Ateneo de Zamboanga University

College of Nursing
Topic outline:
Ethico-Legal and Moral Considerations in Nursing Leadership Management
A. Ethico-Moral Aspects of Nursing
1. Code of Ethics for Nurses in the Philippines
2. ICN Code of Ethics for Nurses

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A. ETHICO MORAL ASPECTS OF NURSING

Code of Ethics for Filipino Nurses
The professional code of ethics for Filipino nurses strongly emphasizes the fourfold
responsibility of the nurse, the universality of nursing practice, the scope of their responsibilities to the
people they serve, to their co-workers, to society and environment, and to their profession.

The Code of Ethics used by Filipino nurses prior to 1984, was the code promulgated by the
International Council for Nurses. In 1982, the PNA Special Committee developed a Code of Ethics for
Filipino Nurses, but was not implemented.

In 1984, the Board of Nursing adopted the Code of Ethics of the ICN, adding “promotion of
spiritual environment” as the fifth-fold responsibility of the nurse.

In 1989, the Code of Ethics promulgated by the PNA was approved by the Professional
Regulation Commission and was recommended for use. This was approved In October 25, 1990 by the
general assembly of the PNA .

In July 14, 2004, a new Code of Ethics for Filipino Nurse was adopted under R.A. 9173 and was
promulgated by the BON.

The Code of Ethics for Filipino Nurses embodies ethical principles and guidelines to be
observed, stipulated under seven (7) articles. The ethical principles are stated below.

Article I – Preamble
1. Health is a fundamental right. The Filipino RN, believing in the worth and dignity of each human
being, recognizes the primary responsibility to preserve health at all cost. This responsibility
encompasses promotion of health, prevention of illness, alleviation of suffering, and restoration
of health. However, when the foregoing are not possible, assistance towards a peaceful death
shall be his/her obligation.
2. To assume this responsibility, RNs have to gain knowledge and understanding of man’s cultural,
social, spiritual, psychological, and ecological aspects of illness, utilizing the therapeutic process.
Cultural diversity and political and socio-economic status are inherent factors to effective nursing
care.
3. The desire for the respect and confidence of clientele, colleagues, co workers, and the members
of the community provides the incentive to attain and maintain the highest possible degree of
ethical conduct.

Article II – Registered Nurses and People

1. Values, customs, and spiritual beliefs held by individual shall be represented.
2. Individual freedom to make rational and unconstrained decisions shall be respected.
3. Personal information acquired in the process of giving nursing care shall be held in strict
confidence.

Article III – Registered Nurses and Practice

 1. Human life is inviolable.
2. Quality and excellence in the care of patients are the goals of nursing practice.
3. Accurate documentation of actions and outcomes of delivered care is the hallmark of nursing
accountability.
4. Registered nurses are the advocates of the patients: they shall take appropriate steps to
safeguard their rights and privileges.
5. Registered Nurses are aware that their actions have professional ethical, moral and legal
dimensions. They strive to perform their work in the best interest of all concerned.

Article IV – Registered Nurses and Co-workers

1. The RN is in solidarity with other members of the health care team in working for the patient’s best
interest.
2. The RN maintains collegial and collaborative working relationship with colleagues and other health
care providers.

Article V – Registered Nurses, Society, and Environment

1. The preservation of life, respect for human rights, and promotion of healthy environment shall be a
commitment of a RN.
2. The establishment of linkages with the public in promoting local, national, and international efforts
to meet health and social needs of the people as a contributing member of society is a noble
concern of a RN.

Article VI – Registered Nurses and the Profession

1. Maintenance of loyalty to the nursing profession and preservation of its integrity are ideal.
2. Compliance with the by-laws of the accredited professional organization (PNA) and other
professional organizations of which the RN is a member is a lofty duty.
3. Commitment to continual learning and active participation in the development and growth of the
profession are commendable obligations.
4. Contribution to the improvement of the socio-economic conditions and general welfare of nurses
through appropriate legislation is a practice and visionary mission.

Article VII – Administrative Penalties, Repealing Clause and Effectivity

The certificate of registration of the RN shall either be revoked or suspended for violation of any
provisions of this Code pursuant to Sec. 23 (f), Art.IV of R.A. No. 9173 and Sec. 23 (f), rule III of Board Res.
No. 425, Series of 2003, the IRR.
* *Art. IV of R.A. 9173 – Examination and Registration
Sec. 23. Revocation and Suspension of Certificate of Registration/Professional License and Cancellation
of Special/Temporary Permit. – The Board shall have the power to revoke or suspend the certificate of
registration/professional license or cancel the special/temporary permit of a nurse upon any of the
following grounds:
(a) For any of the causes mentioned in the preceding section;
(b) For unprofessional and unethical conduct;
(c) For gross incompetence or serious ignorance;
(d) For malpractice or negligence in the practice of nursing;
(e) For the use of fraud, deceit, or false statements in obtaining a certificate of
registration/professional license or a temporary/special permit;
(f) For violation of this Act, then rules and regulations, Code of Ethics for nurses and technical
standards for nursing practice, policies of the Board and the Commission, or the conditions and
limitations for the issuance of the temporary/special permit; or
(g) For practicing his/her profession during his/her suspension from such practice;
Provided, however, That the suspension of the certificate of registration/professional license shall
be for a period not to exceed four (4) years.

** Rule III of Board Res. No. 425, Series of 2003, the IRR (Implementing Rules and Regulations
o Same as rule III of Board Res. No. 425, Series of 2003, the IRR except: (f) For violation of RA No.
9173 and this IRR, Code of Ethics for nurses and Code of Technical Standards for nursing practice,
 policies of the Board and the Commission, or the conditions and limitations for the issuance of the
special/temporary permit; or

For this purpose, the suspension of the Certificate of Registration/Professional License shall be for a period
not to exceed four (4) years.

International Council of Nurses (ICN) Code of Ethics for Nurses

THE ICN CODE OF ETHICS FOR NURSES

An international code of ethics for nurses was first adopted by the International Council of Nurses
(ICN) in 1953. It has been revised and reaffirmed at various times since, most recently with this
review and revision completed in 2021.

Revised 2021
LEGEND - ORIGINAL TEXT FROM 2012 CODE -
NEW ADDED TEXT

PURPOSE OF THE CODE

The ICN Code of Ethics for Nurses is a statement of the ethical values, responsibilities and professional
standards of nurses. It guides everyday ethical nursing practice and can serve as a regulatory tool to
guide and define ethical nursing practice.

The ICN Code of Ethics for Nurses provides ethical guidance in relation to nurses’ roles, responsibilities,
behaviors, decision-making and relationships with patients and people who are receiving nursing care.
It is to be used in combination with the laws, regulations and professional standards of countries that
govern nurses’ practice. The values and obligations expressed in this Code apply to nurses in all
settings, roles and domains of practice, and should be aspired to by all nursing students.

PREAMBLE

From the origins of organized nursing in the mid-1800s, nurses have consistently recognised four
fundamental nursing responsibilities: to promote health, to prevent illness, to restore health, and to
alleviate suffering. The need for nursing is universal.
Inherent in nursing is a respect for human rights, including cultural rights, the right to life and choice,
to dignity and to be treated with respect. Nursing care is respectful of and unrestricted by
considerations of age, colour, culture, disability or illness, gender, sexual orientation, nationality,
politics, race, religious or spiritual beliefs, legal, economic or social status.
Nurses render health services to the individual, the family, community and populations and coordinate
their services with those of other health care professionals and related groups.

THE ICN CODE The ICN Code of Ethics for Nurses has four principal elements that outline the standards
of ethical conduct. These four elements, nurses and patients or people requiring care, nurses and
practice, nurses and the profession, and nurses and global health, give a framework for the standards
of ethical conduct.

ELEMENTS OF THE CODE

1. NURSES AND PATIENTS OR PEOPLE REQUIRING CARE

1.1 Nurses’ primary professional responsibility is to people requiring nursing care whether individuals,
families, communities or populations (hereinafter referred to as either ‘patients’ or ‘people
requiring care’).
1.2 Nurses promote an environment in which the human rights, values, customs, religious and spiritual
beliefs of the individual, family and community are respected and promoted by everyone.
1.3 Nurses ensure that the individual receives accurate, sufficient and timely information in a culturally
appropriate manner on which to base consent for care and related treatment.
1.4 Nurses hold in confidence personal information and respect the privacy, confidentiality and
interests of patients in the lawful collection, use, access, transmission, storage and disclosure of
this information.
1.5 Nurses respect the privacy and confidentiality of colleagues and people requiring care and uphold
the integrity of the nursing profession in person and in all media, including social media.
1.6 Nurses share with society the responsibility for initiating and supporting action to meet the health
and social needs of all people.
1.7 Nurses advocate for equity and social justice in resource allocation, access to health care and other
social and economic services.
1.8 Nurses demonstrate professional values such as respect, justice, responsiveness, compassion,
empathy, trustworthiness and integrity.
1.9 Nurses provide evidence-informed, person-centred care, recognising and using the values and
principles of primary health care and health promotion.
1.10 Nurses encourage a culture of safe health care and raise any concerns regarding the safety of
people and health services.
1.11 Nurses support and protect the right to self-determination of all patients and other health care
professionals.
1.12 Nurses ensure that use of technology and scientific advances are compatible with the safety,
dignity and rights of people. In the case of devices, such as robots, nurses ensure that care remains
person-centred and that such devices support and do not replace human relationships.

2. NURSES AND PRACTICE

2.1. Nurses carry personal responsibility and accountability for nursing practice, and for maintaining
competence by continual learning. They engage in continuous professional development and
lifelong learning.
2.2 Nurses maintain fitness to practice so as not to compromise the ability to provide care.
2.3 Nurses practise within the limits of their individual competence and use judgement when accepting
and delegating responsibility.
2.4 Nurses value their own dignity, well-being and health. They know that positive practice
environments, characterised by professional recognition, education, support structures, adequate
resourcing, management practices and occupational health and safety, are pivotal to achieve
them.
2.5 Nurses, at all times maintain standards of personal conduct which reflect well on the profession
and enhance its image and public confidence. In their professional role, nurses recognise and
maintain personal relationship boundaries.
2.6 Nurses share their knowledge and provide feedback, mentorship and guidance for the professional
development of nursing students, novice nurses, other nurses and other health care providers.
2.7 Nurses foster and maintain a practice culture that promotes ethical behaviour and open dialogue.
2.8 Nurses may conscientiously object to participating in a particular medical procedure or research
study but must ensure that people receive care.
2.9 Nurses maintain a person’s right to give and withdraw informed consent to access their genetic
information, including activities linked to genetic and genomic-based research. They protect the
use, privacy and confidentiality of genetic information and human genome materials. They also
foster the equitable access to genomic technologies.
2.10 Nurses develop and sustain collaborative and respectful relationships with colleagues and other
members of the health care team. They recognise and respect their knowledge, skills and
perspectives.
2.11 Nurses take appropriate actions to safeguard individuals, families and communities when their
health is endangered by a co-worker, any other person, policy, practice or misuse of technology.
2.12 Nurses are active participants in the promotion of patient safety. They promote ethical conduct
when errors or near misses occur, speak up when patient safety is threatened, and work with
others to reduce the potential of errors.

3. NURSES AND THE PROFESSION

3.1 Nurses assume the major role in determining and implementing acceptable standards of clinical
nursing practice, management, research and education.
3.2 Nurses are active in developing a core of research-based, updated professional knowledge that
supports evidence-informed practice.
3.3 Nurses are active in developing and sustaining a core of professional values.
3.4 Nurses, through their professional organisations, participate in creating a positive practice
environment that supports individual practice and ensures safe quality care, and maintains safe,
equitable social and economic working conditions for nurses.
3.5 Nurses contribute to positive and ethical organisational environments and challenge unethical
practices and settings.
3.6 Nurses engage in the creation, dissemination and use of research.
3.7 Nurses prepare for and respond to emergencies, disasters, conflicts, epidemics and conditions of
scarce resources.

4. NURSES AND GLOBAL HEALTH

4.1 Nurses value access to health care as a human right, affirming the need for universal health
coverage.
4.2 Nurses uphold the dignity, freedom and worth of all human beings and oppose all forms of
exploitation, such as human trafficking and child labour.
4.3 Nurses lead or contribute to health policy development.
4.4 Nurses support and work towards the achievement of the United Nations Sustainable Development
Goals.
4.5 Nurses recognise the significance of the social determinants of health. They contribute to, and
advocate for, policies and programmes that address them.
4.6 Nurses collaborate and practise to preserve, sustain and protect the natural environment and are
aware of its consequences on health. They advocate for initiatives that reduce environmentally
harmful practices in order to promote health and well-being.
4.7 Nurses collaborate with other health professions and the public to uphold principles of justice by
promoting responsibility in human rights, equity and fairness and by promoting the public good
and a healthy planet.
SUGGESTIONS FOR USE of the ICN Code of Ethics for Nurses

The ICN Code of Ethics for Nurses is a guide for action based on social values and needs. It will have
meaning only as a living document if applied to the realities of nursing and health care in all settings in
which nursing care is delivered.

To achieve its purpose the Code must be understood, internalised and used by nurses in all aspects of
their work. It must be available to students and nurses throughout their study and work lives.
Nurses and nursing students can therefore:
• Study the standards under each element of the Code.
• Reflect on what each standard means to you. Think about how you can apply ethics in your nursing
domain: practice, education, research or management.
• Discuss the Code with co-workers and others.
• Use a specific example from experience to identify ethical dilemmas and standards of conduct as
outlined in the Code. Identify how you would resolve the dilemmas.
• Work in groups to clarify ethical decision making and reach a consensus on standards of ethical
conduct.
• Collaborate with your National Nurses Association, co-workers, and others in the continuous
application of ethical standards in nursing practice, education, management, research and policy.

DISSEMINATION of the ICN Code of Ethics for Nurses

To be effective the ICN Code of Ethics for Nurses must be familiar to nurses. We encourage you to help
with its dissemination to schools of nursing, practising nurses, the nursing press and other mass media.
The Code should also be disseminated to other health professions, the general public, consumer and
policy-making groups, human rights organizations and employers of nurses.
https://www.nzno.org.nz/Portals/0/Files/Documents/Consultation/Sue%20Gasquoine%20Feedback%202020-08-11/2020-11-11%20CoE_Version%20for
%20Consultation_October%202020_EN.pdf?ver=IgEV1G-xTMg4UIaBMDf5Cw%3D%3D

B. Legal Aspects
1. The Nursing Act of 2002 (RA 9173)
2. Legal Responsibilities of Nurses
3. Malpractice, Negligence, Tort, and Crimes
4. Contracts / Wills / Testament
 Legal Aspects of Nursing

RA 9173 - THE PHILIPPINE NURSING ACT OF 2002

1. Title of the law and its provision (Article I)
2. Declaration of Policy (Article II)
3. Organization of the Board of Nursing (Article III)
4. Examination and Registration (Article IV)
5. Nursing Education (Article V)
6. Nursing Practice (Article VI)
7. Health Human Resources Production, Utilization and Development (Article VII)
8. Penal and Miscellaneous Provisions (Article VIII)

RA 9173 - THE PHILIPPINE NURSING ACT OF 2002

• The Board is now composed of a Chairman and six members instead of a Chairman and four members
• Submission of names of qualified nominees by the Accredited Professional Organization (APO) to the
Commission, three (3) nominees per vacancy, not later than three months before the vacancy
• The Commission submits to the office of the President two (2) nominees per vacancy not later than two
months before the vacancy occurs. The appointment must be issued not later than thirty (30) days before
scheduled licensure examination.

THE PHILIPPINE NURSING ACT OF 2002

BOARD OF NURSING
 ELSIE A. TEE - Chairman Board of Nursing
 CARMELITA C. DIVINAGRACIA – Member
 MERLE L. SALVANI - Member
 ZENAIDA C. GAGNO - Member
 CARFREDDA P. DUMLAO - Member
 MARYLOU B. ONG - Member
 ELIZABETH C. LAGRITO - Member

Qualifications of Board Members

✓ Educational requirement for members of the Board is not limited to registered nurses with Master’s
degree in nursing but also to registered nurses with master’s degrees in education, or other allied
medical profession provided that the Chairperson and majority of the members are holders of a Master’s
degree in nursing
✓ Of the ten years of continuous practice of the profession prior to appointment, the last five (5) years
must be in the Philippines.

Added the powers and duties of the Board

✓ Adopt and regulate a Code of Ethics and Code of Technical Standards for the practice of nursing
within one year from the effectivity of this act.
✓ Recognize specialty organization in coordination with accredited professional organization.

Licensure Examination and Registration

✓ Specific dates of examination has been deleted
✓ Specific dates of examination – not earlier than one (1) month and not later than 2 months after the
closing of each semestral term.
✓ Specific age of applicants has been deleted

Ratings
✓ Specific number of times an examinee may take the licensure examination has been deleted
✓ Removal examination shall be taken within two (2) years after the last failed examination

Revocation and Suspension of Certificate of Registration

✓ Implementing Rules and Regulations, Code of Ethics, Code of Technical Standards, for Nursing
Practice and policies of the Board and of the Commission
✓ Sec. 28g for practicing the profession during the period of suspension
✓ Period of Suspension of the certificate of registration/professional license not to exceed four (4) years

Nursing Education
✓ Requirement for inactive nurses returning to practice – Nurse who have not actively practiced the
profession shall undergo one (1) month of didactic training and three (3) months of practicum
✓ Qualifications of Faculty – Requirement of clinical experience in a field of specialization has been reduced
from three (3) years to one (1) year in a field of specialization THE PHILIPPINE NURSING ACT OF 2002
✓ The Dean of the College of Nursing must have at least five (5) years of experience in teaching and
supervising a nursing education program.

Nursing Practice
✓ Scope of Nursing – Duties and responsibilities of the Nurse
✓ Special training for intravenous injections but Nursing Service Administrators still require formal training
for the safety of the patient and the protection of the nurse and of the institution. ✓ Special training for
suturing the Lacerated perineum
Note: This is being undertaken by the Association of Nursing Service Administrators of the Philippines
(ANSAP) with the Maternal and Child Association of the Philippines (MCNAP)
✓ Observe the Code of Ethics and the Code of Technical Standards to maintain competence through
continual professional education
✓ Health human resource production and Utilization
The minimum base pay of nurses working in the public health institutions shall not be lower than salary
grade

Comprehensive Nursing Specialty Program

✓ The Board is mandated to formulate and develop a comprehensive nursing specialty program that
would upgrade the level of skills and competency of specialty nurse clinicians in the country

Brief History of the Philippine Nursing Law

Republic Act No. 2493 dated February 5, 1915 – The first law affecting the practice of nursing in the
Philippines.
a. Sec. 7 – states that every person desiring to practice nursing in the Philippines shall apply to the Director
of Health for a Certificate of registration as a nurse.
b. Sec. 8 – states that it shall be unlawful for any person to practice as a nurse in any of its branches in the
Phil. until the proper certificate of registration has been obtained.
c. This is also an act that provides for the examination and registration of nurses in the Philippines.
The first law that had to do with the practice of nursing was contained in Act No.2493 in 1915,
which regulated the practice of medicine. This act provided for the examination and registration of nurses
in the Philippine Islands.
During that time, the applicants need to be only twenty years old, of good physical health and good
moral character. Graduates of intermediate courses of the public school could enter the school of nursing,
which was then giving only two years, and a half of instruction. These graduates were called first class
nurses. Those who desired to be second-class nurses filed an application with the district health officer in
the district where they resided.
In 1919 Act 2808 was passed-this is known as the First True Nursing Law. It created among others a
board of examiners for nurses. However, it was in 1920 that the first board examination in the Philippines
was given.
Republic Act No. 2808 dated March 1, 1919 – an act regulating the practice of nursing profession in the
Philippines otherwise known as the Nursing Law.
Significance of this Law
✓ The first board of examinees for nurses was created composed of three members appointed by the
Secretary of Interior (one doctor of medicine as chairman and two members who are registered nurses, had
experience in the nursing profession for at least five years of reputable character)

The Board has the following powers:

1. Issue and revoke certificates of registration for practitioners of the nursing profession.
2. Study the conditions affecting the practice of the nursing profession in all parts of the Philippines.
3. Exercise the power conferred by the law to maintain efficient, ethical and technical standards in nursing
profession.
4. Promulgate regulations governing the nurse examination and standards to be attained.

Republic Act No. 4007 dated December 5, 1931 (Reorganization Law) – took effect the conduct of board
examination and placed the direct supervision of the Bureau of Civil Service.
✓ RA 465 – standardized the fees charge by the examining board.
✓ RA 546 – reorganized and placed all the board examinees under the direct supervision of the Pres. of the
Phil.
On June 19, 1953, the Philippine Nursing Law or R.A. 877was passed. This act regulated the
practice of nursing in the Philippines. One of the landmarks in the history of the nursing profession in the
Philippines is the Presidential Proclamation of a Nurses' Week.
Under Proclamation No. 539 dated October 17, 1958 the President of the Philippines designated
the last week of October every year beginning in 1958 as Nurses' Week.

✓ RA 877 dated June 19, 1953 – was enacted as an entirely new law created by the Filipino Nurses
Associated (now PNA) namely: Ms. Obdulia Kabigting as chairman; Dean JV Sutejo and Conchita Ruiz.
The act was sponsored by Sen. Geronima Pecson.
✓ The purpose is to “regulate the practice of nursing in the Philippines and to set up provisions for the
registration of the nurses for the establishment and maintenance of standards of nursing education and
practice.”
✓ RA 1080 dated June 15, 1954 – An act declaring the BAR and BOARD OF EXAMINATION as “Civil
Service Examination”
On June 18, 1966, Republic Act 4704 amended certain portions of R.A. 877. The following were
included among the salient changes:
a. The scope of nursing practice was broadened to circumscribe the whole management of the care
of patients and the acts constituting professional practice of nursing were spelled out to include such
services as reporting, recording and evaluation of a patient’s case, execution of nursing procedures
and techniques, direction and education to secure physical and mental care and the application and
execution of physician’s orders concerning treatment and medication.
b. The minimum age required of applicants for admission to the nurse’s examination was lowered
from 21 to 18 years of age, but no candidate who passed the examination was permitted to practice the
profession until he or she reached the age of 21.
Republic Act 7164, introduced by Senator Heherson Alvarez, codified and revised all the laws
regulating the practice of nursing in the Philippines. It was known as the Philippine Nursing Act of 1991.
In October 21, 2002, Republic Act No. 9173 otherwise known as “The Philippine Nursing Act f 2002”
replaced R.A. 7164 .
 [ RA 9173 October 21, 2002 – an act providing for a more responsive nursing profession repealing for
the purpose RA # 7164, otherwise known as the Philippine Nursing Act of 1991.]

There are laws governing the practice of Nursing, one of which is House Bill No. 4955, AN ACT PUNISHING
THE MALPRACTICE OF ANY MEDICAL PRACTITIONER IN THE PHILIPPINES AND FOR OTHER PURPOSES

LAWS AND ORGANIZATIONS PROTECTING NURSES

. ✓ International Labor Organization Convention 149
. ✓ ILO Recommendation 1977
. ✓ International Council of Nurses
. ✓ Philippine Nurses Association
. ✓ Code of Ethics for Nurses
. ✓ Magna Carta for Health Workers (RA 7305)
. ✓ Philippine Nursing Law
. ✓ Philippine Constitution

Legal Liabilities in Nursing

 As nurses begin their professional obligations, their legal responsibilities begin as well.
 Their license to practice attests that they are qualified under the law to practice their profession.
 The Philippine Nursing Act of 1992 is the best guide the nurse can utilize as it defines the scope of
nursing practice.
 There are also standards of care that may be used as criteria in evaluating their work. The nurses
are enjoined to be familiar with the Philippine Nursing Law, and the standards of nursing care,
other laws which affect nursing practice and their code of ethics.

Responsibility and Accountability for the Practice of Professional Nursing

 When nurses undertake to practice their profession, they are held responsible and accountable for
the quality-of performance of their duties. Nurses employed in an agency, institution, or hospitals are
responsible directly to their immediate supervisors. Private duty nurses, being independent practitioners,
are held to a standard of conduct that is expected of reasonably prudent nurses. The standard is clearly
defined, legal expectation to which nurses are held accountable.
A nurse assumes responsibility and accountability for all nursing care delivered

Responsibility
 is the obligation to perform duties, tasks or roles using sound professional judgement and being
answerable for the decisions made in doing this.
 refers to the execution of duties associated with a nurse’s particular role. That is, the nurse is
responsible for providing care within established standards of the profession. The responsible
nurse demonstrates characteristics of reliability and dependability.

Accountability
 refers to the ability to answer for one’s own actions. The nurse is accountable to herself most of
all. He/she also balances accountability to the patient, the profession, the employing institution,
and society.
 is being able to give an account of one’s nursing judgments, actions and omissions. Accountability
is about maintaining competency and safeguarding quality patient care outcomes and standards of
the profession, while being answerable to those who are affected by one’s nursing practice.
ACCOUNTABILITY TO THE CLIENT
• The foremost accountability of the nurse is to the client. You hold yourself out to the client as
someone having the special knowledge, training and skills associated with nursing.
ACCOUNTABILITY TO THE EMPLOYER
• As an employee you have the responsibility to work within the scope of employment as defined by
the employer.
• You are responsible to know your terms of employment, and to work within those terms.
ACCOUNTABILITY TO THE PROFESSION
• As a nurse you are accountable to meet the standards of your profession. These standards may be
contained in the nursing Act itself or in Regulations accompanying that Act.

Liability
 an obligation one has incurred or might incur through any act or failure to act.
 When the nurse fails to meet the legal expectations of care, the client can initiate action if
harm or injury is incurred by the client

LEGAL CONCEPTS AND ISSUES IN NURSING

✓ LIABILITY: is an obligation or debt that can be enforced by law. A person who is liable for malpractice
is usually required to pay for damages.
✓ DAMAGES: refers to compensation in money recoverable for a loss of damage.

NEGLIGENCE – failure to do something which a reasonable and prudent person should have done. Types
of negligence
• Commission – wrong doing
• Omission – total neglect of care – didn’t do anything

ELEMENTS OF NEGLIGENCE
✓ Existence of a duty on the part of the person charged to use due care under circumstances
✓ Failure to meet the standard of due care
✓ The foreseeability of harm resulting from failure to meet the standard
✓ The fact that the breach of this standard resulted in an injury to the plaintiff
• One shall act with justice, give every man his due, observe honesty and good faith.
- Civil Code, Article
• Those who, in the performance of their obligations through negligence cause any injury to another, are
liable for damages.
- Civil Code, Article 19
TYPES OF NEGLIGENCE
As a crime (culpa criminal)
✓ Felony committed by culpa or fault due to imprudence, lack of foresight, lack of skills, negligence
As torts (culpa contractual)
✓ Negligence – malfeasance, misfeasance, non-feasance
✓ Malfeasance – performance of an act which ought not to be done
✓ Misfeasance – improper performance of some act which might lawfully be done
✓ Nonfeasance – omission of some act which ought to be performed
As quasi-delict (culpa aquiliana)
✓ No pre-existing contractual relations
✓ Negligence, lack of due care

EXAMPLES OF NEGLIGENCE
✓ Burns
✓ Objects left inside the patient’s body
✓ Falls of elderly
✓ Falls of children
✓ Failure to observe and take appropriate action as needed

SPECIFIC EXAMPLES OF NEGLIGENCE

✓ Failure to report observations to attending physicians
✓ Failure to exercise the degree of diligence which the circumstances of the particular case demands
✓ Mistaken identity
✓ Wrong medicine, wrong concentration, wrong route, wrong dose

RES IPSA LOQUITOR - “the thing speaks for itself”

• Doctrine that infers negligence from the very nature of an accident or injury in the absence of direct
evidence on how any defendant behaved.

Elements:
✓ The injury is of the kind that does not ordinarily occur without negligence.
✓ The injury is caused by an agency or instrumentality within the exclusive control of the defendant. ✓
The injury-causing accident is not by any voluntary action or contribution on the part of the plaintiff. ✓
The defendant's non-negligent explanation does not completely explain plaintiff’s injury.

PESPONDEAT SUPERIOR - “let the master answer"

• Doctrine that a party is responsible for (has vicarious liability for) acts of their agents.

There are three considerations generally:

• Was the act committed within the time and space limits of the agency?
• Was the offense incidental to, or of the same general nature as, the responsibilities the agent is
authorized to perform?
• Was the agent motivated to any degree to benefit the principal by committing the act?

BONUS PATER FAMILIAS- “good father of a family"

• The employer is liable upon finding that he has been negligent in the selection of his employees (culpa
in eligiendo) or in the supervision of his employees (culpa in vigilando).

Frolicand Detour
• Detour occurs when an employee or agent makes a minor departure from his employer's charge.
• Frolic is a major departure when the employee is acting on his own and for his own benefit, rather than
a minor sidetrack in the course of obeying an order from the employer.

QUI FACIT PER ALIUM FACIT PER SE -"He who acts through another does the act himself."
• The master is obliged to perform the duties by employing servants, he is responsible for their act in the
same way that he is responsible for his own acts.

FORCE MAJEURE - ”superior force"

• Essentially frees both parties from liability or obligation when an extraordinary event or circumstance
beyond the control of the parties, such as a war, strike, riot, crime, or an event described by the legal
term act of God (hurricane, flood, earthquake, volcanic eruption, etc.), prevents one or both parties from
fulfilling their obligations under the contract.

MALPRACTICE
• Acts or conducts that are not authorized or licensed or competent or skilled to perform, resulting
to injuries or non- injurious consequences
• Negligent act committed in the course of professional performance
Legal defense in negligence
• Nurses should know and attain that standard of care in giving service and that they have
documented the care they give in a concise and accurate manner
• If the patient’s careless conduct contributes to his own injury, the patient cannot bring suit against
the nurse.

ELEMENTS OF MALPRACTICE
• Duty of the nurse
• Dereliction or breach of duty
• Direct result (injury or harm)
• Damages
• Exceeds the limits of the standards of care
• Foreseeability of harm

EXAMPLES OF MALPRACTICE
• Misdiagnosis of an illness, failure to diagnose or relay diagnosis
• Birth Injuries
• Surgical Complications
• Prescription errors
• Failure to provide treatment
• Anesthesia related complications
• Failure to follow advance directive
• Failure of hospital or pharmacy to dispense the right medicine, dosage

INCOMPETENCE
✓ Is the lack of ability, legal qualifications or fitness to discharge the required duty
✓ Although a nurse is registered, if in the performance of her duty she manifests incompetency, there
is ground for revocation or suspension of her certificate of registration

Liability of nurses for the work of unlicensed assistive personnel

• Unlicensed assistive personnel (UAP) are unlicensed health care providers trained to function in a
supportive role by providing patient/client care activities as delegated by the RN.
• The term includes, but is not limited to nurse aides, orderlies, assistants, attendants, or technicians.
• Nursing aides perform selected nursing activities under the direct supervision of nurses.
• Their responsibilities usually pertains to the routine care of chronically ill patients. They are therefore
responsible for their own actions.

Five Rights of Delegation:

• Right Task: The task is appropriate for delegation;
• Right Circumstances: The appropriateness of the patient setting, available resources, and other
relevant factors are considered;
• Right Person: The right person is delegating the right task to the right person to be performed on the
right person;
• Right Direction/Communication: A clear, concise description of the task, including its objective, limits
and expectations is given; and
• Right Supervision: Appropriate monitoring, evaluation, intervention, and feedback are provided
(NCSBN, 1995).

Responsibilities and duties of a UAPs

• Observing, documenting and reporting clinical and treatment information, including patients'
behavioral changes
• Assisting with motion exercises and other rehabilitative measures
• Taking and recording blood pressure, temperature, pulse, respiration, and body weight
• Assisting with ambulation and mobilization of patients
• Collecting specimens for required medical tests
• Providing emotional and support services to patients, their families and other caregivers
 • Assisting with personal hygiene
• Assisting with meal preparation, grocery shopping, dietary planning, and food and fluid intake.

MEDICAL ORDERS, DRUGS AND MEDICATIONS

• R.A. 6675 states that only validly registered medical, dental, and veterinary practitioners are authorized
to prescribe drugs.
• All government health agencies shall use generic terminology or generic names in all transactions
related to purchasing, prescribing, dispensing and administering of drugs and medicines.
Generics Act of 1988
• Drug outlets, including drugstores, hospital and non- hospital pharmacies and non-traditional outlets
such as supermarkets and stores, shall inform any buyer about any and all other drug products having
the same generic name, together with their corresponding prices so that the buyer may adequately
exercise, his option.
Generics Act of 1988
In accordance with R.A. 5921, all prescriptions must contain the following information:
• name of the prescriber
• office address
• professional registration number
• professional tax receipt number
• patient’s/client’s name, age, and sex, and date of prescription.
Pharmacy Law

Role of the nurse in drug administration

• The nurse is also responsible for ensuring that they have the knowledge to ensure the correct
administration of drugs. This includes pharmacology, anatomy and physiology, and legal issues.
• Medication charts are legal documents and must be completed accurately and unambiguously in order
to ensure that patients receive safe and optimal drug therapy.
• The nurse is also responsible for ensuring that they have the knowledge to ensure the correct
administration of drugs. This includes pharmacology, anatomy and physiology, and legal issues.
• Medication charts are legal documents and must be completed accurately and unambiguously in order
to ensure that patients receive safe and optimal drug therapy.

IV THERAPY AND LEGAL IMPLICATIONS

✓ Philippine Nursing Act of 1991 Section 28 states that in the administration of intravenous injection,
special training shall be required according to protocol established
✓ Board of Nursing Resolution No. 8 states that without such training and who administers intravenous
injections to patients shall be held liable either criminally under Sec 30 Art. VII of said law or
administratively under sec 21 Art III or both (whether causing or not an injury or death to the patient)

SCOPE OF DUTIES AND RESPONSIBLITIES IN IV THERAPY

✓ Interpretation of the doctor’s orders for IV therapy
✓ Performance of venipuncture, insertion of needles, cannulas except TPN and cut down
✓ Preparation, administration, monitoring and termination of intravenous solutions such as additives,
intravenous medications, and intravenous push ✓ Administration of blood/blood products as ordered by
the physicians
✓ Recognition of solutions and medicine incompatibilities
✓ Maintenance and replacement of sites, tubing, dressings, in accordance with established procedures
✓ Establishment of flow rates of solutions, medicines, blood and blood components
✓ Utilization of thorough knowledge and proficient technical ability in the use/care, maintenance, and
evaluation of intravenous equipment
✓ Nursing management of total parenteral nutrition, out- patient intravenous care
✓ Maintenance of established infection control and aseptic nursing interventions
✓ Maintenance of appropriate documentation, associated with the preparation, administration and
termination of all forms of intravenous therapy.

TELEPHONE ORDERS
✓ Doctors should limit telephone orders to extreme emergency where there is no alternative. Nurse should
read back such order to the physician to make certain the order has been correctly written.
✓ Such order should be signed by the physician within 24 hours
✓ The nurse should sign the physician’s name per her own and note the time and order was received
✓ Created as a means of communication among health care practitioners.
✓ Serve two important functions: to provide legal documentation, and obtain third party payments (e.g.
health insurance)
✓ If information is not charted, it was not done or observed
MEDICAL RECORDS

• Supplies rich material for medical and nursing research

• Serves as a legal protection for the hospital, doctor, and nurse by reflecting the disease or condition of the
patient and his management.
• “if it was not charted, it was not observed or done”
• Nurses are expected to record fully, accurately, legibly and promptly their observations from admission to
the time of the patient’s discharge.
• Nurses are legally and ethically bound to protect the patient’s chart from unauthorized person.

Legal Responsibilities of Students

 Nursing students are responsible for acquiring the knowledge and skills
necessary to become a safe practitioner. Included in this knowledge and skill
development is the awareness of ethical principles and the process of ethical decision
making. Nursing students must act as reasonably prudent persons, equivalently with
education and experience, when performing nursing duties. They must perform only
those tasks that they are competent to perform.

Liability for the Work of Nursing Students

Under the Philippine Nursing Act of 2002 R.A. 9173, nursing students do not perform
professional nursing. They are to be supervised by their Clinical Instructors.
In order that the errors committed by nursing students will be avoided/minimized,
the following measures should be taken:
1. Nursing students should always be under the supervision of their Clinical Instructors.
2. They should be given assignments that are in level of their training, experience
and competency.
3. They should be advised to seek guidance specially if they are performing a
procedure for the first time.
4. They should be oriented to the policies of the nursing unit where they are
assigned.
5. Their performance should be assessed frequently to determine their strengths
and their weaknesses.
6. Frequent conferences with the students will reveal their problems, which they
may want to bring to the attention of their instructors or vice - versa. Discussions
of these problems will iron out doubts and possible solutions may be provided

Charting Done by Nursing Students

When a nurse or a clinical instructor countersigns the charting of a nursing
student, she attests that she has personal knowledge of information and that such is
accurate and authentic. Anyone who countersigns without verification commits herself
to possible legal risk.
Source: Venzon, L. & Venzon, R. (2010). Professional Nursing in the Philippines 11 th edition

LEGAL PROTECTIONS IN THE NURSING SERVICE

✓ Be very familiar with the Philippine Nursing Law
✓ Beware of laws that affect nursing practice
✓ At the start of employment, get a copy of your job description, the agency’s rules, regulations and
policies
✓ Upgrade your skills and competence
 ✓ Accept only such responsibility that is within the scope of your employment and your job description
✓ Do not delegate your responsibility to others
✓ Determine whether your subordinates are competent in the work are assigning them
✓ Develop good interpersonal relationships with your co- workers, whether they be your supervisors,
peers, or subordinates
✓ Consult your superiors for problems that may be too big for you to handle
✓ Verify orders that are not clear to you or those that seem to be erroneous
✓ The doctors should be informed about the patient’s condition
✓ Keep in mind the value and necessity of keeping accurate and adequate records
✓ Patients are entitled to an informed consent

TORTS

• A legal wrong, committed against a person or property independent of a contract which renders the person
who commits it liable for damages in a civil action.
• A person who has been wronged seeks compensation for the injury or wrong he has suffered from the
wrong doer.
Examples of tort
ASSAULT AND BATTERY
• Assault is a unjustifiable attempt to touch another person or even the threat of doing so.
• Battery is the actual carrying out of the threatened physical contact

DEFAMATION OF CHARACTER occurs where a person discusses another individual in terms that diminish
reputation.

Defamation of character
✓ Slander – oral defamation of a person by speaking unprivileged or false words by which his reputation is
damaged.
✓ Libel – defamation by written words, cartoons or such representations that cause a person to be avoided,
ridiculed or held in contempt or tend to injure him in his work.

FALSE IMPRISONMENT
• It is making someone wrongfully feel that he or she cannot leave the place.
• The unjustifiable detention of a person without a legal warrant within boundaries fixed by the defendant by
an act or violation of duty intended to result in such confinement.

USE OF RESTRAINTS
• Restraints should be used with caution and discretion.
• All patients should have the right to independence and freedom of movement.
• Restraints require a physician’s order.
• If a patient or his legal guardian refuses to be restrained, this should be documented in the patient’s
medical record.

INVASION OF RIGHT TO PRIVACY AND BREACH OF CONFIDENTIALITY

• The right to privacy is the right to be left alone, the right to be free from unwarranted publicity and exposure
to public view as well as the right to live one’s life without having anyone’s name, picture or private
affairs made public against one’s will.
• Nurses may become liable for invasion of right to privacy if they divulge information from a patient’s chart
to improper sources or unauthorized persons

CRIMES, MISDEMENORS, AND FELONIES

CRIME - act committed or omitted in violation of the law.

Criminal offenses are composed of two elements:
1. Criminal Act
2. Evil/criminal intent
A conspiracy to commit a crime exists when two or more persons agree to commit a felony and decide to do
it.

Conspiracy to commit a crime

• Principals - are those who take a direct part in the execution of the act, who directly force or induce others
to commit it; or who cooperate in the commission of the offense by another act without which it would not
have been accomplished.
• Accomplices - are those who, not being principals, cooperate in the execution of the offense by previous
and simultaneous act.
• Accessories - are those who, having the knowledge of the commission of the crime. Assisting the offender
to profit from the crime either by disposing the body, concealing or assisting in escape of the principal of
the crime.

Criminal actions
• Misdemeanor - a general name for criminal offense which does not in law amount to felony.
• Felony - a public offense for which a convicted person is liable to be sentenced to death or be imprisoned
in a penitentiary or prison. It is committed with deceit and fault.

Criminal negligence
✓ Reckless Imprudence - when a person does an act or fails to do involuntary without malice, from which
damage results immediately.
✓ Simple Imprudence - means that the person or nurse did not use precaution and the damage was not
immediate or the impending danger was not evident or manifest.

Criminal intent
✓ Is the state of mind of a person at the time the criminal act is committed, that is, he/she knows that an act
is lawful and still decided to do it anyway.
✓ Deliberate intent includes two other elements without which there can be no crime. These are freedom
and intelligence.
✓ When a person accused of the crime offers evidence showing insanity, necessity, compulsion, accident,
or infancy the court will decide if he did not commit a criminal offense and will declare the person not
guilty.

Classes of felonies
• Consummated - when all the elements necessary for its execution and accomplishment are present.
• Frustrated - when the offender performs all the acts or execution which will produce the felony as a
consequence but which nevertheless, do not produce it by reason of causes independent of the will of
the perpetrator.
• Attempted - when the offender commences the commission of the same directly by overt acts, and does
not perform the acts which shall produce the felony.

Felonies according to degree of punishment

• Grave Felonies - are those to which the law attaches the capital punishment or penalties which in any of
their periods are afflictive. (imprisonment ranging from 6 yrs and 1 day with fine not exceeding P6,000)
• Less Grave Felonies - are those which the law punishes with penalties which in their maximum period are
correctional (imprisonment ranging from 1 month and 1 day to 6 yrs or fine not exceeding 6,000 but not
below 200)
• Light Felonies - are those infractions of law for the commission of which the penalty of “arresto menor”
(imprisonment for 1 day to 30 days or a fine not exceeding 200 or both of which are imposed)

CIRCUMSTANCES AFFECTING CRIMINAL LIABILITY

JUSTIFYING CIRCUMSTANCES
• These are the defenses in which the accused is deemed to have acted in accordance with the law and
therefore the act is lawful.

JUSTIFYING CIRCUMSTANCES
Circumstances which exempts a person from criminal liability:
• There is no mens rea or criminal intent
• The circumstances pertain to the act and not to the actor. Hence all who participated in the act will be
benefited. Thus if the principal is acquitted there will be no accomplices and accessories.
• These apply only to intentional felonies, not to acts by omissions or to culpable felonies or to violations of
special laws
• When he acts in defense of his rights
• When he acts in defense of his relatives rights
• When he acts in defense of a strangers rights and that the person defending is not induced by revenge or
evil motives.
• When any person who, in order to avoid an injury does an act which causes damage to another provided
that an evil sought to be avoided actually exists.
• When he acts in the fulfillment of a duty or in lawful exercise of a right or office.

EXEMPTING CIRCUMSTANCES
• These are defenses where the accused committed a crime but is not criminally liable.
• There is a crime, and there is civil liability but no criminal.
EXEMPTING CIRCUMSTANCES
Circumstances which exempts a person from criminal liability:
• The basis is the lack of any of the elements which makes the act/omission voluntary, i.e. freedom,
intelligence, intent or due care.
• They apply to both intentional and culpable felonies and they may be available in violations of special laws.
• These defenses pertain to the actor and not the act.
• They are personal to the accused in whom they are present and the effects do not extend to the other
participants. Thus if a principal is acquitted, the other principals, accessories and accomplices are still
liable.
• An imbecile or an insane person, unless the latter has acted during a lucid interval • A person under nine
years of age
• A person over nine years of age and under fifteen unless he acted with discernment.

MITIGATING CIRCUMSTANCES
• Are those which do not constitute justification or excuse of the offense in question, but which, in fairness
and mercy, may be considered as extenuating or reducing the degree of moral culpability.

MITIGATING CIRCUMSTANCES
There are certain circumstances under which the law exempts a person from criminal liability:
• Circumstances which are otherwise justifying or exempting were it not for the fact that all requisites
necessary to justify the act or to exempt the offender from criminal liability in the respective cases are
not attendant
• When the offender has no intention to commit so grave a wrong as the one committed
• When the offender is under eighteen years of age or over 70 years old
• When sufficient provocation or threat on the part of the offended party immediately precedes the act
• When the act is committed in the immediate vindication of a grave offense to the one committing the
felony, his/her spouse, ascendants, descendants, legitimate, natural or adopted brothers, or relative by
affinity within the same degree

MITIGATING CIRCUMSTANCES
Circumstances which exempts a person from criminal liability:
• When a person acts upon an impulse so powerful as naturally to have produced an obfuscation
• When the offender voluntarily surrenders himself to a person in authority or confesses before the court
prior to the presentation of the evidence for the prosecution
• When the defender is deaf and dumb, blind or otherwise suffering from physical defect

MITIGATING CIRCUMSTANCES
Lack of education is not mitigating in:
✓ Rape
✓ Forcible abduction
✓ Arson
✓ Treason
✓ In crimes against chastity like seduction and acts of lasciviousness
✓ Those acts committed in a merciless or heinous manner

AGGRAVATING CIRCUMSTANCES
• Are those attending the commission of a crime and which increase the criminal liability of the offender or
make his guilt more severe.

There are certain circumstances under which the law exempts a person from criminal liability:
• When the offender takes advantage of his public position
• When the crime is committed in contempt of or with insult to public authorities

AGGRAVATING CIRCUMSTANCES
Circumstances which exempts a person from criminal liability:
• When the act is committed with insult or disregard of the respect of the offended party on account of his
rank, age, sex
• When the act is committed with abuse or confidence or obvious ungratefulness
• When a crime is committed in a place of worship
• When the crime is committed on the occasion of a conflagration, shipwreck, earthquake, epidemic or other
calamity or misfortune
• When the crime is committed in consideration of a price, reward or promise
• When the crime is committed by means of inundation, fire, poison, explosion, standings of a vessel or
intentional damage
• When the act is committed with evident premeditation or after unlawful entry
• When craft, fraud, or disguise is employed when the wrong done in the commission of the crime is
deliberately augmented by causing other wrongs not necessary for its commission

ALTERNATIVE CIRCUMSTANCES
• Those which may either be appreciated as mitigating or aggravating according to the nature and effects of
the crime and other conditions attending its commission.

MORAL TURPITUDE
• Is an act of baseness, vileness or depravity in social or private duties which a man owes to his fellow man
or to society in general, an act contrary to the accepted and customary rule of right and duty between men
MURDER
• Is the unlawful killing of a human being with intent to kill. It is a very serious crime.
• Nurses should keep in mind that death resulting from a criminal abortion is murder.
• Euthanasia is also considered murder.

HOMICIDE
• Is the killing of a human being in another.
• It may be committed without criminal intent, by any person whom kills another, other than his father,
mother, or child or any of his ascendants or descendants, or his spouse, without any of the
circumstances attendant the crime of murder enumerated above being present.

ABORTION
• Is illegal according to the revised penal code. The patient should assume responsibility for her
abortion.
• She should be made to sign a statement relieving the hospital and its personnel from liability
• INFANTICIDE - Is the killing of a child less than three days of age. The mother of the child who
commits this crime shall suffer penalty of imprisonment ranging from two years and four months
and 1 day to 6 years
• PARRICIDE - is a crime committed by one who kills her/his father, mother or child whether
legitimate or illegitimate, or any of his/her ascendants or descendants or his/her spouse.
• ROBBERY - is a crime against a person or property
CONSENT TO MEDICAL AND SURGICAL PROCEDURE
• CONSENT - a “ free and rational act that presupposes knowledge of the thing to which consent is being
given by a person who is legally capable to give consent”
• NATURE OF CONSENT - an authorization by the patient or a person authorized by the law to give the
consent on the patient’s behalf.
• INFORMED CONSENT – a written consent should be signed to show that the procedure is the one
consented to and that the person understands the nature of the procedure

Essential elements of informed consent

• The diagnosis and explanation of the condition
• A fair explanation of the procedures to be done and used and the consequences
• A description of alternative treatments or procedures
• A description of the benefits to be expected
• Material rights
• The prognosis, the recommended care, procedure is refused

The nurse’s responsibility in witnessing the giving of informed consent involves:

• witnessing the exchange between the client and the physician
• witnessing the client affix his signature
• establishing that the client really understood.

Who must consent?

• Legal age
• Patient must consent in his own behalf
• If he is incompetent, or physically unable, and is not in emergency case, consent must be taken from
another who is authorized to give it in his own behalf.

Consent of minors
• Parents or someone standing in their behalf, gives the consent to medical or surgical treatment of a minor.
• Parental consent is not needed if the patient is married or emancipated

Consent of mentaly ill

• A mentally incompetent person cannot legally consent to medical or surgical treatment.
 • The consent must be taken from parents or legal guardian.

Mental competency
• All patients are presumed to be competent unless declared incompetent by a court of law.
• Supporting documentation of the patient’s behaviors, speech, decision making and physical and mental
status are very useful in establishing his/her mental competency

Emergency situation
• No consent is necessary because inaction at such time may cause greater injury.
• If time is available and an informed consent is possible, it is best that this be taken to protect all the parties
concerned.

Refusal to consent
• A patient who is mentally and legally competent has the right to refuse the touching of his body or to submit
to a medical or surgical procedure no matter how necessary, nor how imminent the danger to his life or
health if he fails to submit to treatment.

Consent for sterilization

• Sterilization is the termination of the ability to produce offspring.
• The husband and the wife must consent to the procedure if the operation is primarily to accomplish
sterilization.
• If emergency cases like ectopic pregnancy and abruptio placentae, consent from patient is sufficient.

LEGAL RISKS FOR SAFETY EQUIPMENT

✓ The nurse should exercise reasonable care in selecting equipment to be used in patients.
✓ Generally, a nurse is not liable for a non-observable and non- discoverable defect in the equipment.

Contract
• Is a meeting of minds between two persons where they bind themselves to give something or to render
some services.
• Anything could be subjected to a contract as long as these are not contrary to law, morals, good customs,
public order and public policy.

Kinds of contract
• Formal Contracts - refers to an agreement b/w parties and is required to be in writing e.g. marriage
contracts
• Informal Contracts - one in which concluded as the result of a written document where the law does not
require the same to be in writing.
• Express Contracts - The one in which the conditions and terms of contract are given orally or in writing by
the parties concerned.
• Implied Contracts - one that is concluded as a result of acts of conduct of the parties to which the law
ascribes an objective intentions to enter into a contract.
• Void contracts - one that is inexistent from the very beginning and therefore may not be enforced.
• Illegal contracts - one that is expressly prohibited by law

Illegal contracts
• Those that are made in protection of the law
• Consent obtained by fraud
• Those obtained under duress
• Those obtained under undue influence
• Those obtained through material misrepresentation

Wills
• It is a legal declaration of a person’s intentions upon death.
• DECEDENT - a person whose property is transmitted through succession whether or not he left a will. If he
left a will he is called a TESTATOR. If a woman TESTATRIX
• HOLOGRAPHIC WILL - a will that is written and signed by the testator
• HEIR is a person called to succession either by the provision of a will or by operation of law
• There should be a witness who knows the handwriting and signature of the testator explicitly declares that
the will and the signature are in the handwriting of the testator

Nurse’s obligation in the execution of a will

• The nurse should note the soundness of the patient’s mind and that there was free from fraud or undue
influence and that the patient was above 18 years or of age .
• The patient should write that the will was signed by the testator, that the witnesses were all present at the
same time and signed the will I the presence of the testator

Living will
• Is an individual’s signed request to be allowed to die when life can be supported only mechanically or by
heroic measures.
• It also includes the decision to accept or refuse any treatment, service or procedure used to diagnose or
treat his/her physical or mental condition and decisions to provide

Advance directive & health care proxy

• The patient designates a health care representative, usually a member of the family, a friend or a family
physician to make decisions for him/her when he/she is unable, due to physical or mental incapacity,
accept or refuse treatment, service or procedure used to diagnose or treat his/her physical or mental
condition and decisions to provide, withhold or withdraw life sustaining measures

Important points
• A nurse especially those taking care of well-to-do patients should remember that the main requisite for
making a will is testamentary capacity or sanity.
• The person who makes a will should at least be 18 years old and is not prohibited by law.
• The will is written and should be witnessed by three credible witnesses, unless it is holographic will.
• A holographic will is one that is entirely written, dated and signed by hand.
• There is no legal reason for the nurse to refuse to witness the preparation of a will.

NURSING JURISPRUDENCE NURSING LEGISLATION

LAW - the word "law" may be defined as a rule of conduct pronounced by controlling authority,
which may be enforced.
There are three essential characteristics of every law.
 The first one is the authority or the right to declare the rule exists.
 The second is that such rule is pronounced or expressed and that its source can be
identified.
 Lastly, a right to enforce the same must be provided.

TYPES OF LAW ACCORDING TO SOURCE OF AUTHORITY

✓ Divine Law – laws authored by God
✓ Human Law – laws authored by men

TYPES OF HUMAN LAW

PRIVATE OR CIVIL LAW - body of law deals with relationship among private individuals
PUBLIC LAW - body of law for the welfare of the general public; relationship between individuals and the
government and government agencies

PUBLIC LAW – department of law which is concerned with the state in its political or sovereign capacity. It
is a law that applies generally to people of the state adopting or enacting it.
✓ Criminal Law – treats the nature, extent and degree of every crime and adjusts to it the adequate
and necessary penalty.
✓ International Law – the law which regulates the intercourse of nations
• Public International Law – control the conduct of independent state in their relation to each
other.
• Private International Law – conflict law

✓ Political Law – Regulates the relation between the state and individuals that compose it.
• Constitutional Law - law that relates the constitution, as a permanent system of political and
juridical government, as distinguished from statutory and common law, which relate to
matters subordinate to such constitution.
• Administrative Law – the body of rules and regulations and orders and decisions created by
administrative agencies of government.
• Law of Public Administration
• Law of Public Corporation

✓ Private Law – law that relates the private matters which do not concern the public at large
• Civil Law – organizing the family and regulating property.
• Commercial Law – relates to the rights of property and the relations of persons engaged in
commerce.
• Remedial Law – methods of enforcing rights or obtaining redress (correcting the wrong)
 THE GOOD SAMARITAN LAW
✓ A nurse, therefore, who renders first aid or treatment at the scene of an emergency and who does
so within the standard of care, acting in good faith, is relieved of the consequences of the act.
LAWSUIT
 Proceeding in court for a purpose.
Purpose:
1. Enforce a right
2. Redress a wrong

PARTIES TO A CASE
✓ Complainant VS Defendant: CIVIL CASE
✓ Plaintiff VS Accused: CRIMINAL CASE

WITNESS
✓ an individual held upon to give necessary details either for the accused or against the accused

STATUTE OF LIMITATIONS
✓ Refers to the length of time following the event during which the plaintiff may file a suit.

DUE PROCESS
✓ A fair and orderly process which aims to protect and enforce a person’s right.

FUNDAMENTAL REQUIREMENTS OF DUE PROCESS

1. Right to be informed
2. Right to remain silent
3. Right to competent counsel
4. No use of violence, threat, torture
5. Right to know the witness face to face

PHASES OF DUE PROCESS

✓ PRE-TRIAL - eliminate matters not in dispute, agree on issues or settle procedural matters.
✓ TRIAL - facts are presented and determined; law applied at the end.

WRITTEN ORDERS OF COURT WRIT- legal notes from court

SUBPOENA - an order in court
✓ Duces tecum (papers) bring documents, objects, materials, chart to court
✓ Ad testificandum (person) testify as witness at a specified time and place

WRITTEN ORDERS OF COURT

✓ SUMMON - a writ commanding an authorized person to notify a party to appear in court to answer a
complaint made against him.
✓ WARRANT - a writing from a competent authority in pursuance of law, directing the doing of an act
addressed to a person competent to do it

TYPES OF WARRANT
✓ Warrant of arrest - a court order to arrest or detain a person
✓ Search warrant - a court order to search for properties

CONTROLLED SUBSTANCES

• R.A. 6425 known as the Dangerous Drug Act of 1972 covers the administration and regulation of the
manufacture, distribution, dispensing of controlled drugs.
• Persons authorized to prescribe or dispense these drugs are required to register and have a special
license for this purpose

COMMON LEGAL TERMS

• Affidavit - is a written statement made under oath before a notary public or other person duly authorized
• Contempt of Court - is the willful disobedience to, or open disrespect for, the rules of court
• Defendant - the person being accused of a wrongdoing; the therefore needs to defend themselves
• Day in court - the right of a person to appear in court and be heard concerning his compliant/ defense
• Due process - is fair and orderly process which aims to protect and enforce a person’s rights
• False Testimony - is punishable both criminal and civil law
• Hearsay Evidence - is evidence that is derived from something the witness heard from others
• Inquest - is the legal inquiry into the cause or manner of a death
• Perjury - is the willful telling of a lie under oath
• Plaintiff - the person who files the lawsuit and is seeking for a perceived wrongdoing
• Prima facie Evidence - evidence, which if unexplained or uncontradicted would establish the fact
alleged
• Privileged Communication - statements uttered in good faith. These are not permitted to be divulged in
court justice.
• Statute of Limitations - define the length of time following the event during which the plaintiff may file
the lawsuit
• Subpoena - is an order that requires a person to attend at a specific time and place to testify as witness
• Subpoena Duces Tecum - is a subpoena that requires a witness to bring required papers/ documents
and the like which may be in his possession
• Summons - is a writ commanding an authorized person to notify a party to appear in court to answer a
complaint made against them
• Warrant - is writing from a competent authority in pursuance of law, directing the doing of an act, and
addressed to a person competent to do it