Ethico-Legal

Community
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Health Nursing I
Considerations
in Community
Health Nursing
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OUTCOME

▪ Practice nursing
in accordance
with law, legal,
ethical and moral
principles.
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▪ “Caring for the health of people is a most sensitive and

demanding profession because it directly affects life
itself and the quality of a person’s existence. For this
reason, as can be gleaned from inscriptions on
ancient clay tablets, medical practice has been
reserved for the most respected, credible, ethical
and compassionate intellectuals in the
community. Which gives us an idea of how the
medical profession was looked up to since time
immemorial (del Rosario, S.A., 2016).”
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“Ignorance to the law

excuses no one.”
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TERMINOLOGY

Laws are formal written rules of behavior that govern conduct and
ensure the protection of citizens.

Ethics refers to moral principles and values that guide human

behaviors.

The healthcare system combines the practice of medicine and

nursing with a complex system of laws, societal beliefs, and cultural
values.
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RA 9173: The Philippine Nursing Act of 2002
Article VI, Section 28
▪ Scope of Nursing – A person shall be deemed to be practicing nursing
within the meaning of this Act when he/she singly or in collaboration
with another, initiates and performs nursing services to individuals,
families and communities in any health care setting.

▪ It includes, but not limited to, nursing care during conception, labor,
delivery, infancy, childhood, toddler, preschool, school age,
adolescence, adulthood, and old age.

▪ As independent practitioners, nurses are primarily responsible for the

promotion of health and prevention of illness
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Duty of a Nurse in the Philippines
A. Nursing care includes, but not limited to:
• Traditional and innovative approaches,
• Therapeutic use of self,
• Executing health care techniques and procedures
• Essential primary health care,
• 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.
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Duty of a Nurse in the Philippines

▪ B. Establish linkages with community resources and

coordination with the health team;

▪ C. Provide health education to individuals, families and

communities;
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Duty of a Nurse in the Philippines

▪ D. Teach, guide and supervise students in nursing education

programs including the administration of nursing services in
varied settings such as hospitals and clinics; undertake
consultation services; engage in such activities that require the
utilization of knowledge and decision-making skills of a
registered nurse; and

▪ E. Undertake nursing and health human resource development

training and research, which shall include, but not limited to, the
development of advance nursing practice;
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Board Resolution No.220 series of

2004: Code of Ethics for Registered
Nurses
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Article 2 Section 5:

▪ REGISTERED Nurses must (42):

a. consider the individuality and totality of patients when they
administer care.
b. respect the spiritual beliefs and practices of patients
regarding diet and treatment.
c. uphold the rights of individuals.
d. take into consideration the culture and values of patients in
providing nursing care. However, in the event of conflicts, their
welfare and safety must take precedence.
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Values: “A person's principles or
Let’s standards of behavior; one's judgment of
Differentiate! what is important in life.” (i.e., “hiya”,
“utang na loob”, “Pakikisama”)

Beliefs: “an acceptance that a statement

is true or that something exists.” (i.e.,
“Paglilihi”, “usog”, and “pasma”)

Norms: “a standard or pattern, especially

of social behavior, that is typical or
expected of a group.” (i.e. adding “po” and
“opo” when talking to an elderly.)
 z Culture: “a customary beliefs, social
Let’s forms, and material traits of a racial,
religious, or social group .” (i.e.
Differentiate! Filipino culture)

Tradition: “the transmission of

customs or beliefs from generation to
generation, or the fact of being
passed on in this way.”

Morality: “concerned with the

principles of right and wrong
behavior and the goodness or
badness of human character.”
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Article 3
Section 6: Human life is inviolable.

Quality and excellence in the care of

the patients are the goals of nursing
practice.

Accurate documentation of actions

and outcomes of delivered care is
the hallmark of nursing accountability
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Article 3 Respect respect the “Patients’ Bill of Rights” in the

delivery of nursing care.
Section 8:

provide the patients or their families with all

Provide pertinent information except those which
may be deemed harmful to their well-being.

Uphold uphold the patients’ rights when conflict

arises regarding management of their care.
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Patient’s Bill of Rights

1. Right to
Appropriate Medical 2. Right to Informed 3. Right to Privacy
Care and Humane Consent and Confidentiality
Treatment

5. The Right to
4. Right Choose Health Care 6. Right to Self-
to Information Provider and Determination
Facility.

7. Right to 8. Right to Medical

Religious Belief. Records
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9. Right Right to Leave.

Right to Refuse Participation In Medical

10. Right
Research.

Right to Correspondence and to Receive

11. Right
Visitors.

12. Right Right to Express Grievances.

13. Right
Right to be Informed of His Rights and
Obligations as a Patient.
 be conscious of their obligations as
z Be citizens and, as such, be involved in
community concerns.
Article 5
Section 14 be equipped with knowledge of health
Be resources within the community and take
active roles in primary health care.

actively participate in programs, projects,

Participate
in and activities that respond to the
problems of society.

lead their lives in conformity with the

Lead principles of right conduct and proper
decorum.

Project
project an image that will uplift the
nursing profession at all times.
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Public Health Laws

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#Republic Act 7305: Magna Carta of
Public Health Workers

▪ “Is enacted to ensure that health workers are properly

compensated, which will in turn benefit patients through the
delivery of quality health care service. “

▪ “Subsistence allowance, laundry allowance, longevity pay,

hazard pay, remote assignment allowance, housing and
higher salary grade upon retirement, among others. “
 z #Presidential Decree No. 856, series
1975: Code on Sanitation
▪ “The health of the people, being of paramount importance,
all efforts of public services should be directed towards the
protection and promotion of health; and”

▪ “With the advance in the field of sanitation in recent years,

there arises the need for updating and codifying our
scattered sanitary laws to ensure that they are in keeping
with modern standards of sanitation and provide a handy
reference and guide for their enforcement;”
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#Presidential Decree No. 856, series
1975: Code on Sanitation
▪ Water supply

▪ Food establishment

▪ Markets and Abattoirs (slaughter house)

▪ Public Laundry

▪ School Sanitation and Health services

▪ Industrial Hygiene

▪ Public swimming or bathing places

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#Presidential Decree No. 856, series
1975: Code on Sanitation
▪ Rest Areas, Bus Terminals, Bus Stops, and Service Stations

▪ Camps and Picnic Grounds

▪ Dancing Schools, Dance Halls and Night Clubs

▪ Tonsorial and Beauty Establishments

▪ Massage Clinics and Sauna Bath Establishments

▪ Hotels, Motels and Apartments, Lodging, Boarding, or

Tenement Houses, and Condominiums
▪ Port, Airport, Vessel and Aircraft Sanitation
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#Republic Act No. 8749: The Philippine
Clean Air Act of 1999

▪ It is a comprehensive air quality

management policy and program which
aims to achieve and maintain healthy air
for all Filipino
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R.A. 6675: "Generics Act of 1988."
▪ To promote, encourage and require the use of generic terminology in the
importation, manufacture, distribution, marketing, advertising and
promotion, prescription and dispensing of drugs;
To ensure the adequate supply of drugs with generic names at the
lowest possible cost and endeavour to make them available free for
indigent patients;

To encourage the extensive use of drugs with generic names through a

national system of procurement and distribution;To emphasize the
scientific basis for the use of drugs, in order that health professionals
may become more aware and cognisant of the therapeutic effectiveness;
and

To promote drug safety by minimizing duplication in medications and/or

use of drugs with potentially adverse drug interactions.
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R.A. 7875: National health insurance act
(Philhealth) amended by RA 9241 and 10606
▪ a) provide all citizens of the Philippines with the mechanism to gain financial
access to health services;

▪ b) create the National Health Insurance Program, hereinafter referred to as

the Program, to serve as the means to help the people pay for health care
services;

▪ c) prioritize and accelerate the provision of health services to all Filipinos,

especially that segment of the population who cannot afford such services;
and

▪ d) establish the Philippine Health Insurance Corporation, hereinafter referred

to as the Corporation, that will administer the Program at central and local
levels.
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R.A. 11223 Universal Health Care Bill

▪ 14 March 2019: It is a time for celebration in the Philippines. President Rodrigo

Duterte has just signed a Universal Health Care (UHC) Bill into law (Republic
Act No. 11223) that automatically enrolls all Filipino citizens in the National
Health Insurance Program and prescribes complementary reforms in the health
system.
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REPUBLIC ACT NO. 7719 : "National
Blood Services Act of 1994".

▪ AN ACT PROMOTING VOLUNTARY BLOOD

DONATION, PROVIDING FOR AN ADEQUATE
SUPPLY OF SAFE BLOOD REGULATING BANKS,
AND PROVIDING PENALTIES FOR VIOLATION
THEREOF.
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R.A. 3573: The Law on Notifiable
Diseases
▪ Hospitals and Medical practitioner are hereby directed to report to
the Centers for Health Development (formerly DOH Regional Health
Office) diseases attended as enumerated in the revised list of
notifiable or reportable diseases. The revised list as provided in DOH
Circular No. 157-D, series of 1990 includes the following:
▪ AIDS/HIV, Infection Bronchitis, Chickenpox, Cholera, Dengue Hemorrhagic
Fever, Diarrhea, Diphtheria, Diseases of the Heart Dysentery, Filariasis, Goiter,
Gonorrhea, Hepatitis, Viral Influenza, Leprosy, Malaria, Malignant Neoplasms,
Measles, Pneumonia Poliomyelitis, Schistosomiasis, Syphilis, tetanus, tetanus
neonatorum, ,typhoid fever, TB meningitis, TB respiratory, other forms of TB,
whooping cough
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R.A. 9253: "Expanded Senior Citizens
Act of 2003."
▪ (a) To motivate and encourage the senior citizens to contribute to
nation building;

(b) To encourage their families and the communities they live with
to reaffirm the valued Filipino tradition of caring for the senior
citizens;

(c) To give full support to the improvement of the total well-being

of the elderly and their full participation in society considering
that senior citizens are integral part of Philippine society;

.
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▪ (d) To recognize the rights of senior citizens to take their
proper place in society. This must be the concern of the
family, community, and government;

(e) To provide a comprehensive health care and

rehabilitation system for disabled senior citizens to
foster their capacity to attain a more meaningful and
productive ageing; and

(f) To recognize the important role of the private sector in

the improvement of the welfare of senior citizens and to
actively seek their partnership
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▪ Income tax exemption for minimum wage earners

▪ Training fee exemption on socio-economic

programs
▪ Free medical and dental services in government
facilities
▪ Free flu and pneumococcal vaccinations for
indigent senior citizens
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Benefits

▪ Scholarships and financial assistance for seniors’

education in public and private schools

▪ Retirement benefits from SSS, GSIS, and Pag-IBIG

▪ Discounts in special programs for senior citizens

▪ Express lanes for senior citizens in all government

offices and commercial establishments
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R.A. 9165: Comprehensive Dangerous
Drugs Act of 2002
▪ RA 9165 repealed RA 6425, or the Dangerous Drugs Act
of 1972. The law mandates the Dangerous Drugs Board
(DDB) to be the policy- and strategy-making body that
plans and formulates programs on drug prevention and
control.

▪ Article 9, Section 77 of the law states that the DDB “shall

develop and adopt a comprehensive, integrated, unified
and balanced national drug abuse prevention and control
strategy. It shall be under the Office of the President.”
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R.A. 9165: Comprehensive Dangerous
Drugs Act of 2002

▪ The law also created the Philippine Drug

Enforcement Agency (PDEA) under the Office of the
President. It serves as the implementing arm of the
DDB; it is responsible for the efficient and effective
law enforcement of all the provisions on any
dangerous drugs, controlled precursors and essential
chemicals as provided in the Act.
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Article II of the law enumerated unlawful acts and
corresponding penalties:

▪ • Section 4 –Importation of dangerous drugs; penalty: life

imprisonment to death with fines of P500,000 to P10,000,000.

▪ • Section 5 –Sale, trading, administration, dispensation,

delivery, distribution of dangerous drugs.

▪ In summary, under RA 9165, those caught importing, selling,

manufacturing, and using illegal drugs and its forms may be
fined and imprisoned for at least 12 years or a lifetime,
depending on the severity of the crime.
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R.A. 9502: "Universally Accessible
Cheaper and Quality Medicines Act of
2008".
▪ Pursuant to the attainment of this general policy, an effective
competition policy in the supply and demand of quality
affordable drugs and medicines is recognized by the State as a
primary instrument. In the event that full competition is not
effective, the State recognizes as a reserve instrument the
regulation of prices of drugs and medicines, with clear
accountability by the implementing authority as mandated in this
Act, as one of the means to also promote and ensure access to
quality affordable medicines.
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R.A. 9262: Anti-Violence Against
Women and Their Children Act of 2004
▪ "Violence against women and their children" refers to any
act or a series of acts committed by any person against a
woman who is his wife, former wife, or against a woman with
whom the person has or had a sexual or dating relationship,
or with whom he has a common child, or against her child
whether legitimate or illegitimate, within or without the family
abode, which result in or is likely to result in physical, sexual,
psychological harm or suffering, or economic abuse including
threats of such acts, battery, assault, coercion, harassment or
arbitrary deprivation of liberty.
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▪ Furthermore, RA 9262 gives women and their children the right to
file a protection order. A protection order is "an order issued for the
purpose of preventing further acts of violence against a woman or
her child and granting other necessary relief."[41]
▪ The protection order "safeguards the victim from further harm,
minimizing any disruption in the victim's daily life and facilitating
the opportunity and ability of the victim to independently regain
control over her life."[41]
▪ The types of protection orders that may be issued are: the
barangay protection order (BPO), the temporary protection order
(TPO), and the permanent protection order (PPO).[41]
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▪ For BPOs, the order is usually issued by the Punong
Barangay or Barangay Kagawad. Barangay officials are
expected to "respond immediately to a call for help or request
for assistance or protection of the victim."[41]
▪ Likewise, they are expected to "arrest the suspected
perpetrator without a warrant when any of the acts of violence
is occurring, or when he/she has personal knowledge that any
act of abuse has just been committed, and there is imminent
danger to the life or limb of the victim."[41]
▪ Any barangay official or law enforcer who fails to report the
incident shall be liable for a fine not exceeding P10,000 and/or
whenever applicable, criminal, civil, or administrative liability
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Possible Sanctions

▪ Any person who violates this provision

shall suffer the penalty of one (1) year
imprisonment and a fine of not more
than Five Hundred Thousand pesos
(P500,000.00).
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R.A. 10121: "Philippine Disaster Risk
Reduction and Management Act of 2010"

▪ This Act provides for the development of policies and plans

and the implementation of actions and measures pertaining
to all aspects of disaster risk reduction and management,
including good governance, risk assessment and early
warning, knowledge building and awareness raising,
reducing underlying risk factors, and preparedness for
effective response and early recovery.
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▪ RA10121 provides for the calamity fund to be

used in support of disaster risk reduction or
mitigation, prevention, and preparedness
activities for the potential occurrence of
disasters and not just for response, relief, and
rehabilitation efforts.
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R.A. 7600: "The Rooming-In and Breast-
Feeding Act of 1992".
▪ Normal Spontaneous Deliveries. -
The following newborn infants be
put to the breast of the mother
immediately after birth and
forthwith roomed-in within thirty
(30) minutes:
▪ (a) well infants regardless of age
of gestation; and(b) infants with
low birth weights but who can
suck.
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▪ Deliveries by
Caesarian. - Infants
delivered by
caesarian section
shall be roomed-in
and breastfed within
three (3) to four (4)
hours after birth.
 ▪ Right of the Mother to
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Breastfeed. - It shall be the
mother’s right to breastfeeed
her child who equally has the
right to her breastmilk.
Bottlefeeding shall be allowed
only after the mother has
been informed by the
attending health personnel of
the advantages of
breastfeeding and the proper
techniques of infant formula
feeding and the mother has
opted in writing to adopt
formula feeding for her infant.
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R.A. 10354: The Responsible Parenthood and
Reproductive Health Act of 2012 (RH Law)

▪ A law in the Philippines,

which guarantees
universal access to
methods on
contraception, fertility
control, sexual
education, and maternal
care.
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Elements of the Law
▪ (1) Family planning information and services;

▪ (2) Maternal, infant and child health and nutrition, including breast
feeding;

▪ (3) Prevention of abortion and management of post-abortion

complications;

▪ (4) Adolescent and youth reproductive health guidance and

counseling;

▪ (5) Prevention and management of reproductive tract infections

(RTIs), HIV/AIDS and sexually transmittable infections (STIs);
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Elements of the Law
▪ (6) Elimination of violence against women and children and other
forms of sexual and gender-based violence;
▪ (7) Education and counselling on sexuality and reproductive health;

▪ (8) Treatment of breast and reproductive tract cancers and other

gynecologic conditions and disorders;
▪ (9) Male responsibility and involvement and men’s RH;

▪ (10) Prevention, treatment and management of infertility and sexual

dysfunction;
▪ (11) RH education for the adolescents; and

▪ (12) Mental health aspect of reproductive health care.

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R.A. 10152: Mandatory Infants and children
health immunization Act of 2011

▪ Requires that
mandatory basic
immunization shall be
given for free at any
government hospital or
health center to infants
and children up to five
(5) years of age
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▪ SEC. 3. Coverage.—The mandatory basic immunization for all
infants and children provided under this Act shall cover the
following vaccine-preventable diseases:

▪ (a) Tuberculosis;
(b) Diphtheria, tetanus and pertussis;
(c) Poliomyelitis;
(d) Measles;
(e) Mumps;
(f) Rubella or German measles;
(g) Hepatitis-B;
(h) H. Influenza type B (HIB); and
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▪ This law obligates any physician, nurse, midwife,

nursing aide or skilled birth attendant who delivers or
assists in the delivery of a newborn prior to delivery to
inform parents or legal guardian of the newborn of the
availability, nature and benefits of immunization against
vaccine-preventable diseases at birth. (Sec. 5, Id.)

▪ This provision ensures that every parent shall be

informed of his/her right to access the mandatory basic
immunization for his/her babies.
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R.A. 10666: Children safety on Motorcycles
Act of 2015
▪ It is illegal to operate a two-
wheeled
motorcycle on public
roads if a child is on board,
specifically if there’s a
heavy volume of vehicles,
there’s a high density of fast
moving vehicles, or where
there’s a speed limit of more
than 60 kph is imposed.
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▪ The exception here is if the child’s feet can

comfortably reach the motorcycle’s foot peg for the
pillion rider, the child’s arms can reach around and
grasp the waist of the motorcycle rider, and the child
is wearing a standard protective helmet. Another
exception is if the child being transported requires
immediate medical attention.
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Penalty
▪ Any person who operates a motorcycle in violation of Section
4 of this Act shall be fined with an amount of three thousand
pesos (P3,000.00) for the first offense; five thousand pesos
(P5,000.00) for the second offense; and ten thousand pesos
(P10,000.00) for the third and succeeding offenses.

▪ Moreover, for the third offense, the driver’s license of the

offender shall be suspended for a period of one (1) month.

▪ Violation of these provisions beyond the third time shall result

to automatic revocation of the offender’s driver’s license.
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R.A.10821: Children's Emergency Relief
and protection Act of 2016

▪ Mandates the provision of emergency relief

and protection for children before, during, and
after disaster and other emergency situations.
It refers to situations when children are
gravely threatened or endangered by
circumstances that affect their survival and
normal development.
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▪ The Act includes provisions
on establishing shelters for
displaced children,
promoting children’s rights,
and addressing the needs
of unaccompanied or
separated children,
including immediate care,
tracing of relatives, and
family reunification.
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P.D. 603: Child and youth welfare code
of the Philippines
Art. 3. Rights of the Child,

▪ (1) Every child is endowed with the dignity and worth of a

human being from the moment of his conception, as generally
accepted in medical parlance, and has, therefore, the right to be
born well.

▪ (2) Every child has the right to a wholesome family life that
will provide him with love, care and understanding, guidance
and counseling, and moral and material security.
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▪ (3) Every child has the right to a well-rounded development of his
personality to the end that he may become a happy, useful and active
member of society.

▪ The gifted child shall be given opportunity and encouragement to

develop his special talents.

▪ The emotionally disturbed or socially maladjusted child shall be

treated with sympathy and understanding, and shall be entitled to
treatment and competent care.

▪ The physically or mentally handicapped child shall be given the

treatment, education and care required by his particular condition.
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▪ (4) Every child has the right to a balanced diet, adequate clothing,
sufficient shelter, proper medical attention, and all the basic physical
requirements of a healthy and vigorous life.

▪ (5) Every child has the right to be brought up in an atmosphere of

morality and rectitude for the enrichment and the strengthening of his
character.

▪ (6) Every child has the right to an education commensurate with

his abilities and to the development of his skills for the improvement
of his capacity for service to himself and to his fellowmen.
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▪ (7) Every child has the right to full opportunities for safe and
wholesome recreation and activities, individual as well as social, for the
wholesome use of his leisure hours.

▪ (8) Every child has the right to protection against exploitation,

improper influences, hazards, and other conditions or circumstances
prejudicial to his physical, mental, emotional, social and moral
development.

▪ (9) Every child has the right to live in a community and a society that
can offer him an environment free from pernicious influences and
conducive to the promotion of his health and the cultivation of his
desirable traits and attributes.
▪
z (10) Every child has the right to the care, assistance, and protection
of the State, particularly when his parents or guardians fail or are
unable to provide him with his fundamental needs for growth,
development, and improvement.

▪ (11) Every child has the right to an efficient and honest

government that will deepen his faith in democracy and inspire him
with the morality of the constituted authorities both in their public and
private lives.

▪ (12) Every child has the right to grow up as a free individual, in

an atmosphere of peace, understanding, tolerance, and universal
brotherhood, and with the determination to contribute his share in the
building of a better world.
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DUTIES OF PARENTS

▪ (1) To give him affection, companionship and understanding;

▪ (2) To extend to him the benefits of moral guidance, self-discipline and

religious instruction;

▪ (3) To supervise his activities, including his recreation;

▪ (4) To inculcate in him the value of industry, thrift and self-reliance;

▪ (5) To stimulate his interest in civic affairs, teach him the duties of
citizenship, and develop his commitment to his country;
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▪ (6) To advise him properly on any matter affecting his

development and
▪ well-being;
▪ (7) To always set a good example;
▪ (8) To provide him with adequate support, as defined in
Article 290 of the Civil Code; and
▪ (9) To administer his property, if any, according to his best
interests, subject to the provisions of Article 320 of the Civil
Code.
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▪ Parents and guardians are responsible

for the damage caused by the child
under their parental authority in
accordance with the Civil Code.
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R.A. 9211: Tobacco
Regulation Act of 2003

▪ An omnibus law
regulating smoking in
public places, tobacco
advertising, promotion
and sponsorship, and
sales restrictions,
among other
requirements.
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▪ Smoking is prohibited in enumerated indoor public places and workplaces

such as government facilities, healthcare and educational institutions, and
facilities frequented by minors while, in other public places and
workplaces, including bars and nightclubs, designated smoking areas are
allowed.

▪ Smoking is prohibited in public land transport, aircraft, and public

transport terminals. Public watercraft may have designated smoking
areas.

▪ Sub-national jurisdictions may enact smoke free laws that are more
stringent than the national law.
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Penalty
▪ On the first offense, a fine of not less than Five hundred pesos (Php500.00)
but not more than One thousand pesos (Php1,000.00) shall be imposed.

▪ On the second offense, a fine of not less than One thousand pesos
(Php1,000.00) but not more than Five thousand pesos (Php5,000.00) shall
be imposed.

▪ On the third offense, in addition to a fine of not less than Five thousand
pesos (Php5,000.00) but not more than Ten thousand pesos
(Php10,000.00), the business permits and licenses to operate shall be
cancelled or revoked.
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