BASICS OF PHILIPPINE

MEDICAL JURISPRUDENCE
AND ETHICS

2010 EDITION

JOSUE N. BELLOSILLO
BU C. CASTRO
EMMANUEL LJ. MAPILI
ALBERT D. REBOSA
ANTONIO D. REBOSA

Published by

CENTRAL BOOK SUPPLY, INC.

927 Quezon Avenue, Quezon City
Philippines
 TABLE OF CONTENTS

Foreword/in

Preface/vii

AcknowledgmentsI-a.

Chapter 1
MEDICAL JURISPRUDENCE

1.1. Medical Jurisprudence defined/l

1.2. Distinction with legal and forensic medicine/2
1.3. The law of Hippocrates/3

1. Responsibilities to patientI \
2. Responsibilities to the profession / 6
3. Responsibilities to colleagues/l
4. Responsibilities to society11
5. Responsibilities to allied health professionals I %

1.4. Medical law/9

1.5. History of Philippine medical law/ll
1.6. Place of law in the medical profession/ll
1.7. Functions of the law in medicine/12
1.8. Sources of law/13

1. Statutory lawI Xh
2. Constitutional lawI'13
3. Administrative law/13
4. Common Iaw/l3

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1.9 Classification of law/14

1. Public lawI'16
(a) Criminal law/16
(b) International law/16
(i) Public international law116
(ii) Private international law/16
(c) Political law/16
(i) Constitutional law/16
(ii) Administrative law/11
(iii) I ^ w of public administration/XI
(iv) J^zw of public corporation / \1
2. Private law/Yl
(a) Civil law/\1
(b) Commercial law/\l
(c) Remedial law/Yl

1.10. Medical legislation/18

1.11. Medical ethics/18
1.12. Common legal terms/18

1. Torts/li
2. Deposition/is
3. Plaintiff/18
4. Defendant/18
5. Defamation/\%
6. Expert witness/18
7. GcW Samaritan LMW/19
8. Interrogatory/19
9. Malpractice/'19
10. Negligence/19
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11. Proximate cause/19

12. Reasonable care/19

Chapter 2
REGULATION OF THE MEDICAL PROFESSION

2.1. Basis of state regulation/20

2.2. Constitutional basis/20
2.3. Statutory basis/21
2.4. Reason for regulation/22
2.5. Warranties in the practice of medicine/23

Chapter 3
MEDICAL EDUCATION SYSTEM
IN THE PHILIPPINES

3.1. Commission on Higher Education (CHED)/25

3.2. Association of Philippine Medical Colleges/26
3.3. Admission requirements to a medical college/26

1. National Medical Admission Test (NMA T)/27

(a) Three-Flunk Rule/21
(b) Academic freedom, not absolute/28
(c) Equal protection not violated/2%

3.4. Medical school curriculum/29

3.5. Clinical clerkship/29
3.6. Medical education credentials awarded/30
3.7. Medical internship/30

1. Medical internship progam /30

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Chapter 4
LICENSURE AND REGISTRATION
OF PHYSICIANS

4.1. Licensure/31

1. Qualifications of candidatesfor board examinations/'31

2. Scope of examination/32
3. Documents to accompany an application for licensure examina-
tion/32
4. Passing rate/33

4.2. Oath taking and conferment ceremonies/34

1. The Hippocratic Oath/ 34

2. Administrative Oath/3b

4.3. Certificate of registration/36

1. Right to be registered as physicians/36

2. Rule of reciprocity / 39
3. Groundsfor refusal of issuance of certificates of registration/41
4. Duty of the Board ofMedicine to issue certificates ofregistra-
tion/'42
5. Grounds for reprimand, suspension or revocation of registration
certificate/^
6. Rights of'respondents/'45
7. Appeal for judgment/ \6
8. Reinstatement/ M

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Chapter 5
PROFESSIONAL REGULATORY BOARD
OF MEDICINE

5.1. Professional Regulation Commission/48

5.2. Powers of the PRC/50

1. As administrative body/50
2. As quasi-legislative body/50
3. As quasi-judicial body/50

5.3. Board of Medicine/52

1. Appointment of the chairman of the professional regulatory

board/52
2. Criteria for selection of nominees/ 53
3. Disqualification / 55
4. Reappointment of the chairman or member of the professional
regulatory board/56
5. Compensation of the members of the professional regulatory
boards/56
6. Purpose of compensation / 51
7. Basis of therightto salary/51
8. Prohibition against additional or double compensation/51
9. Powers, functions and responsibilities of the various professional
regulatory boards/51

5.4. Authority of the Board Medicine t o determine stand-

i n g of m e d i c a l schools/60
5.5. Applicability of right against self-incrimination before
the Board of Medicine/61
5.6. P M A with Legal Personality t o Q u e s t i o n Authority of
Board of Medicine/62

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Chapter 6
PRACTICE OF MEDICINE

6.1. Practice of Medicine/64

6.2. Prerequisite to the Practice of Medicine/64
6.3. Acts Constituting Practice of Medicine/65
6.4. Cases on Acts Constituting Practice of Medicine/65

1. Acceptance of compensation without proper certificate ofregistra-

tion/65
2. Acts constitute practice of medicine whether or not done for a
fee/65
3. Acts of investment in stocks not acts constituting practice of
medicine/66
4. License to practice drugless healing cannot be implied/66
5. Advertised himself and offered services as physician/ 66
6. Falsely using thetitleofM.D. after one's name/61

6.5. Acts not construed to be practice of medicine by

provision of law/67
6.6. Acts not construed to be practice of medicine by
decisions of courts/69
6.7. Faith healing, healing by prayer or divine healing/69

1. Psychic surgery and spiritualism/10

6.8. Limited practice without any certificate of registra-

tion/71
6.9. Penalties for illegal practice of medicine/73
6.10. Employment of non-resident aliens/74

1. Employment permit of non-resident aliens/'l'4

2. Prohibition against transfer of'employment'/74

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3. Submission of list/15

6.11. Forms of Medical Practice/75

1. Sole proprietorship/15
2. Associate practice/l5
3. Medical group practice/16
(a) Partnership/16
(b) Corporation /16

Chapter 7
PHYSICIANS AND CONSTITUTION

7.1. Constitution/77
7.2. The Philippine State/ 77

1. People 111
2 Territory/1',
(a) The Philippine national territory/'78
3. Government/18
(a) Executive branch/18
G) Appointingpower/'78
Removal power/18
(iii) Control power/18
(iv) Military power/19
W Pardoning power/19
(vi) Borrowing power/19
(vii) Diplomatic power/19
(viii) Budgetary power/19
(ix) Informing power/19

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(b) Legislative branch/19

(i) Appropriation power/19
(ii) Taxation power/19
(iii) Expropriation power/19
(c) judicial branch/19
4. Sovereignty /19

7.3. The Fundamental Powers of the State/80

1. Police power/ %0
2. Power of eminent domain/ 80
3. Power of taxation/80

1A. The Bill of Rights/80

1. Due process/ 80
2. Equal protection / 81
3. Searches and seizure/81
4. Privacy of communication and correspondence / 8\
5. Freedom of speech and expression / 81
6. Liberty of abode and travel/82
7. R/g/f/ /<> information / 82
8. R/g/tf to form associations / 82
9. R/gA/ /o compensation in expropriation cases/'82
10. The impairment clause/82
11. Fn?e # « m /o courts/ 83
12. Miranda rights/83

7.5. Rights Inherent in the Practice of Medicine/83

1. Right to choose patients/ 83

2. Right to limit the practice of medicine / 8\

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3. Right to determine appropriate procedure / 8\

4. Right to avail of hospital services/'84

7.6. Rights Incidental to the Practice of Medicine/84

1. Right of way while responding to an emergency call/84

2. Right to be paid for medical services rendered/84
3. Right to membership to medical societies/84
4. Right of exemption from execution of instruments and library/84
5. Right to hold certain positions in public andprivate services/85
6. Right to perform certain services/85
1.1. Citizenship/85

1. Doctrine of jus sanguinis/86

2. Doctrine of jus soli/86

Chapter 8
PHYSICIANS AND CONTRACTS

8.1. Law of Contracts, elements/87

1. Manifestation of assent/ 81
2. Legal subject matter/88
3. Legal capacity to contract/88
4. Consideration / 88

8.2. Physician-Patient Contractual Relationship/88

1. Commencement of physician-patient contractual relationship / 88

2. Nature of physician-patient contractual relationship/89
(a) Consensual/89
(b) Fiduciary/90

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8.3. Essential Requisites of Contracts/ 90

1. Consent/ 90
2. Object or subject matter/91
(a) Types of medical care/92
(i) General andfamily practice/92
(ii) Specialty practice/ 92
(1) Anesthesiology/ 92
(2) Dermatology / 93
(3) Internal medicine/ 93
(4) Neurology / 93
(5) Obstetrics and Gynecology/93
(6) Ophthalmology and Otolaryngology/94
(7) Pathology/94
(8) Pediatrics/94
(9) Psychiatry/94
(10) Radiology/94,
(11) Surgery /95
(12) Public Health / 95
3. Cause or consideration /95
(a) Medical fees/96
(b) IGW.r of medical fees/96
(i) Simple contractual fee/96
(ii) Retainer fee/91
(iii) Contingent fee/91
(iv) Commission orfee splitting or dichotomous fee/98
(v) Straight fee orpackage deal agreement/98
(c) Reasonableness of medical fees/98
(d) Medical billing/99
(i) Payment at time of services/'99

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(ii) Billing when extension of credit is necessary/99

(iii) Using outside collection assistance/100
(e) Salary scale of public health workers/100

(i) Salary scale/100

(ii) Equality in salary scale/101
(iii) Salaries to be paid in legal tender/101
(iv) Deductions prohibited/101
(f) Additional compensation/101
(i) Hazard allowance/102
(ii) Subsistence allowance/102
(iii) Longevity pay/103
(iv) Laundry allowance/103
(v) Remote assignment allowance/'104

8.4. Forms of Contractual Relationship/104

8.5. Cases when there is no physician-patient relation-
ship/105
8.6. Termination of Physician-Patient Relationship/105

1. Sample letter of withdrawal from case/106

2. Sample letter to confirm discharge by patient/101
3. Patient abandonment/101

8.7. Defective Contracts/108

1. Rescissible contracts/108
2. Voidable contracts/108
3. Unenforceable contracts/109
4. Void contracts/111

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Chapter 9
PHYSICIANS AND TORTS

9.1. Torts/112
9.2. Professional Liability/112
9.3. Classifications of Medical Professional liability/113

1. Feasance/ \13
2. Malfeasance / 1V>
3. Misfeasance/113
4. Nonfeasance/113

9.4. Medical Malpractice or Negligence Cases/113

9.5. The Four D's of Negligence/114

1. Duty/114
2. Derelict/115
3. Direct cause/115
4. Damages/115

9.6. Two-pronged Evidence/116

1. Standards of practice/116
2. Sources of proof of standard of care/116

9.7. Medical Malpractice/117

9.8. Sample Cases of Medical Malpractice/117

1. Unauthorised and unknown experimentation /ill

2. Failure to perform C-section andfailure to recognise and treat sei-
zures in the periodfollowing the birth/ill
3. Surgical injury/\18
4. Failure to recognise and treat heart attack/118

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5. Surgicalprecipitation of stroke/118
6. Wrongful amputation of arm and shoulder/119
7. Failure to diagnose cancer/119
8. Surgical injury/119

9.9. Jurisprudence on Medical Professional Liability/120

1. L E O N I L A GARCIA-RUEDA, vs. WILFREDO

L. PASCASIO, et al.
G.R. No. 118141, September 5, 1997/120
2. ROGELIO E. RAMOS, et al. vs. COURT OF
APPEALS
G.R. No. 124354, December 29,1999/122
3. LEAH ALESNA REYES, et al. vs.
SISTERS OF MERCY HOSPITAL, et al.
G.R. No. 130547, October 3, 2000/129
4. PROFESSIONAL SERVICES, INC. vs.
NATIVIDAD and ENRIQUE AGANA
G.R. No. 126297, January 31, 2007/133

9.10. Doctrines applied in medical practice cases/135

9.11. Doctrine of respondeat superior or doctrine of vicari-
ous liability or doctrine of imputed negligence or
command responsibility/135

1. Doctrine of ostensible agent or holding out theory or agency by es-

toppel/135
2. Borrowed servant doctrine/131
3. Captain-of-the-ship doctrine/131
4. Doctrine of independent contractor/131
5. Full time but not regular/138

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9.12. Jurisprudence on respondeat superior/141

1. ROGELIO E. RAMOS, et al. vs. COURT OF

APPEALS
G.R. No. 124354, December 29, 1999/141

9.13. Doctrine of res ipsa loquitur or common knowledge

doctrine/142

1. Requisites of res ipsa loquitur/142

2. Application of res ipsa loquitur in medical malpractice/143
3. Res ipsa loquitur, when applicable/143
4. Res ipsa loquitur, when not applicable/143

9.14. Jurisprudence on res ipsa loquitur/145

1. DR. VICTORIA L. BATIQUIN, et al. vs.

COURT OF APPEALS
G.R. No. 118231, July 5,1996/145
2. ROGELIO E. RAMOS, et al. vs. COURT
OF APPEALS
G.R. No. 124354, December 29, 1999/150
3. LEAH ALESNA REYES, et al. vs.
SISTERS OF MERCY HOSPITAL, et al.
G.R. No. 130547, October 3, 2000/152

9.15. Doctrine of contributory negligence (doctrine of

common fault)/ 152
9.16. Doctrine of continuing negligence/152
9.17. Doctrine of assumption of risk/153
9.18. Doctrine of last clear chance/153
9.19. Doctrine of foreseeability/154

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1. Force majeure/154
2. Act of God/154
3. Accident/155

9.20. Fellow servant doctrine/155

9.21. Rescue doctrine or Good Samaritan Law/155
9.22. Deep pocket rule/156
9.23. Factors increasing medical malpractice cases/156

Chapter 10
PHYSICIANS AND DAMAGES

10.1. Damages/158

1. Damages that may be recovered/158

2. Computation for loss of earning capacity /159

10.2. D a m n u m absque injuria/159

10.3. Actual damages/159
10.4. Moral damages/159

1. Basis of award of moral damages/160

2. Conditions for award of moral damages/160
3. Legalprovisions mandating award of moral damages/160
4. Moral damages not recoverable on clearly unfounded suit/161

10.5. Temperate or moderate damages/162

10.6. Liquidated damages/162
10.7. Exemplary or corrective damages/162
10.8. Jurisprudence on Damages/162

1. DR. NINEVETCH CRUZ vs. COURT OF

APPEALS

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G.R. No. 122445, November 18, 1997/162

2. ROGELIO E. RAMOS, et al. vs. COURT
OF APPEALS
G.R. No. 124354, December 29, 1999/165

Chapter 11
PHYSICIANS AND CRIMINAL LAW

11.1. Application of the provisions of the Revised Penal

Code/171

1. Application of the provisions of the Revised Penal Code/111

2. Criminal law/172
3. Limitations on power of Congress to enact penal laws/112
(a) No ex postfacto law shall be enacted/112
(b) No bill of attainder shall be enacted/112
(c) No law that violates equalprotection clause shall be en-
acted/112
(d) No law which imposes cruel and unusual punishments nor
excessivefinesshall be enacted/112
4. Characteristics of criminal law/112
(a) General/112
Exceptions:
(i) Treaty stipulations/112
(ii) Laws of Preferential application/112
(iii) Principles of Public International Law/172
(b) Territorial/112
(c) Prospective/112

11.2. Felonies/173

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1. Definitions/113
2. Requisites ofdolo/113
(a) Freedom/113
(b) Intelligence/113
(c) Intent/113
3. Requisites ofculpa/113
(a) Freedom/113
(b) Intelligence/113
(c) Negligence and imprudence/ Y13
4. Elements offelonies/'173
5. Criminal liability/174
6. Aberratio ictus/ll4
7. Error inpersonae/114
8. Consummated, frustrated, and attempted felonies/114
9. Conspiracy andproposal to commitfelony /115
10. Grave felonies, less grave felonies andlightfelonies/'115

11.3. Circumstances affecting criminal liability/176

1. Justifying circumstances/116
2. Exempting circumstances/111
3. Justifying circumstance vs. exempting circumstance/118
4. Elements of accident without fault or intention of causing it/119
5. Elements of a person who acts under the compulsion of an irre-
sistibleforce/119
6. Elements of uncontrollable fear/119
7. Elements of insuperable cause/119
8. Entrapment vs. instigation/180
9. Mitigating circumstances/180
10. Aggravating circumstances/181
11. Alternative circumstances /184

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11.4. Persons criminally liable for felonies/185

1. Who are criminally liable/185

(a) Principals/185
(b) Accomplices/185
(c) Accessories/185
2. Principals/185
3. Accomplices/185
4. Accessories/185
5. Accessories who are exemptfrom criminal liability/'186

11.5. Penalties/186

1. Reclusion perpetual 186

2. Reclusion temporal/181
3. Prision mayor and temporary disqualification/181
4. Prision correctional, suspension, and destierro/181
5. Arresto mayor/181
6. Arresto menor/181
7. Bond to keep the peace /181

11.6. Extinction of criminal liability/187

1. Total extinction of criminal liability /181

2. Partial extinction of criminal liability/188

11.7. Crimes against p u b l i c interest/188

1. Falsification by public officer, employee or notary or ecclesiastic

minister/188
2. Falsification by private individual and use of falsified docu-
ments/190

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3. False medical certificates, false certificates of merits or service,

etc. /190
4. Usingfalse certificates/190

11.8. Crimes against persons/190

1. Parricide/190
2. Murder/191
3. Homicide/191
4. Giving assistance to suicide/192
5. Infanticide /192
6. Abortion/192
(a) Intentional abortion/192
(b) Unintentional abortion/193
(c) Abortion practiced by the woman herself or by herpar-
ents/193
(d) Abortion practiced by a physician or midwife/194
(e) Dispensing of abortive/194
7. Physical injuries/194
(a) Mutilation/194
(b) Serious physical injuries /194
(c) Administering injurious substances or beverages/195
(d) Less serious physical injuries/195
(e) Slight physical injuries and maltreatment/195
8. Rape/195

11.9. Crimes against personal liberty and security/196

1. Kidnapping and serious illegal detention /196

2. Slight illegal detention/191
3. Abandonment of person in danger and abandonment of one's
own victim/191

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11.10. Crimes against property/198

1. Robbery/198
2. Execution of deeds by means of violence or intimidation /198
3. Theft/198
4. Qualified theft/199

11.11. Crimes against chastity/199

1. Adultery /199
2. Concubinage / 200
3. Acts of lasciviousness/200
4. Qualified seduction/200
5. Simple seduction/200
(a) Qualified seduction vs. simple seduction/201
6. Corruption of minors/201
1. White slave trade/201
8. Forcible abduction/201
9. Consented abduction/201
10. Sexual perversion or unnatural sexual offenses/201
(a) Cunnilingus 1201
(b) Exhibitionism / 202
(c) Fellatio/202
(d) Fetishism/202
(e) Lesbianism / 202
(*) Masochism/202
(g) Masturbation/202
(h) Pedophilia/202
® Sadism/202
0) Transvestism/ 203
(k) Voyeurism/203
0) Zoophilia/203

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11. Anti-Sexual Harassment Act of 1995/ 203

11.12. Crimes against the civil status of persons/207

1. Simulation of births, substitution of one childfor another and

concealment or abandonment of a legitimate child/201
2. Usurpation of civil status/201

11.13. Crimes against honor/208

1. IJbel/208

2. Slander/208

11.14. Quasi-Offenses/208

1. Reckless negligence or reckless imprudence/208

2. Jurisprudence on reckless imprudence/209
3. Somera Case: Homicide through reckless imprudence/ 2X3
Chapter 12
HOSPITALS AND THE LAW

12.1. Hospital defined/215

12.2. Classification of hospitals/216
.1. As to scope of infirmity admitted/216
(a) General hospital/ 216
(b) Specialised hospital/216
2. Functional classification/216
(a) Diagnostic hospital/216
(b) Maternity hospital/216
(c) Rehabilitation hospital/216
(d) Surgical hospital/211
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(e) Cosmetic hospital/211

3. As to control andfinancial support/211
(a) Public or government hospital/211
(b) Private hospital/211
(i) Private charitable or eleemosynary hospital/211
(ii) Private pay hospital/218

12.3. Vicarious liability of hospital/218

1. Government orpublic hospital/218

2. Private charitable, voluntary or eleemosynary hospital/218
(a) Trustfund doctrine/218
(b) Public policy theory/218
(c) Implied waiver theory/218
(d) Independent contractor theory/218
3. Private hospital forprofit/218

12.4. Jurisprudence on vicarious liability of hospitals/219

1. P R O F E S S I O N A L SERVICES, I N C . vs.
N A T I V I D A D and E N R I Q U E AGANA
G.R. No. 126297, January 31, 2007/219
2. ROGELIO P. NOGALES vs. CAPITOL
MEDICAL CENTER
G.R. No. 142625, December 19, 2006/220

12.5. Jurisprudence on non-liability of hospital/225

1. ROGELIO E. RAMOS, et al. vs. COURT

OF APPEALS
G.R. No. 124354, December 29, 1999/225

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12.6. Attendance to emergencies or serious cases/228

12.7 Transfer of patient/228
12.8 Hospital Detention Law/229

Chapter 13
PHYSICIANS AND EVIDENCE

13.1. Evidence/231
13.2. Qualification of witnesses/231
1. Ordinary witness vs. expert witness/232

13.3. Physician-patient privilege/232

1. Requisites ofprivileged communications between doctor and pa-

tient/232
2. Scope of the privilege/232
3. Duration of the privilege/233
4. Cases where privilege do not apply/233
5. Legal disclosures/233
6. Duty of confidentiality extends to the hospitals/ 233

13.4. Jurisprudence on physician-patient privilege/234

1. N E L L Y LIM vs. C O U R T OF APPEALS

G.R. No. 91114, September 25, 1992/234
2. MA. PAZ F E R N A N D E Z K R O H N vs.
C O U R T OF APPEALS
G.R. No. 108854, June 14, 1994/236

13.5. Expert testimony/238

1. Presentation of expert testimonyy'239

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(a) Qualifying a witness as an expert/239

(b) Admissibility of expert witness/239
(c) The asking of hypothetical questions/240
(d) It is not proper to include assumptions not supported by
evidence/241
2. Litigation of medical negligence/241
3. Expert testimony generally relied upon in malpractice suits/242
4. When expert testimony dispensed with in malpractice suits/242
5. Competent expert witnesses/242
6. Qualifications/242

13.6. Jurisprudence on expert witness/243

1. P E O P L E vs. ROGELIO P E L O N E S
G.R. Nos. 86159-60, February 28, 1994/243
2. DR. NINEVETCH CRUZ vs. COURT
OF APPEALS
G.R. No. 122445, November 18, 1997/245
3. ROGELIO E. RAMOS, et al. vs. COURT
OF APPEALS
G.R. No. 124354, December 29,1999/256
4. LEAH ALESNA REYES, et al. vs.
SISTERS OF MERCY HOSPITAL, et al.
G.R. No. 130547, October 3, 2000/258

13.7. Hearsay rule/264

13.8. Dying declaration/265
13.9. Jurisprudence on hearsay rule/265

1. MA. PAZ FERNANDEZ KROHN vs.

COURT OF APPEALS
G.R. No. 108854, June 14,1994/265

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13.10. Weight and sufficiency of evidence/266

1. Substantial evidence/266
2. Preponderance of evidence/266
3. Proof beyond reasonable doubt/266

Chapter 14
MEDICAL RECORD

14.1. Patient's clinical record/267

14.2. What patient's clinical record includes/268
14.3. Reasons for patient's clinical record/269
14.4. Correcting a handwritten entry on patient's clinical
record/269
14.5. Right of access to medical record/269

1. The patient/ 269

2. The attending doctor/210
3. The hospital/210
4. The nurse/210
5. Insurance and HMO representatives/211

14.6. Types of medical records and confidentiality/271

1. Hospital medical records/211

2. Physicians'private office records/211

14.7. D o c u m e n t a r y evidence/271

1. Best Evidence Rule/211

2. Secondary Evidence/211
3. Parol Evidence Rule/212

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Chapter 15
PHILHEALTH

15.1. Pertinent laws/273

1. National Health Insurance Act of 1995/213

2. Republic Act No. 9241/213
3. Section 2, Article XIII of the 1987 Constitution/214

15.2. Philippine Health Insurance Corporation/274

1. Exemptions from taxes and duties/214

2. Powers and functions/214
3. Quasi-judicial powers/211
4. The Board of Directors/218
(a) Composition/218
(b) Appointment and tenure/280
(c) Meetings and quorum/280
(d) Allowances and per diems/ 280

15.3. History/280
15.4. Definition of Terms/282

1. Beneficiary/282
2. Benefit Package/282
3. Capitation/282
4. Contribution/282
5. Coverage/282
6. Dependent /282
7. Diagnostic procedure/283
8. Emergency / 283
9. Employee/283
10 . Employer/283

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11. Enrollment/283
12. Fee for service/283
13. Global budget/283
14. Government Service Insurance System/284
15. Health Care Provider /284
16. Health Insurance Identification (ID) Card/285
17. Indigent/285
18. Inpatient education package/285
19. Member/285
20. Means test/285
21. Medicare/286
22. National Health Insurance Program/286
23. Pensioner/286
24. Personal Health Services/286
25. Philippine Medical Care Commission/286
26. Philippine National Drug Formulary/286
27. Portability/281
28. Prescription drug/281
29. Public health services/281
30. Quality assurance/ 281
31. Residence/281
32. Retiree/281
33. Self-employed/281
34. Social Security System/288
35. Treatment procedure/288
36. Utilisation review1288
37. Rehabilitation center/288
38. Home care and medical rehabilitation services/288

15.5. National Health Insurance Fund/288

1. The basic benefit fund/289

2. Supplementary benefit funds / 290
3. Reserve fund/290

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15.6. Membership/294

1. Initial members in 1995/294

2. Classification of current members/ 294
(a) Paying Members/294
(b) Indigent member/294
(c) Privately-sponsored member/294
(d) Non-paying member/294
3. Requirementfor registration/'294
4. Requirementsfor declaration of dependents/295
5. Requirementsfor registration ofemployers/'295

15.7. Accreditation/296

1. Requirements/296
2. Additional requirements for hospitals / 291
3. Additional requirements for physicians/ 298

15.8. Benefit package/298

1. What the benefit package includes/298

2. What are excluded unless recommended by Philhealth/299

15.9. Premium contributions/299

15.10. Penalties/300

Chapter 16
MEDICAL E T H I C S

16.1. Ethics/302
16.2. Medical ethics/302
16.3. Definition of terms/303

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1. Ethics/303
2. Medical etiquette/303
3. Bioethics/304
4. Bioethical issue/304
5. Ethical dilemma/304
6. Moral reasoning/304
7. Values/304
8. Moral uncertainty/304
9. Moral or ethicalprinciples/ 304
(a) Autonomy/304
(b) Beneficence/305
(c) Nonmaleficence / 305
(d) Justice/305
(e) Fidelity/305
(f)

16.4. Thinking ethically/305

16.4. Approaches to ethical dilemma/306

1. Beneficence/309
2. Autonomy/310
3. Justice/311

16.5. Resolving ethical problems/312

Chapter 17
CODES OF ETHICS

17.1. Code of ethics/310

17.2. Historical codes/314

1. Oath and Law of Hippocrates/315

2. The Oath ofHippocrates/316

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17.3. Philippine Medical Association/318

17.4. PMA Code of Ethics of the Medical Profession/320
17.5. Board of Medicine Code of Ethics/325

Chapter 18
CASE STUDIES ON MEDICAL ETHICS

18.1. Case study re: cultural misunderstandings in the

medical care of cancer patient/340
18.2. Case study re: raising issues of culturally competent
health care for a muslim woman/357
18.3. Case study re: public guardian in charge of the medi-
cal care for a conserved patient/378
18.4. Case study re: public guardian in charge of an old
woman with multiple illnesses/380
18.5. Case study re: prevention vs. treatment in HIV/AIDS
program/381
18.6. Case study re: decision to discontinue life-sustaining
treatment/383
18.7. Case study on addressing ethical issues confronting
governments, NGOs, and pharmaceutical companies
when faced with an epidemic/386
18.8. Case Study on what should a physical therapist do
when she suspects that her patient isn't being entirely
honest with his physician/391
18.9. Case Study on the ethical questions involved when a
company is the only supplier of a high-risk, life-saving
product/393
18.10. Case Study whether physicians have a duty to refer
patients to alternative forms of therapy/395
18.11. Case study re: maternal vs. fetal rights/400
18.12. Case study on assisted suicide/404

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Chapter 19
RIGHTS AND DUTIES OF PATIENTS

19.1. Universal bill of rights of patient /407

19.2. Duties of patient/409
19.3. Dying person's bill of rights/413

Chapter 20
INFORMED CONSENT

20.1. Informed consent defined/412

20.2. Subject matter of informed consent/413

1. Non-consensualphysical contact/4X3
2. Non-consensual medical treatment andprocedure/ 414
(a) GEORGETTE MALETTE vs. DAVID
SHULMAN
Ontario Court of Appeal No. 29-88, Mar. 30,
1990/414

20.3. Doctrines re informed consent/418

20.4. Elements of informed consent/419
20.5. Kinds of consent/422
20.6. Who can give informed consent/422

1. The patient/ 422

2. The spouse/422
3. The eldest child/422
4. The parents of the patient/423
5. The grandparents of the patient/423
6. The brother or sister of the patient/ 423
7. The nearest kin available/423

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8. The State/424

20.7. Instances where no consent is needed/424

20.8. Competency/424
20.9. Test for mental capacity/425
20.10. Questions to ask/426
20.11. Assessment of consent/426
20.12. Examples of informed consent/427
20.13. Surgery/428
20.14. Research/429
20.15. Jurisprudence on informed consent/430

1. ROGELIO P. NOGALES vs. CAPITOL

MEDICAL CENTER
G.R. No. 142625, December 19, 2006/430

APPENDICES
A P P E N D I X 1 - Republic Act No. 9502 - Universally Accessible
Cheaper and Quality Medicines Act of 2008/435

A P P E N D I X 2 - Republic Act No. 9484 - The Philippine Dental Act

of2OO7/461

A P P E N D I X 3 - Republic Act No. 9439 - An Act Prohibiting the

Detention of Patients in Hospitals and Medical Clinics on Grounds
of Non-payment of Hospital Bills or Medical Expenses/486

A P P E N D I X 4 - Republic Act No. 9173 - Philippine Nursing Act of

2002/488

A P P E N D I X 5 - EXCERPTS FROM Republic Act No. 9165 -

Dangerous Drugs Act of 2002/506

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A P P E N D I X 6 - Republic Act No. 8981 - PRC Modernisation Act of

2000/526

A P P E N D I X 7 - Republic Act No. 8423 - Traditional and Alternative

Medicine Act (TAMA) of 19971543

A P P E N D I X 8 - Republic Act No. 8344 - An Act Penalising the

Refusal of Hospitals and Medical Clinics to Administer Appropriate
Initial Medical Treatment and Support in Emergengi or Serious
Cases, Amendingfor the Purpose B.P. 702, (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)/ 558

A P P E N D I X 9 - Republic Act No. 8050 - Revised Optometty Law of

1995/562

A P P E N D I X 10 - Republic Act No. 7600 - The Rooming-In and

Breastfeeding Act of 1992/580

A P P E N D I X 11 - Republic Act No. 7392 - Philippine Midwifery Act

of 1992/581

A P P E N D I X 12 - Republic Act No. 7305 - Magna Carta of Public

Health Workers/598

A P P E N D I X 13 - Republic Act No. 7170 - Organ Donation Act of

1991 (As Amended on February 20, 1995)/ 614

A P P E N D I X 14-Republic Act No. 6675-The Generics Act of 1988

(As amended by R^A. 9502)/ 623

A P P E N D I X 15 - EXCERPTS FROM Republic Act No. 5921 -

An Act Regulating the Practice of Pharmacy and Setting Standards
of Pharmaceutical Education in the Philippines and of Other Pur-
poses/631

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A P P E N D I X 16 - Republic Act No. 5680 - Philippine Physical and

Occupational Therapy Law/635

A P P E N D I X 17 - Republic Act No. 2382 - The Medical Act of 1959

(As amended by R.A. 5946 and R.A. 4224)/650

A P P E N D I X 18 - PRC Resolution No. 06-342 (A), Series of 2006 -

New Rules of Procedure in Administrative Investigations in the PRC
and the Professional Regulatory Boards/669

Bibliography/699

Glossary/104

Index /719

—oOo—

xlii