Even tolls are decided by SC
BY AMADO P. MACASAET
Civility and reasonableness in RH debate
A.G ROMUALDEZ JR., M.D
‘On RH, it is possible
for reasonable individuals
with extremely
different positions on
an issue to speak to one
another without rancor
or disrespect.’
CREDIT for introducing civility and reasonableness into the discourse on reproductive health legislation should go to the three Jesuits who proposed some talking points on the provisions of the various bills being discussed in the Philippine Congress.
Whether the talking points actually constituted common grounds for possible agreements may be questionable but they provided at least the beginnings of a common language for elements on each side who are willing to move away from extreme positions.
Last week, there were two forums on religion and reproductive health. One was at the Ateneo Professional Schools in Makati sponsored jointly by the Ateneo Human Rights Center, the Frederick Neumans Foundation for Freedom, and the Forum for Family Planning and Development. Speakers presented the perspectives of Muslims, Evangelical Christians, and Roman Catholics.
In this forum, it was clear that the preponderance of opinion favored some form of State intervention to provide poor Filipino couples the means to exercise responsible parenthood. The religions however differed on the range of options allowed within their sets of beliefs. Evangelical Christians were the most liberal, supporting all the family planning interventions now provided by the Department of Health. Most Muslim religious leaders were said to have cautioned against surgical methods such as tubal ligation and vasectomy. The Catholic position appeared to be the most restrictive, based mainly on fears that some methods were possibly abortive.
The second one, in the UP Manila campus, organized by a group of UP College of Medicine students, highlighted the viewpoints of three medical doctors (all Catholics) whose backgrounds ranged from community medicine to surgery to the basic sciences. The fact that one of them was also a Jesuit priest was an added feature.
The U.P. forum revealed differences within the medical profession. One discussant was opposed outright to any form of legislation on the grounds that it was unnecessary. On the other hand, two discussants supported some form of legislated government intervention with one of them advocating safeguards against coercion and the possible use of abortive methods.
Two points stood out in all the discussions of both forums. One is that, on each of the many issues related to reproductive health, there exist broad ranges of possible positions depending on individual belief systems and life experiences. The fact is, within the Catholic Church (inclusive of hierarchy, clergy, and laity), there is not one monolithic view on any of the issues. In fact, it is possible to remain a practicing Catholic while being an "abortionist" - in the sense of one who favors removing abortion from the purview of the Philippine penal code (analogous to "abolitionists" in Britain and America in the mid-nineteenth century who wanted an end to slavery).
The second point is that it is possible for reasonable individuals with extremely different positions on an issue to speak to one another without rancor or disrespect. There seemed to be agreement that it is unproductive, as the Jesuit doctor at the UP forum put it, to "mock the position and arguments" of those with whom one disagrees.
It is notable that, except for one remark from the audience at the Ateneo forum, Pope Benedict XVI’s recently publicized views on condom use, did not feature prominently in any of the discussions of the two forums. This is likely because most discussions focused on family planning which was not mentioned at all in the Pope’s statements.
Nevertheless, from the informal talk before and after the forums, it was clear that the Pope’s condom statement has taken the conversation on reproductive health to a new level. With his statements, the Holy Father has added the dimension of compassion and sympathy for possible victims of disease and other effects of unregulated sexuality to the current conservative emphasis on sin or wrong doing.
Perhaps the rancor and rhetoric that marked the encounter between two sets of activists at the Manila Cathedral last week will now be replaced by concern and care for all Filipinos, rich and poor alike, who will suffer from the effects of unrelieved poverty among the masses.
Non-communicable diseases have been increasing throughout the world. In the Philippines, even as infections continue to be common, the so-called lifestyle-related problems of cardiovascular disease, cancer, and diabetes as well as accidents and violence have become prominent causes of morbidity and mortality.
The future implications of this "epidemiologic shift" for our health system are dire. These health problems generally require sophisticated technological interventions. They also tend to be long-lasting or chronic in duration. Consequently, curative measures are extremely expensive and will put added pressure on our already stressed health care financing system.
To avoid this, health plans and policies of the present must introduce programs aimed at influencing the behavior of individuals and communities towards healthy lifestyles. These should promote and facilitate regular physical activity, sensible dietary habits, avoidance of excessive intake or complete abstention from noxious substances such as alcohol and nicotine, as well as consciousness of the adverse health effects of climate change and environmental degradation.
Such plans and policies will be difficult to promulgate because, as a recent issue of The New England Journal of Medicine put it: "There is a paradox that complicates efforts to address non-communicable diseases globally: modern processes of production and globalization are key components of economic development worldwide that have brought about many improvements in health, yet the negative effects of globalization (including increased incidence of non-communicable diseases) contribute to poverty and widening disparities. Current political and economic incentives favor industry and other interest groups at the expense of health: consider the subsidies paid for corn-based agriculture and mass-produced processed foods, the tobacco revenue generated in countries with a government-owned, sponsored or supported (writer’s italics) tobacco industry, industrial growth in the face of environmental pollution, and the spread of the sedentary automobile-and-television culture."
At present, it appears that such health concerns are not a priorities of government, judging from the fact business and economic issues remain the overwhelmingly dominant considerations of overall policy-making - including even the health sector.