STATE REGULATION OF HOSPITAL OPERATION
refrigerator – the removal of which would cause the
Definition:
 Licensure - granting a license to operate and maintain a hospital
according to an approved minimum standard.
 Accreditation - a process that a health care institution, provider,
or program undergoes to demonstrate compliance with standards
developed by an official agency.
 Certification - a process indicating that an individual or institution
has met predetermined standards; Acknowledgment by a medical
specialty board of successful completion of requirements for
recognition as a specialist.
Cases:
MANILA DOCTORS HOSPITAL, petitioner, vs. SO UN CHUA and VICKY TY,
respondents.
G.R. No. 150355 | July 31, 2006 (1D)
Facts:
 Respondent Chua, mother of Ty, was admitted to petitioner
hospital for hypertension and diabetes.
 While Chua was confined, another daughter Judith Chua was
admitted for treatment of injuries sustained after a vehicular
accident. Ty shouldered the hospital bills for the two.
 After Judith was discharged, respondent Chua remained confined.
Ty was able to pay P435,800.00. The hospital bills eventually
totaled P1,075,592.95. When Ty was unable to pay the bills, the
hospital allegedly pressured her, by cutting off the telephone line
in her room and removing the air-conditioning unit, television set,
and refrigerator, refusing to render medical attendance and to
change the hospital gown and bed sheets, and barring the private
nurses or midwives from assisting the patient, to settle the same
through the signing of a promissory note.
 Ty issued postdated checks to pay the note. The checks bounced.
The petitioner alleged that that as early as one week after
respondent Chua had been admitted to its hospital, Dr. Rody Sy,
her attending physician, had already given instructions for her to
be discharged, but respondents insisted that Chua remain in
confinement.
 It also alleged that Ty voluntarily signed the agreement that she
will pay the bills and that no undue pressure was exerted by
them; and that the cutting-off of the telephone line and removal
of the air-conditioning unit, television set, and refrigerator cannot
constitute unwarranted actuations, for the same were resorted to
as cost-cutting measures and to minimize respondents' charges
that were already piling up, especially after respondent Ty refused
to settle the balance notwithstanding frequent demands. Finally it
alleged that this case was instituted by Ty to provide leverage
against the hospital for filing criminal charges against the latter for
violation of BP 22.
Issue: Whether or not the hospital is liable for damages
Held: No
 Conclusions are bereft of sound evidentiary basis, self-serving
and uncorroborated as they are
 Indeed the operation of private pay hospitals and medical clinics is
impressed with public interest and imbued with a heavy social
responsibility. But the hospital is also a business, and, as a
business, it has a right to institute all measures of efficiency
commensurate to the ends for which it is designed, especially to
ensure its economic viability and survival. And in the legitimate
pursuit of economic considerations, the extent to which the public
may be served and cured is expanded, the pulse and life of the
medical sector quickens, and the regeneration of the people as a
whole becomes more visibly attainable.
 In the institution of cost-cutting measures, the hospital has a
right to reduce the facilities and services that are deemed to be
non-essential, such that their reduction or removal would not be
detrimental to the medical condition of the patient.
o For the moment, the question to be considered is
whether the subject facilities are indeed non-essential
Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel Capule’s Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 – 2016 | Arellano University School of Law
– the air-conditioner, telephone, television, and
adverse health effects and emotional trauma the
respondents so claimed.
o Corollary to this question is whether the petitioner
observed the diligence of a good father of the family in
the course of ascertaining the possible repercussions
of the removal of the facilities prior to the removal
itself and for a reasonable time thereafter, with a view
to prevent damage.
 The evidence in the record firmly establishes that the staff of the
petitioner took proactive steps to inform the relatives of
respondent Chua of the removal of facilities prior thereto, and to
carry out the necessary precautionary measures to ensure that
her health and well-being would not be adversely affected: as
early as around two weeks after her admission
 Authorities, including those of common law origin, explicitly
declare that a patient cannot be detained in a hospital for non-
payment of the hospital bill.
o If the patient cannot pay the hospital or physician's bill,
the law provides a remedy for them to pursue, that is,
by filing the necessary suit in court for the recovery of
such fee or bill.
o If the patient is prevented from leaving the hospital for
his inability to pay the bill, any person who can act on
his behalf can apply in court for the issuance of the
writ of habeas corpus.
 The form of restraint must be total; movement must be
restrained in all directions. If restraint is partial, e.g., in a
particular direction with freedom to proceed in another, the
restraint on the person's liberty is not total.
o However, the hospital may legally detain a patient
against his will:
 when he is a detained or convicted
prisoner, or
 when the patient is suffering from a very
contagious disease where his release will be
prejudicial to public health, or when the
patient is mentally ill such that his release
will endanger public safety,
 or in other exigent cases as may be
provided by law.
o Moreover, under the common law doctrines on tort, it
does not constitute a trespass to the person to
momentarily prevent him from leaving the premises or
any part thereof because he refuses to comply with
some reasonable condition subject to which he
entered them. In all cases, the condition of this kind of
restraint must be reasonable in the light of the
circumstances.
o At any rate, as stated above, the patient is free to leave
the premises, even in the ostensible violation of these
conditions, after being momentarily interrupted by the
hospital staff for purposes of informing him of those
reasonable conditions, such as the assessment of
whether the patient is fit to leave, insane, or suffering
from a contagious disease, etc., or simply for purposes
of making a demand to settle the bill.
o If the patient chooses to abscond or leave without the
consent of the hospital in violation of any of the
conditions deemed to be reasonable under the
circumstances, the hospital may nonetheless register
its protest and may choose to pursue the legal
remedies available under law, provided that the
hospital may not physically detain the patient, unless
the case falls under the exceptions abovestated.
 Authorities are of the view that, ordinarily, a hospital, especially if
it is a private pay hospital, is entitled to be compensated for its
services, by either an express or an implied contract, and if no
express contract exists, there is generally an implied agreement
that the patient will pay the reasonable value of the services
rendered; when a hospital treats a patient's injuries, it has an
1
 enforceable claim for full payment for its services, regardless of  However, in some cases, the Court had ruled that sanctioning an
the patient's financial status. erring employee with suspension would suffice as the extreme
penalty of dismissal would be too harsh.
HOSPITAL MANAGEMENT SERVICES, INC. - MEDICAL CENTER MANILA, o Considering that this was the first offense of
Petitioner, vs. HOSPITAL MANAGEMENT SERVICES, INC. - MEDICAL CENTER respondent De Castro in her nine (9) years of
MANILA EMPLOYEES ASSOCIATION-AFW and EDNA R. DE CASTRO, employment with petitioner hospital as a staff nurse
Respondents. without any previous derogatory record and, further,
G.R. No. 176287 | January 31, 2011 (2D) as her lapse was not characterized by any wrongful
motive or deceitful conduct.
Facts:
 One Rufina Causaren, an 81-year-old patient confined at
petitioner hospital fell from the right side of the bed as she was
trying to reach for the bedpan.
 Because of what happened, the niece of patient Causaren staying
in the room was awakened and she sought assistance from the
nurse station. Instead of personally seeing the patient,
respondent De Castro directed ward-clerk orientee Guillergan to
check the patient. The vital signs of the patient were normal.
Later, the physician on duty and the nursing staff on duty for the
next shift again attended to patient Causaren.
 A formal investigation was conducted regarding the said incident.
The Investigation Committee found that the subject incident
happened between 11:00 a.m. to 11:30 a.m. of March 23, 1999.
The three other nurses for the shift were not at the nurse station.
 The committee recommended that despite her more than seven
years of service, respondent De Castro should be terminated from
employment for her lapse in responding to the incident and for
trying to manipulate and influence her staff to cover-up the
incident. A notice of termination was sent to the respondent.
 Respondent De Castro, with the assistance of respondent
association, filed a Complaint for illegal dismissal against
petitioners.
 LA: In favor of respondent; NLRC: Reversed LA; CA: Upheld LA

Issue: Whether or not respondent De Castro’s dismissal is illegal

Held: Yes
 Petitioners anchor respondent De Castro’s termination of
employment on the ground of serious misconduct for failure to
personally attend to patient Causaren who fell from the bed as
she was trying to reach for the bedpan.
 Petitioners anchor respondent De Castro’s termination of
employment on the ground of serious misconduct for failure to
personally attend to patient Causaren who fell from the bed as
she was trying to reach for the bedpan.
o Despite our finding of culpability against respondent
De Castro; however, we do not see any wrongful
intent, deliberate refusal, or bad faith on her part
when, instead of personally attending to patient
Causaren, she requested Nursing Assistant Tatad and
ward-clerk orientee Guillergan to see the patient, as
she was then attending to a newly-admitted patient at
Room 710.
o Being her first offense, respondent De Castro cannot
be said to be grossly negligent so as to justify her
termination of employment. Moreover, petitioners’
allegation, that respondent De Castro exerted undue
pressure upon her co-nurses to alter the actual time of
the incident so as to exculpate her from any liability,
was not clearly substantiated.
 Negligence is defined as the failure to exercise the standard of
care that a reasonably prudent person would have exercised in a
similar situation.
o The Court emphasizes that the nature of the business
of a hospital requires a higher degree of caution and
exacting standard of diligence in patient management
and health care as what is involved are lives of
patients who seek urgent medical assistance. An act
or omission that falls short of the required degree of
care and diligence amounts to serious misconduct
which constitutes a sufficient ground for dismissal.

Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel Capule’s Syllabus 2
Rivad, Sherine L. | 1st Sem AY 2015 – 2016 | Arellano University School of Law
STATE REGULATION OF PRACTICE OF MEDICINE
Dent v. West Virginia
129 U.S. 114 | January 14, 1889 (U.S. Supreme Court)
Facts: Frank Dent was a physician of the Eclectic sect, a group which
accepted and taught the conventional medical science of the time. However,
in the area of therapeutics, the Eclectics carried on a rigorous campaign
against excesses of drugging and bleeding, which were still practices used by
many physicians at the time. In addition, all but one of their medical schools
were open to women.
Dent had been in practice for six years when he was convicted under an 1882
West Virginia law which required physicians to hold a degree from a
reputable medical college, pass an examination, or prove practice in West
Virginia for the previous ten years. In this case, the State Board of Health
refused to accept Dent's degree from the American Medical Eclectic College
of Cincinnati.
Held:
The Court's unanimous opinion which upheld the West Virginia statute noted
that each citizen had a right to follow any lawful calling, subject to natural
restraints such as age, sex, etc., as well as state restrictions, as long as those
state restrictions were reasonable. In addition, the Court ruled that
medicine, because of the careful nature of its training, the large knowledge
of the human body required of doctors, and nature of life-and-death
circumstances with which doctors dealt, reliance needed to be placed on
the assurance of a license. Certain circumstances might prompt states to
exclude people without licenses from practicing medicine.
FELIX MARQUEZ, petitioner, vs. THE BOARD OF MEDICAL EXAMINERS and
THE SECRETARY-TREASURER OF THE BOARD OF MEDICAL EXAMINERS,
respondent.
G.R. No. L-24119 | August 8, 1925 (EB)
Facts: Petitioner is a graduate of the Chicago Medical College, having
received the degree of M.D. from said institution on June 8, of the year 1922.
No question appears to have been made by the respondents with respect to
the petitioner's qualifications of the physician's examinations in other
respects, but they have denied him admission to the examinations on the
grounds that the Chicago Medical College, where the petitioner was
graduated, has been classified as a Class C medical college by the National
Medical State Board of the United States. For this reason the respondents, in
accordance with the regulations of the board now in effect, have denied the
requisite standing to said institution and excluded petitioner.
Issue: Whether or not petitioner has a right to be admitted for medical
examinations
Held: No
In the argument for the petitioner it is admitted that under Act No. 3111, and
the regulations now in force, the petitioner is disqualified to take the
examinations; but it is pointed out that at the time he began and even when
he conducted his course in the Chicago Medical School, said institution was
still recognized as a reputable medical institution; and the question
submitted is whether the petitioner's case should be governed by the law and
regulations in force at the time of his enrollment in and graduation from the
Chicago Medical School, or by those in force at the time he filed his
application for admission, on or about September 26, 1924. It is submitted for
the petitioner that his case should be governed by the law and regulations at
the time of his graduation. To hold otherwise, it is insisted, is to make the law
retroactive in effect and to do irreparable damage to the petitioner, who has
pursued his work in the institution referred to in good faith, believing that
said school had the status necessary to qualify him from examination.
The position taken by the petitioner is, we think, untenable. 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 conceivably, in isolated cases,
result in hardship, nevertheless the interests of the public require that the
board should be free to exercise its judgment and discretion without
Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel Capule’s Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 – 2016 | Arellano University School of Law
reference to the effect of the determination of the question in particular
instances. There can in the nature of things be no vested right in an existing
law, which would preclude its change or repeal. No one who has
commenced preparation in a particular institution has any inchoate right on
account of that fact. If the law were otherwise upon this point, 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.
PHILIPPINE MEDICAL ASSOCIATION, petitioner, vs. BOARD OF MEDICAL
EXAMINERS and JOSE MA. TORRES, respondents.
G.R. No. L-25135 | September 21, 1968 (EB)
Facts: Torres graduated from the University of Barcelona, Spain, with the
degree of Licentiate in Medicine and Surgery. He was granted special
authority to practice medicine in Lamitan, Basilan City, where he resides,
pursuant to Section 771(e) of the Revised Administrative Code:
SEC. 771. Persons exempt from registration. — Registration shall
not be required of the following classes of persons: . . .
(e) In cases of epidemic or in municipalities where there is no
legally qualified practicing physician, or when the circumstances
require it, in the interest of the public health, the Director of
Health may issue special authorizations, to all medical students
who have completed the first three years of their studies, or to
persons who have qualified in medicine, and to graduate or
registered nurses, who may request it.
On motion for reconsideration filed by respondent, the Board issued a
resolution, granting respondent a certificate to practice medicine in the
Philippines without the examination required in Republic Act No. 2882. The
resolution relied therefor upon The Treaty on the Validity of Academic
Degrees and The Exercise of the Professions between the Republic of the
Philippines and the Spanish State.
Petitioner herein, Philippine Medical Association, addressed the Chairman of
the Board a communication requesting reconsideration of said resolution,
upon the ground that, pursuant to said Medical Act of 1959, respondent has
to take and pass the examination therein prescribed, before he can be
allowed to practice medicine in the Philippines. Said Chairman then replied,
stating "that the final decision on the matter will have to come from the
President of the Philippines upon whose authority said resolution has been
finally approved and implemented."
Issue: Whether or not he Board had violated Republic Act No. 2882 in
granting respondent's certificate for the general practice of medicine in the
Philippines without the examination prescribed in said Act
Held: Yes
The main issue herein hinges on the interpretation of Article I of the Treaty
aforementioned, reading as follows:
The nationals of both countries who shall have obtained degrees or diplomas
to practice the liberal professions in either of the Contracting States, issued
by competent national authorities, shall be deemed competent to exercise
said professions in the territory of the Other, subject to the laws and
regulations of the latter. When the degree or diploma of Bachelor, issued by
competent national authorities allows its holder without requiring further
evidence of proficiency to pursue normally higher courses of study, he shall
also be deemed qualified to continue his studies in the territory of either
Party in conformity with the applicable laws and regulations of the State
which recognizes the validity of the title or diploma in question, and with the
rules and regulations of the particular educational institution in which he
intends to pursue his studies.
Inasmuch as the theory of respondent herein cannot be accepted without
placing graduates from our own educational institutions at a disadvantage
vis-a-vis Spanish graduates from Spanish schools, colleges or universities.
Indeed, the latter could — under respondent's pretense — engage in the
3
practice of medicine in the Philippines without taking the examination
prescribed in Republic Act No. 2882, whereas the former would have to take
and pass said examination. Worse still, since — as we ruled in the Garcia
case — the benefits of the aforementioned Treaty cannot be availed of in the
Philippines except by Spanish subjects, the result would be — should
respondent's contention be sustained — that graduates from Spanish schools
of medicine would be entitled to practice medicine in the Philippines without
examination, if they were Spanish subjects, but not if they are Filipinos.
Surely said treaty was not made to discriminate against Philippine schools,
colleges or universities, much less against nationals of the Philippines.
The Court held that said Treaty merely extended to diplomas issued or
degrees conferred by educational institutions of Spain the same recognition
and treatment that we accord to similar diplomas or degrees from local
institutions of learning; that holders of said Spanish diplomas or degrees
must take the examination prescribed by our laws for holders of similar
diplomas or degrees from educational institutions in the Philippines; that
resolution No. 25, series of 1965, of respondent Board is violative of Republic
Act No. 2882
TERESITA TABLARIN et. al, in their behalf and in behalf of applicants for
admission into the Medical Colleges during the school year 1987-88 and
future years who have not taken or successfully hurdled tile National Medical
Admission Test (NMAT). petitioners, vs. THE HONORABLE JUDGE ANGELINA
S. GUTIERREZ, Presiding Judge of Branch XXXVII of the Regional Trial Court of
the National Capital Judicial Region with seat at Manila, THE HONORABLE
SECRETARY LOURDES QUISUMBING, in her capacity as Chairman of the
BOARD OF MEDICAL EDUCATION, and THE CENTER FOR EDUCATIONAL
MEASUREMENT (CEM), respondents.
G.R. No. 78164 | July 31, 1987 (EB)
Facts: The petitioners seek admission into colleges or schools of medicine.
However the petitioners either did not take or did not successfully take the
National Medical Admission Test (NMAT). Republic Act 2382 as amended by
R.A. 4224 and 5946, known as the Medical Act of 1959 created, among
others, the Board of Medical Education (BME) whose functions include "to
determine and prescribe requirements for admission into a recognized
college of medicine" (Sec. 5 (a). Section 7 of the same Act requires from
applicants to present a certificate of eligibility for entrance (cea) to medical
school from the BME. MECS Order No. 52, s. 1985, issued by the then
Minister of Education, Culture and Sports, established a uniform admission
test called National Medical Admission Test as additional requirement for
issuance of a certificate of eligibility.
Petitioners then filed with the RTC a petition for Declaratory Judgment and
Prohibition with a prayer Temporary Restraining Order and Preliminary
Injunction seeking to enjoin the Sec. of educ, BME from enforcing Sec. 5(a)
and (f) of R.A. 4224 and MECS Order no. 2 and from requiring the taking and
passing of the NMAT as condition for securing (cea).
Issue: Whether or not Sec. 5(a) and (f) of R.A. 4224 and MECS Order no. 2
violate the constitution as they prescribe an unfair, unreasonable and
inequitable requirement
Held: No
Perhaps the only issue that needs some consideration is whether there is
some reasonable relation between the prescribing of passing the NMAT as a
condition for admission to medical school on the one hand, and the securing
of the health and safety of the general community, on the other hand. This
question is perhaps most usefully approached by recalling that 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, is also well recognized. Thus, legislation and administrative
regulations requiring those who wish to practice medicine first to take and
pass medical board examinations have long ago been recognized as valid
exercises of governmental power. Similarly, the establishment of minimum
medical educational requirements-i.e., the completion of prescribed
courses in a recognized medical school-for admission to the medical
profession, has also been sustained as a legitimate exercise of the
Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel Capule’s Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 – 2016 | Arellano University School of Law
regulatory authority of the state. What we have before us in the instant case
is closely related: the regulation of access to medical schools. MECS Order
No. 52, s. 1985, articulates the rationale of regulation of this type: the
improvement of the professional and technical quality of the graduates of
medical schools, by upgrading the quality of those admitted to the student
body of the medical schools. That upgrading is sought by selectivity in the
process of admission, selectivity consisting, among other things, of limiting
admission to those who exhibit in the required degree the aptitude for
medical studies and eventually for medical practice. The need to maintain,
and the difficulties of maintaining, high standards in our professional schools
in general, and medical schools in particular, in the current state of our social
and economic development, are widely known.
The Court believes that 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."
THE BOARD OF MEDICAL EDUCATION and the HON. LOURDES R.
QUISUMBING, in her capacity as Secretary of the Department of Education,
Culture and Sports and Chairman, Board of Medical Education, petitioners,
vs. HON. DANIEL P. ALFONSO, Presiding Judge of the Regional Trial Court,
Branch 74, Fourth Judicial Region, Antipolo, Rizal, and the PHILIPPINE
MUSLIM-CHRISTIAN COLLEGE OF MEDICINE FOUNDATION, INC.,
respondents.
G.R. No. 88259 | August 10, 1989 (EB)
Facts: Petitioners BME, the government agency which supervises and
regulates the country’s medical colleges, Sec. Quisimbing, chairman of the
Department of Education, Culture and Sports prayed for a writ of certiorari to
nullify the order of herein Respondent Judge Alfonso in Civil case No. 1385
restraining the enforcement of Pet. Order of closure of Philippine Muslim-
Christian College of Medicine Foundation Inc(the college). -The college was
founded on 1981 for the purpose of producing physicians who will
emancipate Muslim citizens from age-old attitudes of health. -However,
because of the unstable peace and order situation in Mindanao, the college
was established in Antipolo, Rizal, given a temporary permit to operate
instead of the originally proposed location in Zamboanga City. Antipolo was
adopted as its permanent site and the name was changed to Rizal College of
Medicine. -In 1985, DECS & BME authorized the Commission on Medical
Education to conduct a study of all Medical Schools in the Philippines. -The
report showed that the college fell very much short of the minimum
standards set for medical schools. Further, the team of inspectors cited the
ff. Grounds among others: (a)the College was not fulfilling its purpose due
inappropriate location (b)lack of university affiliation for balance humanistic
and scientific education (c) absence of philosophy based hospitals for
student’s training (d)more than 60% of the college faculty did not teach full
time -The school disputed these findings as biased and discriminatory and
requested BME to send another team of doctors for re-evaluation. 2nd team
confirmed the previous findings and recommended the phase-out of the
school. -There were third and fourth evaluations but the college failed both
and was rendered inadequate in all aspects. -The DECS recommended the
college for closure but somehow the college succeeded to have the Board
form yet another team of inspectors but although the findings show that
there were major efforts to improve the college, it is still rendered
inadequate and recommended for closure w/ provisions to disperse its
students to other medical schools. -Mr. Victor Sumulong(chairman of BOT),
upon learning the same proposed a gradual phase-out so as not to dislocate
the students and minimized financial losses
ALLOWED to operate until May 1989. -The college appealed the decision to
the OP, but the Executive Secretary found no reason to disturb the contested
decision
AFFIRMED! -The college filed civil case No. 1385 applying for a writ of
preliminary injunction to restrain its implementation
APPROVED! (by Judge Alfonso holding that there were no evidence
supporting the findings in the June 18, 1988 report, and that contrary to the
findings, the laboratory and library areas were big enough and operations in
the base hospital was going smoothly.) -Thus, the present petition.
4
Issue: Whether or not Judge Alfonso acted with grave abuse of discretion in
substituting his judgment to for the members/evaluators

Held: Given that the Secretary of Education, Culture and Sports exercises the
power to enjoin compliance with the requirements laid down for medical
schools and to mete out sanctions where he finds that violations thereof
have been committed, it was a grave abuse of discretion for the respondent
judge to issue the questioned injunction and thereby thwart official action, in
the premises correctly taken, allowing the College to operate without the
requisite government permit. A single ocular inspection, done after the
College had been pre-warned thereof, did not, in the circumstances, warrant
only the findings of more qualified inspectors about the true state of the
College, its faculty, facilities, operations, etc. The, members of the evaluating
team came from the different sectors in the fields of education and medicine,
and their judgment in this particular area is certainly better than that of the
respondent Judge whose sole and only visit to the school could hardly have
given him much more to go on than a brief look at the physical plant and
facilities and into the conduct of the classes and other school activities.
Respondent Judge gravely abused his discretion in substituting his judgment
for theirs. It is well-settled doctrine that courts of justice should not generally
interfere with purely administrative and discretionary functions; that courts
have no supervisory power over the proceedings and actions of the
administrative departments of the government; involving the exercise of
judgment and findings of facts, because by reason of their special knowledge
and expertise over matters falling under their jurisdiction, the latter are in a
better position to pass judgment on such matters and their findings of facts
in that regard are generally accorded respect, if not finality, by the courts.
There are, to be sure, exceptions to this general rule but none of them
obtains in this case.

Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel Capule’s Syllabus 5
Rivad, Sherine L. | 1st Sem AY 2015 – 2016 | Arellano University School of Law
DEPARTMENT OF EDUCATION, CULTURE AND SPORTS (DECS) and DIRECTOR
OF CENTER FOR EDUCATIONAL MEASUREMENT, petitioners, vs. ROBERTO
REY C. SAN DIEGO and JUDGE TERESITA DIZON-CAPULONG, in her capacity
as Presiding Judge of the Regional Trial Court of Valenzuela, Metro Manila,
Branch 172, respondents.
G.R. No. 89572 | December 21, 1989 (EB)
Facts: The private respondent is a graduate of the University of the East with
a degree of Bachelor of Science in Zoology. The petitioner claims that he took
the NMAT three times and flunked it as many times. 1 When he applied to
take it again, the petitioner rejected his application on the basis of the MECS
Order No. 12, Series of 1972 which provides that:
h) A student shall be allowed only three (3) chances to take the NMAT. After
three (3) successive failures, a student shall not be allowed to take the NMAT
for the fourth time.
In his original petition for mandamus, he first invoked his constitutional rights
to academic freedom and quality education. By agreement of the parties, the
private respondent was allowed to take the NMAT. In an amended petition
filed with leave of court, he squarely challenged the constitutionality of the
said rule. The additional grounds raised were due process and equal
protection.
Issue: Whether a person who has thrice failed the National Medical
Admission Test (NMAT) is entitled to take it again
Held: No
In Tablarin v. Gutierrez, this Court upheld the constitutionality of the NMAT
as 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 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
"improv[ing] the quality of medical education in the country."
Given the widespread use today of such admission tests in, for
instance, medical schools in the United States of America (the
Medical College Admission Test [MCAT] and quite probably, in
other countries with far more developed educational resources
than our own, and taking into account the failure or inability of
the petitioners to even attempt to prove otherwise, we are
entitled to hold that the NMAT is reasonably related to the
securing of the ultimate end of legislation and regulation in this
area. That end, it is useful to recall, is the protection of the public
from the potentially deadly effects of incompetence and
ignorance in those who would undertake to treat our bodies and
minds for disease or trauma.
The subject of the challenged regulation is certainly within the ambit of the
police power. It is the right and indeed the responsibility of the State to
insure that the medical profession is not infiltrated by incompetents to
whom patients may unwarily entrust their lives and health.
The method employed by the challenged regulation is not irrelevant to the
purpose of the law nor is it arbitrary or oppressive. The three-flunk rule is
intended to insulate the medical schools and ultimately the medical
profession from the intrusion of those not qualified to be doctors.
While every person is entitled to aspire to be a doctor, he does not have a
constitutional right to be a doctor. This is true of any other calling in which
the public interest is involved; and the closer the link, the longer the bridge
to one's ambition. The State has the responsibility to harness its human
resources and to see to it that they are not dissipated or, no less worse, not
used at all. These resources must be applied in a manner that will best
promote the common good while also giving the individual a sense of
satisfaction.
The right to quality education invoked by the private respondent is not
absolute. The Constitution also provides that "every citizen has the right to
Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel Capule’s Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 – 2016 | Arellano University School of Law
choose a profession or course of study, subject to fair, reasonable and
equitable admission and academic requirements.
The contention that the challenged rule violates the equal protection clause
is not well-taken. A law does not have to operate with equal force on all
persons or things to be conformable to Article III, Section 1 of the
Constitution.
There can be no question that a substantial distinction exists between
medical students and other students who are not subjected to the NMAT and
the three-flunk rule. 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 accountant, for example, while belonging to an
equally respectable profession, does not hold the same delicate
responsibility as that of the physician and so need not be similarly treated.
There would be unequal protection if some applicants who have passed the
tests are admitted and others who have also qualified are denied entrance.
In other words, what the equal protection requires is equality among equals.
PROFESSIONAL REGULATION COMMISSION (PRC) et al. vs. ARLENE V. DE
GUZMAN et al.
G.R. No. 144681 | June 21, 2004 (2D)
Facts: The respondents are all graduates of the Fatima College of Medicine,
Valenzuela City, Metro Manila. They passed the Physician Licensure
Examination conducted in February 1993 by the Board of Medicine (Board).
Petitioner Professional Regulation Commission (PRC) then released their
names as successful examinees in the medical licensure examination. Shortly
thereafter, the Board observed that the grades of the seventy-nine successful
examinees from Fatima College in the two most difficult subjects in the
medical licensure exam, Biochemistry (Bio-Chem) and Obstetrics and
Gynecology (OB-Gyne), were unusually and exceptionally high. Eleven Fatima
examinees scored 100% in Bio-Chem and ten got 100% in OB-Gyne, another
eleven got 99% in Bio-Chem, and twenty-one scored 99% in OB-Gyne.
For its part, the NBI found that “the questionable passing rate of Fatima
examinees in the 1993 Physician Examination leads to the conclusion that the
Fatima examinees gained early access to the test questions.”
Issue: Whether or not respondents should be allowed to take their oaths as
physicians and be registered in the rolls of the PRC, having fulfilled the
requirements of Republic Act No. 2382
Held: No
Respondents counter that having passed the 1993 licensure examinations for
physicians, the petitioners have the obligation to administer to them the
oath as physicians and to issue their certificates of registration as physicians
pursuant to Section 20 of Rep. Act No. 2382.
The intent or meaning of the statute should be ascertained from the statute
taken as a whole, not from an isolated part of the provision. Accordingly,
Section 20, of Rep. Act No. 2382, as amended should be read in conjunction
with the other provisions of the Act. Thus, to determine whether the
petitioners had the ministerial obligation to administer the Hippocratic Oath
to respondents and register them as physicians, recourse must be had to the
entirety of the Medical Act of 1959.
A careful reading of Section 20 of the Medical Act of 1959 discloses that the
law uses the word "shall" with respect to the issuance of certificates of
registration. Thus, the petitioners "shall sign and issue certificates of
registration to those who have satisfactorily complied with the requirements
of the Board." In statutory construction the term "shall" is a word of
command. It is given imperative meaning. Thus, when an examinee satisfies
the requirements for the grant of his physician’s license, the Board is obliged
to administer to him his oath and register him as a physician, pursuant to
Section 20 and par. (1) of Section 2225 of the Medical Act of 1959.
However, the surrounding circumstances in this case call for serious inquiry
concerning the satisfactory compliance with the Board requirements by the
respondents. The unusually high scores in the two most difficult subjects was
phenomenal, according to Fr. Nebres, the consultant of PRC on the matter,
6
and raised grave doubts about the integrity, if not validity, of the tests. These
doubts have to be appropriately resolved.
The function of mandamus is not to establish a right but to enforce one that
has been established by law. If no legal right has been violated, there can be
no application of a legal remedy, and the writ of mandamus is a legal remedy
for a legal right. There must be a well-defined, clear and certain legal right to
the thing demanded. It is long established rule that a license to practice
medicine is a privilege or franchise granted by the government.
It is true that this Court has upheld the constitutional right of every citizen to
select a profession or course of study subject to a fair, reasonable, and
equitable admission and academic requirements. But like all rights and
freedoms guaranteed by the Charter, their exercise may be so regulated
pursuant to the police power of the State to safeguard health, morals, peace,
education, order, safety, and general welfare of the people. Thus, persons
who desire to engage in the learned professions requiring scientific or
technical knowledge may be required to take an examination as a
prerequisite to engaging in their chosen careers. This regulation takes
particular pertinence in the field of medicine, to protect the public from the
potentially deadly effects of incompetence and ignorance among those
who would practice medicine. In a previous case, it may be recalled, this
Court has ordered the Board of Medical Examiners to annul both its
resolution and certificate authorizing a Spanish subject, with the degree of
Licentiate in Medicine and Surgery from the University of Barcelona, Spain,
to practice medicine in the Philippines, without first passing the examination
required by the Philippine Medical Act. In another case worth noting, we
upheld the power of the State to upgrade the selection of applicants into
medical schools through admission tests.
In the present case, the aforementioned guidelines are provided for in Rep.
Act No. 2382, as amended, which prescribes the requirements for admission
to the practice of medicine, the qualifications of candidates for the board
examinations, the scope and conduct of the examinations, the grounds for
denying the issuance of a physician’s license, or revoking a license that has
been issued. Verily, to be granted the privilege to practice medicine, the
applicant must show that he possesses all the qualifications and none of the
disqualifications. Furthermore, it must appear that he has fully complied with
all the conditions and requirements imposed by the law and the licensing
authority. Should doubt taint or mar the compliance as being less than
satisfactory, then the privilege will not issue. For said privilege is
distinguishable from a matter of right, which may be demanded if denied.
Thus, without a definite showing that the aforesaid requirements and
conditions have been satisfactorily met, the courts may not grant the writ of
mandamus to secure said privilege without thwarting the legislative will.
BOARD OF MEDICINE, DR. RAUL FLORES (now DR. JOSE S. RAMIREZ), in his
capacity as Chairman of the Board, PROFESSIONAL REGULATION
COMMISSION, through its Chairman, HERMOGENES POBRE (now DR.
ALCESTIS M. GUIANG), Petitioners, vs. YASUYUKI OTA, Respondent.
G.R. No. 166097 | July 14, 2008 (3D)
Facts: Yasuyuki Ota (respondent) 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 one-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 Professional Regulation
Commission (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
the Philippines in admitting foreigners into the practice of medicine.
Respondent submitted a duly notarized English translation of the Medical
Practitioners Law of Japan duly authenticated by the Consul General of the
Philippine Embassy to Japan, Jesus I. Yabes; thus, he was allowed to take the
Medical Board Examinations in August 1992, which he subsequently passed.
In spite of all these, the Board of Medicine (Board) 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
Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel Capule’s Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 – 2016 | Arellano University School of Law
in the law of Japan as there is no Filipino or foreigner who can possibly
practice there."
Issue: Whether or not the Board erred in not issuing the license of
respondent to practice medicine in the Philippines
Held: Yes
There is no question that a license to practice medicine is a privilege or
franchise granted by the government. It is a right that is earned through
years of education and training, and which requires that one must first
secure a license from the state through professional board examinations.
It must be stressed however that the power to regulate the exercise of a
profession or pursuit of an occupation cannot be exercised by the State or its
agents in an arbitrary, despotic, or oppressive manner. A political body which
regulates the exercise of a particular privilege has the authority to both
forbid and grant such privilege in accordance with certain conditions. As the
legislature cannot validly bestow an arbitrary power to grant or refuse a
license on a public agency or officer, courts will generally strike down license
legislation that vests in public officials discretion to grant or refuse a license
to carry on some ordinarily lawful business, profession, or activity without
prescribing definite rules and conditions for the guidance of said officials in
the exercise of their power.
R.A. No. 2382, which provides who may be candidates for the medical board
examinations, merely requires a foreign citizen to submit competent and
conclusive documentary evidence, confirmed by the Department of Foreign
Affairs (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.
Nowhere in said statutes is it stated that the foreign applicant must show
that the conditions for the practice of medicine in said country are practical
and attainable by Filipinos. Neither is it 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.
While it is true that respondent failed to give details as to the conditions
stated in the Medical Practitioners Law of Japan -- i.e., the provisions of the
School Educations Laws, the criteria of the Minister of Health and Welfare of
Japan in determining whether the academic and technical capability of
foreign medical graduates are the same as or better than that of graduates of
medical schools in Japan, and who can actually qualify to take the
preparatory test for the National Medical Examination – respondent,
however, presented proof that foreigners are actually practicing in Japan and
that Filipinos are not precluded from getting a license to practice there.
7
SPECIAL LAWS APPLICABLE TO PHYSICIANS I
THE PEOPLE, Respondent, v. JOSEPHINE CHAVEZ, Appellant.
Crim. No. 579. Fourth Dist. Jan. 10, 1947
Facts: The defendant was charged with the murder of her newborn baby. A
jury found her guilty of manslaughter and she has appealed from the
judgment. An autopsy was performed by a physician. He testified that the
cord on the baby was about eighteen inches long, untied and depleted of
blood; that the baby would live until it bled to death.
The appellant first contends that there is no substantial evidence to support
the verdict in that it does not sufficiently appear from the evidence that this
infant was born alive and became a human being; that it appears from the
testimony of another doctor, called by the defense, that the doctor
performing the autopsy did not use certain tests which might have been used
and did not open the infant's head and heart which this other doctor thought
might disclose some possibilities; and that it follows that the question of
whether this infant was born alive and became a human being rests entirely
on pure speculation.
Issue: Whether or not the child herein was born alive and became a human
being within the meaning of the homicide statutes
Held: Yes
The evidence is sufficient to support a finding, beyond a reasonable doubt,
that a live child was actually born here, and that it died because of the
negligence of the appellant in failing to use reasonable care in protecting its
life, having the duty to do so. This baby was completely removed from its
mother and even the placenta was removed. A factual question was
presented and the opinion of the autopsy physician was evidence which
could be considered by the jury. His opinion was that the baby was born
alive and that it breathed and had heart action. He gave good reasons for
that opinion and while he admitted that there could be a possible doubt his
evidence justifies the inference that there was no valid ground for a
reasonable doubt. While he admitted that he had not used certain tests
suggested by the other doctor he stated that he knew of these tests but he
did not consider them necessary here. With respect to the test most relied
upon by the defense, it was stated by both doctors that this test would show
only what the autopsy physician testified he had discovered by other means.
The doctor called by the defense had not seen the baby's body and his
testimony was based upon his general laboratory experience. While it may
be said that there was some conflict between the testimony of these two
doctors no more than a conflict appears. The question was one of fact for the
jury and, in our opinion, the evidence is sufficient to support its findings. If it
could be said that there might be a possible doubt with respect to this phase
of the case, it cannot be said that there was necessarily a reasonable doubt.
The finding of the jury is sufficiently supported, and the implied finding that
this was a human being rests on a factual basis and not upon speculation.
SPECIAL LAWS APPLICABLE TO PHYSICIANS II
DR. FILOTEO A. ALANO, Petitioner, vs. ZENAIDA MAGUD-LOGMAO,
Respondent.
G.R. No. 175540 | April 7, 2014 (3D)
Facts:
 Respondent Zenaida Magud-Logmao is the mother of deceased
Arnelito Logmao. Petitioner Dr. Filoteo Alano is the Executive
Director of the National Kidney Institute (NKI).
 At the NKI, Arnelito, who was brought to the East Avenue Medical
Center (EAMC) in Quezon City by two sidewalk vendors, who
allegedly saw the former fall from the overpass near the Farmers’
Market in Cubao, Quezon City, was immediately attended to and
given the necessary medical treatment.
 As he had no relatives around, Jennifer B. Misa, Transplant
Coordinator, was asked to locate his family by enlisting police and
media assistance.
 The next day, Arnelito had been pronounced brain dead by Dr.
Abdias V. Aquino, a neurologist, and by Dr. Antonio Rafael, a
neurosurgeon and attending physician of Arnelito, and that a
Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel Capule’s Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 – 2016 | Arellano University School of Law
repeat electroencephalogram (EEG) was in progress to confirm
the diagnosis of brain death.
 Upon learning that Arnelito was a suitable organ donor and that
some NKI patients awaiting organ donation had blood and tissue
types compatible with Lugmoso, Dr. Ona inquired from Jennifer
Misa whether the relatives of Arnelito had been located so that
the necessary consent for organ donation could be obtained.
 As the extensive search for the relatives of Arnelito yielded no
positive result and time being of the essence in the success of
organ transplantation, Dr. Ona requested Dr. Filoteo A. Alano,
herein petitioner, to authorize the removal of specific organs from
the body of Arnelito for transplantation purposes.
 On March 3, 1988, Dr. Alano issued to Dr. Ona a Memorandum,
which reads as follows:
As shown by the medical records, the said patient died on March
3, 1988 at 9:10 in the morning due to craniocerebral injury. Please
make certain that your Department has exerted all reasonable
efforts to locate the relatives or next-of-kin of the said deceased
patient, such as appeal through the radios and television, as well
as through police and other government agencies and that the
NBI [Medico-Legal] Section has been notified and is aware of the
case.
If all the above has been complied with, in accordance with the
provisions of Republic Act No. 349 as amended and P.D. 856,
permission and/or authority is hereby given to the Department of
Surgery to retrieve and remove the kidneys, pancreas, liver and
heart of the said deceased patient and to transplant the said
organs to any compatible patient who maybe in need of said
organs to live and survive.
 Consequently, respondent filed with the trial court a complaint
for damages against several doctors, including petitioner herein,
alleging that they conspired to remove the organs of Arnelito
while the latter was still alive and that they concealed his true
identity.
 The court a quo rendered judgment finding only Dr. Filoteo Alano
liable for damages to plaintiff and dismissing the complaint
against the other defendants for lack of legal basis.
 CA affirmed the lower court’s decision. Hence this petition.
Issue: W/N respondent's sufferings were brought about by petitioner's
alleged negligence in granting authorization for the removal or retrieval of
the internal organs of respondent's son who had been declared brain dead,
making petitioner liable for damages
Held: No
 Petitioner maintains that when he gave authorization for the
removal of some of the internal organs to be transplanted to
other patients, he did so in accordance with the letter of the law,
Republic Act (R.A.) No. 349, as amended by Presidential Decree
(P.D.) 856, i.e., giving his subordinates instructions to exert all
reasonable efforts to locate the relatives or next of kin of
respondent's son.
o Thus, petitioner insists that he should not be held
responsible for any damage allegedly suffered by
respondent due to the death of her son and the
removal of her son’s internal organs for transplant
purposes.
 The appellate court affirmed the trial court's finding that there
was negligence on petitioner's part when he failed to ensure that
reasonable time had elapsed to locate the relatives of the
deceased before giving the authorization to remove said
deceased's internal organs for transplant purposes.
 The Memorandum dated March 3, 1988 issued by petitioner,
stated thus:
A careful reading of the above shows that petitioner instructed his
subordinates to "make certain" that "all reasonable efforts" are
exerted to locate the patient's next of kin, even enumerating ways
in which to ensure that notices of the death of the patient would
reach said relatives. It also clearly stated that permission or
authorization to retrieve and remove the internal organs of the
8
 deceased was being given ONLY IF the provisions of the applicable
law had been complied with.
o Such instructions reveal that petitioner acted
prudently by directing his subordinates to exhaust all
reasonable means of locating the relatives of the
deceased. He could not have made his directives any
clearer. He even specifically mentioned that
permission is only being granted IF the Department of
Surgery has complied with all the requirements of the
law.
o Verily, petitioner could not have been faulted for
having full confidence in the ability of the doctors in
the Department of Surgery to comprehend the
instructions, obeying all his directives, and acting only
in accordance with the requirements of the law.
 Furthermore, as found by the lower courts from the records of
the case, the doctors and personnel of NKI disseminated notices
of the death of respondent's son to the media and sought the
assistance of the appropriate police authorities as early as March
2, 1988, even before petitioner issued the Memorandum.
o Prior to performing the procedure for retrieval of the
deceased's internal organs, the doctors concerned also
the sought the opinion and approval of the Medico-
Legal Officer of the NBI.
 Thus, there can be no cavil that petitioner employed reasonable
means to disseminate notifications intended to reach the relatives
of the deceased. The only question that remains pertains to the
sufficiency of time allowed for notices to reach the relatives of the
deceased.
o If respondent failed to immediately receive notice of
her son's death because the notices did not properly
state the name or identity of the deceased, fault
cannot be laid at petitioner's door. The trial and
appellate courts found that it was the EAMC, who had
the opportunity to ascertain the name of the
deceased, who recorded the wrong information
regarding the deceased's identity to NKI. The NKI could
not have obtained the information about his name
from the patient, because as found by the lower
courts, the deceased was already unconscious by the
time he was brought to the NKI.
NIEVES ESTARES BALDOS, substituted by FRANCISCO BALDOS and MARTIN
BALDOS, Petitioners, vs. COURT OF APPEALS and REYNALDO PILLAZAR a.k.a.
REYNALDO ESTARES BALDOS, Respondents.
G.R. No. 170645 | July 9, 2010 (2D)
Facts: Reynaldo Pillazar, alias Reynaldo Baldos, was born on 30 October 1948.
However, his birth was not registered in the office of the local civil registrar
until roughly 36 years later or on 11 February 1985. His certificate of live
birth indicated Nieves Baldos as his mother and Bartolome Baldos as his
father. Nieves Baldos also appeared as the informant on the certificate of live
birth.
On 8 March 1995, Nieves Baldos filed in RTC for cancellation of the late
registration of Reynaldo’s birth. She claimed that Reynaldo was not really her
son.
Issue: Whether the late registration of Reynaldo’s birth is valid
Held: Yes
Presidential Decree No. 651, otherwise known as An Act Requiring the
Registration of Births and Deaths in the Philippines which Occurred from 1
January 1974 and Thereafter, provides:
Sec. 1. Registration of births. All babies born in hospitals, maternity clinics,
private homes, or elsewhere within the period starting from January 1, 1974
up to the date when this decree becomes effective, irrespective of the
nationality, race, culture, religion or belief of their parents, whether the
mother is a permanent resident or transient in the Philippines, and whose
births have not yet been registered must be reported for registration in the
office of the local civil registrar of the place of birth by the physician, nurse,
Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel Capule’s Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 – 2016 | Arellano University School of Law
midwife, hilot, or hospital or clinic administrator who attended the birth or in
default thereof, by either parent or a responsible member of the family or a
relative, or any person who has knowledge of the birth of the individual child.
The report referred to above shall be accompanied with an affidavit
describing the circumstances surrounding the delayed registration. (Emphasis
supplied)
Sec. 2. Period of registration of births. The registration of the birth of babies
referred to in the preceding section must be done within sixty (60) days from
the date of effectivity of this decree without fine or fee of any kind. Babies
born after the effectivity of this decree must be registered in the office of the
local civil registrar of the place of birth within thirty (30) days after birth, by
the attending physician, nurse, midwife, hilot or hospitals or clinic
administrator or, in default of the same, by either parent or a responsible
member of the family or any person who has knowledge of the birth.
The parents or the responsible member of the family and the attendant at
birth or the hospital or clinic administrator referred to above shall be jointly
liable in case they fail to register the new born child. If there was no
attendant at birth, or if the child was not born in a hospital or maternity
clinic, then the parents or the responsible member of the family alone shall
be primarily liable in case of failure to register the new born child. (Emphasis
supplied)
Presidential Decree No. 76612 amended P.D. No. 651 by extending the
period of registration up to 31 December 1975. P.D. No. 651, as amended,
provided for special registration within a specified period to address the
problem of under-registration of births as well as deaths. It allowed,
without fine or fee of any kind, the late registration of births and deaths
occurring within the period starting from 1 January 1974 up to the date when
the decree became effective.
Since Reynaldo was born on 30 October 1948, the late registration of his
birth is outside of the coverage of P.D. No. 651, as amended. The late
registration of Reynaldo’s birth falls under Act No. 3753, otherwise known as
the Civil Registry Law, which took effect on 27 February 1931. As a general
law, Act No. 3753 applies to the registration of all births, not otherwise
covered by P.D. No. 651, as amended, occurring from 27 February 1931
onwards. Considering that the late registration of Reynaldo’s birth took place
in 1985, National Census Statistics Office (NCSO) Administrative Order No. 1,
Series of 1983 governs the implementation of Act No. 3753 in this case.
Under NCSO A.O. No. 1-83, the birth of a child shall be registered in the
office of the local civil registrar within 30 days from the time of birth. Any
report of birth made beyond the reglementary period is considered
delayed. The local civil registrar, upon receiving an application for delayed
registration of birth, is required to publicly post for at least ten days a
notice of the pending application for delayed registration. If after ten days
no one opposes the registration and the local civil registrar is convinced
beyond doubt that the birth should be registered, he should register the
same.
Reynaldo’s certificate of live birth, as a duly registered public document, is
presumed to have gone through the process prescribed by law for late
registration of birth. It was only on 8 March 1995, after the lapse of ten long
years from the approval on 11 February 1985 of the application for delayed
registration of Reynaldo’s birth, that Nieves registered her opposition. She
should have done so within the ten-day period prescribed by law. Records
show that no less than Nieves herself informed the local civil registrar of the
birth of Reynaldo. At the time of her application for delayed registration of
birth, Nieves claimed that Reynaldo was her son. Between the facts stated in
a duly registered public document and the flip-flopping statements of Nieves,
we are more inclined to stand by the former.
Applications for delayed registration of birth go through a rigorous process.
The books making up the civil register are considered public documents and
are prima facie evidence of the truth of the facts stated there. As a public
document, a registered certificate of live birth enjoys the presumption of
validity. It is not for Reynaldo to prove the facts stated in his certificate of
live birth, but for petitioners who are assailing the certificate to prove its
alleged falsity. Petitioners miserably failed to do so. Thus, the trial court and
9
the Court of Appeals correctly denied for lack of merit the petition to cancel
the late registration of Reynaldo’s birth.
ROMMEL JACINTO DANTES SILVERIO, petitioner, vs. REPUBLIC OF THE
PHILIPPINES, respondent.
G.R. No. 174689 | October 22, 2007 (1D)
Facts: Petitioner Rommel Jacinto Dantes Silverio filed a petition for the
change of his first name and sex in his birth certificate.
He further alleged that he is a male transsexual, that is, "anatomically male
but feels, thinks and acts as a female" and that he had always identified
himself with girls since childhood. Feeling trapped in a man’s body, he
consulted several doctors in the United States. He underwent psychological
examination, hormone treatment and breast augmentation. His attempts to
transform himself to a "woman" culminated on January 27, 2001 when he
underwent sex reassignment surgery in Bangkok, Thailand. He was thereafter
examined by Dr. Marcelino Reysio-Cruz, Jr., a plastic and reconstruction
surgeon in the Philippines, who issued a medical certificate attesting that he
(petitioner) had in fact undergone the procedure.
Issue: Whether or not a person successfully petition for a change of name
and sex appearing in the birth certificate to reflect the result of a sex
reassignment surgery
Held: No. A Person’s First Name Cannot Be Changed On the Ground of Sex
Reassignment.
The State has an interest in the names borne by individuals and entities for
purposes of identification. A change of name is a privilege, not a right.
Petitions for change of name are controlled by statutes. In this connection,
Article 376 of the Civil Code provides:
ART. 376. No person can change his name or surname without
judicial authority.
This Civil Code provision was amended by RA 9048 (Clerical Error Law). In
particular, Section 1 of RA 9048 provides:
SECTION 1. Authority to Correct Clerical or Typographical Error
and Change of First Name or Nickname. – No entry in a civil
register shall be changed or corrected without a judicial order,
except for clerical or typographical errors and change of first
name or nickname which can be corrected or changed by the
concerned city or municipal civil registrar or consul general in
accordance with the provisions of this Act and its implementing
rules and regulations.
RA 9048 now governs the change of first name. It vests the power and
authority to entertain petitions for change of first name to the city or
municipal civil registrar or consul general concerned. Under the law,
therefore, jurisdiction over applications for change of first name is now
primarily lodged with the aforementioned administrative officers. The intent
and effect of the law is to exclude the change of first name from the
coverage of Rules 103 (Change of Name) and 108 (Cancellation or Correction
of Entries in the Civil Registry) of the Rules of Court, until and unless an
administrative petition for change of name is first filed and subsequently
denied. It likewise lays down the corresponding venue, form and procedure.
In sum, the remedy and the proceedings regulating change of first name are
primarily administrative in nature, not judicial.
Petitioner’s basis in praying for the change of his first name was his sex
reassignment. He intended to make his first name compatible with the sex he
thought he transformed himself into through surgery. However, a change of
name does not alter one’s legal capacity or civil status. RA 9048 does not
sanction a change of first name on the ground of sex reassignment. Rather
than avoiding confusion, changing petitioner’s first name for his declared
purpose may only create grave complications in the civil registry and the
public interest.
Before a person can legally change his given name, he must present proper
or reasonable cause or any compelling reason justifying such change. In
addition, he must show that he will be prejudiced by the use of his true and
Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel Capule’s Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 – 2016 | Arellano University School of Law
official name. In this case, he failed to show, or even allege, any prejudice
that he might suffer as a result of using his true and official name.
In sum, the petition in the trial court in so far as it prayed for the change of
petitioner’s first name was not within that court’s primary jurisdiction as
the petition should have been filed with the local civil registrar concerned,
assuming it could be legally done. It was an improper remedy because the
proper remedy was administrative, that is, that provided under RA 9048. It
was also filed in the wrong venue as the proper venue was in the Office of
the Civil Registrar of Manila where his birth certificate is kept. More
importantly, it had no merit since the use of his true and official name does
not prejudice him at all. For all these reasons, the Court of Appeals correctly
dismissed petitioner’s petition in so far as the change of his first name was
concerned.
The changes sought by petitioner will have serious and wide-ranging legal
and public policy consequences. First, even the trial court itself found that
the petition was but petitioner’s first step towards his eventual marriage to
his male fiancé. However, marriage, one of the most sacred social
institutions, is a special contract of permanent union between a man and a
woman. One of its essential requisites is the legal capacity of the contracting
parties who must be a male and a female. To grant the changes sought by
petitioner will substantially reconfigure and greatly alter the laws on
marriage and family relations. It will allow the union of a man with another
man who has undergone sex reassignment (a male-to-female post-operative
transsexual). Second, there are various laws which apply particularly to
women such as the provisions of the Labor Code on employment of women,
certain felonies under the Revised Penal Code and the presumption of
survivorship in case of calamities under Rule 131 of the Rules of Court,
among others. These laws underscore the public policy in relation to women
which could be substantially affected if petitioner’s petition were to be
granted.
Petitioner REPUBLIC vs. JENNIFER B. CAGANDAHAN
G.R. No. 166676 | September 12, 2008 (2D)
Facts: Respondent Jennifer Cagandahan filed a Petition for Correction of
Entries in Birth Certificate. In her petition, she alleged that she was born on
January 13, 1981 and was registered as a female in the Certificate of Live
Birth but while growing up, she developed secondary male characteristics
and was diagnosed to have Congenital Adrenal Hyperplasia (CAH) which is a
condition where persons thus afflicted possess both male and female
characteristics. She further alleged that she was diagnosed to have clitoral
hyperthropy in her early years and at age six, underwent an ultrasound
where it was discovered that she has small ovaries. At age thirteen, tests
revealed that her ovarian structures had minimized, she has stopped growing
and she has no breast or menstrual development. She then alleged that for
all interests and appearances as well as in mind and emotion, she has
become a male person. Thus, she prayed that her birth certificate be
corrected such that her gender be changed from female to male and her first
name be changed from Jennifer to Jeff.
Issue: Whether or not respondent’s petition of correction of entries in the
birth certificate of respondent to change her sex or gender, from female to
male, on the ground of her medical condition known as CAH, and her name
from "Jennifer" to "Jeff," under Rules 103 and 108 of the Rules of Court can
be properly granted
Held: Yes
Respondent undisputedly has CAH. This condition causes the early or
"inappropriate" appearance of male characteristics. A person, like
respondent, with this condition produces too much androgen, a male
hormone. A newborn who has XX chromosomes coupled with CAH usually
has a (1) swollen clitoris with the urethral opening at the base, an ambiguous
genitalia often appearing more male than female; (2) normal internal
structures of the female reproductive tract such as the ovaries, uterus and
fallopian tubes; as the child grows older, some features start to appear male,
such as deepening of the voice, facial hair, and failure to menstruate at
puberty. About 1 in 10,000 to 18,000 children are born with CAH.
CAH is one of many conditions that involve intersex anatomy. During the
twentieth century, medicine adopted the term "intersexuality" to apply to
10
human beings who cannot be classified as either male or female. The term is
now of widespread use. According to Wikipedia, intersexuality "is the state of
a living thing of a gonochoristic species whose sex chromosomes, genitalia,
and/or secondary sex characteristics are determined to be neither exclusively
male nor female. An organism with intersex may have biological
characteristics of both male and female sexes."
Intersex individuals are treated in different ways by different cultures. In
most societies, intersex individuals have been expected to conform to either
a male or female gender role. Since the rise of modern medical science in
Western societies, some intersex people with ambiguous external genitalia
have had their genitalia surgically modified to resemble either male or
female genitals. More commonly, an intersex individual is considered as
suffering from a "disorder" which is almost always recommended to be
treated, whether by surgery and/or by taking lifetime medication in order to
mold the individual as neatly as possible into the category of either male or
female.
In deciding this case, we consider the compassionate calls for recognition of
the various degrees of intersex as variations which should not be subject to
outright denial. "It has been suggested that there is some middle ground
between the sexes, a ‘no-man’s land’ for those individuals who are neither
truly ‘male’ nor truly ‘female’." The current state of Philippine statutes
apparently compels that a person be classified either as a male or as a
female, but this Court is not controlled by mere appearances when nature
itself fundamentally negates such rigid classification.
under the law, the Court affirms as valid and justified the respondent’s
position and his personal judgment of being a male.
In so ruling we do no more than give respect to (1) the diversity of nature;
and (2) how an individual deals with what nature has handed out. In other
words, we respect respondent’s congenital condition and his mature
decision to be a male. Life is already difficult for the ordinary person. We
cannot but respect how respondent deals with his unordinary state and
thus help make his life easier, considering the unique circumstances in this
case.
As for respondent’s change of name under Rule 103, this Court has held that
a change of name is not a matter of right but of judicial discretion, to be
exercised in the light of the reasons adduced and the consequences that will
follow.[28] The trial court’s grant of respondent’s change of name from
Jennifer to Jeff implies a change of a feminine name to a masculine name.
Considering the consequence that respondent’s change of name merely
recognizes his preferred gender, we find merit in respondent’s change of
name. Such a change will conform with the change of the entry in his birth
certificate from female to male.

In the instant case, if we determine respondent to be a female, then there is

no basis for a change in the birth certificate entry for gender. But if we
determine, based on medical testimony and scientific development showing
the respondent to be other than female, then a change in the subject’s birth
certificate entry is in order.

Biologically, nature endowed respondent with a mixed (neither consistently

and categorically female nor consistently and categorically male)
composition. Respondent has female (XX) chromosomes. However,
respondent’s body system naturally produces high levels of male hormones
(androgen). As a result, respondent has ambiguous genitalia and the
phenotypic features of a male.

Ultimately, we are of the view that where the person is biologically or

naturally intersex the determining factor in his gender classification would
be what the individual, like respondent, having reached the age of
majority, with good reason thinks of his/her sex. Respondent here thinks of
himself as a male and considering that his body produces high levels of male
hormones (androgen) there is preponderant biological support for
considering him as being male. Sexual development in cases of intersex
persons makes the gender classification at birth inconclusive. It is at
maturity that the gender of such persons, like respondent, is fixed.

Respondent here has simply let nature take its course and has not taken
unnatural steps to arrest or interfere with what he was born with. And
accordingly, he has already ordered his life to that of a male. Respondent
could have undergone treatment and taken steps, like taking lifelong
medication, to force his body into the categorical mold of a female but he did
not. He chose not to do so. Nature has instead taken its due course in
respondent’s development to reveal more fully his male characteristics.

In the absence of a law on the matter, the Court will not dictate on
respondent concerning a matter so innately private as one’s sexuality and
lifestyle preferences, much less on whether or not to undergo medical
treatment to reverse the male tendency due to CAH. The Court will not
consider respondent as having erred in not choosing to undergo treatment in
order to become or remain as a female. Neither will the Court force
respondent to undergo treatment and to take medication in order to fit the
mold of a female, as society commonly currently knows this gender of the
human species. Respondent is the one who has to live with his intersex
anatomy. To him belongs the human right to the pursuit of happiness and
of health. Thus, to him should belong the primordial choice of what courses
of action to take along the path of his sexual development and maturation.
In the absence of evidence that respondent is an "incompetent" and in the
absence of evidence to show that classifying respondent as a male will
harm other members of society who are equally entitled to protection

Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel Capule’s Syllabus 11
Rivad, Sherine L. | 1st Sem AY 2015 – 2016 | Arellano University School of Law