Letter to President Rodrigo Roa Duterte from Doctors for Life

January 11, 2017

PRESIDENT RODRIGO ROA DUTERTE
Office of the President
Republic of the Philippines
Malacanang Palace, Manila

Dear President Duterte,

Peace be with you!

When you assumed office as our Chief Executive, you have issued a lot of statements which inspired us; that as a President you will,

  1. Uphold the constitution
  2. Respect the rule of law
  3. Recognize the separation of Church and State which means religious freedom  must be respected (because the state will not espouse any) tenets which are basic requirements of democracy.

We would like to bring to your attention therefore that it is precisely because of these concerns why a TRO was imposed by the Supreme Court (SC) on RA 10354 or the RH LAW. There were eight (8) provisions declared by the SC as unconstitutional and violative of :

1- Article 2 section 12 of the Constitution which states that life must be respected from the moment of conception until natural death

2- religious freedom

3- family code among others.

Last January 9, however, you issued executive no 12 which included strict implementation of RA 10354 (RH Law)

As a physicians and citizens of this Country, these are our concerns:

  1. RH LAW VIOLATES THE RIGHT TO LIFE OF THE UNBORN
  2. CONTRACEPTIVES AS ABORTIFACIENTS

A1. Pills

The issue on the abortifacient drugs and devices which would prevent implantation of a human being in the early stage of development is an important issue because it violates Article II, Section 12 of the Philippine Constitution which protects life from the moment of conception ( fertilization) until natural death.

These abortifacient drugs and devices which prevent implantation as listed in the textbooks of Embryology, Anatomy and Pharmacology should be identified, for example:

  1. the birth control pills (BCPs) – Norgestrel and Ethinyl estradiol ( e.g. Lo/Ovral, TRUST pill, Femenal, etc. used by the DOH)

It is important to take note that up to 1975, the U.S. Physicians Drug Reference only listed the following mechanisms of action :

  1. Inhibition of ovulation, other alterations include
  2. Changes in the cervical mucus which cause the difficulty of the sperm entry into the uterus.1

After wards however, when abortion was already legal in the US, the third mechanism was already included:

  1. Modification of endometrium preventing implantation of the fertilized ovum which can result to abortion.

(Abortion was legalized in the US in 1973. The 1978 edition of the U.S. Physicians Drug Reference already listed this no. 3 effect.)   

Why was the 3rd mechanism of contraceptives which will render them as potential abortifacents were not included in the Physicians Drug Reference prior to the legalization of abortion in the US? For the simple reason that if this mechanism was included prior to abortion legalization, majority of these contraceptives would have been banned from the market prior to 1973.

Since Pill is a contraceptive how will it cause abortion?

Even if the woman is on the pill ovulation is not always suppressed since no drug works 100%.

Ovulation occurs in 2% to 10% of cycles of women taking the pill.

  • known as breakthrough ovulation.

(Textbook of Contraceptive Practice of Cambridge (Cambridge University Press)

  • later researches employing reduced dosage formulation of the pill which is currently being used, had shown higher breakthrough or escape ovulation in 30% of cycles.

                                            (Letterie, G.S; Contraception, 1998; 57, 39-14.) 

What happens when ovulation occurs while the woman is on the Pill?

  • if the woman is sexually active, then the egg can be fertilized,

            Loss of the embryo or abortion may result through the following:

  • transfer of the embryo through the fallopian tube slows down so that this new life maybe too old to be viable when it enters the uterus.
  • more importantly the underdevelopment of the uterine lining caused by the pill prevents nidation or implantation.
  • this 3rd action of the pill remains to be listed in the website of the pharmacology of drugs up to the present.
  • pharmacologists therefore recognizes the reality of breakthrough ovulation.
  • if the fertilized embryo eventually dies and the remains are passed with the next bleeding, this will not be true menstruation but a form of chemical abortion because the uterine lining is rendered hostile for implantation.

(As early as 1967, the representatives of a major hormone producer already admitted that with the O.C.’s ovulation and the possibility of fertilization took place up to 7 % of cases, BUT subsequent implantation of the fertilized egg in the womb would usually be prevented.)

Abortifacient Contraception: The Pharmaceutical Holocaust
Rudolf Ehmann, M.D., Head, OB-GYN, Kantonsspital Hospital, Switzerland

The reality of breakthrough ovulation is manifested by “survivor pregnancies” as attested to by a study of Alan Guttmacher Institute ( the research arm of International Planned Parenthood (IPPF) a strong supporter of RH law worldwide). In theory, the Pill reaches an effectiveness of over 99% but in practice the rate is much lower. Between 1.9% and 18.1% of women will experience an ‘unplanned pregnancy’ in the first year of using the pill.7

  • Even RH Law or RA 10354 itself states:
  • Drugs and devices that prevent implantation are illegal in Sec. 2 (d); Sec. 4, (a)        
  • It also emphatically declares that abortion is illegal ( 2, d; Sec. 3,d,e, Sec. 4, e, l, q. no. 3,s, Sec. 9, Sec. 19 no. 2, Sec. 23)

(Sect.2(d)…guarantees universal access to medically safe, non-abortifacient, effective, legal, affordable, and quality RH care services, methods, devices, supplies which do not prevent implantation of a fertilized ovum as determined by FDA. )  

Pregnancy is a sequence of events begins with fertilization, implantation, embryonic development and fetal development which normally ends with birth about 38 weeks later.

  • the human somatic (body) cells have 46 chromosomes, 23 from each parent
  • therefore this new human life is not a part of the body of a woman but another human being with its own genetic code

Therefore, from the moment of fertilization up to its end, the product of conception is a human being that deserve respect and protection. (Tortora and Grabowski the authors of this reference are both members of the American Association for the Advancement of Science (AAAS)

A2. IUD (Intrauterine Device)

  • * acts primarily by preventing the embryo from implanting –
  • not by preventing conception.
  • therefore an abortifacient, NOT a contraceptive.
  1. JEROME LEJEUNE an expert on Fundamental Genetics

( from the University of Paris)

  • It is described as a small object made of plastic, copper or stainless steel that is inserted into the cavity of the uterus.Most commonly used IUD is the CopperT. IUDs cause changes in the uterine lining that prevent implantation of the fertilized ovum.
  • Although newer IUDs are treated with Levonorgestrel to prevent ovulation it also does not work 100% therefore also potential abortifacients.

“Make no mistake, the Pill and the IUD are abortifacients.”

On the debate on Family Planning

National Abortion Federation (NAF) June 1985 Congress, Boston, USA

This data has been used as entry point to the legalization of Abortion in the U.S. and Worldwide –

WHAT DO PRO-RH LAWYERS SAY:

On the opposition to the Louisiana Law Banning ABORTION:

“Because nearly ALL birth control devices, except the diaphragm and condom, operate between the time of conception… and implantation…, the statute would appear to ban most contraceptives.”

RUTH COLKER
TulaneLawSchool Professor
Dallas Morning News, 23A,
February 6, 1992

“…IUDs and low dose birth control pills act as abortifacients.”

ATTY. FRANK SUSSMAN
Lawyer for Missouri abortion clinics
Arguments before the U.S. Supreme Court
April 27, 1989

How about other ‘contraceptives’?

A3. Injectable Progesterone (Deprovera)

Depot medroxyprogesterone acetate’s mechanism of action appear to be multiple and include ovulation inhibition, increase cervical mucus viscosity and production of an endometrium unfavorable for fertilized ovum implantation.

A4. Progesterone Implants (Norplant System including Implanon)

  • Provides levonorgestrel in six silastic containers that are implanted subdermally (under the skin); effect lasts for 60 months or 5years.
  • Progestin induces changes in the cervical mucus and endometrium (changes in endometrium can inhibit blastocyst formation)

A5. Post Coital Contraception
(Morning after pill)

  • Contains 50mcg of ethinyl estradiol and 0.25mcg of levonorgestrel; acts by alteration of endometrium, sperm penetration and tubal motility

All these data point out to the fact that almost all of the so called “contraceptives” (except condom) available in our country and all private outlets and all rural health clinics and related government institutions cause alteration in the integrity of the endometrial lining, which inhibits implantation of the newly fertilized ovum, classifying them as abortifacients.

Evidently even those pro- RH lawyers cited above, believe and understand that life begins, without doubt with the fusion of the egg & sperm or at fertilization.

“EXPERTS who deny the abortifacient properties of the pill and IUD have actually transferred the beginning of life from fertilization to implantation or nidation.’’This is what the ACOG has done in the U.S. not because of new scientific information but to be politically correct so, in the U.S. they have formed the ‘Association of Obstetrician & GYN for Life’

Bernard N. Nathanson M.D.
Obstetrician – Gynecologist
Former Director of the World’s Largest ABORTION Clinic in America
N.Y.City’s Center for Reproductive & Sexual Health
Presided over 60,000 AB & Co-founder of National Abortion Rights League (NARAL)
Helped make abortion legal in the U.S.,
Was the most prominent abortionist in the U.S. until he realized its horror through ultrasound

Based on these data we feel that the time has come to rectify the enormous injustice that the human being at the earliest stage of development, have been subjected to because of lack of information and acknowledgement of the sanctity of life from the moment of fertilization.

The Supreme Court did an objective study and this is an important basis for the TRO.

References:

1 –   U.S.Physicians Drug Ref., 1975, p. 1631

2 –   U.S. Physicians Drug Reference, ,1978 p. 1817; 1997 p. 2746.

3 –   Up to Date On Line 2017. www.uptodate.com                            

4 –   Bertram G. Katzung,M.D.,PhD.   Basic & Clinical Pharmacology, 8th ed. 2001, p. 693

5 – Tortora& Grabowski, The Reproductive System,Chapter 28, Principle of Anatomy and Physiology, 9th edition C 2000. p. 1008-1009.

6- Tortora& Grabowski, Chapter 29, Principles of Anatomy & Physiology; c 2000 p. 102

7- Harlap, S, Kost K, et al, Preventing Pregnancy… NY: The Alan GuttmacherInst, 1991; 36-37

***

RA 10354 requires that:

The FOOD and DRUG ADMINISTRATION (FDA) makes a list of all these drugs and devices that are abortifacient but the big problem is up to now they have not come up with this list and FDA has not conducted a public hearing.

            For the SC to lift the TRO, FDA has to comply with this requirement.

            Why does the FDA not comply with this?

Unwanted Pregnancy and Sexually Transmitted Disease: Is Condom the Answer?

FACTS

  1. Christian Doctrine and Natural Law encourages and protects the sanctity of the sexual act within the confine of matrimony. The only answer to unwanted pregnancy is abstinence prior to marriage. Sexually transmitted diseases, as the name implies is a consequence of having a sexual act with a contaminated partner. Therefore, the only genuine program of prevention versus AIDS and other Sexually Transmitted Diseases is abstinence for single people and fidelity to one’s conjugal partner (if both partner had been practicing abstinence prior to marriage, there is zero chance of anyone of them having STD).

If we encourage and teach our young to practice self -mastery thru living a disciplined, chaste life, we don’t have to spend millions of pesos for condoms and we don’t have to worry any of them becoming pregnant at any time or catching a fatal disease like AIDS at any time. These million of pesos which we can save, we can spend for free education for our young people who are very poor but willing to work hard to finish college education. By doing this, we instill not only discipline but most importantly, the value of self control and the value of waiting among our young that will empower them to truly become good, obedient and productive citizens in the future.

Other data regarding Condom are as follows:

  • there are intrinsic voids in the condom seen by electron microscopy at 5 to 50 micra whereas the size of the HIV virus 0.1 micron therefore this is a major reason for its high failure rate on top of the reported breakage and slippage especially high among the young. (rubber expert C.M. ROWLAND the Editor – Rubber Chemistry & Technology U.S. Naval Lab)
    • * failure rate = 20 %.

     Cochrane Database of Systematic Reviews

HIV in the Philippines – 2016

TOTAL REPORTED CASES   31, 160* highest at NCR-      98 % are males     – (28,701) mostly among MSM (males having sex with males), females – ( 2,448),majority bet 25-34 yrs old.    Total AIDS cases –   2,646

In the U.S. – HIV: by 2012 – 1,218, 400 Americans are infected

By now there are 1,210,835 m dx with AIDS ( www.cdc.gov       aids.gov )

If massive condom distribution through schools to the young people in the US have not prevented rapid spread of HIV AIDS, why will we copy this program in our country?

  • American educators and groups have activated their Abstinence and Self mastery program because they have realized that risk elimination is definitely better than simply risk reduction

Abstinence and True love Waits programs were launched and strengthened by responsible groups which were presented in a conference on Bioethics for the Third Milleneum held in Buffalo New York.

  • fidelity and abstinence are in fact NOT faith-based AIDS prevention but   EVIDENCE-BASED. ( 2010 Ethics Medics).
  • Affirming Love, Avoiding AIDS What Africa can teach the West published in 2010. ( Matthew Hanley and Jokin De Irala )
  • MATERNAL MORTALITY RATE( MMR): What is the factual data?

From the 1940s to the 1990’s inspite of limited budget the Infant and maternal mortality rates in the Philippines has been progressively coming down. So we have been wondering about the incredible figures constantly floated in media for the advocacy of certain groups…

  • 500,000 annual maternal deaths???“abortion advocates have been using this figure for more than 4 decades to promote their version of maternal…health policy…”This figure is constantly being floated in media, however –
  • The   Lancet, a British medical   journal published in 2010 an Institute of Health Metrics Evaluation (IHME) study refuted this highly controversial data which has long been questioned even by various groups in the U.S.

Furthermore, at the time that media and DOH have been floating the figure of 162 per 100,000, the DOH website in 2004 – 2005   showed the MMR at 1.1per thousand.

  • The formula used in computing for Maternal Mortality by Main Cause is – Number & Rate/1000 Livebirths per year

Then suddenly at the height of the RH advocacy, they announced a Family Health Survey showing an MMR of 221/per 100,000?? When this was reviewed the data gathering and the above formula were not used in coming up with this figure.

  • Close to the actual figure provided in the DOH website and more credible is the study supported by a Grant from Bill and Melinda Gates Foundation   entitled – Maternal Mortality for 181 countries: 1980 to 2008: a Systematic Analysis of Progress towards the MDG –by Margaret C. Hogan, et al.The MMR of the Philippines in this study was – 84/ 100,000.   We invite responsible health providers to read this extensive research work in public health.
  • By 2009, the DOH reported in its website the Number & Rate/1000 Livebirthsas 9 per thousand, close to the study of Hogan ,et al as mentioned earlier.

On May 16, 2011, DOCS audit Maternal death rate was featured in Philippine Daily Inquirer which disclosed that in a meeting held in Baguio city, Secretary Enrique Ona supported the audit being done by the doctors of DOH of the country’s maternal deaths after discovering discrepancies due to different measurement standards used by government and private hospitals.

Finally the another figure came out in May 2014 – as announced by the Secretary of Health at the time Dr. Enrique Ona which was an MMR of 0.6 per thousand; then suddenly based on data being floated in media the figure went back to the Family Survey data this year??

The FREEDOM OF INFORMATION Executive Order No. 2, s. 2016        

  • We thank you for this piece of legislation which strengthens the right of EVERYONE to CORRECT, FACTUAL, AND TRUTHFUL INFORMATION. This should not be applicable just on political and financial issues of Government but likewise on health issues and information disseminated and pertinent to health care.
  • Among the Rights of Patients listed by World Medical Association Declaration of Rights of the Patient which is upheld by the DOH are the following:
  • Right to medical care of good quality,
  • Right to information,
  • Right to health education,
  • Right to freedom of choice, Right to dignity ,
  • Right to religious assistance,
  • Right not to undergo procedures against the patients’ will.

**This is posted in all Philhealth accredited hospitals.

The top 3 causes of death in this country are

            1- Diseases of the Heart,

            2- Diseases of the Vascular System and

            3- Malignancies and among women the most common is Breast Cancer.

  • From the DOH data in 2004 a total of 72,379 women died from these top 3 causes shouldn’t these be the focus of our concern? Please take note that these causes are also listed as serious adverse effects of the synthetic estrogen which is in the birth control pill.

ADVERSE DRUG REACTIONS or EFFECTS ( ADRs) of the PILL on the health of women:

ALL Women have the right to know these adverse effects especially the poor who have no easy access to appropriate treatment when they suffer from these ADRs. Some meta-analysis are the following:

Association between the current Use of Low dose Oral Contraceptives and Cardiovascular Arterial Disease: A Meta-Analysis

*Risk Of Arterial Thrombosis in Relation to Oral Contraceptives (RATIO) Study

Oral Contraceptives and the Risk of Ischemic Stroke

*Oral Contraceptive use as a Risk Factor for Developing Premenopausal Breast Cancer, A Meta-analysis–

In fact on July 29, 2005 from the The International Agency for Research on Cancer ( IARC ) of WHO PRESS RELEASE No 167 announced the following:

IARC MONOGRAPHS PROGRAMME FINDS COMBINED ESTROGEN PROGESTOGEN CONTRACEPTIVES AND MENOPAUSAL THERAPY ARE CARCINOGENIC TO HUMANS Group I Category

*Group 1 – category is used when there is sufficient evidence of carcinogenicity in humans

(Not nil as declared by on one of the authors from the senate before the Supreme Court comparing it to the use of the cell phone or the microwave!)

WOMEN’S RIGHTS? or WOMEN’S WOE? 

            Women rich or poor have the right to know. These pills are NOT treatment for disease but forms of family planning therefore all potential recipients have the right to know all these information because there are methods without ADRs. That is the requirement of informed decision and Autonomy- COMPLETE, CORRECT, TRUTHFUL and FACTUAL information. Inspite of these information if they still want to use them then at least when they get sick they know where it came from. 

WHO takes care of the poor patients who suffer from adverse effects ?

The SC commented that the government should be responsible for taking care of these women if they suffer from ADRs but as it is when that happens is they have to take care of themselves.

For example women who suffer from premature Hypertension because of BCPs have to buy their own medicines or just die from stroke and those implanted with Implanon are asked to pay    five thousand pesos ( php 5k) to have it removed if they can no longer bear the ADRs or adverse effects?! That is a women’s right protected?  

Overpopulation – FACT or Fancy?

   The SC recognized the population control agenda of RA 10354 

We invite you to look into 1– the document Kissengerreport2004.pdf an analysis of National Security Memorandum 200 ( NSSM 200) which was declassified in 1984. The analysis done by Brian Clowes,PhD shows the real agenda of this policy which targeted 13 developing countries including the Philippines. 2- Population Research Institute headed by Steven Mosher, (the first Fellow sent by Stanford to study China’s One Child Policy) at pri@pop.org . If we review UN data much of the Group of 8 Countries are suffering from demographic winter that is why they are in need of immigrant population to sustain their economy and provide manpower. These countries have actively contracepted and aborted so they are now suffering from the repercussions of this policy. As JULIAN SIMON, a well known demographer and economist expounds,“ It is not slower population growth that brings prosperity but rather it is PROSPERITY that SLOWS POPULATION GROWTH.

There is also a new science called CHAOS that reminds us that “POPULATIONCORRECTS ITSELF ”. How?? – will make interesting reading and study for the policy makers.   It also expounds that “Any specie that is actively being killed will eventually become extinct.”

Much of the overpopulation myth has been propagated by groups with racist agenda. The American Birth Control Review was started in 1917 by Margaret Sanger. She then launched     the ABC LEAGUE on NOV. 10, 1921 at the First ABC Conference in New York City. She targeted certain immigrant populations which she feels are undesirable and her work was largely lauded by her friends. She eventually changed the name to a more appealing term – Planned Parenthood Federation of America and to put an Asian face to it launched International Planned Parenthood (IPPF) in India in 1952. The local arm is Family Planning Organization of the Philippines (FPOP).

On the celebration of the 100th birthday of Margaret Sanger, Faye Waddleton, National President at the time proudly declared …we should be very proud of what we are and what our mission is. It is a very grand mission… abortion is only the tip of the icebergThe extreme application of this agenda has not stopped. Not too long ago IPPF has been exposed about the fact that they are selling baby parts of aborted babies for whatever reason.

Even a number of vaccines that is being produced are now derived from aborted fetal lines referred to as human diploid cells. Some scientists have recognized the repercussions of these on the health of children. This is worth OUR study especially by DOH. Take note that there are now litigations filed in the U.S. and Europe related to adverse effects on health of the current content and manner of vaccination. Japan, Belgium and France have stopped mandatory vaccination of certain vaccines. Our health officials should look into this. There is now a list of ethical and unethical vaccines. Parents and guardians must know.

ESTROGEN as Endocrine Environmental Disruptor or Endocrine Disruptor Compounds (EDCs)

The British, Japanese and American environmentalists have observed and reported the contamination of river beds with estrogen compounds which affect the gonads (reproductive organ) of the male fish. This is something that the British biochemist Dr. Edward Charles Dodds, who developed the synthetic estrogen on the British side predicted and was concerned about when he introduced this drug in the market in 1938 (a Nazi Doctor was the first to develop it Adolph F . Butenandt ). Unfortunately his recommendations on how this drug should be used prudently and with care to avoid contamination of the environment were not followed. These observations have already been documented by the research work of scientists from UP Los Banos e.g. Dr. Michelle Paraso, et al. They have found Laguna de Bay to be contaminated with this compound (17B- estradiol ( E2) and have documented the same effect on the gonads of the male fish that were studied. They have reported these to the DENR before but have not been attended to. We brought this up to the attention of Sec. Gina Lopez who invited our group during the consultation meeting with other groups. We hope that serious and sustained effort will be done to address this problem. There are now young and dynamic Environmental Engineers who have come home to serve our country. We hope they will be asked to help clean our waterways scientifically.  

***

Finally, respect for Religious Freedom was upheld by the SC decision –

Provisions of RA 10354 which violates religious freedom were also declared as unconstitutional namely Section 23(a)(3), Section 23 Punishable Acts (a)(1), Section 23 (b) and the corresponding provision in the IRR, particularly Section 5.24.

Mr. President, we thank you for finding time to read our concerns. We hope that we were able to bring to your attention that what we are after is for the RH Law to respect the Right to Life, the right to correct, factual and truthful information so that women can make a genuine Informed Decision and Autonomy, the right to Religious freedom, and the right of conscience.

We will unceasingly pray that you as the father of our nation continuously protect the poor and the marginalized, most especially the most fragile segment of our society: the unborn.

Respectfully yours,

For Doctors for Life, Philippines ( SGD)

DOLORES OCTAVIANO, MD, FPCP, FPSEM
Chair, Committee on Advocacy
Head Section of Endocrinology
St. Paul’s Hospital, Iloilo  

ELEANOR B. PALABYAB,MD,FPOGS
President
Assoc. Prof Davao Medical School

REYNALDO J. ECHAVEZ, M.D
Co Chair Committee on Advocacy
Former Governor Philippine Medical Asstn.

BENITO V. SUNGA, M.D,FPCS, FPUA
VP for Luzon
St. Louie University, Baguio

ANGELITA MIGUEL-AGUIRRE,MD,FPCP
Advisory Board
Professor of Medicine & Bioethics UST FMS

RENE C. BULLECER, MD
VP for Visayas
AIDS FREE Philippines, Cebu

ORESTES MONZON, MD, FPCR
Advisory Board
Philippine Heart Center  

THERESE BORROMEO- LUMICAO MD, FPSMS, DPPS
VP for Mindanao
Servwide, Cagayan De Oro

LIGAYA ACOSTA, PhD
Advisory Board
Human Life Intl, Asia & Oceania

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