BIOETHICS experts, doctors, and other health professionals criticized Reproductive Health Bill 5043 for reducing maternal health into a matter of “pregnancy prevention” or fertility control and for styling itself as anti-abortion while promoting birth-control methods that are “potentially abortifacient agents.”
They also criticized the bill and its proponents for exaggerating maternal health problems contrary to the government’s own statistics that show pregnancy complications are not a leading cause of death among Filipino mothers.
In a colloquium last November 13 at the UST Faculty of Medicine and Surgery conference room, leaders of the Southeast Asian Center for Bioethics, Medicine’s Department of Bioethics, the Bioethics Society of the Philippines, Catholic Physicians’ Guild of the Philippines, and the Philippine Nurses Association issued a “consensus statement” that generally opposed RH 5043 in its present form.
“We are all of the same intention in protecting the mother during her reproductive years,” the statement said. “This bill, however, does not address the problems of reproductive health in a holistic manner and focuses mainly on pregnancy prevention.”
It added that the bill “must consider the rights of others involved, specifically the unborn, and those tasked with their care.”
The statement also noted that “the anti-abortion stance of the bill is contradicted by the promotion of contraceptive agents (IUD and hormonal contraceptives) which actually act after fertilization and are potentially abortifacient agents.”
The experts added that “the bill should be re-shaped into a fully comprehensive reproductive health bill after all the voices are heard.”
The position paper was released on November 14. (Read full text of Consensus Statement on RH Bill 5043)
Dr. Josephine Lumitao of the Faculty of Medicine and Surgery and UST Hospital, who took part in the colloquium, questioned the bill for condemning abortion but advocating methods that hinder conception.
While the bill denies support for abortion, it promotes hormonal contraceptives and intrauterine devices, which prevent conception, and abortifacients, which destroys the fertilized egg, Lumitao said.
Hormonal contraceptives, in the form of a pill, skin patch, or injection, — all widely available in the market — contain hormones that prevent ovulation, and render the outer layer of the uterus unfavorable for implantation of the fertilized egg, which leads to its death due to lack of nutrition, she said.
Intrauterine devices, a contraceptive placed inside the uterus, prevent implantation.
“Is it not contradictory if the bill promotes abortifacient methods?” Lumitao said.
Without virtue
The health experts also criticized the bill’s compulsory sex-education provision. “(Human) sexuality, not sex education, should be taught,” they said in their statement:
“Sex education is an important part in the integral development of the child. The responsibility lies first with the parents. Their role should be stressed. It should also involve the school with teachers who should be educated. The absence of content regarding the values in the way sex education is taught gives an impression that there is no universal value; human sexuality, not sex education, should be taught.”
Dr. Angie Aguirre of the Makati Medical Society said that the bill’s compulsory sex education provision is values-neutral because only the technicalities of sexual intercourse are being taught sans ethics or virtues.
“Many biology teachers only discuss the scientific aspects without adding lessons about the morality of the act and the sanctity of sex. They do it because that is the only part included in the curriculum and in the books,” Aguirre said.
“(Mentors) must teach the students the way they want to teach their own children,” she added. She said sex and family matters are better left off to parents.
Aguirre said that in Catholic schools, sex and family life go hand-in-hand with theology subjects.
Classroom lectures on sex should also consider the maturity of the students, Dr. Angeles Tan-Alora, member of the Southeast Asian Center for Bioethics said.
“The sex education program should be progressive with input appropriate to the maturity of the student,” she explained.
Medical oppression
The experts likewise questioned the bill’s provisions, forcing doctors to refer patients to family planning centers. They said the provisions encroach on the medical profession and on freedom of conscience.
“Clinical decision-making cannot be mandated but must be left to the informed conscience of the health practitioner,” their statement said. “Refusing to refer patients to family planning services based on conscientious objection cannot be penalized.”
The statement added: “Human freedom is a universal right. Health professionals and educators should be free to conscientiously object without fear of penalty and sanction.”
The experts added the bill paints an exaggeratedly bleak picture of maternal mortality to press the need for birth control.
Dr. Victoria Edna Monzon, chairwoman of Medicine’s Department of Bioethics, said that based on Department of Health figures in 2007, “nowhere could you find maternity problems as part of the top seven diseases that kill mothers.”
While not addressing the top maternal diseases, the bill would rather focus on fertility control, Monzon said.
“The bill is anti-poor, anti-family, anti-couple, anti-parent, anti-nature, and above all, anti-life,” she said.
Citing World Bank data, Monzon said that the most common causes of maternal mortality are malnutrition and the absence of pre-natal and post-natal check-ups.
“These causes are the things that (lawmakers) have to look into instead of legislating a birth-control bill,” she said.
Fr. Fausto Gomez, O.P., president of the Southeast Asian Center for Bioethics and a member of the Pontifical Academy for Life of the Holy See, said maternal health problems should be solved not by an “anti-birth policy” but by “means that are socially and economically based.”
Gomez added that all the means to be employed should respect the dignity of life and of persons, citing the consensus statement:
“In the pursuit of the authentic common good, let us appreciate the obligation to ensure that no other aims or goals, no matter how pressing, obscure will overshadow our value of and respect for life and the dignity of the person and the family.”
‘Conservative’ ideology
Sought for comment, Ramon San Pascual, executive director of the Philippine Legislators’ Committee on Population and Development, one of the main proponents of the bill, said the religious and conservative position was unfounded.
He said the bill would provide a wider freedom of choice by promoting artificial contraceptives and natural methods favored by the Church. The bill will allow conscientious objections, he claimed.
“We are not obliging the citizenry to solely use artificial methods. We are also promoting the natural method as their choice,” San Pascual said in a phone interview. “Before, the law stated natural family planning as the only method acceptable. That is an example of a ‘no other choice.’”
It will also reduce abortion, San Pascual said.
“Abortion, according to studies, is very rampant in the urban poor areas. The bill aims to eliminate this by promoting contraceptives approved by the Bureau of Food and Drugs,” he said. “If safe artificial methods are available, the demand for abortion would definitely decrease.”
However, San Pascual stressed that while the bill covers maternal health, it does not want to limit the discourse to the mothers’ lives and safety only.
“The bill wants to address the problems which were not given emphasis in a long while. I do not really mind about what other countries are doing, we must concentrate on our own. The RH bill is very much applicable here,” he said.
