Professional Documents
Culture Documents
Med Juris Lect
Med Juris Lect
PROFESSIONAL
REGULATIONS COMMISSIONS
To have general supervision and regulation of all professions requiring
examinations which includes the practice of medicine
BOARD OF MEDICINE
Its primary duties are to give examinations for the registration of physicians
and supervision, control and regulation of the practice of medicine
BOARD OF MEDICAL EDUCATION
Composition:
Chairman - Secretary of Education
Members - Secretary of Health
Director, Bureau of Private Schools
Chairman, Board of Medicine
Representative, PMA
Council of Deans,APMC
Dean, UP-College of Medicine
Functions:
1. To determine and prescribe the requirements for admission into a recognized
college of Medicine;
2. To determine and prescribe requirements for the minimum physical facilities;
3. To determine and prescribe the minimum number and qualifications of teaching
personnel;
4. To determine and prescribe the minimum required curriculum;
5. To authorize the implementation of experimental curriculum;
6. To accept applications for admission to a medical school;
7. To select, determine and approve hospitals for training;
8. To promulgate, prescribe and enforce the necessary rules and regulations.
PROFESSIONAL REGULATIONS
COMMISSION
Composition:
Commissioner
Two Associate Commissioner
Composition:
Six members appointed by the president from a
list submitted by the Executive Council of the PMA.
Qualifications:
- Natural-born citizen;
- Duly-registered physician;
- In the practice of medicine for at least 10 years;
- Of good moral character and of recognized standing in the medical
profession as certified by PMA;
- Not a member of any faculty of any medical school (including any
pecuniary interest).
Powers, Functions and Responsibilities:
1. To determine and prepare the contents of the licensure examinations;
2. To promulgate such rules and regulations for the proper conduct of the
examinations, correction and registration;
3. To administer oath;
4. To study the conditions affecting the practice of medicine;
5. To investigate violations, issue summons, subpoena and subpoena duces
tecum;
6. To conduct hearings or investigations of administrative cases filed before
them;
7. To promulgate decisions on such administrative cases subject to the review
of the Commission;
8. To issue certificate of registration;
9. To suspend, revoke or reissue certificate of registration for causes provided
by law or by the rules and regulations promulgated;
10.To promulgate, with the approval of PRC, rules and regulations in harmony
with the provisions of the Medical Act of 1959 and necessary for the proper
practice of medicine.
ADMISSION TO THE PRACTICE OF
MEDICINE
Prerequisites:
1. Minimum age requirement
- at least 21 years of age
2. Proper Educational Background
Requirements for Admission in the College of Medicine
Holder of a Bachelors degree;
Not convicted of any crime involving moral turpitude;
Certificate of Eligibility from the Board of Medical Education;
Good moral character .
3. Examination Requirements
- must have passed the corresponding Board Examination
Preliminary Examination
-At least 19 years of age;
- Of good moral character;
-Have completed the first two years of the medical course;
Final or Complete Examination
-Citizen of the Philippines or of any country who has submitted
competent and conclusive - documentary evidence confirmed
by the DFA showing that his countrys existing laws permit citizens
of the Philippines to practice medicine under the same rules and
regulations governing citizens thereof (RECIPROCITY RULE).
4. Holder of certificate of registration
No issuance to any candidate who has been:
-Convicted by a court of competent jurisdiction of any crime involving
moral turpitude;
-Found guilty of immoral or dishonorable conduct after investigation
by the Board of Medicine;
-Declared to be of unsound mind.
Scope of Examination:
Preliminary - Anatomy and Histology
Physiology
Biochemistry
Microbiology and Parasitology
Final - Pharmacology and Therapeutics
Pathology
Medicine
Obstetrics and Gynecology
Pediatrics and Nutrition
Surgery and Ophthalmology,
Otorhinolaryngology
Preventive Medicine and Public Health
Legal Medicine, Ethics and Medical
Jurisprudence
PRACTICE OF MEDICINE
What is the practice of medicine?
It is a privilege or franchise granted by the State to
any person to perform medical acts upon
compliance with law, that is, the Medical Act of
1959 as amended which has been promulgated by
the State in the exercise of police power to protect
its citizenry from unqualified practitioners of
medicine.
It is diagnosing and applying and the usage of
medicine and drugs for curing, mitigating, or
relieving bodily disease or conditions.
ACTS CONSTITUTING THE
PRACTICE OF MEDICINE
(pursuant to Sec.10, Art. III of
the Medical Act of 1959 as
amended):
A) who shall for compensation, fee, reward in any form
paid to him directly or through another, or even without
the same, physically examine any person, and diagnose,
treat, operate or prescribe any remedy for human disease,
injury, deformity, physical, mental, psychical condition or
any ailment, real or imaginary, regardless of the nature of
the remedy or treatment administered, prescribed or
recommended;
B) who shall by means of signs, cards, advertisement,
written or printed matter, or through the radio, television
or any other means of communication, either offer or
undertake by any means or method to diagnose, treat,
operate, or prescribe any remedy for human disease,
injury, deformity, physical, mental or psychical
condition;
C) who shall falsely use the title of M.D. after his name,
shall be considered as engaged in the practice of
medicine.
By DECISIONS OF COURTS are not
considered to constitute practice of
medicine:
a) One who takes bp reading;
b) Application of medicated massage;
c) Hospital;
d) Nurse anesthesist
Exemptions
Forms of Physician-Patient
Relationship
COMMENCEMENT
It is the very time the physician is
obliged to comply with the legal duties
and obligations to his patient.
TERMINATION
It is the time when the duties and obligations by a
physician to his patient ceases. The following are
some ways of termination of the relationship:
1.Recovery of the patient or when the physician considers that his
medical services will no longer be beneficial to the patient;
2. Withdrawal of the physician provided: a) with consent of the patient,
and b) patient is given ample time and notice;
3. Discharge of the physician by the patient;
4. Death of either party;
5. Incapacity of the physician
6. Fulfillment of the obligations stipulated in the contract;
7. In emergency cases, when the physician of choice of the patient is
already available or when the condition of emergency ceases;
8. Expiration of the period as stipulated;
9. Mutual agreement for its termination.
RIGHTS OF PHYSICIAN
INHERENT RIGHTS
to choose patients
to limit practice of medicine
to determine appropriate management
procedures
to avail of hospital services
INCIDENTAL RIGHTS
right of way while responding to emergency
right of exemption from execution of instruments and
Library to hold certain public/private offices to perform certain
services to compensation right to membership in medical societies
NB: The law does not give any qualification the right of the
physician to choose his patient, however, the Code of Medical
Ethics and RA 6615 provides otherwise in cases of emergency.
Related provisions
Art II, Sec.2 Code of Ethics
xxxfree to choose whom he will servexxx..always
respond to any request for his assistance in emergency.xxx
Sec.1 RA 6615
All government and private hospitalsxxx .are required to
render immediate emergency medical assistancexxx.
1. Patient ;
2. If patient is minor, consent must be obtained from the parents;
3. In the absence of the parents, consent of the grandparents must
be obtained, paternal grandparents having preference;
4. In the absence of parents and grandparents, eldest brother or
sister, provided one is of age and not disqualified by law to give
consent;
5. Other person who may give consent having substitute parental
authority.
Subject matter is legal
The subject matter or procedure applied
to the patient and which the patient
consented must not be that which the law
penalizes or against public policy.
NB:
- consent of minor is not valid if the procedure
will not benefit him
- expressed refusal of a minor to surgery shall not
prevail over the existing emergency
- Doctrine of parens patriae , the court may grant
consent for the minor.
RIGHT TO RELIGIOUS
BELIEF
- Art. III , Sec. 5, Philippine Constitution
No law shall be made respecting an
establishment of religion or prohibiting the free
exercise therof. The free exercise and enjoyment
of religious profession and worship, without
discrimination or preference, shall forever be
allowed. No religious test shall be required for the
exercise of civil or political rights.
RIGHT OF PRIVACY
RIGHT OF DISCLOSURE OF
INFORMATION
- When the law provides for treatment, the patient has no right to
refuse treatment
CRIMINAL
An act or omission which constitute a crime by the physician;
Laws: Revised Penal Code and other special laws;
Penalty: imprisonment and/or fine.
CIVIL
Awarded against a physician to compensate for theinjury he
suffered on account of the physicians act or omission as a breach
of the contractual relationship of both parties;
Laws. Civil Code of the Philippines and other related laws;
Art. 100, RPC states that Every person criminally liable is
civilly liable.Penalty: damages
ADMINISTRATIVE LIABILITIES
Quantum of evidence needed: substantial
evidence, such relevant evidence as a reasonable
mind might accept as adequate to support a
conclusion
- The thing speaks for itself; nature of the wrongful act or injury
is suggestive of negligence.
- General rule: expert testimony is necessary to prove that a
physician has done a negligent act or that has deviated from the
standard of medical practice.
DOCTRINE OF CONTRIBUTORY
NEGLIGENCE
- Doctrine of Common Fault
- It has been defined as conduct on the part of the
plaintiff or injured party, contributing as a legal
cause to the harm he has suffered, which falls
below the standard which he is required to
conform to his own protection.
- It is the act or omission amounting to want of
care on the part of the complaining party which,
concurring with the defendants negligence, is the
proximate cause of the injury.
Related Civil Code Provisions
Art. 2179, Civil Code
When the plaintiffs own negligence was the
immediate and proximate cause of his injury, he
cannot recover damages. But if his negligence
was only contributory, the immediate and
proximate cause of injury being the defendants
lack of due care, the plaintiff may recover
damages, but the court may mitigate the damages
to be awarded.
Art.2214, Civil Code
In quasi-delicts, the contributory negligence of the
plaintiff shall reduce the damages that he may
recover.
Shared responsibility
- when the injury suffered by the patient is
caused by the negligent act of two or more
persons, each of them acting concurrently and
successively in the production of injury.
SPECIFIC ACTS OR OMISSIONS WHICH CONSTITUTE
MEDICAL MALPRACTICE
1. Drug reaction;
- failure to note history of allergy
- failure to test for signs of reaction
- failure to stop treatment when the drug reaction has been
observed
- failure to provide adequate therapy to encounter a reaction
- treatment with a drug not proper for the illness
2. Overdosage;
3. Failure to give warning of the side effects;
4. Administering medicine on the wrong route;
5. Administration of the wrong medicine;
6. Administration of a drug on the wrong person;
7. Infection following an injection;
8. Injury to the nerves
9. Failure to administer the drug.
Doctrine of Strict Liability
A person injured by a defective product can recover
compensation from his injury from anyone in the
distributive chain who sold the product while the defect
was present, even though the seller exercises every
conceivable caution to prevent and discover the defects.
Negligence or carefulness is not in issue in a case
under the doctrine nor is any warranty or promise in issue.
A drug manufacturer is liable if his product is
contaminated by any impurities which harm the user.
If the drug has side effects, it is the duty of the
manufacturer to warn the physician of it either through the
literature attached or accompanying the drug or through
the services of the promoters. Once the physician has been
forewarned, the manufacturer has no duty to insure that the
warning reaches the patient in normal circumstances.
LIABILITIES OF HOSPITALS
Sec.2(a), RA 4226, Hospital Licensure Act
HOSPITAL means a place devoted primarily to the maintenance
and operation of facilities for the diagnosis, treatment, and care of
individuals suffering from illness, disease, injury or deformity, or in
need of obstetrical or other medical and nursing care.
The term hospital shall also be construed as any institution, building
or place where there are installed beds, cribs, bassinets for twenty-four
hour use or longer by patients in the treatment of diseases, ..xxx.
1. Failure to admit;
2. Failure to examine and/or treat;
3. Negligence in the application of management
procedures.
An AMBULANCE is a motor vehicle specifically designed, equipped
and used for the transportation of the sick, injured or wounded persons
operated by trained
personnel for ambulance service.
Hospital Pharmacy
1. Actual or Compensatory;
2. Moral;
3. Exemplary
4. Nominal;
5. Temperate;
6. Liquidated
ACTUAL OR COMPENSATORY DAMAGES
1. Death
Art. 2206, Civil Code
The amount of damages for the death caused
by a crime or quasi-delict shall be at least three
thousand pesos(75,000.00), even though there may
have been mitigating circumstances.
2. Physical Disability
3. Loss of Earning Capacity
4. Medical, Surgical, Hospital, and Related Expenses
5. Loss of Service or Support
6. Funeral Expenses
MORAL DAMAGES
Physical Suffering
Mental Anguish
Fright and Moral Shock
Besmirched Reputation and Social
EXEMPLARY OR CORRECTIVE
DAMAGES
RA 6615
An act requiring government and private hospitals or clinics duly
licensed to extend medical assistance in emergency cases.
RA 8344
An act penalizing the refusal of hospitals and medical clinics to
administer appropriate initial medical treatment and support in
emergency or serious cases, amending BP Blg. 702, otherwise known
as An act prohibiting the demand or deposits or advance payments for
the confinement or treatment of patients in hospital and medical clinics
in certain cases.
Art. 275, Revised Penal Code
Abandonment of persons in danger and abandonment of ones
own victim
The penalty of arresto mayor shall be imposed upon:
1. Anyone who shall fail to render assistance to any person whom he
shall find in an uninhabited place wounded or in danger or dying,
when he can render such assistance without detriment to himself,
unless such omission shall constitute a more serious offense.
2. Anyone who shall fail to help or render assistance to another whom
he has accidentaqlly wounded or injuredxxx.
Standard of Care in Emergencies
Sec. 24, Rule 130, Rules of Court The following persons cannot
testify as to matters learned in confidence in the following cases:
1. The husband or the wife, during or after the marriage, cannot be
examined without the consent of the other as to any communication
received in confidence by one from the other during the marriage except in
a civil case by one against the other, or for a crime committed by one
against the other or the latters direct descendants and ascendants;
1. Interns;
2. Confidential information obtained by one of
the physicians practicing medicine in partnership
with another physician whereby the patients of
both are the patients of the firm.
Nurses and attendants who were present and
assisting the physician when the communication
was made.
When Communication Is Not A Privileged
Communication
N.B.
Medical witness may have the right to base his opinion
from standard textbooks.
In cross-examination, medical textbooks are admissible in
evidence to discredit a witness who has based his
testimony upon it.
Learned Treatises
Kinds of Subpoena
1. Subpoena ad testificandum
A process requiring a person to appear before a trial or hearing of
an action or investigation conducted under our laws or for the taking of
a deposition at a certain definite date, time and place to testify on some
material issues.
2. Subpoena duces tecum
A process which requires a person to produce at the trial some
documents or papers which are under his control or possession that are
pertinent to the issues of his controversy, at a certain date, time and
place.
3. Subpoena duces tecum and testificandum
N.B.
Failure to comply with a subpoena without justifiable reason is a ground
for reprimand, suspension or revocation of the certificate of registration.
Sec. 2, Art. III, Code of Medical Ethics
It is the duty of every physician, when called upon by the judicial
authorities, to assist in the administration of justice on matters which
are medico-legal in character.
Requisites:
1. That the witness deliberately or intentionally falsified
the truth;
2. That the other portions of the testimony to be
discredited, are not corroborated by circumstances or other
unimpeached evidence;
3. The false testimony must be on material point.
When it is not applicable
Penal Provisions
-Violation of the provisions of this Code constitute
unethical and unprofessional conduct and therefore a
sufficient ground for the reprimand, suspension or
revocation of the certificate of registration of the offending
physician in accordance with the provisions of Sec. 24,
par. 12 of the Medical Act of 1959.
RIGHT AGAINST SELF-INCRIMINATION
Sec. 17. Art. III, Philippine Constitution states that,
No person shall be compelled to witness against himself.