Ethico-Legal Considerations in Health Assessment

At the end of this unit, the students are expected to:

Cognitive:
1. Describe the relevant ethico-legal guidelines in conducting health assessment as well as the practice
of the nursing profession.
2. Describe the patient’s bill of rights.
3. Describe the data privacy act.
Affective:
1. Listen attentively during class discussions
2. Demonstrate tact and respect when challenging other people’s opinions and ideas
3. Accept comments and reactions of classmates on one’s opinions openly and graciously.
Psychomotor:
1. Participate actively during class discussions
2. Confidently express personal opinion and thoughts in front of the class
A. Relevant Ethico-Legal Considerations in Conducting Health Assessment

Philippine Nursing Code of Ethics

• Promulgated by the Philippine Regulatory Board of Nursing
• Philippine Nurses Association and Association of Nursing Service Administrators of the
Philippines
• Mandated by the article III, Section 9, of republic 9173oServes as ethico-legal basis in the practice of
the nursing profession in the Philippines

Code of Ethics for Nurses

Article I Preamble
• Sec. 1
o Health is a fundamental right of every individual. The Filipino registered nurse believing in the
worth and dignity of each human being, recognizes the primary responsibility to preserve health
at all cost. This responsibility encompasses the 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.
• Sec. 2
o To assume this responsibility, registered nurses 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.
• Sec. 3
o 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
Sec. 4
Ethical Principles
• Values, customs, and spiritual beliefs held by individuals shall be respected.
• Individual freedom to make rational and unconstrained decisions shall be respected.
• Personal information acquired in the process of giving nursing care shall be held in strict
confidence.

Sec. 5
Guidelines to be observed:
REGISTERED Nurses must
• Consider the individuality and totality of patients when they administer care.
• Respect the spiritual beliefs and practices of patients regarding diet and treatment.
• Uphold the rights of individuals.
• 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.

Article III Registered Nurses and Practice

Sec. 6
Ethical Principles
• 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.

Sec 7
Guidelines to be observed:
REGISTERED Nurses must
• Know the definition and scope of nursing practice which are in the provisions of R. A. No. 9173, known
as the “Philippine Nursing Act of 2002” and Board Res. No. 425, Series of 2003, the “Rules and
Regulations Implementing the Philippine Nursing Act. of 2002”, (the IRR).
• Be aware of their duties and responsibilities in the practice of their profession as defined in the
“Philippine Nursing Act of 2002” and the IRR.
• Acquire and develop the necessary competence in knowledge, skills, and attitudes to effectively
render appropriate nursing services through varied learning situations.

Sec. 8
Guidelines to be observed:
REGISTERED Nurses must
 Respect the “Patients’ Bill of Rights” in the delivery of nursing care.
 Provide the patients or their families with all pertinent information except those which may be
deemed harmful to their well-being.
 Uphold the patients’ rights when conflict arises regarding management of their care.

Sec. 10
Ethical Principle
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.
Sec 11
Guidelines to be observed:
REGISTERED Nurses must:
• Perform their professional duties in conformity with existing laws, rules regulations. Measures,
and generally accepted principles of moral conduct and proper decorum.
• Not allow themselves to be used in advertisement that should demean the image of the
profession (i.e. indecent exposure, violation of dress code, seductive behavior, etc.).
• Decline any gift, favor or hospitality which might be interpreted as capitalizing on patients.
• Not demand and receive any commission, fee or emolument for recommending or referring a patient
to a physician, a co-nurse or another PRC-BN health care worker; not to pay any commission, fee or
other compensations to the one referring or recommending a patient to them for nursing care.
• Avoid any abuse of the privilege relationship which exists with patients and of the privilege access
allowed to their property, residence or workplace.

Article VI Registered Nurses and the Profession

Sec. 16
Ethical Principles
• Maintenance of loyalty to the nursing profession and preservation of its integrity are ideal.
• Compliance with the by-laws of the accredited professional organization (PNA), and other
professional organizations of which the Registered Nurse is a member is a lofty duty.
• Commitment to continual learning and active participation in the development and growth of the
profession are commendable obligations.
• Contribution to the improvement of the socio-economic conditions and general welfare of
nurses through appropriate legislation is a practice and a visionary mission.

B. Patient’s Bill of Rights

• A document that provides patient with information on how they can reasonably expect to be treated
during the course of their hospital stay.
• These documents are, in almost all cases, not legally-binding.
• Provide goals and expectations for patient treatment.
1. Right to Appropriate Medical Care and Humane Treatment.
• Every person has a right to health and medical care
• Patient has the right to appropriate health and medical care of good quality
• Patient’s human dignity, convictions, integrity, individual needs and culture shall be respected
• Patient has the right to be directed to wait for care, or be referred or sent for treatment elsewhere,
where the appropriate care can be provided
• Patients in emergency shall be extended immediate medical care and treatment without any
deposit, pledge, mortgage or any form of advance payment for treatment
2. Right to Informed Consent.
• The patient has a right to a clear, truthful and substantial explanation, in a manner and language
understandable to the patient, of all proposed procedures, whether diagnostic, preventive, curative,
rehabilitative or therapeutic
• That the patient will not be subjected to any procedure without his written informed consent, except
in the following cases:
o Emergency cases
o Epidemic control
o Law makes it compulsory for everyone to submit a procedure
o Patient is a minor, legally incompetent and requires a third-party consent
o Disclosure of material information to patient will jeopardize the success of treatment
o Patient waives his right in writing
• Informed consent is obtained from a patient concerned if he is of legal age and of sound mind, the
following persons may give consent:
o Spouse
o Son or daughter of legal age
o Either parent
o Brother or sister of legal age
o Guardian
3. Right to Privacy and Confidentiality.
• The patient has the right to be free from unwarranted public exposure, except in the following cases:
o When his mental or physical condition is in controversy and the appropriate court, in its discretion,
order him to submit to a physical or mental examination by a physician
o When the public health and safety so demand
o When the patient waives this right in writing
• The patient has the right to demand that all information, communication and records pertaining to his
care be treated as confidential, except:
o When such disclosure will benefit public health and safety
o When it is in the interest of justice and upon the order of a competent court
o When the patients waive in writing the confidential nature of such information
o When it is needed for continued medical treatment or advancement of medical science
4. Right to Information.
• The patient or his/her legal guardian has a right to be informed of the result of the evaluation of the
nature and extent of his/her disease
• The patient or his legal guardian has the right to examine and be given an itemized bill of the hospital
and medical services rendered in the facility or by his/her physician and other health care providers
o The patient is entitled to a thorough explanation of such bill
• The patient or his/her legal guardian has the right to be informed by the physician or
his/her delegate of his/her continuing health care requirements following discharge
• The patient is entitled to a brief, written summary of the course of his/her illness
• He/she is likewise entitled to the explanation of, and to view, the contents of medical record of
his/her confinement but with the presence of his/her attending physician or in the absence of the
attending physician, the hospital's representative
5. The Right to Choose Health Care Provider and Facility.
• The patient is free to choose the health care provider to serve him as well as the facility except when
he is under the care of a service facility or when public health and safety so demands or when the
patient expressly waives this right in writing
• The patient has the right to discuss his condition with a consultant specialist, at the patient’s request
and expense
• The patient has the right to seek for a second opinion and subsequent opinions, if appropriate, from
another health care provider/practitioner
6. Right to Self-Determination.
• The patient has the right to avail himself/herself of any recommended diagnostic and treatment
procedures
• Any person of legal age and of sound mind may make an advance written directive for physicians to
administer terminal care when he/she suffers from the terminal phase of a terminal illness, provided
that:
o He is informed of the medical consequences of his choice
o He releases those involved in his care from any obligation relative to the consequences of his
decision
o His decision will not prejudice public health and safety
7. Right to Religious Belief.
• The patient has the right to refuse medical treatment or procedures which may be contrary to his
religious beliefs
8. Right to Medical Records.
• The patient is entitled to a summary of his medical history and condition
• He has the right to view the contents of his medical records, except psychiatric notes and other
incriminatory information obtained about third parties
• At his expense and upon discharge of the patient, he may obtain from the health care institution a
reproduction of the same record whether or not he has fully settled his financial obligation with the
physician or institution concerned
• The health care institution shall safeguard the confidentiality of the medical records and to likewise
ensure the integrity and authenticity of the medical records
9. Right to Leave.
• The patient has the right to leave hospital or any other health care institution regardless of his
physical condition, provided that:
o He/she is informed of the medical consequences of his/her decision
o He/she releases those involved in his/her care from any obligation relative to the consequences of his
decision
o His/her decision will not prejudice public health and safety
• No patient shall be detained against his/her will in any health care institution on the sole basis of his
failure to fully settle his financial obligations
o However, he/she shall only be allowed to leave the hospital provided
appropriate arrangements have been made to settle the unpaid bills
10. Right to Refuse Participation in Medical Research.
• The patient has the right to be advised if the health care provider plans to involve him in medical
research, including but not limited to human experimentation which may be performed only with the
written informed consent of the patient
11. Right to Correspondence and to Receive Visitors.
• The patient has the right to communicate with relatives and other persons and to receive
visitors subject to reasonable limits prescribed by the rules and regulations of the health care institution
12. Right to Express Grievances.
• The patient has the right to express complaints and grievances about the care and services received
without fear of discrimination or reprisal and to know about the disposition of such complaints
13. Right to be Informed of His Rights and Obligations as a Patient.
• Every person has the right to be informed of his rights and obligations as a patient
It shall be the duty of health care institutions to inform of their rights as well as of the institution's rules
and regulations that apply to the conduct of the patient while in the care of such institution.

C. Data Privacy Act

• Republic Act No. 10173, also known as the Data Privacy Act of 2012 (DPA), aims to protect personal
data in information and communications systems both in the government and the private sector.
• Protect the fundamental human right of privacy, of communication while ensuring free flow of
information to promote innovation and growth.
• The unauthorized processing of personal information shall be penalized by imprisonment
ranging from one (1) year to three (3) years and a fine of not less than Five hundred thousand pesos
(Php500,000.00) but not more than Two million pesos (Php2,000,000.00)
• The unauthorized processing of sensitive personal information shall be penalized by
imprisonment ranging from three (3) years to six (6) years and a fine of not less than Five hundred
thousand pesos (Php 500,000.00) but not more than Four million pesos (Php 4,000,000.00)

OLFU Data Privacy Manual

https://www.privacy.gov.ph/data-privacy-act/
https://ayohhealth.com/2019/05/30/data-privacy-act-in-office-health/
http://ehealth.doh.gov.ph/index.php/79-data-privacy-act-2012/70-data-privacy-act-2012
https://www.coursehero.com/file/65605656/Relevant-Ethico-Legal-Guidelines-in-Conducting-
Health-Assessmentdocx/

Weber, J.R., and Kelley, J. H., (2018) Health Assessment in Nursing

6th Edition, Philadelphia: Wolters Kluwer
https://www.abclawcenters.com/blog/2017/04/03/what-is-a-patient-bill-of-rights/
https://samch.doh.gov.ph/index.php/patients-and-visitors-corner/patients-rights
https://www.privacy.gov.ph/data-privacy-act/
http://ehealth.doh.gov.ph/index.php/79-data-privacy-act-2012/70-data-privacy-act-2012
https://www.prc.gov.ph/uploaded/documents/Board%20of%20Nursing-CE.
pdf