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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

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Foreword/in Preface/vii

Acknowledgments I-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. Responsibilities to patient I \

2. Responsibilities to the profession / 6

3. Responsibilities to colleagues/l 4. Responsibilities to society 11

5. Responsibilities to allied health professionals I % 1.4. Medical law/9

1.5. History of Philippine medical law/ll 1.6. Place of law in the medical profession/ll 1.7. Functions of the law in medicine/12 1.8. Sources of law/13

1. Statutory law I Xh

2. Constitutional law I'13

3. Administrative law/13 4. Common Iaw/l3

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1.9 Classification of law/14 1. Public law I'16

(a) Criminal law/16 (b) International law/16

(i) Public international law 116 (ii) Private international law/16 (c) Political law/16

(i) Constitutional law/16 (ii) Administrative law/11

(iii) I ^ w of public administration/XI (iv) J^zw of public corporation / \1

2. Private law/Yl

(a) Civil law/\1 (b) Commercial law/\l (c) Remedial law/Yl 1.10. Medical legislation/18 1.11. Medical ethics/18 1.12. Common legal terms/18

1. Torts/li 2. Deposition/is 3. Plaintiff/18 4. Defendant/18 5. Defamation/\% 6. Expert witness/18 7. GcW Samaritan LMW/19 8. Interrogatory/19 9. Malpractice/'19 10. Negligence/19

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11. 12. Proximate Reasonable cause/19 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. Commission on Higher Education (CHED)/25

3.2. Association of Philippine Medical Colleges/26

3.3. Admission requirements to a medical college/26

1. National Medical Admission Test (NMA T)/27 (a) Three-Flunk Rule/21

(b) Academic freedom, not absolute/28 (c) Equal protection not violated/2%

3.4. Medical school curriculum/29 3.5. Clinical clerkship/29

3.6. Medical education credentials awarded/30 3.7. Medical internship/30

1. Medical internship progam /30

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Chapter 4

LICENSURE AND REGISTRATION OF PHYSICIANS

4.1. Licensure/31

1. Qualifications of candidates for board examinations/'31 2. Scope of examination/32

3. Documents to accompany an application for licensure

examina-tion/32

4. Passing rate/33

4.2. Oath taking and conferment ceremonies/34 1. The Hippocratic Oath/ 34

2. Administrative Oath/3b 4.3. Certificate of registration/36

1. Right to be registered as physicians/36 2. Rule of reciprocity / 39

3. Grounds for refusal of issuance of certificates of registration/41

4. Duty of the Board of Medicine to issue certificates ofregistra-tion/'42

5. Grounds for reprimand, suspension or revocation of registration

certificate/^

6. Rights of 'respondents/'45 7. Appeal for judgment/ \6 8. Reinstatement/ M

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Chapter 5

PROFESSIONAL REGULATORY BOARD OF MEDICINE

5.1. Professional Regulation Commission/48 5.2. Powers of the PRC/50

1. As administrative body/50

2. As quasi-legislative body/50

3. As quasi-judicial body/50

5.3. B o a r d of M e d i c i n e / 5 2

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 the right to salary/51

8. Prohibition against additional or double compensation/51 9. Powers, functions and responsibilities of the various professional

regulatory boards/51

5.4. Authority of t h e B o a r d M e d i c i n e t o d e t e r m i n e s t a n d -i n g of m e d -i c a l schools/60

5.5. Applicability of right a g a i n s t self-incrimination before the Board of M e d i c i n e / 6 1

5.6. P M A with L e g a l Personality t o Q u e s t i o n Authority of B o a r d of M e d i c i n e / 6 2

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Chapter 6

PRACTICE OF MEDICINE 6.1. Practice of Medicine/64

6.2. Prerequisite to the Practice of Medicine/64 6.3. Acts Constituting Practice of Medicine/65

6.4. Cases on Acts Constituting Practice of Medicine/65 1. Acceptance of compensation without proper certificate

ofregistra-tion/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 the title ofM.D. after one's name/61 6.5. Acts not construed to be practice of medicine by

provision of law/67

6.6. Acts not construed to be practice of medicine by decisions of courts/69

6.7. Faith healing, healing by prayer or divine healing/69 1. Psychic surgery and spiritualism/10

6.8. Limited practice without any certificate of registra-tion/71

6.9. Penalties for illegal practice of medicine/73 6.10. 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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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) Partnership/16 (b) Corporation /16

Chapter 7

PHYSICIANS AND CONSTITUTION 7.1. Constitution/77

7.2. The Philippine State/ 77 1. People 111

2 Territory/1',

(a) The Philippine national territory/'78 3. Government/18

(a) Executive branch/18

G)

(iii) (iv)

W

(vi) (vii) (viii) (ix) Appointingpower/'78 Removal power/18 Control power/18 Military power/19 Pardoning power/19 Borrowing power/19 Diplomatic power/19 Budgetary power/19 Informing power/19 XV

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(b) Legislative branch/19

(i) Appropriation power/19 (ii) Taxation power/19 (iii) 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. Due process/ 80 2. Equal protection / 81 3. Searches and seizure/81

4. Privacy of communication and correspondence / 8\ 5. Freedom of speech and expression / 81

6. Liberty of abode and travel/82 7. R/g/f/ /<> information / 82 8. R/g/tf to form associations / 82

9. R/gA/ /o compensation in expropriation cases/'82 10. The impairment clause/82

11. Fn?e # « m /o courts/ 83 12. Miranda rights/83

7.5. Rights Inherent in the Practice of Medicine/83 1. Right to choose patients/ 83

2. Right to limit the practice of medicine / 8\

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3. Right to determine appropriate procedure / 8\

4. Right to avail of hospital services/'84

7.6. Rights Incidental to the Practice of Medicine/84

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 and private services/85 6. Right to perform certain services/85

1.1. Citizenship/85

1. Doctrine of jus sanguinis/86

2. Doctrine of jus soli/86

Chapter 8

PHYSICIANS A N D 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) Consensual/89 (b) Fiduciary/90

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8.3. Essential Requisites of Contracts/ 90 1. Consent/ 90

2. Object or subject matter/91

(a) Types of medical care/92

(i) General and family practice/92 (ii) 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) Simple contractual fee/96 (ii) Retainer fee/91

(iii) Contingent fee/91

(iv) Commission or fee splitting or dichotomous fee/98 (v) Straight fee or package deal agreement/98 (c) Reasonableness of medical fees/98

(d) Medical billing/99

(i) Payment at time of services/'99 xvm

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(ii) Billing when extension of credit is necessary/99 (iii) Using outside collection assistance/100 (e) Salary scale of public health workers/100

(i) Salary scale/100

(ii) Equality in salary scale/101

(iii) Salaries to be paid in legal tender/101 (iv) Deductions prohibited/101

(f) Additional compensation/101 (i) Hazard allowance/102 (ii) Subsistence allowance/102 (iii) Longevity pay/103

(iv) Laundry allowance/103

(v) Remote assignment allowance/'104

8.4. Forms of Contractual Relationship/104

8.5. Cases when there is no physician-patient relation-ship/105

8.6. 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

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Chapter 9

PHYSICIANS AND TORTS 9.1. Torts/112

9.2. Professional Liability/112

9.3. Classifications of Medical Professional liability/113 1. Feasance/ \13

2. Malfeasance / 1V>

3. Misfeasance/113 4. Nonfeasance/113

9.4. Medical Malpractice or Negligence Cases/113 9.5. T h e 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. Medical Malpractice/117

9.8. Sample Cases of Medical Malpractice/117 1. Unauthorised and unknown experimentation /ill

2. Failure to perform C-section and failure to recognise and treat sei-zures in the period following the birth/ill

3. Surgical injury/\18

4. Failure to recognise and treat heart attack/118

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5. Surgical precipitation 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. W I L F R E D O

L. PASCASIO, et al.

G.R. No. 118141, September 5, 1997/120

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 9.10. Doctrines applied in medical practice cases/135 9.11. Doctrine of respondeat superior or doctrine of

vicari-ous liability or doctrine of imputed negligence or command responsibility/135

1. Doctrine of ostensible agent or holding out theory or agency by

es-toppel/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

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9.12. Jurisprudence on respondeat superior/141

1. ROGELIO E. RAMOS, et al. vs. COURT OF APPEALS

G.R. No. 124354, December 29, 1999/141

9.13. Doctrine of res ipsa loquitur or common knowledge doctrine/142

1. Requisites of res ipsa loquitur/142

2. Application of res ipsa loquitur in medical malpractice/143

3. Res ipsa loquitur, when applicable/143 4. Res ipsa loquitur, when not applicable/143 9.14. 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

9.15. Doctrine of contributory negligence (doctrine of common fault)/ 152

9.16. Doctrine of continuing negligence/152 9.17. Doctrine of assumption of risk/153 9.18. Doctrine of last clear chance/153 9.19. Doctrine of foreseeability/154

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1. Force majeure/154

2. Act of God/154

3. Accident/155

9.20. Fellow servant doctrine/155

9.21. Rescue doctrine or Good Samaritan Law/155 9.22. Deep pocket rule/156

9.23. Factors increasing medical malpractice cases/156 Chapter 10

PHYSICIANS AND DAMAGES 10.1. Damages/158

1. Damages that may be recovered/158

2. Computation for loss of earning capacity /159 10.2. D a m n u m absque injuria/159

10.3. Actual damages/159 10.4. Moral damages/159

1. Basis of award of moral damages/160 2. Conditions for award of moral damages/160

3. Legal provisions mandating award of moral damages/160

4. Moral damages not recoverable on clearly unfounded suit/161

10.5. Temperate or moderate damages/162 10.6. Liquidated damages/162

10.7. Exemplary or corrective damages/162 10.8. Jurisprudence on Damages/162

1. DR. NINEVETCH CRUZ vs. COURT OF APPEALS

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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) No ex post facto law shall be enacted/112

(b) No bill of attainder shall be enacted/112

(c) No law that violates equal protection clause shall be

en-acted/112

(d) No law which imposes cruel and unusual punishments nor

excessive fines shall be enacted/112

4. Characteristics of criminal law/112 (a) General/112

Exceptions:

(i) Treaty stipulations/112

(ii) Laws of Preferential application/112 (iii) Principles of Public International Law/172 (b) Territorial/112

(c) Prospective/112 11.2. Felonies/173

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1. Definitions/113 2. Requisites ofdolo/113 (a) Freedom/113 (b) Intelligence /113 (c) Intent/113 3. Requisites ofculpa/113 (a) Freedom/113 (b) Intelligence /113

(c) Negligence and imprudence/ Y13 4. Elements of felonies/'173

5. Criminal liability/174 6. Aberratio ictus/ll4 7. Error inpersonae/114

8. Consummated, frustrated, and attempted felonies/114 9. Conspiracy and proposal to commit felony /115

10. Grave felonies, less grave felonies andlightfelonies/'115

11.3. Circumstances affecting criminal liability/176

1. Justifying circumstances/116

2. Exempting circumstances/111

3. Justifying circumstance vs. exempting circumstance/118 4. Elements of accident without fault or intention of causing it/119 5. Elements of a person who acts under the compulsion of an

irre-sistible force/119

6. Elements of uncontrollable fear/119 7. Elements of insuperable cause/119 8. Entrapment vs. instigation/180 9. Mitigating circumstances/180 10. Aggravating circumstances/181 11. Alternative circumstances /184

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11.4. Persons criminally liable for felonies/185 1. Who are criminally liable/185

(a) Principals/185 (b) Accomplices/185 (c) Accessories/185 2. Principals/185 3. Accomplices/185 4. Accessories/185

5. Accessories who are exempt from criminal liability/'186 11.5. Penalties/186

1. Reclusion perpetual 186

2. Reclusion temporal/181

3. Prision mayor and temporary disqualification/181 4. Prision correctional, suspension, and destierro/181 5. Arresto mayor/181

6. Arresto menor/181

7. Bond to keep the peace /181 11.6. Extinction of criminal liability/187

1. Total extinction of criminal liability /181 2. Partial extinction of criminal liability /188 11.7. C r i m e s a g a i n s t 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

docu-ments/190

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3. False medical certificates, false certificates of merits or service,

etc. /190

4. Usingfalse certificates/190

11.8. Crimes against persons/190

1. Parricide/190

2. Murder/191

3. Homicide/191

4. Giving assistance to suicide/192 5. Infanticide /192

6. Abortion/192

(a) Intentional abortion/192 (b) Unintentional abortion/193

(c) Abortion practiced by the woman herself or by

herpar-ents/193

(d) Abortion practiced by a physician or midwife/194 (e) Dispensing of abortive/194

7. Physical injuries/194 (a) Mutilation/194

(b) Serious physical injuries /194

(c) Administering injurious substances or beverages/195 (d) Less serious physical injuries/195

(e) 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

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11.10. Crimes against property/198 1. Robbery/198

2. Execution of deeds by means of violence or intimidation /198

3. Theft/198

4. Qualified theft/199

11.11. Crimes against chastity/199 1. Adultery /199

2. Concubinage / 200

3. Acts of lasciviousness/200 4. Qualified seduction/200 5. Simple seduction/200

(a) Qualified seduction vs. simple seduction/201 6. Corruption of minors/201

1. White slave trade/201

8. Forcible abduction/201 9. Consented abduction/201

10. Sexual perversion or unnatural sexual offenses/201 (a)

(b)

(c) (d) (e) (*)

(g)

(h)

®

0)

(k)

0)

Cunnilingus 1201 Exhibitionism / 202 Fellatio/202 Fetishism/202 Lesbianism / 202 Masochism/202 Masturbation/202 Pedophilia/202 Sadism/202 Transvestism/ 203 Voyeurism/203 Zoophilia/203 XXVlll

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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 child for 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) Diagnostic hospital/216 (b) Maternity hospital/216 (c) Rehabilitation hospital/216 (d) Surgical hospital/211

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(e) Cosmetic hospital/211

3. As to control and financial support/211 (a) Public or government hospital/211 (b) Private hospital/211

(i) Private charitable or eleemosynary hospital/211 (ii) Private pay hospital/218

12.3. Vicarious liability of hospital/218 1. Government or public hospital/218

2. Private charitable, voluntary or eleemosynary hospital/218

(a) Trust fund doctrine/218 (b) Public policy theory/218 (c) Implied waiver theory/218

(d) Independent contractor theory/218 3. Private hospital for profit/218

12.4. Jurisprudence on vicarious liability of hospitals/219 1. P R O F E S S I O N A L S E R V I C E S , I N C . vs.

N A T I V I D A D and E N R I Q U E AGANA

G.R. N o . 126297, January 31, 2007/219

2. ROGELIO P. NOGALES vs. CAPITOL MEDICAL CENTER

G.R. No. 142625, December 19, 2006/220 12.5. 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

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12.6. Attendance to emergencies or serious cases/228

12.7 Transfer of patient/228

12.8 Hospital Detention Law/229

Chapter 13

PHYSICIANS AND EVIDENCE

13.1. Evidence/231

13.2. Qualification of witnesses/231

1. Ordinary witness vs. expert witness/232

13.3. Physician-patient privilege/232

1. Requisites of privileged communications between doctor and

pa-tient/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. Jurisprudence on physician-patient privilege/234 1. N E L L Y LIM vs. C O U R T O F APPEALS G.R. N o . 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 O F APPEALS G.R. N o . 108854, June 14, 1994/236 13.5. Expert testimony/238

1. Presentation of expert testimony y'239

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(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 o n expert witness/243 1. P E O P L E vs. R O G E L I O P E L O N E S

G.R. Nos. 86159-60, February 28, 1994/243

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

13.7. Hearsay rule/264

13.8. Dying declaration/265

13.9. Jurisprudence on hearsay rule/265

1. MA. PAZ FERNANDEZ KROHN vs.

COURT OF APPEALS

G.R. No. 108854, June 14,1994/265

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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. Patient's clinical record/267

14.2. What patient's clinical record includes/268 14.3. Reasons for patient's clinical record/269

14.4. Correcting a handwritten entry on patient's clinical record/269

14.5. Right of access to medical record/269

1. The patient/ 269

2. The attending doctor/210

3. The hospital/210

4. The nurse/210

5. Insurance and HMO representatives/211

14.6. Types of medical records and confidentiality/271

1. Hospital medical records/211

2. Physicians' private office records/211

14.7. 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

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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. Exemptions from taxes and duties/214 2. Powers and functions/214

3. Quasi-judicial powers/211 4. 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. History/280

15.4. Definition of Terms/282

1. 2. 3. 4. 5. 6. 7. 8. 9. 10 Beneficiary/282 Benefit Package/282 Capitation/282 Contribution/282 Coverage/282 Dependent /282 Diagnostic procedure/283 Emergency / 283 Employee/283 . Employer/283 XXXIV

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11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. Enrollment/283 Fee for service/283 Global budget/283

Government Service Insurance System/284 Health Care Provider /284

Health Insurance Identification (ID) Card/285 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 review 1288 Rehabilitation center/288

Home care and medical rehabilitation services/288 15.5. National Health Insurance Fund/288

1. The basic benefit fund/289

2. Supplementary benefit funds / 290

3. Reserve fund/290

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15.6. Membership/294

1. Initial members in 1995/294

2. Classification of current members/ 294

(a) Paying Members/294 (b) Indigent member/294

(c) Privately-sponsored member/294 (d) Non-paying member/294 3. Requirement for registration/'294

4. Requirements for declaration of dependents/295 5. Requirements for 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 p a c k a g e / 2 9 8

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. Ethics/302 16.2. Medical ethics/302 16.3. Definition of terms/303 XXXVI

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1. Ethics/303 2. Medical etiquette/303 3. Bioethics/304 4. Bioethical issue/304 5. Ethical dilemma/304 6. Moral reasoning/304 7. Values/304 8. Moral uncertainty/304 9. Moral or ethical principles/ 304

(a) Autonomy/304 (b) Beneficence/305 (c) Nonmaleficence / 305 (d) Justice/305 (e) Fidelity/305 (f) 16.4. Thinking ethically/305

16.4. 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. Code of ethics/310

17.2. Historical codes/314

1. Oath and Law of Hippocrates/315 2. The Oath of Hippocrates/316

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17.3. Philippine Medical Association/318

17.4. PMA Code of Ethics of the Medical Profession/320 17.5. Board of Medicine Code of Ethics/325

Chapter 18

CASE STUDIES ON MEDICAL ETHICS 18.1. Case study re: cultural misunderstandings in the

medical care of cancer patient/340

18.2. Case study re: raising issues of culturally competent health care for a muslim woman/357

18.3. Case study re: public guardian in charge of the medi-cal care for a conserved patient/378

18.4. Case study re: public guardian in charge of an old woman with multiple illnesses/380

18.5. Case study re: prevention vs. treatment in HIV/AIDS program/381

18.6. Case study re: decision to discontinue life-sustaining treatment/383

18.7. Case study on addressing ethical issues confronting governments, NGOs, and pharmaceutical companies when faced with an epidemic/386

18.8. Case Study on what should a physical therapist do when she suspects that her patient isn't being entirely honest with his physician/391

18.9. Case Study on the ethical questions involved when a company is the only supplier of a high-risk, life-saving product/393

18.10. Case Study whether physicians have a duty to refer patients to alternative forms of therapy/395

18.11. Case study re: maternal vs. fetal rights/400 18.12. Case study on assisted suicide/404

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Chapter 19

RIGHTS AND DUTIES OF PATIENTS 19.1. Universal bill of rights of patient /407

19.2. Duties of patient/409

19.3. Dying person's bill of rights/413 Chapter 20

INFORMED CONSENT 20.1. Informed consent defined/412

20.2. Subject matter of informed consent/413 1. Non-consensual physical contact/4X3

2. Non-consensual medical treatment and procedure/ 414

(a) GEORGETTE MALETTE vs. DAVID SHULMAN

Ontario Court of Appeal No. 29-88, Mar. 30, 1990/414

20.3. Doctrines re informed consent/418 20.4. Elements of informed consent/419 20.5. Kinds of consent/422

20.6. Who can give informed consent/422 1. The patient/ 422

2. The spouse/422

3. The eldest child/422

4. The parents of the patient/423 5. The grandparents of the patient/423 6. The brother or sister of the patient/ 423

7. The nearest kin available/423

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8. The State/424

20.7. Instances where no consent is needed/424

20.8. Competency/424

20.9. Test for mental capacity/425

20.10. Questions to ask/426

20.11. Assessment of consent/426

20.12. Examples of informed consent/427

20.13. Surgery/428

20.14. Research/429

20.15. 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

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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 Generics Act of 1988 (As amended by R^A. 9502)/ 623

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 Pur-poses/631

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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. 06342 (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—

References

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