RH Bill: Lagman and His Critics

Reproductive health bill: Facts, fallacies

By Rep. Edcel Lagman

Philippine Daily Inquirer 8/03/2008

THE BILL IS NATIONAL IN SCOPE, COMPREHENSIVE, rights-based and provides adequate funding to the population program. It is a departure from the present setup in which the provision for reproductive health services is devolved to local government units, and consequently, subjected to the varying strategies of local government executives and suffers from a dearth of funding.

The reproductive health (RH) bill promotes information on and access to both natural and modern family planning methods, which are medically safe and legally permissible. It assures an enabling environment where women and couples have the freedom of informed choice on the mode of family planning they want to adopt based on their needs, personal convictions and religious beliefs.

 

The bill does not have any bias for or against either natural or modern family planning. Both modes are contraceptive methods. Their common purpose is to prevent unwanted pregnancies.

The bill will promote sustainable human development. The UN stated in 2002 that "family planning and reproductive health are essential to reducing poverty." The Unicef also asserts that "family planning could bring more benefits to more people at less cost than any other single technology now available to the human race."

Coverage of RH. (1) Information and access to natural and modern family planning (2) Maternal, infant and child health and nutrition (3) Promotion of breast feeding (4) Prevention of abortion and management of post-abortion complications (5) Adolescent and youth health (6) Prevention and management of reproductive tract infections, HIV/AIDS and STDs (7) Elimination of violence against women (8) Counseling on sexuality and sexual and reproductive health (9) Treatment of breast and reproductive tract cancers (10) Male involvement and participation in RH; (11) Prevention and treatment of infertility and (12) RH education for the youth.

Strengthening of Popcom. The existing Population Commission shall be reoriented to promote both natural and modern family planning methods. It shall serve as the central planning, coordinating, implementing and monitoring body for the comprehensive and integrated policy on reproductive health and population development.

Capability building of community-based volunteer workers. The workers shall undergo additional and updated training on the delivery of reproductive healthcare services and shall receive not less than 10-percent increase in honoraria upon successful completion of training.

Midwives for skilled birth attendance. Every city and municipality shall endeavor to employ an adequate number of midwives and other skilled attendants.

Emergency obstetrics care. Each province and city shall endeavor to ensure the establishment and operation of hospitals with adequate and qualified personnel that provide emergency obstetrics care.

Hospital-based family planning. Family planning methods requiring hospital services like ligation, vasectomy and IUD insertion shall be available in all national and local government hospitals.

Contraceptives as essential medicines. Reproductive health products shall be considered essential medicines and supplies and shall form part of the National Drug Formulary considering that family planning reduces the incidence of maternal and infant mortality.

Reproductive health education. RH education in an age-appropriate manner shall be taught by adequately trained teachers from Grade 5 to 4th year high school. As proposed in the bill, core subjects include responsible parenthood, natural and modern family planning, proscription and hazards of abortion, reproductive health and sexual rights, abstinence before marriage, and responsible sexuality.

Certificate of compliance. No marriage license shall be issued by the Local Civil Registrar unless the applicants present a Certificate of Compliance issued for free by the local Family Planning Office. The document should certify that they had duly received adequate instructions and information on family planning, responsible parenthood, breast feeding and infant nutrition.

Ideal family size. The State shall encourage two children as the ideal family size. This is neither mandatory nor compulsory and no punitive action may be imposed on couples having more than two children.

Employers’ responsibilities. Employers shall respect the reproductive health rights of all their workers. Women shall not be discriminated against in the matter of hiring, regularization of employment status or selection for retrenchment. Employers shall provide free reproductive health services and commodities to workers, whether unionized or unorganized.

Multimedia campaign. Popcom shall initiate and sustain an intensified nationwide multimedia campaign to raise the level of public awareness on the urgent need to protect and promote reproductive health and rights.

* * *

Smear offensive

Rep. Edcel C. Lagman

THERE IS A CONTINUING campaign to discredit the reproductive health bill through misinformation. Straightforward answers to the negative propaganda will help educate and enlighten people on the measure.

The bill is not antilife. It is proquality life. It will ensure that children will be blessings for their parents since their births are planned and wanted. It will empower couples with the information and opportunity to plan and space their children. This will not only strengthen the family as a unit but also optimize care for children who will have more opportunities to be educated, healthy and productive.

The bill does not interfere with family life. In fact, it enhances family life. The family is more than a natural nucleus; it is a social institution whose protection and development are impressed with public interest. It is not untouchable by legislation. For this reason, the State has enacted the Civil Code on family relations, the Family Code, and the Child and Youth Welfare Code.

The bill does not legalize abortion. It expressly provides that "abortion remains a crime" and "prevention of abortion" is essential to fully implement the Reproductive Health Care Program. While "management of post-abortion complications" is provided, this is not to condone abortion but to promote the humane treatment of women in life-threatening situations.

It will not lead to the legalization of abortion. It is not true that all countries where contraceptive use is promoted eventually legalize abortion. Many Catholic countries criminalize abortion even as they vigorously promote contraceptive use like Mexico, Panama, Guatemala, Brazil, Chile, Colombia, Dominican Republic, El Salvador, Honduras, Nicaragua, Venezuela, Paraguay and Ireland. The Muslim and Buddhist countries of Indonesia and Laos also promote contraceptive use yet proscribe abortion. According to studies, correct and regular use of contraceptives reduces abortion rates by as much as 85 percent and negates the need to legalize abortion.

Contraceptives do not have life-threatening side effects. Medical and scientific evidence shows that all the possible medical risks connected with contraceptives are infinitely lower than the risks of an actual pregnancy and everyday activities. The risk of dying within a year of riding a car is 1 in 5,900. The risk of dying within a year of using pills is 1 in 200,000. The risk of dying from a vasectomy is 1 in 1 million and the risk of dying from using an IUD is 1 in 10 million. The probability of dying from condom use is absolutely zero. But the risk of dying from a pregnancy is 1 in 10,000.

The bill will not promote contraceptive mentality. The bill does not prohibit pregnancy. Critics are mistaken in claiming that because contraceptives would be readily available, people would prefer to have no children at all. Couples will not stop wanting children simply because contraceptives are available. Contraceptives are used to prevent unwanted pregnancies but not to stop pregnancies altogether. Timed pregnancies are assured.

The bill does not impose a two-child policy. It does not promote a compulsory policy strictly limiting a family to two children and no punitive action shall be imposed on parents with more than two children. This number is not an imposition or is it arbitrary because results of the 2003 National Demographic and Health Survey show that the ideal of two children approximates the desired fertility of women.

Sexuality education will neither spawn "a generation of sex maniacs" nor breed a culture of promiscuity. Age-appropriate RH education promotes correct sexual values. It will not only instill consciousness of freedom of choice but also responsible exercise of one's rights. The UN and countries which have youth sexuality education document its beneficial results: understanding of proper sexual values is promoted; early initiation into sexual relations is delayed; abstinence before marriage is encouraged; multiple-sex partners is avoided; and spread of sexually transmitted diseases is prevented.

It does not claim that family planning is the panacea for poverty. It simply recognizes the verifiable link between a huge population and poverty. Unbridled population growth stunts socioeconomic development and aggravates poverty. The connection between population and development is well-documented and empirically established.

UN Human Development Reports show that countries with higher population growth invariably score lower in human development. The Asian Development Bank in 2004 also listed a large population as one of the major causes of poverty in the country.

The National Statistics Office affirms that large families are prone to poverty with 57.3 percent of families with seven children mired in poverty while only 23.8 percent of families with two children are poor. Recent studies also show that large family size is a significant factor in keeping families poor across generations.

Family planning will not lead to a demographic winter. UP economics professors in their paper "Population and Poverty: The Real Score" declared that the threat of a so-called demographic winter in the Philippines is "greatly exaggerated, and using it as an argument against a sensible population policy is a plain and simple scare tactic."

The National Statistical Coordinating Board projected that a replacement fertility of 2.1 children per couple could be reached only by 2040. Moreover, despite a reduced population growth rate, the effects of population momentum would continue for another 60 years by which time our total population would be 240 million.

Humanae Vitae is not an infallible doctrine. In 1963, Pope John XXIII created the Papal Commission on Birth Control to study questions on population and family planning. The Commission included ranking prelates and theologians.

Voting 69 to 10, it strongly recommended that the Church change its teaching on contraception as it concluded that "the regulation of conception appears necessary for many couples who wish to achieve a responsible, open and reasonable parenthood in today's circumstances."

However, it was the minority report that Pope Paul VI eventually supported and which became the basis of Humanae Vitae.

Even 40 years ago when the encyclical was issued, theologians did not generally think that it was infallible. Monsignor Fernando Lambruschini, spokesperson of the Vatican at the time of its release, said "attentive reading of the encyclical Humanae Vitae does not suggest the theological note of infallibility? It is not infallible."

Five days after the issuance of the encyclical, a statement against it was signed by 87 Catholic theologians. It asserted that "Catholics may dissent from 'noninfallible Church doctrine' and that "Catholic spouses could responsibly decide in some circumstances to use artificial contraception."

(Rep. Edcel C. Lagman of Albay is the principal author of the proposed Reproductive Health and Population Development Act of 2008.) 

RESPONSES:

Reckless and irresponsible

By Jo Imbong

[Philippine Daily Inquirer, 8/16/2008]

REP. EDCEL LAGMAN, THE PRINCIPAL AUTHOR OF THE proposed Reproductive Health and Population Development Act of 2008 asserts, among others, that the bill is neither antilife nor antifamily, that contraceptives are not life-threatening and that the bill does not impose a two-child policy.

Prolife? To value human life is to respect and protect life in all its seasons. “Human life begins at fertilization.” (Records of the Constitutional Commission, Vol. IV, Sept. 18, 1986, pp. 761, 801) hence, “the State shall equally protect the life of the mother and the life of the unborn from conception.” (Constitution, Article II, Section 12). Lagman said in a House hearing that the bill would protect human life “from implantation.”

By that token, the zygote not yet in the mother’s womb is not protected. Pills and the IUD hinder implantation of the embryo in the uterus, thereby precipitating the embryo’s destruction. That is abortion. And yet, “every child ... needs appropriate legal protection before as well as after birth” (UN Convention on the Rights of the Child).

Not life-threatening? Records are rife of perforation of the uterus and serious pelvic infections in women with IUDs that public midwives have refused to extract. The Mayo Foundation found that oral contraceptives are associated with an increase risk of breast cancer. DepoProvera increases a woman’s risk for chlamydia and gonorrhea. Oral contraceptives containing cyproterone increase risk of deep venous blood clots.

Levonorgestrel is banned in this country as the Bureau of Food and Drugs found it to be abortifacient. Life-threatening ectopic pregnancies occur in mothers long after undergoing tubal ligation, particularly those sterilized before age 30.

Contraceptives as essential medicines? Contraceptives do not treat any medical condition. Fertility is not a disease. It attests to health! The bill targets “the poor, needy and marginalized.” This is most unkind to them whose real needs are jobs, skills, education, lucrative opportunities, nutrition, and essential medicines for anemia, tuberculosis, infections and childhood diseases.

Remember, every citizen has the right to health (Art. II, Sec.15), hence, the State has a duty to protect the citizens against dangerous substances (Constitution, Art. XVI, Sec.9), and protect women in their maternal function (Art. XIII,Sec. 14).

Family friendly? The “encouragement” to have two children is manipulation both brazen and subtle. It can set the stage for a stronger application of the recommendation through legislative amendments. Spouses have a basic, original, intrinsic and inviolable right “to found a family in accordance with their religious convictions and the demands of responsible parenthood” (Art. XV, Sec. 3 [1]). This includes their right to progeny.

The bill mocks parents with fine and imprisonment in refusing to expose their children to mandatory “age-appropriate” reproductive health education starting Grade 5 outside the loving confines of home and family.

Vulnerable and malleable, our children will be taught “adolescent reproductive health” and “the full range of information on family planning methods, services and facilities
 for six years. This is child abuse of the highest order. And yet, “every child has the right to be brought up in an atmosphere of morality and rectitude for the enrichment and strengthening of his character.” (Child and Youth Welfare Code)

The ... care and nurtur[ance] of the child reside first in the parents (Article II, Sec. 12, Constitution), whose primary function and freedom include preparation for obligations the state can neither supply nor hinder. (Brantley v. Surles, 718 F. 2d. 1354,1358-59) The State did not create the family, and “the child is not a creature of the State.” (Pierce vs. Society of Sisters, 268, U.S. 510, 535.) That is the law of nature, and no human institution has authority to amend it.

Quality of life? The bill wants to “uplift the quality of life of the people.” Population control started in 1976 “to increase the share of each Filipino in the fruits of economic progress.” In other words -- to eliminate poverty. Has it?

The General Appropriations Act of 2008 earmarks an enormous amount for “family planning and reproductive health services,” including contraceptives. For the Department of Health it is P3.19 billion; for Popcom -- P386.5 million, quite apart from funds for other agencies of government and local government units for the same programs. Add $2.4 million from the United Nations Population Fund for population and development and reproductive health for 2008, plus $2.2 million for 2009.

Today’s average family has three children compared with seven in the ‘70s. But the billions of pesos spent have not reduced poverty or benefited the poor.

If Congress passes this bill, it wagers the future of the country. Citizens have a right to resist misplaced and irresponsible exercise of authority because the good of the people is the supreme law. Salus populi est suprema lex.

The path of irresponsible legislation is a dreadful path: If an act is made legal, it will be perceived as moral. If an act is perceived as moral, it will become a norm. If it is observed by all as a norm, then it is too late. By then, you will have changed the culture. That is not simply reckless. It is the ultimate breach of public trust.

(Jo Imbong, a lawyer, is the executive secretary of the Legal office of the Catholic Bishops? Conference of the Philippines and consultant to the CBCP Episcoal Commission on Family and Life.)

No place for the RH bill in our law

By Francisco S. Tatad

[Philippine Daily Inquirer, 8/16/2008]

THE REPRODUCTIVE HEALTH bill in the House of Representatives is being presented as a health bill and an antipoverty bill at the same time. It is neither. It is not what its authors say it is; it is everything they say it is not. It is an ideological attack on human life, the family, and our social and cultural values.

The bill rests on a flawed premise; it is unnecessary, unconstitutional, oppressive of religious belief and destructive of public morals and family values. Its enactment into law will only deepen the already frightening ignorance about the real issues. It should be rejected.

1. Flawed premise

Our population growth rate (National Statistics Office) is 2.04 percent, total fertility rate (TFR) is 3.02. The CIA World Factbook has lower figures -- growth rate, 1.728 percent; TFR, 3.00.

Our population density is 277 per square km. GDP per capita (PPP) is $3,400. Fifty other countries have a much lower density, yet their per capita is also much lower. Thirty-six countries are more densely populated, yet their GDP per capita is also much higher. Are the few then always richer, the many always poorer? Not at all.

Our median age is 23 years. In 139 other countries it is as high as 45.5 years (Monaco). This means a Filipino has more productive years ahead of him than his counterpart in the rich countries where the graying and dying population is no longer being replaced because of negative birth rates.

Our long-term future is bright, because of a vibrant and dynamic population.

2. Unnecessary

Women who say they should be free to contracept (regardless of what the moral law or science says) are not being prevented from doing so, as witness the 50-percent contraceptive prevalence rate. It is a free market. But as we are not a welfare state, taxpayers have no duty to provide the contraceptives to try and cure pregnancy, which is not a disease.

The State’s duty is to protect women from real diseases. At least 80 women die every day from heart diseases, 63 from vascular diseases, 51 from cancer, 45 from pneumonia, 23 from tuberculosis, 22 from diabetes; 16 from lower chronic respiratory diseases. Why are our lawmakers not demanding free medicines and services for all those afflicted?

Indeed, maternal death could be brought down to zero just by providing adequate basic and emergency obstetrics-care facilities and skilled medical services to women. The local officials of Gattaran, Cagayan and Sorsogon City have shown this. Why do our lawmakers insist on stuffing our women with contraceptives and abortifacients instead?

In 2005, the cancer research arm of the World Health Organization concluded that oral contraceptives cause breast, liver and cervical cancer. Shouldn?t our lawmakers demand that contraceptives be banned or at least labeled as “cancer-causing,” or “dangerous to women’s health?” Why do they want them classified as “essential medicines” instead?

3. Unconstitutional

a.) The Philippines is a democratic and republican State. Yet the bill seems to assume we are a centrally planned economy or a totalitarian State, which controls the private lives of its citizens. Truth is, there are certain activities of man as man where the individual is completely autonomous from the State.

Just as the State may not tell a politician or a journalist how or when to think, write or speak, it may not enter the bedroom and tell married couples how or when to practice marital love.

b.) Article II, Section 12 of the Constitution says: “The State recognizes the sanctity of family life and shall protect and strengthen the family as a basic autonomous social institution. It shall equally protect the life of the mother and the life of the unborn from conception. The natural and primary right and duty of parents in the rearing of the youth for civic efficiency and the development of moral character shall receive the support of the Government.”

The use of “sanctity” makes State obedience to God’s laws not only a solemn teaching of the Church, but also an express constitutional mandate. Now, when the State binds itself to “equally protect the life of the mother and the life of the unborn from conception,” it necessarily binds itself not to do anything to prevent even one married woman from conceiving. A state-funded contraceptive program is an abomination.

4. Oppressive of religious belief

The bill seeks to tell the Catholic majority not to listen to the Church and to listen to anti-Catholic politicians instead. It seeks to establish a program which Catholic taxpayers will fund in order to attack a doctrine of their faith. Is there a worse despotism? Would the same people do the same thing to the followers of Islam or some politically active religious pressure group?

The pro-RH lobby claims surveys have shown that most Catholic women want to use contraception, regardless of what the Church says about it. It is a desperate attempt to show that right or wrong can now be reduced to what you like or dislike. The truth is never the result of surveys. Contraception is wrong not because the Church has banned it; the Church has banned it because it is wrong. No amount of surveys can change that.

5. Destructive of public morals

The bill seeks to impose a hedonistic sex-oriented lifestyle that aims to reduce the conjugal act to a mere exchange of physical sensations between two individuals and marriage to a purely contraceptive partnership.

Not only is it hedonistic, it is above all eugenicist. It seeks to eliminate the poor and the “socially unfit.” While it neither mandates a two-child family nor legalizes abortion, it prepares the ground for both.

In 1974, the US National Security Study Memorandum 200, titled “Implications of Worldwide Population Growth for US Security and Overseas Interests,” launched the two-child family as a global population policy to be achieved by 2000. But “no country has reduced its population growth without resorting to abortion,” said that document.

Now you know what’s next, and where it’s all coming from.

(Former Sen. Francisco S. Tatad represents the Asia-Pacific on the Governing Boards of the International Right to Life Federation, Cincinnati, Ohio and the World Youth Alliance, New York, NY. Comments to http://franciscotatad.blogspot.com)