BASICS OF PHILIPPINE
MEDICAL JURISPRUDENCE
AND ETHICS
2010 EDITION
JOSUE N. BELLOSILLO
BU C. CASTRO
EMMANUEL LJ. MAPILI
ALBERT D. REBOSA
ANTONIO D. REBOSA
Published by
CENTRAL BOOK SUPPLY, INC.
927 Quezon Avenue, Quezon City
Philippines
TABLE OF CONTENTS
Foreword/in
Preface/vii
AcknowledgmentsI-a.
Chapter 1
MEDICAL JURISPRUDENCE
1.1. Medical Jurisprudence defined/l
1.2. Distinction with legal and forensic medicine/2
1.3. The law of Hippocrates/3
1.
2.
3.
4.
5.
1.4.
1.5.
1.6.
1.7.
1.8.
Responsibilities to patientI \
Responsibilities to the profession / 6
Responsibilities to colleagues/l
Responsibilities to society11
Responsibilities to allied health professionals I %
Medical law/9
History of Philippine medical law/ll
Place of law in the medical profession/ll
Functions of the law in medicine/12
Sources of law/13
1.
2.
3.
4.
Statutory lawI Xh
Constitutional lawI'13
Administrative law/13
Common Iaw/l3
IX
Table of Contents
1.9
Classification of law/14
1. Public lawI'16
(a)
(b)
Criminal law/16
International law/16
(i)
(ii)
(c)
Public international law116
Private international law/16
Political law/16
(i)
(ii)
(iii)
(iv)
Constitutional law/16
Administrative law/11
I ^ w of public administration/XI
J^zw of public corporation / \1
2. Private law/Yl
(a)
(b)
(c)
Civil law/\1
Commercial law/\l
Remedial law/Yl
1.10. Medical legislation/18
1.11. Medical ethics/18
1.12. Common legal terms/18
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Torts/li
Deposition/is
Plaintiff/18
Defendant/18
Defamation/\%
Expert witness/18
GcW Samaritan LMW/19
Interrogatory/19
Malpractice/'19
Negligence/19
Table of Contents
11. Proximate cause/19
12. Reasonable care/19
Chapter 2
REGULATION OF THE MEDICAL PROFESSION
2.1. Basis of state regulation/20
2.2. Constitutional basis/20
2.3. Statutory basis/21
2.4. Reason for regulation/22
2.5. Warranties in the practice of medicine/23
Chapter 3
MEDICAL EDUCATION SYSTEM
IN THE PHILIPPINES
3.1.
3.2.
3.3.
Commission on Higher Education (CHED)/25
Association of Philippine Medical Colleges/26
Admission requirements to a medical college/26
1. National Medical Admission Test (NMA T)/27
3.4.
3.5.
3.6.
3.7.
(a)
Three-Flunk Rule/21
(b)
(c)
Academic freedom, not absolute/28
Equal protection not violated/2%
Medical school curriculum/29
Clinical clerkship/29
Medical education credentials awarded/30
Medical internship/30
1.
Medical internship progam /30
XI
Table of Contents
Chapter 4
LICENSURE AND REGISTRATION
OF PHYSICIANS
4.1.
Licensure/31
1.
2.
3.
4.
4.2.
Oath taking and conferment ceremonies/34
1.
2.
4.3.
Qualifications of candidatesfor board examinations/'31
Scope of examination/32
Documents to accompany an application for licensure examination/32
Passing rate/33
The Hippocratic Oath/ 34
Administrative Oath/3b
Certificate of registration/36
1.
2.
3.
4.
5.
6.
7.
8.
Right to be registered as physicians/36
Rule of reciprocity / 39
Groundsfor refusal of issuance of certificates of registration/41
Duty of the Board ofMedicine to issue certificates ofregistration/'42
Grounds for reprimand, suspension or revocation of registration
certificate/^
Rights of'respondents/'45
Appeal for judgment/ \6
Reinstatement/ M
Xll
Table of Contents
Chapter 5
PROFESSIONAL REGULATORY BOARD
OF MEDICINE
5.1.
5.2.
Professional Regulation Commission/48
Powers of the PRC/50
1. As administrative body/50
2. As quasi-legislative body/50
3. As quasi-judicial body/50
5.3.
Board of Medicine/52
1. Appointment of the chairman of the professional regulatory
board/52
2. Criteria for selection of nominees/ 53
3. Disqualification / 55
4. Reappointment of the chairman or member of the professional
regulatory board/56
5. Compensation of the members of the professional regulatory
boards/56
6. Purpose of compensation / 51
7. Basis of therightto salary/51
8. Prohibition against additional or double compensation/51
9. Powers, functions and responsibilities of the various professional
regulatory boards/51
5.4.
5.5.
5.6.
Authority of the Board Medicine t o determine standi n g of m e d i c a l schools/60
Applicability of right against self-incrimination before
the Board of Medicine/61
P M A with Legal Personality t o Q u e s t i o n Authority of
Board of Medicine/62
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Table of Contents
Chapter 6
PRACTICE OF MEDICINE
6.1.
6.2.
6.3.
6.4.
Practice of Medicine/64
Prerequisite to the Practice of Medicine/64
Acts Constituting Practice of Medicine/65
Cases on Acts Constituting Practice of Medicine/65
1. Acceptance of compensation without proper certificate ofregistration/65
2. Acts constitute practice of medicine whether or not done for a
fee/65
3. Acts of investment in stocks not acts constituting practice of
medicine/66
4. License to practice drugless healing cannot be implied/66
5. Advertised himself and offered services as physician/ 66
6. Falsely using thetitleofM.D. after one's name/61
6.5.
6.6.
6.7.
Acts not construed to be practice of medicine by
provision of law/67
Acts not construed to be practice of medicine by
decisions of courts/69
Faith healing, healing by prayer or divine healing/69
1. Psychic surgery and spiritualism/10
6.8.
6.9.
6.10.
Limited practice without any certificate of registration/71
Penalties for illegal practice of medicine/73
Employment of non-resident aliens/74
1. Employment permit of non-resident aliens/'l'4
2. Prohibition against transfer of'employment'/74
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Table of Contents
3. Submission of list/15
6.11.
Forms of Medical Practice/75
1. Sole proprietorship/15
2. Associate practice/l5
3. Medical group practice/16
(a)
(b)
Partnership/16
Corporation /16
Chapter 7
PHYSICIANS AND CONSTITUTION
7.1.
7.2.
Constitution/77
The Philippine State/ 77
1. People 111
2 Territory/1',
(a)
3.
The Philippine national territory/'78
Government/18
(a)
Executive branch/18
Appointingpower/'78
Removal power/18
(iii) Control power/18
(iv) Military power/19
W Pardoning power/19
(vi) Borrowing power/19
(vii) Diplomatic power/19
(viii) Budgetary power/19
(ix) Informing power/19
G)
XV
Table of Contents
(b)
Legislative branch/19
(i)
(ii)
(iii)
Appropriation power/19
Taxation power/19
Expropriation power/19
(c) judicial branch/19
4. Sovereignty /19
7.3.
The Fundamental Powers of the State/80
1. Police power/ %0
2. Power of eminent domain/ 80
3. Power of taxation/80
1A.
The Bill of Rights/80
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
7.5.
Due process/ 80
Equal protection / 81
Searches and seizure/81
Privacy of communication and correspondence / 8\
Freedom of speech and expression / 81
Liberty of abode and travel/82
R/g/f/ /<> information / 82
R/g/tf to form associations / 82
R/gA/ /o compensation in expropriation cases/'82
The impairment clause/82
Fn?e # « m /o courts/ 83
Miranda rights/83
Rights Inherent in the Practice of Medicine/83
1. Right to choose patients/ 83
2. Right to limit the practice of medicine / 8\
xvi
Table of Contents
7.6.
3.
Right to determine appropriate procedure / 8\
4.
Right to avail of hospital services/'84
Rights Incidental to the Practice of Medicine/84
1.
1.1.
Right of way while responding to an emergency call/84
2. Right to be paid for medical services rendered/84
3. Right to membership to medical societies/84
4. Right of exemption from execution of instruments and library/84
5. Right to hold certain positions in public andprivate services/85
6. Right to perform certain services/85
Citizenship/85
1.
2.
Doctrine of jus sanguinis/86
Doctrine of jus soli/86
Chapter 8
PHYSICIANS AND CONTRACTS
8.1.
Law of Contracts, elements/87
1. Manifestation of assent/ 81
2. Legal subject matter/88
3. Legal capacity to contract/88
4. Consideration / 88
8.2.
Physician-Patient Contractual Relationship/88
1. Commencement of physician-patient contractual relationship / 88
2. Nature of physician-patient contractual relationship/89
(a)
(b)
Consensual/89
Fiduciary/90
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Table of Contents
8.3.
Essential Requisites of Contracts/ 90
1. Consent/ 90
2.
Object or subject matter/91
(a)
Types of medical care/92
(i)
(ii)
General andfamily practice/92
Specialty practice/ 92
(1)
Anesthesiology/ 92
(2)
Dermatology / 93
(3)
Internal medicine/ 93
(4)
Neurology / 93
(5)
Obstetrics and Gynecology/93
(6)
Ophthalmology and Otolaryngology/94
(7)
Pathology/94
(8)
Pediatrics/94
(9)
Psychiatry/94
(10) Radiology/94,
(11) Surgery /95
(12) Public Health / 95
3. Cause or consideration /95
(a) Medical fees/96
(b) IGW.r of medical fees/96
(i)
(ii)
(iii)
(iv)
(v)
(c)
(d)
Simple contractual fee/96
Retainer fee/91
Contingent fee/91
Commission orfee splitting or dichotomous fee/98
Straight fee orpackage deal agreement/98
Reasonableness of medical fees/98
Medical billing/99
(i)
Payment at time of services/'99
xvm
Table of Contents
(ii) Billing when extension of credit is necessary/99
(iii) Using outside collection assistance/100
(e)
Salary scale of public health workers/100
(i)
(ii)
(iii)
(iv)
(f)
Additional compensation/101
(i)
(ii)
(iii)
(iv)
(v)
8.4.
8.5.
8.6.
Salary scale/100
Equality in salary scale/101
Salaries to be paid in legal tender/101
Deductions prohibited/101
Hazard allowance/102
Subsistence allowance/102
Longevity pay/103
Laundry allowance/103
Remote assignment allowance/'104
Forms of Contractual Relationship/104
Cases when there is no physician-patient relationship/105
Termination of Physician-Patient Relationship/105
1. Sample letter of withdrawal from case/106
2. Sample letter to confirm discharge by patient/101
3. Patient abandonment/101
8.7.
Defective Contracts/108
1. Rescissible contracts/108
2. Voidable contracts/108
3. Unenforceable contracts/109
4. Void contracts/111
xix
Table of Contents
Chapter 9
PHYSICIANS AND TORTS
9.1.
9.2.
9.3.
Torts/112
Professional Liability/112
Classifications of Medical Professional liability/113
1.
2.
3.
4.
9.4.
9.5.
Feasance/ \13
Malfeasance / 1V>
Misfeasance/113
Nonfeasance/113
Medical Malpractice or Negligence Cases/113
The Four D's of Negligence/114
1. Duty/114
2. Derelict/115
3. Direct cause/115
4. Damages/115
9.6.
Two-pronged Evidence/116
1. Standards of practice/116
2. Sources of proof of standard of care/116
9.7.
9.8.
Medical Malpractice/117
Sample Cases of Medical Malpractice/117
1. Unauthorised and unknown experimentation /ill
2. Failure to perform C-section andfailure to recognise and treat seizures in the periodfollowing the birth/ill
3. Surgical injury/\18
4. Failure to recognise and treat heart attack/118
xx
Table of Contents
5. Surgicalprecipitation of stroke/118
6. Wrongful amputation of arm and shoulder/119
7. Failure to diagnose cancer/119
8. Surgical injury/119
9.9.
Jurisprudence on Medical Professional Liability/120
1.
L E O N I L A GARCIA-RUEDA, vs. WILFREDO
L. PASCASIO, et al.
G.R. No. 118141, September 5, 1997/120
9.10.
9.11.
2.
ROGELIO E. RAMOS, et al. vs. COURT OF
APPEALS
G.R. No. 124354, December 29,1999/122
3.
LEAH ALESNA REYES, et al. vs.
SISTERS OF MERCY HOSPITAL, et al.
G.R. No. 130547, October 3, 2000/129
4.
PROFESSIONAL SERVICES, INC. vs.
NATIVIDAD and ENRIQUE AGANA
G.R. No. 126297, January 31, 2007/133
Doctrines applied in medical practice cases/135
Doctrine of respondeat superior or doctrine of vicarious liability or doctrine of imputed negligence or
command responsibility/135
1. Doctrine of ostensible agent or holding out theory or agency by estoppel/135
2. Borrowed servant doctrine/131
3. Captain-of-the-ship doctrine/131
4. Doctrine of independent contractor/131
5. Full time but not regular/138
xxi
Table of Contents
9.12.
Jurisprudence on respondeat superior/141
1.
9.13.
Doctrine of res ipsa loquitur or common knowledge
doctrine/142
1.
2.
3.
4.
9.14.
9.15.
9.16.
9.17.
9.18.
9.19.
ROGELIO E. RAMOS, et al. vs. COURT OF
APPEALS
G.R. No. 124354, December 29, 1999/141
Requisites of res ipsa loquitur/142
Application of res ipsa loquitur in medical malpractice/143
Res ipsa loquitur, when applicable/143
Res ipsa loquitur, when not applicable/143
Jurisprudence on res ipsa loquitur/145
1.
DR. VICTORIA L. BATIQUIN, et al. vs.
COURT OF APPEALS
G.R. No. 118231, July 5,1996/145
2.
ROGELIO E. RAMOS, et al. vs. COURT
OF APPEALS
G.R. No. 124354, December 29, 1999/150
3.
LEAH ALESNA REYES, et al. vs.
SISTERS OF MERCY HOSPITAL, et al.
G.R. No. 130547, October 3, 2000/152
Doctrine
common
Doctrine
Doctrine
Doctrine
Doctrine
of contributory negligence (doctrine of
fault)/ 152
of continuing negligence/152
of assumption of risk/153
of last clear chance/153
of foreseeability/154
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Table of Contents
1. Force majeure/154
2. Act of God/154
3. Accident/155
9.20.
9.21.
9.22.
9.23.
Fellow servant doctrine/155
Rescue doctrine or Good Samaritan Law/155
Deep pocket rule/156
Factors increasing medical malpractice cases/156
Chapter 10
PHYSICIANS AND DAMAGES
10.1.
Damages/158
1.
2.
10.2.
10.3.
10.4.
D a m n u m absque injuria/159
Actual damages/159
Moral damages/159
1.
2.
3.
4.
10.5.
10.6.
10.7.
10.8.
Damages that may be recovered/158
Computation for loss of earning capacity /159
Basis of award of moral damages/160
Conditions for award of moral damages/160
Legalprovisions mandating award of moral damages/160
Moral damages not recoverable on clearly unfounded suit/161
Temperate or moderate damages/162
Liquidated damages/162
Exemplary or corrective damages/162
Jurisprudence on Damages/162
1.
DR. NINEVETCH CRUZ vs. COURT OF
APPEALS
xxru
Table of Contents
G.R. No. 122445, November 18, 1997/162
2.
ROGELIO E. RAMOS, et al. vs. COURT
OF APPEALS
G.R. No. 124354, December 29, 1999/165
Chapter 11
PHYSICIANS AND CRIMINAL LAW
11.1.
Application of the provisions of the Revised Penal
Code/171
1. Application of the provisions of the Revised Penal Code/111
2. Criminal law/172
3. Limitations on power of Congress to enact penal laws/112
(a)
(b)
(c)
No ex postfacto law shall be enacted/112
No bill of attainder shall be enacted/112
No law that violates equalprotection clause shall be enacted/112
(d) No law which imposes cruel and unusual punishments nor
excessivefinesshall be enacted/112
4. Characteristics of criminal law/112
(a)
General/112
Exceptions:
(b)
(c)
11.2.
(i) Treaty stipulations/112
(ii) Laws of Preferential application/112
(iii) Principles of Public International Law/172
Territorial/112
Prospective/112
Felonies/173
XXIV
Table of Contents
1. Definitions/113
2. Requisites ofdolo/113
(a)
(b)
(c)
3.
Requisites ofculpa/113
(a)
(b)
(c)
4.
5.
6.
7.
8.
9.
10.
11.3.
Freedom/113
Intelligence/113
Intent/113
Freedom/113
Intelligence/113
Negligence and imprudence/ Y13
Elements offelonies/'173
Criminal liability/174
Aberratio ictus/ll4
Error inpersonae/114
Consummated, frustrated, and attempted felonies/114
Conspiracy andproposal to commitfelony /115
Grave felonies, less grave felonies andlightfelonies/'115
Circumstances affecting criminal liability/176
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Justifying circumstances/116
Exempting circumstances/111
Justifying circumstance vs. exempting circumstance/118
Elements of accident without fault or intention of causing it/119
Elements of a person who acts under the compulsion of an irresistibleforce/119
Elements of uncontrollable fear/119
Elements of insuperable cause/119
Entrapment vs. instigation/180
Mitigating circumstances/180
Aggravating circumstances/181
Alternative circumstances /184
XXV
Table of Contents
11.4.
Persons criminally liable for felonies/185
1. Who are criminally liable/185
(a) Principals/185
(b) Accomplices/185
(c) Accessories/185
2.
3.
4.
5.
11.5.
Penalties/186
1.
2.
3.
4.
5.
6.
7.
11.6.
Principals/185
Accomplices/185
Accessories/185
Accessories who are exemptfrom criminal liability/'186
Reclusion perpetual 186
Reclusion temporal/181
Prision mayor and temporary disqualification/181
Prision correctional, suspension, and destierro/181
Arresto mayor/181
Arresto menor/181
Bond to keep the peace /181
Extinction of criminal liability/187
1. Total extinction of criminal liability /181
2. Partial extinction of criminal liability/188
11.7.
Crimes against p u b l i c interest/188
1. Falsification by public officer, employee or notary or ecclesiastic
minister/188
2. Falsification by private individual and use of falsified documents/190
xxvi
Table of Contents
3. False medical certificates, false certificates of merits or service,
etc. /190
4. Usingfalse certificates/190
11.8.
Crimes against persons/190
1.
2.
3.
4.
5.
6.
Parricide/190
Murder/191
Homicide/191
Giving assistance to suicide/192
Infanticide /192
Abortion/192
(a)
(b)
(c)
(d)
(e)
Intentional abortion/192
Unintentional abortion/193
Abortion practiced by the woman herself or by herparents/193
Abortion practiced by a physician or midwife/194
Dispensing of abortive/194
7. Physical injuries/194
(a)
(b)
(c)
(d)
(e)
Mutilation/194
Serious physical injuries /194
Administering injurious substances or beverages/195
Less serious physical injuries/195
Slight physical injuries and maltreatment/195
8. Rape/195
11.9.
Crimes against personal liberty and security/196
1. Kidnapping and serious illegal detention /196
2. Slight illegal detention/191
3. Abandonment of person in danger and abandonment of one's
own victim/191
xxvii
Table of Contents
11.10. Crimes against property/198
1.
2.
3.
4.
Robbery/198
Execution of deeds by means of violence or intimidation /198
Theft/198
Qualified theft/199
11.11. Crimes against chastity/199
1.
2.
3.
4.
5.
Adultery /199
Concubinage / 200
Acts of lasciviousness/200
Qualified seduction/200
Simple seduction/200
(a)
6.
1.
8.
9.
10.
Qualified seduction vs. simple seduction/201
Corruption of minors/201
White slave trade/201
Forcible abduction/201
Consented abduction/201
Sexual perversion or unnatural sexual offenses/201
(a)
Cunnilingus 1201
(b) Exhibitionism / 202
Fellatio/202
Fetishism/202
Lesbianism / 202
Masochism/202
(g) Masturbation/202
(h) Pedophilia/202
® Sadism/202
0) Transvestism/ 203
(k) Voyeurism/203
0) Zoophilia/203
(c)
(d)
(e)
(*)
XXVlll
Table of Contents
11. Anti-Sexual Harassment Act of 1995/ 203
11.12. Crimes against the civil status of persons/207
1. Simulation of births, substitution of one childfor another and
concealment or abandonment of a legitimate child/201
2. Usurpation of civil status/201
11.13. Crimes against honor/208
1. IJbel/208
2. Slander/208
11.14.
Quasi-Offenses/208
1. Reckless negligence or reckless imprudence/208
2. Jurisprudence on reckless imprudence/209
3. Somera Case: Homicide through reckless imprudence/ 2X3
Chapter 12
HOSPITALS AND THE LAW
12.1.
Hospital defined/215
12.2.
Classification of hospitals/216
.1. As to scope of infirmity admitted/216
(a)
General hospital/ 216
(b)
Specialised hospital/216
2. Functional classification/216
(a)
(b)
(c)
(d)
Diagnostic hospital/216
Maternity hospital/216
Rehabilitation hospital/216
Surgical hospital/211
XXIX
Table of Contents
(e)
Cosmetic hospital/211
3. As to control andfinancial support/211
(a)
(b)
Public or government hospital/211
Private hospital/211
(i)
(ii)
12.3.
Private charitable or eleemosynary hospital/211
Private pay hospital/218
Vicarious liability of hospital/218
1. Government orpublic hospital/218
2. Private charitable, voluntary or eleemosynary hospital/218
(a)
(b)
(c)
(d)
3.
12.4.
12.5.
Trustfund doctrine/218
Public policy theory/218
Implied waiver theory/218
Independent contractor theory/218
Private hospital forprofit/218
Jurisprudence on vicarious liability of hospitals/219
1.
P R O F E S S I O N A L SERVICES, I N C . vs.
N A T I V I D A D and E N R I Q U E AGANA
G.R. No. 126297, January 31, 2007/219
2.
ROGELIO P. NOGALES vs. CAPITOL
MEDICAL CENTER
G.R. No. 142625, December 19, 2006/220
Jurisprudence on non-liability of hospital/225
1.
ROGELIO E. RAMOS, et al. vs. COURT
OF APPEALS
G.R. No. 124354, December 29, 1999/225
XXX
Table of Contents
12.6.
12.7
12.8
Attendance to emergencies or serious cases/228
Transfer of patient/228
Hospital Detention Law/229
Chapter 13
PHYSICIANS AND EVIDENCE
13.1.
13.2.
Evidence/231
Qualification of witnesses/231
1.
13.3.
Ordinary witness vs. expert witness/232
Physician-patient privilege/232
1. Requisites ofprivileged communications between doctor and patient/232
2. Scope of the privilege/232
3. Duration of the privilege/233
4. Cases where privilege do not apply/233
5. Legal disclosures/233
6. Duty of confidentiality extends to the hospitals/ 233
13.4.
13.5.
Jurisprudence on physician-patient privilege/234
1.
N E L L Y LIM vs. C O U R T OF APPEALS
G.R. No. 91114, September 25, 1992/234
2.
MA. PAZ F E R N A N D E Z K R O H N vs.
C O U R T OF APPEALS
G.R. No. 108854, June 14, 1994/236
Expert testimony/238
1. Presentation of expert testimonyy'239
XXXI
Table of Contents
(a) Qualifying a witness as an expert/239
(b) Admissibility of expert witness/239
(c) The asking of hypothetical questions/240
(d) It is not proper to include assumptions not supported by
evidence/241
2. Litigation of medical negligence/241
3. Expert testimony generally relied upon in malpractice suits/242
4. When expert testimony dispensed with in malpractice suits/242
5. Competent expert witnesses/242
6. Qualifications/242
13.6.
Jurisprudence on expert witness/243
1.
P E O P L E vs. ROGELIO P E L O N E S
G.R. Nos. 86159-60, February 28, 1994/243
13.7.
13.8.
13.9.
2.
DR. NINEVETCH CRUZ vs. COURT
OF APPEALS
G.R. No. 122445, November 18, 1997/245
3.
ROGELIO E. RAMOS, et al. vs. COURT
OF APPEALS
G.R. No. 124354, December 29,1999/256
4.
LEAH ALESNA REYES, et al. vs.
SISTERS OF MERCY HOSPITAL, et al.
G.R. No. 130547, October 3, 2000/258
Hearsay rule/264
Dying declaration/265
Jurisprudence on hearsay rule/265
1.
MA. PAZ FERNANDEZ KROHN vs.
COURT OF APPEALS
G.R. No. 108854, June 14,1994/265
XXXll
Table of Contents
13.10. Weight and sufficiency of evidence/266
1. Substantial evidence/266
2. Preponderance of evidence/266
3. Proof beyond reasonable doubt/266
Chapter 14
MEDICAL RECORD
14.1.
14.2.
14.3.
14.4.
14.5.
Patient's clinical record/267
What patient's clinical record includes/268
Reasons for patient's clinical record/269
Correcting a handwritten entry on patient's clinical
record/269
Right of access to medical record/269
1.
2.
3.
4.
5.
14.6.
The patient/ 269
The attending doctor/210
The hospital/210
The nurse/210
Insurance and HMO representatives/211
Types of medical records and confidentiality/271
1. Hospital medical records/211
2.
14.7.
Physicians'private office records/211
D o c u m e n t a r y evidence/271
1. Best Evidence Rule/211
2. Secondary Evidence/211
3. Parol Evidence Rule/212
xxxm
Table of Contents
Chapter 15
PHILHEALTH
15.1.
Pertinent laws/273
1. National Health Insurance Act of 1995/213
2. Republic Act No. 9241/213
3. Section 2, Article XIII of the 1987 Constitution/214
15.2.
Philippine Health Insurance Corporation/274
1.
2.
3.
4.
Exemptions from taxes and duties/214
Powers and functions/214
Quasi-judicial powers/211
The Board of Directors/218
(a) Composition/218
(b) Appointment and tenure/280
(c) Meetings and quorum/280
(d) Allowances and per diems/ 280
15.3.
15.4.
History/280
Definition of Terms/282
1. Beneficiary/282
2. Benefit Package/282
3. Capitation/282
4. Contribution/282
5. Coverage/282
6. Dependent /282
7. Diagnostic procedure/283
8. Emergency / 283
9. Employee/283
10 . Employer/283
XXXIV
Table of Contents
11. Enrollment/283
12. Fee for service/283
13.
Global budget/283
14. Government Service Insurance System/284
15. Health Care Provider /284
16. Health Insurance Identification (ID) Card/285
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
15.5.
Indigent/285
Inpatient education package/285
Member/285
Means test/285
Medicare/286
National Health Insurance Program/286
Pensioner/286
Personal Health Services/286
Philippine Medical Care Commission/286
Philippine National Drug Formulary/286
Portability/281
Prescription drug/281
Public health services/281
Quality assurance/ 281
Residence/281
Retiree/281
Self-employed/281
Social Security System/288
Treatment procedure/288
Utilisation review1288
Rehabilitation center/288
Home care and medical rehabilitation services/288
National Health Insurance Fund/288
1.
2.
3.
The basic benefit fund/289
Supplementary benefit funds / 290
Reserve fund/290
XXXV
Table of Contents
15.6.
Membership/294
1. Initial members in 1995/294
2. Classification of current members/ 294
(a)
(b)
(c)
(d)
Paying Members/294
Indigent member/294
Privately-sponsored member/294
Non-paying member/294
3. Requirementfor registration/'294
4. Requirementsfor declaration of dependents/295
5. Requirementsfor registration ofemployers/'295
15.7.
Accreditation/296
1. Requirements/296
2. Additional requirements for hospitals / 291
3. Additional requirements for physicians/ 298
15.8.
Benefit package/298
1. What the benefit package includes/298
2. What are excluded unless recommended by Philhealth/299
15.9. Premium contributions/299
15.10. Penalties/300
Chapter 16
MEDICAL E T H I C S
16.1.
16.2.
16.3.
Ethics/302
Medical ethics/302
Definition of terms/303
XXXVI
Table of Contents
1.
2.
3.
4.
5.
6.
7.
8.
9.
Ethics/303
Medical etiquette/303
Bioethics/304
Bioethical issue/304
Ethical dilemma/304
Moral reasoning/304
Values/304
Moral uncertainty/304
Moral or ethicalprinciples/ 304
(a) Autonomy/304
(b) Beneficence/305
(c) Nonmaleficence / 305
(d) Justice/305
(e) Fidelity/305
(f)
16.4.
16.4.
Thinking ethically/305
Approaches to ethical dilemma/306
1. Beneficence/309
2. Autonomy/310
3. Justice/311
16.5.
Resolving ethical problems/312
Chapter 17
CODES OF ETHICS
17.1.
17.2.
Code of ethics/310
Historical codes/314
1.
2.
Oath and Law of Hippocrates/315
The Oath ofHippocrates/316
xxxvii
Table of Contents
17.3.
17.4.
17.5.
Philippine Medical Association/318
PMA Code of Ethics of the Medical Profession/320
Board of Medicine Code of Ethics/325
Chapter 18
CASE STUDIES ON MEDICAL ETHICS
18.1.
18.2.
18.3.
18.4.
18.5.
18.6.
18.7.
18.8.
18.9.
18.10.
18.11.
18.12.
Case study re: cultural misunderstandings in the
medical care of cancer patient/340
Case study re: raising issues of culturally competent
health care for a muslim woman/357
Case study re: public guardian in charge of the medical care for a conserved patient/378
Case study re: public guardian in charge of an old
woman with multiple illnesses/380
Case study re: prevention vs. treatment in HIV/AIDS
program/381
Case study re: decision to discontinue life-sustaining
treatment/383
Case study on addressing ethical issues confronting
governments, NGOs, and pharmaceutical companies
when faced with an epidemic/386
Case Study on what should a physical therapist do
when she suspects that her patient isn't being entirely
honest with his physician/391
Case Study on the ethical questions involved when a
company is the only supplier of a high-risk, life-saving
product/393
Case Study whether physicians have a duty to refer
patients to alternative forms of therapy/395
Case study re: maternal vs. fetal rights/400
Case study on assisted suicide/404
XXXVlll
Table of Contents
Chapter 19
RIGHTS AND DUTIES OF PATIENTS
19.1.
19.2.
19.3.
Universal bill of rights of patient /407
Duties of patient/409
Dying person's bill of rights/413
Chapter 20
INFORMED CONSENT
20.1.
20.2.
Informed consent defined/412
Subject matter of informed consent/413
1. Non-consensualphysical contact/4X3
2. Non-consensual medical treatment andprocedure/ 414
(a)
20.3.
20.4.
20.5.
20.6.
GEORGETTE MALETTE vs. DAVID
SHULMAN
Ontario Court of Appeal No. 29-88, Mar. 30,
1990/414
Doctrines re informed consent/418
Elements of informed consent/419
Kinds of consent/422
Who can give informed consent/422
1.
2.
3.
4.
5.
6.
7.
The patient/ 422
The spouse/422
The eldest child/422
The parents of the patient/423
The grandparents of the patient/423
The brother or sister of the patient/ 423
The nearest kin available/423
XXXIX
Table of Contents
8.
20.7.
20.8.
20.9.
20.10.
20.11.
20.12.
20.13.
20.14.
20.15.
The State/424
Instances where no consent is needed/424
Competency/424
Test for mental capacity/425
Questions to ask/426
Assessment of consent/426
Examples of informed consent/427
Surgery/428
Research/429
Jurisprudence on informed consent/430
1.
ROGELIO P. NOGALES vs. CAPITOL
MEDICAL CENTER
G.R. No. 142625, December 19, 2006/430
APPENDICES
A P P E N D I X 1 - Republic Act No. 9502 - Universally Accessible
Cheaper and Quality Medicines Act of 2008/435
A P P E N D I X 2 - Republic Act No. 9484 - The Philippine Dental Act
of2OO7/461
A P P E N D I X 3 - Republic Act No. 9439 - An Act Prohibiting the
Detention of Patients in Hospitals and Medical Clinics on Grounds
of Non-payment of Hospital Bills or Medical Expenses/486
A P P E N D I X 4 - Republic Act No. 9173 - Philippine Nursing Act of
2002/488
A P P E N D I X 5 - EXCERPTS
FROM Republic Act No. 9165 Dangerous Drugs Act of 2002/506
xl
Table of Contents
A P P E N D I X 6 - Republic Act No. 8981 - PRC Modernisation Act of
2000/526
A P P E N D I X 7 - Republic Act No. 8423 - Traditional and Alternative
Medicine Act (TAMA) of 19971543
A P P E N D I X 8 - Republic Act No. 8344 - An Act Penalising the
Refusal of Hospitals and Medical Clinics to Administer Appropriate
Initial Medical Treatment and Support in Emergengi or Serious
Cases, Amendingfor the Purpose B.P. 702, (An Act Prohibiting the
Demand of Deposits or Advance Payments for the Confinement or
Treatment of Patients in Hospitals and Medical Clinics in Certain
Cases)/ 558
A P P E N D I X 9 - Republic Act No. 8050 - Revised Optometty Law of
1995/562
A P P E N D I X 10 - Republic Act No. 7600 - The Rooming-In and
Breastfeeding Act of 1992/580
A P P E N D I X 11 - Republic Act No. 7392 - Philippine Midwifery Act
of 1992/581
A P P E N D I X 12 - Republic Act No. 7305 - Magna Carta of Public
Health Workers/598
A P P E N D I X 13 - Republic Act No. 7170 - Organ Donation Act of
1991 (As Amended on February 20, 1995)/ 614
A P P E N D I X 14-Republic Act No. 6675-The
(As amended by R^A. 9502)/ 623
Generics Act of 1988
A P P E N D I X 15 - EXCERPTS FROM Republic Act No. 5921 An Act Regulating the Practice of Pharmacy and Setting Standards
of Pharmaceutical Education in the Philippines and of Other Purposes/631
xli
Table of Contents
A P P E N D I X 16 - Republic Act No. 5680 - Philippine Physical and
Occupational Therapy Law/635
A P P E N D I X 17 - Republic Act No. 2382 - The Medical Act of 1959
(As amended by R.A. 5946 and R.A. 4224)/650
A P P E N D I X 18 - PRC Resolution No. 06-342 (A), Series of 2006 New Rules of Procedure in Administrative Investigations in the PRC
and the Professional Regulatory Boards/669
Bibliography/699
Glossary/104
Index /719
—oOo—
xlii