Imbong vs Ochoa

Facts: Despite calls to withhold support thereto, however, Republic Act (R.A.) No. 10354, otherwise known as the
Responsible Parenthood and Reproductive Health Act of 2012 (RH Law),was enacted by Congress on December 21,
2012. Shortly after the President placed his imprimatur  on the said law, challengers from various sectors of society
came knocking on the doors of the Court, beckoning it to wield the sword that strikes down constitutional
disobedience. Aware of the profound and lasting impact that its decision may produce, the Court now faces the iuris
controversy as presented in fourteen (14) petitions and two (2) petitions-in-intervention. A perusal of the foregoing
petitions shows that the petitioners are assailing the constitutionality of RH Law on the following
GROUNDS:
•   The RH Law violates the right to life of the unborn. According to the petitioners, the
implementation of the RH Law would authorize the purchase of hormonal
contraceptives, intra-uterine devices and injectables which are abortives, in violation of
Section 12, Article II of the Constitution which guarantees protection of both the life of
the mother and the life of the unborn from conception.
•   The RH Law violates the right to health and the right to protection against hazardous
products. The petitioners posit that the RH Law provides universal access to
contraceptives which are hazardous to one's health, as it causes cancer and other
health problems.
•   The RH Law violates the right to religious freedom. The petitioners contend that the RH
Law violates the constitutional guarantee respecting religion as it authorizes the use of
public funds for the procurement of contraceptives. For the petitioners, the use of public
funds for purposes that are believed to be contrary to their beliefs is included in the
constitutional mandate ensuring religious freedom. It is also contended that the RH
Law threatens conscientious objectors of criminal prosecution, imprisonment and other
forms of punishment, as it compels medical practitioners 1] to refer patients who seek
advice on reproductive health programs to other doctors; and 2] to provide full and
correct information on reproductive health programs and service, although it is against
their religious beliefs and convictions. In this connection, Section 5.23 of the
Implementing Rules and Regulations of the RH Law (RH-IRR), provides that skilled
health professionals who are public officers cannot be considered as
conscientious objectors. It is also argued that the RH Law providing for the
formulation of mandatory sex education in schools should not be allowed as it is an
affront to their religious beliefs. 
•   The RH Law violates the constitutional provision on involuntary servitude. According to the
petitioners, the RH Law subjects medical practitioners to involuntary servitude because,
to be accredited under the PhilHealth program, they are compelled to provide forty-eight
(48) hours of pro bono services for indigent women, under threat of criminal
prosecution, imprisonment and other forms of punishment.
•   The RH Law violates the right to equal protection of the law. It is claimed that the RH
Law discriminates against the poor as it makes them the primary target of the
government program that promotes contraceptive use. The petitioners argue that, rather
than promoting reproductive health among the poor, the RH Laws eeks to introduce
contraceptives that would effectively reduce the number of the poor.
•   The RH Law is "void-for-vagueness" in violation of the due process clause of
the Constitution. In imposing the penalty of imprisonment and/or fine for "any
violation," it is vague because it does not define the type of conduct to be treated as
"violation" of the RH Law.
   In this connection, it is claimed that "Section 7 of the RH Law violates the right to due process
by removing from them (the people) the right to manage their own affairs and to decide
what kind of health facility they shall be and what kind of services they shall offer."  It
ignores the management prerogative inherent in corporations for employers to conduct
their affairs in accordance with their own discretion and judgment. 
•   The RH Law violates the right to free speech. To compel a person to explain a full range of
family planning methods is plainly to curtail his right to expound only his own preferred
way of family planning. The petitioners note that although exemption is granted to
 institutions owned and operated by religious groups, they are still forced to refer their
patients to another healthcare facility willing to perform the service or procedure.
•   The RH Law intrudes into the zone of privacy of one's family protected by the Constitution.
It is contended that the RH Law providing for mandatory reproductive health education
intrudes upon their constitutional right to raise their children in accordance with their
beliefs. 
   It is claimed that, by giving absolute authority to the person who will undergo reproductive
health procedure, the RH Law forsakes any real dialogue between the spouses and
impedes the right of spouses to mutually decide on matters pertaining to the overall
well-being of their family. In the same breath, it is also claimed that the parents of a
child who has suffered a miscarriage are deprived of parental authority to determine
whether their child should use contraceptives
The respondents, aside from traversing the substantive arguments of the petitioners, pray for the
dismissal of the petitions for the principal reasons that 1] there is no actual case or controversy and, therefore,
the issues are not yet ripe for judicial determination.;2] same petitioners lack standing to question the RH Law;
and 3] the petitions are essentially petitions for declaratory relief over which the Court has no original
jurisdiction. 
Meanwhile, on March 15, 2013, the RH-IRR for the enforcement of the assailed legislation took effect.
On March 19, 2013, after considering the issues and arguments raised, the Court issued the Status
Quo Ante Order (SQAO), enjoining the effects and implementation of the assailed legislation for a period of one
hundred and twenty (120) days, or until July 17, 2013. 
Issues: Whether the RH law is unconstitutional:
1]  Right to Life
2]  Right to Health
3]  Freedom of Religion and the Right to Free Speech
4]  The Family
5]  Freedom of Expression and Academic Freedom
6]  Due Process
7]  Equal Protection
8]  Involuntary Servitude

Held: 1. RIGHT TO LIFE: Black's Law Dictionary gives legal meaning to the term "conception" as the fecundation of
the female ovum by the male spermatozoon resulting in human life capable of survival and maturation under normal
conditions.
Records of the Constitutional Convention also shed light on the intention of the Framers regarding the
term "conception" used in Section 12, Article II of the Constitution. From their deliberations, it clearly refers to the
moment of "fertilization."
From the deliberations above-quoted, it is apparent that the Framers of the Constitution emphasized
that the State shall provide equal protection to both the mother and the unborn child from the earliest
opportunity of life,that is, upon fertilization or upon the union of the male sperm and the female ovum. It is
also apparent is that the Framers of the Constitution intended that to prohibit Congress from enacting
measures that would allow it determine when life begins.
Equally apparent, however, is that the Framers of the Constitution did not intend to ban all
contraceptives for being unconstitutional. In fact, Commissioner Bernardo Villegas, spearheading the need to
have a constitutional provision on the right to life, recognized that the determination of whether a contraceptive
device is an abortifacient is a question of fact which should be left to the courts to decide on based on established
evidence. From the discussions above, contraceptives that kill or destroy the fertilized ovum should be
deemed an abortive and thus prohibited. Conversely, contraceptives that actually prevent the union of the
male sperm and the female ovum, and those that similarly take action prior to fertilization should be
deemed non-abortive, and thus, constitutionally permissible. 
In all, whether it be taken from a plain meaning, or understood under medical parlance, and more
importantly, following the intention of the Framers of the Constitution, the undeniable conclusion is that a zygote is
a human organism and that the life of a new human being commences at a scientifically well-defined moment of
conception, that is, upon fertilization.
 Contrary to the assertions made by the petitioners, the Court finds that the RH Law, consistent with
the Constitution, recognizes that the fertilized ovum already has life and that the State has a bounden duty
to protect it. The conclusion becomes clear because the RH Law,  first, prohibits any drug or device that
induces abortion (first kind),which, as discussed exhaustively above, refers to that which induces the killing or the
destruction of the fertilized ovum, and, second, prohibits any drug or device the fertilized ovum to reach and be
implanted in the mother's womb (third kind).
By expressly declaring that any drug or device that prevents the fertilized ovum to reach and be
implanted in the mother's womb is an abortifacient (third kind), the RH Law does not intend to mean at all that life
only begins only at implantation, as Hon. Lagman suggests. It also does not declare either that protection will
only be given upon implantation, as the petitioners likewise suggest. Rather, it recognizes that: one, there is a
need to protect the fertilized ovum which already has life, and two, the fertilized ovum must be protected
the moment it becomes existent — all the way until it reaches and implants in the mother's womb. After
all, if life is only recognized and afforded protection from the moment the fertilized ovum implants — there is
nothing to prevent any drug or device from killing or destroying the fertilized ovum prior to implantation. DTAHEC
From the foregoing, the Court finds that inasmuch as it affords protection to the fertilized ovum, the  RH
Law does not sanction abortion. To repeat, 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. It started earlier. And as defined by the RH Law, any drug or
device that induces abortion, that is, which kills or destroys the fertilized ovum or prevents the fertilized
ovum to reach and be implanted in the mother's womb, is an abortifacient.
2. RIGHT TO HEALTH: The legislative intent in the enactment of the RH Law in this regard is to leave intact the
provisions of R.A. No. 4729. There is no intention at all to do away with it. It is still a good law and its requirements
are still in to be complied with. Thus, the Court agrees with the observation of respondent Lagman that the effectivity
of the RH Law will not lead to the unmitigated proliferation of contraceptives since the sale, distribution and
dispensation of contraceptive drugs and devices will still require the prescription of a licensed physician. With R.A.
No. 4729 in place, there exists adequate safeguards to ensure the public that only contraceptives that are safe
are made available to the public.
Thus, in the distribution by the DOH of contraceptive drugs and devices, it must consider the provisions
of R.A. No. 4729, which is still in effect, and ensure that the contraceptives that it will procure shall be from a duly
licensed drug store or pharmaceutical company and that the actual dispensation of these contraceptive drugs
and devices will done following a prescription of a qualified medical practitioner. The distribution of contraceptive
drugs and devices must not be indiscriminately done. The public health must be protected by all possible means.
As pointed out by Justice De Castro, a heavy responsibility and burden are assumed by the government in
supplying contraceptive drugs and devices, for it may be held accountable for any injury, illness or loss
of life resulting from or incidental to their use.
Stated differently, the provision in Section 9 covering the inclusion of hormonal contraceptives, intra-
uterine devices, injectables, and other safe, legal, non-abortifacient and effective family planning products and
supplies by the National Drug Formulary in the EDL is not mandatory. There must first be a determination by the
FDA that they are in fact safe, legal, non-abortifacient and effective family planning products and supplies. There
can be no predetermination by Congress that the gamut of contraceptives are "safe, legal, non-abortifacient and
effective" without the proper scientific examination. 

3. FREEDOM OF RELIGION AND THE RIGHT TO FREE SPEECH: Verily, the principle of separation of Church
and State is based on mutual respect. Generally, the State cannot meddle in the internal affairs of the church,
much less question its faith and dogmas or dictate upon it. It cannot favor one religion and discriminate against
another. On the other hand, the church cannot impose its beliefs and convictions on the State and the rest of the
citizenry. It cannot demand that the nation follow its beliefs, even if it sincerely believes that they are good for the
country.
Consistent with the principle that not any one religion should ever be preferred over another,
the Constitution in the above-cited provision utilizes the term "church" in its generic sense, which refers to a
temple, a mosque, an iglesia, or any other house of God which metaphorically symbolizes a religious
organization. Thus, the "Church" means the religious congregations collectively.
Balancing the benefits that religion affords and the need to provide an ample barrier to protect the State
from the pursuit of its secular objectives, the Constitution lays down the following mandate in Article III, Section 5
and Article VI, Section 29 (2), of the 1987 Constitution: 
 In short, the constitutional assurance of religious freedom provides two guarantees: the Establishment
Clause and the  Free Exercise Clause.
The establishment clause "principally prohibits the State from sponsoring any religion or favoring any
religion as against other religions. It mandates a strict neutrality in affairs among religious groups."  Essentially, it
prohibits the establishment of a state religion and the use of public resources for the support or prohibition of a
religion.
On the other hand, the basis of the free exercise clause is the respect for the inviolability of the human
conscience. Under this part of religious freedom guarantee, the State is prohibited from unduly interfering with
the outside manifestations of one's belief and faith. Explaining the concept of religious freedom, the Court,
in  Victoriano v. Elizalde Rope Workers Union wrote:
The constitutional provisions not only prohibits legislation for the support of any religious
tenets or the modes of worship of any sect, thus forestalling compulsion by law of the acceptance
of any creed or the practice of any form of worship (U.S. Ballard, 322 U.S. 78, 88 L. ed. 1148,
1153),but also assures the free exercise of one's chosen form of religion within limits of
utmost amplitude. It has been said that the religion clauses of the Constitution are all 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. Any legislation whose effect or purpose
is to impede the observance of one or all religions, or to discriminate invidiously between
the religions, is invalid, even though the burden may be characterized as being only
indirect.(Sherbert v. Verner,374 U.S. 398, 10 L.ed.2d 965, 83 S. Ct. 1970) But if the state
regulates conduct by enacting, within its power, a general law which has for its purpose and
effect to advance the state's secular goals, the statute is valid despite its indirect burden on
religious observance, unless the state can accomplish its purpose without imposing such
burden. (Braunfeld v. Brown,
As expounded in  Escritor,
The establishment and free exercise clauses were not designed to serve contradictory
purposes. They have a single goal — to promote freedom of individual religious beliefs and
practices. In simplest terms, the free exercise clause prohibits government from inhibiting
religious beliefs with penalties for religious beliefs and practice, while the establishment clause
prohibits government from inhibiting religious belief with rewards for religious beliefs and
practices. In other words, the two religion clauses were intended to deny government the power
to use either the carrot or the stick to influence individual religious beliefs and practices.
Corollary to the guarantee of free exercise of one's religion is the principle that the guarantee of
religious freedom is comprised of two parts: the freedom to believe, and the freedom to act on one's
belief. The first part is absolute. As explained in Gerona v. Secretary of Education:
The realm of belief and creed is infinite and limitless bounded only by one's
imagination and thought. So is the freedom of belief, including religious belief, limitless
and without bounds. One may believe in most anything, however strange, bizarre and
unreasonable the same may appear to others, even heretical when weighed in the scales of
orthodoxy or doctrinal standards. But between the freedom of belief and the exercise of said
belief, there is quite a stretch of road to travel.
The second part however, is limited and subject to the awesome power of the State and can be
enjoyed only with proper regard to the rights of others. It is "subject to regulation where the belief
is translated into external acts that affect the public welfare.”
Legislative Acts and the Free Exercise Clause
Thus, in case of conflict between the free exercise clause and the State, the Court adheres to
the doctrine of benevolent neutrality. This has been clearly decided by the Court in Estrada v. Escritor,
(Escritor) where it was stated "that benevolent neutrality-accommodation, whether mandatory or permissive, is
the spirit, intent and framework underlying the Philippine Constitution." In the same case, it was further explained
that"
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.
"The purpose of accommodation is to remove a burden on, or facilitate the exercise of, a
 person's or institution's religion." "What is sought under the theory of accommodation is not a
declaration of unconstitutionality of a facially neutral law, but an exemption from its application or
its 'burdensome effect,' whether by the legislature or the courts." 
In ascertaining the limits of the exercise of religious freedom, the compelling state interest test is
proper. Underlying the compelling state interest test is the notion that free exercise is a fundamental right and
that laws burdening it should be subject to strict scrutiny. In  Escritor,it was written:
Philippine jurisprudence articulates several tests to determine these limits. Beginning
with the first case on the Free Exercise Clause,  American Bible Society, the Court mentioned
the "clear and present danger" test but did not employ it. Nevertheless, this test continued to
be cited in subsequent cases on religious liberty. The Gerona  case then pronounced that the test
of permissibility of religious freedom is whether it violates the established institutions of society
and law. The Victoriano case mentioned the "immediate and grave danger" test as well as the
doctrine that a law of general applicability may burden religious exercise provided the law is the
least restrictive means to accomplish the goal of the law. The case also used, albeit
inappropriately, the "compelling state interest" test. After Victoriano, German went back to
the Gerona rule. Ebralinag then employed the "grave and immediate danger" test and
overruled the Gerona test. The fairly recent case of Iglesia ni Cristo went back to the "clear and
present danger" test in the maiden case of American Bible Society. Not surprisingly, all the
cases which employed the "clear and present danger" or "grave and immediate danger"
test involved, in one form or another, religious speech as this test is often used in cases
on freedom of expression. On the other hand, the Gerona and German cases set the rule that
religious freedom will not prevail over established institutions of society and law. Gerona,
however, which was the authority cited by German has been overruled by Ebralinag which
employed the "grave and immediate danger" test. Victoriano was the only case that employed
the "compelling state interest" test, but as explained previously, the use of the test was
inappropriate to the facts of the case. 
The case at bar does not involve speech as in  American Bible Society,
Ebralinag and Iglesia ni Cristo where the "clear and present danger" and "grave and
immediate danger" tests were appropriate as speech has easily discernible or immediate
effects. The Gerona and German doctrine, aside from having been overruled, is not congruent
with the benevolent neutrality approach, thus not appropriate in this jurisdiction. Similar
to Victoriano, the present case involves purely conduct arising from religious belief. The
"compelling state interest" test is proper where conduct is involved for the whole gamut
of human conduct has different effects on the state's interests: some effects may be
immediate and short-term while others delayed and far-reaching.A test that would protect
the interests of the state in preventing a substantive evil, whether immediate or delayed, is
therefore necessary. However, not any interest of the state would suffice to prevail over the right
to religious freedom as this is a fundamental right that enjoys a preferred position in the hierarchy
of rights — "the most inalienable and sacred of all human rights", in the words of Jefferson. This
right is sacred for an invocation of the Free Exercise Clause is an appeal to a higher sovereignty.
The entire constitutional order of limited government is premised upon an acknowledgment of
such higher sovereignty, thus the Filipinos implore the "aid of Almighty God in order to build a
just and humane society and establish a government." As held in Sherbert, only the gravest
abuses, endangering paramount interests can limit this fundamental right. A mere balancing of
interests which balances a right with just a colorable state interest is therefore not appropriate.
Instead, only a compelling interest of the state can prevail over the fundamental right to
religious liberty. The test requires the state to carry a heavy burden, a compelling one, for
to do otherwise would allow the state to batter religion, especially the less powerful ones
until they are destroyed. In determining which shall prevail between the state's interest
and religious liberty, reasonableness shall be the guide. The "compelling state interest"
serves the purpose of revering religious liberty while at the same time affording
protection to the paramount interests of the state.This was the test used in  Sherbert which
involved conduct, i.e.,refusal to work an Saturdays. In the end, the "compelling state interest"
test, by upholding the paramount interests of the state, seeks to protect the very state, without
which, religious liberty will not be preserved. [Emphases in the original. Underlining supplied.] 
The Court's Position
In the case at bench, it is not within the province of the Court to determine whether the use of
contraceptives or one's participation in the support of modern 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.
At first blush, it appears that the RH Law recognizes and respects religion and religious beliefs and
convictions. It is replete with assurances the no one can be compelled to violate the tenets of his religion or defy
his religious convictions against his free will.
While the Constitution prohibits abortion, laws were enacted allowing the use of contraceptives. To
some medical practitioners, however, the whole idea of using contraceptives is an anathema. Consistent with the
principle of benevolent neutrality, their beliefs should be respected. 
The Establishment Clause and Contraceptives
In the same breath that the establishment clause restricts what the government can do with
religion, it also limits what religious sects can or cannot do with the government. They can neither cause
the government to adopt their particular doctrines as policy for everyone, nor can they not cause the
government to restrict other groups. To do so, in simple terms, would cause the State to adhere to a
particular religion and, thus, establishing a state religion. 
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 Free Exercise Clause and the Duty to Refer
While the RH Law, in espousing state policy to promote reproductive health manifestly respects diverse
religious beliefs in line with the Non-Establishment Clause, the same conclusion cannot be reached with respect
to Sections 7, 23 and 24 thereof. The said provisions commonly mandate that 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.
In a situation where the free exercise of religion is allegedly burdened by government legislation or
practice, the compelling state interest test  in line with the Court's espousal of the Doctrine of Benevolent
Neutrality in  Escritor, finds application. In this case, the conscientious objector's claim to religious freedom would
warrant an exemption from obligations under the RH Law, unless the government succeeds in demonstrating a
more compelling state interest in the accomplishment of an important secular objective. Necessarily so, the plea
of conscientious objectors for exemption from the RH Law deserves no less than strict scrutiny.
In applying the test, the first inquiry is whether a conscientious objector's right to religious freedom has
been burdened. As in Escritor, there is no doubt that an intense tug-of-war plagues a conscientious objector.
One side coaxes him into obedience to the law and the abandonment of his religious beliefs, while the other
entices him to a clean conscience yet under the pain of penalty. The scenario is an illustration of the predicament
of medical practitioners whose religious beliefs are incongruent with what the RH Law promotes.
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 modern 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. 
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. 
Moreover, the guarantee of religious freedom is necessarily intertwined with the right to free speech, it
being an externalization of one's thought and conscience. This in turn includes the right to be silent. With the
constitutional guarantee of religious freedom follows the protection that should be afforded to individuals in
communicating their beliefs to others as well as the protection for simply being silent. The Bill of Rights
guarantees the liberty of the individual to utter what is in his mind and the liberty not to utter what is not
in his mind. While the RH Law seeks to provide freedom of choice through informed consent, freedom of
choice guarantees the liberty of the religious conscience and prohibits any degree of compulsion or
burden, whether direct or indirect, in the practice of one's religion. 
In case of conflict between the religious beliefs and moral convictions of individuals, on one hand, and
the interest of the State, on the other, to provide access and information on reproductive health products,
services, procedures and methods to enable the people to determine the timing, number and spacing of the birth
of their children, 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. 
Interestingly, on April 24, 2013, Scotland's Inner House of the Court of Session, found in the case
of Doogan and Wood v. NHS Greater Glasgow and Clyde Health Board, that the midwives claiming to be
conscientious objectors under the provisions of Scotland's Abortion Act of 1967, could not be required to
delegate, supervise or support staff on their labor ward who were involved in abortions. The Inner House stated
"that if 'participation' were defined according to whether the person was taking part 'directly' or 'indirectly' this
would actually mean more complexity and uncertainty."
While the said case did not cover the act of referral, the applicable principle was the same — they could
not be forced to assist abortions if it would be against their conscience or will.
Institutional Health Providers
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. The
same applies to Section 23 (a) (1) 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. 
In the case of Islamic Da'wah Council of the Philippines, Inc. v. Office of the Executive Secretary it was
stressed:
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."
The Court is not oblivious to the view that penalties provided by law endeavour 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.
This is discriminatory and violative of the equal protection clause. The conscientious objection clause
should be equally protective of the religious belief of public health officers. There is no perceptible distinction why
they should not be considered exempt from the mandates of the law. The protection accorded to other
conscientious objectors should equally apply to all medical practitioners without distinction whether
they belong to the public or private sector. After all, the freedom to believe is intrinsic in every individual
and the protective robe that guarantees its free exercise is not taken off even if one acquires employment in
the government. 
It should be stressed that intellectual liberty occupies a place inferior to none in the hierarchy of human
values. The mind must be free to think what it wills, whether in the secular or religious sphere, to give expression
to its beliefs by oral discourse or through the media and, thus, seek other candid views in occasions or
gatherings or in more permanent aggrupation. Embraced in such concept then are freedom of religion, freedom
of speech, of the press, assembly and petition, and freedom of association. 
The discriminatory provision is void not only because no such exception is stated in the RH Law itself
but also because it is violative of the equal protection clause in the Constitution.
Compelling State Interest
The foregoing discussion then begets the question on whether the respondents, in defense of the
subject provisions, were able to: 1] demonstrate a more compelling state interest to restrain conscientious
objectors in their choice of services to render; and 2] discharge the burden of proof that the obligatory character
of the law is the least intrusive means to achieve the objectives of the law.
Unfortunately, a deep scrutiny of the respondents' submissions proved to be in vain. The OSG was
curiously silent in the establishment of a more compelling state interest that would rationalize the curbing of a
conscientious objector's right not to adhere to an action contrary to his religious convictions. During the oral
arguments, the OSG maintained the same silence and evasion.
Resultantly, the Court finds no compelling state interest which would limit the free exercise
clause of the conscientious objectors, however few in number. Only the prevention of an immediate and
grave danger to the security and welfare of the community can justify the infringement of religious
freedom. If the government fails to show the seriousness and immediacy of the threat, State intrusion is
constitutionally unacceptable. 
Freedom of religion means more than just the freedom to believe. It also means the
freedom to act or not to act according to what one believes. And this freedom is violated when
one is compelled to act against one's belief or is prevented from acting according to one's belief. 
\
Apparently, in these cases, there is no immediate danger to the life or health of an individual in the
perceived scenario of the subject provisions. After all, a couple who plans the timing, number and spacing of the
birth of their children refers to a future event that is contingent on whether or not the mother decides to adopt or
use the information, product, method or supply given to her or whether she even decides to become pregnant at
all. On the other hand, the burden placed upon those who object to contraceptive use is immediate and occurs
the moment a patient seeks consultation on reproductive health matters.
Moreover, granting that a compelling interest exists to justify the infringement of the conscientious
objector's religious freedom, the respondents have failed to demonstrate "the gravest abuses, endangering
paramount interests" which could limit or override a person's fundamental right to religious freedom. Also, the
respondents have not presented any government effort exerted to show that the means it takes to achieve its
legitimate state objective is the least intrusive means. Other than the assertion that the act of referring would
only be momentary, considering that the act of referral by a conscientious objector is the very action being
contested as violative of religious freedom, it behooves the respondents to demonstrate that no other means can
be undertaken by the State to achieve its objective without violating the rights of the conscientious objector. The
health concerns of women may still be addressed by other practitioners who may perform reproductive health-
related procedures with open willingness and motivation. Suffice it to say, a person who is forced to perform an
act in utter reluctance deserves the protection of the Court as the last vanguard of constitutional freedoms. 
At any rate, there are other secular steps already taken by the Legislature to ensure that the right to
health is protected. Considering other legislations as they stand now, R.A. No. 4729 or the Contraceptive
Act, R.A. No. 6365 or "The Population Act of the Philippines" and R.A. No. 9710, otherwise known as
"The  Magna Carta  of Women," amply cater to the needs of women in relation to health services and programs.
The pertinent provision of Magna Carta on comprehensive health services and programs for women.
As an afterthought, Asst. Solicitor General Hilbay eventually replied that the compelling state interest
was "Fifteen maternal deaths per day, hundreds of thousands of unintended pregnancies, lives changed, ...." He,
however, failed to substantiate this point by concrete facts and figures from reputable sources.
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.
Granting that there are still deficiencies and flaws in the delivery of social healthcare programs for
Filipino women, they could not be solved by a measure that puts an unwarrantable stranglehold on religious
beliefs in exchange for blind conformity.
Exception: Life Threatening Cases
All this notwithstanding, the Court properly recognizes a valid exception set forth in the law. 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. Thus, during the oral
arguments, Atty. Liban, representing CFC, manifested: "the forced referral clause that we are objecting on
grounds of violation of freedom of religion does not contemplate an emergency." 
In a conflict situation between the life of the mother and the life of a child, the doctor is morally obliged
always to try to save both lives. If, however, it is impossible, the resulting death to one should not be deliberate.
Atty. Noche explained: 
Principle of Double-Effect. — May we please remind the principal author of the RH Bill
in the House of Representatives of the principle of double-effect wherein intentional harm on the
life of either the mother of the child is never justified to bring about a "good" effect. In a conflict
situation between the life of the child and the life of the mother, the doctor is  morally obliged
always to try to save both lives. However, he can act in favor of one (not necessarily the
mother) when it is medically impossible to save both, provided that no direct harm is intended
to the other. If the above principles are observed, the loss of the child's life or the mother's life
is not intentional and, therefore, unavoidable. Hence, the doctor would not be guilty of abortion
or murder. The mother is never pitted against the child because both their lives are equally
valuable.
Accordingly, if it is necessary to save the life of a mother, procedures endangering the life of the child
may be resorted to even if is against the religious sentiments of the medical practitioner. As quoted above,
whatever burden imposed upon a medical practitioner in this case would have been more than justified
considering the life he would be able to save.
Family Planning Seminars
Anent the requirement imposed under Section 15 as a condition for the issuance of a marriage license,
the Court finds the same to be a reasonable exercise of police power by the government. A cursory reading of
the assailed provision bares that the religious freedom of the petitioners is not at all violated. All the law requires
is for would-be spouses to attend a seminar on parenthood, family planning breastfeeding and infant nutrition. It
does not even mandate the type of family planning methods to be included in the seminar, whether they be
natural or artificial. As correctly noted by the OSG, those who receive any information during their attendance in
the required seminars are not compelled to accept the information given to them, are completely free to reject the
information they find unacceptable, and retain the freedom to decide on matters of family life without the
intervention of the State. 
4. THE FAMILY AND THE RIGHT TO PRIVACY: The above provision refers to reproductive health procedures like
tubal litigation and vasectomy which, by their very nature, should require mutual consent and decision between the
husband and the wife as they affect issues intimately related to the founding of a family. Section 3, Art. XV of
the Constitution espouses that the State shall defend the "right of the spouses to found a family." One person
cannot found a family. The right, therefore, is shared by both spouses. In the same Section 3, their right "to
participate in the planning and implementation of policies and programs that affect them" is equally recognized.
The RH Law cannot be allowed to infringe upon this mutual decision-making. By giving absolute authority
to the spouse who would undergo a procedure, and barring the other spouse from participating in the decision
would drive a wedge between the husband and wife, possibly result in bitter animosity, and endanger the marriage
and the family, all for the sake of reducing the population. This would be a marked departure from the policy of the
State to protect marriage as an inviolable social institution. 
Decision-making involving a reproductive health procedure is a private matter which belongs to the
couple, not just one of them. Any decision they would reach would affect their future as a family because the size of
the family or the number of their children significantly matters. The decision whether or not to undergo the
procedure belongs exclusively to, and shared by, both spouses as one cohesive unit as they chart their own
destiny. It is a constitutionally guaranteed private right . Unless it prejudices the State, which has not shown
any compelling interest, the State should see to it that they chart their destiny together as one family.
As highlighted by Justice Leonardo-de Castro, Section 19 (c) of R.A. No. 9710, otherwise known as the
"Magna Carta for Women," provides that women shall have equal rights in all matters relating to marriage and
family relations, including the joint decision on the number and spacing of their children. Indeed, responsible
parenthood, as Section 3 (v) of the RH Law states, is a shared responsibility between parents. Sec. 23 (a) (2)
(i) of the RH Law should not be allowed to betray the constitutional mandate to protect and strengthen the family
by giving to only one spouse the absolute authority to decide whether to undergo reproductive health procedure. 
The right to chart their own destiny together falls within the protected zone of marital privacy and such
state intervention would encroach into the zones of spousal privacy guaranteed by the Constitution. In our
jurisdiction, the right to privacy was first recognized in Morfe v. Mutuc, where the Court, speaking through Chief
Justice Fernando, held that "the right to privacy as such is accorded recognition independently of its identification
with liberty; in itself, it is fully deserving of constitutional protection." Morfe  adopted the ruling of the US Supreme
Court in Griswold v. Connecticut, where Justice William O. Douglas wrote: 
We deal with a right of privacy older than the Bill of Rights — older than our political
parties, older than our school system. Marriage is a coming together for better or for worse,
hopefully enduring, and intimate to the degree of being sacred. It is an association that promotes
a way of life, not causes; a harmony in living, not political faiths; a bilateral loyalty, not
commercial or social projects. Yet it is an association for as noble a purpose as any involved in
our prior decisions.
Ironically, Griswold invalidated a Connecticut statute which made the use of contraceptives a criminal
offense on the ground of its amounting to an unconstitutional invasion of the right to privacy of married persons.
Nevertheless, it recognized the zone of privacy rightfully enjoyed by couples. Justice Douglas in Griswold wrote
that "specific guarantees in the Bill of Rights have penumbras, formed by emanations from those guarantees that
help give them life and substance. Various guarantees create zones of privacy." 
At any rate, in case of conflict between the couple, the courts will decide.
The Family and Parental Consent
Equally deplorable is the debarment of parental consent in cases where the minor, who will be
undergoing a procedure, is already a parent or has had a miscarriage.
There can be no other interpretation of this provision except that when a minor is already a parent or
has had a miscarriage, the parents are excluded from the decision making process of the minor with regard to
family planning. Even if she is not yet emancipated, the parental authority is already cut off just because there is
a need to tame population growth.
It is precisely in such situations when a minor parent needs the comfort, care, advice, and guidance of
her own parents. The State cannot replace her natural mother and father when it comes to providing her needs
and comfort. To say that their consent is no longer relevant is clearly anti-family. It does not promote unity in the
family. It is an affront to the constitutional mandate to protect and strengthen the family as an inviolable social
institution. 
More alarmingly, it disregards and disobeys the constitutional mandate that "the natural and primary
right and duty of parents in the rearing of the youth for civic efficiency and the development of moral character
shall receive the support of the Government." 
To insist on a rule that interferes with the right of parents to exercise parental control over their minor-
child or the right of the spouses to mutually decide on matters which very well affect the very purpose of
marriage, that is, the establishment of conjugal and family life, would result in the violation of one's privacy with
respect to his family. It would be dismissive of the unique and strongly-held Filipino tradition of maintaining close
family ties and violative of the recognition that the State affords couples entering into the special contract of
marriage to as one unit in forming the foundation of the family and society. 
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.
First Exception: Access to Information
Whether with respect to the minor referred to under the exception provided in the second paragraph of
Section 7 or with respect to the consenting spouse under Section 23 (a) (2) (i),a distinction must be made. There
must be a differentiation between access to information about family planning services, on one hand, and access
to the reproductive health procedures and modern family planning methods themselves, on the other. Insofar as
access to information is concerned, the Court finds no constitutional objection to the acquisition of information by
the minor referred to under the exception in the second paragraph of Section 7 that would enable her to take
proper care of her own body and that of her unborn child. After all, Section 12, Article II of
the Constitution mandates the State to protect both the life of the mother as that of the unborn child. Considering
that information to enable a person to make informed decisions is essential in the protection and maintenance of
ones' health, access to such information with respect to reproductive health must be allowed. In this situation, the
fear that parents might be deprived of their parental control is unfounded because they are not prohibited to
exercise parental guidance and control over their minor child and assist her in deciding whether to accept or
reject the information received. 
 Second Exception: Life Threatening Cases
As in the case of the conscientious objector, an exception must be made in life-threatening cases that
require the performance of emergency procedures. In such cases, the life of the minor who has already suffered
a miscarriage and that of the spouse should not be put at grave risk simply for lack of consent. It should be
emphasized that no person should be denied the appropriate medical care urgently needed to preserve the
primordial right, that is, the right to life. 
In this connection, the second sentence of Section 23 (a) (2) (ii) should be struck down. By effectively
limiting the requirement of parental consent to "only in elective surgical procedures," it denies the parents their
right of parental authority in cases where what is involved are "non-surgical procedures." Save for the two
exceptions discussed above, and in the case of an abused child as provided in the first sentence of Section 23
(a) (2) (ii),the parents should not be deprived of their constitutional right of parental authority. To deny them of
this right would be an affront to the constitutional mandate to protect and strengthen the family. 

5. ACADEMIC FREEDOM: It is asserted that Section 14 of the RH Law, in relation to Section 24 thereof,
mandating the teaching of Age- and Development-Appropriate Reproductive Health Education under threat of
fine and/or imprisonment violates the principle of academic freedom. According to the petitioners, these
provisions effectively force educational institutions to teach reproductive health education even if they believe
that the same is not suitable to be taught to their students. Citing various studies conducted in the United States
and statistical data gathered in the country, the petitioners aver that the prevalence of contraceptives has led to
an increase of out-of-wedlock births; divorce and breakdown of families; the acceptance of abortion and
euthanasia; the "feminization of poverty";the aging of society; and promotion of promiscuity among the youth.
At this point, suffice it to state that 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.
At any rate, Section 12, Article II of the 1987 Constitution provides that the natural and primary right and
duty of parents in the rearing of the youth for civic efficiency and development of moral character shall receive
the support of the Government. Like the 1973 Constitution and the 1935 Constitution, the 1987
Constitution affirms the State recognition of the invaluable role of parents in preparing the youth to become
productive members of society. Notably, it places more importance on the role of parents in the development of
their children by recognizing that said role shall be "primary," that is, that the right of parents in upbringing the
youth is superior to that of the State.
It is also the inherent right of the State to act as  parens patriae to aid parents in the moral development
of the youth. Indeed, the Constitution makes mention of the importance of developing the youth and their
important role in nation building. Considering that Section 14 provides not only for the age-appropriate-
reproductive health education, but also for values formation; the development of knowledge and skills in self-
protection against discrimination; sexual abuse and violence against women and children and other forms of
gender based violence and teen pregnancy; physical, social and emotional changes in adolescents; women's
rights and children's rights; responsible teenage behavior; gender and development; and responsible
parenthood, and that Rule 10, Section 11.01 of the RH-IRR and Section 4 (t) of the RH Law itself provides for the
teaching of responsible teenage behavior, gender sensitivity and physical and emotional changes among
adolescents — the Court finds that the legal mandate provided under the assailed provision supplements, rather
than supplants, the rights and duties of the parents in the moral development of their children. 
Furthermore, as Section 14 also mandates that the mandatory reproductive health education program
shall be developed in conjunction with parent-teacher-community associations, school officials and other interest
groups, it could very well be said that it will be in line with the religious beliefs of the petitioners. By imposing
such a condition, it becomes apparent that the petitioners' contention that Section 14 violates Article XV, Section
3 (1) of the Constitution is without merit. 
While the Court notes the possibility that educators might raise their objection to their participation in the
reproductive health education program provided under Section 14 of the RH Law on the ground that the same
violates their religious beliefs, the Court reserves its judgment  should an actual case be filed before it.

6. DUE PROCESS: 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. EQUAL PROTECTION: 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.
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 elucidate above, sanction abortion. As Section 3 (l) explains, the "promotion
and/or stabilization of the population growth rate is incidental to the advancement of reproductive health."
Moreover, the RH Law does not prescribe the number of children a couple may have and does not
impose conditions upon couples who intend to have children. While the petitioners surmise that the assailed law
seeks to charge couples with the duty to have children only if they would raise them in a truly humane way, a
deeper look into its provisions shows that what the law seeks to do is to simply provide priority to the poor in
the implementation of government programs to promote basic reproductive health care. 
With respect to the exclusion of private educational institutions from the mandatory reproductive health
education program under Section 14, suffice it to state that the mere fact that the children of those who are less
fortunate attend public educational institutions does not amount to substantial distinction sufficient to annul the
assailed provision. On the other hand, substantial distinction rests between public educational institutions and
private educational institutions, particularly because there is a need to recognize the academic freedom of
private educational institutions especially with respect to religious instruction and to consider their sensitivity
towards the teaching of reproductive health education. 

8. INVOLUNTARY SERVITUDE: It should first be mentioned that the practice of medicine is undeniably imbued
with public interest that it is both a power and a duty of the State to control and regulate it in order to protect and
promote the public welfare. Like the legal profession, the practice of medicine is not a right but a privileged
burdened with conditions as it directly involves the very lives of the people. A fortiori, this power includes the power
of Congress to prescribe the qualifications for the practice of professions or trades which affect the public welfare,
the public health, the public morals, and the public safety; and to regulate or control such professions or trades,
even to the point of revoking such right altogether.
Moreover, as some petitioners put it, 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 bono or otherwise.