Supreme Court of the Philippines, The Responsible Parenthood and Reproductive Health Act of 2012:
Opinions supporting freedom of conscience (April, 2014)
Mariano C. Del Castillo
Concurring and Dissenting Opinion
Mariano C. Del Castillo
3.b- Free Exercise Clause vis-a-vis the Duty to Inform [Section 23(a)(1)]
and the Duty to Refer [Section 23(a)(3)] [P. 39]
I shall jointly discuss
the constitutional validity of the duty to inform and duty to refer under
the RH Law because they are intricately related to each other. The
ponencia ruled that the duty to inform and duty to refer imposed on the
conscientious objector is unconstitutional for being violative of the Free
Exercise of Religion Clause, to wit:
Resultantly, the Court finds no
compelling state interest which would limit the free exercise clause of
the conscientious objectors, however few in number. Only the prevention
of an immediate and grave danger to the security and welfare of the
community can justify the infringement of religious freedom. If the
government fails to show the seriousness and immediacy of the threat,
State intrusion is constitutionally unacceptable. . .
***
[P. 40] I agree that the duty to refer, under pain of penal
liability, placed on the conscientious objector is unconstitutional,
however, I find that the conscientious objector's duty to inform is
constitutional.
To place the Free Exercise of Religion Clause challenge in its proper
context, it is necessary to distinguish two key concepts in the RH Law:
(1)
the duty to inform, and
(2) the duty to refer.
The main provisions42 on the duty to inform and duty to refer vis-a-vis
the conscientious objector is found in Section 23(a)(1) in relation to
23(a)(3) of the RH Law, viz:
SEC. 23. Prohibited Acts. - The following acts are
prohibited: (a) Any health care service provider, whether public or
private, who shall:
(1) Knowingly withhold information or restrict the
dissemination thereof, and/or intentionally provide 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, non-abortifacient and effective family planning methods;
xxx
[P. 41] (3) Refuse to extend quality health care
services and information on account of the person's marital status,
gender, age, religious convictions, personal circumstances, or nature of
work: Provided, That the conscientious objection of a health care service
provider based on his/her ethical or religious beliefs shall be
respected; however, the conscientious objector shall immediately refer the
person seeking such care and services to another health care service
provider within the same facility or one which is conveniently
accessible: Provided, farther, That the person is not in an emergency
condition or serious case as defined in Republic Act No. 8344, which
penalizes the refusal of hospitals and medical clinics to administer
appropriate initial medical treatment and support in emergency and senous
cases;
The duty to inform is embodied in the above-quoted Section 23(a)(1),
which penalizes a public or private health care service provider for:
(1)
knowingly withholding information or restricting the dissemination of
information, and/or
(2) intentionally providing incorrect information;
where "information" pertains to the programs and services on reproductive
health including the right to informed choice and access to a full range
of legal, medically-safe, non-abortifacient and effective family planning
methods.
This provision, thus, seeks to ensure that all persons, who are qualified
to avail of the benefits provided by the law, shall be given complete and
correct information on the reproductive health programs and services of
the government under the RH Law. It does not provide any exception to the
duty to inform. Thus, a conscientious objector is mandated to provide
complete and correct information even if this will include information on
artificial contraceptives to which he or she objects to on religious
grounds. Otherwise, he or she shall suffer the penal liability under the
law.
The duty to refer, on the other hand, is provided in the proviso of
Section 23(a)(3), which is likewise quoted above. This provision
penalizes a public or private health care service provider for refusing
to extend quality health care services and information on account of a
person's marital status, gender, age, religious convictions, personal
circumstances, or nature of work. However, it respects the right of the
conscientious objector by permitting him or her to refuse to perform or
provide the health care services to which he or she objects to on
religious or ethical grounds provided that he or she immediately refers the
person seeking such care and services to another health care service
provider within the same facility or one which is conveniently
accessible. As an exception to the exception, the conscientious objector
cannot refuse to perform or provide such health care services if it
involves an emergency condition or serious case under Republic Act No.
8344.
[P. 42] It should be noted that the first sentence of Section 23(a)(3) of
the RH Law refers to the refusal to extend quality health care services
and information. However, the proviso in the aforesaid section, which
imposes the duty to refer on the conscientious objector, is limited to
referring the person to another health care service provider for purposes
of availing health care services only, not health care services and
information. The implication is that the conscientious objector is
required to provide complete and correct information, and, in the event that
the person asks for health care services that the conscientious objector
objects to on religious or ethical grounds, the conscientious objector
has the duty to refer the person to another health care service provider.
This interpretation is in accord with the wording of Section 23(a)(1) of
the RH Law, which provides no exceptions to the duty to inform.
It should be further noted, and not insignificantly, that Section 23(a)(3) of the RH Law does not state that the conscientious objector
should refer the person to another health care service provider who can
perform or provide the heath care services to which the conscientious
objector objects to on religious or ethical grounds. Thus, a literal
reading of this provision would permit the conscientious objector to
refer the person to another health care service provider who is himself a
conscientious objector. The IRR attempts to fill this ambiguity in Section
5.24(b) to (e) thereof, viz:
Section 5.24 Public Skilled Health Professional as a
Conscientious Objector. In order to legally refuse to deliver
reproductive health care services or information as a conscientious
objector, a public skilled health professional shall comply with the
following requirements:
xx xx
b) Extraordinary diligence shall be
exerted to refer the client seeking care to another skilled health
professional or volunteer willing and capable of delivering the desired
reproductive health care service within the same facility;
c) If
within the same health facility, there is no other skilled health
professional or volunteer willing and capable of delivering the desired
reproductive health care service, the conscientious objector shall refer
the client to another specific health facility or provider that is
conveniently accessible in consideration of the client's travel
arrangements and financial capacity;
d) Written documentation of compliance
with the preceding requirements; and
[P. 43] e) Other requirements as determined by the
DOH.
In the event where the public skilled health
professional cannot comply with all of the above requirements, he or she
shall deliver the client's desired reproductive health care service or
information without further delay.xx x
This notwithstanding, and for purposes of the succeeding discussion on
the Free Exercise of Religion Clause, the necessary premise is that the
duty to refer involves referring the person to another health care
service provider who will perform or provide the health care services to
which the conscientious objector objects to on religious or ethical
grounds. Though this is not explicitly stated in the RH Law, the law must
be so reasonably construed given the policy of the law to provide
universal access to modern methods of family planning.
As noted earlier, the duty to inform and the duty to refer are
intricately related. The reason is that the duty to inform will normally
precede the duty to refer. The process of availing reproductive health
programs and services under the RH Law may be divided into two phases.
In the first phase, the person, who goes to a health service provider to
inquire about the government's reproductive health programs and services
under the RH Law, will be provided with complete and correct information
thereon, including the right to informed choice and access to a full
range of legal, medically-safe, non-abortifacient and effective family
planning methods.
In the second phase, after receiving the information, the person would
then ordinarily reach a decision on which reproductive health programs
and services, if any, he or she wishes to avail. Once he or she
makes a decision, he or she now asks the health service provider where
and how he or she can avail of these programs or services.
From the point of view of the health care service provider, the first
phase involves the transmission of information. Petitioners claim that
this act of giving complete and correct information, including
information on artificial contraceptives, imposes a burden on a
conscientious objector, like a Catholic doctor, because he or she is
required to give information on artificial contraceptives which he or she
believes to be immoral or wrong.
I disagree.
Petitioners failed to convincingly show that the act of giving complete
and correct information, including those on artificial contraceptives,
burdens a Catholic doctor's religious beliefs. Note that the law merely
requires the health service provider to give complete and correct
information. Presumably this can even be done by simply giving the person
a handout containing the list of the
[P. 44] government's reproductive health programs and services under the
RH Law. The valid secular purpose of the duty to inform is readily
apparent and the State interest in ensuring complete and correct
information is direct and substantial in order that the person may make
an informed and free choice.
The law does not command the health service provider to endorse a
particular family planning method but merely requires the presentation of
complete and correct information so that the person can make an informed
choice. A conscientious objector, like a Catholic doctor, is, thus, not
compelled to endorse artificial contraceptives as the preferred family
planning method. On its face, therefore, there appears to be no burden
imposed on the conscientious objector under the duty to inform.
To my mind, to successfully claim that a conscientious objector, like a
Catholic doctor, is burdened by the duty to inform, petitioners should have
demonstrated that, for a Catholic doctor, the mere mention of artificial
contraceptives (what they are and how they work) to the person is immoral
under the tenets of the Catholic faith. In the case at bar, petitioners
failed to carry this onus. Moreover, after providing the complete and
correct information as mandated by the RH Law, there is nothing to
prevent the conscientious objector, like a Catholic doctor, from speaking
against artificial contraceptives on religious or ethical grounds because
the RH Law cannot curtail freedom of speech; the Constitution is deemed
written into the law.
For the foregoing reasons, I find that petitioners failed to clearly show
that the act of giving complete and correct information on reproductive
health programs and services under the RH Law burdens a conscientious
objector's religious beliefs. Thus, I find that the duty to inform under
Section 23(a)(1) of the RH Law is constitutional even with respect to the
conscientious objector. In other words, the conscientious objector has
the duty to inform under the aforesaid section.
I now turn to the duty to refer. As already mentioned, I reach an
opposite result here. The central reason is that the second phase
involves a crucial distinguishing feature from the first phase. In the
first phase, the person merely receives the complete and correct
information from the health service provider but, in the second case, the
person now decides to act on the information. He or she makes a decision
to avail of one or more of the government's reproductive health programs
and services under the RH Law. In case the person seeks to avail of a
program or service which the conscientious objector objects to on religious
or ethical grounds, Section 23(a)(3) imposes on the conscientious
objector the duty to refer the person to a health service provider who
can perform or provide such program and service
[P. 45] This is an entirely different scenario. The person has already
made a decision and now seeks to accomplish an act which the
conscientious objector considers immoral or wrong on religious or ethical
grounds. When the RH Law compels the conscientious objector to make such
a referral, under pain of penal liability, the religious or ethical
beliefs of the conscientious objector is clearly burdened because he or
she is made to either
(1) join in this intention or
(2) aid in the
accomplishment of this intention which he or she considers immoral or wrong.
To illustrate, a Catholic doctor, who objects to the use of artificial
contraceptives, is compelled to refer a person who seeks such services to
another health care service provider who will, in turn, perform or
provide services related to artificial contraception. In such a case, the
Catholic doctor is effectively commanded to either
(1) join in the
intention of the person to use artificial contraceptives or
(2) aid in
the accomplishment of this intention.
From another perspective, the
Catholic doctor may view the referral as an essential link in the chain
of events which would lead to the availment of the person of such artificial
contraceptives.
Consequently, in the above scenario, I am of the view that the religious
or ethical beliefs of the conscientious objector are clearly burdened by
the duty to refer, thus, calling for the application of the test
enunciated in Estrada v. Escritor, to wit:
1. The sincerity and centrality of the religious
belief and practice;
2. The State's compelling interest to override the
conscientious objector's religious belief and practice; and
3. The
means the State adopts in pursuing its interest is the least restrictive
to the exercise of religious freedom.45
Anent the first test, insofar as the Catholic health service provider is
concerned vis-a-vis the use of artificial contraceptives, I find that
petitioners have met the sincerity and centrality test. The Catholic
Church's teaching on the use of artificial contraceptives as immoral,
evil or sin is of time immemorial and well documented. Its sincerity and
centrality to the Catholic faith cannot be seriously doubted as a papal
encyclical, Humanae Vitae, has even been principally devoted to
re-stating or expressing the Catholic Church's teaching on artificial
contraceptives, to wit:
[Quotes
Humanae Vitae 13 and 14]
[P. 46] Because petitioners have met the first test, the burden
shifts to the government to meet the last two tests in order for the
constitutional validity of the duty to refer to pass muster.
[P. 47] Anent the second test, the government failed to establish a
compelling State interest to justify the duty to refer under pain of
penalty. The purpose of the duty to refer is to facilitate the availment
of the government's reproductive health programs and services. That is,
it is logically more convenient that, after receiving complete and
correct information on the government's reproductive health programs and
services from a conscientious objector, the person should be readily
referred to another health service provider who can perform or provide the
chosen program or service to which the conscientious objector objects to
on religious grounds.
The primary State interest, therefore, that the duty to refer serves is
the facility of availing such programs and services or, in short, the
person's convenience. Put another way, if there were no duty to refer
and, thus, the conscientious objector is allowed to say to the person,
"Sorry, I do not know of and/or cannot refer you to such a health service
provider because I would be helping you to accomplish something that I
consider immoral or wrong," then, at most, the person suffers the
inconvenience of having to look for the proper health service provider,
on his or her own, who can provide or perform the chosen program or
service. Plainly, the person's convenience cannot override the
conscientious objector's religious freedom; a right founded on respect for
the inviolability of the human conscience.47
Anent the third test, which is intimately related to the second test,
there are clearly other means to achieve the purpose of the duty to
refer. Upon the implementation of the RH Law, through Sections 5.22,48
5.23,49 and 5.2450 of[P. 48] 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 (which refer simply to the
identity and location of all non-conscientious objector health service
providers). This is well-within the State's administrative and logistical
capability given its enormous machinery and the mandate of Section 20 of the
RH Law, which provides that:
SEC. 20. Public Awareness. - The DOH and the
LGUs shall initiate and sustain a heightened nationwide multimedia-campaign
to raise the level of public awareness on the protection and promotion of
reproductive health and rights including, but not limited to, maternal
health and nutrition, family planning and responsible parenthood information
and services, adolescent and youth reproductive health, guidance and
counseling and other elements of reproductive health care under Section 4(
q). Education and information materials to be developed and disseminated for
this purpose shall be reviewed regularly to ensure their effectiveness and
relevance.
The information, then, as to which health service provider is not a
conscientious objector can easily be disseminated through the information
campaign of the government without having to burden the conscientious
objector with the duty to refer.
Based on the foregoing, the duty to refer fails to meet the criteria set
in Estrada v. Escritor.51 Thus, it is unconstitutional.
[P. 49] Before closing the discussion on the duty to inform and the duty
to refer, I wish to highlight the preferred status that religious freedom
occupies in the hierarchy of constitutional rights by way of analogy. Let
us assume that the State promulgates a law which subsidizes the purchase
of weapons due to rising criminality. The law requires store owners, in
the business of selling such weapons, to fully inform their buyers of the
available weapons subsidized by the government. A store owner is, thus,
required to inform a buyer that the following are the government
subsidized weapons: knives and guns. The store owner would have no
problem acceding to this duty to inform. But suppose, one day, a buyer
comes to his store and says that he wants to buy a gun in order to kill or
murder his neighbor. The store owner, assuming he acts in accordance with
his conscience, would ordinarily refuse to sell the gun. If the law,
however, requires the store owner to refer the buyer to another store
where the buyer can avail of this gun, despite the latter's motive for
buying the gun, would this not impose a burden on the conscience of the
store owner?
To a non-believer, the matter of the duty to refer relative to, say,
artificial contraceptives may seem too inconsequential to merit
constitutional protection. But the Court cannot judge the truth or
falsity of a religious belief nor the seriousness of the consequences
that its violation brings upon the conscience of the believer. For to the
believer, referring a person to a health service provider where the
latter can avail of artificial contraceptives may be of the same or similar
level as referring a person to a store owner where he can purchase a gun to
kill or murder his neighbor. It constitutes a breach of his or her
covenant relationship with his or her God, and, thus, affects his or her
eternal destiny. That, precisely, is the province of the Free Exercise of
Religion Clause. That the believer may not have to choose between his or
her earthly freedom (imprisonment) and his or her eternal destination.
In view of the foregoing, I find that the duty to refer imposed on the
conscientious objector under Sections 7 and 23(a)(3) of the RH Law is
unconstitutional for violating the Free Exercise of Religion Clause.
Consequently, the phrase, "Provided, further, That these hospitals shall
immediately refer the person seeking such care and services to another
health facility which is conveniently accessible," in Section 7 and the
phrase, "however, the conscientious objector shall immediately refer the
person seeking such care and services to another health care service
provider within the same facility or one which is conveniently
accessible," in Section 23(a)(3) of the RH Law should be declared void.
Consequently, Sections 5.24(b) to (e) and 5.25 of the IRR, which
implements the aforesaid provisions of the RH Law, are void.
In another vein, I agree with the ponencia that the last paragraph of
Section 5.24 of the IRR is ultra vires because it effectively amends
Section 4(n) in relation to Section 23(a)(3) of the RH Law.
[P. 50] Under Section 4(n) of the RH Law, a public health care service
provider is defined as follows:
SEC. 4. Definition of Terms. - For the purpose of this
Act, the following terms shall be defined as follows:
(n) Public health care service provider refers to:
(1)
public health care institution, which is duly licensed and accredited and
devoted primarily to the maintenance and operation of facilities for
health promotion, disease prevention, diagnosis, treatment and care of
individuals suffering from illness, disease, injury, disability or
deformity, or in need of obstetrical or other medical and nursing care;
(2) public health care professional, who is a doctor of medicine, a nurse or
a midwife;
(3) public health worker engaged in the delivery of health
care services; or
(4) barangay health worker who has undergone training
programs under any accredited government and NGO and who voluntarily
renders primarily health care services in the community after having been
accredited to function as such by the local health board in accordance
with the guidelines promulgated by the Department of Health (DOH).
While last paragraph of Section 5.24 of the IRR states:
Provided, That skilled health professionals such as
provincial, city, or municipal health officers, chiefs of hospital, head
nurses, supervising midwives, among others, who by virtue of their office
are specifically charged with the duty to implement the provisions of the
RPRH Act and these Rules, cannot be considered as conscientious
objectors. (Emphasis supplied)
The above-enumerated skilled health professionals fall within the
definition of a "public health care service provider'' under Section 4(n)
of the RH Law. Under Section 23(a)(3) of the RH Law, both public and
private health service providers may invoke the right of a conscientious
objector. The last paragraph of Section 5.24 of the IRR is, thus, void
insofar as it deprives the skilled health professionals enumerated
therein from the right to conscientious objection.
I also agree with the ponencia that the last paragraph of Section 5 .24
of the IRR is unconstitutional for being violative of the Equal
Protection Clause although I find that the proper standard of review is
the strict scrutiny test.
The IRR effectively creates two classes with differential treatment with
respect to the capacity to invoke the right of a conscientious objector:
(1)
skilled health professionals such as provincial, city, or municipal
health officers, chiefs of hospital, head nurses, supervising midwives,
among others, who by virtue of their office are specifically charged with
the duty to implement the provisions of the RH Law and its IRR, and
(2)
skilled health professionals not belonging to (1).
Those belonging to the
first class cannot invoke the right of a conscientious objector while
those in the second class are granted that right
[P. 51]In our jurisdiction, equal protection analysis has generally
followed the rational basis test coupled with a deferential attitude to
legislative classifications and a reluctance to invalidate a law absent a
clear and unequivocal showing of a breach of the Constitution.52
However, when the classification burdens a suspect class or impinges on
fundamental rights, the proper standard of review is the strict scrutiny
test.53
Under the strict scrutiny test, the government must show a compelling or
overriding end to justify either:
(1) the limitation on fundamental rights
or
(2) the implication of suspect classes.54
The classification will
only be upheld if it is shown to be suitably tailored to serve a
compelling State interest.55 Suspect classes include classifications
based on race, nationality, alienage or denominational preference while
classifications impinging on fundamental rights include those affecting
marriage, procreation, voting, speech and interstate travel.56
Here, the classification impinges on the fundamental right of free
exercise of religion, as operationalized through the right of a
conscientious objector, which the RH Law recognizes and respects. The
government must, therefore, show that the differential treatment between
the first class and second class of skilled health professionals serves a
compelling State interest.
I find that the State has failed to prove how curtailing the right of
conscientious objection of those belonging to the first class will further a
compelling State interest. One perceptible reason for depriving the right of
conscientious objection to those belonging to the first class appears to be
the fear that this will paralyze or substantially degrade the effective
implementation of the RH Law considering that these skilled health
professionals are employed in public health institutions and local
government units.
This fear rests on at least two assumptions:
(1) most, if not all,
skilled health professionals belonging to the first class are
conscientious objectors, and
(2) the State is incapable of securing the
services of an adequate number of skilled health professionals who are
not conscientious objectors.
Both assumptions have not been proven by the
State. And, even if it were so proven, it must be recalled that the right
of the conscientious objector is a limited one: he or she may refuse to
perform or provide reproductive health services to which he or she objects
to on religious grounds. In such a case, the solution is for the person
to avail of such services elsewhere. Consequently, the State would now
have to show that the inconvenience caused on the part of the person, who
must secure such services
[P. 52] elsewhere (which could be as near as the doctor in the next room
or as far-flung as the doctor in another province or region) overrides
the freedom of religion of conscientious objectors belonging to the first
class. As earlier noted, it is self-evident that the person's convenience
cannot override the freedom of religion of the conscientious objector; a
constitutionally protected right predicated on respect for the
inviolability of the human conscience. (Even if this inconvenience would
entail, for example, added transportation costs, it cannot be seriously
argued that one can place a monetary value on the inviolability of the
human conscience.)
Hence, I find that the last paragraph of Section 5.24 of the IRR is
unconstitutional on equal protection grounds. . .
***
6- Due Process and Free Speech Clause [P. 63]
I agree with the ponencia that the void for vagueness doctrine is
inapplicable to the challenged portions of the RH Law for reasons stated in
the ponencia.
However, I find it necessary to discuss in greater detail why the void
for vagueness doctrine is not applicable particularly with respect to the
duty to inform under Section 23(a)(1) of the RH Law. The reason is
that the void for vagueness challenge is inextricably related to freedom of
speech which, under the exceptional circumstances of this case, once again
requires the Court to take steps to protect this constitutional right
pursuant to its expanded jurisdiction and as a penumbra to its power to
issue rules for the protection and enforcement of constitutional rights.
[P. 64] As previously discussed,
Section 23(a)(1) of the RH Law imposes a
duty to inform on both public and private health care service providers:
SEC. 23. Prohibited Acts. - The following acts are
prohibited:
(a) Any health care service provider, whether public or
private, who shall:
(1) Knowingly withhold information or restrict the
dissemination thereof, and/or intentionally provide 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, non-abortifacient and effective family planning methods;
In effect, the law requires that complete and correct information on the
government's reproductive health programs and services, including the right
to informed choice and access to a full range of legal, medically-safe,
nonabortifacient and effective family planning methods, be given to all
persons who are qualified beneficiaries under the RH Law. The law and its
IRR however, does not define the nature and extent of "complete and
correct information." Petitioners claim that, without this definition,
the duty to inform should be nullified under the void for vagueness
doctrine.
I disagree.
The RH Law enjoys the presumption of constitutionality and should be
given a construction which will avoid its nullity. The phrase "[k]nowingly
withhold information or restrict the dissemination thereof, and/or
intentionally provide incorrect information regarding programs and
services" under Section 23(a)(1) of the RH Law should be reasonably and
narrowly construed as merely requiring the health care service provider
to provide and explain to persons the list of the government's
reproductive health programs and services under the RH Law. To
illustrate, ifthe government's reproductive health programs and services
under the RH Law consists of A, B, C and D, then a health care service
provider is required to transmit this information to a person qualified
to avail of the benefits under the law.
But it is not as simple as that.
The RH Law itself provides that the individual should be allowed to make
a free and informed choice. As a result, the government has set a
self-limiting policy that it will not endorse any particular family
planning method. Yet, invariably, potential beneficiaries of these
programs and services will seek the advice or counsel of health care
service providers as to which programs and services they should avail of.
[P. 65] When this occurs, can the government control the opinions that
health care service providers will give the potential beneficiaries by
limiting the content of such opinions? That is, can the government
prevent health care service providers from giving their opinions or
controlling the content of their opinions, in favor or against, a
particular reproductive health service or program by mandating that only
a particular opinion will comply with the "complete and correct information"
standard under Section 23(a)(1) of the RH Law?
I submit that the government cannot do so without violating the Free
Speech Clause.
The "complete and correct information" standard cannot be construed as
covering matters regarding the professional opinions (including the opinions
of a conscientious objector on religious or ethical grounds as previously
discussed) of health service providers, either for or against, these
programs and services because this would constitute an abridgement of
freedom of speech through subsequent punishment. The government cannot
curtail such opinions without showing a clear and present danger that
will bring about the substantive evils that Congress has a right to
prevent.69 In the case at bar, there is no attempt on the part of the
government to satisfy the clear and present danger test. Consequently, the
"complete and correct information" standard under
Section 23(a)(1) should be
narrowly construed in order not to violate the Free Speech Clause. As
earlier noted, the only way to save it from constitutional infirmity is
to construe the "complete and correct information" standard as referring
to information containing the list of the government's reproductive
health programs and services under the RH Law. Anything beyond that would
transgress the free speech guarantee of the Constitution.
Indubitably, an expansive and broad intetpretation of the "complete and
correct information" standard will give the government the unbridled
capacity to censor speech by only allowing opinions on the reproductive
health programs and services under the RH Law which it favors. The
government can use the "complete and correct information" standard to
force health care service providers to endorse the former' s preferred
family planning method despite the clear policy of the RH Law granting
free and informed choice to the individual. This cannot be done without
violating the Free Speech Clause.
Of course, this would mean that health care service providers, who are
for or against certain programs and services under the RH Law, will be
able to influence potential beneficiaries over which family planning
method or means to avail of. This is the price of living in a democratic
polity, under our constitutional order, where opinions are freely
expressed and exchanged. The Constitution
[P. 66] guarantees freedom of speech and, thus, tilts the balance in
favor of the individual's right to free speech unless the State can show
that controlling the individual's speech can pass the clear and present
danger test. Here, as aforestated, the government has failed to satisfy
this test. If the government desires to push a preferred family planning
method, it has the full machinery of the State to back up its information
campaign under Section 20 of the RH Law. However, it cannot force
individual health care service providers, under pain of penal liability,
to express opinions that are favorable to certain reproductive health
programs and services under the RH Law. Government may try to convince
health care service providers, but not force them.
The above disquisition should not, of course, be taken to mean that
health care service providers shall be exempt from their professional or
ethical responsibilities which they owe to their patients and which may
result to administrative, civil or criminal liabilities of the former
based on their code of ethical conduct not unlike the code of ethics for
lawyers. But, unavoidably, the professional opinion or advice of health
care service providers will be sought by potential beneficiaries under
the RH Law and, in that instance, the "complete and correct information"
standard cannot be utilized by the State to curtail the health care
service provider's freedom of speech.
Thus, I find that the "complete and correct information" standard under
Section 23(a)(1) of the RH Law and, hence, the duty to inform (as discussed
in a previous subsection) is constitutional only insofar as it
requires health care service providers to provide a list of the
government's reproductive health programs and services under the RH Law
to qualified beneficiaries. Further, given the aforediscussed peculiar
circumstances of this case and in order to adequately protect the right
to free speech of health care service providers, it is necessary for the
Court to issue an order directing the DOH to generate the complete and
correct list of the government's reproductive health programs and
services under the RH Law which will serve as the template for the
"complete and correct information " standard and, hence, the duty to
inform under Section 23(a)(1) of the RH Law. The DOH should be directed
to distribute this template to all health care service providers covered
by the RH Law. This will forestall any confusion on the nature and scope
of the "complete and correct information" standard which is necessary given
the penal clause under the duty to inform.
Notes
42. Estrada v. Escritor, 455 Phil. 4 11
(2003).
***
45. Id. at 600.
***
47. Bernas, The 1987 Constitution of the Republic of the
Phjlippines: A Commentary (2009) at 330.
48. Section 5.22 Exemption of Private
Hospitals from Providing Family Planning Services. Private health
facilities shall provide a full range of modem family planning methods to
clients, unless the hospital is owned and operated by a religious group, or
is classified as a non-maternity specialty hospital, as part of their annual
licensing and accreditation requirements.
In order to receive exemption
from providing the full range of modem family planning methods, the health
care facility must comply with the following requirements:
a) Submission of proof of hospital ownership and
management by a religious group or its status as a non-maternity specialty
hospital;
b) Submission to the DOH of an affidavit stating the
modem family planning methods that the facility refuses to provide and the
reasons for its objection;
c) Posting of a notice at the entrance of the
facility, in a prominent location and using a
clear/legible layout and
font, enumerating the reproductive health services the facility does not
provide; and
d) Other requirements as determined by the DOH.
Within sixty (60) days from the effectivity of these
Rules, the DOH shall develop guidelines for the implementation ofthls
provision.
49. Section 5.23 Private Skilled Health
Professional as a Conscientious Objector. ln order to legally refuse to
deliver reproductive health care services or information as a conscientious
objector, a private skilled health professional shall comply with the
following requirements:
a) Submission to the DOH of an affidavit stating the
modem family planning methods that he or she refuses to provide and his or
her reasons for objection;
b) Posting of a notice at the entrance of the clinic
or place of practice, in a prominent location and using a clear/legible
font, enumerating the reproductive health services he or she refuses to
provide; and
c) Other requirements as determined by the DOH.
Within sixty (60) days from the effectivity of these
Rules, the DOH shall develop guidelines for the implementation of this
provision.
50. Section 5.24 Public Skilled Health
Professional as a Conscientious Objector. In order to legally refuse to
deliver reproductive health care services or information as a conscientious
objector, a public skilled health professional shall comply with the
following requirements:
a) The skilled health professional shall explain to
the client the limited range of services he/she can provide;
b) Extraordinary diligence shall be exerted to refer
the client seeking care to another skilled health professional or volunteer
willing and capable of delivering the desired reproductive health care
service within the same facility;
c) If within the same health facility, there is no
other skilled health professional or volunteer willing and capable of
delivering the desired reproductive health care service, the conscientious
objector shall refer the client to another specific health facility or
provider that is conveniently accessible in consideration of the client's
travel arrangements and financial capacity;
d) Written documentation of compliance with the
preceding requirements; and
e) Other requirements as determined by the DOH.
In the event where the public skilled health
professional cannot comply with all of the above requirements, he or she
shall deliver the client's desired reproductive health care service or
information without further delay.
Provided, That skilled health professionals
such as provincial, city, or municipal health officers, chiefs of hospital,
head nurses, supervising midwives, among others, who by virtue of their
office are specifically charged with the duty to implement the provisions of
the RPRH Act and these Rules, cannot be considered as conscientious
objectors.
Within sixty (60) days from the effectivity of these
rules, the DOH shall develop guidelines for the implementation of this
provision.
51. Supra note 44.
52. Central Bank Employees Assoc., Inc. v. Bangko Sentral ng
Pilipinas, 487 Phil. 531 , 583-584 (2004).
53. Id. at 585.
54. Id. at 644. (Panganiban, J. dissenting)
55. Id.
56. Id. at 645-646.
***
69. See Cruz, Constitutional Law (2007), at 2 13-2 I 5.