LIABILITIES OF A PHYSICIAN

The Liability of a Physician

- If a health care provider causes injury or death to the patient through a negligent act or
omission.Thus, the physician owed a duty to the patient
- Can be divided into three:
● Administrative (punishable through the revocation of license)
● Criminal (punishable through imprisonment)
● Civil (punishable through monetary compensation)
- The following are the sources:
● Civil codes
● Revised penal code
● Special laws
● Ethics of Medical Profession in the Philippines
● Medical Act of 1959 as amended

Administrative Liability
- A procedure that is conducted by analyzing a medical malpractice complaint by the
Monitoring and Professional Committee for malpractice cases, established in the public
health authorities of each country
- Makes sure that the primary objective of the practice of medicine is practiced. Which is
service to mankind irrespective of race, age, disease, disability, gender, sexual
orientation, social standing, creed or political affiliation. In medical practice, reward or
financial gain should be a subordinate consideration.

An Administrative Liability Complaint is done through the following:

It is commenced via Complaint
Filed by any person, form or the board itself
Filed in the PRC (Professional Regulation Commission)
Where the professional in question is summoned by subpoena via in-person, mail,
publication

An Administrative Liability Hearing then follows this process:

1.Filed with the PRC (PMA for ethical misconduct)
2.In writing and under oath
3.Must set forth distinctly, clearly and concisely the charge
4.In six copies
5.Proof needed is convincing evidence
6.Penalty imposable is reprimand or suspension or revocation of license
7.Rights of the accused
8.30 days reglementary period.
9.Decision appealable to the PRC, then to the Office of the President
10. Reinstatement of license after 2 years.

One of the most common complaints is medical malpractice.

Medical Malpractice:

By definition: Medical malpractice happens when a hospital, doctor, or other health care
professional injures a patient due to a negligent act or omission.

As a lawsuit: A type of claim which a victim has available to him or her to redress a
wrong committed by a medical professional which has caused bodily harm.

The requirements for establishing medical malpractice are often referred to as the “four Ds:”

1. Duty
2. Deviation Four elements of med neg: duty, breach, injury, proximate cause
3. Direct Causation
4. Damages

Duty:

Is there a Physician-Patient Relationship?

Duty entails professional physician-patient relationships. Created when the patient avails

the services of the doctor and the doctor agrees to provide care to the patient.

DUTIES UNDER HIPPOCRATIC OATH

1.) Practice medicine with conscience and dignity.

2.) Health of patient as the first consideration.

3.) Confidentiality

DUTIES UNDER ETHICS OF MD

1.) Art I. Section 2 - preserve human life from conception, complete loyalty to the
resources of his science, absolute secrecy, emergency care as humanitarian duty.

2.) Article 1, Section 3 - shall serve their interest with the greatest solitude, giving them
always his best talent and skill.

3.) Article 2 - secure all possible benefits that may depend upon professional skill and
care
 DUTIES UNDER THE LAW

Art. 1173 2nd par. - “……If the law or contract does not state the diligence which is to be
observed in the performance, that which is expected of a good father of a family shall be
required’ (ordinary diligence)

DUTIES UNDER SOLIS' BOOK

1.)Duty to possess knowledge and skill of the profession

2.)Duty to utilize such knowledge and skill with care and diligence

3.)Duty to exercise the best judgment

4.)Duty to observe utmost good faith to his patient

Deviation:

Is there a breach of standard and/or duty?

A breach is an act of failing to observe law, agreement or code of conduct

BREACH OF DUTY BY VIOLATION OF POSITIVE LAW - rights are ultimately

determined by government fiat

BREACH OF DUTY BY NEGLIGENCE - deficiency in perception, lack of foresight,

failure in advertence, omission of diligence

BREACH OF DUTY BY IGNORANCE - absence of knowledge

BREACH OF DUTY BY DEPARTURE FROM ACCEPTED PRACTICE - may/may be

manifested in the presence of injuries

res ipsa loquitur – the things speak for itself

1.) evidence as to the recognized standards of the medical community in the particular
kind of case

2.) a showing that the physician in question negligently departed from this standard in
his treatment
Direct Causation:

- The element of injury to the patient in medical malpractice cases is straightforward – it is

the direct result of the doctor’s breach.

INJURY CAUSED BY THE DOCTOR’S NEGLIGENCE:

Test for negligence:

Would a prudent man, in the position of the person to whom negligence is

attributed, foresee harm to the person injured as a reasonable consequence of
the course about to be pursued?

Characterized by:

- deficiency in perception
- lack of foresight
- failure in advertence
- paying proper attention and using due diligence in foreseeing
them

INJURY CAUSED BY THE DOCTOR’S IMPRUDENCE:

- deficiency of action
- lack of skill
- failure in precaution
- avoided by taking the necessary precaution once foreseen

Reckless Imprudence

1.) The doing of the failure is voluntary

2.) Done without malice

3.) Results in damage/injury

4.) Inexcusable lack of precaution based on employment, intelligence and other

circumstances

Simple Imprudence - those cases in which the damage impending to be caused

is not immediate nor the danger clearly manifest.
 ON CAUSE IN FACT AND PROXIMATE CAUSE:

Cause in fact - the action is necessary for the condition (but not a sufficient condition for
resulting injury) because of this a second test is used to determine if an action is close
enough to harm for it to be legally valid this is called proximate cause

Proximate cause - sometimes called the legal cause, is the key principle for insurance
and is concerned with how the loss or damage actually occurred

MEDICAL MALPRACTICE IN A NUTSHELL:

The medical professional in question violated the standard of care.

The medical professional's negligence resulted in injury.

The resulting injury caused significant harm to the patient.

Examples are the following:

1. Failure to diagnose or misdiagnosis

2. Misreading or ignoring laboratory results
3. Unnecessary surgery
4. Surgical errors or wrong site surgery
5. Improper medication or dosage
6. Poor follow-up or aftercare
7. Premature discharge
8. Disregarding or not taking appropriate patient history
9. Failure to order proper testing
10. Failure to recognize symptoms

When medical malpractice is proven, revocation of license may occur. In all likelihood, doctors
will lose their license to practice after two determinations: if they are deemed a threat to society
or if their behavior is so negligent and reckless that it goes beyond ordinary negligence
allegations.

REVOCATION OF LICENSE

- Licensure and certification may serve as a lever for ensuring that practicing health
professionals meet specific standards and continue to maintain competence in a given
content area.
- Losing your license through a disciplinary proceeding can irreparably harm your
reputation, career, and livelihood.
 REPUBLIC ACT NO. 2382 “THE MEDICAL ACT OF 1959”

· Section 1. Objectives. - This Act provides for and shall govern (a) the
standardization and regulation of medical education; (b) the
examination for registration of physicians; and (c) the supervision,
control and regulation of the practice of medicine in the Philippines.

Section 20. Issuance of Certificates of Registration for Refusal of Same -

The Commissioner of the Civil Service, the Chairman, the members and
the Secretary of the Board of Medical Examiners shall sign and issue
certificates of registration to those who have satisfactorily complied with
the requirements of the Board. They shall not issue a certificate of
registration to any candidate who has been convicted by a court of
competent jurisdiction of any criminal offense involving moral turpitude, or
has been found guilty of immoral or dishonorable conduct after the
investigation by the Board of Medical Examiners or has been declared to
be of unsound mind

· Section 24. Grounds for reprimand, suspension or revocation or

registration certificate.- Any of the following shall be sufficient ground
for reprimanding a physician, or for suspending or revoking a
certificate of registration as physician:

GROUNDS OF REVOCATION:

PERSONAL DISQUALIFICATION

1. Immoral or dishonorable conduct - Includes falsifying any records regarding licensing,

being dishonest, and impersonating another practitioner. Personal or professional incapacity
includes chronic substance abuse, continuing to practice when severe physical limitations
prevent adequate care, and practicing outside the scope of training.

2. Insanity - impairment of the mind as prevents a person from distinguishing right and wrong

3. Gross negligence, ignorance or incompetence in the practice - of his or her profession

resulting in an injury to or death of the patient;

4. Addiction - 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;
CRIMINAL ACTS

5. Fraud in the acquisition of the certificate of registration - Doctors can be investigated

and lose their license if they engage in insurance fraud. Charging uninsured patients different
fees than insurance company payees, using incorrect insurance codes, and changing medical
records are a few of the reasons that an investigation could be opened.

6. Conviction by a court of competent jurisdiction of any criminal offense involving moral

turpitude; - If a doctor has a prior conviction or is being prosecuted, even for a felony, this does
not necessarily mean that his license will be automatically revoked. However, if the conviction is
for a violation of a licensing regulation, license revocation is likely.

7. Performance of or aiding in any criminal abortion;

8. Knowingly issuing any false medical certificate;

9. Aiding or acting as a dummy of unqualified or unregistered person to practice

medicine;

UNPROFESSIONAL CONDUCT

10. False or extravagant or unethical advertisements wherein other things than his name,
profession, limitation of practice, clinic hours, office and home address, are mentioned -
Engaging in unethical behaviors, such as age or race discrimination or false advertising, may
result in a doctor’s license being revoked. In addition, committing medical malpractice could also
lead to a doctor losing his license in a disciplinary action if the malpractice is serious enough.

11. Issuing any statement or spreading any news or rumor which is derogatory to the
character & reputation of another physician without justifiable motive;

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 for suspension of his registration certificate if there is a risk to
the physician’s life.