Lesson 1: Moral and Spiritual
Responsibility of a Profession Nurse
★ What we call "HUMANE “ cannot be
limited to the attainment of certain
standards,such as bodily well-being,
pain relief, warm and cordial
dealings, and a high quality of life.
★ All of these are only part of the
human attention due to a sick
person : SPIRITUAL ATTENTION
ought to complete the picture.
★ Every care personnel who
understand the Christian meaning of
life considers every person as a
creation of God and therefore,
worthy of respect
★ A sick person needs spiritual
attention, in the strict sense of the
term.
★ Health professional shall first clarify
certain issues and then analyze how
to go about giving these kind of
attention to a patient
★ And finally we shall see how the said
issues may be resolved.
Moral and Spiritual Responsibility of a
Profession Nurse.
★ Moral Principles
a. the golden rule
b. double effect
c. the principles of totality
d. Epikia
e. one who act through an
agent is himself responsible
f. the end does not justice the
means
g. the greatest good for the
greatest number
What is spirituality?
★ Spirituality involves the recognition
of a feeling or sense or belief that
there is something greater than
myself, something more to being
human than sensory experience,
and that the greater whole of which
we are part is cosmic or divine in
nature.
https://www.youtube.com/watch?v=kTUIZck
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MORAL
★ Moral issues deals with social
norms such as respect for life,
freedom, and love
★ Issues which provoke the
conscience or feelings as quilt,
shame, self - esteem, courage or
hope
★ Issues which we respond with word
ought, should, right, bad, wrong.
WHY SPIRITUAL NURSING IS
IMPORTANT?
❖ Spiritual well-being - is important
for individual's health potential and
the experience of illness or
hospitalization can threaten optimum
achievement of once potential
“As a nurse, we have the opportunity to heal
the heart, mind, soul and body of our
patient, their family and ourselves”
 ★ Professional nursing embraces
spiritual care as a dimension of
practice.
Nurses’ practice patterns in the area of
spiritual care can be grouped into
two categories including
★ religious and
★ nonreligious interventions
Religious interventions - include treating
patients’ religious beliefs without
prejudice, providing them with
opportunities for connecting with God
and expressing their values and beliefs,
helping them practice their religion, and
referring them to clerical and religious
leaders.
Nonreligious interventions - include
nurses’ presence for patients and their
families,
★ making direct eye contact when
communicating with patients
★ sympathizing with patients and
their families
★ listening to patients and their
families attentively, and
★ having love and enthusiasm for
patients
AS OF NOW HOW WILL FUTURE NURSE
PRACTICE SPIRITUAL CARING TO
PATIENT?
★ Spirituality nursing (2 units) is
offered in the current curriculum but
as an elective course only.
★ Educators are trying to be role
models for their students; in turn,
nursing student also experience and
understand spiritual care informally
with continuous presence in clinical
practices and observing the
behaviors of the educators
BIBLICALLY:
★ The Golden Rule is the ethical
principle of treating other people as
one's self would prefer to be treated.
★ One of Jesus' most famous and
impactful teachings, the Golden Rule
can be found in the Bible verses:
Matthew 7:12 and Luke 6:31:
Matthew 7:12
“ Do unto others what you would want
others do unto you” for this sums up the
Law and the Prophets.”
Luke 6:31
“Do to others as you would have them do
to you.”
Meaning of the Golden Rule in the Bible:
★ "Golden Rule" is not explicitly found
in Scripture, this became the popular
way of referring to the words of
Jesus in Matthew 7:12 and Luke
6:31.
★ It encompasses the empathic
essence of morality, a simple yet
powerful way of saying that we
should recognize the respective
dignity of our fellow man and not
forget we all are capable of
inflicting immoral actions.
★ This is vital in following the
commandments of God and creating
a more virtuous world.
Principle of totality
★ The principle of totality states that all
decisions in medical ethics must
prioritize the good of the entire
person, including physical,
 psychological and spiritual
factors
★ The principle of totality is used as an
ethical guideline by Catholic
healthcare institutions.
EXAMPLE: The Principle of Totality
- An individual may not dispose of his
organs or destroy their capacity to
function, except to the extent that
this is necessary for the general
well-being of the whole body.
Destroying an organ or interfering
with its capacity to function prevents
the organ from achieving its natural
purpose.
The Principle of Double Effect:
★ Aquinas recognized that there are
times when the action you think you
ought to do will have good and bad
effects.
★ In effect, you have an ethical
dilemma or conflict.
Under these circumstances, it is
permissible to perform an action causing
bad effects if you meet these four
conditions:
1. The action itself is morally neutral or
morally good.
2. The bad effect is not the means by
which the good effect is achieved.
3. The motive must be the
achievement of the good effect only.
4. The good effect is at least
equivalent in importance to the bad
effect.
Epikia
★ There is always an exemption to the
rule
★ Epika stands for compassion,
creativity, reliability, generosity,
loyalty and a love for domestic life
How to provide spiritual care:
1. PASTORAL VISIT - it is the primary
role of priests to administer
sacraments.
2. The sacraments of penance- how
to make a good confession
(examination of conscience, sorrow for
sins,resolution,confession of
sins,satisfaction or fulfillment of the
penance,
3. Sacrament of the holy eucharist
4. Sacrament of the anointing of the
sick
5. The sacrament of baptism
Lesson 2: Legal Aspects and the Nurse
PATIENT'S BILL OF RIGHTS
1. The right to considerate and
respectful care
2. The right to relevant, current and
understandable information
concerning diagnosis, treatment
prognosis,
3. specific procedures, treatment, risks
involved, medically reasonable
alternative benefits needed to make
informed consent.
4. The right to make decisions
regarding his plan of care; in case of
refusal he is entitled to other
appropriate care and service or be
transferred to another hospital
5. The right to have advance directive(
such as a living will) concerning
treatment or designating a surrogate
decision maker.
6. The right to every consideration of
his privacy such as in case
discussion, consultation and
treatment
 7. The right 10 confidentiality of
communications and records
8. The right to review his records
concerning his medical care and
have these explained to him except
when restricted by law.
9. The right to be informed of business
relationship among the hospital,
educational institution, health care
providers that may influence the
patient's treatment and care
10. The right to consent or decline to
participate in experimental research
affecting care
11. The right to reasonable continuity of
care when appropriate and be
informed of other care options when
hospital care is no longer
appropriate
12. The right to be informed of hospital
policies that relate to patient
Lesson 3: NURSING JURISPRUDENCE
★ jurisprudence derives from
the Latin term juris prudentia,
which means "the study,
knowledge, or science of law.
NURSING AS A PROFESSION
PROFESSION
- Is a calling that requires special
knowledge, skills and preparation .
- An occupation that requires
advanced knowledge and skills that
it grows out of needs for special
services.
CHARACTERISTICS OF A PROFESSION
★ A basic profession requires an
extended education of its members
as well as a liberal foundation.
★ A profession has a theoretical body
of knowledge leading to defined
skills, abilities and norms.
★ A profession that provides a specific
service.
★ Members of a profession have
autonomy in decision making and
practice
★ The profession has a code of ethics
for practice
NURSING
★ A discipline involved in the delivery
of health care to the society.
★ A helping profession
★ service –oriented to maintain health
and well-being of people.
★ An art and science
LEARNING OUTCOME:
CO4.Practice nursing in accordance with
existing laws, legal, ethical and moral
principles.
LEGAL ASPECTS OF NURSING:
TOPICS ON:
★ LAWS
★ ACCOUNTABILITY
★ RESPONSIBILITY
★ LEGAL DOCTRINE
Responsibility
- Is the obligation to perform duties,
tasks or roles
- Using sound professional judgement
and being answerable for the
decisions made in doing this.
Accountability
- Is being able to give an account of
one’s nursing judgements,actions
and omissions.
- It is also about maintaining and
safeguarding quality patient care
 outcomes and standards of the
profession while being answerable
to those affected by one’s nursing
practice.
Accountability to the Client
- as the nurses foremost
accountability is the client. You hold
yourself 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 through the job
description.
- You are responsible to know your
terms of employment and to work
with in the 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 the Regulations of the Act.
RESPONSIBILITIES OF THE NURSE TO
THE PATIENT'S
★ Nurses should not accept tips or
expensive gifts that may induce
them to give more care to favored
patients and neglect those who
cannot give
★ When engaged in an agency, the
nurse should complete the length of
time stipulated in the contract
★ Nurses should commit themselves to
the welfare of those entrusted to
their care.
★ They should be loyal to their own
sworn duty.
PATIENT’S RESPONSIBILITIES in their
care
★ Providing adequate information
★ Complying with Instructions
★ Informing the physician of refusal to
treatment
★ Paying Hospital charges
★ Following hospital rules and
regulations
★ Showing respect and considerations
RESPONSIBILITIES OF THE NURSE TO
THE PHYSICIAN
★ It shall be the duty of the nurse to:
★ Provide nursing care through
utilization of the nursing process. It
includes, but not limited to traditional
and innovative approaches,
therapeutic use of self, executing
health care techniques and
procedures.
“Nursing is a caring profession”
- comfort measures, health teachings,
and administration of written
prescription for treatment, therapies,
oral, topical and parenteral
medications, internal examination
during labor in the absence of
antenatal bleeding and delivery.
- In case of suturing of perineal
laceration, special training shall be
provided according to protocol
established.
DUTIES OF NURSES
★ Utilize nursing process in providing
nursing care
★ Undertake nursing and health
human resource development
training and research
 ★ Teach, guide, supervise nursing
students
★ Interrelationship or linkage with
community resources and health
care team
★ Educate Individual, family and
community
★ Strict or duty- bound adherence to
the code of ethics
LAWS AFFECTING NURSES AND
NURSING
LAW
- The sum total of rules and
regulations by which society is
governed.
- It is man- made and regulates social
conduct in a formal and binding way.
- A rule of civil conduct prescribed by
the supreme power in a state
commanding what is right and
prohibiting what is wrong.
3 ESSENTIAL CHARACTERISTICS OF
LAW
1. The right to declare that the law exist
2. That such rule is pronounced or
expressed and that its source can be
3. The right to enforce the same must
be provided.
HIERARCHY OF LAW
Divine Law/NATURAL LAW
- Laws authored by God. The inherent
tendency that humans have to take
actions that follow our nature and
purpose as human beings ; based
on the idea to promote good and
avoid evil.
- Aimed at the preservation of society
- Basic concepts similar to those
found in the deontological ethical
system
Criminal law
- Law that regulates conduct is
considered offensive against the
general public because it harms the
welfare of society as a whole.
- Examples: murder ,robbery, rape
,embezzlement (theft or
misappropriation of funds placed in
one's trust or belonging to one's
employer.
- Prosecuted by the state ,not by
individuals
- Violations are called crimes resulting
to prison, or death.
Statutory law
- Law that arises from formal
legislative enactment or from other
entities with legislative power.
Common law
- Law that regulates human social
conduct as expressed in judicial
decisions that interpret cases raised
in disputes taken to court .
- Based on precedent
Types of crimes:
FELONY: crimes of a serious nature that
usually carries a penalty of imprisonment.
Misdemeanor: A crime of a less serious
nature than a felony. Punishable by a fine of
less than $10,000;jail time less than 1 year.
- Level of crime is determined by the
legislature.
Civil law
- Law that protect the legal right and
enforces the legal duties of private
persons ( or group of persons )
- EXAMPLES OF CIVIL LAW:
● Contract law
● Treaty law
● Marriage law
● Tort law
Legal Terms - Liability
- Liability and obligation or debt that
can be enforced by law in cases of
malpractice a person found guilty of
a tort is considered legally liable, or
legally responsible for the outcome
TORT
- A tort, in common law jurisdiction.
- Is a civil wrong that causes a
claimant to suffer loss or harm,
resulting in legal liability for the
person who commits the tortious act.
It can include intentional infliction of
emotional distress, negligence,
financial losses, injuries, invasion of
privacy, and many other things
THREE TYPES OF TORTS
Intentional torts
- Willful acts that violate another
person’s rights or property – usually
physical acts; may result in a crime.
★ Assault
- saying or doing something that will
make a person genuinely fear that
he /she will be touched without
consent( threat).
★ Battery
- Unconsented touching a person, or
anything he or she is wearing or
holding, or anything that is attached
to him or her without the person's
permission; does not have to cause
injury.
★ false imprisonment
- Making a person stay in a
place against his or her
wishes; can be verbal,
physical or chemical.
★ Intentional infliction of emotional
distress
- The use of extreme or
outrageous conduct that
causes severe emotional
distress in the patient or
family.
★ conversion of property
- Interference by the nurse
with the right to possession
of the patient’s property by
either intermeddling or
destroying the property.
Quasi-intentional torts
- Violation of a person’s reputation,
personal privacy, or freedom from
malicious or unfounded legal
prosecution.
★ Defamation of character –the
sharing of information that
unintentionally harms a person’s
reputation.
* Slander - oral defamation of
character that is intentional and
malicious.
* Libel- written defamation of
character that is intentional and
malicious.
★ Invasion of privacy – violation of a
person’s right to keep information
about self ,family and property from
public scrutiny.
Public law
- A department of law which is
concerned with the state in its
political or sovereign capacity. It
applies generally to people of the
state adopting or enacting it.
Criminal law
- Treat the nature, extent and degree
of every crime and adjust to it the
adequate and necessary penalty.
International law
- The law which regulates the
intercourse of nations.
LAWS THAT PROMOTE THE WELFARE
AND WELL-BElNG OF NURSES
LABOR CODE (PD 442)
- defines among other things, hours
of work contract (including
termination of contract) and nurse
staffing in industrial clinics
CIVIL SERVICE LAW (PD 807)
- provide for the recruitment and
selection of employees in
government service; qualification
standards; personnel evaluation
system; and personnel discipline).
- Also provides that no employee
of the Civil service can be
suspended except for cause as
provided for by law and after due
process
EXECUTIVE ORDER No. 180
- Uphold the right to organize of
government employees in
accordance with the 1987
constitution that states,
- "the rights of people. to form
unions, associations, or societies
for purposes not contrary to law
shall not be abridged".
MAGNA CARTA OF PUBLIC HEALTH
WORKERS ( RA 7305)
- has provisions on benefits, rights
and responsibilities of public
health workers. Public health
workers include everybody who
works in government health
institutions such as hospitals and
laboratories.
SALARY STANDARDIZATION LAW (RA
6758)
- provides for the standardization of
salaries of those working in
government. One of the
benchmark positions is Nurse I
which is assigned salary grade Ill.
- (RA )173 upgrades the entry
salary of nurses In government to
grade 15)
RA 7041
- (An Act Requiring Regular
Publication of Existing Vacant
Positions in Government Offices)-
- The intention of this law is for
government offices to be
transparent in their recruitment
practices.
- By publishing the presence of
vacant positions, applicants are
less likely to be subjected to
unethical practices in government
practices.
ANTI- SEXUAL HARASSMENT ACT
(RA 7877)
- protects employees against sexual
harassment.
Sexual harassment
- is committed by any person who

exercises authority, influence or
moral ascendancy of another by
demanding, requesting or
requiring sexual favor regardless
of whether or not it accepted by
the object of sexual solicitation
RESPONSIBILITY AND
ACCOUNTABILITY FOR THE PRACTICE
OF PROFESSIONAL NURSING
- Nurses employed in an agency,
institution or hospital are directly
responsible to their immediate
supervisors.
- Private duty nurses, being
independent practitioners, are held
to a standard of conduct that is
expected of reasonably prudent
nurse.
WHAT IS 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 - refer to compensation ,
money recoverable for a loss of
damage.
PROFESSIONAL NEGLIGENCE
"NEGLIGENCE“—
- refers to the commission or omission
of an act, pursuant to a duty, that a
reasonably prudent person in the
same or similar circumstance would
or would not to, and acting or the
non-acting of which is the proximate
cause of injury to another person to
his property.
ELEMENTS OF PROFESSIONAL
NEGLIGENCE
1. Existence of a duty on the part of the
person charged to use due care
under circumstances
2. Failure to meet the standard of due
care
3. The foreseeability of harm resulting
from failure to meet the standard
 4. The fact that the breach of this
standard resulted in an injury to the
plaintiff.
Common act of negligence:
Examples:
● Errors due to family assistance
● Administration of medicine without a
doctor's prescription
● Burns resulting from hot water
bag,Heat lamps, vaporizers, sitz
bath
MALPRACTICE
What makes a nurse liable for
malpractice?
A nurse will be liable for malpractice if he or
she:
● Injures a patient with a piece of
medical equipment like knocking
something heavy onto the patient,
● Burning the patient
● Or leaving a sponge inside the
patient after surgery.
Common Causes for Malpractice Suits
★ Burns: from hot water, heating pads,
lights, malfunctioning equipment,
too-strong solutions, showers, baths
★ Falls: out of bed, while ambulating,
due to wet floors, defective
equipment, over-sedation
★ Failure to observe and take
appropriate action: refusing to
answer call lights, orthopedic
injuries, not taking vital signs,
leaving patients alone
★ Medication and injection errors
★ Dispensing meds as an RN
★ Mistaken identity: meds,
procedures, surgery
★ Failure to communicate: not
informing MD of patient problems;
poor shift reports; inability to reach
MD
★ Abandonment: leaving a patient
alone who should not be left
alone—double shifts?
★ Loss or damage to patient
property: dentures, clothing,
hearing aids
★ Things left in patients during
surgery:res ipsa loquitur—the thing
speaks for itself
★ Lack of informed consent:
permission must be Voluntary (no
coercion). Informed (person must
clearly understand choices and what
is to be done. Physician’s job to get
informed consent
Issues in Health - Care Litigation
What is litigation?
- The formal definition of litigation is
the process of taking legal action. It
is the act, process or practice of
settling a legal dispute. Litigators are
lawyers that participate in the act or
process of settling civil
(non-criminal) disputes between
parties.
Informed consent
- Both a legal and an ethical issue
- The voluntary permission by a client
or by the client’s designated proxy to
carry out a procedure on the client
- Claims that they did not grant
informed consent before a surgery
or invasive procedure can form the
basis of lawsuits
- The physician must provide this
information.
- Information required
- Treatment proposed
 - Material risk involved (potential
complications)
- Acceptable alternative treatments
- Outcome hoped for
- Consequences of not having
treatment
Patient Self-Determination Act
Two types of advance directives
★ Living will: Document stating what
health care a client will accept or
refuse after the client is no longer
competent or able to make that
decision.
★ Medical durable power of
attorney: Health-care proxy,
designates another person to make
health-care decisions for a person if
the client becomes incompetent or
unable to make such decisions.
Legal Concepts
Good Samaritan Law
- Written to encourage health-care
professionals to help in emergency
situations.
- Reduces the professional liability
when responsible care is used.
- Care given must be in the
professional’s scope of practice and
training.
- Rests on the concept of “implied
consent.”
Legal Definitions of the Good Samaritan
Rule
- is a doctrine of law which gives legal
protection to a person who comes to
the aid of an injured or ill person,
without expectation of
compensation, from being liable for
negligence as long as the volunteer
aid-giver acted with reasonable care.
And without gross negligence.
- The Good Samaritan doctrine is
legislated to encourage Good
Samaritans to come to the aid of
others.
True emergency
- exists when a person will either die
or have a permanent injury if not
treated immediately.
Consent is considered implied
- the person, if awake or able, would
want care.
Can be used with children under 18.
Statute of limitation
- a time period after which a
malpractice suit cannot be filed.
- Generally, 2 years after the
discovery of injury
- In children, up to age 21
The Good Samaritan Defense
- The most common ingredients for
successful invocation of the Good
Samaritan doctrine are:
- (1) the care rendered was performed
voluntarily, as the result of the
emergency, without expectation of
compensation;
- (2) the initial emergency or injury
was not caused by the person
invoking the defense, and
- (3) the emergency care was not
given in a grossly negligent or
reckless manner.
Expert witness
- A person called to provide special
information or opinions in cases that
require special study or experience.
- Usually an instructor or nursing
supervisor
 - Can give opinions—usually
testimony only
allows facts
Suit-Prone Patients
● Very demanding
● Very critical of all aspects of the
hospital experience
● Very dependent
● Critical of other nurses
● Have filed lawsuits before
● Insensitive to patient needs
● Undereducated
● Overconfident
● Authoritarian
● Inflexible
● Preoccupied with personal issues
Protection Against Lawsuits
● Maintain good medical records.
● Establish good relationships with
clients.
● Keep nursing skills current.
● Assess the client frequently for
changes.
● Maintain professional manners.
● Avoid making statements that may
admit fault
● Don’t criticize other professionals.
● Stay within your scope of practice.
● Be definite about instructions.
● Take extra precautions with
telephone orders.
● Monitor the care of those you
supervise.
● Check the condition of health-care
equipment you are using.
● If in doubt, stop!
● Watch for adverse outcomes
(medications, treatments,
etc.).
● If you suspect a lawsuit, notify your
insurance carrier
immediately.
● Never tell a patient you have
malpractice insurance.
● If a suit is filed, don’t talk to anyone
but your lawyer.
Protecting Nurses from Malpractice:
7 Things You Need to Know
1. Be Present to Your Patient
- A symptom missed, or a
question that should have
been asked about allergies,
lifestyle, or health history, can
create a serious or even fatal
health care error.
- Be present to each patient
and foster a positive,
long-term professional
relationship with them.
2. Explain Consent and Health
Information Exchange
- Even if an individual seems
to understand the nature of
giving consent for care
providers to share electronic
health records, it is important
to have the patient review
and formally sign consent to
participate in the local health
record exchange.
3. Engage in Additional Continuing
Education Training
- To enhance performance,
nurses are recommended to
seek more than the basic
annual requirement to further
their skills, and also to help
protect them against the
liability of a malpractice suit.
- A nurse who has engaged in
extensive annual continuing
education and training is able
to defend his or her expertise
better in a malpractice suit
4. Never Wait to Refer a Patient
- Emergency room nurses
experience this on a frequent
basis.
- When someone appears to
be having a mild emergency
or uncomfortable symptom, it
can be easy to misdiagnose
the problem.
- any small delay in seeking a
referral to a specialist, or a
consultation with a doctor,
can place nurses at risk for
malpractice, particularly if a
symptom was ignored (or
misunderstood) and the
condition or emergency
escalated into a
life-threatening circumstance.
5. Remember to Document
Thoroughly
- For nurses, the file and
procedural documentation
offers an advantage.
- First, it assists doctors to
help determine an accurate
diagnosis, allowing them to
create a treatment care plan.
- The Second reason is to
provide legal documentation
regarding methods,
observations, tests, and
results in the event of a
malpractice liability suit.
- Without the documentation,
it can be hard to prove in
court that all reasonable
measures and investigations
were conducted,
- which is why accurate
reports and files are so
important for medical
professionals.
6. Avoid Talking Shop on Social
- Social media is not the place
for any medical professional
to be sharing about their
workplace, the nature of their
work, or using patient names
or details that are otherwise
confidential.
- Sharing about your day is
natural, but sharing health
records, patient pictures
(without their consent), or
clinical observations publicly
can land you in court.
7. Measure Twice, Dispense Once
- Medications for patients in a
hospital or long-term care
facility can change on a daily
basis.
- Anything can impact the
accuracy of prescription
medications, including
mislabeled drugs, faulty
intravenous equipment, and
more.
- That is why it’s important to
double check charts for
changes and clarify when
prescription medications do
not align with other
treatments.
- Nurses are the first line of
defense to prevent drug
interactions, and they should
use extra precaution when
dispensing medications.
- it is estimated that nursing
malpractice suits account for
only 2 to 4% of annual legal
problems for hospitals and
private clinics, recent shifts in
malpractice law mean that
patients can receive
compensation from doctors
 and nurses involved in their
treatment or care.
- When malpractice limits or
caps have been reached in
terms of the doctor’s medical
coverage, patients may also
be able to pursue
compensation for damages
through the nurse’s insurer.
Malpractice Insurance
Two types of policies:
Claims-made
- protect you only while your policy is
in effect. Can purchase “tails” that
expand the policy Usually a little cheaper
Occurrence polices
- protect against any claims that
occurred during the policy period no
matter when it was made.
Student Clinical Practice
● Many nurses work with student
nurses.
● Student nurses do NOT practice on
the instructor’s nor the staff’s
license.
● Students practice under an
EXEMPTION in the nurse practice
act that allows non-nurses to
practice nursing in certain situations.
● Students are liable for their own
actions.
● Instructors and registered nurses
(RNs) can be held liable under
supervisor liability.
What are Doctrines?
- The basic meaning of the term
doctrine is “teaching.”
2 TYPES OF DOCTRINE
Christian doctrine
- accordingly, is the attempt to state in
intellectually responsible terms the
message of the gospel and the
content of the faith it elicits.
Legal doctrine
- is a framework, set of rules,
procedural steps, or test, often
established through precedent in the
common law, through which
judgments can be determined in a
given legal case.
(A doctrine comes about when a judge
makes a ruling where a process is outlined
and applied, and allows for it to be equally
applied to like cases. When enough judges
make use of the process, it may become
established as the de facto method of
deciding situations.)
Examples of legal doctrines include:
THE DOCTRINE OF RES IPSA LOQUITUR
- “The thing speaks for itself.” no
further proof is required.
- When the harm that resulted from
negligence and the responsibility for
the harm are clear and anyone
would agree on it, the term res ipsa
loquitur is used.
Examples: Doctrine of RES IPSA
LOQUITUR
1. A patient came out from the OPD
section experiencing pain on the
buttocks after injection, the felt weak
and was subsequently paralyzed.
His sciatic nerve was injured
2. A sponge is left inside a patient
following surgery
3. The carcass of an animal is
discovered inside a food can.
4. Failure to report observations to
attending Physicians
5. Failure to exercise the degree of
diligence which the circumstances of
the particular case demands
6. Mistaken Identity
7. Wrong medicine, wrong
concentration, wrong route, wrong
dose
8. Defects in the equipment such as
stretchers and wheelchairs may lead
to falls thus injuring the patients
MALPRACTICE
- The principle that the occurrence of
an accident implies negligence
- Implies the idea of improper or
unskillful care of a patient by a nurse
- It also denotes stepping beyond
someone's authority with serious
consequences
Examples:
● 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 directives
● Failure of hospital or pharmacy to
dispense the right medicine dosage
DOCTRINE OF FORCE MAJEURE
- It is an irresistible or superior force,
one that cannot be foreseen or
prevented ; a fortuitous event ; an
"act of God".
- No person shall be held liable for
nonperformance of what "as
expected of him/her if the cause of
the non-performance was a force
majeure (e.g. devastating typhoons,
earthquakes and other calamities)
THE DOCTRINE OF RESPONDEAT
SUPERIOR
- Doctrine that a party is responsible
for(has vicarious liability for) acts of
their agents.
- The doctrine is founded on the
principle that he who expects to
derive advantage from an act which
is done by another for him must
answer for any injury which a third
person may sustain from it.
- The doctrine rests upon the
proposition that in doing the acts out
of which the accident arose, the
servant was representing the master
at the time
There 3 generally considerations
1. Was the act committed within the
time and space limit of the agency?
2. Was the offense incidental to or of
the same general nature as the
responsibility the agent is authorized
to perform?
3. Was the agent motivated to any
degree to benefit the principle by
committing the act?
Example:
1. The hospital will be held liable, if, In
an effort to cut down on expenses it
decides to hire underboard nurses or
midwives in place of professional
 nurses, and these persons prove to
be incompetent
2. The surgeon will be held responsible
in case a laparotomy pack is left in a
patient's abdomen
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 incompetence, there is a
ground for revocation or suspension
of her certificate of registration
MEDICAL ORDERS, DRUGS AND
MEDICATIONS
- R.A. 6675 states that only validly
registered medical, dental, and
veterinary practitioners \ either in
private institutions/corporations or in
the government, are authorized to
prescribe drugs.
THE DOCTRINE OF 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
eligienda) or in the supervision of his
employees(Culpa in vigilando)
THE DOCTRINE OF FROLIC AND
DETOUR
DETOUR
- occurs when an employee or agent
makes a minor departure from his
employer’s charge.
FROLIC
- a major departure when the
employee is acting on his own and
for his benefits , rather than a minor
sidetrack in the course of obeying an
order from the employer.
THE DOCTRINE OF QUI FACIT PER
ALIUMFACIT 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 acts in the same
way that he is responsible for his
own acts
THE DOCTRINE OF FORCE MAJEURE
- “SUPERIOR FORCE”
- Essentially free both parties from
liabilities or obligations when an
extraordinary event or circumstance
beyond the control of the parties like
war, riots, flood, earthquake,
volcanic eruption etc. or in legal
terms acts of God , prevents one or
both parties from fulfilling their
obligations under the contract.