Legal Medicine (Atty.

Capule) Midterm Notes (As per pointers)

I. RA 8344 DEMAND OF DEPOSITS

especially in the case of poor or indigent patients

(Sec. 3, RA 8344)

Is it unlawful to demand a deposit?

Item 3 of IRR of RA 8344 provides:

NO. It becomes unlawful when the deposit/advance

payment is demanded as a prerequisite for
confinement or medical treatment of a patient in
such hospital or medical clinic or to refuse to
administer medical treatment and support as
dictated by good practice of medicine to prevent
death or permanent disability

1. The transferring and receiving hospital, shall

be as much as practicable, be within ten (10)
kilometer radius of each other.
2. The transfer of patients contemplated under
this Act shall at all times be properly
documented.
3. Hospitals may require a deposit or advance
payment when the patient is no longer under
the state of emergency and he/she refuses to
be transferred.

Is refusal unlawful?
NO. If there is strict compliance with the procedure
on transfer, it is not construed as refusal.

When are hospitals required to extend medical

services?

Procedure / Requisites for valid transfer:

1. there is inadequacy of medical capabilities
of the hospital
2. the patient or his next of kin consents to the
transfer, provided that if the patient is
unconscious, incapable of giving consent
and/or unaccompanied, the physician can
transfer the patient even without his consent
3. The receiving hospital or medical clinic
agrees to the transfer
4. such transfer shall be done only after
necessary emergency treatment and support
have been administered to stabilize the
patient
5. that it has been established that such transfer
entails less risks than the patient's continued
confinement

Hospitals are required to render immediate medical

assistance and provide facilities and medicine
within its capabilities on emergency cases, where
patients are in danger of dying and/or suffering
serious physical injuries, (Sec. 1, RA 6615)
Note: Doctrine of Reasonable Reliance Hospital
without emergency services allowed; Provided, that
there is an announcement to the community that
such hospital has no emergency services, so the
people in the community will not rely on the
hospital for such emergency services.
II. RA 9439 DETENTION OF PATIENTS
(NOTE: The provisions of RA 9439 is NOT
APPLICABLE to patients who stayed in private
rooms)

No hospital or clinic, after being informed of the

medical indications for such transfer, shall
refuse to receive the patient nor demand from
the patient or his next of kin any deposit or
advance payment

Is it unlawful to detain patients for non-payment

of hospital bills/medical expenses?
YES. Sec. 1 provides that it shall be unlawful for
any hospital or medical clinic in the country to
detain or to otherwise cause, directly or
indirectly, the detention of patients who have fully
or partially recovered or have been adequately
attended to, or who may have died, for reasons of

Transfer of Patients
After the hospital or medical clinic mentioned
above shall have administered medical treatment
and support, it may cause the transfer of the patient
to an appropriate hospital consistent with the needs
of the patient, preferably to a government hospital,
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Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)

of the medical sector quickens, and the regeneration

of the people as a whole becomes more visibly
attainable. In the institution of cost-cutting
measures, the hospital has a right to reduce the
facilities and services that are deemed to be nonessential, such that their reduction or removal would
not be detrimental to the medical condition of the
patient.

non-payment in part or in full of hospital bills or

medical expense.
Rights of patients that have fully or partially
recovered, and already wish to leave the hospital or
medical clinic, BUT financially incapable to settle
medical expenses
1. right to leave the hospital or medical clinic
2. right to demand the issuance of the
corresponding medical certificate and other
pertinent papers required for the release of
the patient from the hospital or medical
clinic upon the execution of a promissory
note covering the unpaid obligation
3. In case of a deceased patient, any surviving
relative has the right to demand the
corresponding death certificate and other
documents required for interment and other
purposes. (Also, under PD 651, hospitals
are required to issue a death certificate even
if hospital bills are not yet paid)

For the moment, the question to be considered is

whether the subject facilities are indeed nonessential - the air-conditioner, telephone, television,
and refrigerator the removal of which would cause
the adverse health effects and emotional trauma the
respondents so claimed. Corollary to this question is
whether the petitioner observed the diligence of a
good father of the family in the course of
ascertaining the possible repercussions of the
removal of the facilities prior to the removal itself
and for a reasonable time thereafter, with a view to
prevent damage.
After an extensive analysis of the record, it becomes
rather worrisome to this Court that the courts a quo
unreservedly drew their conclusions from the selfserving and uncorroborated testimonies of the
respondents the probative value of which is highly
questionable. We hold that the respondents failed to
prove the damages so claimed.

Execution of promissory note is required

The rights of the patients can only be exercised after
executing and securing a promissory note, either by
a mortgage or by a guarantee of a co-maker, who
will be jointly and severally liable with the patient
for the unpaid obligation.

The evidence in the record firmly establishes that

the staff of the petitioner took proactive steps to
inform the relatives of respondent Chua of the
removal of facilities prior thereto, and to carry out
the necessary precautionary measures to ensure that
her health and well-being would not be adversely
affected.

The hospital can choose the guarantor or the comaker. It has the right to make sure that the comaker is capable of paying or fulfilling the
obligation.
Case: Manila Doctors v. Chua and Ty
Ruling: The operation of private pay hospitals and
medical clinics is impressed with public interest and
imbued with a heavy social responsibility. But the
hospital is also a business, and, as a business, it has
a right to institute all measures of efficiency
commensurate to the ends for which it is designed,
especially to ensure its economic viability and
survival. And in the legitimate pursuit of economic
considerations, the extent to which the public may
be served and cured is expanded, the pulse and life

A patient cannot be detained in a hospital for nonpayment of the hospital bill The form of restraint
must be total; movement must be restrained in all
directions. If restraint is partial, e.g., in a particular
direction with freedom to proceed in another, the
restraint on the person's liberty is not total.
However, the hospital may legally detain a
patient against his will when he is a detained or
convicted prisoner, or when the patient is
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Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)

suffering from a very contagious disease where

his release will be prejudicial to public health, or
when the patient is mentally ill such that his
release will endanger public safety, or in other
exigent cases as may be provided by law.

IV. RECIPROCITY
The registration or issuance of license of a foreigner
professional rests in the PRC. The requirements for
registration or licensing, however, must be
substantially the same as those required and
contemplated by the laws of the Philippines. It is
further required that the laws of the foreign start
allow the citizens of the Philippines to practice their
profession on the same basis, grant, and privileges
as those enjoyed by the citizens of the foreign
country.

Authorities are of the view that, ordinarily, a

hospital, especially if it is a private pay hospital, is
entitled to be compensated for its services, by either
an express or an implied contract, and if no express
contract exists, there is generally an implied
agreement that the patient will pay the reasonable
value of the services rendered; when a hospital
treats a patient's injuries, it has an enforceable claim
for full payment for its services, regardless of the
patient's financial status.

Case: Board of Medicine v. Ota

Facts: Ota is a Japanese national, married to a
Filipina, has been residing in the PH for more than
10 years, and graduated Doctor of Medicine. He
filed an application to take the board exams. PRC
requires him to submit affidavit stating that if he
passes the boards, he cannot practice medicine until
he submits proof that reciprocity exists between
Japan and the Philippines in admitting foreigners
into the practice of medicine. Ota submitted a duly
notarized English translation of the Medical
Practitioners Law of Japan duly authenticated by
the Consul General of the Philippine Embassy to
Japan. He was allowed to take the boards and he
passed. In spite of all these, the Board of Medicine
denied Otas request for a license to practice
medicine in the Philippines on the ground that no
genuine reciprocity can be found in the law of
Japan, as there is no Filipino or foreigner who can
possibly practice there. Ota filed petition before the
RTC. RTC ruled in favor of Ota stating that there is
adequate proof that there exists a principle of
reciprocity and ordering PRC to issue the license.
PRC appealed to CA. CA affirmed RTC Ruling.

III. PRC IDENTIFICATION

Powers, Functions, and Responsibilities of the
Commission (Sec. 7)
PRC upon recommendation of the PR Board
concerned has power to approve the registration
and authorize issuance of certificate or license of
registration and professional ID card
To supervise foreign nations who are authorized by
existing laws to practice their professions either as
holders of a certificate of registration and a
professional identification card or a temporary
special permit in the Philippines;
To supervise professionals who were former
citizens of the Philippines and who had been
registered and issued a certificate of registration and
a professional identification card prior to their
naturalization as foreign citizens, who may, while in
the country on a visit, sojourn or permanent
residence, practice their profession:

Issue: Whether or not the principle of reciprocity

exists.

Provided, that prior to the practice of their

profession they shall have first been issued a
special permit and updated professional
identification card by the Board concerned
subject to approval by the Commission and
upon payment of the permit and annual
registration fees

Held: Yes. The contention of the PRC that the

requirements to practice medicine in Japan are
practically impossible for a Filipino to comply with,
there are also ambiguities in the Medical
Practitioners Law of Japan, and there had not been a
3

Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)

single Filipino who was issued a license to practice

medicine by the Japanese Government is untenable.
What the law requires is for the foreigner to
show proof that a Filipino can practice in his
foreign country. It is enough that the laws in the
foreign country permit a Filipino to get license and
practice therein. Requiring respondent to prove first
that a Filipino has already been granted license and
is actually practicing therein unduly expands the
requirements provided for under R.A. No. 2382 and
P.D. No. 223.

schizophrenia. Nevertheless, the subpoena was

issued. Counsel for Nelly filed an urgent motion to
quash the subpoena. Respondents counsel claimed
that the witness will testify as an expert witness and
would not testify on any information acquired while
attending to the petitioner in a professional capacity.
Lower Court ruled in favor of Juan. CA also ruled
in favor of Juan stating that Nelly failed to establish
the confidential nature of the testimony given by
Dr. Acampado.
Issue: Whether or not there is breach of
confidentiality clause

V. PRIVILEGED COMMUNICATION

Held: No. In order that the privilege may be

successfully claimed, the following requisites must
concur:

Sec. 24, RRE. Disqualification by reason of

privileged communication. The following
persons cannot testify as to matters learned in
confidence in the following cases:

1. the privilege is claimed in a civil case;

xxx
2. the person against whom the privilege is
claimed is one duly authorized to practice
medicine, surgery or obstetrics;

(c) A surgeon authorized to practice medicine,

surgery or obstetrics cannot in a civil case, without
the consent of the patient, be examined as to any
advice or treatment given by him or any
information which he may have acquired in
attending such patient in a professional capacity,
which information was necessary to enable him to
act in that capacity, and which would blacken the
reputation of the patient

3. such person acquired the information

while he was attending to the patient in
his professional capacity;
4. the information was necessary to enable
him to act in that capacity; and
5. the information was confidential, and, if
disclosed, would blacken the reputation
(formerly character) of the patient.

Case: Lim v. CA
Facts: Petitioner Nelly Lim and Respondent Juan
Lim are lawfully married to each other. Juan filed a
petition for annulment of marriage in the ground
that Nelly has been suffering from schizophrenia
before, during, and even after their marriage.

These requisites conform with the four (4)

fundamental conditions necessary for the
establishment of a privilege against the
disclosure of certain communications, to wit:

He presented three witnesses, one of which is the

Chief of the Female Services of National Mental
Hospital, Dr. Acampado. The counsel for Juan
orally applied for the issuance of subpoena ad
testificandum, the counsel for Nelly opposed the
motion on the ground that the testimony sought to
be elicited from the witness is privileged since the
latter had examined the petitioner in a professional
capacity and had diagnosed her to be suffering from

1. The communications must originate in a

confidence that they will not be disclosed.
2. This element of confidentiality must be
essential to the full and satisfactory
maintenance of the relation between the
parties.
4

Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)

3. The relation must be one which in the

opinion of the community ought to be
sedulously fostered

Case: Krohn v. CA
Facts: A confidential psychiatric evaluation report
is being presented in evidence before the trial court
in a petition for annulment of marriage grounded on
psychological incapacity. The witness testifying on
the report is the husband who initiated the
annulment proceedings, not the physician who
prepared the report. The subject of the evaluation
report is the wife, who invokes the rule on
privileged communication between physician and
patient, and seeks to enjoin her husband from
disclosing the contents of the report. RTC allowed
the admission of the psychiatric evaluation report as
evidence because it is material to the case and
because there was no objection on the part of the
wife during the time it was referred to in the
complaint. CA affirmed.

4. The injury that would inure to the

relation by the disclosure of the
communications must be greater than the
benefit thereby gained for the correct
disposal of litigation.
The physician may be considered to be acting in his
professional capacity when he attends to the patient
for curative, preventive, or palliative treatment.
Thus, only disclosures which would have been
made to the physician to enable him "safely and
efficaciously to treat his patient" are covered by the
privilege.
It is to be emphasized that "it is the tenor only of the
communication that is privileged. The mere fact of
making a communication, as well as the date of a
consultation and the number of consultations, are
therefore not privileged from disclosure, so long as
the subject communicated is not stated. One who
claims this privilege must prove the presence of
these aforementioned requisites. Petitioner failed to
discharge that burden. Dr. Acampado was presented
and qualified as an expert witness. She did not
disclose anything obtained in the course of her
examination, interview and treatment of the
petitioner; moreover, the facts and conditions
alleged in the hypothetical problem did not refer to
and had no bearing on whatever information or
findings the doctor obtained while attending to the
patient.

Issue: Whether or not the presentation of the report

is a breach of the privileged communication rule
Held: No. It does not fall under the requisites laid
down in the case of Lim v. CA. Moreover, the
person against whom the privilege is claimed is not
one duly authorized to practice medicine, surgery or
obstetrics. He is simply the patient's husband who
wishes to testify on a document executed by
medical practitioners. Plainly and clearly, this does
not fall within the claimed prohibition. Neither can
his testimony be considered a circumvention of the
prohibition because his testimony cannot have the
force and effect of the testimony of the physician
who examined the patient and executed the report.
VI. MEDICAL ACT OF 1959, AS AMENDED
and other related provisions and concepts

The statutory physician-patient privilege, though

duly claimed, is not violated by permitting a
physician to give expert opinion testimony in
response to a strictly hypothetical question in a
lawsuit involving the physical mental condition of a
patient whom he has attended professionally, where
his opinion is based strictly upon the hypothetical
facts stated, excluding and disregarding any
personal professional knowledge he may have
concerning such patient.

LEGAL MEDICINE
Branch of medicine that deals with the application
of medical knowledge to the purposes of law and in
the administration of justice.
MEDICAL JURISPRUDENCE
Deals with the aspect of law and legal concepts in
relation with the practice of medicine
5

Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)

MEDICAL JURISPRUDENCE includes:

-

Licensure and regulatory laws;

Physician-patient-hospital
relationship
together with the other paramedical
personnel, their rights, duties and
obligations;
Liabilities for non-compliance with the law.

Administrative acts, orders, Rules and

Regulation
Local customs
Generally
accepted
principles
of
International law

LAW AND THE PRACTICE OF MEDICINE

The State must maintain high standard of practice
by setting up rules and regulations with regards to
qualifications and procedure for the admission to
the profession. These are legal safeguards to
guarantee the safety of the patient and impose
liability to the practitioner who through his act or
omission causes damage or injury to the health and
welfare of the patient.

PURPOSES OF LEGAL MEDICINE

- To protect the public from charlatans;
- To promote professionalism and foster
professional interrelationship;
- To develop awareness of the rights, duties
and obligations of the patient, physician, and
the hospital;
- To control the increasing number of medical
malpractice suits against physicians;
- To explain the purpose and procedure of
certain legislation;
- To study the need to amend, repeal our
health care laws in harmony with the recent
scientific and social development.

The right to regulate the practice of medicine is

based on the police power of the state.
LICENSURE AND REGULATORY LAWS
ADMINISTRATIVE BODIES
1. BOARD OF MEDICAL EDUCATION

ADVERSARIAL TRIAL SYSTEM

-

Primarily concerned with the standardization and

regulation of medical education.

Philippine courts is a court litigation where

there is competition of inconsistent version
of facts and theories in law during trial;
Each party to the contest is given equal
opportunity to investigate the case, gather
and present all proofs in support of his
allegation, and give argument that his
contention is correct;
Ultimate purpose is for a just solution.
it often undermines the pursuit of truth as
the opposing parties seek to win at all cost
without the obligation to reveal the facts
which may be detrimental to their case. The
lawyer aims to win the fight not to help the
court discover facts or establish the truth.

Composition:
Chairman - Secretary of Education
Members:
1. Secretary of Health
2. Director, Bureau of Private Schools
3. Chairman, Board of Medicine
4. Representative, PMA
5. Council of Deans, APMC
6. 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;

SOURCES OF LAW
- Constitution
- Laws enacted by the legislative body
- Decrees, Orders, Proclamation, Letters, CA,
BP, RA
6

Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)

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.

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.

2. PROFESSIONAL REGULATIONS
COMMISSION (PRC)
To have general supervision and regulation of all
professions requiring examinations which includes
the practice of medicine.
Composition:
Commissioner
Two Associate Commissioner
Functions:
Exercise general administrative, executive and
policy-making functions for the whole agency.
3. 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.

ADMISSION
MEDICINE

TO

THE

PRACTICE

OF

Prerequisites:
Composition:
1. Minimum age requirement
- at least 21 years of age

Six members appointed by the president from a list

submitted by the Executive Council of the PMA.

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;

Qualifications:
-

Natural-born citizen;
Duly registered physician;
In the practice of medicine for at least 10
years;
7

Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)

-Certificate of Eligibility from the Board of

Medical Education;
-Good moral character

Surgery and Ophthalmology,

Otorhinolaryngology
Preventive Medicine and Public Health
Legal Medicine, Ethics and Medical
Jurisprudence

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).

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):

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.

1. 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;
2. 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;

Scope of Examination:
Preliminary - Anatomy and Histology
Physiology
Biochemistry
Microbiology and Parasitology
Final - Pharmacology and Therapeutics
Pathology
Medicine
Obstetrics and Gynecology
Pediatrics and Nutrition
8

Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)

3. who shall falsely use the title of M.D. after

his name, shall be considered as engaged in
the practice of medicine.

ILLEGAL PRACTICE OF MEDICINE

Practice of medicine by any person not qualified
and not duly-admitted to perform medical acts in
compliance with law.

By DECISIONS OF COURTS, the following are

not considered to constitute practice of medicine:

Penalties
1.
2.
3.
4.

One who takes BP reading;

Application of medicated massage;
Hospital;
Nurse anesthetist

Pursuant to Sec.28, Art. IV, Medical Act of 1959

as amended Any person found guilty of illegal
practice shall be punished by a fine of not less than
one thousand pesos or more than ten thousand pesos
with subsidiary imprisonment in case of insolvency
or by imprisonment of not less than one year no
more than five years, or by both such fine and
imprisonment, in the discretion of the court.

Exemptions:
By PROVISIONS OF LAW, the following are not
considered to constitute practice of medicine
(Sec.11, Art. III, Medical Act of 1959 as amended):

Qualified to practice medicine in the Philippines

1. Any medical student duly enrolled in an
approved medical college;
2. dentist;
3. physiotherapist;
4. optometrist;
5. Any person who renders any service
gratuitously in cases of emergency or in
places where the services of a physician,
nurse or midwife are not available;
6. Any person who administers or recommends
any household remedy as per classification
of existing Pharmacy Laws;
7. Clinical psychologist with the prescription
and direct supervision of a physician;
8. Prosthetist

1. Those who have complied with the prerequisites

to the practice of medicine in accordance with
Sec. 8, Art. III, Medical Act of 1959 as
amended;
2. Those who can have limited practice without
any certificate of registration in accordance with
Sec.12, Art. III, Medical Act of 1959 as
amended:
-

Related to constitutional guarantee to religious

freedom (freedom to believe and freedom to act in
accordance with ones belief);

Exclusive consultation in specific and

definite cases;
Attached to international bodies to perform
certain definite work in the Philippines;
Commissioned medical officers stationed in
the Philippines in their own territorial
jurisdiction;
Exchange professors in special branches of
medicine;
Medical students who have completed the
first four years of medical course, graduates
of medicine and registered nurses who may
be given limited and special authorization by
the DOH;

Acted in pursuance of his religious belief and with

the tenets of his church he professes, not deemed to
be a practice of medicine but part of his religious
freedom.

3. Balikbayan Physicians pursuant to PD 541,

Allowing Former Filipino Professionals to
Practice Their Respective Professions in the
Philippines, proviso:

Note: Faith Healing

There is nothing in the Medical Act of 1959
exempting it from the definition of the acts which
constitute practice of medicine;

Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)

Of good standing prior to their departure and

in their adopted country;
Have registered with PRC and paid their
professional fee;
Pay the corresponding income tax;

5. Medical Students pursuant to Sec.11(a) and

Sec.12(d), Art.III, Medical Act of 1959 as
amended;

RIGHTS GENERALLY ENJOYED BY EVERY

CITIZEN

6. Limited practitioners of medicine

- Those that are governed by specific
licensure laws

Rationale why artificial persons cannot practice

medicine

management

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

4. Foreign physicians qualified to practice by

Reciprocity Rule or by endorsement;

to determine appropriate
procedures
to avail of hospital services

Pursuant to the provisions of Art. III, bill of

rights, Philippine Constitution 1987

RIGHTS OF PATIENTS

Cannot
be subjected to
licensure
examinations as required by law;
Practice of medicine may be employed and
controlled by unqualified physicians;
Professional relationship between the patient
and the physician will be impaired;
Deprivation of free choice of physicians.

ADDITIONAL NOTES

Right to give consent to diagnostic and

treatment procedures
Right to religious belief
Right of privacy
Right to disclosure of information
Right to confidential information
Right to choose his physician
Right of treatment
Right to refuse necessary treatments

Basis of Consent
1. The physician-patient relationship
fiduciary in nature.
2. Patients right to self-determination.
3. Contractual relationship.

PHYSICIAN
He is a person who after completing his secondary
education follows a prescribed course of medicine
at a recognized university or medical school, at the
successful completion of which, is legally licensed
to practice medicine by the responsible authorities
and is capable of undertaking the prevention,
diagnosis, and treatment of human illness by the
exercising independent judgment and without
supervision. (WHO)

is

Purposes
1. To
protect
the
patient
from
unnecessary/unwarranted procedure applied
to him without knowledge
2. To protect the physician from any
consequences for failure to comply with
legal requirements

RIGHTS OF PHYSICIAN
INHERENT RIGHTS
- to choose patients (except in emergency
cases)
- to limit practice of medicine
10

Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)

too remote from the development of the

injury suffered by the patient.
3. The result must be the natural continuous
and probable consequences.

Instances When Consent Is Not Necessary

1. In cases of emergency, there is an implied
consent or the physician is privilege
because he is reasonably entitled to assume
consent
2. When the law made it compulsory for
everyone to submit to the procedure

DOCTRINE OF EFFICIENT INTERVENING

CAUSE
In the causal connection between the negligence of
the physician and the injury sustained by the
patient, there may be an efficient intervening cause
which is the proximate cause of the injury.

MEDICAL MALPRACTICE
Failure of a physician to properly perform the duty
which devolves upon him in his professional
relation to his patient which results to injury.
It may be defined as bad or unskillful practice of
medicine resulting to injury of the patient or failure
on the part of the physician to exercise the degree of
care, skill and diligence, as to treatment in a manner
contrary to accepted standards of medicine resulting
to injury to the patient.

DOCTRINE OF VICARIOUS LIABILITY

Doctrine of
Responsibility.

Imputed

Negligence/Command

Vicarious liability means the responsibility of a

person, who is not negligent, for the wrongful
conduct or negligence of another.

Elements of Medical Malpractice

CAPTAIN-OF-THE-SHIP DOCTRINE
1. The physician has a duty to the patient;
2. The physician failed to perform such duty
to his patient;
3. As a consequence of the failure, injury
was sustained by the patient;
4. The failure of the physician is the
proximate cause of the injury sustained
by the patient.

This doctrine innunciates liability of the surgeon not

only for the wrongful acts of those who are under
his physical control but also those wherein he has
extension of control.
DOCTRINE OF RES IPSA LOQUITOR
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.

Criminal medical malpractice, the act or omission

complained of must be punishable by law at the
time of commission or omission.
Proximate Cause

Requisites of Res Ipsa Loquitur Doctrine:

that cause, which, in natural continuous sequence,
unbroken by an efficient intervening cause,
produces the injury and without which the result
would not have occurred.
1. There must be a direct physical connection
between the wrongful act of the physician
and the injury sustained by the patient.
2. The cause or the wrongful act of the
physician must be efficient and must not be

1. The accident must be of a kind which

ordinarily does not occur in the absence of
someones negligence;
2. It must be caused by an agency or
instrumentality within the exclusive control
of the defendant;
3. It must not have been due to any voluntary
action or contribution on the part of the
plaintiff.
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Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)

Some cases wherein the Doctrine of Res Ipsa

Loquitor has been applied:
1. Objects left in the patients body at the time
of caesarian section;
2. Injury to a healthy part of the body;
3. Removal of a wrong part of the body when
another part wad intended;
4. Infection resulting from unsterilized
instruments;
5. Failure to take radiographs to diagnose a
possible fracture;
Instances where the Doctrine of Res Ipsa
Loquitor does not apply:
1. Where the Doctrine of Calculated Risk is
applicable;
2. When an accepted method of medical
treatment involves hazards which may
produce injurious results regardless of
the care exercised by the physician.
3. Bad Result Rule;
4. Honest Errors of judgment as to
Appropriate Procedure;
5. Mistake in the Diagnosis
In most medical malpractice suits, there is a
necessity for a physician to give his expert medical
opinion to prove whether acts or omissions
constitute medical negligence. This doctrine has
been regarded as rule of sympathy to counteract the
conspiracy of silence

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