Principle of Human Dignity Human person is

Principle of Human Dignity • Human person is made in the image of God. • All are equally persons, have the same human rights, and have the same claim to justice, dignity and respect. • Every person must be valued as a unique, irreplaceable member of the human community

Jesus preached the good news of God’s love for the “little ones, ” the outcasts rejected by secular and religious authorities, including powerless little children, whom he declared should be given special respect in the Kingdom of God. Mk 9: 33

Principle of Autonomy • recognizes the rights of individuals to self determination • acknowledges patients' personal liberty, and their right to decide their own course and follow through a plan that they freely agree on.

Principle of Autonomy • NOT ABSOLUTE! • Assumes rational thinking on the part of the individual & may be challenged when the rights of others are infringed upon by the individual.

Principle of Beneficence Principle of Non-maleficence • To do good to the • To avoid harm to the patient, or what will further the would be against the patient's interests.

Principle of Cooperation • Cooperating or approving in an evil act regardless of full knowledge of the action. – Formal Cooperation • Participate readily in the act – Material Cooperation • Not freely participating in the evil act – Immediate – performing something essential to the act. – Mediate – participating in a nonsense or accidental manner.

Principle of Informed Consent • person’s right to make decisions regarding medical procedures based on a sufficient knowledge of the benefits, burdens, and risks involved. • Elements – Competence – Disclosure – Understanding – Voluntariness

Principle of Double Effect • The intention must be morally and intrinsically good. • The intention must cause more good effect and avoid as much as possible any bad effect. • The foreseen beneficial act must not be achieved by the evil act. • The benefits of the action must be equal or greater than the foreseen harmful effects.

is one that is induced with the immediate purpose of destroying the human fetus at any stage after conception Arthur Bagabag

• Spontaneous abortion (miscarriage) • Induced abortion

• Fetal loss due to natural cause before the 20 th week of gestation • risk of spontaneous abortion decreases sharply after the 8 th week • This risk is greater in those – with a known history of several spontaneous abortions or an induced abortion – with systemic diseases – over age 35

Other causes • infection (of either the woman or fetus) • immune response • serious systemic disease • accidental trauma

abortion that has been caused by deliberate human action a. medical b. surgical

Medical and Surgical Methods • Medical Abortion • Surgical Abortion

Medical Termination • The drugs used to terminate pregnancy act by – inhibiting the synthesis of progesterone – inducing myometrial contractions – antagonizing the action of progesterone – inhibiting the development of the trophoblast

• NEJM, 2000

Mifepristone/Misoprostol Mechanism of Action • Progesterone Blockade • Decidual • Necrosis • Rhythmic • Uterine • Contractions • Detachment • Cervical • Ripening • Expulsion • Abortion

Mifepristone • Anti-progesterone • Binds tightly to progesterone receptors • Causes conceptus to separate from the uterine wall • Causes capillary leakage in uterine wall • Enhances contractility of uterus • Softens and dilates cervix

Misoprostol • Increases contractility of, and induces contractions in, the uterus • Readily available in US • Teratogen, category X

Times of Expulsion in Women Using Mifepristone/Misoprostol • Source: Spitz, NEJM, 1998

Adverse Events with Medical Abortion • • Most common is excessive bleeding Incomplete emptying of the uterus Pain Infection

1 in 4 women - have a surgical procedure (Php 4, 000 -15, 000)

• Surgical Termination

Surgical Abortion First Trimester

Procedure • Dilation • Suction

Cervical Dilation, Uterine Manipulation and Evacuation Passage of mechanical dilators through the cervix generally will cause some level of discomfort for most women Pain generally tends to increase toward the end of the procedure as the uterus contracts after emptying

Instruments

Dilation • Chemical (misoprostol) • Osmotic (laminaria or synthetic) • Mechanical

Osmotic Dilators

Manual Dilation

Suction • Electric vacuum aspirator • Manual vacuum aspirator

Electric Vacuum Aspiration

Cannulae • Medgyn. com • Flexible Rigid

th • 8 week preborn • Suction Abortion • performed using a smaller tube • requiring little dilation of the cervix • "menstrual extraction. “ • fetal remains are not removed, • infection results ands needs scraping

• 8 th week • Suction • Aspiration • most common method • suction curette (hollow tube with a • knife-edged tip) is inserted into the • womb • then connected to a vacuum machine • by a transparent tube

• 8 th week • Suction Aspiration • vacuum suction, 29 times more • powerful than a household vacuum • cleaner, tears the fetus and placenta • into small pieces which are sucked • through the tube into a bottle • and discarded

• 8 th week • Dilation • & Curretage • Similar to suction method • added insertion of a hook shaped • knife(curette) which cuts the baby • into pieces • pieces are scraped out through • the cervix and discarded

• 12 th week

Second Trimester Abortion Options • Dilation and Evacuation • Intact Dilation and Evacuation • Labor Induction – Hypertonic Saline – Urea – Oxytocin – Prostaglandins

Mid to Late Second Trimester Abortion • One, two or three day process • Dilation (Day 1 and sometimes 2) – Laminaria – Misoprostol • Intrafetal injection (Day 1) – Digoxin – KCl • Evacuation of the uterus (Day 1, 2 or 3) – Suction – Forceps

• 18 th week Dilation &Evacuation • a pair of forceps is inserted into the womb • to grasp part of the fetus • The teeth of the forceps twist and tear the • bones of the unborn child • This process is repeated until the fetus • is totally dismembered and removed • Usually the spine must be snapped • and the skull crushed in order to remove

• 18 th week • Salt poisoning • (saline injection) • long needle injects a strong salt solution • through the mother's abdomen into the baby's sac • baby swallows this fluid and is poisoned by it • acts as a corrosive, burning off the outer layer • of skin and normally takes somewhat over an • hour for the baby to die from this • within 24 hours, labor will usually set in • and the mother will give birth to a dead or dying baby

• 6 th month • Prostaglandin • Chemical Abortion • chemicals developed may cause the uterus • to contract intensely, pushing out • the developing baby. • The contractions are more violent than • normal, natural contractions, so the unborn • baby is frequently killed by them – • some have even been decapitated.

• 6 th month • Prostaglandin Chemical Abortion

• 6 th month • Hysterectomy • Or • Caesarean • mainly in the last three months of pregnancy • womb is entered by surgery through the wall of • the abdomen • The technique is similar to a Caesarean delivery, • except that the umbilical cord is usually cut while • the baby is still in the womb, thus cutting off his • oxygen supply and causing him to suffocate.

• 6 th month • Hysterectomy • Or • Caesarean • Sometimes the baby is removed alive • and simply left in a corner to die • of neglect or exposure.

Mechanical Procedure • “hilot” - a masseuse with a difference: her caress is used to abort fetuses • • rough strokes, pincer-like grips and pounding of the lower abdomen 150 pesos >20% of poor women approach hilots or insert catheters in their vaginas At least 800 women are estimated to die every year from complications

Partial-Birth Abortion • first coined by the National Right to Life Committee (NRLC) in 1995 to describe a recently introduced medical procedure to remove fetuses from the womb • "dilation and extraction, " or D&X, and "intact D&E" • removing the fetus intact by dilating a pregnant woman's cervix, then pulling the entire body out through the birth canal

Partial-Birth Abortion • In 1995, Rep. Charles Canady (R-FL) included the term as part of a bill he proposed that would make it a federal crime to perform a "partial-birth" abortion • Two abortion physicians, one in Ohio and one in California, independently developed variations on the method by extracting the fetus intact

Partial-Birth Abortion • It involved dilating the woman's cervix, then pulling the fetus through it feet first until only the head remained inside • Using scissors or another sharp instrument, the head was then punctured, and the skull compressed, so it, too, could fit through the dilated cervix.

• Partial-Birth Abortion

Partial-Birth Abortion

Partial-Birth Abortion

Partial-Birth Abortion

Partial-Birth Abortion

Dr. Bernard Nathanson, once the head of the world's largest abortion clinic, explains (with the help of ultrasound technology) the true horror and evil of abortion. Viewers of The Silent Scream will be stunned to see a 12 -week-old 'fetus‘ becoming desperate while attempting to escape the abortionist's suction curette. The tiny baby's heart rate doubles during the procedure that ends its life.

Reference: http: //www. silentscream. org/

INDIRECT ABORTION Martin Arcilla

Difference between Direct Abortion and Indirect Abortion Direct Abortion Ø One that is induced with the immediate purpose of destroying the human fetus at any stage after conception

Difference between Direct Abortion and Indirect Abortion Ø One in which the direct, moral object of the action is therapy for the mother, but in which the death of the fetus is a side effect that cannot be avoided

Indirect Abortion Ø Termed indirect when the pregnant uterus itself is excised because its condition is such that its removal is medically necessary; Ø If the uterus contains a living and nonviable fetus, the fetus will of course inevitably die;

Indirect Abortion Ø There is no direct attack upon the fetus; Ø Its death is merely permitted as a secondary effect of an act which needs to be performed and which it is permissible to perform.

Indirect Abortion Ø The reason for the removal is that the pregnancy, added to some pathological condition from which the mother is suffering, increases her difficulties or even lessens her chances of survival.

Principle of Double Effect “Nothing hinders one act from having two effects, only one of which is intended, while the other is beside the intention. Now moral acts take their species according to what is intended, and not according to what is beside the intention, since this is accidental. ”

Principle of Double Effect Four conditions for invoking this principle: 1. The directly intended object of the act must not be intrinsically contradictory to one’s fundamental commitment to God and neighbor. 2. The intention of the agent must be to achieve the beneficial effects and as far as possible to avoid the harmful effects.

Principle of Double Effect 3. The beneficial effects must not be achieved by means of the evil effect. 4. The foreseen beneficial effects must be equal to or greater than the foreseen harmful effects.

• First condition is fulfilled – The operating surgeon's intention is to save the life of the mother. – He foresees the death of the fetus, but he does not desire this evil effect.

• Secondition is fulfilled ØThe surgeon's act consists in ridding the woman of a diseased part of her body which is jeopardizing her life. ØThe presence of the living fetus in the diseased womb does not alter the nature of the act which the surgeon performs. ØIf the fetus were not present, the surgical operation of removing a diseased and dangerous part of the woman's body would obviously be an act which of its nature is not evil.

• Third condition is fulfilled ØThe evil effect (the death of the fetus) does not cause the good effect (saving the life of the mother). ØWhether the fetus were harmed by the operation or not would make no difference in regard to producing the good effect.

• Fourth condition is fulfilled ØSafeguarding the mother's health is a proportionately grave reason for permitting the death of the fetus.

Ectopic Pregnancy • A complication of pregnancy in which the fertilized ovum is implanted in any tissue other than the uterine wall. • Most occur in the Fallopian tube but can also occur in the cervix, ovaries, and abdomen. • The fetus produces enzymes that allow it to implant in varied types of tissues • An embryo implanted elsewhere than the uterus can cause great tissue damage in its efforts to reach a sufficient supply of blood.

Normal Female Anatomy

Ectopic Pregnancy

Ectopic Pregnancy • The fertilized ovum lodges in some part of the Fallopian tube. • The reason that it does not continue its descent into the uterus may be the pathological condition of the tube itself or of the ovum. • Once the fertilized ovum takes up its nesting place in the tube, it begins to bore into the wall of the tube, seeking as it does life-giving nourishment.

Ectopic Pregnancy • This "boring-in" action on the part of the tiny embryo perforates the inner layers of the tube and the tube soon becomes weakened by internal hemorrhaging. • There is present a pathological condition of the tube, caused by the erosive action of the trophoblast which is destroying the muscle wall and penetrating blood vessels.

Ectopic Pregnancy • The growing fetus causes the tube to swell, and this swelling dangerously stretches the tube's outer wall. • Left in this condition, the tube will ordinarily rupture; and unless surgery is performed very soon after the rupturing, the mother may die.

Virtues of a Catholic Health Care Giver Desiree Argana

Ob/Gyn Association Pushes “abortion agenda” on Pro-Life Doctors • Washington DC, Dec 12, 2007 / 11: 55 am (CNA). - An association of Christian doctors harshly criticized a national organization of obstetricians for supporting ethical codes that will force pro-life physicians to violate their consciences by referring patients to other doctors for abortions.

"The Limits of Conscientious Refusal in Reproductive Medicine" • The American College of Obstetricians and Gynecologysts (ACOG) Committee of Ethics’ position paper • targets pro-life physicians • insists that doctors who object to abortion must refer a patient to a physician who will perform abortions

CMA PROTEST LETTER • "Many physicians had been realizing that because of their aggressive abortion lobbying, ACOG officials do not represent the values of most physicians and mainstream medicine. • Advocating policies to prevent us from exercising our life-affirming values • “If you don't toe the ACOG line on abortion, the 'morning-after pill, ' and the application of reproductive technology, then you shouldn't be practicing obstetrics --and if you do, we're going to do everything in our power to force you to accommodate our abortion agenda. "

“My conscience can no longer support their lack of conscience. ACOG's strategy seeks to marginalize dissenting opinions. I as an obstetrician have a moral obligation not only to act in my patient's best interest, but also in the best interest of the developing baby, and of society as a whole. ” - Christian Medical Association (CMA) Executive Vice President Gene Rudd, MD

“A Catholic hospital cannot refer people for abortions - they can't say you can't have it here but there's a place just round the corner” -Archbishop of Westminster's spokesman

VIRTUE • A good operative habit • the person good and the action good

VIRTUOUS PHYSICIAN • Is one whose actions are in conformity with the nature of his profession based on the practice of the corresponding code of ethics and principles and observance of the moral law.

Health Care Provider • “Health care is a ministerial instrument of God’s outpouring love for the suffering person… and it is an act of love of God shown in the loving care for the person. ” - (Charter for Health Care Workers)

Roles of Health Care Provider • considers the patient as an integral part of a family and the community • provides high standard clinical care (excluding and diagnosing serious illness and injury, managing chronic disease and disability) • personalized preventive care within a long term, trusting relationship

Virtues of Health Care Professionals • Theological Virtues – FAITH – HOPE – CHARITY

Virtues and Values of a Catholic Physician • Prudence • Diligence • Humility • Fortitude • Brotherly Love and charity • Justice • Meekness

COMPETENCE • The physician must have scientific competence. • It presupposes diligence in research, updating of medical knowledge and consultation with peers when the condition is not within our expertise which needs humility, patience and perseverance

Compassionate • gives rise to an active desire to alleviate another's suffering. • the principle of compassion: Do to others as you would have done to you. • act of charity

GREAT HEART • Includes respect, public spiritedness, integrity, humility. • It would include all the bioethical principles of health care • Public spiritedness- medicine as a vocation • Integrity - uprightness and wholeness of character – we should tell the truth, we should not lie or give wrong information or deceive people

Committed health care providers • 'A unique responsibility belongs to health care personnel: doctors, pharmacists, nurses, chaplains, men and women religious, administrators and volunteers. Their profession calls for them to be guardians and servants of human life. . Absolute respect for every innocent human life also requires the exercise of conscientious objection in relation to procured abortion and euthanasia. (Evangelium Vitae, n. 89)

Committed health care providers • As Catholics we in fact only occasionally are obliged to stand up for what we believe. The majority of what is accepted as medical ethics. • career structure where one's progress is almost entirely dependent upon the approval of consultants, refusing to participate can and, on occasion, does lead to failure of progression of one's career. In other words being truly Catholic can be profoundly career negative

Linacre Institute of the Catholic Medical Association Position on Various Bioethical Issues • Since there is no incompatibility between science and religion, it is possible to provide the high standards of medical care without compromising Catholic principles. • Life of every individual is created in the image and likeness of God and is therefore sacred and must be respected from conception to natural death.

Situation: What if the life of the mother or of the child to be born is in danger? • one obligation: to make every effort to save the lives of both, of the mother and of the child. • the finest and most noble aspirations of the medical profession to search continually for new means of ensuring the life of both mother and child

Linacre • The patient’s autonomy does not supersede the conscience of the physician. Therefore the physician must be free to refuse to participate in immoral procedures, and free to refuse to refer to other physician who might be willing to perform such procedures.

Linacre • Abortion is an unspeakable crime and no catholic physician should cooperate formally or materially to its performance. • The life of an individual is a great good which is good of the person and not just a good for the person. Life is not merely instrumental to other goals- it is an intrinsic good.

4. In the context of his primary responsibility to his patient, the physician, must consider the concerns of other groups, including the patient's relatives, other health care providers and the community in which he lives. 5. The physician also has duties to the community in which he lives as well as to the profession of which he is a member.

CODE OF ETHICS OF THE MEDICAL PROFESSION 2. The physician belongs to a noble profession whose primary purpose is to provide competent and compassionate medical care. 3. In the pursuit of his profession, the physician's primary objective is the best interest of the patient, respecting human dignity regardless of stage of development, socio-economic status, religion, gender, political beliefs, racial background or other circumstances.

The Hippocratic Oath A. D. 1995 Restatement of the Oath of Hippocrates (Circa 400 B. C. ) I SWEAR in the presence of the Almighty and before my family, my teachers and my peers that according to my ability and judgment I will keep this Oath and Stipulation: TO RECKON all who have taught me this art equally dear to me as my parents and in the same spirit and dedication to impart a knowledge of the art of medicine to others. I will continue with diligence to keep abreast of advances in medicine. I will treat without exception all who seek my ministrations, so long as the treatment of others is not compromised thereby, and I will seek the counsel of particularly skilled physicians where indicated for the benefit of my patient.

The Hippocratic Oath A. D. 1995 Restatement of the Oath of Hippocrates (Circa 400 B. C. ) I WILL FOLLOW that method of treatment which according to my ability and judgment, I consider for the benefit of my patient and abstain from whatever is harmful or mischievous. I will neither prescribe nor administer a lethal dose of medicine to any patient even if asked nor counsel any such thing nor perform act or omission with direct intent deliberately to end a human life. I will maintain the utmost respect for every human life from fertilization to natural death and reject abortion that deliberately takes a unique human life.

The Hippocratic Oath A. D. 1995 Restatement of the Oath of Hippocrates (Circa 400 B. C. ) WITH PURITY, HOLINESS AND BENEFICENCE I will pass my life and practice my art. Except for the prudent correction of an imminent danger, I will neither treat any patient nor carry out any research on any human being without the valid informed consent of the subject or the appropriate legal protector thereof, understanding that research must have as its purpose the furtherance of the health of that individual. Into whatever patient setting I enter, I will go for the benefit of the sick and will abstain from every voluntary act of mischief or corruption and further from the seduction of any patient.

The Hippocratic Oath A. D. 1995 Restatement of the Oath of Hippocrates (Circa 400 B. C. ) WHATEVER IN CONNECTION with my professional practice or not in connection with it I may see or hear in the lives of my patients which ought not be spoken abroad I will not divulge, reckoning that all such should be kept secret. WHILE I CONTINUE to keep this Oath unviolated may it be granted to me to enjoy life and the practice of the art and science of medicine with the blessing of the Almighty and respected by my peers and society, but should I trespass and violate this Oath, may the reverse be my lot. Adapted and endorsed by 35 inter-faith ethicists and physicians. Copyright, 1995, Value of Life Committee, Inc. ; P. O. Box 35279; Brighton, MA 02135.

“Honourable and skillful doctors are therefore worthy of all praise when they make every effort to protect and preserve the life of both mother and child. . . On the contrary, those who encompass the death of the one or the other, whether on the plea of medical treatment or from a motive of misguided compassion, act in a manner unworthy of the high repute of the medical profession, " 1930. (18) -Pius XI, Encyclical Casti Connubii, Dec. 31,

Abortion is crime against society, says Pope Benedict VATICAN CITY (CNS) -- Abortion is a crime of aggression not only against the unborn, but also against society, Pope Benedict XVI said. "Children have the right to be born and to grow in the midst of a family founded on matrimony, where the parents are the first educators of children in the faith and where they can grow to full human and spiritual maturity, " the pope said By Cindy Wooden Catholic News Service

Thank You!

Responsible Parenthood and Population Management Act of 2005 (short title) House Bill No. 3773 Arnold Aquino

House Bill No. 3773 • An Act Providing for an Integrated and Comprehensive National Policy on Responsible Parenthood, Population Management and Human Development, Creating a Responsible Parenthood and Population Management Council, and for other Purposes • Thirteenth Congress (2005) • Rep. Edcel Lagman, Josefina Joson, Juan Ponce Enrile Jr, and 48 other representatives

• Policy and Guiding Principles • House Bill No. 3773 • Right to equality and equity, development, reproductive health, education • Choose and make independent decisions on the number, spacing and timing of their children in accordance with one’s religious convictions, cultural beliefs and the demands of responsible parenthood • Freedom of choice fully guaranteed

• Policy and Guiding Principles • House Bill No. 3773 • Sustainable human development is better assured with a manageable population of healthy, educated and productive citizens • Limited resources. . . to service a burgeoning multitude makes allocations grossly inadequate and meaningless • Manpower is the principal asset. . . ensure birth of healthy children and promote responsible parenting

• Policy and Guiding Principles • House Bill No. 3773 • Parents and couples, including unmarried individuals, should be afforded free and full access to relevant, adequate and enlightening information on reproductive health and human sexuality and should be guided by qualified State workers and professional private practitioners

• Policy and Guiding Principles • House Bill No. 3773 • Respect for. . . reproductive health rights promote not only the rights and welfare of adult individuals and couples but those of adolescents’ and children’s as well • While the full range of family planning methods, techniques and devices shall be made available, abortion shall remain to be penalized under the Revised Penal Code and relevant jurisprudence

• Definition of Terms • House Bill No. 3773 • Family Planning (route of responsible parenthood) – Enables couples to decide, freely and responsibly, the number and spacing of children – Provision of information. . . to have informed choice and access to a full range of safe and effective family planning methods, techniques and devices, excluding abortion which is a crime

• Definition of Terms • House Bill No. 3773 • Reproductive Health – State of complete well-being in matters relating to the reproductive system, its functions and processes – Satisfying sex life, capability to reproduce – Freedom to decide IF, WHEN and HOW OFTEN to do so

• Definition of Terms • House Bill No. 3773 • Reproductive Health Rights – Right to decide the number, spacing and timing of children, and other decisions concerning reproduction free of discrimination, coercion and violence – To have the means and information to carry out decision and attain the highest standard of sexual and reproductive health

• Definition of Terms • House Bill No. 3773 • Reproductive Health Care • - Availability and access to a full range of methods, techniques and services that contribute to reproductive and – sexual health Preventing and solving reproductive problems in order to achieve enhancement of life and personal relations

• Definition of Terms • House Bill No. 3773 • Reproductive Health Care – Elements include: • >family planning services • >prevention of abortion • >prevention and management of RTIs/STIs, and reproductive disorders • >education on sexuality and sexual & reproductive health

• Definition of Terms • House Bill No. 3773 • Reproductive Health and Sexuality Education – Acquiring information on the reproductive system and processes of human sexuality – Forming attitudes and beliefs about sex, sexual identity, interpersonal relationships, affection, intimacy and gender roles – Critically evaluating moral, religious, social, cultural dimensions of such issues, including contraception and abortion

• Definition of Terms • House Bill No. 3773 • Population Management –Encourages limitation to two children per family –Attain optimum fertility rate for equitable allocation and utilization of resources –Realize a balanced spatial distribution, discouraging migration to urban centers and thickly populated areas –Conduct studies on and provide incentives for the deceleration of population growth

• Provisions • House Bill No. 3773 • Responsible Parenthood and Population Management Council – 18 members from different governmental departments (NEDA, DOH, Dep. Ed, DOLE, etc), local government units, and non-government organizations

• Provisions • House Bill No. 3773 • Ten percent (10%) of the Gender and Development (GAD) budget of all government departments, agencies, bureaus and offices funded in the annual General Appropriations Act. . . shall be allocated to support the operations of the Council

• Provisions • House Bill No. 3773 • Functions of the Council – To facilitate the involvement and participation (of public and private organizations) in reproductive health care service delivery and in the production, distribution and delivery of quality reproductive health and family planning supplies and commodities to make them accessible and affordable to ordinary citizens

• Provisions • House Bill No. 3773 • Functions of the Council – Information drive on responsible parenthood and on all methods and techniques to prevent unwanted, unplanned and mistimed pregnancies, releasing information bulletins to all government departments and agencies, non-government organizations and the private sector, schools, public and private libraries, tri -media outlets, workplaces, hospitals and concerned health institutions

• Provisions • House Bill No. 3773 • Functions of the Council – To direct all public hospitals in the country to make available to the indigent mothers who deliver their children in these government hospitals upon the mother’s request the procedure of ligation without cost to them

• Provisions • House Bill No. 3773 • Mandatory Reproductive Health and Sexuality Education – Reproductive Health and Sexuality Education in an age-appropriate manner shall be taught by adequately trained teachers starting from Grade 5 up to Fourth Year High School – Sexuality Curriculum, as formulated by the Council, common to private and public schools, based on the following subjects and standards:

• Provisions • House Bill No. 3773 • Mandatory Reproductive Health and Sexuality Education Subjects/Standards – Reproductive health and sexual rights – Reproductive health care and services – Attitudes, beliefs and values on sexual development, behavior, and health – Proscription and hazards of abortion and management of post-abortion complications – Natural and modern family planning to prevent unwanted/unplanned/mistimed pregnancies

• Provisions • House Bill No. 3773 • Mandatory Reproductive Health and Sexuality Education Subjects/Standards – Responsible Parenthood – Use and application of natural family planning methods – Use and application of modern contraceptive devices – Abstinence before marriage – Prevention and treatment of HIV/AIDS, Breast, Cervical, Prostate Cancer and other gynecological disorders

• Provisions • House Bill No. 3773 • Mandatory Reproductive Health and Sexuality Education Subjects/Standards – Safe sex – Maternal, Peri-Natal and Post-Natal education, care and services

• Provisions • House Bill No. 3773 • Ideal Family Size – State shall encourage two children as the ideal family size to attain the desired population growth rate; the provision is not mandatory or compulsory, and no punitive action may be imposed on couples having more than two children. Children from these families shall have preference in grant of scholarships at tertiary level, considering financial need and academic aptitude

• Provisions • House Bill No. 3773 • Private Practitioners’ Support – Private reproductive health care service providers, including but not limited to gynecologists and obstetricians, shall endeavor to render such services free of charge or at reduced professional fee rates to indigent and low income patients.

• Provisions • House Bill No. 3773 • Employers’ Responsibilities • Multi-Media Campaign • Mobile Health Care Service • Capability Building of Barangay Health Workers

• Prohibited Acts • House Bill No. 3773 • For healthcare providers (private or public) • Knowingly withholding information, or restricting the dissemination thereof, and/or intentionally providing incorrect information regarding programs and services on reproductive health including the right to informed choice and access to a full range of legal, medically-safe and effective family planning methods

• Prohibited Acts • House Bill No. 3773 • For healthcare providers (private or public) • Refusing to perform voluntary sterilization and ligation and other legal and medically-safe reproductive health care services on any person of legal age on the ground of lack of third party consent or authorization: • Provided, That in the case of abused minors as certified to by the Department of Social Welfare and Development, and pregnant minors, no prior parental consent shall be necessary

• Prohibited Acts • House Bill No. 3773 • For healthcare providers (private or public) • Refusing to extend quality health care services and information on account of the person’s marital status, gender or sexual orientation, age, religion, personal circumstances, and nature of work: • Provided, That all conscientious objections of health care service providers based on ethical and religious grounds shall be respected: • Provided, however, That the conscientious objector shall immediately refer the person seeking such care and services to another health care service provider

• Penalties • House Bill No. 3773 • Imprisonment ranging from one (1) month to six (6) months or a fine of Twenty Thousand Pesos (P 20, 000. 00) or both such fine and imprisonment at the discretion of the proper court. • In addition, violators of this Act shall be liable to the offended or injured parties, women and/or couples for civil damages the amount of which shall be subject to the discretion of the competent court

• Opinion • UN Population Fund Country Representative Suneeta Mukherjee - 10 Filipinas die every day while giving birth - Of ~3 million pregnancies each year, half are unplanned, and one out of three unplanned end in abortion - Need for a national policy on population • “What we want is informed choice and responsible parenthood” • Feminist Majority Foundation • http: //feminist. org/newsbyte/uswirestory. asp? id=10491

• Opinion • HB 3773: Lessons to be Learned • Ireland, 1951. The Mother & Child Scheme (Noel Browne) • “The Church will deny your right to proper healthcare if your continued health impedes its own interests. The Church isn’t looking out for you; its interests are not the same as yours” • “Nonexistent ‘culture of death’” • Reason is the Reason • http: //micketymoc. bluechronicles. net/? p=203

• Opinion • Getting Medieval in the City of Manila • “Atienza has pursued a rabidly pro-Church, anticontraception program in his city that hurts his constituents more than it helps; religion is coercive, and will allow no other choice. It’s a throwback to the medieval past, and a dangerous portent of a Church-dominated future. ” • Reason is the Reason • http: //micketymoc. bluechronicles. net/? p=203

• Opinion • Fidel Ramos: GMA’s population policy lacks political will - “The poverty gap and deprivation further worsens as family size increases. ” • - “PGMA has muddled population issues by her anachronistic policy of providing Government support only for natural methods. . . has put mothers’ and babies’ lives at risk for the sake of political expediency and religious traditionalism. ” • Reason is the Reason • http: //micketymoc. bluechronicles. net/? p=203

• Opinion • Wrong reasons for opposing HB 3773 - “To say that (Mayor) Atienza’s group’s, as well as the Catholic church’s, opposition to HB 3773 is based on the reference to two children and the mandatory health and sexuality education is a gross oversimplification. ” - “The state encourages two children as an ideal family size, which is not mandatory or compulsory. Res ipsa loquitur. ” • House on a Hill, April 6, 2005 • http: //houseonahill. net/wrong-reasons-for-opposing-hb-3773/

• Opinion • Wrong reasons for opposing HB 3773 - “It is the responsibility of the state to provide people with all the tools, including information, to make informed choices. The state, through HB 3773, is doing its responsibility. ” • House on a Hill, April 6, 2005 • http: //houseonahill. net/wrong-reasons-for-opposing-hb-3773/

• Opinion • The Basic Assumptions of House Bill 3773 are all wrong - “The words ‘reproductive health’ are false propaganda; contraceptives are all risky. ” - “Philippines is not overpopulated: Japan now has 125 M people, almost 43 M more. Singapore is more densely populated, yet pay their women to have more babies. ” • JUNK HOUSE BILL 3773 • http: //adrian. i. ph/blogs/adrian/2005/08/03/junk-house-bill-3773 -contraception-billthat-penalizes-non-adherents/

• Opinion • Culture of Death: House Bill 3773 - “The bill is pro-abortion because it condones abortion by legalizing and institutionalizing ‘post-abortion care’, even though it specifically mentions that it does not endorse abortion as a means of birth control” - “’Reproductive rights’ is a deceptive term used by pro-abortionists and in other countries includes abortion, or ‘access to abortion’ in particular. ” http: //blog. 360. yahoo. com/blog-Se. Tk. W 9 ohaanms 151 mj 5 EXi 1 C 6 o 4 KUUSDQg--? cq=1&p=220

• Opinion • Culture of Death: House Bill 3773 - “It suggests a 2 -child policy for the Philippines. . . and does discriminate against people with more than 2 kids” - “It mandates sex education from grade 5 using government-approved modules only; un-Christian, immoral, unbiblical sexeducation propaganda from pro-abortionists will be taught to young children. ” • http: //blog. 360. yahoo. com/blog-Se. Tk. W 9 ohaanms 151 mj 5 EXi 1 C 6 o 4 KUUSDQg--? cq=1&p=220

• Philippine Population • National Statistics Office - 88. 75 M Filipinos in 2007 (results of latest Census of Population as of Aug. 1, 2007) - Lowest population growth rate since the 1960’s: 2. 04% annual population growth rate for the period 2000 to 2007 • National Statistics Office • http: //www. census. gov. ph/data/pressrelease/2008/pr 0830 tx. html

• CBCP Stand - “Anti-Life Bill” - “The government has been pushing for the use of artificial birth control methods such as intrauterine devices, pills and Depo Provera injectables, which the Church has strongly opposed” (Manila Times, July 13, 2008)

• Evangelium Vitae (Pope John Paul II) • It may be that many people use contraception with a view to excluding the subsequent temptation of abortion. • Negative values inherent in the "contraceptive mentality“, very different from responsible parenthood, lived in respect for the full truth of the conjugal act, are such that they in fact strengthen this temptation when an unwanted life is conceived.

• Evangelium Vitae (Pope John Paul II) • Contraception and abortion are often closely connected, as fruits of the same tree. They imply a self-centered concept of freedom, which regards procreation as an obstacle to personal fulfillment. • The life which could result from a sexual encounter thus becomes an enemy to be avoided at all costs, and abortion becomes the only possible decisive response to failed contraception.

• Current Status • 14 th Congress (filed 07/01/2007 – present) • House Bill 17 "Reproductive Health, Responsible Parenthood and Population Development Act of 2007" • Bill Status: Pending with the Committee on Health since 2007 -07 -24

• “Sweeter even than to have had the joy of caring for children of my own has it been to me to help bring about a better state of things for mothers generally, so their unborn little ones could not be willed away from them. ” • - Susan B. Anthony, 1889