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LEGAL MEDICINE

Atty.. Ivy D. Patdu, MD
A.Y. 2016 - 2017
HEALTH PROFESSIONS UNDER PRC
1.

3.

What Health Related Professions are regulated by the Professional Regulations Commission? (Just have
a general idea of what these professions are)
Dentistry - R.A. No. 9484
Medical Technology - R.A. No. 5527
Chemisty - R.A. No. 5527
Medicine - R.A. No. 2382
Midwifery - R.A. No. 7392
Nursing - R.A. No. 9173
Nutrition and Dietetics - P.D. No. 1286
Optometry - R.A. No. 8050
Pharmacy - R.A. No. 5921
Physical and Occupational Therapy - R.A. 5680
Psychology - R.A. No. 10029
Radiologic and X-Ray Technology - R.A. No. 7431
Respiratory Therapy - R.A. No. 7431
Veterinary Medicine - R.A. No. 9268
Sanitary Engineering - R.A. No. 1364
Social Workers - R.A. No. 4373

Civil Code, Art. 26
Art. 26. Every person shall respect the dignity, personality, privacy and peace of mind of his neighbors and
other persons. The following and similar acts, though they may not constitute a criminal offense, shall
produce a cause of action for damages, prevention and other relief:
(1) Prying into the privacy of another's residence:
(2) Meddling with or disturbing the private life or family relations of another;
(3) Intriguing to cause another to be alienated from his friends;
(4) Vexing or humiliating another on account of his religious beliefs, lowly station in life, place of
birth, physical defect, or other personal condition.

4.

What is Medical or Health Privacy?
 It is the practice of keeping information about a patient confidential. This involves both
conversational discretion on the part of health care providers, and the security of medical
records.

MEDICAL PRIVACY
2.

It can also refer to the physical privacy of patients from other patients and providers while in a
medical facility.

PRIVACY is the state of being free from intrusion or disturbance in one's private life or affairs. Privacy
pertains to an individual’s right to be free from unwanted external scrutiny.

Philippine Constitution, Art. III, Sec. 1,3
Section 1. No person shall be deprived of life, liberty, or property without due process of law, nor shall any
person be denied the equal protection of the laws.

CONFIDENTIALITY refers to the privacy of information and its protection against unauthorized disclosure.
Confidentiality points to the duty that rest on those to whom private information has been entrusted, that is,
that they will not unnecessarily disclose such privilege communication.
MEDICAL OR HEALTH PRIVACY is the protection of the confidential nature of personal health
information, includes communication between health provider and patient, personal data and information
about disease or patient’s condition as contained in medical records.

Section 3. (1) The privacy of communication and correspondence shall be inviolable except upon lawful
order of the court, or when public safety or order requires otherwise, as prescribed by law.
(2) Any evidence obtained in violation of this or the preceding section shall be inadmissible for any purpose
in any proceeding.

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LEGAL MEDICINE
Atty.. Ivy D. Patdu, MD
A.Y. 2016 - 2017
5.

Rules of Court, Rule 128, Section 24
•Privilege is extended to communications made for the purpose of securing the services of a
counsel even if the counsel later refuses the professional relationship
•When consulted as a friend or a participant in a business, not as a lawyer, it would not fall
under this privilege
•Communication may be oral or written (also by facsimile, cellular phone, or other electronic
means)
•Not extend to communication where the client’s purpose is the furtherance of a future intended
crime
•Statements need not be made directly to attorney
•Those made to the attorney’s secretary, clerk or stenographer for the transmission to the
attorney for the purpose of the professional relationship, or with a view to such relationship are
covered by the privilege

RULE 130
Section 24. Disqualification by reason of privileged communication. —
The following persons cannot testify as to matters learned in confidence in the following cases:
(a)
The husband or the wife, during or after the marriage, cannot be examined without the consent
of the other as to any communication received in confidence by one from the other during the marriage
except in a civil case by one against the other, or in a criminal case for a crime committed by one against
the other or the latter's direct descendants or ascendants;
Marital Privilege Rule
Elements:
1.There must be a valid marriage between the husband and wife
2.There is a communication received in confidence by one from the other
3.The confidential communication was received during the marriage

(c)
A person authorized to practice medicine, surgery or obstetrics cannot in a civil case, without the
consent of the patient, be examined as to any advice or treatment given by him or any information which
he may have acquired in attending such patient in a professional capacity, which information was
necessary to enable him to act in capacity, and which would blacken the reputation of the patient;


Information acquired by the spouse before the marriage even if received confidentially
will not fall squarely under this section
•To be considered confidential:
1. must be made during marriage
2. by reason of the marital relations
3. intended not to be shared

Physician-patient Privilege
•applies to a civil case
•Information which cannot be disclosed refers to:
1. any advice given to the client
2. any treatment given to the client
3. any information acquired in attending such patient provided that the advice, treatment or
information was made or acquired in a professional capacity and was necessary to enable him
to act in that capacity
4. information sought to be disclosed would tend to blacken the reputation of the patient

•Communications in private between husband and wife are presumed to be confidential
•Marital privilege rule may be WAIVED by failure of the claimant to object timely to its
presentation or by any conduct that may be construed as implied consent
(b)
An attorney cannot, without the consent of his client, be examined as to any communication
made by the client to him, or his advice given thereon in the course of, or with a view to, professional
employment, nor can an attorney's secretary, stenographer, or clerk be examined, without the consent of
the client and his employer, concerning any fact the knowledge of which has been acquired in such
capacity;

•Relationship does not need to be a result of a contractual relationship
•Privilege survives the death of the patient
•May be WAIVED by the patient, expressly or impliedly

Attorney-Client Privilege
Requisites:
1.There must be a communication made by the client to the attorney, or an advice given by the
attorney to his client
2.The communication or advice must be given in confidence
3.The communication or advice must be given either in the course of the professional
employment or with a view to professional employment
- does not require a perfected atty-client relationship

(d)
A minister or priest cannot, without the consent of the person making the confession, be
examined as to any confession made to or any advice given by him in his professional character in the
course of discipline enjoined by the church to which the minister or priest belongs;
Priest/minister-penitent privilege
•Person making the confession holds the privilege
•Extends also to any advice given by the minister or priest

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Such person acquired the information while he was attending to the patient in his professional capacity.The privilege is claimed in a civil case. be examined as to any advice or treatment given by him or any information which he may have acquired in attending such patient in a professional capacity. LIM’s counsel opposed this on the ground that the testimony sought to be elicited from the witness is privileged since the latter had examined the petitioner in a professional capacity and had diagnosed her to be suffering from schizophrenia.. CA Denied to the petition on the ground that the petitioner failed to establish the confidential nature of the testimony given by or obtained from Dr. In order that the privilege may be successfully claimed." Petitioner filed with CA a petition for certiorari and prohibition to annul the order of the RTC Judge on the ground that it was issued with grave abuse of discretion amounting to lack of jurisdiction. circumstances and symptoms. Section 24 of the Revised Rules on Evidence which reads: "SECTION 24. 4.The communications must originate in a confidence that they will not be disclosed. Acampado took the witness stand and was asked hypothetical questions related to her field of expertise.The person against whom the privilege is claimed is one duly authorized to practice medicine. the Chief of the Female Services of the National Mental Hospital and a specialist in Psychiatry.The relation must be one which in the opinion of the community ought to be sedulously fostered 4. Ivy D. — The following persons cannot testify as to matters learned in confidence in the following cases: xxx xxx xxx (e) A public officer cannot be examined during his term of office or afterwards. military 2. Trial court allowed the witness to testify and Dr. 214 SCRA 273.The information was necessary to enable him to act in that capacity. would blacken the reputation (formerly character) of the patient. and. other national security matters 6.LEGAL MEDICINE Atty. 24. without the consent of the patient. which information was necessary to enable him to act in that capacity. Disqualification by reason of privileged communication. and 5. MD A. Lydia Acampado.” SIM’s counsel announced that he would present as his next witness Dr. surgery or obstetrics. as to communications made to him in official confidence. Hence this petition under Rule 45." These requisites conform with the 4 fundamental conditions necessary for the establishment of a privilege against the disclosure of a certain communications to wit: 1. CA committed no reversible error in its challenged resolution. Acampado pursuant to par. and which would blacken the reputation of the patient. (c) Sec. 1. surgery or obstetrics cannot in a civil case. Patdu. ISSUE/S: WON CA erred in holding that not all the essential elements of the rule on physician-patient 3 .Y. The law in point is paragraph (c). (21a) Privileged communications to public officers •Communications are privileged when the court finds that the disclosure would adversely affect the public interest •Privilege may be invoked not only during the term of office of the public officer but also afterwards •Chavez v PCGG rules that there is privilege against disclosure on certain matters involving state secrets regarding the following: 1.The injury that would inure to the relation by the disclosure of the 5. Rule 130 exist . and to prohibit him from proceeding with the reception of Dr.communications must be greater than the benefit thereby gained for the correct disposal of litigation.This element of confidentiality must be essential to the full and satisfactory maintenance of the relation between the parties. 3. when the court finds that the public interest would suffer by the disclosure.NO HELD: Petition is devoid of any merit. untrammeled by apprehension of their subsequent and enforced disclosure and publication on the witness stand. and be enabled safely and efficaciously to treat his patient.The information was confidential." This rule on the physician-patient privilege is intended to facilitate and make safe full and confidential disclosure by the patient to the physician of all facts. if disclosed. 2. the following requisites must concur: Lim vs Court of Appeals.2017 •Confession and advice must be made or given pursuant to the course of discipline of the denomination or sect to which the minister or priest belongs •Not every communication is privileged •Must be made pursuant to confession of sins privileged communication under Sec. 281-282 (1992) FACTS:JUAN SIM filed with RTC a petition for annulment of such marriage on the ground that petitioner has been allegedly suffering from a mental illness called schizophrenia “before. She neither revealed the illness she examined and treated the petitioner for nor disclosed the results of her examination and the medicines she had prescribed. 2. 2016 . It rests in public policy and is for the general interest of the community. 24 of Rule 130 of the Revised Rules of court which states the conditions that would render as inadmissible testimonial evidence. 3. (c) A person authorized to practice medicine. to the end that the physician may form a correct opinion. diplomatic 3. Acampado’s testimony. during and after the marriage and until the present.

electro-mechanical. data. (b) "Computer" refers to any device or apparatus which. digital or otherwise. storing. retrieved or produced electronically.Dr. unauthorized access to computer systems Is punishable by a fine and mandatory imprisonment. no showing that Dr. symbols or other modes of written expression according to mathematical and logical rules or of performing any one or more of these functions. (g) "Electronic Key" refers to a secret code which secures and defends sensitive information that cross over public channels into a form decipherable only with a matching electronic key.7. characteristic and/or sound in electronic form. sending. The mere fact of making a communication. as well as the date of a consultation and the number of consultations. optical or similar means. moreover. 4. recording. Acampado’s testimony that the petitioner was never interviewed alone. processing. Acampado was presented and qualified as an expert witness. she did not disclose anything obtained in the course of her examination.In the first place. transmitting. transmitted. described or however represented. or ii. symbols or other modes of written expression. as well. 2016 . retrieving. 7. Acampado's answers to the questions propounded to her relating to the hypothetical problem were influenced by the information obtained from the petitioner. or share it with. between or among points specified by a user. or otherwise processing electronic data messages or electronic documents and includes the computer system or other similar device by or in which data is recorded or stored and any procedures related to the recording or storage of electronic data message or electronic document. by which a right is established or an obligation extinguished. Otherwise stated. interview and treatment of the petitioner. is capable of receiving. her testimony before the trial court cannot then be excluded. Acampado could be covered by the privilege. Acampado never disclosed any information obtained from the petitioner regarding the latter's ailment and the treatment recommended therefor. Provides that any person with access to electronic data messages or documents has the obligation of confidentiality or the duty not to convey the information to. (f) "Electronic Document" refers to information or the representation of information. the failure to seasonably object thereto amounted to a waiver thereof. 3.Y. any other person. The term does not include a person acting as an intermediary with respect to that electronic data message or electronic data document. Pertinent provisions of the law with regard to Medical Privacy: (j) "Service provider" refers to a provider of i.. addressee or any third party Section 5. There is. generated and/or sent. We agree with CA’s observation that the petitioner failed to discharge that burden for the following reasons: impulse. data. of electronic documents of the user's choosing. recorded. by electronic. so long as the subject communicated is not stated. receives and/or stores provides other services in respect of that electronic data message or electronic document. On-line services or network access or the operator of facilities therefor.LEGAL MEDICINE Atty. including entities offering the transmission. (c) "Electronic Data Message" refers to information generated. GENERAL RULE: Service providers shall have no authority •to modify or alter the content of the electronic data message or electronic document received OR •to make any entry therein on behalf of the originator. processed. or magnetic 4 . 1. The necessary technical means by which electronic documents of an originator may be stored and made accessible to designated or undesignated third party. As an expert witness. There is authority to the effect that information elicited during consultation with a physician in the presence of third parties removes such information from the mantle of the privilege.2017 It is to be emphasized that "it is the tenor only of the communication that is privileged. Definition of Terms (a) "Addressee" refers to a person who is intended by the originator to receive the electronic data message or electronic document. figures. 2. The term does not include a person acting as an intermediary with respect to that electronic document. sent. (d) "Information and Communications System" refers to a system intended for and capable of generating. or by other means. are therefore not privileged from disclosure. Ivy D. the facts and conditions alleged in the hypothetical problem did not refer to and had no bearing on whatever information or findings the doctor obtained while attending to the patient. MD A. which is receive. or producing information. stored. 5. (e) "Electronic Signature" refers to any distinctive mark. receiving. or by which a fact may be prove and affirmed. her expert opinion excluded whatever information or knowledge she had about the petitioner which was acquired by reason of the physician-patient relationship existing between them. or providing of connections for online communications. Patdu. routing.Granting ex gratia that the testimony of Dr." One who claims this privilege must prove the presence of thses requisites. received or stored by electronic. The Electronic Commerce Act of 2000 (Sec. or on whose behalf. figures.31-33) (h) "Intermediary" refers to a person who in behalf of another person and with respect to a particular electronic document sends. representing the identity of a person and attached to or logically associated with the electronic data message or electronic document or any methodology or procedures employed or adopted by a person and executed or adopted by such person with the intention of authenticating or approving an electronic data message or electronic document. the electronic document purports to have been created.It was clear that Dr. As correctly held by the Court of Appeals. (i) "Originator" refers to a person by whom. storing. Under this law. Dr.

000. or destroy using a computer or other similar information and communication devices. to secretly overhear.000. without the knowledge and consent of the owner of the computer or information and communications system. Obligation of Confidentiality. dissemination. apart from the addition of any endorsement and any authorized change. removal.not being authorized by all the parties to any private communication or spoken word. or by using any other device or arrangement. (d) Other violations of the provisions of this Act. making available to the public. or distribution. 7394 and other relevant to pertinent laws through transaction covered by or using electronic data messages or electronic documents. Patdu. Penalties. uploading. communication. Section 7. downloading. AND •That document is capable of being displayed to the person to whom it is to be presented: oProvided.The following Acts. alteration. resulting in the corruption. substitution. modification. or other material pursuant to any powers conferred under this Act. •This Act does NOT modify any statutory rule relating to admissibility of electronic data massages or electronic documents. or however otherwise described. use. 4200. reproduction. storage. or an electronic signature of an electronic data message or electronic document shall only be authorized and enforced in favor of the individual or entity having a legal right to the possession or the use of plaintext. alter. as follows: (a) Hacking or crackling with refers to unauthorized access into or interference in a computer system/server or information and communication system. . or any access in order to corrupt. electronic signature or copyrighted works including legally protected sound recordings or phonograms or information material on protected works. or broadcasting of protected material. importation.000. 1-2) Acts Punishable It shall be unlawful for any person: Section 31. Legal Recognition of Electronic Documents Electronic documents shall have the legal effect. electronic signature or file or solely for the authorized purposes. validity or enforceability as any other document or legal writing. information. 1) b.LEGAL MEDICINE Atty. the internet. intercept. shall be penalized by fine and/or imprisonment. The Anti-Wiretapping Law (RA No. such as. to tap any wire or cable. shall be penalized with a maximum penalty of one million pesos (P 1.be he a participant or not in the act or acts penalized in the next preceding sentence. book.Except for the purposes authorized under this Act. any person who obtained access to any electronic key. or record such communication or spoken word by using a device commonly known as a dictaphone or dictagraph or dictaphone or walkie-talkie or tape recorder. electronic data message or electronic document. (a)Law requires a document to be in writing •Electronic document is valid and has legal effect IF omaintains its integrity and reliability AND ocan be authenticated so as to be usable for subsequent reference: electronic document has remained complete and unaltered. That NO provision of this Act shall apply to vary any and all requirements of existing laws on formalities required in the execution of documents for their validity (c) Violations of the Consumer Act of Republic Act No. NOTE: •For evidentiary purposes. through the use of telecommunication networks. 1 par. NOTE: Paragraph (a) applies whether the requirement therein is in the form of an obligation or whether the law simply provides consequences for the document not being presented or retained in its original from. What are the requisites for an electronic document to have legal effect? Section 33. to knowingly 5 .Y.00) and a maximum commensurate to the damage incurred and a mandatory imprisonment of six (6) months to three (3) years. theft or loss of electronic data messages or electronic documents shall be punished by a minimum fine of One Hundred Thousand pesos (P 100.Access to an electronic file.000. The electronic key for identity or integrity shall not be made available to any person or party without the consent of the individual or entity in lawful possession of that electronic key. steal. . . including the introduction of computer viruses and the like. shall not convey to or share the same with any other person. and who shall retain the electronic document in accordance with the specific request or as necessary for the purpose of performing the services it was engaged to perform Section 32. (Sec.2017 EXCEPTION: they are specifically authorized to do so. Ivy D. and electronic document is reliable in the light of the purpose for which it was generated and in the light of all relevant circumstances. Lawful Access. destruction. correspondence. but not limited to. shall be penalized with the same penalties as provided in those laws. a. 2016 . register. an electronic document shall be the functional equivalent of a written document under existing laws.00) and a maximum commensurate to the damage incurred and a mandatory imprisonment of six (6) months to three (3) years. or any change which arises in the normal course of communication. in a manner that infringes intellectual property rights shall be punished by a minimum fine of one hundred thousand pesos (P 100. MD A.00) or six (6) years imprisonment. storage and display. EXCEPT the rules relating to authentication and best evidence. alteration.. (b) Piracy or the unauthorized copying. (b)Law requires that a document be presented or retained in its original form •There exists a reliable assurance as to the integrity of the document from the time when it was first generated in its final form. Sec. 8.

•Information on automated processes where the data will or likely to be made as the sole basis for any decision significantly affecting or will affect the data subject. That the notification under subsection (b) shall not apply should the personal information be needed pursuant to a subpoena or when the collection and processing are for obvious purposes. if the offender is an alien he shall be subject to deportation proceedings. upon conviction thereof. •Date when his or her personal information concerning the data subject were last accessed and modified. or when the information is being collected and processed as a result of legal obligation Penalty Any person who willfully or knowingly does or who shall aid. The Data Privacy Act (Rights of Data Subject and Penal Provisions) Who is a Data subject?  It refers to an individual whose personal information is processed. 5. false. and •The designation. withdraw or order the blocking. or any other such record. 3. possess any tape record. and the extent to which such access is authorized. Dispute the inaccuracy or error in the personal information and have the personal information controller correct it immediately and accordingly. 4. if the same is allowed by the data subject.e. 2) Any information supplied or declaration made to the data subject on these matters shall not be amended without prior notification of data subject: Provided. 2. where personal information is processed by electronic means and in a structured and commonly used format. That the use of such record or any copies thereof as evidence in any civil. of any communication or spoken word secured either before or after the effective date of this Act in the manner prohibited by this law. Be informed whether personal information pertaining to him or her shall be. 2016 . unlawfully obtained.Y. What are the rights of a data subject? The data subject is entitled to: 1. between the collector and the data subject. the personal information controller may notify third parties who have previously received such processed personal information. •Reasons for the disclosure of the personal information to recipients. •The period for which the information will be stored. as well as the technical standards. •The identity and contact details of the personal information controller or its representative. modalities and procedures for their transfer. to access. The Commission may specify the electronic format referred to above. (Sec. unless the request is vexatious or otherwise unreasonable. the following: •Contents of his or her personal information that were processed. criminal investigation or trial of offenses mentioned in section 3 hereof.. and. Suspend. to any other person: Provided. including when it is necessary for the performance of or in relation to a contract or service or when necessary or desirable in the context of an employer-employee relationship.. and 6 . 1 par. •The recipients or classes of recipients to whom they are or may be disclosed. That the third parties who have previously received such processed personal information shall he informed of its inaccuracy and its rectification upon reasonable request of the data subject. either verbally or in writing. shall not be covered by this prohibition.LEGAL MEDICINE Atty. correction. or to communicate the contents thereof. used for unauthorized purposes or are no longer necessary for the purposes for which they were collected. to obtain from the personal information controller a copy of data undergoing processing in an electronic or structured format. disc record. Patdu. If the personal information have been corrected. or causes such violation shall. i. wire record. Be furnished the information indicated hereunder before the entry of his or her personal information into the processing system of the personal information controller. In this case. permit. or to replay the same for any other person or persons. are being or have been processed. as well as the right to lodge a complaint before the Commission. 2) 9. which is commonly used and allows for further use by the data subject. Ivy D. permits. •Sources from which personal information were obtained. •Names and addresses of recipients of the personal information. •Purposes for which they are being or are to be processed. •Manner by which such data were processed. outdated. be punished by imprisonment for not less than six months or more than six years and with the accessory penalty of perpetual absolute disqualification from public office if the offender be a public official at the time of the commission of the offense. whether complete or partial. Reasonable access to. or at the next practical opportunity: •Description of the personal information to be entered into the system. MD A. and •The existence of their rights. removal or destruction of his or her personal information from the personal information controller’s filing system upon discovery and substantial proof that the personal information are incomplete. (Sec. What is the right to data portability?  The data subject shall have the right.2017 •Methods utilized for automated access. or name or identity and address of the personal information controller. or copies thereof. upon demand. the personal information controller shall ensure the accessibility of both the new and the retracted information and the simultaneous receipt of the new and the retracted information by recipients thereof: Provided. or cause to be done any of the acts declared to be unlawful in the preceding section or who violates the provisions of the following section or of any order issued thereunder. or aids. or to furnish transcriptions thereof. •Scope and method of the personal information processing.

the exercise of freedom of abode. or public policy Sec. 9165.LEGAL MEDICINE Atty. Ivy D. (b) a person has executed a legacy in accordance with Sec. the identity of personal information controller. or tissue for transfusion. organ. RA 8505 (What must be kept confidential?) Section 16. the provision of medical service or any other kind of service. or research. or the right to travel. purpose. legitimate purpose.. Prohibitions on compulsory HIV testing. OThe processing of information shall be adequate. 3) Form submitted by the victim/complainant to the court. 3 of Republic Act No. (c) a donation is executed in accordance with Sec.2017 6. including the risks and safeguards involved. Such consent shall be obtained from the person concerned if he/she is of legal age or from the parents or legal guardian in the case of a minor or a mentally incapacitated individual. entry or continued stay in the country. 15. and extent of the processing of his or her personal data. transplantation. (a) a person volunteers or freely agrees to donate his/her blood. and not excessive in relation to a declared and specified purpose. his or her rights as a data subject. outdated. or blood shall be considered as having been given when: Proportionality. 1) It is the duty of the police officers to ensure only persons authorized by the offended party shall be allowed inside the room where the investigation or medical or physical examination is being conducted. Principles of Transparency. 30-42 Art. Personal data shall be processed only if the purpose of the processing could not reasonably be fulfilled by other means. – Compulsory HIV testing as a precondition to employment. 10. unlawfully obtained or unauthorized use of personal information. Under RA 9165 or the Comprehensive Dangerous Drugs Act of 2002: 1) Judicial and medical records of drug dependents under the voluntary submission program. In relation to Right to Privacy and Confidentiality – RA No. oThe data subject must be aware of the nature.Y. which he or she is an heir or assignee at any time after the death of the data subject or when the data subject is incapacitated or incapable of exercising the rights as enumerated in the immediately preceding section. admission to educational institutions. RA No. 9262. Transparency. oThe processing of information shall be compatible with a declared and specified purpose which must not be contrary to law. organ. oYes. 3) Record of proceedings on suspension of sentence. Under RA 9262 or Anti-Violence Against Women and Their Children of 2004 Are these rights transmissible? 1) Medical/health records of the victim 2) All records pertaining to cases of violence against women and children. Any information and communication relating to the processing of personal data should be easy to access and understand. 2) The name and personal circumstances of the offended party and the accused must not be disclosed to the public. The lawful heirs and assigns of the data subject may invoke the rights of the data subject for. Under RA 8505 or Rape Victim Assistance and Protection Act of 1998 oThe processing of personal data shall be allowed subject to adherence to the principles of transparency. However. 15-17. 7170. program. Patdu. SCREENING AND COUNSELLING Legitimate purpose. except how to determine how many times he/she has voluntarily submitted. suitable. 2016 . Legitimate Purpose and Proportionality. or the continued enjoyment of said undertakings shall be deemed unlawful. RA No. 2) Records of a drug dependent who was rehabilitated and discharged under the compulsory submission 7 . 11. 8504 Philippine AIDS Prevention and Control Act of 1998 Sec. – No compulsory HIV testing shall be allowed. incomplete. tissue. MD A. That written informed consent must first be obtained. necessary. also known as the"Organ Donation Act of 1991". and proportionality. false. Lawful consent to HIV testing of a donated human body. Consent as a requisite for HIV testing. including those in the barangay. 3) Past sexual conduct of the complainant shall not be disclosed unless material and relevant to the case. morals. III TESTING. Be indemnified for any damages sustained due to such inaccurate. 7170. using clear and plain language. the State shall encourage voluntary testing for individuals with a high risk for contracting HIV: Provided. relevant. and how these can be exercised. 4) The Court may require to exclude all others from attending the hearing and conduct all proceedings consistent with upholding the dignity and privacy of women and children. 4 of Republic Act No.

8 . particularly the identity and status of persons with HIV. (b) when informing other health workers directly involved or about to be involved in the treatment or care of a person with HIV/AIDS: Provided. 4 of Republic Act No. VI CONFIDENTIALITY Sec. hand delivered. otherwise known as the "Family Code of the Philippines". medical instructors. The person concerned if he/she is of legal age or 2. Compulsory HIV testing as a precondition to: •1. 7659. (b) When the determination of the HIV status is necessary to resolve the relevant issues under the Family Code of the Philippines. No compulsory HIV testing shall be allowed. Admission to educational institutions. transplantation. •5. (c) when responding to a subpoena duces tecum and subpoena ad testificandum issued by a Court with jurisdiction over a legal proceeding where the main issue is the HIV status of an individual: Provided. Patdu.A. 7719. workers. MD A. file. further. That such treatment or care carry the risk of HIV transmission: Provided. insurance companies. Medical confidentiality. 7659.A. Exceptions to the mandate of confidentiality. That the judicial proceedings be held in executive session. 3815. and other custodians of any medical record. Ivy D. and Note: Lawful consent to HIV testing of a donated human body. Section 31. (a) a person volunteers or freely agrees to donate his/her blood..Y. or ART. otherwise known as the "National Blood Services Act". organ. – Compulsory HIV testing may be allowed only in the following instances: (a) When a person is charged with any of the crimes punishable under Articles 264 and 266 as amended by Republic Act No. data. or the right to travel. otherwise known as the "Organ Donation Act" and Republic Act No. oEXTENT: The following prohibitions on compulsory HIV testing are also covered (c) a donation is executed in accordance with Sec. further. Q: Who may give consent? oSuch consent shall be obtained from: Section 17. EXCEPTIONS: Compulsory HIV testing may be allowed only in the following instances: (a) when complying with reportorial requirements in conjunction with the AIDSWATCH programs provided in Sec. employers. 7170 or the Organ Donation Act and R. 7719 or the National Blood Services Act. or blood shall be considered as having been given when: (c) When complying with the provisions of Republic Act No. 27 of this Act. (b) When the determination of the HIV status is necessary to resolve the relevant issues under Executive Order No. The provision of medical service or any other kind of service.2017 Q: Is voluntary HIV testing allowed? YES. or research. recruitment agencies. 3 of Republic Act No. and (c) When complying with the provisions of R. also known as the"Organ Donation Act of 1991". 309. 1. 30. •2. That such workers shall be obliged to maintain the shared medical confidentiality. and personally opened by the judge: Provided. organ. o REQUISITE before voluntary HIV testing may be conducted: WRITTEN INFORMED CONSENT must first be obtained.LEGAL MEDICINE Atty. (b) a person has executed a legacy in accordance with Sec. The exercise of freedom of abode. •3. Employment. 7170. Q: Is compulsory HIV testing allowed? GENERAL RULE: NO. From the parents or legal guardian in the case of a minor or a mentally incapacitated individual. 335 and 338 of the Revised Penal Code or under R. 8353. 335 and 338 of Republic Act No. That the confidential medical record shall be properly sealed by its lawful custodian after being double-checked for accuracy by the head of the office or department. otherwise known as the "Revised Penal Code"or under Republic Act No. The State shall encourage voluntary testing for individuals with a high risk for contracting HIV.A. Exception to the prohibition on compulsory testing. – Medical confidentiality shall not be considered breached in the following cases: Not: The continued enjoyment of said undertakings shall be deemed unlawful. tissue. (a) When a person is charged with any of the Crimes punishable under Articles 264 and 266. or tissue for transfusion. data encoders. or test results are directed to strictly observe confidentiality in the handling of all medical information. – All health professionals. 2016 . Entry or continued stay in the country. •4. 7170. 7170.

laboratories or clinics.s 30 and 32 of this Act shall suffer the penalty of imprisonment for six (6) months to four (4) years. 35. SCOPE: The law extends the duty not just to health professionals but also to: oHealth instructors. oInsurance companies. oRecruitment agencies. 9 . Provided. MD A. discipline. Section 36. further. (c) of this Act and in accordance with the provision of Sec. laboratories or clinics. without prejudice to administrative sanctions such as fines and suspension or revocation of the violator's license to practice his/her profession. (d) a person authorized to receive such results in conjunction with the AIDSWATCH program as provided in Sec. Disclosure to sexual partners. Section 34. 2016 . Patdu. as well as the cancellation or withdrawal of the license to operate any business entity and the accreditation of hospitals. Q: When is a person obliged to disclose his/her HIV status? Any person with HIV is obliged to disclose his/her HIV status and health condition to his/her spouse or sexual partner at the earliest opportune time Q: What is the effect if someone violated the patient confidentiality? ART. benefits or services to a student or prospective student on the basis of his/her actual. That the confidential medical record shall be properly sealed by its lawful custodian after being double-checked for accuracy by the head of the office or department. – Any person with HIV is obliged to disclose his/her HIV status and health condition to his/her spouse or sexual partner at the earliest opportune time. employers. – Discrimination in any form from pre-employment to postemployment. promotion or assignment. Discrimination in schools. Ivy D. Termination from work on the sole basis of actual. Release of HIV/AIDS test results. as well as the cancellation or withdrawal of the license to operate any business entity and the accreditation of hospitals. That such workers shall be obliged to maintain the shared medical confidentiality. (c) of this Act and in accordance with the provision of Sec. Section 32. (c) a legal guardian in the case of insane persons or orphans. – No educational institution shall refuse admission or expel. Q: When HIV testing is validly conducted. (c) when responding to a subpoena duces tecum and subpoena ad testificandum issued by a Court with jurisdiction over a legal proceeding where the main issue is the HIV status of an individual: Provided. including hiring. hand delivered. without prejudice to administrative sanctions such as fines and suspension or revocation of the violator's license to practice his/her profession. (b) either parent of a minor child who has been tested. as provided under subSec. to whom shall the HIV/AIDS results be released? All results of HIV/AIDS testing shall be confidential and shall be released only to the following persons: (a) the person who submitted himself/herself to such test. (d) a person authorized to receive such results in conjunction with the AIDSWATCH program (e) a justice of the Court of Appeals or the Supreme Court. segregate. deny participation. 27 of this Act. perceived or suspected HIV status of an individual is prohibited.s 30 and 32 of this Act shall suffer the penalty of imprisonment for six (6) months to four (4) years. 16 hereof.Y.LEGAL MEDICINE Atty. further. 8504 oAny violation of medical confidentiality as provided in Sec. perceived or suspected HIV status is deemed unlawful. 16 hereof. (b) either parent of a minor child who has been tested. VII DISCRIMINATORY ACTS AND POLICIES Sec.2017 EXCEPTIONS: Medical confidentiality shall not be considered breached in the following cases: (a) when complying with reportorial requirements in conjunction with the AIDSWATCH programs. – Any violation of medical confidentiality as provided in Sec. as provided under subSec. and personally opened by the judge: Section 33. and oOther custodians of medical records. That such treatment or care carry the risk of HIV transmission: Provided. (e) a justice of the Court of Appeals or the Supreme Court. (c) a legal guardian in the case of insane persons or orphans. Penalties for violations of confidentiality. Discrimination in the workplace. based on the actual. oData encoders. – All results of HIV/AIDS testing shall be confidential and shall be released only to the following persons: (a) the person who submitted himself/herself to such test. oCo-workers. (b) when informing other health workers directly involved or about to be involved in the treatment or care of a person with HIV/AIDS: Provided. perceived or suspected HIV status.A.. GENERAL RULE: he is punishable under R. That the judicial proceedings be held in executive session. Q: Who has the duty of maintaining patient confidentiality The duty of maintaining patient confidentiality is imposed on all persons involved in handling and maintaining patient records.

based on the actual. or refused lawful entry into or deported from Philippine territory on account of his/her actual. Section 42.Y.000. Becky was consequently dismissed from employment. licenses/permits of schools. Ivy D. Credit services cannot be denied based on HIV status.A.LEGAL MEDICINE Atty. promotion or assignment. Denial of burial services. what if the School contended that they cannot be tolerating that a person who is afflicted with AIDS/STD to be working in such close proximity to the students’ food for fear that they might be transmitted with the disease. Restrictions on travel and habitation. – A deceased person who had AIDS or who was known. MD A. including hiring. In addition. 2) HIV does not survive long enough in the environment to pose a real risk through contact of this sort. placed in isolation. Discrimination in ANY FORM from pre-employment to post-employment.00). In addition. blood-to-blood contact (injection needles and health care settings). perceived or suspected HIV status of an individual is prohibited. Section 39. – No person shall be denied health care service or be charged with a higher fee on account of actual. Inhibition from public service. perceived or suspected HIV status. NO. There are 2 main reasons for this: Section 38. That the person with HIV has not concealed or misrepresented the fact to the insurance company upon application. or deny participation in activities based on real or perceived HIV status. there is no evidence that people get infected with HIV by having their food prepared by HIV positive people. Discrimination in ANY FORM based on the actual. Becky is the head chef of St. One day. Termination from work on the sole basis of actual. 8504. Bernard College. – The freedom of abode. Discrimination in hospitals and health institutions.I. Schools are not allowed to refuse admission. perceived or suspected HIV status. licenses/permits of schools. Section 40. He said: “P. or assignment based on actual or suspected HIV status. Under R. 2016 . Penalties for discriminatory acts and policies. Q: What are the discriminatory acts prohibited? Employers cannot discriminate in hiring. Is the school liable for terminating Becky? YES. Q: In the same problem above. The school is not justified in terminating Becky. firing. 1) HIV is only known to be transmitted in three ways: sexual transmission. lodging and travel of a person with HIV shall not be abridged. o All discriminatory acts and policies referred to in this Act shall be punishable with a penalty of imprisonment for six (6) months to four (4) years and a fine not exceeding Ten thousand pesos (P10.000. – The right to seek an elective or appointive public office shall not be denied to a person with HIV. oMoreover. Patdu. No person shall be quarantined. perceived or suspected HIV status of an individual is prohibited. Becky! Nagkasakit ako dahil sayo! Nakipagtalik ka sa akin yun pala may sakit ka!”. suspected or perceived to be HIV-positive shall not be denied any kind of decent burial services. ka. Insurance cannot be refused based on HIV status. Decent burials cannot be denied based on HIV status. A person with HIV has the legal right to travel. A person with HIV has every legal right to seek pubic office. hospitals and other institutions found guilty of committing discriminatory acts and policies described in this Act shall be revoked. Hospitals and heath services cannot refuse treatment or discriminate based on HIV status. Extension and continuation of credit and loan shall likewise not be denied solely on the basis of said health condition. and from mother to infant.2017 Section 37.00). Other routes of transmission are theoretical only. hospitals and other institutions found guilty of committing discriminatory acts and policies described in this Act shall be revoked. perceived or suspected HIV status: Provided. The scene was the talk of the town among students and teachers. a man went to Becky’s workplace and made a scene. punish students. Exclusion from credit and insurance services. Scientists found that drying fluids containing very high concentrations of HIV (concentrations that are not normally encountered in day-to-day life) reduced the number of infectious virus by 90% to 99%. including health.. live. is the school justified in terminating Becky? 10 . promotion. Quarantines and other restrictions are illegal. perceived or suspected HIV status is deemed unlawful. Q: For instance. Section 41. accident and life insurance shall not be denied to a person on the basis of his/her actual. – All credit and loan services. – All discriminatory acts and policies referred to in this Act shall be punishable with a penalty of imprisonment for six (6) months to four (4) years and a fine not exceeding Ten thousand pesos (P10. provided the person does not lie about their HIV status. and lodge with the same freedom as any other citizen.

Exemptions. treat.Shall by means of signs.Certificates of registration shall not be required of the following persons: PHYSICIAN LIABILITY (a) Physicians and surgeons from other countries called in consultation only and exclusively in specific and definite cases. operate or prescribe any remedy for human disease. clinic hours. deformity. (c) any duly registered masseur or physiotherapist.LEGAL MEDICINE Atty. MD A. ignorance or incompetence in the practice of his or her profession resulting in an injury to or death of the patient. be necessary. Such authorization shall automatically cease when the epidemic or national emergency is declared terminated by the Secretary of Health. (6) Addiction to alcoholic beverages or to any habit forming drug rendering him or her incompetent to practice his or her profession.D. or provided that such application of massage or physical means shall be limited to physical or muscular development. Medical Act of 1959. (a) any medical student duly enrolled in an approved medical college or school under training. real or imaginary. b. 10 and therefore not considered to constitute a practice of medicine. Patdu. after his name. (b) Commissioned medical officers of the United States armed forces stationed in the Philippines while rendering service as such only for the members of the said armed forces and within the limit of their own respective territorial jurisdiction. (10) Issuing any statement or spreading any news or rumor which is derogatory to the character and reputation of another physician without justifiable motive. Section 11. are mentioned. 27-28 Section 10 – Acts constituting the practice of medicine The following are considered engaged in the practice of medicine: I. or in places where the services of a duly registered physician. (c) Foreign physicians employed as exchange professors in special branches of medicine or surgery whose service may in the discretion of the Board of Medical Education. serving without any professional fee in any government or private hospital. cards. (2) Immoral or dishonorable conduct. provided that he applies massage or other physical means upon written order or prescription of a duly registered physician. or II. (f) any person who administers or recommends any household remedy as per classification of existing Pharmacy Laws. regardless of the nature of the remedy or treatment administered. Ivy D. treat. (7) False or extravagant or unethical advertisements wherein other things than his name. graduates of medicine and registered nurses who may be given limited and special authorization by the Secretary of Health to render medical services during epidemics or national emergencies whenever the services of duly registered physicians are not available. (d) Medical students who have completed the first four years of medical course. or through the radio. 10-12. (11) Aiding or acting as a dummy of an unqualified or unregistered person to practice medicine. physical. or Section 24 – Grounds for reprimand. (12) Violation of any provision of the Code of Ethics as approved by the Philippine Medical Association. physically examine any person. spectacles and lenses. limbs or other similar appliances or who is engaged in the mechanical examination of eyes for the purpose of constructing or adjusting eye glasses. fee. 11 . advertisement. (8) Performance of or aiding in any criminal abortion. (4) Fraud in the acquisition of the certificate of registration. 12. or those attached to international bodies or organization assigned to perform certain definite work in the Philippines provided they shall limit their practice to the specific work assigned to them and provided further they shall secure a previous authorization from the Board of Medical Examiners. suspension or revocation of registration certificate. b. physical. There are acts of diagnosis and treatment and yet not construed to be within the purview of Sec. deformity. prescribed or recommended. (9) Knowingly issuing any false medical certificate. psychical condition or any ailment. A person who shall falsely use the title of M. and diagnose. written or printed matter. 24. nurse or midwife are not available. limitation of practice. or to any form of gambling. A person who: a. salary or reward in any form paid to him directly or through another.Y. Sec. injury. Refusal of a physician to attend a patient in danger of death is not a sufficient ground for revocation or suspension of his registration certificate if there is a risk to the physician's life. provided such performance is done in conjunction with a duly registered physician. Any of the following shall be sufficient ground for reprimanding a physician. operate or prescribe any remedy for human disease.Either offer or undertake by any means or method to diagnose. (3) Insanity. or for suspending or revoking a certificate of registration as physician: (1) Conviction by a court of competent jurisdiction of any criminal offense involving moral turpitude. (b) any legally registered dentist engaged exclusively in the practice of dentistry. profession. (d) any duly registered optometrist who mechanically fits or sells lenses. (e) any person who renders any service gratuitously in cases of emergency. (5) Gross negligence. injury. artificial eyes. television or any other means of communication. office and home address..shall for compensation. III.2017 (h) prosthetists who fit artificial limbs under the supervision of a registered physician. 2016 . mental. A person who: a. and (g) any psychologist or mental hygienist in the performance of his duties. Section 12 . provided that he renders such service under the direct supervision and control of a registered physician. mental or psychical condition. or even without the same.

these matters may be placed by a physician within the confines of his clinic or residence. The act of the physician in publishing his or her personal superiority. or when the circumstances of the patient or the family so demand or justify. sites. Ivy D. Professional fees should be commensurate to the services rendered with due consideration to the patient’s financial status. or by both such fine and imprisonment. nature of the case. prognosis. Section 5. except when required in the promotion of justice. provided there is no risk to his or her safety. recognizing the right of a patient to know the capabilities and qualifications of his doctor. compassion.After two years. time consumed and the professional standing and skill of the physician in the community. Code of Medical Ethics II. For the promotion of medical practice. office hours or office or residential addresses may appear. A physician shall not conceal nor exaggerate the patient’s condition except when it is to the latter’s best interest. Section 28. a physician should administer at least first aid treatment and then refer the patient to the primary physician and/or to a more competent health provider and appropriate facility if necessary. Signboards shall not exceed one by two (1x2) meters in size. Duties of Physicians to the Community 3. Section 2. A physician should be free to choose patients. directories and signboards. the attending physician should seek the assistance of the appropriate specialist. Patdu. Any person found guilty of "illegal practice of medicine" shall be punished by a fine of not less than one thousand pesos nor more than ten thousand pesos with subsidiary imprisonment in case of insolvency. A physician involved in multimedia must be well informed of the matter under discussion. classified advertising. Section 2. A physician should exercise good faith and honesty in expressing opinion/s as to the diagnosis. DUTIES OF PHYSICIANS TO THEIR PATIENTS Section 1. rules and regulations. special certificates or diplomas. A physician shall not employ agents in the solicitation and recruitment of patients. Section 3. alert the public and duly constituted health authorities on the dangers of communicable diseases and enforce measures for prevention and cure in accordance with existing laws.. internet. Duties of Physicians to their Colleagues to the Profession 4. Section 27. A physician is encouraged to expose and report to the proper authorities unlicensed medical practitioners. Section 6.has not committed any illegal. b. Section 7.the respondent has acted in an exemplary manner in the community wherein he resides. DUTIES: 1. except when his or her personal safety is at stake. operative techniques or former connections with hospitals or clinics is not allowed.2017 A physician shall obtain from the patient a voluntary informed consent. in times of epidemic and public calamity. in the discretion of the court. In an emergency. A physician shall not commercially endorse any medical or health product.Y. An article written by a physician must be evidence-based and disclose connections with pharmaceutical or health product companies. A physician should only make a general opinion and shall refrain from making a specific diagnosis. In serious/difficult cases. post graduate training and former connections with hospitals or clinics may be posted. The physician should hold as sacred and highly confidential whatever may be discovered or learned pertinent to the patient even after death. and treatment of a case under his/her care. 12 . special certificates or diplomas. a physician may use professional cards. Furthermore. Only the name of the physician and membership to a society or institution may be mentioned or posted. independence and respect for human dignity. members of the immediate family that are of legal age. the Board may order the reinstatement of any physician whose certificate of registration has been revoked if: a. Section 3. safety and public health. Duties of Physicians to Allied Professionals I. Penalties.LEGAL MEDICINE Atty. In case of unconciousness or in a state of mental deficiency the informed consent may be given by a spouse or immediate relatives and in the absence of both. Section 4. A physician shall respect the right of the patient to refuse medical treatment. A physician should cooperate with the duly constituted health authorities in the education and enforcement of laws and regulations for the promotion of health. Duties of Physicians to their Patients 2. specific methods of treatment. immoral or dishonorable act. Timely notice of the worsening of the disease should be given to the patient and/or family. the physician must attend to the victims. therapy or projection to individual cases in his appearances in the broadcast media. 13. DUTIES OF PHYSICIANS TO THE COMMUNITY Section 1. He/she maybe accorded a fair and just remuneration when called upon as an expert witness. For internet web Section 5. or by imprisonment of not less than one year nor more than five years. only the name of the physician. A physician should never condone nor connive with such fake health providers. Except in internet web Section 4. field of specialty. 2016 . publications. MD A. by the party authorized by an advanced directive of the patient. and c. charlatans and quacks in as much as their nefarious practices may cause injury to health and life. A physician shall assist the government in the administration of justice in accordance with law. A physician should be dedicated to provide competent medical care with full professional skill in accordance with the current standards of care. Reinstatement. However. post graduate training. Informed consent in the case of minor should be given by the parents or guardian. sites.

Whenever a physician makes a social or business call on a patient under the care of another. However. However. Physicians should never pay nor receive commission to or from any allied health worker for cases referred. A physician shall waive his professional fees to a colleague. Members of the editorial board of medical journals should possess adequate qualifications. Section 16. The patient should be returned to the care of the primary physician as soon as possible. IV. children and parents who are financially dependent on him. The primary and consultant physicians should always observe the proper protocol of the referral system. DUTIES OF PHYSICIANS TO THEIR COLLEAGUES TO THE PROFESSION Section 13. Section 6. Patdu. the matter should be referred to the Philippine Medical Association or the specialty society concerned. Section 11. 2016 . Section 4. Section 2. a physician should forward a clinical abstract and specify the purpose as to whether the case is for opinion/evaluation. Continuing medical education conferences and professional meetings must contribute to improve and optimize patients care or address the educational needs of the targeted medical audience. Ivy D. Any remuneration should be reasonable and should not constitute an enticement. A physician is encouraged to report to the Philippine Medical Association or the Board of Medicine personal knowledge of any corrupt or dishonest conduct of the members of the profession. or for transfer of service. Physicians may request donations for a charitable purpose for as long as it does not redound to his or her personal benefit. Section 8. Written articles and scientific presentations in scientific conferences should include full disclosure of any pharmaceutical support and should be independent of any commercial influence. lodging and meal expenses. DUTIES OF PHYSICIANS TO ALLIED PROFESSIONALS Section 1. Section 14. Section 5. A physician shall not receive any commission for referring patients to a colleague. Section 7. Section 10. Research activities shall be ethically defensible. the attending physician should always seek consultation from an available appropriate specialist. In making a referral. after the lectures.LEGAL MEDICINE Atty. Only gifts of reasonable value that primarily entail benefit to patient care or related to physicians’ work may be accepted by a physician from a health product company. the substitute physician shall treat the patient with the same dedication and quality of care extended to his/her own patient. 13 . The physician shall not derive any form of material gain from product samples. MD A.. Section 3. Section 15. nominal gifts during occasions may be received by a physician. in cases where a physician has to suspend service during temporary absences. socially responsible. Research trials conducted by physicians for an industry should be done in accordance with the national or institutional guidelines for the protection of human subjects. With the consent of the patient. making comments pertaining to the case is unethical unless if an emergency arises. arrangements for these should not influence the planning nor interfere with the CME activities. Physicians may accept reasonable subsidies from health and other industries to support their participation in CME events. Scholarships for physicians and medical students are permissible as long as the selection of scholars are made by the organizers or academic institutions concerned. The consultant may make another referral but should seek permission from the primary physician. When necessary. Section 5. Section 2. for co-management. Section 9. third person or institution. V. Physicians may participate in post-marketing or similar activities where they are asked to try new products on patients provided that the patients are properly informed and have given their informed consent. Section 1. When commercial exhibits are part of the overall program.2017 III. The faculty/speaker/consultant of conferences or meetings is allowed to accept from health industries honoraria and reimbursement for reasonable transportation. the sponsoring entity may promote or indicate their branded products. his or her spouse. They must be organized by a medical society on its own or in cooperation with sponsoring entities. Section 3. Generic names shall be used during the course of CME activities. RELATIONSHIP OF PHYSICIANS WITH THE HEALTH PRODUCTS INDUSTRY Section 1. Funds from commercial sources may be accepted for the benefit of the association or society. and scientifically valid. Whenever there is an irreconcilable difference of opinion in the management of a case. Physicians are encouraged to report or share the result of such activities to the duly constituted authorities. Section 4. Section 12. Section 6.Y. Only relevant information of the product should be included in the exhibit area.

The attending physician of any: hospital medical clinic sanitarium or other medical establishments. f) the place where the injury was sustained. all cases of violations of this Act or of its implementing rules and regulations. 212. The license or permit of the attending physician shall be cancelled upon the third violations of this Act or of its implementing rules and regulations. MD A. It refers to the lack of sufficient intelligence and knowledge of the full significance of one’s acts (People vs Nabong) -General Rule: Lack of sufficient education is MITIGATING SECTION 3.LEGAL MEDICINE Atty. hear and decide. SECTION 1. 174. 15. Amending Presidential Decree No. or any other medical practitioner. d) the nature and probable cause of the patient’s injury. 263. Patdu. upon due notice. in consultation with the Philippine Constabulary. Any violation of this Act or of the aforesaid rules and regulations issued by the Secretary of Health. -Alternative Circumstances oRelationship oIntoxication oDegree of instruction and education of the offender The report called shall indicate. in consultations with the Philippine Constabulary. RPC Arts.Y. e) the approximate time and date when the injury was sustained. 365 Provided. the following: a) the name.2017 14. 1987) SECTION 4. who has treated any person for serious or less serious physical injuries as these injuries are defined in Articles 262. Revised Penal Code Provided.00). age and address of the patient. 259. 347. 169 (July 10. -Instruction or Education As an alternative circumstance. g) the time. shall be punished administratively with a fine that shall not be less than One Hundred Pesos (P100. 264 and 265 of the RPC shall report the fact of such treatment promptly to the nearest government health authority: 15. The Board of Medicine shall have the original and exclusive jurisdiction to investigate. EO No.. date and nature of the treatment. further. 14 . shall promulgate the rules and regulations necessary to carry out the purposes of this Act. That no fee shall be charged for the transmission of such report through government communication facilities: Article 15. upon written request. Ivy D. c) the name and address of the person who brought the patient for medical treatment. 2016 . the prognosis and/or disposition of the patient.Alternative Circumstance -Those which must be taken into consideration as aggravating or mitigating according to the nature and effects of the crime and the other conditions attending its commission. -Exceptions: oCrimes against property oCrimes against chastity oTreason oMurder oRape The Secretary of Health. SECTION 2. b) the name and address of the nearest of kin of the patient. and h) the diagnosis. be made available to law enforcement agencies. That records of the reports kept by said health authorities shall. when practicable. subject to review by the Professional Regulation Commission when seasonably appealed thereto.00) nor more than Five Hundred Pesos (P500. it does not refer only to literacy but more to the level of intelligence of the accused. 1.

Abortion Practiced by a Physician or Midwife in dispensing of abortives a. Revised Penal Code -Certificate is any writing by which testimony is given that a fact has or has not taken place.2017 -The operative act in the simulation is the registration of the child in the registry of births as the pretending parents own. knowing that she did not possess the necessary technical knowledge or skill to do so.Would a prudent man. -Punishable Acts oSimulation of births oSubstitution of one child oConcealment or abandonment of a legitimate child 2. not being a regular practitioner. Ivy D. 1.That said physician or midwife takes advantage of his or her scientific knowledge or skill Test of Negligence. oThat it be without malice. prescribing for.. causes or assists in causing the abortion iv. Revised Penal Code The allegations in the information in this case that the accused acted with reckless negligence in diagnosing. physical condition. time and place.That the abortion is intended iii.Concealment or Abandonment of legitimate child (elements) oThe child must be legitimate oThe offender conceals or abandons such child oThe offender has the intent to cause such child to lose its civil status (2) Private individual who falsified a certificate falling in the classes mentioned in par. said accused was found guilty and convicted by this Court of physical injuries through imprudence under the old Penal Code. and on the day of the supposed delivery. Revised Penal Code -The simulation which is a crime is that which alters the civil status of person 1.LEGAL MEDICINE Atty.That there is no proper prescription from a physician iii.Simulation of births. since ordinary diligence counsels one not to tamper with human life by trying to treat a sick man when he knows that he does not have the special skill. the law imposes a duty on the actor to refrain from that course or to take precaution against its mischievous results.Simulation of Birth – When the woman pretends to be pregnant when in fact she is not. and may consequently reasonably foresee harm or injury to the latter. sufficiently charge the crime of homicide through reckless imprudence. false certificate of Merit or Service (1) Physician or surgeon who. takes the child of another as her own. MD A. in connection with the practice of his profession. substitution of one child.That the offender dispenses any abortive -Case : People vs Vda de Golez Article 347. thus causing her death. in the position of the person to whom negligence is attributed. who must be a physician or midwife. O The crime is False Medical Certificate by a private individual Article 365. and competence to attempt such treatment and cure. knowledge.That the offender. Patdu. 2016 . oThat material damage results from the reckless imprudence. 1. 1 and 2 of Art. undertook to render medical assistance to another. Revised Penal Code -Reckless Imprudence (elements) oThat the offender does or fails to do an act. 1. In a similar case wherein the accused.Imprudence or Negligence Article 259. causing physical injuries to the latter. and concealment or abandonment of a legitimate child. and other circumstances regarding persons. taking into consideration his employment or occupation. and treating the deceased Susana Tam. 15 .As to pharmacists (elements) i. and oThat there is inexcusable lack of precaution on the part of the offender. degree of intelligence. and the failure to do so constitutes negligence (Picart vs Smith) b.That the offender is a pharmacist ii.That there is a pregnant woman who has suffered an abortion ii. issued a false certificate O The crime is False Medical Certificate by a Physician -The one who simulates and furnishes the child both liable as Principals 3.As to physician and midwife (elements) i. foresee harm to the person injured as a reasonable consequence of the course about to pursued? If so. Article 174. 174. oThat the doing or the failure to do that act is voluntary.False Medical Certificate.Y.

Immediate cause of death is shock. the negligence must be the proximate cause of the injury. ignorance or incompetence other than administrative liability. The following day. Rowena noticed that the clinic was untidy.2017 -Negligence causing Injury to the patient O The Medical Act imposes the penalty of imprisonment. only a preponderance of evidence is required to establish civil liability. Cruz and Dr. For. disseminated intravascular coagulation (DIC) as antecedent cause. A few hours later.LEGAL MEDICINE Atty. so they did. this Court finds the petitioner civilly liable for the death of Lydia Umali. O Gross negligence. Cruz and Ercillo that there was nothing he could do. and scheduled her for a hysterectomy operation or the removal of uterus on 23 Mar 1991. but there was no more type A blood available in the blood bank. Rowena asked Dr. but when he arrived. Lydia was already in shock and possibly dead (BP: 0/0). our hands are bound by the dictates of justice and fair dealing which hold inviolable the right of an accused to be presumed innocent until proven guilty beyond reasonable doubt. cannot be attributed to the petitioner's fault or negligence. Later in the evening. this transfer was without the consent of the relatives. Dr. Angeles told Drs. ignorance. This court has no recourse but to rely on the expert testimonies rendered by both prosecution and defense witnesses that substantiate rather than contradict petitioner's allegation that the cause of Lydia's death was DIC which. for while a conviction of a crime requires proof beyond reasonable doubt. Cruz was closing her abdominal wall. Cruz asked the family to buy additional blood. or incompetence in the practice of Medicine resulting in an injury to or death to the patient may be basis for reward of damages under the Civil Code which makes every person who negligently causes to another liable to indemnify the latter for the same (Articles 19-21. The probability that Lydia's death was caused by DIC was unrebutted during trial and has engendered in the mind of this Court a reasonable doubt as to the petitioner's guilt. She was then transferred to another hospital so she could be connected to a respirator and further examined. the operation was finished. Cruz and Dr. Ercillo because blood was oozing out from her incision. produces the injury. the connection between the negligence and the injury must be a direct and natural sequence of events. Rowena noticed that her mother was gasping for breath–apparently. unbroken by any efficient intervening cause. Certainly. A person arrived to donate blood which was later transfused to Lydia. However. Cruz said that the operation must go on as scheduled. In order that there may be a recovery for an injury. Ercillo were charged with reckless imprudence and negligence resulting in homicideof 16 . but later. so she tried to persuade her mother not to proceed with the operation. They summoned Dr. Ercillo (anesthesiologist) told them to buy tagamet ampules. most often brought as a civil action for damages under NCC 2176 or a criminal case under RPC 365. Cruz if the operation could be postponed. so the family went out to buy oxygen. Cruz is guilty of reckless imprudence resulting to homicide. HELD: No. Dr. ISSUE: Whether or not Dr. and without which the result would not have occurred. Cruz responsible for Umali’s death. it must be shown that the 'injury for which recovery is sought must be the legitimate consequence of the wrong done. 2016 . no matter in what it consists. 282 SCRA 188 (1997) Doctrine: Medical malpractice suit is a type of claim which a victim has available to him/her to redress a wrong committed by a medical professional which has caused bodily harm. In the new hospital.Y. which. Dr. Dr. An hour later. the oxygen supply had run out. fine or both for any person found guilty of illegal practice of medicine. but held Dr.' And 'the proximate cause of an injury is that cause. with which a civil action for damages is impliedly instituted. unbroken by intervening efficient causes. While Lydia’s relatives were waiting. MD A. she was re-operated upon by Dr. her acquittal of the crime of reckless imprudence resulting in homicide. but Lydia told her daughter that Dr. cannot create a right of action unless it is the proximate cause of the injury complained of. who only found out about it when an ambulance came to take Lydia to the other hospital. Angeles. The Municipal Trial Court in Cities (MTCC) found Dr. however. The heirs of the deceased continue to feel the loss of their mother up to the present time and this Court is aware that no amount of compassion and commiseration nor words of bereavement can suffice to assuage the sorrow felt for the loss of a loved one. RTC and CA affirmed MTCC. Thus. Ercillo not guilty for insufficiency of evidence against her. and they spent the night there.' 16. and Rowena’s sister went out to buy some. FACTS: Lydia Umali was examined by Dr. in natural and continuous sequence. The petitioner is a doctor in whose hands a patient puts his life and limb. the award of moral and exemplary damages in favor of the heirs of Lydia Umali are proper in the instant case. A precious life has been lost and the circumstances leading thereto exacerbated the grief of those left behind. Lydia died while Dr. she went into shock and her blood pressure dropped. Cruz vs Court of Appeals. Cruz who found a myoma or a benign tumor in her uterus. as attested to by an expert witness. Dr.'In other words. While we condole with the family of Lydia Umali.. There is no penalty under the Medical Act of 1959 for gross negligence. 'negligence. Rowena Umali de Ocampo accompanied her mother to the hospital a day before the operation. Patdu. Nevertheless. Ercillo asked them to buy blood for Lydia. Ob-Gyne head of the new hospital. For insufficiency of evidence this Court was not able to render a sentence of conviction but it is not blind to the reckless and imprudent manner in which the petitioner carried out her duties. Ivy D. 2176 of the NCC) Lydia Umali.

Civil Code Arts. (1103) The State is responsible in like manner when it acts through a special agent. Art. (n) Art.LEGAL MEDICINE Atty. That the Effect of such is harmful to others was sufficiently probable to warrant his conduct or guarding against its consequence. (n) A Conduct is said to be negligent when a prudent man in the position of the tortfeasor would have foreseen that an effect harmful to another was sufficiently probable to warrant his foregoing the conduct or guarding against its consequence. no person shall be responsible for those events which could not be foreseen. But if his negligence was only contributory. but the courts shall mitigate the damages to be awarded. though foreseen.2017 17. is obliged to pay for the damage done. so long as they remain in their custody. Determination of negligence is a question of foresight on the part of the actor. When the plaintiff's own negligence was the immediate and proximate cause of his injury. Whoever by act or omission causes damage to another. there being fault or negligence. Responsibility for fault or negligence under the preceding article is entirely separate and distinct from the civil liability arising from negligence under the Penal Code. to one in the position of the actor. The physician violated the applicable standard of care (Beach) 3. in which case what is provided in Article 2176 shall be applicable. Responsibility arising from negligence in the performance of every kind of obligation is also demandable. (n) Test to determine negligence: Did the defendant n doing the alleged negligent act use that reasonable care and caution which an ordinary prudent person would have used in the same situation? If not the person is guilty of negligence Art. The owners and managers of an establishment or enterprise are likewise responsible for damages caused by their employees in the service of the branches in which the latter are employed or on the occasion of their functions. shall apply. Such fault or negligence. 1172. if there is no pre-existing contractual relation between the parties. Art. paragraph 2. If the law or contract does not state the diligence which is to be observed in the performance. but not when the damage has been caused by the official to whom the task done properly pertains. The injury was caused in fact and proximately caused by the substandard conduct (Proximate Causation) The father and. the mother. are responsible for the damages caused by the minor children who live in their company. The obligation imposed by Article 2176 is demandable not only for one's own acts or omissions. Patdu. Risk is the danger which is apparent or should be apparent. or when it is otherwise declared by stipulation. The provisions of Articles 1172 to 1174 are also applicable to a quasi-delict. The fault or negligence of the obligor consist in the omission of that diligence which is required by the nature of the obligation and corresponds with the circumstances of the persons. 1174. The person suffered a compensable injury (Compensable Injury) 4. the plaintiff may recover damages. he cannot recover damages. that which is expected of a good father of a family shall be required. 2176-2180 Employers shall be liable for the damages caused by their employees and household helpers acting within the scope of their assigned tasks. even though the former are not engaged in any business or industry.Y. (1104a) Lastly. (1105a) 18. 2179. or when the nature of the obligation requires the assumption of risk. 17 . 2178. Guardians are liable for damages caused by the minors or incapacitated persons who are under their authority and live in their company. (1902a) Conduct which creates undue risk of harm to other. Ivy D. MD A. 2177. were inevitable. is called a quasi-delict and is governed by the provisions of this Chapter. The burden of proving these elements is on the plaintiff in a malpractice lawsuit. A duty of care was owed by the physician (Duty) 2. or which. But the plaintiff cannot recover damages twice for the same act or omission of the defendant. Elements of Medical Negligence 1. 1173.. teachers or heads of establishments of arts and trades shall be liable for damages caused by their pupils and students or apprentices. What is Negligence? Art. The responsibility treated of in this article shall cease when the persons herein mentioned prove that they observed all the diligence of a good father of a family to prevent damage. Art. in case of his death or incapacity. (1903a) Art. Except in cases expressly specified by the law. 2180. according to the circumstances. 1172-1174. but also for those of persons for whom one is responsible. 2016 . the provisions of Articles 1171 and 2201. of the time and of the place. 2176. The fault or negligence of the obligor consist in the omission of that diligence which is required by the nature of the obligation and correspondence of the persons of the time and of the place Art. but such liability may be regulated by the courts. the immediate and proximate cause of the injury being the defendant's lack of due care. When negligence shows bad faith.

petitioner immediately suggested a D&C procedure instead of closely monitoring the state of pregnancy of Editha. 2179 of NCC provides: When the plaintiff’s own negligence was the immediate and proximate cause of his injury. but the courts shall mitigate the damages to be awarded. Victor B. three months pregnant Editha Ramolete (Editha) was brought to the Lorma Medical Center (LMC) in San Fernando.. It is undisputed that Editha did not return for a follow-up evaluation. In defiance of petitioner’s orders. Editha was discharged from the hospital the following day. The immediate cause of Editha’s injury was her own act. MD A. the chain of continuity as required in order that the doctrine of proximate cause can be validly invoked was interrupted. Had she returned. 1994. Editha was admitted to the LMC on the same day. the plaintiff may recover damages. he stated further that assuming that there was in fact a misdiagnosis. the immediate and proximate cause of the injury being the defendant’s lack of due care. On November 7. Feeling aggrieved it went to PRC for Appeal and the PRC rendered a decision reversing the findings of the Board of Medicine and revoking the License of the petitioner Art. she has no more chance to bear a child." Whether or not the Petition for Review under Rule 43 of Rules of Court is an improper remedy as PRC is not among those quasi-judicial bodies whose judgment or final orders are subject for a petition for review under the CA? On July 30. herein respondent advised her to return on August 4. 1994 or four (4) days after the D&C. Had Editha returned. But if his negligence was only contributory. La Union due to vaginal bleeding. until its eventual rupture. Proximate Cause. petitioner performed the D&C procedure. Granting that the obstetrician-gynecologist has been misled (justifiably) up to the point that there would have been ample opportunity to rectify the misdiagnosis. Thus. however the court said that it was an improper remedy because as the enumeration of the quasi-judicial agencies in Rule 43 is exclusive. Respondents alleged that Editha’s hysterectomy was caused by petitioner’s unmitigated negligence and professional incompetence in conducting the D&C procedure and the petitioner’s failure to remove the fetus inside Editha’s womb. It was one and a half months later that the patient sought consultation with another doctor. until she suffered the alleged severe abdominal pain and vomiting. second. Beatriz de la Cruz. as instructed for herfollow-up evaluation. The omission in not returning for a follow-up evaluation played a substantial part in bringing about Editha’s own injury. third. Manalo. 1994. however respondent failed to show for follow up checkup. Upon advice of petitioner relayed via telephone. petitioner recommended that a D&C procedure be performed on Editha without conducting any internal examination prior to the procedure. Editha had to undergo a procedure for hysterectomy6 and as a result. petitioner could have conducted the proper medical tests and procedure necessary to determine Editha’s health condition and applied the corresponding treatment which could have prevented the rupture of Editha’s uterus. the petition for review of the PRC Decision. he cannot recover damages. The continued growth of an ectopic pregnancy. In Petitioners answer it alleged that it was the respondents own negligence. visit or administer medication on Editha during her first day of confinement at the LMC. Komiya. HELD: 1st Issue: The Court ruled that when complainant was discharged on July 31. On September 16. Editha was once again brought at the LMC. PRC is not among the quasi-judicial bodies whose judgment or final orders are subject of a petition for review to the CA. 1994. in the testimony of Dr. Editha was attended by Dr. The D&C procedure having been conducted in accordance with the standard medical practice. she cannot recover damages from the injury. petitioner advised Editha to undergo a Dilatation and Curettage Procedure (D&C) or "raspa. Editha omitted the diligence required by the circumstances which could have avoided the injury. Petitioner brought the matter to CA in a Petition for Review under Rule 43 of rules of court. because respondent was advised to return for follow up checkup or to check her condition if she still suffering from any abdominal pain or to check for progress. respondent. the same would have been rectified if Editha followed the petitioner’s order to return for a check-up on August 4. as she was suffering from vomiting and severe abdominal pains. This being the case. 2016 . The following day. Patient’s own negligence – Cayao-Lasam vs Ramolete. Due to persistent and profuse vaginal bleeding. Ivy D. After. 1994. 574 SCRA 439 (2008) CA.2017 19. Mayo allegedly informed Editha that there was a dead fetus in the latter’s womb. she was found to have a massive intra-abdominal hemorrhage and a ruptured uterus. 1994. is a dynamic process. The Board of Medicine of the PRC rendered a decision exonerating the Petitioner. Among the alleged acts of negligence were: first. Dr. complainant failed to do so. ISSUE: Whether or not the Petitioners negligence is the PROXIMATE cause of the respondents suffering from intra-abdominal hemorrhage and a ruptured uterus? (Which Constitutes Medical Malpractice) FACTS: On July 28. Mayo and Dr. including the emergence of suggestive ones. petitioner’s failure to check up. thus. This advice was clear in complainant’s Discharge Sheet. Juan V.LEGAL MEDICINE Atty. Editha’s repeat pelvic sonogram showed that aside from the fetus’ weak cardiac pulsation. A pelvic sonogram was then conducted on Editha revealing the fetus’ weak cardiac pulsation. Editha and her husband Claro Ramolete (respondents) filed a Complaint for Gross Negligence and Malpractice against petitioner before the Professional Regulations Commission (PRC). the respondent could have examined her thoroughly. filed at the 18 . 1994. Editha underwent laparotomy. no fetal movement was also appreciated. thus. was improper. had the patient returned.Y. Also. Dr. in defiance of the petitioner’s advice. However. Much change in physical findings could be expected in 1 ½ months. Patdu.

and without which the result would not have occurred. however. 167 SCRA 363 (1988) What is "Res Ipsa Loquitur"? On May 15. An injury or damage is proximately caused by an act or a failure to act. and 5.2017 Proximate cause has been defined as that which. had exclusive control of the instrumentality that caused the injury. Bagabag. Other examples: •Operating on the wrong patient •Operating on the wrong part of the patient Layugan vs IAC FACTS: 20. an unconscious patient certainly cannot be deemed responsible for this type of injury. instrumentalities. Elements for invoking res ipsa loquitur: 1. While repairing. that the proximate cause of the incident was the failure of the driver of the parked truck in installing the early warning device. the court invoked res ipsa loquitur and inferred negligence against the flour company based on the surrounding circumstances. Nueva Vizcaya. “the thing speaks for it self” and implies that the plaintiff need only show that a particular result occurred but for someone’s negligence. Defendant admitted his ownership of the vehicle involved in the accident driven by Daniel Serrano. and as a result.) Blg. right after the curve. The Court held that the law has since been changed. defendant's truck driven recklessly by Daniel Serrano bumped the truck being repaired. plaintiff was injured and hospitalized. a surgical instrument would not be left in a patient in the absence of someone's negligence. 2nd Issue: In virtue of BP 129. the burden is not on the plaintiff to show how the defendant was negligent. knocking him unconscious. or its employees or agents. whenever it appears from the evidence in the case that the act or omission played a substantial part in bringing about or actually causing the injury or damage. but on the defendant to show that he or she was not negligent.Y. 1979 at Baretbet. the Plaintiff.The injury is not the kind that ordinarily occurs in the absence of negligence by someone 3. orders or awards of Regional Trial Courts and quasi-judicial agencies. In the case of Yang v. Yet clearly. Typically. "res ipsa loquitur" would likely apply here.The plaintiff was not responsible for his or her own injury 4. MD A. Batas Pambansa Bilang 129 became effective and in its Section 29. conferred on the Court of Appeals "exclusive appellate jurisdiction over all final judgments. Although the man was unable to present any direct evidence of negligence. Smith left forceps in patient's abdomen. a man had been outside a flour dealer when a barrel of flour fell out of a window and struck him. 2016 . Nueva Vizcaya. Res ipsa loquitur: Layugan vs Intermediate Appelate Court. unbroken by any efficient intervening cause.Evidence of the actual cause of the injury is not obtainable 2. not a truck helper being a brother-in-law law of the driver of said truck.LEGAL MEDICINE Atty. produces injury. Invoking Res Ipsa Loquitur: Once this doctrine is successfully invoked. Also. 12938 conferred upon the CA exclusive appellate jurisdiction over appeals from decisions of the PRC. IAC acted incorrectly. Court of Appeals it ruled that Batas Pambansa (B. Res ipsa loquitur allows plaintiffs to use circumstantial evidence to infer negligence.P. 1981." and there may be no recorded proof of how or why the negligence occurred. and that the injury or damage was either a direct result or a reasonably probable consequence of the act or omission.The injury could not have been caused by any instrumentality other than that over which the defendant had control. and it would have been the operating physician and staff who had exclusive control over the surgical tools. the 19 . decisions. Boadle.. A classic example of the type of case in which "res ipsa loquitur" arises is where a sponge or other medical instrument is left inside a person after surgery. In Byrne. So. It follows that in stamping its imprimatur upon the invocation by respondent Isidro of the doctrine of Res ipsa loquitur to escape liability for the negligence of his employee. The popularity of the doctrine grew significantly following the landmark 1863 English case Byrne v. Patdu. the IAC acted correctly in applying the doctrine of Res ipsa loquitur HELD: No. Layugan filed an action for damages against Godofredo Isidro. ISSUE: Whether or not. appeals from the Professional Regulations Commission are now exclusively cognizable by the Court of Appeals. Ivy D. Defendant countered that the plaintiff was merely a bystander. records of the surgery will not include a statement such as "Dr. boards or commissions except those falling under the appellate jurisdiction of the Supreme Court. that the truck allegedly being repaired was parked. On August 14. resolutions. The respondent court rendered a decision finding the petitioner negligent under the doctrine of res ipsa loquitur. hence the driver of the parked car should be liable for damages sustained by the truck of the defendant.The defendant. Res Ipsa Loquitur is a latin phrase meaning. at least in the matter of the particular court to which appeals from the Commission should be taken. the owner of the truck driven by Serrano. The absence or want of care of Daniel Serrano has been established by clear and convincing evidence. occupying almost half of the right lane towards Solano. in natural and continuous sequence. Pedro Layugan and his companion were repairing the tire of their cargo truck which was parked along the right side of the Highway.

upon the request of petitioner Erlinda. is not intended to and does not dispense with the requirement of proof of culpable negligence on the part of the party charged. Finally. when applicable to the facts and circumstances of a particular case. they were certainly not completely independent of each other so as to absolve one from the negligent acts of the other physician. Hosaka and Dr. and in the use and employment of an endotracheal tube. Dr. The doctrine can be invoked when and only when. 21. knew of any anesthesiologist. 1985.Y. MD A. She was released from the hospital only four months later or on November 15. under the circumstances involved. However. no presumptions will be involved and the doctrine becomes inapplicable when the circumstances have been so completely elucidated that no inference of defendant's liability can reasonably be made. the Court of Appeals reversed the trial court’s decision and directed petitioners to pay their "unpaid medical bills" to private respondents. the nailbeds of the patient remained bluish. named Dr. 20 . was allowed to accompany her inside the operating room. She was referred to Dr.2017 respondent court committed reversible error. On December 29. On appeal by private respondents. After due trial. who agreed to perform the operation on her. direct evidence is absent and not readily available. FACTS : Petitioner Erlinda Ramos. Even the counsel of Dr.LEGAL MEDICINE Atty. or more than three (3) hours after the scheduled operation. Calderon. direct evidence is absent and not readily available. Petitioners filed with this Court a petition for review on certiorari. Herminda went out the Operating Room to express her concern to Rogelio that the operation was not going well and when she returned back. Essentially. after seeking professional medical help. The doctrine of Res ipsa loquitur as a rule of evidence is peculiar to the law of negligence which recognizes that prima facie negligence may be established without direct proof and furnishes a substitute for specific proof of negligence. Hence. During the operation. where plaintiff has knowledge and testifies or presents evidence as to the specific act of negligence which is the cause of the injury complained of or where there is direct evidence as to the precise cause of the accident and all the facts and circumstances attendant on the occurrence clearly appear. she saw Erlinda for the first time on the day of the operation itself. Still. Gutierrez. a surgeon. Captain of Ship Doctrine. As she herself admitted. 1999. who was then Dean of the College of Nursing at the Capitol Medical Center. Petitioners filed for damages against the respondent in the RTC of Quezon City. On the day of operation. Gutierrez omitted to perform a thorough preoperative evaluation on Erlinda. Gutierrez admitted to this fact during the oral arguments. Had she been able to check petitioner Erlinda’s airway prior to the operation. Hosaka came late at around 12:10 in the afternoon. Another doctor was called to intubate the patient. It merely determines and regulates what shall be prima facie evidence thereof and facilitates the burden of plaintiff of proving a breach of the duty of due care. under the circumstances involved. it has generally been held that the presumption of inference arising from the doctrine cannot be availed of. Dr. the trial court found that private respondents were negligent in the performance of their duties to Erlinda. this Court promulgated the decision which private respondents now seek to be reconsidered. Hosaka and Dr. Dr. whatever the source of the evidence. res ipsa loquitur – Ramos vs Court of Appeals. Erlinda remained in comatose condition until she died on August 3. 380 SCRA 467 (2002) Doctrine of Captain of the Ship applies in this case because while the professional services of Dr. Since neither petitioner Erlinda nor her husband. Patdu. Since the illfated operation. Hosaka recommended to them the services of Dr. Gutierrez would most probably not have experienced difficulty in intubating the former. ISSUE : The doctrine can be invoked when and only when. Ivy D. Herminda Cruz. The motion for reconsideration was denied. her sister-in-law. The doctors explained to petitioner Rogelio that his wife had bronchospasm. 1985 at 9:00 in the morning at private respondent De Los Santos Medical Center (DLSMC). Doctrine is inapplicable where the actual cause of injury is established beyond controversy. Erlinda stayed in the ICU for a month. she saw the patient being wheeled to the ICU. and thus the resultant injury could have been avoided. Gutierrez performed a medical procedure on her. HELD: Doctrine of Res Ipsa Loquitur applies because the injury of the patient therein was one which does not ordinarily take place in the absence of negligence in the administration of an anesthetic. 1999. as in this case. The operation was scheduled for June 17. petitioner Rogelio. there is no cogent reason for the Court to reverse its finding that it was the faulty intubation on Erlinda that caused her comatose condition. Hosaka. Gutierrez had a hard time in intubating the patient and it was noticed by Herminda Cruz that Erlinda’s nailbeds turned blue. The rule. and that one does not exercise control over the other. The private respondents were then required to submit their respective comments thereon. She listened the patient’s heart and lungs and checked the latter’s blood pressure to determine if Erlinda was indeed fit for operation. the court a quo rendered judgment in favor of petitioners.. There is no question that Erlinda became comatose after Dr. or is overcome. one hour before the scheduled operation. Gutierrez were secured primarily for their performance of acts within their respective fields of expertise for the treatment of petitioner Erlinda. Dr. whether by the plaintiff or by the defendant. she did not proceed to examine the patient’s airway. 2016 . Gutierrez are liable. Whether or not Dr. was advised to undergo an operation for the removal of a stone in her gall bladder (cholecystectomy). once the actual cause of injury is established beyond controversy. Dr. Further.

as a matter of common knowledge and observation. Angelica’s right leg was amputated by Dr. 22. and platelets. once at the hospital after the surgery. it is conceded that in performing their responsibilities to the patient. Hosaka and Gutierrez worked as a team. Hosaka performed a surgery. This was disputed by respondents who countered that petitioner gave them assurance that there is 95% chance of healing for Angelica if she undergoes chemotherapy and that the only side effects were nausea. Soliman. herein petitioner Dr. RBC. Hosaka himself admitted that he was the attending physician of Erlinda. ISSUE: Whether or not petitioner committed medical malpractice. a layman would be able to say. a patient must prove that a health care provider in most cases a physician. 1993. and that failure or action caused injury to the patient. certainly aggravated the anxiety that she must have been feeling at the time. it was Dr. Respondents were apprehensive due to financial constraints as Reynaldo earns only from P70.2017 recover from the operation before starting the chemotherapy. Angelica Soliman underwent a biopsy of the mass located in her lower extremity at the St. 2016 . Hosaka exercised a certain degree of. Results showed that Angelica was suffering from osteosaucoma. Those were the only side effects of chemotherapy mentioned by petitioner. As a adjuvant treatment to eliminate any remaining cancer cells.) darkening of the skin especially when exposed to sunlight. when Erlinda showed signs of cyanosis. MD A. a medical oncologist. chemotherapy was suggested by Dr. nausea. Dr. Petitioner told respondents that Angelica should be given 2-3 weeks to 21 . however. Gutierrez to administer the anesthesia on his patient. petitioner saw the respondents at the hospital after Angelica’s surgery and discussed with them Angelica’s condition. is that type of claim which a victim has available to him or her to redress a wrong committed by a medical professional which has caused bodily harm. Whenever Dr. Tamayo and referred Angelica to another doctor at SLMC. In order to successfully pursue such claim. From the facts on record it can be logically inferred that Dr. Hosaka and Gutierrez had worked together since 1977. Rubi Li. Third. ostiobiostic type.LEGAL MEDICINE Atty.000-150. 7. She did not give the respondents any assurance that chemotherapy will cure Angelica’s cancer. Ivy D. Hosaka made Erlinda wait for him. Patdu. Petitioner claimed. supervision over the procedure then being performed on Erlinda. hence the indispensability of expert testimonies. 1993. The long period that Dr. and hence minimizing the chances of recurrence and prevent the decease from spreading to other parts of the patient’s body. Upon these facts and under these circumstances. The court went on to say that ordinarily a person being put under anesthesia is not rendered decerebrate as a consequence of administering such anesthesia in the absence of negligence. Lukes Medical Center (SLMC). Hosaka who recommended to petitioners the services of Dr. it was Dr. respondents 11 year old daughter.) Falling hair. Drs. 4. that she explained to respondents that even when a tumor is removed. she explained the following side effects of chemotherapy treatment to respondents: First. It could be safely said that her anxiety adversely affected the administration of anesthesia on her. day by day. Drs. Hosaka who gave instructions to call for another anesthesiologist and cardiologist to help resuscitate Erlinda. In effect. 165279. June 7. a high-grade (highly malignant) cancer of the bone which usually affects teenage children. twice at her clinic and fourth when Angelica’s mother called her through long distance. Dr. Gutierrez. 2011 HELD: No. 2. Their work cannot be placed in separate watertight compartments because their duties intersect with each other. Hosaka is also liable.) low count of WBC. 1.Y. Second.) loss of appetite. medical negligence. GR No. Medical negligence cases are best proved by opinions of expert witnesses belonging in the same general neighborhood and in the same general line of practice as defendant physician or surgeon. 3. and vomiting. Angelica experience worsening condition and other physical effect on the body such as discoloration. Petitioner. 5. The deference of courts to the expert opinion of qualified physicians stems from the former’s realization that the latter possess unusual technical skills which layman in most instances are incapable of intelligently evaluating. On July 23. that the consequences of professional treatment were not as such as would ordinarily have followed if due care had been exercised As the chemotherapy session started. vomiting and hair loss. there are still small lesions undetectable to the naked eye and that adjuvant chemotherapy is needed to clean out the small lesions in order to lessen the chance of cancer to recur. assured them not to worry about her professional fee and told them to just save up for medicines to be used. Gutierrez possessed the necessary competence and skills.000 a year from his jewelry and watching repair business.) nausea and vomiting. he would always engage the services of Dr.. either failed to do something which a reasonably prudent health care provider would have done or that he or she did something that a reasonably health care provider would not have done. During these consultations with respondents. FACTS: On July 7. She actually talked to the respondents four times.) Damage to kidney and heart. Thus. The type of lawsuit which has been called medical malpractice or more appropriately. at the very least. Elements of Medical Negligence – Li vs. Doctrine of Informed Consent. 6. he represented to petitioners that Dr.) possible sterility due to the effects on Angelica’s ovary. Following this diagnosis. Tamayo in order to remove the tumor.

Through CMC's acts. The Decision dated September 5. and a surgeon who performs an operation without his patient’s consent commits an assault. 3. a plaintiff must show that: (1) the hospital.2017 September 1. Villaflor. 8904 is REINSTATED and UPHELD. The doctrine of informed consent within the context of physician-patient relationships goes as far back into english common law. In the process. For a hospital to be liable under the doctrine of apparent authority. doctors were charged with the tort of battery if they have not gained the consent of their patients prior to performing a surgery or procedure. the plaintiff must also prove that the hospital had knowledge of and acquiesced in them.) as a direct and proximate result of the failure to disclose. CMC impliedly held out Dr.. who was then 37 years old. There are four essential elements a plaintiff must proved in a malpractice action based upon the doctrine of informed consent: 1. Branch 8. is a risk that cannot be ruled out.5 cm. Estrada was an employee or agent of CMC. Respondents could not have been unaware in the course of initial treatment and amputation of Angelica’s lower extremity that her immune system was already weak on account of the malignant tumor in her knee. Corazon Nogales ("Corazon").. Ivy D. Dr.) he failed to disclose or inadequately disclosed those risks. Corazon started to experience convulsionsAt 6:22 a. decrease in blood platelets. an exception to this principle. The Decision dated June 15. however. Estrada advised her immediate admission to the Capitol Medical Center ("CMC"). Estrada. In general. but such conclusion can be reasonably drawn from the general side effects of chemotherapy already disclosed. In the instant case. Estrada") beginning on her fourth month of pregnancy or as early as December 1975. 511 SCRA 204. by the nature of the disease itself. As early as 1767. This exception is also known as the "doctrine of apparent authority”. Dr. exercising ordinary care for her own welfare and faced with a choice of undergoing the proposed treatment. Petition for review on certiorari is GRANTED. CMC clothed Dr. may intelligently exercise his judgement by reasonably balancing the probable risk against the probable benefits. That death can possibly result from complications of the treatment or the underlying cancer itself. so that a patient. fire and exercise real control over their attending and visiting "consultant" staff. in Civil Case No. In other words. Patdu.Y. Corazon began to manifest moderate vaginal bleeding which rapidly became profuse. The gravamen in an informed consent requires the plaintiff to point to significant undisclosed information relating to the treatment which could have altered her decision to undergo it. post partum. the seminal case was Schoendorff vs Society of New York Hospital which involved unwanted treatment performed by a doctor.. MD A. each patients reaction to the chemical agents even with pre-treatment laboratory tests cannot be precisely determined by the physician.) plaintiff was injured by the proposed treatment. 2. every human being of adult year and sound mind has a right to determine what shall be done with his own body. The basis for holding an employer solidarily responsible for the negligence of its employee is found in Article 2180 of the Civil Code which considers a person accountable not only for his own acts but also for those of others based on the former's responsibility under a relationship of patria potestas.m. From a purely ethical norm. Oscar Estrada ("Dr. Estrada. When petitioner informed the respondents beforehand of the side effects of chemotherapy which includes lowered counts of white and red blood cells. there is reasonable expectation on the part of the doctor that the respondents understood very well that the severity of these side effects will not be the same for all patients undergoing the procedure. a hospital is not liable for the negligence of an independent contractor-physician. t 6:13 a. 2004 of the Court of Appeals in CA-G. immediately or sometime after the administration of chemotherapy drugs. as with most other major medical procedures. Estrada at his home. HELD: Private hospitals. ISSUE: Whether or not CMC is vicariously liable for the negligence of Dr. informed consent evolved into a general principle of law that a physician has a duty to disclose what a reasonably prudent physician in the medical community in the exercise of reasonable care would disclose to his patient as to whatever grave risk of injury might be incurred from a proposed course of treatment. 1997 of the Regional Trial Court of Legazpi City.At 6:27 a. assisted by Dr. 2004 and the Resolution dated 22 .R. After examining Corazon. CV No. There is. 228-29 (2006) FACTS: Pregnant with her fourth child. consistent with ordinary care and prudence. hire. the court held that there was adequate disclosure of material risks inherent in chemotherapy procedure performed with the consent of Angelica’s parents. applied low forceps to extract Corazon's baby. or none at all.0 x 2. as alternative treatment. a 1. In the United States.m. (2) where the acts of the agent create the appearance of authority.) the physician had a duty to disclose material risks. and (3) the plaintiff acted in reliance upon the conduct of the hospital or its agent. 2016 . Corazon died at 9:15 a. Estrada with apparent authority thereby leading the Spouses Nogales to believe that Dr.m. for which he is liable in damages. The cause of death was "hemorrhage. was under the exclusive prenatal care of Dr. 23. piece of cervical tissue was allegedly torn. acted in a manner that would lead a reasonable person to conclude that the individual who was alleged to be negligent was an employee or agent of the hospital. Corazon started to experience mild labor pains prompting Corazon and Rogelio Nogales ("Spouses Nogales") to see Dr.m. Examining the evidence. Consent Forms and Waiver – Nogales vs Capitol Medical Center. The hospital may be liable if the physician is the "ostensible" agent of the hospital. the patient consented to treatment she otherwise would not have consented to. 58013 are SET ASIDE.. possible kidney or heart damage and skin darkening. Estrada as a member of its medical staff. Around midnight of 25 May 1976. Justice Bejamin Cardozo oft-quoted opinion upheld the basic right of a patient to give consent to any medical procedure or treatment. and 4. or its agent.LEGAL MEDICINE Atty.

•Hospital. Dr. CMC extended its medical staff and facilities to Dr. 2016 . efficient and equitable care and treatment of patients. to extend life.To promote the practice of medicine by Physicians within the institution consistent with the acceptable quality of patient care. Estradas request for Corazons admission.To provide the best possible facilities for the care of the sick and injured at all times. readily accommodated Corazon and updated Dr. 24. 23 . the contents of which reinforced Rogelios belief that Dr. 2.To constantly upgrade and improve methods for the care. The second factor focuses on the patients reliance. in a proper legal forum or venue. gave the impression that Dr. contest unreasonable government issuances if any according to existing legal procedures. should conduct educational projects. Prior to Corazons admission and supposed hysterectomy. CMC asked Rogelio to sign release forms. Estrada. cognizant of their social responsibilities. through its personnel. CMC.Duty not to cause detention of patients due to nonpayment •Hospitals should remain and promote harmonious relationships within the organization. recognizing their unique role in safeguarding the nation’s health. Estrada of her condition. except in cases of transfer of patient according to accepted rules and norms. that other hospitals areinferior. the work of other hospitals or related organizations. to provide the best possible care and treatment to all in need of hospitalization. consistent with ordinary care and prudence HOSPITAL ETHICS: •Hospital must recognize that the care of the sick is their first responsibility and a sacred trust. Estradas referral of Corazons profuse vaginal bleeding to Dr. unless allowed in cases where there is a launching or celebration of annual events such as anniversaries. Estrada. Upon Dr. in addressing problems of epidemics and disasters. the cure. and similar event. who was then the Head of the Obstetrics and Gynecology Department of CMC. striving. should seek through compassionate and scientific care and health education.Duty to obtain license 2. Patdu. MD A. Estrada as a member of CMCs medical staff was collaborating with other CMC-employed specialists in treating Corazon. •Hospitals should cooperate with other hospitals. It is sometimes characterized as an inquiry on whether the plaintiff acted in reliance upon the conduct of the hospital or its agent. rules and regulations of the government and shall. HOSPITAL LIABILITY •Hospitals. HOSPITAL’S DUTIES TO THE GOVERNMENT: 1. stimulate research. and in the promotion of health programs and activities that would benefit the patient and the community.2017 First. PRIMARY OBJECTIVE OF THE HOSPITALS: 1. Ivy D. director indirectly. government and non-government. Estrada was a member of CMCs medical staff Third. and improve the general health of the communities they serve. health and welfare agencies. CMC made Rogelio sign consent forms printed on CMC letterhead. in reporting their work to the public. to the extent possible and within their limitations. Second. 2. •Advertisements by a hospital with statements claiming to be the “best hospital”. •Hospitals should seek to inspire the confidence of the entire community and should appreciate and respect the social and religious practices and customs of patients.LEGAL MEDICINE Atty. government programs. WHAT ARE CONSIDERED UNETHICAL ACTS? •Pirating the patient of another hospital. •Offering unconscionable discounts or packages for purposes of soliciting patients. should actively support and encourage every effective means which will ease the financial burdens of illness.Duty to render immediate emergency medical assistance 3.Whenever called upon. •Hospitals. 3. should give a factual and objective interpretation of accomplishments and objectives without putting down directly or indirectly by implication.The hospital shall always conform to the policies. or “hospital with the best doctors” or other statements depicting.Duty not to require deposit in emergency and serious cases 4. •Paying or offering to pay commissions or rebates to health professionals for purposes of soliciting patients.Must inform the government of any illegal or grossly unethical practice of other hospitals which could result to the irreversible disadvantage or harm to the patient or the community.Y. and other recognized organizations engaged in activities related to the health of the country. at all times. •Hospitals. to insure the proper environment for effective. Hospital Code of Ethics DUTIES OF HOSPITALS PROVIDED BY LAW: 1. amelioration and prevention of disease. and 3. CMC granted staff privileges to Dr. Espinola. and encourage preventive health practices in the community. alleviate suffering. must always cooperate with the government in the administration of justice..

injury or deformity. partnership. O It refers to a situation in which a patient has been suddenly or unexpectedly endangered to such an extent that immediate action is needed to save the life and limb or to avoid permanent damages. RA No. Under Section 1. facilities and services beyond first aid extended to emergency cases as required herein.2017 •Hospital should be fair. Penalties. maternity cases. 2. Republic Act No. sanitarial or sanitarial care. or neglect to notify or call a physician oIn the case of Government hospitals: •The imposition of the penalty upon the person or persons guilty of the violations shall be without prejudice to the administrative action that might be proper. An Act Requiring the Licensure of all Hospitals in the Philippines and Authorizing the Bureau of Medical Services to Serve as Licensing Agency. Sec. 2016 . medical center or clinic. or in need of obstetrical or other medical and nursing care. be suspended or revoked. which calls for an immediate action. and all institutions such as those for convalescence. association. Emergency – an unforeseen combination of circumstances. or 26. injuries. The term ‘hospital shall also be construed as any institution.. or bassinets for twenty-four-hour use or longer by patients in the treatment of diseases. diseased-conditions. personnel policies. 1. Ivy D. may arise after a medical procedure may arise. requires all government and private hospitals or clinic duly licensed to operate as such to: o Render immediate emergency medical assistance and oProvide facilities and medicine within its capabilities to patients in emergency cases who are in danger of dying and/or who may have suffered serious physical injuries Section 1. dispensaries and such other names by which they may designated. This Act shall also be known as the Hospital Licensure Act. subject to existing rules. treatment and care of individuals suffering from illness.An accident may occur in the course of a diagnostic or treatment procedure which requires emergency treatment.00 per year. and effort to maintain up-to-date equipment. RA No. whenever justified.Complications.The patient’s condition called for an emergency before the commencement or the management procedures. Under Section 2. The following are instances where a physician may be confronted with a condition of emergency : 1. MD A. oIn the case of private hospitals: •Aside from the imposition of penalty upon the person or persons guilty of the violations. manages or maintains a hospital or hospital clinic within the meaning of this Act without first obtaining a license as provided for in this Act or violates any provision hereof shall be guilty of a misdemeanor. or cribs. or abnormal physical and mental states. 24 . Liability of failure to comply with this RA (Section 3): oThe following shall be punished by imprisonment of 1 month and 1 day to 1 year and 1 day. disease. 000. 4. methods and standards of performance. Patdu. infirmities.00 – PhP 1. 2(a). conducts. 6615 (1972) Any nurse.Y. which require immediate attention.00 [without prejudice to the provisions of RA 2382 in the case of physicians]: Any hospital director. Section 2 ( a) ‘Hospital’ means a place devoted primarily to the maintenance and operation of facilities for the diagnosis.Unforeseen conditions. the expenses and losses of earnings incurred by a private hospital of clinic for medicines. who shall refuse or fail without good cause to render the appropriate assistance pursuant to the requirements of Section 1 after said case had been brought to his attention. 18 (1965) AN ACT REQUIRING THE LICENSURE OF ALL HOSPITALS IN THE PHILIPPINES AND AUTHORIZING THE BUREAU OF MEDICAL SERVICES TO SERVE AS THE LICENSING AGENCY RA 6615 – obliges hospitals and physicians to extend medical assistance in emergency cases.000. shall be deductible expenses and losses for income tax purposes which may be carried over for a period of 5 years. Section 18. – Any person. 6615 An Act Requiring Government and Private Hospital and Clinics to Extend Medical Assistance in Emergency Cases 25. 4226. officer-in-charge or physician in the hospital. and a fine of PhP 300. An Act Requiring Government and Private Hospitals and Clinics to Extend Medical Assistance in Emergency Cases. or corporation who establishes. and not to exceed PhP 50. administrator. any provision of law or regulation to the contrary notwithstanding. discovered during the application of a treatment procedure might require an emergency treatment. 3. deformities. and each day that the hospital shall operate after the first conviction shall be considered a subsequent offense. honest and impartial in all their business relationships and utilize legal and legitimate means in promoting their public relations. •The license of the hospital to operate shall. operates.LEGAL MEDICINE Atty. midwife or medical attendant who shall refuse to extend the appropriate assistance. •Hospitals should be progressive in policies. and upon conviction thereof shall be liable to a fine of not more than five hundred pesos for the first offense and not more than one thousand pesos for each subsequent offense. nurseries. building or place where there are installed beds.

4.2017 It is unlawful for any hospital or medical clinic to refuse administering to patients treatment and support that could prevent their death or permanent disability. SEC. in part or in full. whether government-owned or private. Republic Act No. If the patient is unconscious. In the case of a deceased patient. the law stated.000 to P50. or both. 1997. Ivy D. This Act shall take effect fifteen (15) days after its publication in two national newspapers of general circulation. are prohibited from refusing persons seeking medical help or from detaining them for nonpayment of hospital bills or medical expenses. An Act Prohibiting the Detention of Patients in Hospital and Medical Clinics on Grounds of Nonpayment of Hospital Bills or Medical Expenses RA No. shall be issued the corresponding medical certificate and other pertinent papers required for his/her release “upon the execution of a promissory note covering the unpaid obligation. also prohibits “request. Patients who have fully or partially recovered and who already wish to leave the hospital or medical clinic but are financially incapable to settle. It shall be unlawful for any hospital or medical clinic in the country to detain or to otherwise cause. The Department of Health shall promulgate the necessary rules and regulations to carry out the provisions of this Act. the doctor can transfer the patient even without his consent.” SEC. 25 . with a right to demand the issuance of the corresponding medical certificate and other pertinent papers required for the release of the patient from the hospital or medical clinic upon the execution of a promissory note covering the unpaid obligation. provided that the transfer is done only after necessary emergency treatment and support were administered to stabilize the patient and after it was established that the transfer would entail less risks than the patient’s continued confinement.. or both such fine and imprisonment. who will be jointly and severally liable with the patient for the unpaid obligation. approved on Aug. SEC. the detention of patients who have fully or partially recovered or have been adequately attended to or who may have died. In the case of a deceased patient. their hospitalization expenses. If any provision of this Act is declared void and unconstitutional the remaining provisions hereof not affected thereby shall remain in full force and effect.000. The promissory note shall be secured by either a mortgage or by a guarantee of a co-maker. 25.000. or the Hospital Detention Law. 9439 (2007) The law.000. 2016 . also known as the Anti-Hospital Deposit Law. That patients who stayed in private rooms shall not be covered by this Act. according to Republic Act No. demand or accept any deposit or any other form of advance payment as a prerequisite for confinement or medical treatment of a patient. ALL HEALTH facilities. MD A. at the discretion of the proper court. The hospital or clinic where the patient will be transferred shall not refuse him nor demand from the patient or his next of kin any deposit or advance payment. or upon instruction of its management. 2. 27. 2007. SECTION 1. SEC.000 to P500. Violators of RA 8344 shall be imprisoned for six months to two years and four months.000. RA 9439. If the health facility lacks medical capabilities. 6. Violators of the law shall be fined P20. or imprisonment of not less than one month. incapable of giving consent and/or unaccompanied. the director or officer of the hospital or clinic responsible for the formulation and implementation of the policy shall be imprisoned of four to six years or fined P100. 7. 5. who violates the provisions of this Act shall be punished by a fine of not less than Twenty thousand pesos (P20. approved on April 27.000 or imprisoned for one month to six months. Any officer or employee of the hospital or medical clinic responsible for releasing patients. or fined P20. the corresponding death certificate and other documents required for interment and other purposes shall be released to any of his surviving relatives requesting for the same: Provided.000 to P100. however.00). after the patient or his next of kin consented to the transfer and after the receiving hospital or medical clinic agreed to the transfer. including professional fees and medicines. decrees. If the violation is committed pursuant to an established policy of the hospital or clinic. who wants to leave the hospital.LEGAL MEDICINE Atty. A patient. applies only to charity patients and does not cover patients in private rooms. according to RA 8344. SEC. 8344. All laws.Y. However. shall be allowed to leave the hospital or medical clinic. directly or indirectly. solicit.00). orders. the corresponding death certificate and other documents required for interment and other purposes shall be released to any of his surviving relatives. 3. but not more than six months. SEC. but not more than Fifty thousand pesos (P50. rules and regulations or part thereof inconsistent with this Act are hereby repealed or amended accordingly. 9439. the attending physician may transfer the patient to a facility where the appropriate care can be given. states that health facilities are prohibited from detaining patients who have fully or partially recovered because of nonpayment in part or in full of hospital bills. Patdu. for reasons of nonpayment in part or in full of hospital bills or medical expenses.

Civil Code.act or omission. Ampil took over. Natividad's husband. Fuentes performed and completed the hysterectomy. Agana. 1431 Art.Y. 2. vs Court of Appeals. REPUBLIC ACT 8344. If the violation is committed pursuant to an established policy of the hospital or clinic. in any litigation arising out of such declaration. It concludes the truth in order to prevent fraud or falsehood.. Generally speaking estoppel is a bar which precludes a person from denying or asserting anything to the contrary of that which has. the doctor can transfer the patient even without his consent. to permit Dr. the pains intensified. otherwise known as “An Act Prohibiting the Demand of Deposits or Advance Payments for the Confinement or Treatment of Patients in Hospitals and Medical Clinics in Certain Cases”. Thereafter. Patdu. Ampil obtained the consent of Atty. otherwise known as the Anti-Hospital Deposit Law What are the prohibited acts under the law? 1. A recto-vaginal fistula had formed in her reproductive organ which forced stool to excrete through the vagina. 1997. incapable of giving consent and/or unaccompanied.000 to P100. pp 656-657 Civil Code of the Philipines. RA No. either by the acts of judicial or legislative officers or by his own deed or representation. or upon instruction of its management.If the health facility lacks medical capabilities. conduct or representation of the party sought to be stopped is due to ignorance founded on innocent mistake estoppels will not arise. and to act upon such belief. During the surgery. if the act. Dr. completed the operation and closed the incision. in contemplation of law. Natividad complained of excruciating pain in her anal region. Ampil diagnosed her to be suffering from cancer of the sigmoid. An Act Penalizing the Refusal of Hospitals and Medical Clinics to Administer Appropriate Initial Medical Treatment and Support in Emergency cases. demand or accept any deposit or any other form of advance payment as a prerequisite for confinement or medical treatment of a patient.The law.000. 1431. by his own declaration . the attending physician may transfer the patient to a facility where the appropriate care can be given. and imposes silence on a party only when in conscience and honesty he should not be allowed to speak. Dr. also prohibits “request. Ampil then assured Natividad that the pains would soon vanish. They told her that the pain was the natural consequence of the surgical operation performed upon her. assisted by the medical staff of Medical City.000. provided that the transfer is done only after necessary emergency treatment and support were administered to stabilize the patient and after it was established that the transfer would entail less risks than the patient’s continued confinement. he cannot . Ampil's assurance. However. Ampil was immediately informed. Gutierrez who detected the presence of a foreign object in her vagina a foul-smelling gauze measuring 1. Ivy D. He proceeded to Natividad's house where he managed to extract by hand a piece of gauze measuring 1.LEGAL MEDICINE Atty. Dr. IV) What if the hospital is not equipped with medical facilities or the patient is unconscious? 1. amending for the purpose BP 702. The hospital or clinic where the patient will be transferred shall not refuse him nor demand from the patient or his next of kin any deposit or advance payment. act or omission be permitted to falsify it.5 inches in width. after the patient or his next of kin consented to the transfer and after the receiving hospital or medical clinic agreed to the transfer. and cannot be denied or disproved as against the person relying thereon. either expressed or implied. whether government-owned or private. intentionally and deliberately led another to believe a particular thing to be true. Art. approved on Aug. If the patient is unconscious. Dr. 8344 Sec. Dr.000 to P500. 26 . Another surgical operation was needed to remedy the situation. Fuentes.It is unlawful for any hospital or medical clinic to refuse administering to patients treatment and support that could prevent their death or permanent disability. or fined P20. Dr. PENALTIES: Violators of RA 8344 shall be imprisoned for six months to two years and four months. The principle of estoppels would step in to prevent one party from going back upon his own acts and representations to the prejudice of the other party who relied upon them. prompting Natividad to seek treatment to Dr. Afterwards. After a couple of days. MD A. the operation appeared to be flawed. 2016 .” Thus. necessitating the removal of certain portions of it. her daughter found a piece of gauze protruding from her vagina. (Tolentino. Despite Dr. The gauze had badly infected her vaginal vault. whenever a party has. the director or officer of the hospital or clinic responsible for the formulation and implementation of the policy shall be imprisoned of four to six years or fined P100. However.2017 28. Through estoppel an admission or representation is rendered conclusive upon the person making it. he found that the malignancy in her sigmoid area had spread to her left ovary. 25. solicit. to perform hysterectomy upon Natividad. Thus. 544 SCRA 170 (2008) FACTS: Natividad Agana was admitted at the Medical City (owned by PSI) because of difficulty of bowel movement and bloody anal discharge. 1-4 (1997) 29.ALL HEALTH facilities. Thus Natividad underwent another surgery. Vol. been established as the truth. performed an anterior resection surgery upon her. Dr. Inc. 30. 3. Ampil. Professional Services.5 inches in width. are prohibited from refusing persons seeking medical help or from detaining them for nonpayment of hospital bills or medical expenses. She consulted both doctors about it.

The duty of providing quality medical service is no longer the sole prerogative and responsibility of the physician. Supreme Court has absolved Dr. The decision also anchors its ruling on the doctrine of corporate responsibility. intervenors raise parallel arguments that the Court's ruling on the existence of an employer-employee relationship between private hospitals and consultants will force a drastic and complex alteration in the long-established and currently prevailing relationships among patient. PSI failed its own standard of hospital care. Ampil for the damages sustained by Natividad because of the negligence in leaving two gauzes in her body which was used in her surgery. to oversee or supervise all persons who practiced medicine within its walls. Professional Services. the failure of PSI to fulfill its duties as a hospital corporation gave rise to a direct liability to the Aganas distinct from that of Dr. Fuentes but has held that PSI is solidarily liable with Dr.. Inc. Under the doctrine of apparent authority. Inc vs. PSI created the public impression that he was its agent and thus. Ampil. and to take active steps in fixing any form of negligence committed within its premises. not under the principle of respondeat superior for lack of evidence of an employment relationship with Dr. is justified in presuming that such agent has authority to perform the particular act in question In these cases. it shirked its responsibility and passed it on to others — to Dr. and to Natividad herself to complain before it took any meaningful step. PSI took no heed of the record of operation and consequently did not initiate a review of what transpired during Natividad's operation. (AHI). Such responsibility includes the proper supervision of the members of its medical staff. Its act of displaying his name and those of the other physicians in the public directory at the lobby of the hospital amounts to holding out to the public that it offers quality medical service through the listed physicians. HELD: PSI is liable to the Aganas. Rather. Ampil whom it expected to inform Natividad. Ampil ISSUE: W/N PSI is liable to Natividad Agana? HELD: PSI is estopped from passing the blame solely to Dr. It committed corporate negligence. PSI was impleaded together with Dr. PSI committed a serious breach of its corporate duty when it failed to conduct an immediate investigation into the reported missing gauzes. 2016 . PSI was bound by its duty to provide comprehensive medical services to Natividad Agana. Court of Appeals. 27 . It must be stressed that under the doctrine of apparent authority. Ampil. Ampil and. conversant with business usages and the nature of the particular business. By its inaction. It should be borne in mind that the corporate negligence ascribed to PSI is different from the medical negligence attributed to Dr. Patdu. 611 SCRA 282 (2010) FACTS: Manila Medical Services Inc. This justifies Atty. hence. under the principle of corporate negligence for its failure to perform its duties as a hospital. Ivy D. to exercise reasonable care to protect her from harm. Ampil on the ground that there is an employee-employer relationship between them and as such they are solidarily liable. Ampil was a member of the hospital's staff. the circumstances yield a positive answer to the question. 31. with burdensome operational and financial consequences and adverse effects on all three parties. Accordingly. pro hac vice. The duties of the hospital are distinct from those of the doctor-consultant practicing within its premises in relation to the patient.LEGAL MEDICINE Atty. physician and hospital. the Court en banc accepted the referral and heard the parties on oral arguments on one particular issue: whether a hospital may be held liable for the negligence of physicians-consultants allowed to practice in its premises. To recall the facts of the said decision. Asian Hospital. Ampil but under the principle of ostensible agency for the negligence of Dr. Due to paramount public interest. Agana's belief that Dr. therefore.2017 ISSUE: Whether or not PSI is jointly and severally liable with Dr. the question in every case is whether the principal has by his voluntary act placed the agent in such a situation that a person of ordinary prudence. (MMSI). In their respective memoranda. the hospital has the duty to make a reasonable effort to monitor and oversee the treatment prescribed and administered by the physicians practicing in its premises. MD A. making them liable. Fuentes and Dr. This is because the modern hospital now tends to organize a highlyprofessional medical staff whose competence and performance need also to be monitored by the hospital commensurate with its inherent responsibility to provide quality medical care.Y. As it happened. and Private Hospital Association of the Philippines (PHAP) assailed a decision that will jeopardize the financial viability of private hospitals and jack up the cost of health care. Ampil.