Position Paper on the Republic Health Bill
David D. Dueñas, RN University of La Salette Graduate School
I.
INTRODUCTION
Despite crimes against individuals, groups and humanity, the value of life is most universally recognized. o!ever, ho! this life is enhanced and defended ta"es shape in relation to particular conte#ts. $his involves fostering a culture of life, esta%lishing social support structures and forming attitudes of respect for life.
$his &osition &aper e#amines the ongoing heated discussion to the proposed "reproductive health" (RH) bills that are currently pending in Congress. Numbers of the said bill has been filed in the House of Representatives. These include House Bill ! #no$n as the %Reproductive Health and &opulation and 'evelopment ct of *+*, filed by Rep. -dcel C. agman. This ne$ bill is a re$ritten version of the draconian HB /*01 $hich did not pass in the last Congress despite the underhanded and deceptive tactics of its authors and foreign2 funded proponents. 3ther bills on %reproductive health, filed in the +/ th Congress include HB+*+ by Rep 4anette 5arin of 6loilo HB/+1 by Rep. Bag2o of the 7B8N &arty2ist and HB++!* by Rep. Rodolfo Bia9on of :untinlupa. These bills $ere consolidated into a single one called "n ct &roviding for a Comprehensive &olicy on Responsible &arenthood Reproductive Health and &opulation and 'evelopment." This ne$ version $as approved by the House Committee on &opulation and ;amily Relations on 4anuary 1+ *++. The ne$ consolidated bill as of ;ebruary *++ is numbered HB 000. 6n late :arch *++ ? by =enator :iriam 'efensor2=antiago. Different versions of the %ill mandate the dissemination of information on se# education including different methods of contraception through schools and the !or"place, and the availa%ility of the same information and related treatments and programs in government health services. Government leaders especially those sponsor of the R 'ill in (ongress have mounted an information drive on all forms of media. )n retaliation, the (atholic (hurch has used pastoral letters from %ishops, homilies from the pulpit, and streamers outside churches against the passage of the %ill. Developments on this issue ta"e place almost on a daily %asis. *arious constituencies and sta"eholders have responded to these, either in support or in disagreement. 'ecause it touches areas on religion such as marriage, attitudes to!ards family, human se#uality and life.
II.
COUNTER ARGUMENT
The Bills un! Aborti"acient Contracepti#es in $iolation o" the Constitution &revious versions of the bill e@plicitly fund the procurement and distribution of abortifacient contraceptives such as oral contraceptives other hormonal contraceptives and
the 6A'. n abortifacient ho$ever causes the eventual destruction of the f ertili9ed egg of ne$ly2conceived life. 6t therefore violates the &hilippine Constitution. 6t may be argued that the abortifacient mechanism of some oral contraceptives has not been conclusively proven to occur in human beings or that if it does occur then this occurrence is very rare. -ven if there really $ere any doubt that a contraceptive is abortifacient the death of a human being involved means that the burden of proof is on those $ho $ould deny that these are abortifacients. 6n other $ords they must prove that these contraceptives are in fact non2abortifacient. There is no medical necessity to birth control that
ilipinos !o not %ant an RH &a% The ;ilipino ;amily =urvey (**) revealed that F of :etro :anila residents are against the passage of the controversial reproductive health (RH) bill once they #no$ and understand its provisions. 6t $as conducted from 'ecember 2 ** $as conducted by HBG 6nternational Research using the e@perienced field personnel of the sian Research 3rgani9ation (R3) the &hilippine affiliate of 5allup 6nternational. The poll has called into Duestion claims of $ide public support for the proposed measure made by its authors and supporters. The claims of $idespread support for a reproductive health la$ are also highly Duestionable as they are based on misleading surveys. :ost respondents $ere almost totally una$are of the actual provisions of the bill in Duestion.
Contracepti#es o"ten !o not pre#ent unplanne! pre'nanc( an! )a( actuall( increase the) Numerous studies have sho$n that the increased availability and usage of contraceptives does not necessarily reduce unplanned pregnancies and abortion. 6n fact contraceptives often increase them. ;or e@ample in the Anited =tates ?F of se@ually active $omen of reproductive age "at ris#" of becoming pregnant use contraception and ?F have used it in their lifetime according to the lan 5uttmacher 6nstitute. 6n addition $ith typical use F of $omen using oral contraceptives (3C) $ill become pregnant $ithin one year as $ill +/F of $omen $hose partners use condoms. ;orty2eight percent of $omen $ith unintended pregnancies $ere using contraception in the month they became pregnant. 3ther studies sho$ that greater access to contraception does not reduce unintended pregnancy. rcidiacono (**/) found that among teens increasing access to contraception
may actually increase long run pregnancy rates even though short run pregnancy rates fall. 3n the other hand policies that decrease access to contraception and hence se@ual activity are li#ely to lo$er pregnancy rates in the long run. 6n a study of +! regions of the A.7. over a +02year period &aton (**) found no increase in pregnancies or abortions in underage -nglish girls despite reduced access to contraception and no decrease in underage pregnancies or abortions overall from greater access to contraception. He found "no evidence" that "the provision of family planning reduces either underage conception or abortion rates." 6n his study "Trends in &remarital =e@ in the Anited =tates +/02**1 ;iner (**>) found that the increase in premarital se@ amongst a group of teens turning +/ during the years +!02+>1 %may be partly due to increased availability of effective contraception (in particular the pill) $hich made it less l i#ely that se@ $ould lead to pregnancy., 7irby (+) concluded that most studies that have been conducted during the past * years have indicated that improving access to contraception did not significantly increase contraceptive use or decrease teen pregnancy.
The contracepti#e approach !oes not a!!ress the causes o" )aternal !eaths relate! to pre'nanc( an! chil!birth The contraceptive approach ta#en by the HB 000 (and in its previous versions) treats pregnancy as if it $as a disease and see#s to reduce maternal mortality simply by reducing childbirth. 6nstead of providing urgently needed health care the approach mainly provides condoms and abortifacient contraceptives and therefore ignores the real causes of maternal death $hile attac#ing a non2problem. &reventing pregnancy to lessen maternal deaths ho$ever is li#e preventing people from o$ning a vehicle to lessen vehicular deaths. This approach $ill only succeed in diverting scarce resources a$ay from more urgent problems $hile encouraging even more promiscuity and E as people e@perience even more contraceptive failures E eventually greater demand for abortion. 6nstead of providing contraceptives $ith all their attendant health ris#s and costs maternal deaths related to childbirth can be reduced by increasing access to health facilities and s#illed birth attendants. ccording to the National 'emographic and Health =urvey **? only 00 percent of births occur in health facilities and only !F of births are assisted by a health professional. 6nstead of $asting scarce funds on contraceptives the government should increase access to basic health facilities and trained birth attendants. These measures $ill do more to lo$er maternal deaths than contraceptives. The &hilippines has to deal $ith many other true #iller diseases such as heart and vascular diseases pneumonia tuberculosis cancer and diabetes. The government does not provide free medicines and medical treatment for these because it cannot afford to do so.
hy then should it $aste money on contraceptives $hich do not treat any real diseaseI ®nancy is not a disease.
The contracepti#e approach !oes not a!!ress the real causes o" in"ant )ortalit( 6f $e accept the assertion that infants and children have a greater probability of dying if they are born to mothers $ho are too young or too old if they are born after a short birth interval or if they are of high birth order all these concerns can be safely addressed through modern Natural ;amily &lanning ma#ing contraception unnecessary. Contraceptive methods introduce adverse medical side2effects and as such should not be a preferred method to effect a reduction in infant mortality. :odern Natural ;amily &lanning methods in contrast are completely safe and can be easily used to effect birth spacing and avoid early or late pregnancies. 6nfant mortality can also be significantly reduced using the same means as reducing maternal mortality namely increasing access to health facilities and s#illed health attendants.
Contracepti#es %ill not !ecrease the inci!ence o" *TDs an! )a( actuall( increase it number of studies have lin#ed increased access to contraceptives to an increase in =T's. These includeJ •
TydenKs study in =$eden mentioned earlier also found that bet$een +/ and **+
•
Chlamydia infections rose /*F overall in =$eden and !*F among the young. 6n a **1 study 'avid &aton found that bet$een + and **+ $ith improved
•
access to family planning clinics in the Anited 7ingdom (teen visits rose over 1F) the number of se@ually active teens rose almost *F and =T' rates rose +/.?F. . illiams noted that "6n =cotland there has been a doubling of the rates of Herpes and L5onorrheaM and a four2fold increase in Chlamydia in the past ten years (+12 **1)" despite a three2fold increase in the use of -C and greatly increased access to contraception.
The RH bills are un!ul( coerci#e an! #iolate "ree!o) o" speech+ "ree!o) o" conscience+ an! "ree!o) o" reli'ion s of this $riting the authors of the Bill have announced that they $ill amend the legislation and delete =ection ? (e) of the proposed bill. This section lists the follo$ing as a prohibited actJ %ny person $ho maliciously engages in disinformation about the intent or provisions of this ct., This provision is overly broad and %disinformation, could (and most probably $ill) be construed as prohibiting the e@pression of ob
is an undue restriction of freedom of speech. 6t has no place in any of the la$s of a democratic nation. nother announced amendment $ill be the deletion of section + $hich mandates that employers must provide family planning services (or information on $here to obtain these) presumably including abortifacient contraceptives to their employees. -mployers therefore are not given any choice despite the fact that distribution of these abortifacients and contraceptives may be against their conscience. This section is said to be a reiteration of e@isting la$ and therefore not necessary. 6f health care providers refuse to perform certain services so on religious grounds E presumably because these are morally ob
III.
ARGUMENT*
The Repro!ucti#e Health Bill uphol!s the principle that in!i#i!uals an! couples ha#e the ri'ht to be "ull( in char'e o" their repro!ucti#e !ecisions )t guarantees the freedom of choice of every person over their o!n %odies + !hether or not they !ant to have children, ho! many children they !ill have and the space %et!een their %irths. )t promotes the right of !omen to reproductive selfdetermination %y ensuring that there is an ena%ling environment !here she can ma"e informed decisions on ho! she can %est ensure her overall reproductive health and that of her family, !ithout coercion or fear. The Repro!ucti#e Health Bill ensures uni#ersal access to repro!ucti#e health ser#ices an! in"or)ation
$he %ill !ill provide timely, complete and accurate information on reproductive health as !ell as ready access to safe, ade-uate and afforda%le reproductive health care services. )t provides penalties to those !ho !ould !ithhold information on reproductive health or !ould fail to perform or deliver reproductive health services. )t provides capa%ility%uilding to %arangay health !or"ers !ho are at the forefront of delivering the %asic health services. )t mandates local government units to appropriate funds for reproductive health services. $he %ill !ill save the lives of mothers and children. )t !ill save the future of youth. )t !ill help couples %ecome truly responsi%le parents. The Repro!ucti#e Health Bill ensures an e""ecti#e repro!ucti#e health e!ucation $he %ill does not only instill consciousness of freedom of choice %ut responsi%le e#ercise of ones rights. $he %ill provides for a mandatory reproductive health and se#uality education in our formal education system. /hile it is imperative that the parents and adult mem%ers of the family should initiate this education0 ho!ever, it is a fact that most parents are remiss in this o%ligation or cannot simply perform such %ecause they are overseas !or"ers. 'y ensuring an effective reproductive health education, young people !ill %e provided !ith information and s"ills a%out ta"ing care of their reproductive and se#ual health, and !ill help them ma"e sound decisions no! and in the future. The Repro!ucti#e Health Bill pro)otes population )ana'e)ent in or!er to achie#e social an! econo)ic !e#elop)ent $he gap %et!een the num%er of families !ho !ould li"e to limit family size and the num%er !ho have access to sufficient information and services to do so have risen among the poor ma1ority of 2ilipinos. )t is these children of the poor !ho are unli"ely to finish elementary school, or go to high school or develop technical or professional s"ills for a productive life. &opulation management achieved through the enhancement of reproductive health is fundamental to improving human !elfare, reducing poverty and promoting economic gro!th. $he %ill !ill manage an un%ridled population gro!th that hinders socioeconomic development %y esta%lishing an integrated national policy on population management. The bill !oes not le'ali,e abortion nor !oes it pro)ote se-ual pro)iscuit(
$he %ill continues to proscri%e a%ortion, !hich is a crime under the Revised &enal (ode. o!ever, !hen a%ortion is resorted to, despite the prohi%ition, there is a need to manage posta%ortion complications in a humane and compassionate manner. $he patient should not %e suffered to die due to her desperation. Neither does the %ill encourage a%ortion. 3n the contrary, the correct and consistent use of contraceptives prevents un!anted, unplanned and mistimed pregnancies, !hich are the very pregnancies that are terminated through a%ortion. &lanned pregnancies foreclose intentional a%ortion. I$.
CONC&U*ION
The Reproductive Bill protects life and promotes the wellbeing of families, especially of women and their children. Contrary to what its detractors say, the RH Bill is not “pro-abortion, “anti-life, or “antiwomen. !ith “respect for life as one of its guiding principles, the bill states that it does not see" to “change the law on abortion, as abortion remains a crime and is punishable. #t can be argued, in fact, that in guaranteeing information on and access to “medically-safe, legal, a$ordable and %uality natural and modern family planning methods, the bill see"s “to prevent unwanted, unplanned and mistimed pregnancies the main cause of induced abortions. &oreover, the RH Bill's de(nition of “reproductive health care goes beyond the provision of providing young people the information and values they would need, not only to ta"e care of their reproductive and se)ual health, but also to arrive at sound and responsible decisions regarding their se)uality, se)ual behavior, and family life, whether now or in the future. $he %ill is not a%out a%ortion or se#ual promiscuity. )t is neither an issue of religion nor a -uestion of !hen does life %egins. )t is a%out health and rights. )t is a%out promoting and protecting the %asic human right to health and r eproductive self determination.
Having identi(ed the points of disagreement, in the light of the realities of *ilipino women, poor families, and youth, # have come to conclude that the +hilippines urgently need a national policy on reproductive health and population development. # therefore strongly support the RH Bill's immediate passage in Congress.
REFERENCES
Arcidiacono, P., et al. (2005). Habit persistence and teen sex: Could increased access to contraception have unintended consequences or teen pre!nancies". #oonstra, H., et al. (200$). Abortion in %o&en's lives. e% or*: +utt&acher nstitute, 200$. -iner, . (200/). rends in pre&arital sex in the united states, 1534200. Public Health 6eports. 7olu&e 122 (8anuar94-ebruar9 200/): pp. ///;. H# < AA6= 6esearch +roup. -ilipino -a&il9 >urve9. Conducted ?ece&ber 200, &ade public 8anuar9 2010. 6etrieved ro& http:@@prolie.or!.ph@ho&e@uploads@-ilipino20-a&il9 20>urve920v.2.11.ppt. Birb9, ?. (1). 6elections on t%o decades o research on teen sexual behavior and pre!nanc9. Journal of School Health. an!ahas, . #usiness !roups %or* or 6H co&pro&ise. Philippine ?ail9 nquirer, ove&ber 20, 200.
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9den, ., et al. (2002). o reduced nu&ber o abortions despite easil9 available e&er!enc9 contraceptive pills. a*artidnin!en. Eillia&s, A. (2005). he &ornin! ater pill. >cottish Council o Hu&an #ioethics.
