Sunday, October 05, 2008

My Take on the Reproductive Health Bill (Part 2)

This is Part 2 of my series of blog entries regarding my thoughts on the Reproductive Health Bill. I thought of putting down into recorded words my thoughts on the matter as a way of fulfilling my accountability to the public.

Some people advised me not to be so public about my thoughts since the issue is a highly charged political question. Some “political experts” even told me that the best position to take in this controversial discussion is to be vague so as not to agitate either side of the debate. They also said if I write down my thoughts, there wouldn’t be a way for me to weave my way out of a situation that I might get into.

But isn’t that contrary to having accountability as a public official? Don’t I have the obligation to clearly state what my position is on the matter and explain why it is so? On important discussions where ultimately I will have to take a vote, isn’t the public entitled to know what my considerations on the subject are?

Anyway, at the risk of drawing the wrath of certain sectors, I decided to put on record what I think of the issue at hand. So I started Part 1 and posted it. Since I knew that my thoughts on the matter were quite lengthy, I intentionally cut up the whole thing into a series of entries.

I already had in mind what I will write down for Part 2 and how to present it. But a reaction from someone who read my Part 1 compelled me to amend my Part 2 and conform it to the reaction posted by the reader, who goes by the Multiply name of romanza2005.

(For those who have not read the reaction of romanza2005, please refer to my entry entitled My Take on the Reproductive Health Bill—Part 1)

First of all, romanza2005 worries about “undertones” in the blog entry I made. She even “takes offense” at the story of Grace, a constituent of mine.

I think it is incorrect to start a discussion based on undertones because there is no basis to that argument since undertones are merely perceptions of the reader. It cannot be said that such perceptions are the thoughts or intent of the writer. One would have to take what is written at face value, especially if the way the thoughts are written are straightforward and simple in presentation.

With regard to the story of Grace which romanza2005 feels there are undertones, it is clear to anyone who will objectively read it that I simply related the situation where Grace is in right now. That she has four children and one more on the way. That if she was able to stop having kids after her second child, she would have not gotten herself pregnant for a third, fourth and fifth child.

There was absolutely no suggestion whatsoever that she should “get rid” (as romanza2005 put it) of any of her children. IT was a narration of Grace’s desire to have limited her children if only she had the chance. Obviously, she did not contemplate abortion or getting rid of any of her children since she still has her first four kids and that she is now pregnant and will give birth soon. If she had wanted to “get rid” of any of her children, she could have availed the services of an abortionist , a hilot or patronized the “pang-pa regla” vendors beside Quiapo Church.

I do not see why romanza2005 is offended by a simple narrative of another person’s desire. After all it is Grace’s desire, and she is not imposing her desire or belief on anyone else.

My point in relating that story was to highlight the fact that there are those who desire to limit their children in accordance to what they can afford but there are no reproductive health services available for them. And while some sectors are pushing for the natural family planning method, NFP is not applciable to everyone, especially in cases where one of the partners is not willing or incapable of following the method.

Romanza2005 is correct in pointing out that Grace’s alcoholism is a problem. Because of his alcoholism, NFP is not applicable to them since Grace’s husband is incapable of waiting for the right time to lay with Grace especially when he goes home drunk. Romanza2005 is also correct when she suggested said : “If the Congressman really cares about the Filipino family and their 'quality' of life, why doesn't he help the community by counseling the people on their addictions - whether it's substance abuse like alcoholism, or gambling, or excessive shopping”.

It is obvious that she doesn’t know me personally and the work that I do in my district because if she did, she would know that in the community work that I do for my constituents, I integrate values formation and promotion of responsible parenthood, citizenry, and Christian living.

Even before I became congressman, I was already doing community work in these urban poor areas in my district, particularly the informal settler communities along the railroad tracks. In the seven years that I have been congressman of Muntinlupa, I have consistently gone to the grassroots as part of the social preparation for their eventual relocation out of the railroad tracks.

Unlike traditional politicians who would tell informal settlers that they will not be removed from where they are squatting, I went against the grain and convinced them that the best way for them to attain a better way of life is for them to be relocated. And the more challenging aspect of that is to convince them the relocation site will not be given to them free but they will have to pay monthly amortizations (although at an extremely low cost). Part of that social preparation is to teach them that instead of spending their money on booze, cigarettes or gambling, they should learn how to save and only spend for the basic needs of their families.

I must beg the indulgence of the readers if I had to wave my own flag a bit---but I think the statement which questions the work I do in my district by someone who obviously is speaking from a lack of information needs to be put in the right perspective.

Once again, romanza2005 is correct when she extolled the virtues of the Natural Family Planning Method. Nobody is disputing the fact that NFP is effective, if, as romanza2005 put it, “if couples learn to communicate, sacrifice and abstain from sex until a later time when the woman is infertile”

The key word in her statement that NFP works is IF. Because it is an affirmation of my position that NFP is only effective and applicable in situations where both the man and the woman are willing and able to use that method. What about situations where there is no mutual cooperation?

Which brings us back to the case of Grace. How can NFP work for them? Romanza2005 suggests that we cure Grace’s husband of his alcoholism first. It doesn’t take an alcohol rehab expert to tell us that curing alcoholism does not take place overnight. More so to teach him and Grace how to communicate. Even if it was to be provided free by the government, it would take a lot of time and effort to cure him. In the meantime, he will still be laying with Grace once in a while even during her fertile days….

To anyone who has really spent time in the urban poor communities, it is common knowledge that many of the men drink not because they developed from social drinkers to habitual drunks, but because it is their escape from the daily struggles they face in life. It is their way of forgetting their troubles, a way of enabling themselves to go home and sleep and avoid looking their waiting families in the eyes because it reminds them of their responsibility to provide. But the harsh reality is they are unable to do make ends meet. So liquor becomes the convenient escape.

Romanza2005 is once again correct in saying that proposed Reproductive Health Bill will not solve the problem. It is not seen by the proponents to be the miracle drug that will cure society’s complex problem. But it offers a solution that, when combined with others, will give the struggling Filipinos the ability to deal with the multi-faceted problems that they face.

Another suggestion by Romanza2005 is for Government to “train counselors and psychologists that can help these families overcome domestic abuse, alcoholism, debt”. A good proposition. In fact, government does have counselors and psychologists. But unfortunately, the number of families in such circumstances are so numerous and widespread around the country. It is unfortunate that the Government cannot afford to hire enough counselors and psychologists to cater to all these families. Right now, the Government’s priority is to hire more teachers who will teach the increasing number of students who attend public schools. It is a number that increases dramatically every year.

Romanza2005 got it wrong when she said the bill doesn’t mention abortion. It does. The bill categorically says that abortion remains illegal in the country. It reiterates the position that government will not allow abortion and neither do any of the bills sponsors and supporters espouse the legalization of abortion. Once again, it will be erroneous to insist on an interpretation that the bill will open the doors towards the legalization of abortion.

What the bill provides, however, is a policy of non-discrimination against the treatment of those who underwent illegal abortion.

It is a sad fact that even though the law prohibits abortion and society basically disapproves abortion, there are women who, faced with an unwanted pregnancy, avail themselves of the services of an illegal abortionist. This despite the very strong position of religious groups, society and the law against abortion. We simply cannot predict the confused and disillusioned pregnant woman who is scared of the stigma of a teenage or unwanted pregnancy if she decides to go to an illegal abortionist. AT this present time, it cannot be denied that there are those who offer and there are those who avail of this illegal service.

But matters are made worse when institutions or health practitioners aggravate the stigma of an illegitimate pregnancy terminated by an illegal practice when they refuse to give service to someone who has been in such unfortunate situations. Some get away with it without incident, but some also encounter post-illegal abortion complications. Where do these victims go to for care?

The absence of a policy on Reproductive Health, which includes post-abortion complications, denies these women the health care they rightfully deserve, and even aggravates the condition they are in. Many have even succumbed to such complications, which in the end results in the loss of life of not only of the baby, but of the mother as well.

There is no disagreement that the Natural Family Planning Method should be taught to the people. Romanza2005 even said that “the country would be better off by infusing every high school with lessons on The Billings Method, Natural Family Planning”, although I must add that any lesson to students about family planning should be presented in the right context. It should not be taught straightforward as a means to avoid pregnancy. It should be taught in the light of values and human sexuality.

What the bill proposes is to provide the people with the correct information on all the methods that are safe and effective for family planning. Ultimately, it will be the choice of the couple which method to follow, in accordance to their beliefs, convictions and acceptance. The bill does not prescribe any specific method to be imposed on anyone. It only provides for the availability of correct information and the services that couples decide to avail of.

It is incorrect to think that the bill will set aside the NFP method and only allow modern methods. Romanza comments that “The proposed policy on reproductive health as endorsed by the Congressman, though in rhetoric may sound 'well-intentioned' doesn't address the issue of abstinence and the importance of monogamous relationship, so no wonder one can't help but to question its ulterior motives.”

The bill does not need to prescribe abstinence because it is not the intention to prescribe a specific method to anyone. The simple language of the bill only prescribes the availability of correct information on reproductive health and the various methods of family planning. Although not stated, it includes NFP, abstinence, values education for monogamous relationships, and modern family planning methods.

The language of the bill is simple. It doesn’t prevent the promotion of monogamy and abstinence. The insistence on ulterior methods is misplaced.

There is one statement of romanza2005 which puts the blame on the incidence of teenage pregnancies on parents. She said “These teenage pregnancies could've been avoided if the parents taught them that sex should be between a husband and a wife..These teenage pregnancies could've been prevented if the parents taught their children to delay gratification, to wait, sacrifice, etc....”

I fully agree with romanza2005 that parents have the responsibility of teaching their children moral values and the correct attitude towards sex and pre-marital sex. There is no argument against that. Unfortunately, sometimes even the parents themselves have a wrong set of values when it comes to sex. They can’t teach their children about pre-marital sex because they themselves are involved in extra-marital sex. What moral values would you expect from such?

And what about the role that society plays? How many responsible and upright parents have had to face their son or daughter who engaged in pre-marital sex which bore fruit? What kind influence does society play in those situations?

That is why I am wary of studies on this matter that were undertaken in another country. Because there are differences in culture, traditions, practices, norms, values, and even legal frameworks which may have contributed to what the findings of the studies are. What we need are studies that are done in the Philippine setting so as to put everything in the right perspective.

I arrived at my position on the matter based on first hand, actual experience on how the people live, especially the marginalized sector. While others will insist their points based on studies made in other countries with cultures and societies alien from ours, and arguments that are detached from the real situation on the ground, I rely on what my five senses get from the ground.

If there is any question to my motives, I invite those who doubt to join me and see it for themselves.

5 comments:

EQ said...

The EQualizer Post strongly endorses the definition of reproductive rights agreed at the International Conference on Population and Development, which stated:

'Reproductive rights embrace certain human rights that are already recognized in national laws, international human rights documents and other consensus documents.

These rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health.

More Power Ruffy!

Anonymous said...

As a nursing student who always have the chance to have a glance and mingle with patients that are tend to be deprived (specially when it comes to their health), I was able to relate with your emotions and concerns about the mothers who are very innocent regarding their RIGHTS as a woman. The bill will be a great help to let the people, specially in the rural areas, gain full access in improving their health, life and their status through early and safe prevention of 'unnecessary occurrence' and specially health promotions of maternal health. The bill is acceptable as long as it benefits the most of the 88.57M population of our dear country, and i think it will. I hope it'll be adapted and accepted soon. Anyway, GOD allows great things to happen!...;')

More power to you, Sir Ruffy.

_ahnne_

WillyJ said...

Sir Ruffy,

What I'd like to ask is that if you are in total agreement with the prohibitive and punitive
provisions of the bill. Among these, three items stand out, as we bear in mind the penalties detailed in Sec 22 which includes "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...".

SEC. 12. Mandatory Age-Appropriate Reproductive Health Education..."In support of the natural and primary right of parents in the rearing of the youth,...".

I read mandatory to mean there is no option: children should undergo the government's version of RH education regardless of their parent's preferences. The bill itself concedes that it is the primary right of parents, as detailed in Art II Sec 12 of the Constitution. The bill making it mandatory would usurp on that right, of parents who discern that the POPCOM formulated materials would not be suitable for their own children. Would you deny this judgment call of objecting parents, regardless of whether you agree with their decision or not?

Sec 21, A-5. Refuse to extend reproductive health care services and information...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..

The phrase "That the conscientious objector shall immediately refer the person seeking such care..." effectively negates any allowance for conscientious objection. The bill requires material cooperation from the conscientious objector, in fact forcing the person to
act against his very conscience that is based on religious grounds. It is coercive, no matter which way we look at it. Do you agree with such coercion?

Sec 21 5-e) Any person who maliciously engages in disinformation about the intent or
provisions of this Act.


This provision is certainly too sweeping. Any sort of criticism henceforth after the bill's passage may be construed as "malicious". Would you support all
bills thereafter that contains the clause: "Any person who maliciously engages in disinformation..." or are you allowing an exception just for the sake of this particular RH bill?

I for one do not question your motives to alleviate the plight of your poor constituents. It is in the same vein I surmise that you would be sufficiently motivated to protect the rights of certain sectors in your constituency in spite of them being in the perceived minority.

Ruffy Biazon said...

willyj,

Thanks for posting your comments and questions.

In answer to your questions:

1. I have reservations on Section 22 which pertains to Penalties. In particular, I would like to limit the penalties to the payment of fines and exclude imprisonment. This amendment can be done during the Period for Individual or Committee Amendments whcih come after the Period of Debate.

2. In order to answer your next question, we need to read and consider the ENTIRE section and not just pick out certain phrases.

The provision in question reads:

SEC. 12. Mandatory Age-Appropriate Reproductive Health Education. - Recognizing the importance of reproductive health rights in empowering the youth and developing them into responsible adults, Reproductive Health Education in an age-appropriate manner shall be taught by adequately trained teachers starting from Grade 5 up to Fourth Year High School. In order to assure the prior training of teachers on reproductive health, the implementation of Reproductive Health Education shall commence at the start of the school year one year following the effectivity of this Act. The POPCOM, in coordination with the Department of Education, shall formulate the Reproductive Health Education curriculum, which shall be common to both public and private schools and shall include related population and development concepts in addition to the following subjects and standards:

a. Reproductive health and sexual rights;

b. Reproductive health care and services;

c. Attitudes, beliefs and values on sexual development, sexual behavior and sexual health;

d. Proscription and hazards of abortion and management of post-abortion complications;

e. Responsible parenthood;

f. Use and application of natural and modern family planning methods to promote reproductive health, achieve desired family size and prevent unwanted, unplanned and mistimed pregnancies;

g. Abstinence before marriage;

h. Prevention and treatment of HIV/AIDS and other STIs/STDs, prostate cancer, breast cancer, cervical cancer and other gynecological disorders;

i. Responsible sexuality; and

j. Maternal, peri-natal and post-natal education, care and services

In support of the natural and primary right of parents in the rearing of the youth, the POPCOM shall provide concerned parents with adequate and relevant scientific materials on the age-appropriate topics and manner of teaching reproductive health education to their children. In the elementary level, reproductive health education shall focus, among others, on values formation. Non-formal education programs shall likewise include the abovementioned Reproductive Health Education.


First, I do have reservations on imposing the rule on private educational institutions. I believe Private schools, particularly those which are faith-based, should be excluded from the rule in order not to infringe on their right to have their own belief systems. Once the private schools are excluded, the question on the parents' right to rear their children as prescribed in the Constitution will be addressed.

Public schools, which are purely funded by the State, shall then be covered by this policy, which becomes State policy if passed into law.

A reading of the entire section will show that the proposed mandatory Reproductive Health Education will be:

a. AGE-APPROPRIATE - it means that Grade 5 Students will NOT be taught how to have sex using a condom, but rather be taught Reproductive Health principles that match their understanding and needs at their age.

It is an overstretch of the imagination and myopic view to even think that Grade 5 students will be taught how to have sex using contraceptives.

b. The section provides the exact content that will be taught to students, which will also depend on their age and grade/year level. It should be noted that the Section even EXPLICITLY PROVIDES for USE AND APPLICATION OF NATURAL and modern family planning mehods, ABSTINENCE BEFORE MARRIAGE among other things.

It even further explicitly provides that IN THE ELEMENTARY LEVEL, REPRODUCTIVE HEALTH EDUCATION SHALL FOCUS, AMONG OTHERS, ON VALUES FORMATION.

But the bottomline is that values education of children are the primary responsibility of the parents, no matter what is taught or not taught in schools.

In the absence of a formal curriculum in school, children learn about reproductive health or sex from informal sources, often in a manner and source that is not acceptable to parents. This is obviously against parents' rights and preferences but can they actually do anything about it? If a child learns about sex from his/her friend or classmate, can the parents be assured that what their child is learning from a peer is correct?

As a parent myself, I would rather teach my children about reproductive health and sex based on what I know and believe in, backed up by a studied, formal and accountable curriculum in school.

c. With regard to Sec. 21, A-5, the provision allows a health care service provider to refuse to give Reproductive Health Care Service if it is against that health care service provider's personal beliefs. The provision guarantees that individual health care provider's right to religious beliefs.

On the other hand, the patient seeking a particular health care service has a right to the service he/she is seeking, therefore, the health care provider who does not want to give the service is obligated to refer the one seeking service to another service provider. To deny that referral is a denial of service and a denial of the right of the patient to receive the service he/she is seeking.

To make it worse, it is a denial of service based on a personal belief that is not shared by the patient.

A specific example would be a woman who would like to avail of ligation but is refused by a doctor on the grounds that the doctor's religious beliefs are in the contrary (conscientious objector). The doctor may have a right to her/his own beliefs but does he/she have the right to impose that belief on a patient seeking service?

I don't think so.

The minimum obligation then of that doctor would be to refer the patient to another health care provider, who would then have his/her own right to refuse if it is against his/her beliefs, provided that the patient seeking service is referred to another health care provider.

I do not think that is coercion.

d. With regard to Section 21 E-5, I have my reservations on this. It is subjective and may be deleted in the period of amendments.

But I do understand where the author of that provision is coming from.

It cannot be denied that certain persons or sectors have been insinuating/suggesting/concluding that those who support or promote the bill are driven by ulterior, sinister motives/intent. It is unfair to those implicated by those innuendos and is only based on biased or uninformed assumptions.

One should not use something subjective as a question of intent in any intelligent debate.

With regard to misinformation, it has also been observed that some arguments against the bill are based on a wrong reading / interpretation of the bill, so glaring that it strongly seems deliberate.

But having said that, I reiterate that I have my reservations about the provision in question.

WillyJ said...

Sir Ruffy,

Thank you for the comprehensive response. It is appreciated that you do have reservations on those aspects the bill. Moral theology defines any formal and/or material cooperation on acts against one’s beliefs as ethically and morally objectionable. At the heart of the matter lies freedom of religious expression which includes the right to act or not to act according to one’s beliefs. While it may be argued that such right is not absolute, the underlying principle guaranteed by the Constitution is that the state may not force anyone to act against his conscience. Justice Teehankee had this to say:

1. The right to freely exercise one’s religion is guaranteed in Section 8 of our Bill of Rights. (footnote omitted) Freedom of worship, alongside with freedom of expression and speech and peaceable assembly “along with the other intellectual freedoms, are highly ranked in our scheme of constitutional values. It cannot be too strongly stressed that on the judiciary - even more so than on the other departments - rests the grave and delicate responsibility of assuring respect for and deference to such preferred rights. No verbal formula, no sanctifying phrase can, of course, dispense with what has been so felicitously termed by Justice Holmes ‘as the sovereign prerogative of judgment.’ Nonetheless, the presumption must be to incline the weight of the scales of justice on the side of such rights, enjoying as they do precedence and primacy.’ (J.B.L. Reyes, 125 SCRA at pp. 569-570)

2. In the free exercise of such preferred rights, there is to be no prior restraint although there may be subsequent punishment of any illegal acts committed during the exercise of such basic rights. The sole justification for a prior restraint or limitation on the exercise of these basic rights is the existence of a grave and present danger of a character both grave and imminent, of a serious evil to public safety, public morals, public health or any other legitimate public interest, that the State has a right (and duty) to prevent (Idem, at pp. 560-561).


(emphasis mine).

I trust that the prohibitive and punitive provisions be accorded prominent attention in the forthcoming plenary deliberations. Again, I appreciate your thoughtful response and your expressions of reservations in this respect. I do hope that your expression of reservation redounds into a conviction to protect freedom of religious expression at the same time and with same fervor that you advance your advocacy. More power to you sir.