Category: Sterilization

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

Duterte blames Philippine Church for rapid population rise

Catholic opposition to family planning is main reason for high fertility rate, he says

UCA News

Joe Torres

Philippine President Rodrigo Duterte has blamed the Catholic Church for the rapid growth in the country’s population in recent years.

The Philippines is the 13th most populous country in the world, between Mexico and Ethiopia, with a growth rate of 1.72 percent between 2010 and 2015.

It is the second most populous country in Southeast Asia behind Indonesia and has the highest population-growth rate in the region. . . [Full text]

You’re a surgeon. A patient wants to look like a lizard. What do you do?

As medical treatments advance, the need to accommodate conscientious objection in healthcare is more pressing

The Guardian
Reproduced with permission

David S. Oderberg*

Imagine that you are a cosmetic surgeon and a patient asks you to make them look like a lizard. Would you have ethical qualms? Or perhaps you are a neurosurgeon approached by someone wanting a brain implant – not to cure a disability but to make them smarter via cognitive enhancement. Would this go against your code of professional ethics? With the rapid advance of medical technology, problems of conscience threaten to become commonplace. Perhaps explicit legal protection for conscientious objection in healthcare is the solution.

There is limited statutory protection for those performing abortion, and there is some shelter for IVF practitioners. Passive euthanasia (withdrawal of life support with intent to hasten death) is also part of the debate over doctors’ conscience rights. That’s about it as far as UK law is concerned – though freedom of conscience is enshrined in numerous conventions and treaties to which we are party. Abortion, artificial reproductive technologies (involving embryo research and storage) and passive euthanasia are the flashpoints of current and historic controversy in medical ethics. The debate over freedom of conscience in healthcare goes to the heart of what it means to be a medical practitioner.

Curing, healing, not harming: these are the guiding principles of the medical and nursing professions. But what if there is reasonable and persistent disagreement over whether a treatment is in the patient’s best interests? What if a practitioner believes that treating their patient in a particular way is not good for them? What if carrying out the treatment would be a violation of the healthcare worker’s ethical and/or religious beliefs? Should they be coerced into acting contrary to their conscience?

Such coercion, whether it involve threats of dismissal, denial of job opportunities or of promotion, or shaming for not being a team player, is a real issue. Yet in what is supposed to be a liberal, pluralistic and tolerant society, compelling people to violate their deeply held ethical beliefs – making them do what they think is wrong – should strike one as objectionable.

Freedom of conscience is not only about performing an act but about assisting with it. There are some people who ask doctors to amputate healthy limbs. If you were a surgeon, my guess is that you would refuse. But what about being asked to help out? Would you hand over the instruments to a willing surgeon? Or supervise a trainee surgeon to make sure they did the amputation correctly? If conscientious objection is to have any substance in law, it must also cover these acts of assistance.

This country has a long and honourable tradition of accommodating conscientious objectors in wartime – those who decline to fight or to assist or facilitate the fighting by, say, making munitions. They can be assigned to other duties that may support the war effort yet are so remote a form of cooperation as not to trouble their consciences. In any war, the objectors are a tiny fraction of the combat-eligible population. Yet when it comes to one’s rights, do numbers matter? Has their existence ever prevented a war from being carried out to the utmost? I fail to see, then, why we are tolerant enough to make adjustments for conscientious objectors in the midst of a national emergency, yet in peacetime would be reluctant to afford similar adjustments to members of one of the most esteemed professions.

Do we think medical practitioners should be no more than state functionaries, dispensing whatever is legal no matter how much it is in conflict with personal conscience and professional integrity – lest they be hounded out of the profession? Some academics think expulsion is not good enough. Or should healthcare workers be valets, providing whatever service their patients demand? Perhaps when practitioners find themselves faced with demands for the sorts of treatment I’ve mentioned – or perhaps gene editing treatments or compulsory sterilisation, society will act. Or maybe by then it will be too little, too late.

David S Oderberg is professor of philosophy at the University of Reading, and author of Declaration in support of conscientious protection in medicine

 

 

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]

First compensation claim for compulsory sterilisation in Japan

BioEdge

Michael Cook

A Japanese woman in her 60s is planning to sue the government over her forced sterilization under a 1948 law. This will be the first time that state compensation has been sought for sterilisation. The mentally disabled woman in Miyagi Prefecture was a teenager when she was forced to undergo the procedure.

Records of 2,700 people who were sterilized under the Eugenic Protection Law — which was in force until 1996 — have been found in local government archives, a development which could help victims seek state compensation.

Like some Western countries, Japan has a dark eugenic past.

A 1948 Eugenic Protection Law (EPL) was intended to prevent the births of “inferior descendants” and to foster the health of mothers and pregnant women. It provided for both voluntary and involuntary sterilisation. Doctors could apply for permission for sterilisation to a regional board if a patient suffered from a range of conditions which were believe to be hereditary, including schizophrenia, manic-depressive psychosis, epilepsy, abnormal sexual desire, “remarkable criminal inclination,” Huntington’s disease, muscular dystrophy, albinism, achromatopsia, deafness, haemophilia, and so on.

The Ministry of Health issued guidelines in 1953 clarifying what doctors could do: “It is permissible to restrain the patient’s body, to administer an anesthetic, or to deceive the patient, etc.”

According to government statistics, between 1949 to 1994, 16,520 involuntary sterilizations were performed, 11,356 on women, and 5,164 on men. Most were performed on inmates of psychiatric hospitals and institutions for intellectually disabled people.

Compulsory sterilisation lapsed in 1996 with the passage of the Mother’s Body Protection Law. However, the Japanese government has refused to apologize to the victims of the law or offer them compensation.

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