Ex-Ante Policy Evaluation of the Reproductive Health Bill (H.B. 5043)

INTRODUCTION

  1. Preliminary Situation

The population debate is revived because of the evident global food crisis. Analysts assert that food production cannot sustain the population growth in the Philippines. Today, the Philippine population is nearly 90 million. About 5,800 babies are born daily. They’re equal to three villages, that is, an additional 1,098 villages every year. (PCEC 2008)

The debate on population comprise three contending views; the population pessimists, the population optimists and the population revisionists. The population pessimists do not want a high population growth they believe that a high fertility rate impacts negatively on economic growth. On the other hand, the population optimists think that population is the ultimate resource, they point out that high population growth brings tremendous possibilities for technical change sibce the rate of return in the economy is larger. Next is the population revisionists who believe that population growth may or may not be detrimental to economic and human development. The lawmakers are beginning to realize the importance of providing family planning supplies to poor Filipinos. And as expected, the Roman Catholic Church is opposing this program known as the controversial “Reproductive Health Bill”.

The continued increase of population is a nagging problem among countries throughout the world. It knows no boundaries or GNPs. Countries whether in the north or south is plagued with questions on how to make their population remain at a manageable level. Why not so? This would mean fewer problems on food, housing, security, labor and other services which every government is expected to give to its people.

These are the very same reasons why in 1967, seventeen heads of state including the Philippine President signed the United Nations Declaration on Population which stressed: The population problem must be recognized as a principal element in long-range planning, if governments are to achieve their economic goals and fulfill the aspirations of their people. The succeeding years will see the passage of various bills and executive orders that will show the government’s commitment to the declaration made in 1967.

  1. Outcome of Prior Effort To Resolve the Problem

In 1970, the Philippine Population Program was officially launched through the Executive Order No. 233. It created the Commission on Population (POPCOM) which was mandated to serve as the central coordinating and policy making body of the government in the field of population. This was enacted into law the following year and is now known as Republic Act No. 6365 or the Population Act of the Philippines. The government will also direct both public and private sectors to undertake a National Family Planning Program which respects the religious beliefs and values of individuals.

President Cory Aquino also showed its support to the program. POPCOM’s statement during her term is: “the ultimate goal of the Population Program is the improvement of the quality of human life in a just and humane society…The achievement of this goal requires recognition of the close interrelationships among population, resources and environmental factors.”

The Ramos Administration worked on the adoption of the Philippine Population Management Program and the Population Resources and Environment Framework. By Joseph Estrada’s term, the government campaigned for Responsible Parenthood. The above-mentioned Presidents have one thing in common, and that is non-commitment to campaign for a specific method of reproductive health to be used.

This changed when Gloria Macapagal-Arroyo assumed in office. Her administration clearly supports the natural family planning method (NFP). In 2005, PGMA showed her support for the International Conference on Population and Development (ICPD) by issuing a statement which reiterated the principles that guide the Philippine government in the implementation of population program. These principles are based on the four (4) pillars of Responsible Parenthood, Respect for Life, Birth Spacing, and Informed Choice. Health services, including Reproductive Health services, are devolved by the Local Government Code to the local government units. Local Government Units have the responsibility of providing couples and individuals with information and services to enable them to exercise Responsible Parenthood. These last statements were contradicted in the President’s statements on October 10, 2006 in her guidelines and directives for the DOH, POPCOM and Local government units to take full charge of the implementation of the Responsible Parenthood and Family Planning Program. The Responsible Parenthood and Natural Family Planning Program’s primary policy objective is to promote natural family planning, birth spacing (three years birth spacing) and breastfeeding which are good for the health of the mother, child, family, and community. While Local Government Units can promote artificial family planning because of local autonomy, the national government advocates natural family planning.

  1. Scope and Severity of the Problem

According to a study (Espiritu, et al., 1987), the Philippine population is uneven in terms of distribution. There are areas which are heavily populated like the urban centers while some areas are characterized by scarcity. This unequal distribution may be attributed to basic physical and climatic characteristics, natural resources, market conditions, employment opportunities, transportation facilities, natural increase or migration stream.

The authors also put forth certain variables that bring about changes in population, namely, fertilitymortality and migration. Let us look at each one of these.

  1. Fertility refers to the average number of births per married woman in her lifetime. It is determined by crude birth rate which is the number of births per thousand women.

  2. Mortality refers to the number and percentage of deaths per thousand population.

  3. Migration is simply the process of population movement within the country or from country to country, either outward (emigration), or inward (immigration).

Marriages also affect society and the nature of the population. When people marry young, their chances of having more children are enhanced. For both men and women, the highly marriageable age ranges from 20-24 years. From more indications more persons are contracting marriage every year. Statistical data indicate that single persons dominate which again increases fertility (Phil. Yearbook 1979:128).

  1. Significance of the Study

We are in steady apprehension about the future. We are also aware that much of human nature and experience are constant and repetitive. This study of the Reproductive Health Bill (H.B. 5043) pending in the House of Representatives therefore attempts to distill what constancies we can observe in order to understand our present and guide our future.

The appreciation of the constants reveals imperative policies, methods, and institutions we ought to develop and establish to evolve the society we all desire. The management of the forces of social change is a crucial tool of national survival and growth.

The end-product of this work is a publishable monograph to serve as a guideline for policy-makers in search of solutions to issues of nation-building.

  1. THE POLICY PROBLEM

  1. Statement of the Problem

At present, there is a proposed bill in Congress known as House Bill 5043, “An Act Providing for a National Policy on Reproductive Health, Responsible Parenthood and Population Development” with Albay Congressman Edcel Lagman as the principal author. It is now awaiting its end, whether it will become a law or be shelved for good.

Due to the nature of its proposal and taking into consideration how political and Catholic our country is, it merits being one of the highly discussed and debated bills of all time. It has already divided Philippine society into two – one group for the pro and the other for the anti. Those in favor of the bill includes quite a number of lawmakers, the Iglesia ni Cristo, most Protestant groups, and some prominent politicians and stars like Lea Salonga, former President Fidel V. Ramos and former Prime Minister Cesar Virata to name a few. The opposition group on the other hand also includes lawmakers, members of Cabinet like Lito Atienza, Manila Mayor Alfredo Lim, and of course, the Roman Catholic Church.

For those who are supporting the bill, they think that this will help solve the issue on population and other reproductive health issues. Through the bill, there would be an information campaign and dissemination as well as access to the different methods of family planning – both natural and artificial. The opposition on the other hand thinks that the bill will not solve anything but will just create more problems in the future. Through easy access to information and resources, they fear that this will create a culture of promiscuity and considers artificial family planning methods as the tool towards that road. The Catholic Church is lobbying against the use of contraceptives such as condoms to prevent unwanted pregnancies and control the spread of AIDS. The Arroyo government has largely given in to pressure to promote only the Church-endorsed natural family planning method.

It is becoming increasingly evident moreover that conventional methods of birth control, such as those under the natural family planning methods are inaccurate and unreliable, which could be one of the factors to be blamed for widespread unplanned or unwanted pregnancies.

This study then attempts to clarify what the proposed bill is all about, its policies and programs, by analyzing and determining whether any of its provisions violate Sacred Scripture, as the Roman Catholic Church claims, the Constitution, and other pertinent legislation.

This is a topic of crucial importance to our times.

  1. Major Stakeholders

The following are the major stakeholders in the passage of the bill:

  1. The Church (all Christian churches regardless of denomination)

  2. NGOs/POs

  3. Department of Education

  4. Commission on Higher Education

  5. Technical Education and Skills Development Authority

  6. Department of Health

  7. Private Sector

  8. Media

  9. Family

  1. Goals and Objectives

This study has the following objectives:

  1. To analyze and evaluate the proposed Reproductive Health Bill (H.B. 5043) pending in the House of Representatives.

  2. To establish principles for a unified strategy for the promotion of reproductive health and effective family planning.

  1. FRAMEWORK FOR ANALYSIS

A. Definition of Terms

Reproductive Health therefore refers to the state of physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. This implies that people are able to have a satisfying and safe sex life, that they have the capability to reproduce and the freedom to decide if, when and how often to do so, provided that these are not against the law. This further implies that women and men are afforded equal status in matters related to sexual relations and reproduction.

Reproductive Health Rights are those rights of individuals and couples do decide freely and responsibly the number, spacing and timing of their children; to make other decisions concerning reproduction free of discrimination, coercion and violence; to have the information and means to carry out their decisions; and to attain the highest standard of sexual and reproductive health.

Reproductive Health Care consists of the availability of and access to a full range of methods, techniques, supplies and services that contribute to reproductive and sexual health and well-being by preventing and solving reproductive health-related problems in order to achieve enhancement of life and personal relations. The elements of reproductive health care include:

1. Maternal, infant and child health and nutrition;

2. Promotion of breastfeeding;

3. Family planning information and services;

4. Prevention of abortion and management of post-abortion complications;

5. Adolescent and youth health;

6. Prevention and management of reproductive tract infections (RTIs), HIV/AIDS and other sexually transmittable infections (STIs);

7. Elimination of violence against women;

8. Education and counselling on sexuality and sexual and reproductive health;

9. Treatment of breast and reproductive tract cancers and other gynecological conditions;

10. Male involvement and participation in reproductive health;

11. Prevention and treatment of infertility and sexual dysfunction; and

12. Reproductive health education for the youth.

B. Hypotheses

The following hypotheses will be validated or invalidated:

  1. The proposed Reproductive Health Bill is not contrary to biblical teaching and hence morally sound.

  2. The proposed Reproductive Health Bill is in accordance with the provisions of the Philippine Constitution.

  3. The proposed Reproductive Health Bill is not anti-life but pro-life in that it seeks the improvement of living conditions, which is hampered by the unhealthy rapid increase in our population.

C. Research Methodology

This study adopts the comparative method for each of the major elements of Reproductive Health Care, i.e. artificial contraception and sexuality education, vis-a-vis established rules of conduct found in the Bible or Sacred Scripture, the 1987 Philippine Constitution, and other relevant legislation such as the Family Code. This work seeks to determine whether or not any provision of HB 5043 is contrary to the doctrines of the aforementioned rules of standard.

Using the framework of the New Public Service (Denhardt, 2004) as an alternative view of democratic citizenship, which sees the individual as much more actively sharing in self-government, the role of the citizen should be one that looks beyond self-interest to the larger public interest; it is one that takes a broader and more long-term perspective. Obviously, such an interpretation of democratic citizenship asks much more of the individual. Among other things, it “requires knowledge of public affairs and also a sense of belonging, a concern for the whole, a moral bond with the community whose fate is at stake…”To share in self-rule requires that citizens possess, or come to acquire, certain qualities of character, or civic virtues” (Sandel, 1996:5-6; Denhardt, 2004:173).

“In fact, it has little to do with our private interests, since it concerns the world that lies beyond the self, that was before our birth and that will be there after our death, and that finds its embodiment in activities and institutions with their own intrinsic purposes which may be often at odds with our short term and private interests (d’Entreves, 1992 in Denhardt, 2004:173).

Drawing from the seven key principles of the New Public Service, let us now briefly consider its application to the administration of the Reproductive Health Bill.

  1. Serve citizens, not customers: As we seek to encourage more and more people to fulfill their responsibilities as citizens and for government to be especially sensitive to the voices of citizens, married couples should be educated on the various available means of family planning, may they be natural (NFP) or artificial (condoms, tubal ligations, vasectomy, pills, creams, diaphragms, etc.).

  2. Seek the public interest: Since public administrators must contribute to building a collective, shared notion of the public interest, the goal is not to find quick solutions driven by individual choices—In this case, that of the Roman Catholic Church. Instead, it is the creation of shared interests and shared responsibility. This intergenerational responsibility should be carried out by everyone for the benefit of our children and our children’s children (Oposa vs. Factoran, G.R. No 101083, July 30, 1993).

  3. Value citizenship and public service above entrepreneurship:Instead of just providing tools and means for family planning, public servants should take time and initiative to educate the citizens on the proper use of contraceptives and other family planning models. Good family values should also be inculcated to our married couples in order that they may foster children who could be good responsible citizens someday.

  4. Think strategically, act democratically: Policies and programs meeting public needs can be most effectively and responsibly achieved through collective efforts and collaborative processes. Citizen participation should not be limited to framing issues; it should also extend to policy implementation. In this regard, all sectors of society should participate in providing the education, according to one’s conviction and beliefs, and resources in order to put into action the policies set forth for reproductive health.

  5. Recognize that accountability isn’t simple: Public servants implementing the law should be attentive to more than the market; they should also attend to statutory and constitutional law, community values, political norms, professional standards, and citizen interests.

  6. Serve rather than steer: Increasingly, public servants must use value-based leadership in helping citizens articulate and meet their shared interests rather than attempt to control or steer society into new directions. As means and methods for conducting family planning seminars and the availability of family planning tools become better, public servants should continue to focus their energies on serving the needs of their citizens, instead of merely focusing on their own wants and value preferences.

  7. Value people, not just productivity: public administrators must take into account the personal feelings of their constituents in the process of training and counselling couples with regard to family planning options.

It is inevitable that this study must hazard at definitions. While the selection of established rules of conduct and the definitive characteristics of its doctrines will face arbitrariness, this risk will be mitigated by being internally consistent. The selection of the Christian Bible as one of the standards to which the proposed bill will be pitted against is in itself an example of arbitrariness; its specific thrust is to emphasize the morality of the proposed legislation in a largely “Christian” nation such as the Philippines. Furthermore, this paper takes the assumption that there is indeed overpopulation—in Metropolitan Manila at least—and that it is one of the major causes of poverty that is plaguing the nation.

  1. Analysis of the Problem

So why is the Roman Catholic Church very much against this bill even up to the extent of denying Holy Communion and excommunication to politicians who support these proposed legislations? The Catholic Bishops’ Conference of the Philippines (CBCP) condemns such bills on the ground that it promotes abortion; but does it? In this section, our goal is to give you a basic understanding of the Roman Catholic Church’s stand on issues such as population control, contraception and abortion, and juxtapose them with the Word of God contained in the Bible.

To settle the issue of abortion, the present state of our laws and even that of the pending legislation on reproductive health, DO NOT legalize abortion except in special circumstances such as when the life of the mother is in serious peril or danger and it comes down to a choice between the life of the mother or the child, or that both may perish in case the pregnancy or childbirth is continued. In fact, this was already reiterated by Senator Panfilo Lacson, one of the primary proponents of the reproductive health bill (S.B. No. 43) as reported in the Philippine Daily Inquirer on July 15, 2008. Moreover, we have to clearly define our terms to avoid confusion: Contraception is not abortion. Contraception, as the term itself implies, is the prevention of pregnancy, while abortion is the termination or extraction of a fetus or fertilized egg. The latter is murder which destroys life, while the former is not, since there is no conception yet and hence, no life is created.

The proposed legislation also provides for compulsory sex education for gradeschool and highschool students. The idea itself is not objectionable, what we should be weary of is the content of the materials to be taught and who will teach it. I remember that in high school, such topics were taken up by our priest-teacher, but were nevertheless discussed in accordance with Roman Catholic doctrine. I am not saying that I fully agree with the Roman Catholic position on the subject, but instead, that sex education in itself is not necessarily evil or immoral, it depends on the content and the delivery system; now as to what that content should be, is another topic.

The main issue of the Roman Catholic Church against the said bills is its provision regarding family planning, i.e. birth control, contraception. The official position of the Roman Catholic Church, as provided for by Catholic Answers (www.catholic.com) is stated thus:

In 1968, Pope Paul VI issued his landmark encyclical letter Humanae Vitae (Latin, “Human Life”), which reemphasized the Church’s constant teaching that it is always intrinsically wrong to use contraception to prevent new human beings from coming into existence. 

Contraception is “any action which, either in anticipation of the conjugal act [sexual intercourse], or in its accomplishment, or in the development of its natural consequences, proposes, whether as an end or as a means, to render procreation impossible” (Humanae Vitae 14). This includes sterilization, condoms and other barrier methods, spermicides, coitus interruptus (withdrawal method), the Pill, and all other such methods.

Contraception is wrong because it’s a deliberate violation of the design God built into the human race, often referred to as “natural law.” The natural law purpose of sex is procreation. The pleasure that sexual intercourse provides is an additional blessing from God, intended to offer the possibility of new life while strengthening the bond of intimacy, respect, and love between husband and wife. The loving environment this bond creates is the perfect setting for nurturing children. 

But sexual pleasure within marriage becomes unnatural, and even harmful to the spouses, when it is used in a way that deliberately excludes the basic purpose of sex, which is procreation. God’s gift of the sex act, along with its pleasure and intimacy, must not be abused by deliberately frustrating its natural end—procreation.

In fact, it may be implied from this definition, as it was posited by some Roman Catholic commentators, that the prohibition against contraception also includes natural family planning (NFP) methods and oral sex as it also precludes procreation while engaging in the marital act. The Roman Catholic Church cites the story of Onan and his sin of spilling his seed onto the ground (Gen. 38:8-10). However, what they fail to realize and consider is that Onan was punished (killed) by God due to his disobedience to the Jewish custom during that time, as explained by Adam Clarke, a noted Bible scholar and commentator:

The sin of Onan has generally been supposed to be self-pollution; but this is certainly a mistake; his crime was his refusal to raise up seed to his brother, and rather than do it, by the act mentioned above, he rendered himself incapable of it. We find from this history that long before the Mosaic Law it was an established custom, probably founded on a Divine precept, that if a man died childless his brother was to take his wife, and the children produced by this second marriage were considered as the children of the first husband, and in consequence inherited his possessions. 

So, it was not really the “spilling of his seed on the ground” which is a sin and for which he was punished, but for his disobedience of the custom which developed into a law that was formalized in Deuteronomy 25:7-10.

Furthermore, scientifically and medically speaking, whenever a man abstains from willful ejaculation, through sexual intercourse or masturbation, studies show that most often than not, he will periodically experience nocturnal emissions, or what are commonly known as “wet dreams.” The excess semen stored for a long time is naturally expelled by the body unconsciously during sleep. Therefore, because God was the One who designed the human body to work as such, then the spilling or “wastage” of man’s seed is not inherently evil or sinful. However, let me be clear on one point, lust is a sin, and I doubt it if it is possible to masturbate without entertaining lustful thoughts. So, until anyone can prove to himself and to his conscience that that is possible, masturbation is still considered sinful.

In addition to the foregoing moral and theological criticisms, the Bill is also being faulted for being violative of the Section 12, Article II of the Constitution which reads:

“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.”

In response to this, the following explanations are provided:

First, the bill does not violate or intrude on the “sanctity of family life”. On the contrary, it discharges the obligation of the State to protect and strengthen the family.

  • The family is more than a natural unit. It is a social institution whose well-being is impressed with public interest and concern. It is not immune from legislation. It has to be amenable to the State’s exercise of police power for its protection and development.

  • Laws such as the Civil Code of the Philippines; the Family Code of the Philippines; the Child and Youth Welfare Code; and the Special Protection of Filipino Children Against Child Abuse, Exploitation and Discrimination Act all exist for the protection and welfare of the Filipino family.

Second, the bill does not supplant the primary right of parents in the “… development of moral character” of the youth even as it proposes the teaching reproductive health and sexuality education.

  • This gives support, as required by the Constitution, to parents, particularly to the majority who have defaulted in imparting reproductive health sexuality education to their children because discussing sex at home is taboo.

  • The young usually get their information on sexuality from polluted and inaccurate sources. Thus, there is critical need for formal reproductive health and sexuality education in schools.

Lastly, the use of legal and medically-safe contraceptives, which are not abortifacients, does not violate the constitutional provision on the State’s obligation “to equally protect the life of the mother and the life of the unborn from conception.”

  • The purpose of this provision is to preempt the Congress and the Supreme Court from legalizing abortion. This bill definitely does not legalize abortion.

  • The proceedings of the Constitutional Commission show that there was no intention to ban contraceptives which are not abortifacient.

Let us remember that the purpose of marriage is not solely for procreation as espoused the Roman Catholic Church, but also companionship and love, the expression of which is in the marital act of sexual intercourse. According to Article 68 of the Family Code, “The husband and wife are obliged to live together, observe mutual love, respect and fidelity, and render mutual help and support,” and this includes the act of sexual intercourse as enunciated by the Supreme Court in the celebrated case of Chi Ming Tsoi vs. Court of Appeals (G.R. No. 119190, January 16, 1997) and several others.

According to Yahoo! News (Oct. 17, 2008), “Seven out of ten Catholics (71 percent) and non-Catholics (68 percent) favor the passage of the RH Bill,” the SWS said in a statement. The non-commissioned survey was conducted from September 24 to 27.

“Support for the Reproductive Health Bill is an overwhelming eighty-four (84%) percent among those previously aware of the bill, and a majority fifty-nine (59%) percent among those who became aware of it on account of the survey,” the SWS said (Helen Flores, Philstar News Service, http://www.philstar.com).

Finally, the bill is not anti-life. It is pro-quality life. It will ensure that children will be blessings to 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 in effect strengthens the family as a unit and optimizes care for fewer children who will have more opportunities to be educated, healthy and productive. The capacity of people to make full use of their potentials is imperiled and impaired by a ballooning population and resultant poverty.

Most importantly, the bill is not against the birth of children. It does not advocate that women and couples stop having children; rather, what it only aims to do is to help women and couples achieve their fertility goals.

  1. CONCLUSION AND RECOMMENDATION

To conclude, the most important thing that government can do is to educate the people on the various available methods of family planning, its effects, physically, psychologically, emotionally and spiritually. For as long as the methods presented are not illegal or intrinsically evil such as abortion and infanticide, then married couples should be given a wide array of alternatives to choose from.

The proposed Reproductive Health Care Bill is not in itself evil, immoral, unbiblical, unconstitutional and illegal. Its primary end is the promotion of a better life for Filipinos, especially the women and youth. Unless there is a clear showing that the bill violates any of our standards as set forth in this paper, then the same should be approved and passed as law.

The Church and State should promote responsible parenthood among its members and citizens respectively by information dissemination through public fora, seminars, workshops and the like. Remember, everything that we do, whether public or private acts should have the end in view of God’s potential glory (Sjogren and Robison, 2003). As the Bedans would say, “That in all things, God may be glorified!”

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