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Real concern for women makes RH opposition a no-brainer for doctor

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MANILA, Oct. 8, 2012—Since preserving the health of patients and administering no harmful methods of treatment are part of the Hippocratic oath, a medical doctor openly expressed her opposition to any legislative measure that goes against this, particularly the reproductive health (RH) bill.

“There are many provisions in the RH bill that I will personally contest but from the medical point of view,  sigurado ang talagang labag sa kalooban ko ay to give something that will harm my patients,” said Liza C. Manalo, M.D., head of the Cancer Center of  The Medical City, Pasig City.

First, do no harm

Manalo pointed out that the number one bioethical principle for doctors and other health professionals is “Do good, avoid harm.”

Dr. Liza C. Manalo

“First, do no harm. Posibleng hindi mo mapagaling ang pasyente mo dahil sa sakit niya – cancer, for example. Gusto ko mang gumaling ang lahat ng pasyente ko from cancer…  talagang tatanggapin natin na may mga sakit na malala na [at] hindi na kayang pagalingin ng mga duktor,” Manalo explained.

Pero hindi ko man ikaw kayang pagalingin, ayoko namang ako ang maging dahilan kung bakit ka nagkasakit, and worse, ako ang dahilan kung bakit ka namatay. And in fact, when you require doctors to prescribe artificial contraceptives, that’s practically what you’re asking the doctors to do. To give a drug that I know for a fact can harm the health of my patients,” the Palliative Care specialist pointed out.

Manalo, who has spent years dealing with and treating women in poor communities in and outside Metro Manila, said that even unschooled folks have a clue as to the physical harm that taking hormonal contraceptives brings.

Birth control pills = steroids

Artificial contraceptives belong to the group of medicines called “steroids,” Manalo said, and when she informs her patients about this, many of them recognize the danger right away.

“Actually, sometimes simple folks understand immediately, and say, ‘Steroids, dok? Bibigyan mo ako? Di ba delikado yon?’ They know already that steroids are not given just like that… unnecessarily and unless the need to cure a medical condition outweighs the side effects,” she said.

Steroids are derived from a substance called “cholesterol,” the cancer specialist continued, adding that this often elicits a significant reaction even from ordinary people: “’Ha? Cholesterol? Di ba nakabalot sa puso yon?’ So somehow they understand it, and knowing if that’s the kind of substance in pills, you will understand why the side effects are like that.  Kasi nga steroidal siya, derived from cholesterol ang chemical structure niya. The effects are primarily on the cardiovascular system.”

Healthy women suddenly experiencing serious conditions

Manalo enumerated blood clot, heart attack, thromboembolism, and pulmonary embolism as among the consequences that have commonly been seen in women for years as early as the 1960s.

“Thromboembolism, that’s the most common result in the 1960s when the pill was starting in distribution. Right away that’s the number one side effect of contraceptive pills that they were able to document,” she said.

“In fact, cancer came later; it’s thrombo-embolism that was causing the death of women – young people, previously well, walang sakit, bigla na lang dadating sa emergency room, ang taas-taas ng blood pressure, tapos ang diagnosis either heart attack or stroke,” the physician lamented.

House Bill 4244 and Senate Bill 2865 – often touted as a pro-women measure – proposes the pouring of billions of pesos in taxpayers’ money into the procurement and distribution of contraceptive drugs and devices, along with other supplies, procedures and programs considered part of “reproductive health care.”

Last year, the bill’s co-author Sen. Pia Cayetano revealed that the Department of Health (DOH) is asking for P13.7 billion for the bill’s implementation in 2012 alone, and continued to endorse the measure despite scientific studies and a warning from the International Agency for Research on Cancer (IARC) about Class 1 carcinogenicity of oral contraceptives.

“So as a doctor I will not do any harm consciously with full knowledge and full consent,” Manalo reiterated. “And I know that these artificial contraceptives are harmful, period. No ifs or buts. All they have to do is to check the literature.” (CBCP for Life)


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