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Protection of Conscience Project

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Service, not Servitude
Legal Commentary

Proposed Rwandan law would legalize abortion, make conscientious objection illegal

Law Governing Reproductive Health

Sean Murphy*

After its approval by the Standing Committee on Social Affairs,  Rwandan Member of Parliament Ignatienne Nyirarukundo has brought a proposed Rwandan reproductive health law before the Rwandan Chamber of Deputies for consideration.1  The bill is reported to have been initiated five years ago, and is apparently an improved version of a bill that was criticized for violating human rights, contradicting the Rwandan Constitution, and for being so badly translated that its provisions were sometimes given different meanings in different languages.  That bill was rejected by the Rwandan senate.2

Nonetheless, the English text of the present bill3 continues to suffer from defects like incoherence and inconsistency that may be the product of poor translation.  In addition, it  include provisions that are likely to be controversial for various reasons.  Among them:

  •  it appears to require physicians doing AIDS/HIV tests to violate the principle of informed consent and patient confidentiality (Article 14);
  • it describes offences, like rape, that one would normally expect to find in criminal law, and which may already be covered by Rwandan criminal law (Article 4);
  • it requires spouses to practise "family planning," though it does not impose the obligation on unmarried couples; (Article 12)
  • it legalizes abortions that are approved by three physicians (Article 23).

Commenting on the requirement to practise family planning, MP Juliana Kantengwa complained that the bill did not specify the number of children people should be permitted to have, and that it did not include punitive sanctions to ensure enforcement.4  Her criticism illustrates the potentially oppressive power of such a law.

With respect to freedom of conscience, that oppressive power is manifestly clear.  Article 4(12) makes it an offence for a health care worker to refuse to provide any  form of  "reproductive health care" (i.e., contraception, sterilization and abortion), while Article 17 demands that "all" health care workers are obliged to provide these services faster and more effectively.  The bill requires the government to establish 'reproductive health units' in every hospital, no exceptions being made for private or denominational institutions (Article 18).

A particularly draconian feature of the bill is Article 4(14), which would prohibit any expression of opposition to the bill or to anything it advocates.  This is remarkably similar in intent to a section of the Philippines Reproductive Health Act of 2011, which would have made it illegal for anyone "who maliciously engages in disinformation about the intent or provisions" of the law.  The section was ultimately deleted.

The English text of the Rwandan bill follows in Appendix "A," with a link to the original document that includes French and Kinyarwanda translations.  Some of the significant parts of the bill are highlighted in red.  Mouseover the red text to see Project comments in the right column of the page.

Notes:

1.  Musoni, Edwin, "Reproductive Health Bill in Crucial Stage of Parliament's Scrutiny.The New Times (Rwanda) 10 July, 2013. (Accessed 2013-07-11)

2.  Rwanda Focus, "Lawmakers make a mess of reproductive health bill." 23 June, 2009. (Accessed 2013-07-25)

3.  Reproductive Health Bill.  The document on the Rwandan parliament's website, the English text is reproduced below, is dated October, 2011. (Accessed 2013-07-11)

4.  Musoni, Edwin, "Reproductive Health Bill in Crucial Stage of Parliament's Scrutiny.The New Times (Rwanda) 10 July, 2013. (Accessed 2013-07-11)


Appendix "A"

[Original text in Kinyarwanda, English and French.  Mouseover red text for Project comments.]

CHAPTER I: GENERAL PROVISIONS
Article one: The scope of application

This law governs reproductive health.

Article 2: Definitions

1° reproductive health shall mean a state of physical, mental and social well-being in all matters relating to reproductive system at all stages of life without being limited to reproductive health related diseases and disability. Reproductive health implies that people are able to have a satisfying and safe sex life and that the capacity to reproduce and the freedom to decide when, and how often to do so. Reproductive health also means sexual health, the purpose of which is the enhancement of life and personal relations, and not merely counseling and care related to reproduction and sexually transmitted diseases;

 

Source:  7.2.   Report of the International Conference on Population and Development (Cairo, 5-13 September, 1994) A/CONF.171/13 (Accessed 2013-07-25) Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes.  Reproductive health therefore implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. . .  It also includes sexual health, the purpose of which is the enhancement of life and personal relations, and not merely counselling and care related to reproduction and sexually transmitted diseases. [Provided by the Protection of Conscience Project]

2° reproductive health services shall mean allAppears to include all private, public and denominational health care facilities. facilities including health facilities, different centers with staff, equipment and drugs and other facilities necessary to solve and prevent all issues related to reproductive health;

3° family planning or birth spacing shall mean the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and the timing of their births by taking into account the child, mother and family's welfare;

4° child shall mean any person aged below eighteen (18) years old;

5° adolescent boy shall mean any boy aged between thirteen (13) and twenty (20) years old;

6° adolescent girl shall mean any boy [sic] aged between thirteen (13) and twenty (20) years old;

Article 3: Components of reproductive health

Reproductive health shall include the following:

1°Safe reproduction, be it from the mother's point of view or from the child's point of view;

2° Care for the new born baby;

3° family planning and births spacing;

4°prevention and treatment of sexually transmitted infections including AIDS;

5°ensuring adolescents' reproductive health;

6°prevention of gender-based violence and provision of care for its victims;

7°changing behavour and attitudes so as to provide the woman with the capicity of participating in reproductive health related decisions making process.

Article 4: Restrictions in terms of reproductive health

Notwithstanding other legal provisionsThe relationship between the Rwandan criminal law and this bill is unclear, since some of the offences proposed in this bill are presumably already criminal offences., the following reproductive health related acts shall be prohibited:

1° forcibly subject a person to sexual intercourse;

2° Forcing a person to get married with someone he or she does not want to or forcing a person not to marry or get married with someone she wants to;

3° exercing stigma against an HIV positive or a person suffering from AIDS, AIDS orphans or those affected by other epidemics;

4° having any person induldge [sic] in prostitution;

5° Sexual torture

6° entertaining sexual intercourse with any person who can not afford taking a decision for that matter;

7° exercising pressure or stigma against a mother of illegitimate child;

8° exercising pressure or stigma against a mother of male or female children only, a mother of a handicaped child or any married person suffering from infertility;

9° exercising pressure or stigma against a child born out of the circumstances provided for in points 7 and 8 of this article;

10° exercising pressure, violence against a your spouse;

11° Forcing ones'spouse to have children against his or her will, or where, for health or family planning reasons he or she does not want to;

12° refusing to provide family planning services to any person seeking for themThis makes conscientious objection unlawful. The bill does not state what punishment should be imposed. ;

13° marriages between relatives to less than the 7th degree;

14° Propounding principles that are different from what is provided for by this lawThis suppresses freedom of expression, especially moral or religious teaching that conflicts with the bill, including opposition to contraception and abortion. .

CHAPTER II: INDIVIDUALS RIGHTS IN TERMS OF REPRODUCTIVE HEALTH
Article 5: the right to reproductive health

EverybodyConflicts with Article 6. shall fully enjoy the right on reproductive health issues.

Article 6: The right to decide on reproductive health issues

Any person who has attained the maturity age everybodyIncoherent, and conflicts with Article 5. [sic] shall fully enjoy the right to decide on reproductive health issues.

Article 7: The right to be provided with reproductive health education and services

Every person shall have the right to be provided with education on reproductive health in general and on family methods in particular.

Every person Includes adolescents and childrenshall have the rightClaims of 'rights' in this field are contested. to enjoy access to reproductive health care servicesIncluding (via Article 23) abortion.

Article 8: The spouses' right to decide on the number of children to give birth to or the right to refrain from reproducing

Spouses shall have full right to decide on the number of children to give birth to taking into account the children's, the mother's and the family's welfare. They shall also have the right to refrain from reproducing up mutual consent and to enjoy counselling and other types of assistance dedicated to that matter.

Article 9: Pregnant woman's, child's and husband's right to care

Any pregnant woman and her husband or any mother and her new born baby shall have the right to be protected as provided for by the law.

Article 10: The right to be provided with drugs and health care services meant for keeping them healthy

Every person shall have the right to be provided with drugs and health care services meant for keeping them healthy.They also have the right to be protected from any act as long as it can jeopardize reproductive health.

Article 11: The right for infertile woman, the one who stopped giving birth or who has reached menopose [siic]

Infertile woman, the one who stopped giving birth or who has reached menopause shall have the right to be provided with reproductive health services.

Article 12: The spouse's obligation to use family planning methods

Spouses shall have the obligation to use family planning methodsBill makes it illegal not to practise family planning. Punishment for not doing so is not specified. Permits state control of decisions about childbearing. May conflict with Article 8. for their family's welfare.

Article13: HIV/AIDS test

Everybody shall have the obligation to protect him/herself against HIV/AIDS, voluntary test, and to protect his/her sex parterner.

Article 14: HIV/AIDS testing HIV/AIDS test is subject to testee's consent.

Where a medical doctor finds it necessary to find AIDS status in a child or any other person, he or she shall do so without asking for any authorization and show the result to the guardian or care provider.Appears contrary to principle of informed consent and a violation of physician/patient confidentiality. However, upon requested by the authorized institutions, it should be in accordance law.

Article 15: Refraining from any threat to reproduction ability and from sexually transmitted infections

Every person shall have the obligation to refrain from any threatAppears to prohibit sterilization. to their own or family's reproduction ability, especially from sexually transmitted infections.

Article 16: The parent's obligation ensure the education of their children

Every parent or guardian shall ensure good health and education for their children or those under their guardianship. Every parent or guardian shall talk to their children or those under their trustship about sex and reproductive health

Article 17: Reproductive health service providers' obligations

All reproductive health service providers shall have the obligation to provide for effective and faster services. Conscientious objection to contraception and abortion will be unlawful, though the bill does not specify punishment.

CHAPTER III: GOVERNMENT OBLIGATIONS IN TERMS OF REPRODUCTIVE HEALTH
Article 18: The Government's primary obligation

The Government shall have the following:

1 º Establish a well-equiped specific unit in each hospital and health center No exemption for private or denominational institutions. with means meant for providing sevirces to the population on reproductive health.

2 º sensitizing spouses on the common understanding about family planning;

3 º Sensitizing and assisting pregnant women on delivering at health center and their role in deciding on reproductive health;

4 º Helping the destitute person access reproductive health and family planning services;

5 º Providing with assistance to mentally handicapped people who can not decide on their reproductive health and family planning;

6 º Training on a regular basis those involved in health workers on reproductive health and more specifically on family planning methods;

7 º Training and consulting on a regular basis faith-based organisatuions' [sic] leaders in reproductive health related matters.  Providing Non Governmental Organizations with reproductive health related guidelines;

8 º Training on a regular basis health workers and local government authorities on reproductive health related issues so that they can transfer the knowledge to the population;

9 º Doing any other thing that promotes reproduction health. An order of the Minister in charge of health governs how what is stipulated in this article.

Article 19: Integration of issues of reproductive health into teaching programmes

Teaching programmes and curricula at all levels of education shall integrate issues of reproductive health.

An order of the Minister in charge of education shall specify implementing modalities for this article.

Article 20: The obligation of Public service organs

Public service organs shall devise strategies meant for ensuring their staff enjoy safe reproductive health.

Article 21: Exemption for Drugs and equipment meant for family planning

Drugs and equipment meant for family planning shall be exempted from paying taxes.

Article 22: Services provides by public health facilities

As far as reproductive health, public health facilities shall ensure a quick reception and treatment for free for a victim of gender based violence. Where this is carried out for the purpose of collecting evidence, such services shall also be provided to the suspect for free.

Any victim of raped who has been contaminated HIV/AIDS and other sexually transmitted infections or had other sexual violence related consequences shall be provided with medical treatment.  Public health facilities has the obligation of providing a free family planning services.

Order of the Minister of Health determines how a free family planning services shall be provided by public and semi-public health.

Article 23: Reasons legitimating voluntary abortion

Voluntary abortion as one of contraceptive methods shall be prohibited. However, this type of abortion may be used in case of strong beliefs and decision by a medical team of three (3) authorized medical doctors that the pregnancy or the child born out the pregnancy may have a serious impact on the mother's life. Abortion will be legalized whenever childbirth might have a 'serious impact' on the life of the mother. All childbirth has such an impact.

An order of the Minister in charge of health shall specify implementing modalities thereof.

CHAPTER V: MISCELLANEOUS AND FINAL PROVISIONS
Article 24: Abrogation of inconsistent legal provisions

All previous legal provisions contrary to this law are hereby abrogated.

Article 25: Preparation, review and voting of this law

This law has been prepared in English, reviewed and voted in Kinyarwanda

Article 26: Entry into force

This law comes into force on the date of its publication in the Official Gazette of the Republic of Rwanda.

 

 

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