For the record: Dissecting the Consolidated RH Bill -- Medical, Public Health, & Bioethical Issues

RH Bill Forum III 2011

More on the RH Bill from Dra. Liza Manalo

Part 1:



Part 2:

A little website on the truth about the RH Bill

Please go to Finally, the Truth About the RH Bill (English) and its slightly different Tagalog counterpart, Ang Katotohanan Ukol sa RH Bill. 

This little website contains informative excerpts from presentations on the RH Bill by the following experts:

Atty. Jose Sison (Lawyer)

Prof. Pamela "Mimi" Fabe (Economist and Sociologist)

Liza Manalo M.D. (Doctor of Medicine)

Atty. Rolando Reyes (Lawyer)

Here's an example of the information provided in the website:

A Doctor responds to POGS on Abortifacient Contraceptives

From the blog of Dr. Liza Manalo, Caduceus:

POGS stand on the RH Bill

Apparently, the Philippine Obstetric and Gynecologic Society is in favor of the RH Bills. They are disseminating email to colleagues sending the link to the PCHRD/Philippine Star article on "Noted OB-Gyne says Contraceptives Not Abortifacient."

On the other hand, being an epidemiologist and a teacher of Evidence Based Medicine (EBM) and Bioethics, I have been doing my own share of searching the available literature on this matter and I have found two well designed and well-written researches and publications in well-known peer reviewed scientific journals that prove the contrary:

Postfertilization Effects of Oral Contraceptives and Their Relationship to Informed Consent

Walter L. Larimore, MD; Joseph B. Stanford, MD, MSPH

The primary mechanism of oral contraceptives is to inhibit ovulation, but this mechanism is not always operative. When breakthrough ovulation occurs, then secondary mechanisms operate to prevent clinically recognized pregnancy. These secondary mechanisms may occur either before or after fertilization. Postfertilization effects would be problematic for some patients, who may desire information about this possibility. This article evaluates the available evidence for the postfertilization effects of oral contraceptives and concludes that good evidence exists to support the hypothesis that the effectiveness of oral contraceptives dependsto some degree on postfertilization effects. However, there are insufficient data to quantitate the relative contribution of postfertilization effects. Despite the lack of quantitative data, the principles of informed consent suggest that patients who may object to any postfertilization loss should be made aware of this information so that they can give fully informed consent for the use of oral contraceptives. (Arch Fam Med. 2000;9:126-133)

Mechanisms of action of intrauterine devices: Update and estimation of postfertilization effects

Joseph B. Stanford, MD, MSPH,a and Rafael T. Mikolajczyk, MDb

Salt Lake City, Utah, and Magdeburg, Germany

There are many potential mechanisms of action for the intrauterine device (IUD), which vary by type of IUD (inert, copper, or hormonal). This paper reviews the evidence for each potential mechanism of action. On the basis of available data for fertilization rates and clinical pregnancy rates, the relative contribution of mechanisms acting before or after fertilization were quantitatively estimated. These estimates indicate that, although prefertilization effects are more prominent for the copper IUD, both prefertilization and postfertilization mechanisms of action contribute significantly to the effectiveness of all types of intrauterine devices. (Am J Obstet Gynecol 2002;187:1699-708.)

Weighing the available evidence therefore, who are we supposed to believe? This noted OB-Gynecologist or these other researchers from the US and Germany? Check out the quality of their researches and make your own judgment. What is important is the openness to the truth and to life.

A doctor speaks out

An open letter to our congressmen on the RH Bill

I am aware that there are currently six versions of the Reproductive Health Bill filed in the House of Representatives. While I personally share our legislators concern for women and women’s health, I think the Reproductive Health and Population and Development Act focuses on reproductive health or women’s health without giving due importance and priority to health for all, considering our limited resources.

According to the World Health Organization (WHO) Western Pacific Region Report, in the Philippines, eight of the 10 leading causes of morbidity in the country are caused by infections. They are: acute lower respiratory tract infection and pneumonia; acute watery diarrhea; bronchitis/ bronchiolitis; influenza; tuberculosis; malaria; acute febrile illness; and dengue fever. Among these communicable diseases, pneumonia and tuberculosis continue to be among the 10 leading causes of mortality, causing a significant number of deaths across the country.

At the same time as deaths due to preventable diseases have been in a decline, lifestyle-related diseases have begun to dominate in the leading causes of death, particularly heart diseases, vascular system diseases, cancer, diabetes mellitus, and chronic lower respiratory diseases.

In my opinion therefore, if the government needs to address the top ten leading causes of morbidity and mortality in our country, they need to give priority and adequate funding to developing comprehensive health programs to prevent, diagnose, treat cardiovascular diseases, infections, cancers, chronic obstructive pulmonary disease (COPD) and diabetes mellitus. Exactly how much of our national budget for health and the recently acquired million dollar grant from abroad has been allocated by the government for this purpose? The current Department of Health (DOH) Secretary already said that P900 million has been set aside to purchase contraceptives for use of poor people. But not a single centavo has been allocated for natural method, not even for expenses in properly and fully informing the people of how it is done. Hence the government is in fact favoring the artificial method by using P900 million of the taxpayers’ money to purchase these contraceptives. Clearly the program only boosts the business and further enriches multinational drug companies which are already rich.

Hoping for your consideration of the above points when you deliberate on the RH Bills. Our people need your conscientious study of the facts so that due priority is given to control of communicable and non-communicable diseases over and above RH-related problems.

An extremely important presentation on the RH Bill from a medical perspective

The Medical and Ethical Issues in Reproductive Health Care
By Dr. Maria Fidelis Manalo MSc

Reproductive Health (RH) Bill 2010 - House Bill 96

A more detailed version:
RH Bill