The RH Act (2012) in brief

Appendix “B” of Philippines RH Act: Rx for controversy

Sean Murphy*

An outline of principal sections of the Responsible Parenthood and Reproductive Health Act of 2012 relevant to freedom of conscience.

SEC. 1. Title
  • [Not reproduced here]
SEC. 2. Declaration of Policy

The State recognizes and guarantees the human rights of all persons,1 including their right to equality and nondiscrimination of these rights, the right to sustainable human development, the right to health which includes reproductive health,2 the right to education and information, and the right to choose and make decisions3 for themselves in accordance with their religious convictions, ethics, cultural beliefs and the demands of responsible parenthood.4 . . . [Full text]

Philippines population control and management policies

Appendix “A” of Philippines RH Act: Rx for controversy

Sean Murphy*

Establishment of POPCOM

In 1967, President Ferdinand Marcos joined other world leaders in adding his signature to a Declaration on Population that had been made the previous year by representatives of 12 countries (often incorrectly cited in Philippines government documents as “the UN Declaration on Population”).1 Two years later, Executive Order 171 established the Commission on Population (POPCOM), and in 1970 Executive Order 233 empowered POPCOM to direct a national population programme.2

The Population Act

The Population Act [RA 6365] passed in 1971 made family planning part of a strategy for national development. Subsequent Presidential Decrees required increased participation of public and private sectors, private organizations and individuals in the population programme.3

Under President Corazon Aquino (1986 to 1992) the family planning element of the programme was transferred to the Department of Health, where it became part of a five year health plan for improvements in health, nutrition and family planning. According to the Philippines National Statistics Office, the strong influence of the Catholic Church undermined political and financial support for family planning, so that the focus of the health policy was on maternal and child health, not on fertility reduction.4

The Population Management Program

The Ramos administration launched the Philippine Population Management Program (PPMP) in 1993. This was modified in 1999, incorporating “responsible parenthood” as a central theme.3 During the Philippines 12th Congress (2001-2004) policymakers and politicians began to focus on “reproductive health.”5

Responsible Parenthood and Family Planning Program

In 2006 the President ordered the Department of Health, POPCOM and local governments to direct and implement 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 LGUs can promote artificial family planning because of local autonomy, the national government advocates natural family planning.3

Population policy effectiveness and outcomes

The population of the Philippines grew steadily from about 27million in 1960 to over 100 million in 2018. Starting from similar populations in 1960, Thailand, Myanmar and South Korea now have much lower populations (Figure 1) . . . [Full text]

Philippines RH Act: Rx for Controversy

Diatribe by Philippines’ President turns back the clock

Sean Murphy*

Abstract

Turning back the clock

In June, 2019, Philippines President Rodrigo Duterte blamed the Catholic Church for obstructing government plans to reduce the country’s birth rate and  population.  “They think that spewing out human beings by the millions is a gift from God,” he claimed, adding that health care workers should resign if they are unwilling to follow government policy on population control for reasons of conscience.

Duterte’s authoritarian diatribe clashes with a ruling of the Supreme Court of the Philippines and turns the clock back to times of harsh and extreme rhetoric when the current law (commonly called the RH Act) was being developed.  The RH Act was the product of over fourteen years of public controversy and political wrangling. It was of concern when it was enacted because it threatened some conscientious objectors with imprisonment and fines. 

In January, 2013, the Project reviewed the Act in detail.  Project criticisms about the law’s suppression of freedom of conscience were validated in April, 2014, when the Supreme Court of the Philippines struck down sections of the law as unconstitutional.

Given the long history of attempts at legislative coercion in the Philippines and President Duterte’s obvious hostility to freedom of conscience and religion in health care, the Project’s 2013 review of the RH Act is here updated and republished.

Assuming that the Philippines government’s concern about population growth in the country is justified, it does not follow that it is best addressed by the kind of state bullying exemplified by President Duterte’s ill-tempered and ill-considered eruption.  Aside from the government’s enormous practical advantage in its control of health care facilities, it has at its disposal all of the legitimate means available to democratic states to accomplish its policy goals.  Not the least of these is persuasive rational argument, an approach fully consistent with the best traditions of liberal democracy, and far less dangerous than state suppression of fundamental freedoms of conscience and religion.

TABLE OF CONTENTS

Turning back the clock

A history of coercive legislative measures

Background

The “RH Act” of 2012: General comments

The “RH Act” of 2012: Specific provisions

Freedom of conscience and religion

The Supreme Court weighs in

The way forward

Appendix “A”:  Philippines population control and management policies

Appendix “B”: The “RH Act” (2012)  in brief

Project Comments

Chamber of Pharmacists warns professionals against incorrect dispensing of Morning After Pill

Malta Independent

Rebekah Cilia

The Chamber of Pharmacists (Kamra tal-Ispizjara) has sent an email to its members stating that there is a standard question protocol that pharmacists must follow when dispensing the Morning After Pill without a prescription.

These guidelines, the email said, are professional tools and should be kept confidential.

The Chamber also noted that pharmacists should avoid engaging in public discussions on social media. “The Chamber reprimands pharmacists who do not uphold such standards bringing the profession to disrepute.” [Full text]

Systematic Review of Ovarian Activity and Potential for Embryo Formation and Loss during the Use of Hormonal Contraception

Donna Harrison, Cara Buskmiller, Monique Chireau, Lester A. Ruppersberger, Patrick P. Peung Jr.

Linacre Quarterly

Abstract

The purpose of this review was to determine whether there is evidence that ovulation can occur in women using hormonal contraceptives and whether these drugs might inhibit implantation. We performed a systematic review of the published English-language literature from 1990 to the present which included studies on the hormonal milieu following egg release in women using any hormonal contraceptive method. High circulating estrogens and progestins in the follicular phase appear to induce dysfunctional ovulation, where follicular rupture occurs but is followed by low or absent corpus luteum production of progesterone. Hoogland scoring of ovulatory activity may inadvertently obscure the reality of ovum release by limiting the term “ovulation” to those instances where follicular rupture is followed by production of a threshold level of luteal progesterone, sufficient to sustain fertilization, implantation, and the end point of a positive β-human chorionic gonadotropin. However, follicular ruptures and egg release with subsequent low progesterone output have been documented in women using hormonal contraception. In the absence of specific ovulation and fertilization markers, follicular rupture should be considered the best marker for egg release and potential fertilization. Women using hormonal contraceptives may produce more eggs than previously described by established criteria; moreover, suboptimal luteal progesterone production may be more likely than previously acknowledged, which may contribute to embryo loss. This information should be included in informed consent for women who are considering the use of hormonal contraception.


Harrison D, Buskmiller C, Chireau M, Ruppersberger LA,Peung PP.   Systematic Review of Ovarian Activity and Potential for Embryo Formation and Loss during the Use of Hormonal Contraception. Linacre Quarterly. 2019 Jan 03; 85(4):453–469.

Supreme Court opines on limitations of GPs’ freedom of conscience

International Law Office

Lise Gran, Ole Kristian Olseby

The Supreme Court recently deemed that a municipality’s termination of its agreement with a general practitioner (GP) after she refused to insert an intrauterine device (IUD) for a patient for reasons of conscience relating to her religion was invalid.

Legal background

The criterion for terminating an agreement with a GP is the same as that for terminating an employment agreement under Norwegian law (ie, it must be objectively justified). . . [Full text]

NH House Roundup: House kills ‘medical conscience’ bill, restores rail study

New Hampshire Union Leader

Dave Solomon

CONCORD — A bill that would allow medical professionals to exercise their “rights of conscience” failed in a 218-109 vote in the House of Representatives on Thursday.

The bill, HB 1787, would allow medical professionals to refuse any procedure that goes against their personal beliefs, including abortion, providing contraceptives or contraceptive counseling.

“In our state right now, there are no rights of conscience protections for medical people,” said Rep. Kurt Wuelper, R-Strafford. “Doctors are required in many areas to participate in and perform procedures that violate their consciences. That’s not right.” . . .[Full Text]

Medical professionals divided on bill allowing them to refuse to perform abortions, other procedures

New Hampshire Union Leader

Dave Solomon

CONCORD  –  The national debate over the rights of health care workers to refuse to perform procedures like abortion or assisted suicide is working its way through the New Hampshire State House as lawmakers consider “an act relative to the rights of conscience for medical professionals.”

The medical community is divided over the bill, which would allow medical professionals to refuse any procedure that goes against their personal beliefs, including abortion, providing contraceptives or contraceptive counseling.

Doctors at a public hearing last week testified for and against the bill (HB 1787), which would also cover physician’s assistants, nurses, pharmacists, medical students … basically anyone and everyone who works in the health care profession. The lengthy definition of “health care provider” in the bill includes “hospital or clinic employees.” . . . [Full Text]

The ‘Uber for birth control’ expands in conservative states, opening a new front in war over contraception

Stat

Max Blau

It’s a telemedicine app that seems rather innocuous — enter your info, have it reviewed by a physician, and get a prescription. The California-based company behind it has raised millions to support its mission of expanding access to the pill, ring, or morning-after pill with minimal hurdles.

But that last option is now starting to attract pushback from anti-abortion activists, who consider the morning-after pill equivalent to abortion — and who say lax telemedicine laws are enabling access to this drug with insufficient oversight.

Nurx, an app that’s been called the “Uber for birth control,” lets patients obtain a variety of contraceptives from the touch of a smartphone; it also gives women access to Plan B and Ella, two forms of the morning-after pill, which is effective in preventing a pregnancy after sex. Women can order these drugs in a few easy steps: answer a series of health questions; provide basic demographic information; and choose a preferred drug. A doctor then reviews the patient’s information, writes a prescription, and the drug is delivered to either the patient’s home or her local pharmacy. . .  [Full text]

 

Contraceptive Coverage and the Balance Between Conscience and Access

Ronit Y. Stahl,PhD; Holly Fernandez Lynch, JD, MBE

When the Obama administration included contraception in the essential benefits package to be covered by employer-sponsored health insurance plans under the Affordable Care Act, it sought to preserve access for women while addressing the concerns of employers with religious objections. Although the accommodations and exemptions were not enough for some employers, balance was the ultimate goal. This also was reflected in Zubik v Burwell, the Supreme Court’s most recent decision on the matter; on May 16, 2016, the justices remanded the litigants to the lower court so they could be afforded the opportunity to reach a compromise between religious exercise and seamless contraceptive coverage. No further compromise was forthcoming.

Now the Trump administration has rejected balance as a worthwhile goal.1 Its new contraceptive coverage rules, released on October 6, 2017, prioritize conscientious objection over access.2,3 The rules take effect immediately, and new legal challenges, this time on behalf of patients rather than objecting employers, have already begun.4 The new rules preserve the default requirement that employers must include free access to contraceptives as part of their insurance plans. However, the rules now exempt employers with religious or moral objections to contraceptives, without requiring any alternative approaches to ensure that beneficiaries can obtain contraceptives at no cost.2,3
[Full Text]


Stahl RY, Lynch HF. Contraceptive Coverage and the Balance Between Conscience and Access. JAMA. Published online October 19, 2017. doi:10.1001/jama.2017.17086