JULY 22, 2020 TYPES OF ACTIONS
LEGAL MEDICINE
- Branch of medicine that deals with the application of
medical knowledge to legal problems and legal
proceedings.
Legal Medicine is also called Forensic Medicine.
FORENSIC MEDICINE
- The branch of legal medicine dealing with the
application of medical knowledge to establish facts in
civil or criminal legal cases, such as an investigation into
the cause and time of a suspicious death. Also known as
forensic pathology.
MEDICAL JURISPRUDENCE
– The branch of the law that deals with the application of
law to the practice of medicine.
It also deals with the organization and regulation of the
medical profession; the contractual obligation of a
physician or a health practitioner to the patient; the
professional relationship to his or her colleagues; and the
duties imposed in the practitioner by the State.
JURISPRUDENCE
- Latin term juris prudentia, which means “the study,
knowledge, or science of law.”
Focuses on finding the answer to such abstract questions
as What is law? or in the Philippines, how did the
Supreme Court interpret or apply the law?
 PROBLEM: H and W were married. Five years after their
marriage, they still have not been blessed with a child. They
tried all scientific and non-scientific means for W to conceive
but all methods failed. W had an affair with L. Later, W gave
birth to B. DNA test revealed that B’s DNA matched L’s
DNA. H filed a criminal case against W for adultery which
was decided in favor of the State. W was convicted as an
adulteress. Who is the father of B?
 PROBLEM: H and W were married. A year after the sperm
analysis of H revealed azoospermia. They agreed for an
artificial insemination with X, the brother of H, as the donor of
the sperm. Both H and W authorized such insemination in a
written instrument executed and signed by them before the
birth of Y. 20 years after Y won the lottery. However, a week
after winning 100 million pesos, Y drowned. X now is
claiming that as Y’s biological father, he has a claim to the
estate left by Y. Decide.
JURISDICTION AND VENUE
JURISDICTION is the power and authority of a court to
hear, try and decide a case.
Plaintiff vs. Defendant/Accused
Subject Matter
Res/Thing
Territory
VENUE is the place where the case is to be heard or
tried.
Real Actions
Personal Actions
DIFFERENCES BETWEEN JURISDICTION AND VENUE
JURISDICTION VENUE
Substantive law Procedural law
Conferred by law May be waived by the parties or
by agreement
LEGAL ACTION
-is a process of enforcing a law through a proceeding in court.
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RULE 1, SECTION 3
Cases governed. – These Rules shall govern the procedure to be
observed in actions, civil or criminal and special proceedings.
(a) CIVIL ACTION
-is one by which a party sues another for the enforcement or
protection of a right, or the prevention or redress of a wrong.
(b) CRIMINAL ACTION
-is one by which the State prosecutes a person for an act or
omission punishable by law.
CRIMINAL LAW
-defines crimes and prescribes punishment for such crimes.
(c) SPECIAL PROCEEDING
-is a remedy by which a party seeks to establish a status, a
right, or a particular fact.
(d) ADMINISTRATIVE ACTION
-one by which a party files a complaint before an
administrative agency to make determinations of facts in the
performance of their official duties and to apply the law as
they construe it to the facts so found.
CAUSE OF ACTION
-the act or omission by which a party violates a right of
another.
ELEMENTS:
1. Plaintiff’s right and the defendant’s duty; and
2. The wrongful act or omission of the defendant by
which the plaintiff’s right and the defendant’s duty
had been violated.
RIGHT OF ACTION
-the right to commence a suit.
PARTIES TO A CIVIL ACTION
1. Parties-in-interest (real party in interest)
2. Necessary party
PARTIES TO A CRIMINAL ACTION
1. The State/Government
2. Private complainant
3. Accused
QUANTUM OF EVIDENCE
PREPONDERANCE OF EVIDENCE
-the greater weight of the evidence required in a civil lawsuit
for the judge to decide in favor of one side or the other. This
preponderance is based on the more convincing evidence and
its probable truth or accuracy, and not on the amount of
evidence.
SUBSTANTIAL EVIDENCE
-defined to mean not necessarily preponderant proof as
required in ordinary civil cases but such kind of relevant
evidence which a reasonable mind might accept as adequate to
support a conclusion.
PROOF BEYOND REASONABLE DOUBT
-the standard that must be met by the prosecution’s evidence
in a criminal case in order to successfully find a criminal
defendant guilty of a crime.
-That no other logical explanation can be derived from the
facts except that the defendant committed the crime, thereby
overcoming the presumption that a person is innocent until
proven guilty.
-It does not mean absolute certainty but only moral certainty.

THE CONSTITUTION AND THE MEDICAL PROFESSION
ARTICLE III
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.
ARTICLE XII
SECTION 14
- The sustained development of a reservoir of national talents
consisting of Filipino scientists, entrepreneurs, professionals,
managers, high-level technical manpower and skilled workers
and craftsmen in all fields shall be promoted by the State. The
State shall encourage appropriate technology and regulate its
transfer for the national benefit.
-The practice of all professions in the Philippines shall be
limited to Filipino citizens, save in cases prescribed by law.
RULE 138
ATTORNEYS AND ADMISSION TO THE BAR
SECTION 5
- Additional requirements for other applicants. — All
applicants for admission other than those referred to in the two
preceding section shall, before being admitted to the
examination, satisfactorily show that they have regularly
studied law for four years, and successfully completed all
prescribed courses, in a law school or university, officially
approved and recognized by the Secretary of Education. The
affidavit of the candidate, accompanied by a certificate from
the university or school of law, shall be filed as evidence of
such facts, and further evidence may be required by the court.
-No applicant shall be admitted to the bar examinations unless
he has satisfactorily completed the following courses in a law
school or university duly recognized by the government: civil
law, commercial law, remedial law, criminal law, public and
private international law, political law, labor and social
legislation, medical jurisprudence, taxation, legal ethics and
clinical legal education program.
THE MEDICAL ACT OF 1959, as Amended
OBJECTIVES
(a) To standardize and regulate the medical education;
(b) The examination for registration of physicians; and
(c) To supervise, control and regulate the practice of
medicine in the Philippines.
ENFORCING AGENCIES
-Board of Medical Education under the Department of
Education
-Board of Medical Examiners under the Civil Service
Commission
COMPOSITION OF THE BOARD OF MEDICAL
EXAMINATION:
Chairman: Secretary of Education
Members: 1. Secretary of Health;
2. Director of the Bureau of Private Schools;
3. Chairman of the Board of Medical Examiners;
4. A representative of the Philippine Medical
Association;
5. A representative of the Council of Deans of
Philippine Medical Schools
6. A representative of the Association of the
Philippine Medical
FUNCTIONS OF THE BOARD OF MEDICAL
EDUCATION:
(a) To determine and prescribe the requirements
-for admission into a recognized college of Medicine;
-for the minimum physical facilities;
- the minimum number and qualifications of teaching
personnel;
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-the minimum required curriculum;
(b) To authorize the implementation of experimental
curriculum in a medical school that has exceptional faculty
and instrumental facilities. Provided, that only exceptional
students shall be enrolled in the experimental curriculum;
(c) To accept applications for certification for admission to a
medical school;
(d) To select, determine and approve hospitals for training;
(e) To promulgate and prescribe and enforce the necessary
rules and regulations for the proper implementation of the
foregoing functions.
ADMISSION REQUIREMENTS
-not been convicted by any court of competent jurisdiction of
any offense involving moral turpitude;
-a record showing completion of a bachelor’s degree in
science and arts;
-a certificate of eligibility for entrance to a medical school
from the Board of Medical Education;
-a certificate of good moral character issued by two former
professors in the college of liberal arts;
-birth certificate;
-others required by a specific College of Medicine.
PREREQUISITE TO THE PRACTICE OF MEDICINE
-at least 21 years of age
-has satisfactorily passed the corresponding Board
Examination
-holder of a valid Certificate of Registration duly issued to
him by the Board of Medical Examiners.
GR. NO. 89572, DECEMBER 21, 1989
DECS VS. SAN DIEGO AND JUDGE TERESITA DIZON
CAPULONG
FACTS:
San Diego is a graduate of UE with a degree of Bachelor
of Science in Zoology. He claims that he took the NMAT 3 times
and flunked it as many times. When he applied to take it again,
DECS rejected his application on the basis of MECS Order No. 12,
Series of 1972 which states that: “A student shall be allowed only
3 chances to take the NMAT. After 3 successive failures, a student
shall not be allowed to take the NMAT for the 4th time.” He then
went to the RTC of Valenzuela to compel his admission to the test.
Judge Capulong declared the challenged order invalid and granted
the petition of San Diego and held that he had been deprived of his
right to pursue a medical education through an arbitrary exercise of
the police power.
ISSUE:
Whether a person who has thrice failed the NMAT is
entitled to take it again.
Whether the law requiring the NMAT prior to admission
to a medical school is constitutional.
HELD:
NO. NMAT is a measure intended to limit the admission
to medical schools only to those who have initially proved their
competence and preparation for a medical education. The
regulation of the practice of medicine in all its branches has long
been recognized as a reasonable method of protecting the health
and safety of the public. That the power to regulate and control the
practice of medicine includes the power to regulate admission to
the ranks of those authorized to practice medicine. The government
is entitled to prescribe an admission test like the NMAT as a means
of achieving its stated objective of “upgrading the selection of
applicants into our medical schools” and of “improving the quality
of medical education in the country.”
While every person is entitled to aspire to be a doctor, he does not
have a constitutional right to be a doctor. A person cannot insist on
being a physician if he will be a menace to his patients. If one who
wants to be a lawyer may prove better as a plumber, he should be
so advised and adviced. Of course, he may not be forced to be a
plumber, but on the other hand, he may not force his entry into the
bar.
The medical profession directly affects the very lives of the people,
unlike other careers which, for this reason, do not require more
vigilant regulation.
The court feels that it is not enough to simply invoke the right to
quality education as a guarantee of the Constitution: one must
show that he is entitled to it because of his preparation and
promise. The private respondent has failed the NMAT 5 times.
While his persistence is noteworthy, to say the least, it is certainty
misplaced, like a hopeless love.
GR. NO. L-24119, AUGUST 8, 1925
FELIX MARQUEZ VS. THE BOARD OF MEDICAL
EXAMINERS
FACTS:
Marquez is a graduate of the Chicago Medical College,
having received the degree of M.D. in 1922. Until 1923, the Board
of Medical Examiners accepted favorably the applications of
candidates for the Board Examinations from said school.
In the year 1924, Marquez applied to take the board examination
but they have denied him admission on the grounds that the
Chicago Medical College, where the petitioner graduated, has been
classified as a Class C medical college by the National Medical
State Board of the United States.
Marquez seeks to obtain a writ of mandamus against the Board of
Medical Examiners requiring them to admit him to the physician’s
examination on the ground that his case should be governed by the
law and regulation in force at the time of his enrollment in and
graduation from the Chicago Medical School, not by those in force
at the time he filed his application for admission.
ISSUE:
Whether a Writ of Mandamus should be issued and allow
Marquez to take the Medical Board Exam.
HELD:
NO. The question whether a medical institution is a
“reputable medical school,” in the sense intended by the law, is
vested in the Board of Medical Examiners, and although the action
taken by them may conceivable, in isolated cases, result n
hardship, nevertheless the interests of the public require that the
board should be free to exercise its judgment and discretion
without reference to the effect of the determination of the question
in particular instances. Otherwise, it would be impossible for the
Board of Medical Examiners to give effect to the knowledge which
they, from time to time, acquire as to the standing of medical
schools; and an intending physician, upon matriculating in a
particular college, takes upon himself the risk of changes that may
be made in the standing of the institution by the board.
GR. NO. 32441, MARCH 29, 1930
GOMEZ VS. VENTURA, SECRETARY OF THE INTERIOR
OF GOVERNMENT OF THE PHILIPPINE ISLANDS AND
THE BOARD OF MEDICAL EXAMINERS
FACTS:
Gomez has been charged guilty by the Board of
Examiners for violation of the Opium Law, thus, forever revoking
the plaintiff’s license to practice medicine and surgery.
Gomez filed the issuance of the writ of mandamus to annul the
decision of the Board.
ISSUE:
Whether the decision of the Board should be annulled and
be set aside.
HELD:
NO. As the Attorney-General correctly observes, the
powers vested in the Board of Medical Examiners to suspend or
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revoke a physician’s certificate of registration partake of a quasi-
judicial character, that is, involve the use of discretion. For this
reason, the exercise thereof cannot be reviewed by mandamus,
which is the nature of this cause on its merits.
It is a rule of general application that mandamus will not lie to
review or control the acts of executive officers and boards of state
in respect of matters as to which they are vested with discretion. In
other words, they cannot be compelled to act or render a decision
in any particular way, and this is so, even though the exercise of
this discretion requires the construction and interpretation of
statutes. Where public officials exercise their discretion, it is said
that their conclusions, although disputable, are impregnable to
mandamus.
GR. NO. 144681, JUNE 21, 2004
PROFESSIONAL REGULATION COMMISSION (PRC) VS.
DE GUZMAN, ET. AL.
FACTS:
The respondents are all graduates of the Fatima College
Medicine. They passed the Physician Licensure Examination
conducted in February 1993. Petitioner PRC then released their
names as successful examinees in the medical licensure
examination.
Shortly thereafter, the Board observed that the grades of the 79
successful examinees from Fatima College in the 2 most difficult
subjects in the medical licensure exam, Biochemistry and
Obstetrics and Gynecology, were unusually and exceptionally high
and the unusually high ratings were true only for Fatima College
examinees. It was a record-breaking phenomenon in the history of
the Physician Licensure Examination. Board issued Resolution
withholding the registration as physicians of all the examinees
from the Fatima College of Medicine and asked the NBI to
investigate.
NBI found that “the questionable passing rate of Fatima examinees
in 1993 Physician Examination leads to the conclusion that the
Fatima examinees gained early access to the test questions.”
Respondents filed a special civil action for mandamus with the
RTC which was granted. It ordered the petitioners to administer
the physician’s oath to respondents and enter their names in the
rolls of the PRC.
Board issued Resolution, charged the respondent with “immorality,
dishonest conduct, fraud and deceit” in connection with the Bio-
Chem and Ob-Gyne examinations. It recommended that the test
results of the Fatima examinees be nullified.
CA sustained the RTC’s decision. It held that they all passed said
examination. Having fulfilled the requirements of R.A. 2382, they
should be allowed to take their oaths and be registered in the rolls
of the PRC.
ISSUE:
Whether the CA committed a reversible error of law in
sustaining the judgment of the trial court that respondents are
entitled to a writ of mandamus.
HELD:
YES. The CA relied on a single provision, Sec. 20 of the
R.A. 2382, in concluding that the petitioners had the ministerial
obligation to administer the Hippocratic Oath to respondents and
register them as physicians.
A careful reading of Sec. 20 of the MA of 1959 discloses that the
law uses the word “shall” with respect to the issuance of
certificates of registration. Thus, the petitioner shall sign and issue
certificates of registration to those who have satisfactorily
complied with the requirements of the Board.” When an examinee
satisfies the requirements for the grant of his physician’s license,
the Board is obliged to administer to hism his oath and register him
as a physician, pursuant to Sec. 20 of the MA 1959.
Under the second paragraph of Sec. 22, the Board is vested with
the power to conduct administrative investigations and “disapprove
applications for examination or registration.” In this case, after the
investigation, the Board filed before the PRC admin case against
the respondents to ascertain their moral and mental fitness to
practice medicine. The Board decided to cancel the respondents’
examination papers in the examinations given and further debars
them from taking any licensure examination for a period of 1 year
from the date of the promulgation of the decision.
RA 2382 prescribes, among others, that a person who aspies to
practice medicine in the Philippines, must have “satisfactorily
passed the corresponding Board Examination.” Sec. 22, in turn,
provides that the oath may only be administered “to physicians
who qualified in the examinations.” The operative word here is
“satisfactorily,” defined as “capable of dispelling doubt or
ignorance.” Gleaned from Board Resolution, the students did not
“satisfactorily passed” the licensure examinations. The Board
instead sought to nullify the examination results obtained by the
respondents.
CANDIDATES FOR BOARD EXAMINATION
1. A citizen of the Philippines or a citizen of any foreign
country who has submitted competent and conclusive
documentary evidence, confirmed by the DFA, showing that
his country’s existing laws permit citizens of the Philippines
to practice medicine under the same rules and regulations
governing citizens thereof;
2. He shall be of good moral character;
3. He shall be of sound mind;
4. He shall not have been convicted by a court of competent
jurisdiction of any offense involving moral turpitude;
5. He shall be a holder of the degree of Doctor of Medicine or
its equivalent conferred by a college of medicine duly
recognized by the Government; and
6. He must have completed a calendar year of technical
training known as internship the nature of which shall be
prescribed by the Board of Medical Education.
GR. NO. 166097, JULY 14, 2008
BOARD OF MEDICINE VS. OTA
FACTS:
Yasuyuki Ota is a Japanese national, married to a Filipina,
who has continuously resided in the Philippines for more than 10
years. He graduated from Bicol Christian College of Medicine on
April 21, 1991 with a degree of Doctor of Medicine. After
successfully completing a 1 year post graduate internship training
at the Jose Reyes Memorial Medical Center, he filed an application
to take the medical board examinations in order to obtain a medical
license. He was required by the PRC to submit an affidavit of
undertaking, stating among others, that should he successfully pass
the same, he would not practice medicine until he submits proof
that reciprocity exists between Japan and Philippines in admitting
foreigners into the practice of medicine.
Respondent submitted a duly notarized English transltion of the
Medical Practitioners Law of Japan duly authenticated by the
Consul General of the Philippine Embassy to Japan, thus, he was
allowed to take the Medical Board Examination which he
subsequently passed.
Inspite of all these, the Board of Medicine of the PRC denied
respondent’s request for a license to practice medicine in the
Philippines on the ground that the Board believes that no genuine
reciprocity can be found in the law of Japan as there is no Filipino
or foreigner who can possibly practice there.
ISSUE:
Whether Ota, a Japanese national, should be allowed to
practice medicine here in the Philippines.
HELD:
YES. R.A. 2382 states that the applicant shall submit
competent and conclusive documentary evidence, confirmed by the
DFA, showing that his country’s existing laws permit citizens of
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the Philippines to practice the profession of medicine under the
same rules and regulations governing citizens thereof.
It is not stated that it must first be proven that a Filipino has been
granted license and allowed to practice his profession in said
country before a foreign applicant may be given license to practice
in the Philippines.
In this case, there is no doubt as to the competence and
qualifications of respondent. He finished his medical degree from
Bicol Christian College of Medicine. He completed a 1 year post
graduate internship training at the Jose Reyes Memorial Medical
Center, a government hospital. Then he passed the Medical Board
Examinations which was given on August 8, 1992 with a general
average of 81.83, with scores higher than 80 in 9 of the 12
subjects.
In fine, the only matter being questioned by petitioners is the
alleged failure of respondent to prove that there is reciprocity
between the laws of Japan and the Philippines in admitting
foreigners into the practice of medicine. Respondent has
satisfactory complied with the said requirement.
ACTS CONSTITUTING THE PRACTICE OF MEDICINE
Section 10.
- A person shall be considered as engaged in the practice of
medicine
(a) who shall, for compensation, fee, salary or reward in any
form, paid to him directly or through another, or even without
the same, physically examine any person, and diagnose, treat,
operate or prescribe any remedy for human disease, injury,
deformity, physical, mental, psychical condition or any
ailment, real or imaginary, regardless of the nature of the
remedy or treatment administered, prescribed or
recommended; or
CRISOSTOMO VS. SEC
G.R. 89095 & 89555
2 Japanese Doctors bought shares of stocks in a
corporation that operates as a hospital, UDMC. SC held that acts of
investment in stocks are not acts of practice of medicine. Hence,
not a violation of the Constitution of foreigners practicing a
profession without a license.
(b) who shall by means of signs, cards, advertisements, written
or printed matter or through the radio, television or any other
means of communication, either offer or undertake by any
means or method to diagnose, treat, operate or prescribe any
remedy for any human disease, injury, deformity, physical,
mental or psychical condition; or
PEOLE V. VENTURA
G.R. L-15079, JANUARY 31, 1962
License to practice drugless healing cannot be implied.
PEOPLE VS. BUENVIAJE
47 PHIL 536
Advertised himself and offered medical service.
(c) who shall falsely use the title M.D. after his name.
G.R. NO. L-15079, JANUARY 31, 1962
THE PEOPLE OF THE PHILIPPINES VS. VENTURA
FACTS:
By reason of certain complaints the NBI had received
from the Philippines Federation of Private Medical Practitioners
and from the Board of Medical Examiners, the NBI sent its morgue
attendant Natayan to the clinic of the accused. Natayan was at that
time suffering from pains in his back and he asked the accused to
see his sickness. The accused attended to Natayan, wrote
something on a piece of paper, and then he told him that he
(Natayan) was sick of lumbago. Thereupon, the accused asked
Natayan to pay a certain amount of money. Natayan thenw as
given an enema of hot water bath and was asked to lie down on a
table where his back was exposed to a big bulb for around 15
minutes and afterwards to a red colored bulb for another 10
minutes. Thereafter, Natayan went back to the accused, who told
him to come back to his clinic for 6 consecutive days. Thereafter,
the NBI agents raided the place. The accused, Guillermo, is not a
duly registered masseur or a physician qualified to practice
medicine. He was charged with illegal practice of medicine.
Ventura, testifying on his behalf, admitted that for the past 35
years, he had been practicing as a naturopathic physician, “treating
human ailments without the use of drugs and medicines” and
employing in his practice “electricity, water and hand” without a
license to practice medicine; that during this time he had treated
500,000 patients, more or less, about 90% of whom were healed,
and that he had studied drugless healing in the American
University, Chicago, Illinois, for about 4 years.
He also contended that the Chairman of the Board of Medical
Examiners had even permitted him to serve for free in the Central
Luzon Sanitarium in Tala, Caloocan, Rizal, which is an implied
license to practice drugless healing.
ISSUE:
Whether Ventura is not guilty of illegal practice of
medicine on the ground of implied license to practice drugless
healing.
HELD:
NO, there is no such thing as implied license to practice
drugless healing by the mere fact that the Chairman of the Board of
Medical Examiners had permitted appellant to serve free in the
Central Luzon Sanitarium in Tala, Caloocan, Rizal, or that
countless people persisted in engaging his services. For one thing,
these people might have contracted his services on the mistaken
notion that he has duly licensed to practice his profession, for
another, a repetition of illegal acts can never make them legal.
EXEMPTIONS:
(a) any medical student duly enrolled in an approved medical
college or school, or graduate under training, serving without
any professional fee in any government or private hospital,
provided that he renders such service under the direct
supervision and control of a registered physician;
(b) any legally registered dentist engaged exclusively in the
practice of dentistry;
(c) any duly registered masseur or physiotherapist, provided
that he applies massage or other physical means upon written
order or prescription of a duly registered physician, or
provided that such application of massage or physical means
shall be limited to physical or muscular development;
VENTURA case, he urges acquittal under the MA 1989 wherein
the practice of physiotherapy is recognized as a distinct science.
He claims coverage of said law on the ground that he practices
physiotherapy by massage through physical devices and upon the
recommendation of duty registered physicians.
The SC held that the argument has no merit because there is strong
evidence to the effect that appellant alone diagnoses his patients’
ailments and applies the remedies therefore without written order
or prescription by a registered physician.
(d) any duly registered optometrist who mechanically fits or
sells lenses, artificial eyes, limbs or other similar appliances or
who is engaged in the mechanical examination of the eyes for
the purpose of constructing or adjusting eyeglasses, spectacles,
and lenses;
(e) any person who renders any service gratuitously in cases of
emergency, or in place where the services of a duly registered
physician, nurse or midwife are not available;
(f) any person who administer or recommends any household
remedy as per classification of existing Pharmacy Laws;
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(g) any psychologist or mental hygienist, in the performance
of his duties, provided such performance is done in
conjunction with a duly registered physician.
JULY 29, 2020
LIMITED PRACTICE WITHOUT ANY CERTIFICATE OF
REGISTRATION
(a) Physician and surgeons from other countries called in the
consultation only and exclusively in specific and definite
cases, 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.
(b) Commissioned medical officers of the United States armed
forces stationed in the Philippines and within the limit of their
own respective territorial jurisdiction.
(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, be
necessary.
(d) Medical students who have completed the first 4 years of
medical course, 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. Such
authorization shall automatically cease when the epidemic or
national emergency is declared terminated by the Secretary of
Health.
PROFESSIONAL REGULATION COMMISSION (PRC)
- Regulates and supervises the practice of professional through
42 professional Regulatory Boards including the Board of
Medicine.
- Created by a Presidential Decree (President Marcos)
POWERS:
1. EXECUTIVE/ADMINISTRATIVE POWER
-Implementation
-Enforcement
-Maintenance
2. QUASI-LEGISLATIVE POWER
-Formulate rules and policies
-Once published in the Official Gazette, the same shall
have the force and effect of laws
3. QUASI-JUDICIAL
-Power to investigate erring examinees and professionals
-Administrative cases
-The decision has the force and effect of the decision of
the RTC
ISSUANCE OF CERTIFICATE OF REGISTRATION
-The Commissioner of Civil Service and the secretary of
the Board of Medical Examiners shall sign jointly and
issue certificates of registration to those who have
satisfactorily complied with the requirements of the
Board.
GROUNDS FOR NON ISSUANCE/REVOCATION:
1. Convicted by a court of competent jurisdiction of any
criminal offense involving moral turpitude
2. Guilty of immoral or dishonorable conduct after due
investigation by the board of medical examiners
3. Declared to be of unsound mind
ADMINISTRATIVE INVESTIGATIONS
1. Reprimand erring physicians
2. To subpoena or subpoena duces tecum witnesses
 3. Disapprove applications for examination
registration
4. Suspend or revoke registration certificates.
GROUNDS FOR REPRIMAND, SUSPENSION, OR
REVOCATION OF REGISTRATION CERTIFICATE
1. Conviction by a court of competent jurisdiction of any
criminal offense involving moral turpitude;
2. Immoral or dishonorable conduct;
3. Insanity;
4. Fraud in the acquisition of the certificate of registration;
5. Gross negligence, ignorance or incompetence in the
practice of his or her profession resulting in an injury to
or death of the patient;
6. Addiction to alcoholic beverages or to any habit forming
drug rendering him or her incompetent to practice his or
her profession, or to any form of gambling;
7. False or extravagant or unethical advertisements wherein
other things than his name, profession, limitation of
practice, clinic hours, office and home address, are
mentioned;
8. Performance of or aiding in any criminal abortion;
9. Knowingly issuing any false medical certificate;
10. Issuing any statement or spreading any news or rumor
which is derogatory to the character and reputation of
another physician without justifiable motive;
11. Aiding or acting as a dummy of an unqualified or
unregistered person to practice medicine;
12. Violation of any provision of the Code of Ethics as
approved by the Philippine Medical Association.
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.
PROCEDURES/RULES
(SEE PICTURE)
GOOD SAMARITAN EXEMPTED
-in emergency cases; in places where the services of a duly
registered physician, nurse, or midwife are not available.
DISPENSING OVER THE COUNTER DRUGS
-household remedy
TRADITIONAL MEDICINE
-Traditional Alternative Medicine Act of 1997 (TAMA)
SPIRITUAL HEALING
-religious freedom is recognized by the Constitution but no
individual should use medical titles and should not perform
surgery nor prescribe medications.
CORPORATIONS/JURIDICAL PERSONS
-not exempted.
ILLEGAL PRACTICEOF MEDICINE
-Also called unauthorized practice of medicine.
-Performance of acts considered as constituting the practice of
medicine without falling in any of those exempted by law
without proper license and certificate of registration to
practice medicine.
-Different from malpractice or negligence.
PENALTIES
-Board of Medical Examiners may file an action for
injunction.
PHYSICIAN-PATIENT RELATIONSHIP
-Legal, Moral, Humanitarian and Professional
THE PHYSICIAN-PATIENT CONTRACUAL
RELATIONSHIP
-the physician-patient relationship is a contract.
-it is a relationship that is both consensual and fiduciary.
for -a patient who entrusts himself to a physician’s care creates
not only ethical obligations but also legal obligations that are
defined and weighty.
NATURE OF THE PHYSICIAN-PATIENT CONTRACTUAL
RELATIONSHIP
-The presence of a contractual relationship is the primordial
basis of any negligence cases.
CONTRACT
-NCC Art. 1305 – A contract is a meeting of the minds
between 2 persons whereby one binds himself with respect to
another to give something or to render some service.
A. CONSENSUAL
-based on mutual consent
-meeting of the minds
B. FIDUCIARY
-based on mutual trust and confidence
-the patient must be able to communicate all relevant
information about the illness or injury in order for the
physician to make accurate diagnosis and provide
treatment recommendation.
INNOMINATE CONTRACT OF FACIO UT DES
-Latin term which means “I do and you give”
-Principle of unjust enrichment – that no one shall unjustly
enrich himself at the expense of others.
PARTIES TO A PHYSICIAN-PATIENT CONTRACTUAL
RELATIONSHIP
THE PHYSICIAN
-who renders the medical services in exchange for the
payment in the form of professional fee.
THE PATIENT
-who receives the medical services and in turn pays the
professional fee to the physician.
ESSENTIAL REQUISITES OF CONTRACTUAL
RELATIONSHIP
A. CONSENT
-given by the patient himself or someone authorized by law to
give consent.
NCC: ELEMENTS
1. Must be manifested by the concurrence of the offer
and the acceptance
2. The contracting parties must possess the necessary
legal capacity
-18 years of age
-the following cannot give consent to a contract: Art.
1327 NCC (unemancipated minor, insane [except
during lucid interval 1328 NCC] or demented person,
deaf-mutes who don’t know how to read and write.
3. The consent must be intelligent, free, spontaneous
and real.
-5 vices of consent: (NCC 1330)
-mistake, violence, intimidation, undue influence and
fraud.
B. OBJECT/SUBJECT MATTER
-to render medical service
-must not be outside the commerce of man
-must be legal and not contrary o law, morals, good customs,
public order, or public policy
GARCIA-RUEDA VS. PASCASIO
G.R. 118141, September 5, 1997
In accepting a case, a physician in effect represents that having
the medical training and skill possessed by physicians and
surgeons practicing the same field. He will employ such
training, care and skill in the treatment of his patients. He is
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 therefore has the duty to use at least the same level of care that 1. The physician has a duty to his patient.
any other reasonable competent physician would use to treat a How would a reasonable, careful and prudent physician
condition under the same circumstances. behave in a similar circumstance?

C. CAUSE/CONSIDERATION (ART. 1322) 2. The physician failed to perform such duty to his patient.
Did the physician breach the standard of care in this
1. ONEROUS specific situation?
-from the standpoint of a patient
-patients pay for the medical services rendered 3. As a consequence of the failure of the physician to
perform his duty, injury was sustained by the patient.
2. REMUNERATORY Was there injury or damage to the patient?
-from the standpoint of a physician
-physicians are paid for the medical services rendered 4. The failure of the physician to perform his duty tis the
proximate cause sustained by the patient.
3. GRATUITOUS Was the unreasonable, careless, or inappropriate behavior
-“gratis et amore” on the part of the physician the proximate cause of the
-free injury to the patient?
-pure liberality of the benefactor
1. DUTY
FORMS OF CONTRACTUAL RELATIONSHIP -There must be a physician-patient relationship which is the
primordial basis of medical negligence cases.
1. EXPRESSED -In accepting a case, a physician in effect represents that,
-through verbal acts/oral or written consent form having the needed training and skill possessed by a physician
and a surgeon practicing in the same field, the physician will
2. IMPLIED employ such training standard of care and skill in the
-non-verbal acts but there is a clear indication that both treatment of his/her patients.
parties agree -The Standard of Care for physicians requires that they
exercise that degree of skill, knowledge, training, and care
COMMENCEMENT OF PHYSICIAN-PATIENT ordinarily possessed and exercised by other members of the
CONTRACTUAL RELATIONSHIP profession acting under similar conditions and circumstances.
-from the time the patient asks the physician for medical
service and the latter agreed and the acceptance of the In summary, once a Physician-Patient relationship has been
physician is known to the patient. DOCTRINE OF established, the physician has the duty to:
COGNITION.
1. Possess the medical knowledge required of a reasonably
FREEDOM TO CONTRACT MEDICAL SERVICES AND competent medical practitioner engaged in the same
LIMITATIONS specialty.
-the contracting parties are free to establish such stipulations, 2. Possess the skills required of a reasonably competent
clauses, terms and conditions as they may deem convenient, health care practitioner engaged in the same specialty.
provided they are not contrary to law, morals, good customs, 3. Exercise the care in the application of that knowledge and
public order, or public policy. This is the Principle of skill to be expected of a reasonably competent health care
Autonomy of Contracts. practitioner in the same specialty.
4. Use the medical judgment in the exercise of that care
CASES WHEN THERE IS NO PHYSICIAN-PATIENT required of a reasonably competent health care
CONTRACTUAL RELATIONSHIP practitioner in the same specialty.
1. Pre-employment physical examination
2. Eligibility for insurance physical examination STANDARD OF CARE
3. Psychiatric evaluation of the accused -the level of care, skill, knowledge and treatment, that, under
4. Autopsy the circumstances, is recognized as acceptable and appropriate
5. Casual questions in casual settings by reasonably prudent members of the profession under
similar conditions and circumstances.
NOT PART OF PHYSICIAN-PATIENT CONTRACT -Breach of Standard of Care constitutes negligence.
-No matter what a physician does, he/she will not be found
CRUZ V. CA liable if the standard of care is maintained.
G.R. 122445, NOVEMBER 18, 1997 -Bad result does not necessarily mean malpractice.
-Errors of judgment are not necessarily malpractice.
1. Doctors are not guarantors of care -Highest skill is not required.
2. Doctors do not warrant good results
3. Doctors are not insurers against mishap or unusual The Standard of Care of Specialists:
consequences -a practitioner will be held to this higher standard of care if he
4. Doctors are not liable for honest mistake of judgment. or she has specialized training regardless of whether or not the
practitioner holds himself out as a specialist.
MEDICAL NEGLIGENCE OR MALPRACTICE -a physician has the responsibility to consult a specialist or to
-Type of claim which a victim has available to a person to refer a patient to a specialist when he knows, or in the exercise
redress a wrong committed by a medical professional which of reasonable care should know, that superior treatment might
has caused bodily harm. In order to successfully pursue such a thereby be obtained.
claim, a patient must prove that a health care provider, in most -there is a need for expert testimony to establish the Standard
cases a physician, either failed to do something which a of Care to establish whether the physician deviated from the
reasonably prudent health care provider would have done, or applicable standard of care expected from him when the injury
that he or she did something that a reasonably prudent occurred.
provider would not have done; and that failure or action -a layman is not equipped with the common knowledge or
caused injury to the patient. experience to judge the skill and competence of the practice at
issue and determine whether it meets the standard of such
THE COMPLAINANT/PATIENT MUST BE ABLE TO professional practice in their community.
ESTABLISH THE FOLLOWING: -the standard of care is based on the care that a similarly
trained physician would give.

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KINDS OF STANDARD OF CARE
1. National Standard
-the Philippine jurisdiction uses the national standard of care
as all the certifying specialty boards are national in scope.
-the standard of care does not necessarily mean the “best,” but
rather one that is considered “acceptable” and “adequate” to
reasonable medical practitioners under similar circumstances.
2. Locality Standard
-the physician is not considered negligent if he applies the
method of diagnosis and treatment which the same physicians
in the same locality would have applied when they see similar
cases and under the same situation.
3. Respectable Minority Standard
-so long as respectable minority of physicians endorse the
treatment and believe that it will be effective, the doctor
cannot be held liable for medical malpractice solely for
recommending it.
2. DERELICTION OR BREACH OF DUTY
-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 prudent provider would not have
done;
-In proving that there was breach two-pronged pieces of
evidence are required: evidence as to the recognized standards
of the medical community in the particular kind of case, and a
showing that the physician in question negligently departed
from this standard in the treatment. These entails expert
testimonies which call for a full-blown trial.
3. DAMAGE OR INJURY
-Article 2197. Damages may be:
1. Actual or Compensatory;
2. Moral;
3. Nominal;
4. Temperate or Moderate;
5. Liquidated; or
6. Exemplary or Corrective.
4. DIRECT OR PROXIMATE CAUSE
-that immediate cause of an injury which in the logical,
natural, direct consequence, unbroken by any efficient
intervening cause, produces the injury and without which the
result would not have happened.
-Doctrine of Proximate Cause
-Negligence, cannot create a right of action unless it is the
proximate cause of the injury.
TESTS TO DETERMINE PROXIMATE CAUSE
1. Actual Cause or “but for” test or “Sine qua non” rule.
-The patient would not been harmed were it not for the
physician’s actions.
-this test requires a firm finding that the physician’s
negligence was an absolute prerequisite to what happened.
-This is a question of cause in fact (actual cause). The act or
omission must be material factor (a prerequisite) in the
occurrence of the event.
2. Substantial Factor Test
-The relationship between cause and effect need not be
established with absolute certainty. It merely requires that the
physician’s negligence is a major contributor to the patient’s
injury.
-in determining whether the negligence was a substantial
factor in causing the harm, substantial factor test applies to
event which results in inquiry, not injury itself, and the injury
need not only flow directly from event.
3. Forseeability Test
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-Whether the physician should have reasonably foreseen, as a
risk of his/her conduct, the reasonable consequences or type of
harm suffered by the patient.
-This test requires that:
a. Reasonably forseeable result or type of harm
b. No superseding intervening force
QUASI OFFENSES: CRIMINAL NEGLIGENCE
1. Simple Negligence – penalized under Article 365 of the
Revised Penal Code, is “a mere lack of prevision in a situation
where either the threatened harm is not immediate for the
danger not openly visible.” Put in a slightly different way, the
gravamen of the offense of simple negligence is the failure to
exercise the diligence necessitated or called for the situation
which was not immediately life-destructive but which
culminated, in the death of a patient.
2. Reckless Imprudence
-the elements of reckless imprudence are:
(1) that the offender does not fails to do an act;
(2) that the doing or the failure to do that act is voluntary;
(3) that it be without malice;
(4) that the material damage results from the reckless
imprudence; and
(5) that there is inexcusable lack of precaution on the part of
the offender, taking into consideration his employment or
occupation, degree of intelligence, physical condition, and
other circumstances regarding person, time and place.
PHYSICIAN MAY BECOME LIABLE FOR
MALPRACTICE THROUGH:
1. The physician’s own negligence
2. The negligence of the physician’s employees
3. The physician’s failure to obtain the informed consent of
the patient prior to the treatment
4. Breach of physician-patient relationship
5. Negligence of physician’ partners
AUGUST 5, 2020
A. Medical Negligence Doctrines
APPLICABLE TO BOTH PATIENT AND PHYSICIAN
TORTFEASORS
1. Doctrine of Common Fault
a. Doctrine of Contributory Negligence
-The act or omission amounting to want of ordinary care in the
part of the complainant or plaintiff, which, concurring with the
negligence of the accused or the defendant is the proximate
cause of the injury.
Art. 2179. When the plaintiff’s own negligence was the
immediate and proximate cause of his injury, he cannot
recover damages.
Art. 2214. In quasi-delicts, the contributory negligence of the
plaintiff shall reduce the damages that he may recover.
b. Doctrine of Comparative Negligence
-The degree of negligence of the plaintiff-patient is compared
to the degree of negligence of the defendant-physician.
Art. 2179 x x x But if his negligence was only contributory,
the immediate and proximate cause of the injury being the
defendant’s lack of due care, the plaintiff may recover
damages, but the courts shall mitigate the damages to be
awarded.
2. Doctrine of Assumption of Risk
- Assumption of risk is a defense in the law of torts, which
bars or reduces a plaintiff’s right to recovery against a
negligent tortfeasor if the defendant can demonstrate that the
 plaintiff voluntarily and knowingly assumed the risks at issue
inherent to the dangerous activity in which he was
participating at the time of his injury. The doctrine of
assumption of risk is also known as volenti non fit injuria.
a. Express Agreement/ Implied Acceptance of Risk
b. Knowledge of Risk
c. Voluntary Assumption
d. Injury
3. Doctrine of Last Clear Chance
-Doctrine of Discovered Peril
-Humanitarian Doctrine
-Doctrine of Supervening Negligence
-Under this doctrine, a negligent plaintiff can nonetheless
recover if he is able to show that the defendant or another
person had the last opportunity to avoid the accident.
-Where both parties are negligent in such a way that it would
be impossible to determine whose negligence was the
proximate cause of the accident, the party who had the last
clear chance to avoid the accident by the use of proper care
but failed to do so is considered in law solely responsible for
the consequences of the accident.
APPLICABLE TO PHYSICIAN TORTFEASORS
1. Doctrine of Independent Contractor
-Under this doctrine each and every person is responsible for
his own torts.
-This is direct or primary liability, based upon one’s own
conduct.
-There is no employer-employee relationship in an
independent contractor, hence, the physician is solely liable.
-It has been consistently held that in determining whether an
employer-employee relationship exists between the parties, the
following elements must be present.
(1) selection and engagement of services;
(2) payment of wages;
(3) the power to hire and fire; and
(4) the power to control not only the end to be achieved, but
the means to be used in reaching such an end.
-A physician cannot be held liable for negligence if the injury
sustained by the patient is on account of unforeseen
conditions, after the exercise of due care and diligence.
APPLICABLE TO PHYSICIAN AND THIRD
TORTFEASORS
1. Doctrine of Vicarious Liability
-Imputed Negligence
-Doctrine of Respondeat Superior (Latin term for “let the
master answer”)
-This Doctrine is an exception to the general rule that every
person is responsible for his or her own torts.
-This is based upon a relationship rather that upon conduct.
-Vicarious liability is a legal doctrine that assigns liability for
an injury to a person who did not cause the injury but who has
a particular legal relationship to the person who did act
negligently.
-The doctrine makes the employer responsible for a lack of
care on the part of an employee in relation to those to whom
the employer owes a duty of care.
-For respondeat superior to apply, the employee’s negligence
must occur within the scope of her employment.
-The employer is charged with legal responsibility for the
negligence of the employee because the employee is held to be
an agent of the employer.
-Art. 2181. Whoever pays for the damage caused by his
dependents or employees may recover from the latter what he
has paid or delivered in satisfaction of the claim.
2. Doctrine of Ostensible Agent
-Doctrine of Apparent Authority
-Doctrine of Apparent Agency
-Apparent authority results from a manifestation by the
principal to a third person that another is his agent.
-The manifestation may be made directly to the third person or
to the community at large by signs or advertising.
-Apparent authority exists only to the extent that it is
reasonable for the third person dealing with the agent to
believe the agent is authorized.

RAMOS VS. CA 3. Captain of the Ship Doctrine

1. Private respondent Delos Santos Medical Center is hereby
absolved from liability arising from the injury suffered by
petitioner Erlinda Ramos on June 17, 1985;
2. Private respondents Dr. Orlino Hosaka and Dr. Perfecta
Gutierrez are hereby declared to be solidarily liable for the
injury suffered by petitioner Erlinda on June 17, 1985 and
are ordered to pay petitioners-
(a) P 1,352,000.00 as actual damages;
(b) P 2,000,000.00 as moral damages;
(c) P100,000.00 as exemplary damages;
(d) P100,000.00 as attorney’s fees; and
(e) The costs of the suit.
4.
2. Doctrine of Res Ipsa Loquitor
-Latin term which means “The thing speaks for itself.”
-This Doctrine as a rule of evidence is peculiar to the law of
negligence which recognizes that prima facie negligence may
be established even in the absence of a direct proof and
furnishes a substitute for specific proof of negligence.
-This doctrine is not a rule of substantive law, but merely a
mode of proof or a mere procedural convenience.
-Mere invocation of this doctrine and application of the
doctrine does not dispense with the requirement of proof of
negligence.
-Requisites:
(a) The accident is of a kind which ordinarily does not 1.
occur in the absence of someone’s negligence; 2.
(b) It is caused by an instrumentality within the exclusive 3.
control of the defendant; and
(c) No contributing negligence from the plaintiff.
-In the above requisites, the fundamental element is the 4.
control of the instrumentality which caused the damage. 5.
6.
3. Doctrine of Foreseeability 7.
-Command Responsibility Doctrine
-Under this doctrine, courts assume that the physician is in
control of everyone and everything in an operating room and
thus is liable for anything that goes wrong no matter who was
responsible for the conduct.
-An adaptation from the “borrowed servant rules”, as applied
to an operating room, holding the person in-charge, eg. A
surgeon responsible for all under his supervision, regardless of
whether the ‘captain’ is directly responsible for an alleged
error or act of alleged negligence, and despite the assistant’s
positions as hospital employees.
Borrowed Servant Doctrine
- A principle under which the party usually liable for a
person’s actions is absolved of that responsibility when that
person is asked to do something which is outside of the
bounds of hospital policy.
-The fact that the resident physician, nurse, or operating room
assistant is usually a hospital employee does not change the
outcome of negligence cases, for courts employ the legal
fiction called the borrowed servant rule to transfer hospital
liability to physicians.
DEFENSE DOCTRINES
There is no Physician-Patient Relationship
Elements of Medical Negligence are absent
Doctrine of Common Fault
a. Contributory Negligence
b. Comparative Negligence
Doctrine of Assumption of Risk
Doctrine of Last Clear Chance
Rescue Doctrine
Exercise the Diligence of a Good Father Doctrine

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Rescue Doctrine
-Emergency Doctrine
-It is not contributory negligence to attempt to rescue a person
or property from danger unless the attempt is completely
reckless under the circumstances.
CONCEPT OF PHYSICIAN-PATIENT PRIVILEGED
COMMUNICATION
-also known as confidentiality
-fiduciary relationship
-relationship where a patient justifiably relies upon the
protects his/her personal interest and/or act in his/her best
interests
-power vs. vulnerability
-may be waived by the patient in the absence of a timely
objection
-burden of proof is on the one who claims the privilege
-extends to hospitals
LEGAL BASIS OF THE PHYSICIAN-PATIENT
PRIVILEGED COMMUNICATION
RULES OF COURT
-Rule 130 Admissibility
-Section 24. Disqualification by reason of privileged
communication – The following persons cannot testify as to
matters learned in confidence in the following cases: x x x
(d) 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;
LABOR CODE OF THE PHILIPPINES
-Article 187. Attending Physician
-Any physician attending an injured or sick employee shall
comply with all the regulations of the system (now PhilHealth)
and submit reports in prescribed form as such a time as may
be required concerning his condition or treatment. All medical
information relevant to the particular injury or sickness shall
on demand be made available to the employee or the system.
No information developed in connection with treatment or
examination for which compensation sought shall be
considered as privileged communication.
PHILIPPINE HIV AND AIDS POLICY ACT OF 2018
(REPUBLIC ACT 11166)
-Medical confidentiality refers to the core duty of medical
practice where the information provided by the patient to
health practitioner and his/her health status is kept private and
is not divulged to third parties. The patient’s health status can
however, be shared with other medical practitioner involved in
the professional care of the patient, who will also be bound by
medial confidentiality. Medical specialist, nurse, medical
technologist and all other health workers or personnel
involved in any counseling, testing or professional care of the
patient. It also applies to any person who, in any officially
capacity, has acquired or may have acquired such
confidentiality information;
Medical Confidentiality shall not be considered breached in the
following cases:
(a) when complying with reportorial requirements in conjunction
with the AIDWATCH programs;
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(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, that such treatment or care carry the risk
of HIV transmission: Provided, further, that such workers
shall be obliged to maintain the shared medical
confidentiality;
(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, 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,
hand delivered, and personally opened by the judge. Provided,
further, that the judicial proceedings be held in executive
session.
Any violation of medical confidentiality shall suffer the
penalty of imprisonment for six (6) months for four (4) years,
without prejudice to administrative sanctions such as fines and
suspension or revocation of the violators license to practice
his/her profession, as well as the cancellation or withdrawal of
the license to operate any business entity and accreditation of
hospitals, laboratories or clinics.
Disclosure to sexual partners. – 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.
ETHICAL BASIS OF THE PHYSICIAN-PATIENT
PRIVILEGED COMMUNICATION
1. Hipocratic Oath
2. Code of Ethics
3. Fiduciary Relationship (Contract)
RATIONALE BEHIND THE PHYSICIAN-PATIENT
PRIVILEGED COMMUNICATION
-To make safe full and confidential disclosure by the patient to
the physician and to inspire confidence in disclosing of all the
facts and circumstances and symptoms to the end that the
physician may form a correct diagnosis and render the correct
treatment.
-It rests on public policy and general interest of the
community.
-To prevent the physician from making public information that
will result in embarrassment, humiliation, or disgrace to the
patient.
ESSENTIAL REQUIREMENTS OF PHYSICIAN-PATIENT
PRIVILEGE COMMUNICATION
LIM VS. CA 1992
1. The privilege is claimed in the civil case
2. The person against whom the privilege is claimed is one duly
authorized to practice medicine, obstetrics, and surgery
3. Such person acquired the information while he was attending
to the patient in his professional capacity
4. The information was necessary to enable him to act in that
capacity
5. The information was confidential and, if disclosed, would
blacken the reputation of the patient.
CHAN VS. CHAN
G.R. No. 179786, July 24, 2013
-Josielene of course claims that the hospital records subject of
this case are not privileged since it is the “testimonial”
evidence of the physician that may be regarded as privileged.
The privilege, says Josielene, does not cover the hospital
records, but only the examination of the physician at the trial.
To allow, however, the disclosure during discovery procedure
of the hospital records-the results of tests that the physician
ordered, the diagnosis of the patient’s illness, and the advice
or treatment he gave him-would be to allow access to evidence
that is inadmissible without the patient’s consent. Physician
memorializes all of this information in the patient’s records.
Disclosing them would be equivalent of compelling the
 physician to testify on privileged matters he gained while
dealing with the patient, without the latter’s prior consent.
KROHN VS. CA
G.R. NO. 108854, June 14, 1994
-In the instant case, the person against whom the privilege is
claimed is not one duly authorized to practice medicine,
surgery or obstetrics. He is simply the patient’s husband who
wishes to testify on a document executed by medical
practitioners. Plainly and clearly, this does not fall within the
claimed prohibition. Neither can his testimony be considered a
circumvention of the prohibition because his testimony cannot
have the force and effect of the testimony of the physician
who examined the patient and executed the report.
NELLY LIM VS. CA
G.R. NO. 91114, September 25, 1992
-In order that the privilege may be successfully claimed, the
following requisites must concur:
1. The privilege is claimed in a civil case;
2. The person against whom the privilege is claimed is one
duly authorized to practice medicine, surgery or
obstetrics;
3. Such person acquired the information while he was
attending to the patient in his professional capacity;
4. The information was necessary to enable him to act in that
capacity; and
5. The information was confidential, and, if disclosed, would
blacken the reputation (formerly character) of the
patient.”
These requisites conform with 4 fundamental conditions
necessary for the establishment of a privilege against the
disclosure of certain communications, to wit:
1. The communications must originate in confidence that
they will not be disclosed.
2. This element of confidentiality must be essential to the
full and satisfactory maintenance of the relation between
the parties.
3. The relation must be one which in the opinion of the
community ought to be sedulously fostered
4. The injury that would inure to the relation by the
disclosure of the communications must be greater than the
benefit thereby gained for the correct disposal of
litigation.
The physician may be considered to be acting in his
professional capacity when he attends to the patient for
curative, preventive, or palliative treatment. Thus, only
disclosures which would have been made to the physician to
enable him “safely and efficaciously to treat his patient are
covered by the privilege. It is to be emphasized that “it is the
tenor only of the communication that is privileged. The mere
fact of making a communication, as well as the date of a
consultation and the number of consultations, are therefore not
privileged from disclosure, so long as the subject
communicated is not stated.
One who claims the privilege must prove the presence of these
aforementioned requisites. The petitioner failed to discharge
the burden. Dr. Acampado’s 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.
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.
THE DATA PRIVACY ACT (RA 10173)
What is the Data Privacy Act of the Philippines?
-was passed by the Philippine Congress in 2012 and finally
implemented 5 years later in 2016. RA 10173 assures the “free
flow of information to promote innovation and growth”
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(Republic Act No. 10173, Ch. 1, Sec. 2) while protecting the
users’ fundamental rights to privacy.
How is it implemented?
-RA 10173 protects and maintains the right of customers to
confidentiality by setting a legal list of rules for companies to
regulate the collection, handling, and disposal of all personal
information.
-Companies legally responsible for keeping their customers’
data protected from third parties or any form of misuse,
internally or externally.
What does that mean for data collectors/companies?
-The act applies to any process of personal data by anyone in
government or private sectors.
-All personal data must have legitimate reasons for collection
as well as should be clear to both parties giving and receiving
information. With that being said, all collection must be done
with the customer’s proper consent.
-All personal information used must also be relevant solely
used for its intended and state purposes. Companies must
protect customer information from collection to proper
disposal, avoiding access from unauthorized parties.
What is “personal information?”
-refers to any information whether recorded in a material form
or not, from which the identity of an individual is apparent or
can be reasonable and directly ascertained by the entity
holding the information, or when put together with other
information would directly and certainly identify an
individual” (R.A. 10173, Ch. 1, Sec. 3).
What is “sensitive personal information?”
(1) About an individual’s race, ethnic origin, marital status, age,
color, and religious, philoposophical or political affiliations;
(2) About an individual’s health, education, genetic or sexual life
of a person, or to any proceeding for any offense committed or
alleged to have been committed by such person, the disposal
of such proceedings, or the sentence of any court in such
proceedings;
(3) Issued by government agencies peculiar to an individual
which includes, but not limited to, social security numbers,
previous or cm-rent health records, licenses or its denials,
suspension or revocation, and tax returns; and
(4) Specifically established by an executive order or an act of
Congress to be kept classified.
WHAT IS CONSENT?
-consent of the data subject refers to any freely given, specific,
informed indication of will, whereby the data subject agrees to
the collection and processing of personal information about
and/or relating to him or her. Consent shall be evidenced by
written, electronic or recorded means. It may also be given on
behalf of the data subject by an agent specifically authorized
by the data subject to do so.
WHAT ARE THE RIGHTS OF THE DATA SUBJECT?
The data subject or the individual sharing his/her personal
information has be fully informed of several factors of the data
collecting process. This list includes, but isn’t limited to:
(1) The reason for use
(2) Methods of access
(3) The identity and contact details of the personal
information controller
(4) How long the information will be stored for
(5) Access to their rights.
WHAT STEPS DO I NEED TO TAKE IN COMPLIANCE
WITH THE ACT?
-Companies essentially have to ensure that their data
collection methods are flawless as well as consistently share
the entire process with data subjects, including a breach of
security, should there be any.
-To do this, companies should appoint a Data Protection
Officer and create privacy knowledge programs and privacy
 and data policies to regulate the handling of information, as
well as routine assessments to ensure quality data protection.
-In addition, companies must also have a proper procedure for
breach notification to its customers.

WHAT HAPPENS IF I DO NOT COMPLY?

Improper/unauthorized processing, handling or disposal of
personal information can be penalized by imprisonment up to
six years and a fine of not less than P500,000.00

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