Understanding the Supreme Court Decision on the RH Law

Understanding the Supreme Court
Decision on the RH Law
Briefing on the Decision of the Supreme Court of the Philippines in the
consolidated case of Imbong v. Ochoa (G.R. Nos. 204819, 204934, 204957,
204988, 205003, 205043, 205138, 205478, 205491, 205720, 206355, 207111,
207172 & 207563, April 8, 2014) assailing the constitutionality of RA 10354
Albert Francis E. Domingo, MD
Updated draft as of 19 May 2014. Note: The analyses of this presentation may still
change until the Decision becomes final and executory.

Disclaimers
 This presentation is made possible by the generous support of
the American people through the United States Agency for
International Development (USAID). The contents are the
responsibility of Dr. Albert Francis E. Domingo, and do not
necessarily reflect the views of UPecon Foundation, Inc., USAID,
or the United States Government.
 It is highly encouraged that the SC Decision and
Concurring/Dissenting Opinions be read in their full text.
 The DOH has official FAQs with answers: DC No. 2014-0199.

How the Supreme Court Decides
1. Submission of decisions
and resolutions
2. Promulgation
3. Service, dissemination, and
publication
4. 15-day reglementary
period for motion for
reconsideration (MR)
5. Decision deemed final if no
MR is filed in due time (if an
MR is filed, execution of
decision is stayed)
6. Once decision becomes
final, entry of judgment is
made within 15 days after
the period for MR expires
(or immediately if the Court
requires it)
Reference: Internal Rules of the Supreme
Court (A.M. No. 10-4-20-SC, May 4, 2010)
While the GPH/DOH through the OSG decided not to file an MR, other
party-litigants did (as of 28 April).
(after oral arguments and memoranda…)

Reading a Decision
 The Result is what the Members of the Court have voted
upon, and is contained in the dispositive portion
 The Ratio decidendi (rationes decidendi, plural) or
“reason/s for the decision” are the arguments in support
of the Result
 These are binding for purposes of judicial precedent
 Obiter dicta (obiter dictum, singular) are “by the way”
remarks in a judgment or decision that are “said in
passing”
 These are only persuasive for purposes of judicial precedent

Outline
1. The Result: Some Items Unconstitutional
2. Rationes Decidendi and Obiter Dicta
3. Other Key Provisions Not Unconstitutional
4. Suggested Compliance

The Result:
Some Items Unconstitutional
Rulings on specific provisions of both the Republic Act and its IRR

The Dispositive Portion
WHEREFORE, the petitions are PARTIALLY GRANTED.
Accordingly, the Court declares R.A. No. 10354 as
NOT UNCONSTITUTIONAL except with respect to
the following provisions which are declared
UNCONSTITUTIONAL:
xxx
Reference: Decision, Imbong v. Ochoa, p. 103

1a. The requirement to refer patients seeking MFP
methods is restricted
 Who: Private health facilities, non-maternity
specialty hospitals, and hospitals owned and
operated by a religious group
 What: Cannot be required to refer patients not
in an emergency or life-threatening case* to
another health facility for MFP services
*as defined under Republic Act No. 8344
Affected Section(s) in the RA: 7
Affected Section(s) in the IRR: 5.21, 5.22

1b. Parental consent is needed for minors to
access MFP methods
 Who: Minor-parents or minors who have
suffered a miscarriage
 What: Cannot be allowed access to modern
methods of family planning without written
consent from their parents or guardian/s
Affected Section(s) in the IRR: 4.06, 4.07

2. Health care providers not disseminating
information on RH cannot be punished
 Who: Any health care provider, regardless of his
or her religious beliefs
 What: Cannot be punished for failure or refusal
to disseminate information regarding programs
and services on RH
Affected Section(s) in the RA: 23(a)(1)
Affected Section(s) in the IRR: 5.24, 16.01(a)(1)

3. The consent of the spouse is required for
married individuals to undergo RH procedures
 Who: A married individual not in an emergency
or life-threatening case*
 What: Cannot undergo reproductive health
procedures without the consent of his/her
spouse
Affected Section(s) in the RA: 23(a)(2)(i)
Affected Section(s) in the IRR: 16.01(a)(2)(i)

4. Health care providers not referring non-emergent patients
for RH services or information cannot be punished
 Who: Any health care provider, regardless of his or her
religious beliefs
 What: Cannot be punished for failure or refusal to refer a
patient not in an emergency or life-threatening case* for
RH services or information to another health care service
provider within the same facility or one which is
conveniently accessible
Affected Section(s) in the RA: 23(a)(3)
Affected Section(s) in the IRR: 5.24, 5.25, 16.01(a)(3)

5. Any public officer hindering full RH implementation or not
supporting RH cannot be punished
 Who: Any public officer, regardless of his or her
religious beliefs
 What: Cannot be punished for refusing to
support RH programs, or doing any act that
hinders the full implementation of an RH
program
Affected Section(s) in the RA: 23(b)
Affected Section(s) in the IRR: 5.24

6. Any conscientious objector cannot be required to render
pro-bono RH service to be accredited by PhilHealth
 Who: Any conscientious objector
 What: Cannot be required to render pro-bono
reproductive health service as prerequisite for
PhilHealth accreditation
Affected Section(s) in the IRR: 6.11

7. An abortifacient is any drug or device that can destroy a
fetus or prevent the implantation of a fertilized ovum
 Abortifacient refers to any drug or device that primarily induces
abortion or the destruction of a fetus inside the mother’s womb
or the prevention of the fertilized ovum to reach and be
implanted in the mother’s womb upon determination of the
FDA.
 Contraceptive refers to any safe, legal, effective, and
scientifically proven modern family planning method, device, or
health product, whether natural or artificial, that prevents
pregnancy but does not primarily destroy a fertilized ovum or
prevent a fertilized ovum from being implanted in the mother’s
womb in doses of its approved indication as determined by the
Food and Drug Administration (FDA).
Affected Section(s) in the RA: none
Affected Section(s) in the IRR: 3.01(a), 3.01(j)
Reference: Decision, Imbong v. Ochoa, pp. 52,
53, 104
“… the authors of the RH-IRR gravely abused their office
when they redefined the meaning of abortifacient.”

8. Health service providers who will require
parental consent from minors not in emergencies
or serious situations cannot be punished
 Who: Any health service provider
 What: Cannot be punished for requiring
parental consent from a minor not in an
emergency or serious situation
Affected Section(s) in the RA: 23(a)(2)(ii)
Affected Section(s) in the IRR: 4.07, 16.01(a)(2)(ii)

The Dispositive Portion
xxx
The Status Quo Ante Order issued by the Court on
March 19, 2013 as extended by its Order, dated
July 16, 2013, is hereby LIFTED, insofar as the
provisions of R.A. No. 10354 which have been
herein declared as constitutional.
SO ORDERED.

Rationes Decidendi
and Obiter Dicta
Procedural matters and reasons for the decision

Binding or persuasive?
 If it is related to any item in the Result, then the
argument is ratio decidendi and is therefore
binding
 If it is NOT related to any item in the Result, then
the argument is obiter dictum and is therefore
only persuasive

What is the RH Law?
Despite efforts to push the RH Law as a
reproductive health law, the Court sees it as
principally a population control measure.
… the RH Law does not sanction the taking away
of life. It does not allow abortion in any shape or
form. It only seeks to enhance the population
control program of the government by providing
information and making non-abortifacient
contraceptives more readily available to the
public, especially to the poor.
101
Emphasis supplied

What is the RH Law?
Indeed, at the present, the country has a
population problem, but the State should not use
coercive measures (like the penal provisions of
the RH Law against conscientious objectors) to
solve it.
Emphasis supplied

When does life begin?
Majority of the Members of the Court are of the
position that the question of life begins is a scientific
and medical issue that should not be decided, at this
stage, without proper hearing and evidence…
Naitakda na sa Saligang Batas, at alinsunod naman
dito ang RH Law, na ang buhay ay pangangalagaan
mula sa conception. Kung ano ang puntong iyon ay
katanungan para sa mga dalubhasa ng siyensiya, at
hindi para sa Korte Suprema.
49; also Opinyong Sumasang-ayon at
Sumasalungat, Sereno, CJ., p. 2
Emphasis supplied

When does life begin?
R.A. No. 10354 … protects the ovum upon its
fertilization without saying that life begins upon
fertilization … whether life begins upon fertilization
or upon implantation of the fertilized ovum on the
uterus wall, R.A. No. 10354 protects both asserted
starting points of human life. Absent a definitive
consensus from the scientific and medical
community, this Court cannot venture to
pronounce which starting point of human life is
correct.
Reference: Concurring Opinion, Carpio, J.,
Imbong v. Ochoa, p. 2
Color emphasis supplied

What is an abortifacient?
…an abortifacient is any drug or device that either:
(a) Induces abortion; or
(b) Induces the destruction of a fetus inside the
mother’s womb; or
(c) Prevents the fertilized ovum to reach and be
implanted in the mother’s womb,
upon determination of the FDA.
Emphasis in the original

What is an abortifacient?
… despite the recognition of abortion only at a
late stage from the strict medical viewpoint, the
RH Law’s implied definition of abortion is broad
enough to extend the prohibition against abortion
to cover the fertilized egg or the zygote…
Reference: Separate Concurring Opinion, Brion,
J., Imbong v. Ochoa, p. 23

What contraceptives may be allowed?
…the undeniable conclusion is that
contraceptives to be included in the PNDFS and
the EDL will not only be those contraceptives that
do not have the primary action of causing
abortion or the destruction of a fetus inside the
mother’s womb or the prevention of the fertilized
ovum to reach and be implanted in the mother’s
womb, but also those that do not have the
secondary action of acting the same way.

What contraceptives may be allowed?
It is of course difficult to be completely positive
that a contraceptive primarily intended to
prevent ovulation or fertilization of the ovum will
absolutely not prevent implantation on the uterine
wall and cause abortion. The lack of convincing
empirical evidence that it is so may be an
acceptable excuse. It is the certainty from the
beginning, however, that a given contraceptive
has the inherent and substantial potential for
causing abortion that is not acceptable.
Reference: Concurring Opinion, Abad, J.,
Emphasis supplied

Who determines what contraceptives are
abortifacient or not?
While an abortifacient is outlawed by the
Constitution and the RH Law, the practical
problem in its enforcement lies in the
determination of whether or not a contraceptive
drug or device is an abortifacient. This is where
expert medical opinion is imperative. The
character of the contraceptive as an
abortifacient or non-abortifacient cannot be
legislated or fixed by law and should be confined
to the domain of medical science.
Reference: Concurring Opinion, Leonardo-De
Castro, J., Imbong v. Ochoa, pp. 7-8
Emphasis supplied

Who determines what contraceptives are
abortifacient or not?
By their nature, hormonal contraceptives and IUDs
interfere with the woman’s normal reproductive
system. Consequently, the FDA, which has the
required technical competence and skills, need
(sic) to evaluate, test, and approve their use. The
RH Law acknowledges this need in its policy
statements in Section 2, in its guidelines for
implementation in Section 3, and in its definition of
terms in Section 4(a). It is consistent with the FDA
law and no one can object to it.
Reference: Concurring Opinion, Abad, J.,
Emphasis supplied

Standards that the FDA Should Follow
In determining whether a drug or device is an abortifacient,
the FDA will necessarily engage in a quasi-judicial function.
It will determine whether a set of facts (active properties or
mechanisms of a drug or device) comply with a legal
standard (definition of non-abortifacient)…
In making the aforesaid determination, the FDA should
follow the strict standards laid down in the Constitution, as
adopted in the RH Law, as to what constitute allowable
contraceptives…
Reference: Concurring and Dissenting Opinion,
Del Castillo, J., Imbong v. Ochoa, p. 25

What should the FDA do?
… the FDA must formulate stringent and
transparent rules of procedure in the
screening, evaluation and approval of all
contraceptive drugs and devices to
ensure that they are safe, non-
abortifacient and legal or compliant with
the mandate of the Constitution and the
law.
Castro, J., Imbong v. Ochoa, p. 8
Emphasis supplied

The SC Awaits the Actions of the FDA
… not a single contraceptive has yet been
submitted to the FDA pursuant to the RH Law. It
behooves the Court to await its determination
which drugs or devices are declared by the FDA
as safe, it being the agency tasked to ensure that
food and medicines available to the public are
safe for public consumption…
Emphasis in the original

The SC Awaits the Actions of the FDA
…maaaring isama ng FDA ang ilang maaaring
gamiting abortifacients, tulad ng oxytocin, sa
National Drug Formulary dahil ang mga ito ay
ginagamit upang mailabas ang patay na
sanggol mula sa sinapupunan ng ina…
Nagpapahiwatig namang ang huling
pangungusap sa unang talata ng Section 9 ng
legislative intent na kahit may mga abortifacients
na isasama sa EDL, ipinagbabawal na gamitin
ang mga ito bilang abortifacient, o paraan
upang mapatay ang malusog na sanggol sa
sinapupunan.
Reference: Opinyong Sumasang-ayon at
Sumasalungat, Sereno, CJ., Imbong v. Ochoa,
p. 16
Emphasis supplied

All Registered Contraceptives
Must be Re-evaluated
Since [there] are contraceptives that are already
registered with the FDA under RA No. 3720 as
amended by RA No. 9711, these contraceptives
must undergo evaluation by the FDA under the
provisions of the RH law to determine whether
these are abortifacients – as defined by law and
not by the IRR.

On Contraceptive Procurement, Distribution, and
Dispensation
… A heavy responsibility and burden are assumed
by the government in supplying contraceptive
drugs and devices, for it may be held
accountable for any injury, illness or loss of life
resulting from or incidental to their use.

On Contraceptive Procurement, Distribution,
and Dispensation
Under the RH law, the Food and Drug Administration (FDA) is
tasked to determine whether a drug or device is
abortifacient in nature. Once it determines that it is non-
abortifacient, then the DOH may validly procure them.
However, if the FDA determines that the drug or device is
abortifacient then as a rule, the DOH may not validly
procure, much less distribute, them…
As a matter of exception, the government should be able to
procure and distribute abortifacients or drugs with
abortifacient properties but solely for the purpose of saving
the life of the mother…

There is no Compelling State Interest
Unfortunately, a deep scrutiny of the respondents’
submissions proved to be in vain. The OSG was
curiously silent in the establishment of a more
compelling state interest that would rationalize
the curbing of a conscientious objector’s right not
to adhere to an action contrary to his religious
convictions.

There is no Compelling State Interest
(dissent)
The present condition of the country’s
reproductive health care, taken together with the
Constitution’s mandate to promote and protect
the right to health of the people, constitutes a
compelling state interest as would justify an
incidental burden on the religious freedom of
conscientious objectors.
Reyes, J., Imbong v. Ochoa, p. 18

Are conscientious objectors exempted
from compliance?
In case of conflict between the religious beliefs and
moral convictions of individuals, on one hand, and the
interest of the State, on the other, to provide access
and information on reproductive health products,
services, procedures and methods to enable the
people to determine the timing, number and spacing
of the birth of their children, the Court is of the strong
view that the religious freedom of health providers,
whether public or private, should be accorded
primacy. Accordingly, a conscientious objector should
be exempt from compliance with the mandates of the
RH Law…
Emphasis supplied

from compliance?
The punishment of a healthcare service provider,
who fails and/or refuses to refer a patient to
another, or who declines to perform reproductive
health procedure on a patient because
incompatible (sic) religious beliefs, is a clear
inhibition of a constitutional guarantee which the
Court cannot allow.

from being obligated to give RH info?
… the right to be exempt from being obligated to
render reproductive health service and modern
family planning methods, necessarily includes
exemption from being obligated to give
reproductive health information and to render
reproductive health procedures. The terms
“service” and “methods” are broad enough to
include the providing of information and the
rendering of medical procedures.
Note: Withholding correct information is different from
intentionally giving wrong information.

Exception to the exemption: life threatening cases
While generally healthcare service providers
cannot be forced to render reproductive health
care procedures if doing it would contravene
their religious beliefs, an exception must be made
in life-threatening cases that require the
performance of emergency procedures. In these
situations, the right to life of the mother should be
given preference, considering that a referral by a
medical practitioner would amount to a denial of
service, resulting to unnecessarily placing the life
of a mother in grave danger.

Working with Conscientious Objectors
Upon the implementation of the RH Law, through Sections
5.22, 5.23, and 5.24 of the IRR, the government will already
be able to identify both conscientious objectors and non-
conscientious objectors. It can, therefore, map out an
effective strategy to inform all potential patients or target
beneficiaries where they can avail of the complete
reproductive health programs and services under the RH
Law… This is well-within the State’s administrative and
logistical capability…
Del Castillo, J., Imbong v. Ochoa, pp. 47-48
Emphasis supplied

On the Family and Spousal Consent
Clearly, on its face, Section 23 (a)(2)(i) contradicts
the unity of direction of the spouses, conflicts with
the solidarity of the family, and collides with the
fundamental equality before the law of men and
women. In particular, it goes against the
constitutional right of the spouses to found a
family and to jointly decide on the number and
spacing of their children. Rather than fostering
unity between the spouses, it tends to foment
discord and sow division between them.

On the Family and Spousal Consent (dissent)
Generally, it will be the woman who will ask to undergo
reproductive health procedures. The interpretation of the
majority therefore affects her control over her body. Rather
than enhance the zones of autonomy of a person even in a
married state, the interpretation of the majority creates the
woman’s body as a zone of contestation that gives the
upper hand to the husband…
The autonomy and importance of family should not be
privileged over the privacy and autonomy of a person.
Marriage is not bondage that subordinates the humanity of
each spouse. No person should be deemed to concede
her or his privacy rights and autonomy upon getting
married.
Reference: Dissenting Opinion, Leonen, J.,
Imbong v. Ochoa, pp. 78, 80-81
Emphasis supplied

On the Family and Parental Consent
Equally deplorable is the debarment of parental
consent in cases where the minor, who will be
undergoing a procedure, is already a parent or
has had a miscarriage…

On the Family and Parental Consent
It is neither fair nor just to ascribe the condition of a
minor of either already having a child or having had a
miscarriage as a fault or shortcoming of the parents as
to outrightly or by operation of law deprive the latter
of their natural and primary right. There is therefore no
compelling interest, or even rational basis, to deprive
parents of their constitutionally recognized natural and
primary right to rear their children under the
circumstances provided in the proviso of the second
paragraph of Section 7 of the RH Law.
Castro, J., Imbong v. Ochoa, pp. 50-51

On the Family and Parental Consent (dissent)
Those of us who have not and can never go through the
actual experience of miscarriage by a minor, those of us
who cannot even imagine the pain and stresses of teenage
pregnancy, should not proceed to make blanket rules on
what minors could do in relation to their parents. None of us
can say that in all cases, all parents can be understanding
and extend sympathy for the minors that are legally under
their care. None of us can say that there are instances when
parents would think that the only way to prevent teenage
pregnancy is a tongue lashing or corporeal punishment. We
cannot understand reality only from the eyes of how we
want it to be.
Reference: Dissenting Opinion, Leonen, J.,
Emphasis supplied

Three Exceptions to Requiring Parental Consent
1. Insofar as access to information is concerned,
the Court finds no constitutional objection to
the acquisition of information by the minor …
that would enable her to take proper care of
her own body and that of her unborn child.
2. …in life threatening cases that require the
performance of emergency procedures … the
life of the minor who has already suffered a
miscarriage and that of the spouse should not
be put at grave risk simply for lack of consent.
Reference: Decision, Imbong v. Ochoa, p. 86-87

Three Exceptions to Requiring Parental Consent
3. Save for the two exceptions discussed above,
and in the case of an abused child as
provided in the first sentence of Section
23(a)(2)(ii), the parents should not be deprived
of their constitutional right of parental
authority.

The RH Mandate and Local Government Units
(ponencia)
… whether it pertains to the establishment of
health care facilities, the hiring of skilled health
professionals, or the training of barangay health
workers, it will be the national government that will
provide for the funding of its implementation.
Local autonomy is not absolute. The national
government still has the say when it comes to
national priority programs which the local
government is called upon to implement like the
RH Law.

(dissent)
Sections 8, 13 (last sentence) and 16 use the word
“shall” relative to the duties required of the LGUs
therein. Thus, the duties of the LGUs under these
sections are mandatory.
Emphasis supplied
Sec. 8 – Maternal Death Review and Fetal and Infant
Death Review
Sec. 13 (last sentence) – operation of MHCS
Sec. 16 – Capacity Building of BHWs

(dissent)
… the use of the phrase “shall endeavor” should
be understood as a recognition by Congress of
the realities on the ground where the LGUs may
not have enough funds to fulfill their mandate
under [Sections 5 and 6]. However, if the national
government provides for the needed funds, the
LGUs cannot refuse to cooperate and do its part in
the implementation of these sections. In other
words, under these sections, the law mandates,
not merely encourages, LGUs to fulfill their duties
unless prevented from doing so for justifiable
reasons such as the lack of available funds.
Emphasis supplied

Other Key Provisions
Not Unconstitutional
Other significant provisions of both RA and IRR sustained as Law

“Untouched by the judicial scalpel” - Lagman
 The mandate for government to afford the marginalized
sectors free access to family planning services and
supplies (Sec. 3[c])
 The provision on the Philippine National Drug Formulary,
which includes hormonal contraceptives, IUDs,
injectables and other safe, legal, nonabortifacient and
effective family planning devices and supplies, as
determined by the Food and Drug Administration (Sec. 9)
 The authority of the Department of Health to procure
family planning supplies for distribution to local
government units (LGUs) (Sec. 10)
Reference: Philippine Daily Inquirer.
“Commentary: Fascination over
exceptions”. Published in print 15 April 2014;
Also available online
Section(s) in the RA: 3(c), 9, 10But with qualifiers in the ponencia…

“Untouched by the judicial scalpel” - Lagman
 The mandate for LGUs to assist in the
implementation of the RH Law
 Provision of age- and development-
appropriate reproductive health education to
adolescents in all schools
 Public awareness and nationwide multimedia
campaign for the protection and promotion of
reproductive health and rights
Section(s) in the RA: 5, 6, 8, 16; 14; 20
Reference: Philippine Daily Inquirer.
“Commentary: Fascination over
exceptions”. Published in print 15 April 2014;
Also available online

There are budgets
 Amounts in GAA for “reproductive health and natural and
artificial family planning and responsible parenthood” under
the DOH and other concerned agencies shall be allocated
and utilized for implementation of the RH Law
 Additional sums necessary for the upgrading of facilities to
meet BEmONC and CEmONC standards, training and
deployment of skilled health providers, commodity
requirements, and other RPRH services to be included in
subsequent GAAs
 GAD funds of LGUs and national agencies may be a source
of funding for implementation of the RH Law
Section(s) in the RA: 25

There are facilities and staff
 Hiring by LGUs of skilled health professionals for maternal
health care
 Midwives and nurses administering life-saving drugs in
accordance with DOH guidelines, under emergency
conditions and when there are no physicians available
 Establishment or upgrading by LGUs of health facilities to
provide EmONC, with additional and necessary
funding/assistance by the national government
 Mobile Health Care Service (MHCS)
Section(s) in the RA: 5, 6, 13

And more…
 All LGUs, government hospitals, and other public health
units to conduct an annual Maternal Death Review and
Fetal and Infant Death Review in accordance with DOH
guidelines
 DOH program implementation to prioritize full access of
poor and marginalized through NHTS-PR and other
government measures of identifying marginalization
 “Maximum” PhilHealth benefits for serious and life-
threatening RH conditions

And more…
 Marriage license to be issued only to applicants certified
by the local FP Office as having received adequate
instructions and information on RP, FP, breastfeeding, and
infant nutrition
 LGUs (with the assistance of the DOH via TA and possible
additional honoraria) to be responsible for the training of
BHWs and other barangay volunteers on the promotion
of RH
 Increased access to RH programs for PWDs

And much more…
And everything else in the
IRR found to be not
unconstitutional by the
Supreme Court
Yes. They went through the entire document.

1a. The requirement to refer patients
seeking MFP methods is restricted
 Operational Solution: Since by the amended IRR Sec.
5.21, private health facilities may voluntarily opt to
provide the full range of MFP, using IRR Sec. 5.06 they
may be engaged by the DOH through agreements or
contracts subject to DOH guidelines. These agreements
or contracts may include incentive schemes (e.g.,
commodity grants, etc.).

1b. Parental consent is needed for minors
to access MFP methods
 Operational Solution: By the wording of the Law, its IRR,
and as resolved by the SC Decision, parental consent is
needed for minors only to access MFP methods (clinical
procedures and/or commodities). Giving information
and/or counseling is by itself not an MFP method; it is
what the minor does outside of the clinical setting that
matters.
 Note that IRR Sec. 4.07 as will be amended will still require
that age-appropriate counseling on responsible parenthood
and reproductive health be given to any minor who consults
at health care facilities.

2. Health care providers not disseminating
information on RH cannot be punished
 Operational Solution: By the wording of the Law (Sec. 20),
and its IRR (Rule 10) as upheld by the SC Decision, there
are other channels by which information on RH may be
disseminated to patients/clients other than interpersonal
communication and counseling (IPCC) between
provider and client. Consider the full range of
interventions used in social and behavioral change
communication (SBCC) – both interpersonal and via
mass media.

4. Health care providers not referring non-emergent patients
for RH services or information cannot be punished
 Operational Solution: The SC Decision is clear that
providers cannot be punished for not referring only when
the patient is not in an emergency or life-threatening
case.
 By the RA (Sec. 4(q)) and its IRR (Sec. 3.01(ss)) as upheld by
the SC Decision, the elements of reproductive health care
include the “management of abortion complications”,
which in most cases are emergencies or life-threatening.
 Hence, a conscientiously objecting provider must, by RA
8344 (also referred to by the SC), first stabilize RH-related
emergencies and then refer. Otherwise, s/he may be liable
for violating both RA 8344 and RA 10354.

5. Any public officer hindering full RH implementation or not
supporting RH cannot be punished
 Operational Solution: DOH policies to leverage LGU
performance by way of agreements/contracts (e.g.,
HFEP, MNCHN grants, etc.) should be reviewed for
consistency of its conditionalities for fund/commodity
transfers with the RH standards set forth by the RPRH Law
and its IRR (Rules 4, 5, 6, and 8, etc.).
Note: Only natural persons can register as conscientious
objectors. Juridical persons (e.g., LGUs) cannot. Hence, if
a public official in person is a conscientious objector,
s/he must say so and then step aside

6. Any conscientious objector cannot be required to render
pro-bono RH service to be accredited by PhilHealth
 Operational Solution: While because of the SC Decision
PhilHealth cannot require pro-bono RH services as a
requirement for accreditation, there are other
mechanisms worth exploring (e.g., bonus payments, etc.)
in order to “encourage” (Sec. 17 of the RA) it.
 Alternatively, the requirement for pro-bono RH services might
already be moot, if well-designed PhilHealth benefit
packages (e.g., case rates?) for MFP are to pay for
providers’ services.

7. An abortifacient is any drug or device that can destroy a
fetus or prevent the implantation of a fertilized ovum
 Operational Solution: The RA (Sec. 9) and its IRR (Rule 7)
as upheld by the SC Decision require that the national
formulary shall include hormonal contraceptives, IUDs,
injectables, and other safe, legal, non-abortifacient and
effective FP products and supplies.
 The IRR has specific provisions that are for the FDA to carry
out (especially Sec. 7.04 on certification of being “non-
abortifacient”). These are critical and must be carefully
carried out, because it is expected that attention/debate
will now focus on the FDA’s determination of “non-
abortifacient” status given the strict definition of what an
“abortifacient” is.

8. Health service providers who will require
parental consent from minors not in emergencies
or serious situations cannot be punished
 Operational Solution: The SC Decision is clear that
providers cannot be punished for requiring parental
consent from minors not in an emergency or serious
situation.
 By the RA (Sec. 4(q)) and its IRR (Sec. 3.01(ss)) as upheld by
the SC Decision, the elements of reproductive health care
include the “management of abortion complications”,
which in most cases are emergencies or serious situations.
 Hence, a provider that requires parental consent from a
minor seeking emergency RH care (e.g., management of
abortion complications) may be liable for violating RA 10354.

Q&A / Open Forum
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Understanding the Supreme Court Decision on the RH Law

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