SUBSTANTIVE ISSUES:

1. The Court cannot subscribe to the theory advocated by Hon. Lagman that
life begins at implantation. According to him, “fertilization and
conception are two distinct and successive stages in the reproductive
process. They are not identical and synonymous.” Citing a letter of the
WHO, he wrote that medical authorities confirm that the implantation of
the fertilized ovum is the commencement of conception and it is only
after implantation that pregnancy can be medically detected. This theory
of implantation as the beginning of life is devoid of any legal or scientific
mooring. It does not pertain to the beginning of life but to the viability of
the fetus. The fertilized ovum/zygote is not an inanimate object – it is a
living human being complete with DNA and 46 chromosomes.
Implantation has been conceptualized only for convenience by those who
had population control in mind. To adopt it would constitute textual
infidelity not only to the RH Law but also to the Constitution. It is the
Court’s position that life begins at fertilization, not at implantation.
When a fertilized ovum is implanted in the uterine wall, its viability
is sustained but that instance of implantation is not the point of
beginning of life.

2. RIGHT OF HEALTH-A component to the right to life is the

constitutional right to health. In this regard, the Constitution is replete
with provisions protecting and promoting the right to health. These
provisions are self-executing. Unless the provisions clearly express the
contrary, the provisions of the Constitution should be considered self-
executory. There is no need for legislation to implement these self-
executing provisions. In Manila Prince Hotel v. GSIS, it was stated:
1. x x x Hence, unless it is expressly provided that a legislative
act is necessary to enforce a constitutional mandate, the
presumption now is that all provisions of the constitution are
self-executing. If the constitutional provisions are treated as
requiring legislation instead of self-executing, the
legislature would have the power to ignore and practically
 nullify the mandate of the fundamental law. This can be
cataclysmic. That is why the prevailing view is, as it has
always been, that –… in case of doubt, the Constitution should
be considered self-executing rather than non-self-executing. .
..

2. Unless the contrary is clearly intended, the provisions of the

Constitution should be considered self-executing, as a
contrary rule would give the legislature discretion to
determine when, or whether, they shall be effective. These
provisions would be subordinated to the will of the lawmaking
body, which could make them entirely meaningless by simply
refusing to pass the needed implementing statute.

3. It is not within the province of the Court to determine whether the use of
contraceptives or one’s participation in the support of modem
reproductive health measures is moral from a religious standpoint or
whether the same is right or wrong according to one’s dogma or
belief. For the Court has declared that matters dealing with “faith,
practice, doctrine, form of worship, ecclesiastical law, custom and
rule of a church … are unquestionably ecclesiastical matters which
are outside the province of the civil courts.” The jurisdiction of the
Court extends only to public and secular morality. Whatever
pronouncement the Court makes in the case at bench should be
understood only in this realm where it has authority. Stated otherwise,
while the Court stands without authority to rule on ecclesiastical matters,
as vanguard of the Constitution, it does have authority to determine
whether the RH Law contravenes the guarantee of religious freedom.
Consequently, the petitioners are misguided in their supposition that the
State cannot enhance its population control program through the RH Law
simply because the promotion of contraceptive use is contrary to their
religious beliefs. Indeed, the State is not precluded to pursue its legitimate
secular objectives without being dictated upon by the policies of any one
religion. One cannot refuse to pay his taxes simply because it will cloud
 his conscience. The demarcation line between Church and State
demands that one render unto Caesar the things that are Caesar’s
and unto God the things that are God’s. The Court is of the view 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
(Commissioner Bernas) has written, “at the basis of the free exercise
clause is the respect for the inviolability of the human conscience.
1. The Court is of the strong view that the religious freedom of health
providers, whether public or private, should be accorded primacy.
Accordingly, a conscientious objector should be exempt from
compliance with the mandates of the RH Law. If he would be
compelled to act contrary to his religious belief and conviction, it
would be violative of “the principle of non-coercion” enshrined in the
constitutional right to free exercise of religion.
2. The same holds true with respect to non-maternity specialty hospitals
and hospitals owned and operated by a religious group and health care
service providers. Considering that Section 24 of the RH Law
penalizes such institutions should they fail or refuse to comply with
their duty to refer under Section 7 and Section 23(a)(3), the Court
deems that it must be struck down for being violative of the freedom
of religion.
3. The same applies to Section 23(a)(l) and (a)(2) in relation to Section
24, considering that in the dissemination of information regarding
programs and services and in the performance of reproductive health
procedures, the religious freedom of health care service providers
should be respected. 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.
4. The State cannot, without a compelling state interest, take over the role
of parents in the care and custody of a minor child, whether or not the
 latter is already a parent or has had a miscarriage. Only a compelling
state interest can justify a state substitution of their parental authority.
5. Any attack on the validity of Section 14 of the RH Law
is premature because the Department of Education, Culture and Sports
has yet to formulate a curriculum on age-appropriate reproductive health
education. One can only speculate on the content, manner and medium of
instruction that will be used to educate the adolescents and whether they
will contradict the religious beliefs of the petitioners and validate their
apprehensions. Thus, considering the premature nature of this particular
issue, the Court declines to rule on its constitutionality or validity.
6. A statute or act suffers from the defect of vagueness when it lacks
comprehensible standards that men of common intelligence must
necessarily guess its meaning and differ as to its application. It is
repugnant to the Constitution in two respects: (1) it violates due process
for failure to accord persons, especially the parties targeted by it, fair
notice of the conduct to avoid; and (2) it leaves law enforcers unbridled
discretion in carrying out its provisions and becomes an arbitrary flexing
of the Government muscle. Moreover, in determining whether the words
used in a statute are vague, words must not only be taken in accordance
with their plain meaning alone, but also in relation to other parts of the
statute. It is a rule that every part of the statute must be interpreted with
reference to the context, that is, every part of it must be construed together
with the other parts and kept subservient to the general intent of the whole
enactment.
7. To provide that the poor are to be given priority in the government’s
reproductive health care program is not a violation of the equal protection
clause. In fact, it is pursuant to Section 11, Article XIII of the Constitution
which recognizes the distinct necessity to address the needs of the
underprivileged by providing that they be given priority in addressing the
health development of the people. Thus: Section 11. The State shall adopt
an integrated and comprehensive approach to health development which
shall endeavor to make essential goods, health and other social services
available to all the people at affordable cost. There shall be priority for
the needs of the underprivileged, sick, elderly, disabled, women, and
children. The State shall endeavor to provide free medical care to
paupers. It should be noted that Section 7 of the RH Law prioritizes poor
 and marginalized couples who are suffering from fertility issues and
desire to have children. There is, therefore, no merit to the contention
that the RH Law only seeks to target the poor to reduce their
number. While the RH Law admits the use of contraceptives, it does not,
as elucidated above, sanction abortion. As Section 3(1) explains, the
“promotion and/or stabilization of the population growth rate is incidental
to the advancement of reproductive health.”
8. The notion of involuntary servitude connotes the presence of force,
threats, intimidation or other similar means of coercion and compulsion.
A reading of the assailed provision, however, reveals that it only
encourages private and non- government reproductive healthcare service
providers to render pro bono service. Other than non-accreditation with
PhilHealth, no penalty is imposed should they choose to do otherwise.
Private and non-government reproductive healthcare service providers
also enjoy the liberty to choose which kind of health service they wish to
provide, when, where and how to provide it or whether to provide it all.
Clearly, therefore, no compulsion, force or threat is made upon them
to render pro bono service against their will. While the rendering of
such service was made a prerequisite to accreditation with
PhilHealth, the Court does not consider the same to be an
unreasonable burden, but rather, a necessary incentive imposed by
Congress in the furtherance of a perceived legitimate state interest.
Consistent with what the Court had earlier discussed, however, it should
be emphasized that conscientious objectors are exempt from this
provision as long as their religious beliefs and convictions do not allow
them to render reproductive health service, pro bona or otherwise.
9. The Court finds nothing wrong with the delegation. The FDA does not
only have the power but also the competency to evaluate, register and
cover health services and methods. It is the only government entity
empowered to render such services and highly proficient to do so. It
should be understood that health services and methods fall under the
gamut of terms that are associated with what is ordinarily understood as
“health products.” Being the country’s premiere and sole agency that
ensures the safety of food and medicines available to the public, the
FDA was equipped with the necessary powers and functions to make
it effective. Pursuant to the principle of necessary implication, the
 mandate by Congress to the FDA to ensure public health and safety by
permitting only food and medicines that are safe includes “service” and
“methods.” From the declared policy of the RH Law, it is clear that
Congress intended that the public be given only those medicines that are
proven medically safe, legal, non-abortifacient, and effective in
accordance with scientific and evidence-based medical research
standards. The philosophy behind the permitted delegation was explained
in Echagaray v. Secretary of Justice, as follows:
1. The reason is the increasing complexity of the task of the
government and the growing inability of the legislature to
cope directly with the many problems demanding its attention.
The growth of society has ramified its activities and created
peculiar and sophisticated problems that the legislature
cannot be expected reasonably to comprehend. Specialization
even in legislation has become necessary. To many of the
problems attendant upon present day undertakings, the
legislature may not have the competence, let alone the interest
and the time, to provide the required direct and efficacious,
not to say specific solutions.

10. A reading of the RH Law clearly shows that whether it pertains to the
establishment of health care facilities, the hiring of skilled health
professionals, or the training of barangay health workers, it will be the
national government that will provide for the funding of its
implementation. Local autonomy is not absolute. The national
government still has the say when it comes to national priority programs
which the local government is called upon to implement like the RH Law.