Suyang suya ka na ba sa RH Bill? Eto pa isa.

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I've been following the sessions on about the RH bill in the newspapers. Amused as I am with the theatrical argumentation that could pass as an season-long episode in Face to Face, I do worry about the impact of this bill. As I mention a lot whenever this bill becomes the topic, I am neither pro or anti RH. Heck, I don't even get the point of being anti/pro since I think that the best way for this to work is to hear out and reconcile the points of each of the two factions and then come up with a bill that would benefit the people. Our legislators should stop squalling and get together to pass this bill if it needs to be passed.

Then again, I also worry about the proactive stance of the government to pass this bill. While the bill may have several beneficial effects (of which I still have some reservations)  we cannot discount the permanent negative ones as well.  Will it really reduce maternal mortality rates or increase the incidence of hormone-related cancers? Will it affect the population curve positively which will allow our country to properly allocate its resources or will it trim down the population like what happened to other countries which drastically implemented birth control methods? Will it reduce STI's and HIV prevalence or promote promiscuity? Will it make parents more responsible in Family Planning and sex education for the child or will it lead the children to be knowledgeable yet unguided? Will it empower women or lead them to dependency on contraceptive menthods that are proven to be not 100% effective?

At the end of the day, I do believe that there is still much that should be discussed about this bill. These are crucial times for the country and we simply can't play trial and error since the bill has very polar effects. I am not saying that this bill shouldn't be passed but methods on how this will be implemented must be straightened out first before doing so. Because at the moment, I am not yet too confident on how the bill will be implemented if  it will be passed soon. Are you?

Mandatory Referral of Hospitals in the RH Bill

“…the conscientious objection of a healthcare service provider based on his/her ethical or  religious  beliefs shall be respected; however, the conscientious objector shall immediately refer the person seeking such care and services to another healthcare service provider within the same facility or one which is conveniently accessible who is willing to provide the requisite information and services…" – HB 4244

The passage stated above is one of the most debatable parts in the Reproductive health bill among health professionals. It requires every medical professional (doctors, nurses, etc.) to refer a pregnant woman to another professional if one cannot perform an act due to conflicting ethical views.  So to speak, medical professionals can refuse, but they should provide a contact person to do it. 

Some people argue that this is unethical especially when the client asks the professional to do abortion. That by referring the patient, you are already acting as an accomplice to the morally disturbing situation. However, I believe that patient’s right to information should also be upheld and health care services be extended to all, even those who choose to undergo abortion. 

For example, a patient asks about abortion, you as a health care professional can’t just deny them of all information that they deserve as patients. Therefore, the responsibility then of a doctor/nurse who is under ethical distress is to explain the risks, harm, and other ethico-legal issues to the patient. 

When it comes to performing an abortion, the medical professionals must set clear their values to determine what they would do in such morally distressing circumstances and refuse to participate if it does not conform with their beliefs. Medical professionals know what is good for their patients however they should not impose their beliefs on them and not step on their right to autonomy. It is the body of the patient thus they have the authority to decide for themselves.

 Should the patient still persist to have abortion be done, referral to another medical professional is one good way of ensuring that the abortion will at least be safe. Unsafe abortion as defined by the WHO as ”a procedure for terminating an unintended pregnancy either by individuals without the necessary skills or in an environment that does not conform to minimum medical standards, or both.”  These women usually  resort to self-induced abortions or receive it from traditional healers whose credibility is questionable due to inadequate medical training. (WHO, 2004) I am not saying that abortion is moral and that there is absolutely no wrong with it since it has its own ethical issues and legal implications which are also conficting with my values.  Although when you consider that an estimated 68,000 women die every year (eight women per hour) due to unsafe abortion (WHO, 2004), you will realize how salient it is for them to receive adequate health care.  This is also supported by the study of Juarez, Cabigon, Singh, and Hussain (2005) where they recognized that policies and programs on postabortion care in the Philippines needs improvement.

In a nutshell, patient’s decisions must be respected with their autonomy valued. Nurses/doctors must  assist the patient in coming up with an ethical decision but should not force their beliefs on the patient. Should client still pursue abortion, referral is needed to ensure that the procedure will at least, be safe and free from complications. 

Sources:

• Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associate mortality in 2000. 4^th edition, Geneva, Switzerland: World Health Organization, 2004
• Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, Shah Iqbal Unsafe abortion: the preventable pandemic. The Lancet Sexual and Reproductive Health Series, 2006
• Juarez F, Cabigon J, Singh S, and Hussain R The Incidence of Induced Abortion in the Philippines: Current Level and Recent Trends. International Family Planning Perspectives Volume 31, Number 3, September 2005 
• https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhReAVkEFrhEBSQZVesAmZXBiiJ8h0twStwBjVV38dCxbES__oEsGsbjSmsPLARC8jeMbU-z99nVaCnB38GL7Z9L1BD08r_tyDzUqzZXziwTlLdWz3bDeuUz_sNFROCZjVEG3RWSsh3z4Yz/s1600/tb36injectables.jpg

Bill-Live: Focusing on the Deeper Perspectives of the RH Bill

Last July 24, 2011, the UST Nursing Central Board of Students(NCBS) in collaboration with the UST Office for Student Affairs (OSA) sponsored a symposium entitled “Bill-live: Focusing on the Different Perspectives of the RH Bill” , held at the Tan Yan Kee Student Center AVR from 9:00am to 12:00nn.

The symposium had Paranaque 2^nd district representative Roilo Golez and UST Faculty of Medicine and Surgery Bioethics Chair Dra. Edna Monzon as its speakers. The event was participated by the student leaders from the different colleges and  faculties of the University. “We believe that the leaders are the main stakeholders in promoting the campaign since they are the ones that lead the students to get involved”, said NCBS Asst. Treasurer Eugene Gibb Mendoza.

The first speaker, Hon.Roilo Golez, gave the audience a quick insight on the possible bias that may have occurred in the surveys due to the use of the term “Reproductive Health” rather than “Reproductive Health Bill”. He stressed that the term might have been used to deceive the people as everyone would like to achieve reproductive health same as they would like to have cardiovascular health, mental health and so on. He also argued the validity of the answers of the respondents since a big percentage admitted that they haven’t even read the bill (H.B. 4244) thus rendering them less credible to take a stand.

Golez also addressed the issue on the alleged overpopulation where he cited a different perspective, considering the growing population as a vital resource in nation building. He pointed out that this could work in our advantage over the more developed countries with their inverse growth of population. He also argued that the main problem was not the population itself but rather the improper and faulty allocation of funds. Instead of highlighting the faux issue of population control, why don’t we focus ourselves with the real issue of inadequate classrooms, understaffed health centers and mass starvation? The Filipino people’s money would be more useful if allocated to that way. 

He also pointed out that the bill was unnecessary since similar provisions, some copied verbatim, are already present in the Magna Carta for Women which is already accepted by the public.

Meanwhile, Dr. Edna Monzon discussed about the bioethical and medical aspect of the bill. She explained that the use of contraceptives is a form of abortion since the actual mechanism of contraceptives is to prevent the zygote from implantation in the uterus. The zygote is the product of the union of the sperm and egg cell where cellular division occurs, this is also the stage where life arguably starts. Thus preventing a dividing cell from implanting through the use of contraceptives is clearly a form of chemical abortion. 

Another point by Dra.Monzon is that maternal death is not part of the Top 10 cases that cause morbidity in the Philippines (most of which are lifestyle diseases such as heart attack, stroke, etc.) and that therefore does not immediately need drastic responses to save the lives of the mothers giving birth. In the table presented by Roilo Golez that showed the Safe Reproduction Index, we can deduce that those provinces with understaffed health clinics/lying-ins are the ones with a greater maternal morbidity rate thus the government should focus more on adequate staffing of health institutions.

 She also shared that the inclusion of contraceptives as “essential medicines” in the bill is baseless since pregnancy is not a sickness but rather a state of enhanced wellness. Essential medicines are those supposed to serve the whole population regardless of age group, examples of which are antibiotics, painkillers, and vitamins. Furthermore, the use of the term “medicine” is used for a drug that would offer cure. Clearly the contraceptives are not medicines because of the side effects such as increased incidence of breast cancer and increased rates of ectopic pregnancy.

In every social issue that we encounter, one must be aware of both sides for proper discernment on  a stand. Let us not rely on what we see or hear from others or the media. Rather, we must take a proactive attitude by carefully studying the issue by ourselves and that is only time when we can decide on where we truly stand.

Who Says We're Pro-Life? - UST and the RH Bill

The 400-year old University of Santo Tomas has been one of the steadfast supporters on the campaign against the highly talked about reproductive health bill.  It had already been involved in several pro-life rallies and whose students and faculty are mainstays in public debates. 

As you may have noticed, the university has branded upon itself as Pro-life, in other words against the RH bill. I find this very amusing as to where the university grounded its collective proclamation of being pro-life. Who decided that UST should be pro-life anyway? As far as I know, there were no consultations made with the students regarding the university’s stand on the issue.  If I were to ask random students regarding one’s position on the matter, I bet I shall get the same varied responses as those people outside the four corners of the university. What then is the basis for the collective branding?

In line with this, an interesting observation would be that I do not see anyone, whether student or faculty member, from the UST actively talking publicly in debates favoring the RH bill. Are the Thomasians (students from UST) just unanimous in their belief regarding the issue or are they fearful for the consequences similar to the CBCP’s threatened excommunication on President Aquino? Or are their opinions manipulated by someone, say a professor who gives merit to those who would “troll” a Facebook fan page, say for example, the one of the Akbayan partylist,  in an effort to express disgust with the proposed bill and other social issues? I am not talking about the issue regarding Theology professor Aguedo Florence Jalin. Okay, that was solid irony.

I am familiar with the term “academic freedom” and the responsibility of professors, more so the ones who teach Social Teachings of the Church, to share their opinions based on the lessons to their students but when “incentives” come in, this is clearly beyond the point. 

Before I probe on further, I would like to make clear that this entry is not made to campaign for any side and I personally am not yet decided on the issue. I have read the entirety of the House Bill ­No. 5043and I seriously believe that both parties are aiming for similar goals, just differing in their approaches and ideologies. If both parties would be less defensive, listen and consider more, I have high hopes that the bill could arrive at a compromise, meeting both parties’ issues and concerns.

I would like to say I am  highly satisfied with the kind of education UST has been giving me since I get to learn both sides of the issue with my Theology professors  explaining the catholic perspective while my Social Sciences professors keep us grounded on the other viewpoint. However, I still feel that there is still the unwritten responsibility of siding with the pro-life as I am a student of a Catholic university.

One may say that the University, being the only pontifical and Catholic university of the Philippines is just fulfilling its designated role as an extension of the church. But the University is obviously separate from a church. While UST may be deeply rooted in the Catholic faith, it is still first and foremost a “university” with its mission to find truth and encourage free thinking. With the public proclamations of UST as pro-life, I have my doubts on the interest of the authorities for further discussion on the RH bill topic. What is the essence of a university if it would base its assumptions purely on faith and morality? - cornerstones that widely differ among people, culture, and religion. 

I recently had a conversation with my close friend from a local student publication. She said that their publication is quite keen with the reports on the RH bill, and that they only feature those from the pro-life stand as they represent the voice of the entire student body and thus must reflect the university’s value system. Whatever happened to the fairness and no bias qualities of campus journalism? Where is the veritas (truth) in mental reservation and censorship on the other parts of the story? 

In the constitution of the Philippines, there exists a passage on the separation of the church and the state where one cannot meddle with the affairs of the other. I’m thinking if it would be possible if we could have a separation of the university and the church as well. However, if that would happen, much of what characterizes UST will definitely be lost.

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