Plain Language summary:
[1] Sections 7, 23 and 24 of the RH law obligate hospital or medical practitioners to immediately refer a person seeking health care and services to another accessible healthcare provider despite their conscientious objections based on religious or ethical beliefs.
[2] The obligation to refer imposed by the RH Law violates the religious belief and conviction of a conscientious objector.
“Generally, healthcare service providers cannot be forced to render reproductive health care procedures if doing it would contravene their religious beliefs.”
[3] Exception: in life-threatening cases, healthcare providers cannot invoke freedom of religion.
“But 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.”
[4] Freedom of religion preferred in Constitution; Benevolent neutrality doctrine
“In case of conflict between the State and Constitution’s free exercise of religion clause, the Court adheres to the doctrine of benevolent neutrality” which is “the spirit, intent and framework underlying the Philippine Constitution.”
[5] No compelling State interest to set aside benevolent neutrality
[6] Relevant US case: “Supreme Court Sides with Hobby Lobby”
“In a 5 to 4 ruling, the Supreme Court ruled that the federal government cannot require faith-based companies to provide potentially abortifacient contraceptives to their employees in violation of their owners' religious beliefs.” (Read the complete decision.) |
The Supreme Court, voting unanimously, upheld the Reproductive Health Law as Constitutional. But the Court, at the same time, struck down certain provisions of the RH law because they violate the Constitutional provisions on freedom of religion and freedom of speech. Among the provisions declared un-Constitutional are:
Section 7 and the corresponding provision in the RH-IRR insofar as they: a) require private health facilities and non-maternity specialty hospitals and hospitals owned and operated by a religious group to refer patients, not in an emergency or life-threatening case, as defined under Republic Act No. 8344, to another health facility which is conveniently accessible; xxx
Section 23(a)(l) and the corresponding provision in the RH-IRR, particularly Section 5 .24, insofar as they punish any healthcare service provider who fails and or refuses to disseminate information regarding programs and services on reproductive health regardless of his or her religious beliefs.
Section 23(b) and the corresponding provision in the RH-IRR, particularly Section 5 .24, insofar as they punish any public officer who refuses to support reproductive health programs or shall do any act that hinders the full implementation of a reproductive health program, regardless of his or her religious beliefs; xxx
Obligation to refer violates freedom of religion
“Sections 7, 23, and 24 of the RH law commonly mandate a hospital or a medical practitioner to immediately refer a person seeking health care and services under the law to another accessible healthcare provider despite their conscientious objections based on religious or ethical beliefs.”
The Court ruled that the obligation to refer imposed by the RH Law violates the religious belief and conviction of a conscientious objector:
Once the medical practitioner, against his will, refers a patient seeking information on modem reproductive health products, services, procedures and methods, his conscience is immediately burdened as he has been compelled to perform an act against his beliefs. As Commissioner Joaquin A. Bernas has written, "at the basis of the free exercise clause is the respect for the inviolability of the human conscience."
The Court further explained:
Though it has been said that the act of referral is an opt-out clause, it is, however, a false compromise because it makes pro-life health providers complicit in the performance of an act that they find morally repugnant or offensive. They cannot, in conscience, do indirectly what they cannot do directly. One may not be the principal, but he is equally guilty if he abets the offensive act by indirect participation.
Freedom of religion preferred in Constitution
The Court said:
Freedom of religion was accorded preferred status by the framers of our fundamental law. And this Court has consistently affirmed this preferred status, well aware that it is "designed to protect the broadest possible liberty of conscience, to allow each man to believe as his conscience directs, to profess his beliefs, and to live as he believes he ought to live, consistent with the liberty of others and with the common good."
Penalties by RH law on healthcare service providers who refuse to refer are un-Constitutional
The Court is not oblivious to the view that penalties provided by law endeavor to ensure compliance. Without set consequences for either an active violation or mere inaction, a law tends to be toothless and ineffectual.
Nonetheless, when what is bartered for an effective implementation of a law is a constitutionally-protected right the Court firmly chooses to stamp its disapproval. 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 religious beliefs, is a clear inhibition of a constitutional guarantee which the Court cannot allow.
Exception: in life-threatening situations, healthcare providers cannot invoke freedom of religion
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.
Doctrine of benevolent neutrality
In striking down these provisions, the Supreme Court said that "in case of conflict between the State and Constitution's free exercise of religion clause, the Court adheres to the doctrine of benevolent neutrality" which is "the spirit, intent and framework underlying the Philippine Constitution."
The Court explained what benevolent neutrality is all about:
The benevolent neutrality theory believes that with respect to these governmental actions, accommodation of religion may be allowed, not to promote the government's favored form of religion, but to allow individuals and groups to exercise their religion without hindrance."
No compelling State interest to set aside benevolent neutrality
The Court may set aside benevolent neutrality if there is a compelling state interest. In the case of the RH law, the Office of the Solicitor General said that the compelling State interest was "fifteen maternal deaths per day, hundreds of thousands of unintended pregnancies, lives changed." But the Court rejected this argument:
The undisputed fact, however, is that the World Health Organization reported that the Filipino maternal mortality rate dropped to 48 percent from 1990 to 2008, although there was still no RH Law at that time. Despite such revelation, the proponents still insist that such number of maternal deaths constitute a compelling state interest.
