A personal reflection on the RH Bill -- the sequel

Editor's note: On March 23, 2011, the authors of the controversial Reproductive Health (RH) bill at the House of Representatives agreed to amend several provisions of the measure’s consolidated version, including the introduction of a paragraph in the bill making sex education optional. Section 21, which requires employers with more than 200 employees to “provide reproductive health services to all employees in their own respective health facilities," will be “deleted in its entirety. Read Author's Ammendment to HB 4244"

In October 2010, I wrote A Personal Reflection on the RH Bill. At that time, the debates on the RH Bill was just starting up and certainly without the drama or fever-pitch levels that it has reached these days.

In that particular article, I ended by saying that – “In and of itself, the RH bill has provisions that are acceptable. But there are also others that aren't. The churches, the media, and the government do the people a disservice by not discussing the details of the bill. People are doing themselves a disservice by not even reading the bill.”

I still believe in the same conclusion I made – that the bill has provisions that are useful and helpful to the general population; that there are those that are contentious; and that the best thing to do is to read the bill and make one’s own conclusions. Allow me to share how I reviewed the latest version of the RH Bill HB4244 and to outline my comments about each of its provisions. I hope that through this you will be encouraged to read it for yourself and evaluate it on the basis of its merits in the light of your personal beliefs.

Sec 2 Declaration of Policy	The section cites the recognition and guarantee of “exercise of basic human rights to reproductive health … consistent with their beliefs”, the “promotion of basic gender equality”, “the promotion of the rights and welfare of children.” Perhaps to enhance the RH bill as life-promoting, it should also begin with recognition of the highest of all human rights – the right to life – of the mother and of the fetus or the unborn child. It should also make it explicit that in enacting the bill, no priority is given to the mother OVER the child’s welfare or vice-versa, recognizing inalienable rights of both the mother AND the child. Such a direct declaration shall strongly disavow any allegation that the bill is pro-abortion or promotes abortifacient devices.
Sec 3 Guiding Principles	First among the guiding principles that ought to govern the act is the respect of one’s inalienable right to life. The bill must recognize that from this most basic of all rights, all other rights emanate. Conspicuously absent is any mention of being guided by the principle of “free exercise of religion”. Practical recognition should be given to the free exercise of one’s faith, since any discussions on and the implementation of reproductive health and population development programs will inevitably coincide with a discussion of beliefs. The Constitutional guarantees that no one shall be discriminated against for the exercise of one’s personal belief, be they community worker, doctor, or patient. The bill should enshrine as a guiding principle the right of the “patient” or the “medical professional” or “private institutions” to refuse implementing parts of the Act that will run counter to their inherent beliefs and on ground of “conscience”. Finally, the bill should explicitly protect the right of parents to educate their own children in a manner consistent with their religious convictions and cultural beliefs; that no child shall be forcibly taught matters that may run counter to his or her parents’ preferred upbringing and methods.
Sec 4 Definition of Terms	In “Reproductive Health Care”, among the elements includes “(c ) prescription of abortion and management of abortion related complications”. In lieu of such, and to be consistent with Sec. 2 and Sec 3, the element should be revised to read “(c) management of abortion-related complications”, explicitly deleting the inclusion of “proscription of abortion” among the elements of reproductive health care that the bill accepts. In “Reproductive Health Rights”, the definition should include at the end, “consistent with their religious convictions, cultural beliefs, and the demands of responsible parenthood”.
Sec 5 Midwives for Skilled Attendance	No comments or objections.
Sec 6 Emergency Obstetric and Neonatal Care	No comments or objections.
Sec 7 Access to Family Planning	“All accredited health facilities shall provide a full range of modern family planning methods (ADD: “with the exception of methods that directly interfere with the natural development of a fertilized egg or fetus as well as those that may directly or indirectly have abortifacient effects.”
Sec 8 Maternal and Newborn Healthcare in Crisis Situations	Rather than the generic/broad “disasters and humanitarian crises”, the bill should include in the “definition of terms” (Sec 4) what qualifies as a “Crisis Situation” that will be covered by Sec 8.
Sec 9 Maternal Death Review	No comments or objections.
Sec 10 Family Planning Supplies as Essential Medicines	Practical considerations should dictate that the provision and availability of Family Planning Supplies need to qualified rather than all encompassing. Given limitations of budget and resources, the bill ought to specify as “Family Planning Supplies as Essential Medicines” only those “medications and implements/instruments that are NECESSARY to preserve the life of the mother and the fetus or those that shall be necessary for addressing the ‘Crisis Situations’ as defined by the bill.” By identifying this limitation, government shall address the need to prioritize the allocation of its resources and without having to fund what ought to be part of day-to-day expenses of those that choose to use contraceptives as their preferred method of family planning. That said, perhaps, further, instead of using the phrase “Family Planning Supplies”, the phrase that ought to be used should be “Reproductive Health Supplies” to ensure consistency with the bill’s life-promoting intent.
Sec 11 Procurement and Distribution of Family Planning Supplies	In additions to comments made re: Sec 10, it is suggested that for this section, the same definition of “supplies” be applied. The criteria mentioned in this section “contraceptive prevalence rate”, belies its preference for contraceptive methods over other methods. To remove such impression or actual preference, only the first two – (1) no. of women of reproductive age and (2) cost of family planning supplies should be retained. Since the “family planning supplies” ought to promote and preserve the health of both mother and fetus, perhaps another criteria that ought to be added should be “crude birth rate” which will determine how many cases will potentially require assistance from the hospitals and health care centers.
Sec 12 Integration of Responsible Parenthood and Family Planning Component in Anti-Poverty Programs	This section of the bill belies its intent to use RH as a tool for economic management. It raises the level of importance of family planning in poverty alleviation programs to the level of basic nutrition, basic education, access to potable water, and ecological protection. Such an insertion makes population management a required component of ANY government’s national economic policy. This is especially problematic considering that while on one hand the bill says it is neutral to various family planning methods, on the other, it demonstrates a strong preference for artificial contraceptive methods. At the end of the day, the less contentious and directly beneficial portion of the bill has to do with the prevention of maternal, fetal and infant deaths. As such, it ought to concentrate on its Health Promoting aspects rather than legislating contraception and population control as a tool for development planning. Poverty alleviation programs that have a direct and immediate impact on improving the quality of life of the poor have been proven to be those that involve nutrition, basic education, and access to potable water. Population management as a development policy continues to have a debatable, if not at times outright bogus, effects on actual, historical improvements in people’s lives.
Sec 13 Roles of Local Government	Minor revision – replace the phrase “Family Planning Programs” with “Reproductive Health Programs”.
Sec 14 Benefits for Serious and Life Threatening Reproductive Health Conditions	No comments or objections.
Sec 15 Mobile Health Care Service	No comments or objections.
Sec 16 Mandatory Age-Appropriate Reproductive Health and Sexuality Education	This is now optional - Editor. Also read Read Author's Ammendment to HB 4244 Parents ought to be given a choice on how to educate their children with regard to reproductive health and sex education. While government’s intent may be served in having such included in the curriculum, such is unnecessary for children whose parents take it upon themselves to teach their own kids rather than leave it to the teachers, using a curriculum and materials that may not match their own family value systems. Perhaps an option that can be considered is the requirement of a WAIVER where parents, or a group of parents, can declare that they will be responsible for educating their own kids, in their own way, and following their own value system, but CONSISTENT with the GENERAL principles being promoted by the RH bill. In this manner, government will still put together a curriculum, it will still train teachers, BUT it will not require ALL students to attend. Again, it is absolutely disadvantageous to the public at large not to pass the RH bill if only due to this contentious provision. Some allowance ought to be given for differences in culture or beliefs. At the end of the day, we also need to consider that from a practical perspective, there aren’t enough hours actually spent on Science and Math education without adding a few more about Sex Education. For such RH education to be effective, it cannot be done in just one session or just a few hours, but needs to form part of the overall formation of the young adult which means you will need to spend a good amount of time on it.
Sec 17 Additional duty of the Local Population Officer	No comments or objections.
Sec 18 Certificate of Compliance	No comments or objections.
Sec 19 Capability building of Bgy Health Workers	No comments or objections.
Sec 20 Ideal Family Size	Now deleted. - Editor. Read Author's Ammendment to HB 4244 The specific identification of an ideal size of two children per family does not lend any additional benefit to the bill as it is neither mandatory nor compulsory. Nor does it carry any punitive measures. As such, the provision just adds to the contentious issues surrounding the RH bill without any direct justifiable benefit apart from inciting debate.
Sec 21 Employers’ Responsibilities	Section is now deleted- Editor. Read Author's Ammendment to HB 4244 This is another section of the bill that is superfluous considering that the requirements of this section are already substantially covered by the Labor Code and the laws governing PhilHealth. Similarly, if the government already requires hospitals, health centers, as well as communities, to support and promote reproductive health, the incremental benefit of requiring employers to do the same will be marginal. Finally, this provision of the bill makes it difficult to implement for employers’ whose religious and cultural beliefs are not supportive of a contraceptive culture.
Sec 22 Pro Bono Services for Indigent Women	No comments or objections.
Sec 23 RH programs for PWDs	No comments or objections.
Sec 24 Right to Reproductive Health Care Information	The inclusion of the phrase “non-fraudulent” is contentious as it will be necessary to determine whether the information being shared is fraudulent. Does the inclusion of this qualification mean that the bill will necessarily establish some sort of Bureau of Standards to provide its approval as to whether the info shared in non-fraudulent? Considering the dynamic nature of medical and pharmaceutical research, including those that involve sexual and reproductive health initiatives, sensitivity to timing and the actual propagation or refutation of findings also becomes a matter for consideration in implementing this provision of the bill. All told, the right to information isn’t and shouldn’t be debatable. Its qualification and implementation – who gets it, how it is communicated, where it is communicated – is.
Sec 25 Implementing Mechanisms	N comments or objections.
Sec 26 Reporting Requirements	No comments or objections.
Sec 27 Congressional Oversight	No comments or objections.
Sec 28 Prohibited Acts	Section 28- E on malicious disinformation has been scrapped - Editor. Read Author's Ammendment to HB 4244 On A2, in the case of abused minors whose respondents/perpetrators are parents, rather than leaving the decision to the minor, the courts ought to be required to designate a “guardian” who shall execute the authorization in loco parentis. Where the perpetrator is another member of the family, parental authority must be retained unless a competent court determines direct or participatory culpability on the part of the parent. No other comments or objections on the other provisions.
Sec 29 Penalties	If the person is a juridical entity, the penalty shall be applied as a fine to the partnership or corporation rather than to the President or responsible officer. Deportation as a penalty for aliens appears to be an exaggerated penalty not comparable to the penalties applied to locals.
Sec 30 Appropriations	No comments or objections.
Sec 31 -34	No comments or objections.

Ang.Mungo tweets at @ang_mungo

Editor's note: On March 23, 2011, the authors of the controversial Reproductive Health (RH) bill at the House of Representatives have agreed to amend several provisions of the measure’s consolidated version, including the introduction of a paragraph in the bill making sex education optional. Lagman likewise said that Section 21, which requires employers with more than 200 employees to “provide reproductive health services to all employees in their own respective health facilities, Read Author's Ammendment to HB 4244" will be “deleted in its entirety."

Photo by Noemi Lardizabal-Dado. Some rights reserved.

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scrEaMing mANgo 21 April 12, 08:27 AM

After last night's Sex Education discussion, and all the views thrown, I just had to find more data on RHBill, raising a teen, and general information about being a parent, things most fathers miss out in the child rearing issue. Where is my wife in all of these? She, while being attacked by pains every waking hour with osteoarthritis, is with our daughters, staying strong and keeps the household in one piece. I have to keep up. So, here's a THANK YOU for the worthy information I have begun to collect.