shall suffer the accessory penalty of dismissal from the government service. Violators of this Act shall be civilly liable to the offended party in such amount at the discretion of the proper court.

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The Department of Health have programs in place for reproductive health, responsible parenthood, population development for the longest time.  The problem is efficient implementation and budget.  A new law to address all these is unnecessary and redundant.  Take a look at these DOH programs:

• Family Planning
• Breastfeeding Program / Mother and Baby Friendly Hospital Initiative
• Natural Family Planning
• Child Health
• Adolescent and Youth Health and Development Program
• Safe Motherhood and Women's Health Project
• Newborn Screening

Moreover, the rate of population growth in the Philippines decreased from 3.1% in 1960 to 1.8% in 2009. This rate remained comparatively steady, and was consistent with the decrease in population growth rate worldwide.  A paper published in 2003 asserted that the population program was "ineffectual," not because of lack of population programs and policies but beacuse of "inadequate institutional and financial support".   

(Retrieved from http://www.consciencelaws.org/issues-legal/legal055a.html)

And what about the Catholic Church?

The argument by pro-RH people is that the reason why responsible parenthood is (as they perceive) not working is because of the Catholic Church.   Huh?  What is the evidence for that pronouncement? I invite you to visit the OB wards in hospitals and you will find that 75 to 80% of mothers giving birth in the hospital does not regularly attend mass, do not know their priest, have not gone back to confession since their first confession, are totally unaware of what actions the Church is doing against the RH bill. So what has the Church got to do with the failures of the population program?    In fact surveys show that Catholic women are very much aware of family planning methods and only a mere 5% has cited religion as their reason for not using contraception. This further tells me that the Church is actually ineffective in advancing Catholic teaching on contraception and sterilization.

So, is there a need for the RH Bill?  For me, a definite No. 

The RH Bill is something our lawmakers and government is pushing for to cover up for past failures in the implementation of their population program.  It is also a way of diverting attention from the real problems of this country. If they are serious about population management, then they should realize that what is needed is proper implementation, enough budget, committed health workers who will make these family planning services available during all working days of the week.  Information, accessibility, and availability of services is the key to success...not a new law.  People who want to avail of the services should have access to them. A older friend told me that the law is needed to ensure implementation...that LGU's will now be compelled to implement the law.  I think not.  This country has too many laws and more often than not, implementation is sadly lacking.  What is needed is political will and commitment to make any health program work. What is needed is good education, accessibility to the poor of effective health services, transparency in governance and no to graft and corruption. Only then can we minimize poverty...and then, the problem of overpopulation becomes moot and academic. This law is not empowering women, rather it disrespects them.


Related Post: The Filipino and Catholicism

The Filipino and Catholicism

Last Thursday, Carlos Celdran, the original walking tour guide, artist, blogger, activist and Reproductive Health  (RH) Bill supporter did the unthinkable in this largely Catholic nation...he disrupted a holy mass and was promptly thrown in jail!  A lot of comments and reactions were made, both good and bad, but what struck me was the validation of a personal observation. I am not a religious person and I often forget to pray...but I have always had both a strong faith and conscience. Still, I never really had deep thoughts about God and religion until maybe in my mid 30's when life-changing experiences propelled me to seek more purpose and meaning in my life...which logically (at least for me) led me to understanding why I was a Catholic Christian.   But for the majority of Filipinos, Catholicism is nothing more but trappings.  They were born to Catholic parents, baptized at birth or usually before they learn to walk or talk, undergo catechism and have their first communion, get confirmed before they get married in church and the cycle continues.  How many of these Filipino Catholics really understand and know the religion they practice? Thus, people like Carlos Celdran do irrational things and even get supporters!  Perhaps if  people understood clearly why the Catholic Church takes a stand against policies like the RH Bill, disrespectful and irreverent acts against the Church would not happen. The Bishops and the clergy need to go down to the level of understanding of the people and do better in their pastoral role. They should stop talking in abstract language and putting out thoughts only they understand.  They should begin talking in the language of the people in order to avoid wrong perceptions.  They should do as Jesus did...teaching in parables, something that people at that time understood, bringing His message across.   A lot of comments regarding Celdran made free use of the word "dogma"  in relation to church teachings on contraceptive use,  a clear indication of the lack of understanding for the word.  Media played it up further by declaring that the Bishops will advocate "civil disobedience"... encouraging people not to follow the RH bill hardly constitute civil disobedience! Unfortunately, like the rest of humanity, the Church itself is not perfect...there are so many problems besieging it that pastoral work suffers...and in the end, the conflict between church teachings and the world continues.

And the Reproductive Health Bill?  Being in the medical profession, I am for planned and responsible parenthood.  However, because I know what I am talking about in terms of maternal and child health, I also believe that another bill addressing Reproductive Health is unneccesary, redundant and will only add to the confusion of the already confused populace.  The RH bill  suggests that there is a need to address reproductive health issues of women because the country lacks services for these, when in fact all these are already in place in Department of Health Programs namely: Family Planning, Natural Family Planning , Safe Motherhood and Women's Health, Breastfeeding Program / Mother and Baby Friendly Hospital Initiative, and Adolescent and Youth Health and Development Program .  It's ridiculous to have another law when the old laws cannot even be implemented well.  The answer to our population problem is not birth control.  Birth control distribution and availability will not prevent fetuses found in garbage cans...it will not end the problem of abandoned babies... nor will it create a more stable economy for the country.  Anybody who believes the last one should live in Cuba or Mongolia...both have a low fertility rate and birthrate but you don't see their economy growing any faster.    What it will inevitably result to and this is evidence-based as shown by US statistics is more separations/annulment or divorce, more adultery, increasing STDs, and yes, plummeting birth rates eventually ,which shouldn't really make everyone happy as its negative effects far outweigh the positive.  So if not contraceptives, what then?  How about good old abstinence?  I know it's hard but it works!  Or maybe we should just follow the Brazilians.