Bibliography:
Laura MacCleery. “Facts on Abortion in the Philippines: Criminalization and a General Ban on Abortion.” [2010]† Center for Reproductive Rights. https://www.reproductiverights.org/sites/crr.civicactions.net/files/documents/pub_fac_philippines_1%2010.pdf (02-06-18)
Center for Reproductive Rights . FORSAKEN LIVES: The Harmful Impact of the Philippine Criminal Abortion Ban. 120 Wall Street, 14th Floor New York, NY 10005 United States: Center for Reproductive Rights 2010.
John Paul II. Encyclical Evangelium Vitae. March 25, 1995. The Holy See. http://w2.vati can.va/content/john-paul-ii/en/encyclicals/documents/hf_jp-ii_enc_25031995_ evangelium-vitae.html (01-26-18).
Dombrowski, Daniel A., and Robert Deltete. A Brief, Liberal, Catholic Defense of Abortion. (Urbana, IL: University of Illinois Press, 2000.)
Gillon, Raanan. “Medical Ethics: Four Principles Plus Attention to Scope”. BMJ (British Medical Journal). 1994 Jul 16; 309(6948): 184-188
Trinity Communications. “Catholic Dictionary – Justice.” [2018]† Trinity Communications. https://www.catholicculture.org/culture/library/dictionary/index.cfm?id=34423 (03-04-18)
"THE 1987 CONSTITUTION OF THE REPUBLIC OF THE PHILIPPINES – ARTICLE II | Official Gazette Of The Republic Of The Philippines". 2015. Gov.Ph. http://www.gov.ph/constitutions/the-1987-constitution-of-the-republic-of-the-philippines/the-1987-constitution-of-the-republic-of-the-philippines-article-ii/.
Revised Penal Code (1930), articles 256, 258, 259
ChanRobles Virtual Law Library. “REVISED PENAL CODE OF THE PHILIPPINES – BOOK TWO” [07/19/18]†ChanRobles Virtual Law Library. http://www.chanrobles.com/revisedpenalcodeofthephilippinesbook2.htm#.Wqj3TOhuaUk. (03-04-18)
I. INTRODUCTION
§1: THESIS STATEMENT
The process of ending a pregnancy is termed ‘abortion’. It involves removing the embryo from the uterus. An abortion can be induced through surgery or medicine, or can occur accidentally. Colloquially, abortion refers to an induced end to pregnancy, while an accidental end is termed ‘miscarriage’.
This act alone causes a large number of ethical issues to need to be resolved before any decision regarding it can be done due to it being the possible premature termination of a human life. Regardless, the conclusion as to the ethical viability of abortion is further mired due to the lack of sound consensus on whether or not a developing embryo can be considered ‘alive.’ However, given the data, the Philippines should loosen restrictions on abortion with regards to medical necessity for the preservation of the health and life of the mother.
§2: PHILIPPINE CONTEXT
It is apparent that there is an issue pertaining to abortion in many nations, and the Philippines is no exception. Where close to fifty percent of all pregnancies are unintended, more than fifteen percent are ended in abortion nationwide. All in all estimates in 2012 within the Philippines show that more than six hundred thousand resorted to abortion, over one-sixth of them being hospitalized, and at a rate of three women each day dying to unsafe abortion complications.
In addition, the women who do make it to a hospital are often refused treatment, the reason quoting a health official being that “They look at these women as sinners.” Going so far as to perform post-abortion dilation and even surgery without anesthesia as a punishment.
In fact data from Laura MacCleery, of the Center for Reproductive Rights shows that the Philippine context has seen that abortion remained illegal and criminalized for over a century, under the provisions of the law no exception up to including saving the life or health of a pregnant woman, let alone emergency contraception for conception from rape. In concert with the facts from above, one can easily conclude that the law has not prevented abortion but has rather made the procedure unsafe and potentially deadly for over have a million women each year. Quoting them:
“Physicians and midwives who perform abortions in the Philippines with the consent of a pregnant woman may face up to six years in prison under the Revised Penal Code.(…) According to these laws, these practitioners may have their license to practice suspended or revoked if caught engaging in abortion-related activities. Women who undergo abortion for any reason may be punished by imprisonment for two to six years. (…) The criminal abortion ban has stigmatized the procedure in the medical community, so that women face tremendous barriers and significant abuse when they seek treatment for abortion complications. Filipino women who seek treatment for complications from unsafe abortion have repeatedly reported that the stigma around abortion means that healthcare workers are unwilling to provide care or only treat women after “punishing” women who have undergone abortions by threatening to report them to the police, harassing women verbally and physically, or delaying care. ”
The research of MacCleery stating that the stigma was further perpetuated by the Philippine Government's acquiescence to the demands of the Catholic hierarchy, evident when the 1987 Constitution was the first Philippine Constitution to explicitly recognize a governmental obligation to “protect the life of the unborn from conception.”
In fact the combination of all these factors and the results of these investigations has prompted multiple UN Committees to focus their attention on the Philippines, specifically, three major ones being Committee on Economic Social and Cultural Rights (CESCR), Committee on the Elimination of Discrimination against Women (CEDAW Committee), and the Committee on the Rights of the Child. Quoting the Center for Reproductive Rights’ 2010 publication, the UN committees had the following concerns:
The CESCR has expressed concern that abortion is “illegal in all circumstances [in the Philippines], even when the woman’s life or health is in danger or pregnancy is the result of rape or incest, and that complications from unsafe, clandestine abortions are among the principal causes of maternal deaths.” Further, the Committee notes with concern the “difficulties in obtaining access to artificial methods of contraception, which contribute to the high rates of teenage pregnancies and maternal deaths…” The Committee has asked the government of the Philippines to “address, as a matter of priority, the problem of maternal deaths as a result of clandestine abortions, and consider reviewing its legislation criminalizing abortion in all circumstances.”
The CEDAW has likewise expressed concern about the high incidence of maternal mortality due to induced abortion, barriers limiting women’s access to contraceptives and the poor quality of post-abortion care. The Committee has asked the government to “consider reviewing the laws relating to abortion with a view to removing punitive provisions imposed on women who have abortions and provide them with access to quality services for the management of complications arising from unsafe abortions…”
The CRC has expressed concern about the situation of adolescents whose access to reproductive health services, including counseling and “accurate and objective information” about contraceptives, is limited. The Committee has asked the government to “provide all adolescents with accurate and objective information and services in order to prevent teenage pregnancies and related abortions.”
CHAPTER 1: 1 THOUGHTS OF THE CHURCH
§1: ENCYCLICAL EVANGELIUM VITAE
From John Paul II’s eleventh encyclical the “Evangelium Vitae” or in english “The Gospel of Life” covers many things but is generally an exploration on the Roman Catholic Church’s stance on the dignity of life.
The encyclical consists of four chapters and starts off by presenting the current context where, in modern society, assaults against human life lead to a “culture of death.” That this culture is promoted by powerful cultural, economic, and political pressures, which in the end creates a society overly concerned with being efficient and with little regard for the human person. Where people who by illness, handicap, or even just by the mere fact of their existence, hold back or slows down the lifestyle of those who are more adapted to such, are considered a dead-weight that must be cut off. This culture pervades all levels and walks of life, damaging not just individuals, but distorting relations at international levels.
The first chapter is on violence, with a focus on the roots of human violence and the serious threats to human life we see today. Drawing heavily from Scripture, such as the story of Cain and Abel, whilst explaining the way that personal sin undermines the very foundation for affirming love and life. That a perverse and distorted idea of freedom, of democracy and choice justifies crimes against life at its weakest point. This is poignantly followed by the quote:
“How is it still possible to speak of the dignity of every human person when the killing of the weakest and most innocent is permitted? In the name of what justice is the most unjust of discriminations practised: some individuals are held to be deserving of defence and others are denied that dignity?"
The second chapter, “I Came That They May Have Life” follows the history of man being created in the image and likeness of God, which as shown in the Book of Sirach that in creating us in His image He also “endowed them with strength like his own, and made them in his own image." Not only in the physical sense either but also in distinctive human Spiritual Faculties such as reason, discernment, and free will, that “He filled them with knowledge and understanding, and showed them good and evil.” That the totality of being human isn’t merely existing in time but rather a drive towards the fullness of life.
Also explaining the implications of this momentous action, the human life has its meaning within the context of the good Creation and fulfilled in union with our Lord-Creator. That the dignity of life returns to both its beginning, the fact that it originates from God, and to its end, that it is destined to the fellowship of God and His love. Quoting Saint Irenaeus “The glory of God is man, living man, but the life of man consists in the vision of God.”
Making use of the history within the Old and New Testaments, John Paul II states that humanity’s responsibility in relation to the Gospel of LIfe is not only the care for the innocent, and weak but rather all life. Quoting the encyclical directly: “As one called to till and look after the garden of the world (cf. Gen 2:15), man has a specific responsibility towards the environment in which he lives, towards the creation which God has put at the service of his personal dignity, of his life, not only for the present but also for future generations,” in this case even the care of the environment is our solemn duty, fitting in with our calling as God’s Stewards. That all life is sacred and must be given due protection, our given dominion from God is as a leaseholder of a property, not its sole master.
Chapter Three or “You Shall Not Kill – God’s Holy Law,” follows along its title that life is sacred and must be protected. Therefore, as life is derived from God and the creations of God are always good thus acts ending the lives or their dignity are always fundamentally immoral. Quoting the Holy Father
“Therefore, by the authority which Christ conferred upon Peter and his Successors, and in communion with the Bishops of the Catholic Church, I confirm that the direct and voluntary killing of an innocent human being is always gravely immoral. This doctrine, based upon that unwritten law which man, in the light of reason, finds in his own heart (cf. Rom 2:14-15), is reaffirmed by Sacred Scripture, transmitted by the Tradition of the Church and taught by the ordinary and universal Magisterium.”
The immediate conclusion to this is that suicide, abortion, and euthanasia are always immoral. Abortion in particular, along with infanticide are as “Unspeakable Crimes” for the Roman Catholic Church. That from the very act of fertilization, the ovum is a human life, so the mere probability of it being a human life in any case should justify an absolutely clear prohibition of any act that endangers them.
The last chapter, “You Did It to Me – for a New Culture of Human Life,” emphasises that the Gospel of Life impels us to teach and spread it amongst others. To “above all proclaim the core of this Gospel.” That the Gospel is the proclamation of a living God that calls us into eternal life with Him, all while representing the human life as a sacred relationship and gift from God and His love. As human life as a sacred gift from God must be cherished, nurtured, and cared for, is the reason why abortion and euthanasia are absolutely unacceptable. Finally that our entirety should be devoted to life’s protection, quoting John Paul II:
“Respect for life requires that science and technology should always be at the service of man and his integral development. Society as a whole must respect, defend and promote the dignity of every human person, at every moment and in every condition of that person's life. “
CHAPTER 2: THOUGHTS FOR ABORTION
§1: A BRIEF, LIBERAL, CATHOLIC DEFENSE OF ABORTION
In this work Daniel Dombrowski and Robert Deltete of Seattle University harshly argue that the Catholic tradition on abortion differs greatly from the modern teachings of its Church. This argument is explored through a thorough analysis of two almost opposing philosophies and two, the perversity of sex and the ontological philosophies. In addition to an examination of the teachings of a pair of important Catholic theologians, St. Augustine, who is heavily associated with the perversity of sex, and St. Thomas Aquinas attached to the ontological approach.
The Catholic Position most deferred to as of the current moment is, according to Daniel Callahan:
“1)God Alone is the Lord of Life
2)Human beings do not have the right to take the lives of (innocent) human beings
3)Human life begins at the moment of conception
4)Abortion at whatever stage of development of the fetus is the taking of an innocent
human life
5)The conclusion follows: Abortion is wrong. The only exception to this conclusion is in the
case of abortion that is the indirect result of an otherwise moral and legitimate medical procedure (e.g. the treatment of an ectopic pregnancy and cancerous uterus)”
In addition, despite the modern thoughts and advocacies of the feminist movement no one can say that a woman can have absolute control of their own body. It is argued that very few sensible people would argue that a woman should be able to ingest thalidomide while pregnant and still carry the child to term.
The Ontological argument follows thus, that the fetus is a human person even in the earliest stages of pregnancy. However, as the book covers, not only is this opposed by the above mentioned saints, this belief originated from certain mistakes in seventeenth century science.
However to the contrary of this argument, one must realize that organs only start forming in the fetus at the second month. Though the fetus has a passing resemblance to a human at this point is moot, inside however the fetus a large amount of structural reorganization, not mere growth, needs to be finalized in the months to come.
That fact that four months in there appears to be a brain is also moot as we cannot consider it a functioning organ yet, much less one with the necessary cerebral cortex needed for human rationality. Dombrowski and Deltete quoting Morowitz and Trefil,
“… a pile of wires and switches is not an electrical circuit, and a collection of nerve cells is not a functioning brain. The wires and switches need to be connected in order to make a circuit or computer, and the nerve cells in the cortex need to be connected for there to be a functioning brain.”
The release of synaptic energy that signals the start of the use of the cerebral cortex as a functioning entity, and therefore what could be considered being something distinctively human from a biological standpoint, more often than not occurs near the end of the thirty second week of pregnancy. To summarize though:
“To put the matter in Augustinian or Thomasistic terms: fetal development consists of the transition from a vegetative state to a sentient one, after which it is possible for human ensoulment (or personhood) to occur. In sum: (a) certain physical developments (most notably, a functioning central nervous system) are required for sentiency to occur in a fetus; (b) sentiency is a necessary and sufficient condition for being a moral patient; and (c) along with Augustine and Thomas Aquinas we believe that sentiency is a necessary condition for receiving a human soul.”
The second argument follows that the act of abortion violates both the Generative and the Unitive aspects of Human Sexuality. Which must both be present and worked towards to fulfil the purpose of Human Sexuality. This argument that states that abortion is a perversion of sex is also the argument that defines most of the basis for the traditional grounds of the Roman Catholic Church’s criticism of abortion. However, very few modern Catholics follow such an argument any more.
Though the authors did not completely refute the perversity argument, they instead state that very few modern Roman Catholics still hold fast to this view, noting it as antiquated and both too permissive and too restrictive. They also call into question the belief that this is the only possible view of sexual ethics a Roman Catholic could hold to, especially given how “…most contemporary Catholics are somewhat embarrassed by the largely negative attitude toward sexual relations that the Catholic Church has inherited from St. Augustine.”
Adding to that, they mention two additional reasons that make the Perversity argument problematic: Firstly, that sexual relations can be immoral in marriage, e.g. if there is a lack of consent or agapic respect in the marriage. Secondly, that sexual relations outside of marriage can be moral, such as if the relationship does maintain mutual consent and agapic respect.
CHAPTER 3: CURRENT POLITICAL AND ETHICAL CLIMATE
§1: MEDICAL ETHICS: FOUR PRINCIPLES PLUS ATTENTION TO SCOPE
This work provides a simple, accessible, and a culturally neutral method of approaching ethical issues in healthcare. This method is based on four common prima facie moral commitments:
1)Respect for Autonomy
2)Beneficence
3)Nonmaleficence
4)Justice
This in addition to having concern for their scope of application. While this does not provide hard and fast rules for the reader it does its job in providing principles that can help doctors and health workers to make difficult ethical decisions. This method above all provides a common set of moral commitments, moral language , and moral issues.
Autonomy, best described as deliberate and conscious self determination. Special among the four above mentioned moral agents as with autonomy one can assumedly make decisions based on deliberation. Gillion mentions that subscribing to this agent has many implications such as consulting with the patients and obtaining their consent prior to any actions, hence the requirement for obtaining informed consent among many hospitals. On the other hand, it also requires good communication, thus the necessity to never deceive fellow colleagues and to keep one’s word about all things upto including appointment dates and times, all while not omitting knowledge or lying to those around you.
Beneficence and non-maleficence, are to be considered simultaneously with the aim of producing a net benefit over harm, following the principle of the cure perhaps being worse than the disease. It always follows that while one treats a patient, the risk of unintended harm is unavoidable, thus the moral obligation of the medical profession is to provide a net medical benefit whilst minimizing the harm to the patient. In addition to this, these moral agents call for ensuring that the patients get the best possible care, thus the medical community must be able to provide the care that they claim to be able to do. Hence the rigours of attaining the title of Medical Doctor and it’s more specialized field focuses such as neurology, oncology, and much more.
Attached to the previous moral agent of autonomy, beneficence and non-maleficence require that one must be forthright about the details and the assessment of harm and benefit of any one procedure or treatment.
Finally, Justice, the fourth moral agent and is typically synonymous with fairness. Summarized in the article as “a moral obligation to act on the basis of fair adjudication between competing claims.” More than merely equality, it is important to treat people in accordance to their need, equals equally, needy with much, less needy with less. This moral agent, similar to how the Roman Catholic Church defines it, is to give one what one is due with the recognition of all of their rights.
The text continues by stating that first one must determine who must make the decision, “whether it is I or an organization, profession, or society itself that has to make a decision.” That one should exclude any decisions without moral basis or justification, such as taking bribes, nor any actions that discriminate or prejudice patients. Further expounding that in no way should any healthcare professionals take on the role of a punisher towards their patients, e.g. “withholding antibiotics from smokers who do not give up smoking…”.
Secondly, that no healthcare professional should waste resources at their disposal, stating that “cost and opportunity cost are moral issues and central to distributive justice”
Thirdly, that the rights of the patient should be respected, e.g. “my disapproval of a patient's lifestyle would not be a morally acceptable justification for refusing to provide a certificate of sickness if he or she cannot work because of sickness.”
Fourthly, to follow morally acceptable laws such as informing the authorities should the patient have a highly infectious disease, though this violates their right to privacy it minimizes the risk of others suffering due to the omission of knowledge. Though one may feel morally justified in breaking a law, one is not legally entitled to do so and thus must be prepared to face the consequences of such an action.
§2: THE PHILIPPINE LAW ON ABORTION
The protection of the unborn is enshrined even in the Highest Law in the land of the Philippines. Quoting the twelfth section of the 1987 Philippine Constitution,
“Section 12. The State recognizes the sanctity of family life and shall protect and strengthen the family as a basic autonomous social institution. It shall equally protect the life of the mother and the life of the unborn from conception. The natural and primary right and duty of parents in the rearing of the youth for civic efficiency and the development of moral character shall receive the support of the Government.”
In addition, Section 2 covering Infanticide and Abortion. Specifically Articles 256, 258-259 of the Revised Penal Code of the Philippines details the penalties of such acts. Quoting the ChanRobles Virtual Law Library:
“Section Two. — Infanticide and abortion
Art. 256. Intentional abortion. — Any person who shall intentionally cause an abortion shall suffer:
1. The penalty of reclusion temporal, if he shall use any violence upon the person of the pregnant woman.chanrobles virtual law library
2. The penalty of prision mayor if, without using violence, he shall act without the consent of the woman.
3. The penalty of prision correccional in its medium and maximum periods, if the woman shall have consented.
Art. 258. Abortion practiced by the woman herself of by her parents. — The penalty of prision correccional in its medium and maximum periods shall be imposed upon a woman who shall practice abortion upon herself or shall consent that any other person should do so.
Any woman who shall commit this offense to conceal her dishonor, shall suffer the penalty of prision correccional in its minimum and medium periods.
If this crime be committed by the parents of the pregnant woman or either of them, and they act with the consent of said woman for the purpose of concealing her dishonor, the offenders shall suffer the penalty of prision correccional in its medium and maximum periods.
Art. 259. Abortion practiced by a physician or midwife and dispensing of abortives. — The penalties provided in Article 256 shall be imposed in its maximum period, respectively, upon any physician or midwife who, taking advantage of their scientific knowledge or skill, shall cause an abortion or assist in causing the same.
Any pharmacist who, without the proper prescription from a physician, shall dispense any abortive shall suffer arresto mayor and a fine not exceeding 1,000 pesos.”