Liabilities of Physicians

MEDICAL JURISPRUDENCE: LIABILITIES OF PHYSICIANS Atty. Alejandro F. Daguplo, RMT, MD

10. “IGNORANTIA LEGIS NEMINEM EXCUSAT” ➪ Ignorance of the law does not excuse anyone. *based on Article 3 of the Civil Code 11 1907-

Factors Increasing Frequency of Complaints against Physicians

1. Gradual disappearance of family physicians 2. The doctor’s loose talk 3. Breakdown in rapport and communication 4. Disservices made by mass communication media 5. Malpractice is a sort of disease of society which may appear in endemic form.

6. Incompetence and commercialization of medical practice 7. Proliferation of medicinal drugs 8. Changing attitude of the physician in the management of his patient. Definition of Terms ➪ Plaintiff – civil cases ➪ Complainant – administrative cases ➪ People of the Philippines – criminal cases vs. ➪ Defendant - civil cases ➪ Respondent - administrative cases ➪ Accused - criminal cases

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Commission – PRC Court – MTC or RTC PMA – Philippine Medical Association

LIABILITIES OF PHYSICIANS

1. Administrative  revocation of license 2. Criminal  imprisonment 3. Civil  monetary compensation Sources of Liabilities of M.D.:

1. Ethics of the Medical Profession in the Philippines 2. Medical Act of 1959 as amended 3. Civil Code 4. Revised Penal Code 5. Special laws

“If you have to kill a person, it cost nothing to be polite” A. ADMINISTRATIVE LIABILITY ➪ “The primary objective of the practice of medicine is service to mankind irrespective of race, age, disease, disability, gender, sexual orientation, social standing, creed or political affiliation. In medical practice, reward or financial gain should be a subordinate consideration.”

Characteristics:

1. Filed with the PRC (PMA for ethical misconduct) 2. In writing and under oath 3. Must set forth distinctly, clearly and concisely the charge 4. In six copies 5. Proof needed is convincing evidence 6. Penalty imposable is reprimand or suspension or revocation of license 7. Rights of the accused 8. 30 days reglamentary period. 9. Decision appealable to the PRC, then to the Office of the President

Transcribed by: KC

Reinstatement of license after 2 years

*Perjury can be filed against you if you are proven to have lied under oath I. How commenced ➪ Complaint – must be complete and notarized II. Who can file ➪ Any person ➪ Firm or corporation, thru its duly authorized representative ➪ The Board itself III. Where to file

➪ Professional Regulations Commission IV. Jurisdiction over the respondent, how acquired ➪ Summons Summons, form: ➪ Letter - subpoena requiring appearance of the respondent at a designated time and place or letter requiring him to answer within the period therein specified, and a copy of the complaint and its enclosures *Once a summon has been sent to you, it means that you are already under the jurisdiction of the PRC. *For high profile cases, the Supreme Court gives the finality of a verdict even if verdict was given under a lower court. Summons, how served:

1. Personal service 2. Registered mail 3. Ordinary mail 4. Publication Rights of the Respondent

1. Under the Medical Act: a. to be represented by counsel or be heard in person b. to have a speedy and public hearing c. to confront and to x-examine witnesses against him 2. Under the PRC Rules and Regulation: a. to be represented by counsel or be heard in person b. to have a speedy and public trial c. to confront and to cross-examine witnesses against him d. the parties may appear personally or with aid of counsel 3. Under the Rules of Court ➪ Rule 115 of Revised Rules of Criminal Procedure (took

effect on December 1, 2000) ➪ Sec. 1. Rights of the accused at the trial - In all criminal prosecutions, the accused shall be entitled to the following rights: a. Presumption of innocence b. Right to be informed c. To be present and defend in person and by counsel d. To be a witness in his own behalf e. Against Self incrimination – you cannot be compelled to testify against yourself (“Nemo tenetur seipsum accusare” Villaflor v. Summers – 41 Phil.68) *Nemo tenetur seipsum accusare - no one is bound to incriminate or accuse himself “Accusare nemo se debet, nisi coram deo” - no one ought to accuse himself except in the Presence of God f. Confrontation – cross examination g. Compulsory process to secure attendance and production of evidence – secured by the subpoena h. Speedy, impartial and public trial i. To appeal

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*If there has been a subpoena sent but you did not make an appearance on court, you will be held in contempt.

4. Under the Constitution ➪ Article III. Bill of Rights Grounds under Article V Sec. 24 Medical act of 1959 as amended: ➪ Grounds for reprimand, suspension or revocation of registration certificate which may be classified as follows:

1. 2. 3.

Personal disqualification Criminal acts Unprofessional conduct Grounds under the Rules and Regulation for Administrative Investigation

1. Immoral and dishonorable conduct; 2. Insanity; 3. Conviction of a criminal offense involving moral turpitude; 4. Unprofessional or unethical conduct; 5. Gross negligence of incompetence in the practice of the profession; and 6. The use or perpetration of fraud or deceit in the acquisition of registration certificate. *Offenses involving moral turpitude usually involve intentional acts

1. Personal disqualification 1.1. Immoral or dishonorable conduct ➪ Contrary to existing norms or conduct

is disgraceful, unbecoming, unethical, or repulsive to the moral standards in a society. ➪ "Immoral conduct has been defined as 'that which is willful, flagrant, or shameless, and which shows a moral indifference to the opinion of the good and respectable members of the community' (7 C.J.S. 959).

“… it was highly immoral of respondent, a married man with children, to have taken advantage of his position as chairman of the college of medicine in asking complainant, a student in said college, to go with him to Manila where he had carnal knowledge of her under the threat that she would flunk in all her subjects in case she refused. WHEREFORE, respondent Jose B. Aznar is hereby DISBARRED and his name is ordered stricken off from the Roll of Attorneys. ([A.C. No. 1334. November 28, 1989.] ROSARIO DELOS REYES, complainant, vs. ATTY. JOSE B. AZNAR, respondent.)

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Insanity – impairment of the mind as prevents a person from distinguishing right and wrong

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Gross negligence, ignorance or incompetence in the practice of his profession resulting in an injury to or death of the patient

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Addiction to alcoholic beverages or to any habit-forming drug rendering him incompetent to practice his profession, or to any form of gambling

2. Criminal acts 2.1. Conviction by a court of competent jurisdiction of any criminal

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act of baseness, vileness or depravity in private and social duties w/c a man owes to his fellowmen or to society in general

Some of the particular crimes which have been held to involve moral turpitude are: ➪ adultery ➪ concubinage ➪ rape ➪ arson ➪ evasion of income tax ➪ forgery ➪ bigamy ➪ blackmail ➪ criminal conspiracy to smuggle opium ➪ bribery ➪ dueling ➪ extortion ➪ embezzlement ➪ perjury ➪ libel ➪ seduction under promise of ➪ making fraudulent proof of loss on marriage insurance contract ➪ estafa ➪ murder ➪ falsification of public ➪ mutilation of public records document ➪ fabrication of evidence ➪ estafa thru falsification of ➪ offenses against pension laws public document

3. Unprofessional conduct 3.1. False extravagant or unethical

advertisements wherein other things than his name, profession, limitation of practice,clinic hours, office and home address, are mentioned.

3.2. Issuing

any statement or spreading news or rumor w/c is derogatory to the character and reputation of another physician w/o justifiable motive.

3.3. Violation of any provision of the Code of Ethics as approved by the PMA.

PROCEDURE AND ORDER OF HEARINGS IN THE BOARD

1. Filing of complaint 2. Board investigates if probable cause exist 3. Summons served to respondent requiring

him to answer or appear

before the board

4. Respondent files answer or appear before the board 5. Pre-trial conference 6. Trial proper 7. Judgment 8. MR 9. Appeal Judicial Revocation of the Certificate

1. P.D. No. 169 – failure to report Serious and less serious PI 2. Violation of The Comprehensive Dangerous Drugs Act of

2002 (R.A. 9165) - (Dangerous Drug Act of 1972 as amended [R.A. 6425]) *Judicial revocation means that the court, instead of the PRC will be the one to revoke your license. B. Criminal Liability of Physicians NULLUM CRIMEN, NULLA POENA SINE LEGE – There’s no crime if there’s no law punishing an act Characteristic of Criminal case:

offense involving moral turpitude

1. In the name of the People of the Philippines 2. Filed and tried in court 3. Instituted by filing a complaint or information with the fiscal’s office 4. Filed by the offended party, any peace officer or other public officer

person to practice medicine

5. Right to bail  if there is probable cause 6. Proof beyond reasonable doubt 7. Penalty imposable is imprisonment and/or fine 8. Revocation of license if the law provides or if the crime involved moral

2.2. Fraud in the acquisition of the certificate of registration 2.3. Performance of or aiding in any criminal abortion 2.4. Knowingly issuing a false medical certificate 2.5. Aiding or acting as a dummy of an unqualified or unregistered 'Moral turpitude has been defined as including any act done contrary to justice, honesty, modesty or good morals. ([A.M. No. (2170-MC) P-1356. November 21, 1979.] HON. REMIGIO E. ZARI, complainant, vs. DIOSDADO S. FLORES, respondent.) Transcribed by: KC

charged with the enforcement of the law violated

turpitude

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How commenced: Complaint or information defined: ➪ Complaint is a sworn statement charging a person with an offense, subscribed by the offended party, any peace officer or other public officer charged with the enforcement of the law violated. ➪ Information is an accusation in writing charging a person with an offense subscribed by the fiscal and filed with the court.

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Art. 175, Revised Penal Code Using false certificate (arresto menor) ➪ Art. 259, Revised Penal Code. Abortion practiced by a physician or midwife and dispensing of abortives  relates that abortion should be intentional ➪ Elements:

1. That

there is a pregnant woman who has suffered an abortion

2. That the abortion is intended 3. That the Physician causes or assists in causing the abortion 4. That the M.D. takes advantage of his scientific knowledge or

➪ Who can file: Offended party Any peace officer or other public officer charged with the enforcement of the law violated. ➪ Where to File: Fiscal’s office in cases falling under the RTC Cases falling under the MTC, directly with the court but in chartered cities, with the fiscal’s office ➪ Venue: ➪ Filed in the court where the crime took place Jurisdiction over the accused, how acquired:

1. Arraignment 2. Arrest Rights of the Accused:

1. Rules of Court 2. Under the Philippine Constitution Grounds:

1. Revised Penal Code 2. Special laws Provisions where M.D. are specifically mentioned:

1. Issuance of False medical Certificates (Art. 174, RPC) 2. Abortion (Art. 259, RPC) 3. Simulation of Births, substitution of one child

for another, and concealment or abandonment of a legitimate child (Art. 347, RPC)

4. Failure to report treatment of physical injuries (P.D. 169) 5. Refusal to render treatment in emergency cases (R.A. 6615) 6. Reporting cases of Maltreated or Abused children (P.D.603) Liabilities incidental to the practice of medicine:

1. Criminal negligence and imprudence (Art. 365, RPC) 2. Violation of The Comprehensive Dangerous Drugs

Act of 2002 (R.A. 9165) Dangerous Drug Act of 1972 as amended (R.A. 6425)

3. Violation of Pharmacy Law (R.A. 5921 as amended) 4. Liability in the issuance of Birth and death certificates 5. Defamation (Art. 353 & 359, RPC) 6. Violation of Generic Act of 1988 Guys, the following section has the word “elements” included in the bullets. When you say “elements”, it means that each of the features indicated must be present.

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Art. 174, Revised Penal Code – relates to moral turpitude Par.1 Any physician or surgeon who, in connection with the practice of his profession shall issue a false certificate. ➪ Certificate, defined ➪ Any writing by which testimony is given that a fact has or has not taken place. ➪ Penalty: ➪ Arresto mayor, maximum to prision correctional, minimum (4mos and 1 day to 2 years and four mos)

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Transcribed by: KC

skill. ➪ Penalty ♥ Penalties provided for intentional abortion shall be imposed in the maximum period ♥ (Reclusion temporal, prision mayor, prision correccional) *reclusion temporal ➪ maximum period - 17 years, 4 months and 1 day to 20 years ➪ medium period - 14 years, 8 months and 1 day to 17 years and 4 months ➪ minimum period - 12 years and one day to 14 years and 8 months *prision mayor ➪ maximum period (10 years and one day to 12 years) ➪ medium period (8 years and one day to 10 years) ➪ minimum period (6 years and one day to 8 years) *prision correccional ➪ maximum period (4 years, 2 months and one day to 6 years) ➪ medium period (1 year and 1 day to 1 year and 8 months) ➪ minimum period (4 months and 1 day to 2 years and 4 months)

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Art. 347, Revised Penal Code

➪ Acts Punished under Art. 347. 1. Simulation of birth – orchestrating

a delivery in order to conceal that a woman has conceived a child even if she didn’t

2. Substitution of one child for another – example of this is that

when the name of adopter is indicated in the birth certificate instead of the biological parents

3. Concealing

or abandoning any legitimate child with intent to cause such child to lose its civil status ➪ Liability of M.D. ♥ Cooperates in the execution of any of the above crime in violation of the duties of his profession. ➪ Penalty: prision mayor, and a fine not exceeding 1,000pesos and temporary special disqualification. ➪ P.D. 169. Failure to report Treatments of Physical Injury to Philippine Constabulary (violation is determined by the military tribunal) ➪ Elements:

1. M.D.

treated any person for serious or less serious Physical

Injury

2. Did not report such fact personally or by the fastest means of communication to the nearest PC unit without delay

3. The

failure to report was with malicious intent or gross negligence ➪ Penalty: ♥ Imprisonment of not less than 1 year nor more than three years and/or a fine of not less than 1,000 nor more than 3,000 pesos and cancellation of license after the sentence imposed by the military tribunal has become final and executory. *PD 169 was promulgated by Ferdinand Marcos that’s why there was the term Philippine Constabulary and military tribunal in the title. Serious Physical Injury, How committed: ➪ Wounding, beating, assaulting substance

or

administering

injurious

What is Serious Physical Injury?

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1. Injured

person become insane, imbecile, impotent or blind in consequence of the P.I.

2. When injured person: a. loses the use of speech or the power to hear or to smell or loses an eye, a foot, an arm, or a leg; or

b. loses the use of any such member; or c. becomes incapacitated for the work in w/c he was

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lack of skill failure in precaution avoided by taking the necessary precaution once foreseen

d. becomes deformed; or e. loses any other member of his body; or f. loses the use thereof; or g. becomes ill or incapacitated for the performance of the work he was habitually engaged for more than 90 days, in consequence of the physical injury

1. The offender does of fails to do an act 2. That the doing of or failure to do the act is voluntary 3. That it is done without malice 4. That material damage or injury resulted from it 5. Inexcusable lack of precaution on the part of the offender, taking into consideration –

a. his employment or occupation; b. degree of intelligence, physical condition; and c. other circumstances regarding persons, time and place

3. When the injured person becomes ill or incapacitated for labor for more than 30 days (but must not be more than 90 days) as a result of the physical injury inflicted.

What are Less Serious Physical Injury ➪ Offended party is incapacitated for labor for more than 10 days (but not more than 30 days), or needs medical attendance for the same period of time. ➪ That the P.I. must not be those described in the preceding articles.

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R.A. 6615. Refusal to Extend Medical Assistance in Emergency Cases ➪ Elements:

1. A patient was brought to the hospital or clinic duly licensed to operate;

2. The patient is in danger of dying and/or who may have suffered serious physical injury

3. The hosp. Director, administrator, OIC or M.D. in the hospital,

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medical center or clinic, refused or fail without good cause to render the appropriate assistance after said case was brought to his attention Penalty: ♥ Imprisonment of 1 month and 1 day to one year, and a fine of 300 to 1,000 pesos

P.D. 603. Reporting cases of maltreated or abused child: ➪ Elements:

1. There was a maltreated or abused child, or exploitation of any employed child contrary to the provisions of the labor code;

2. The child was treated in a hospitals, clinics, or other institutions as well as private physicians

3. The

hospital, clinics or other institution or physician failed, within 48 hours, from knowledge of the case, to report in writing to the city or provincial fiscal or to the Local Council for the Protection of Children or to the nearest unit of the of the DSWD.

4. In

cases of sexual abuse, the records shall be strictly confidential. ➪ Penalty: ♥ For # 1-3 Fine of not more than 2,000 pesos. ♥ For #4, fine of not less than 2,000 pesos or by imprisonment of not more than 1 year or both Criminal liabilities incidental to the Practice of Profession

1. Art. 365. Imprudence and Negligence ➪ Title 14 of Revised

Penal Code. Quasi Offenses, Criminal Negligence *Reckless imprudence – not done on purpose with no intention to hurt.

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Imprudence deficiency of action

Transcribed by: KC

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lack of foresight failure in advertence paying proper attention and using due diligence in foreseeing them

Elements of Reckless Imprudence: theretofore

habitually engaged, in consequence of the P.I. inflicted

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Negligence deficiency in perception

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Simple imprudence consists in the lack of precaution displayed in those cases in which the damage impending to be caused is not immediate nor the danger clearly manifest.

“As early as in People v. Vistan, the Court defined simple negligence, penalized under what is now Article 365 of the Revised Penal Code, as "a mere lack of prevision in a situation where either the threatened harm is not immediate or the danger not openly visible." Put in a slightly different way, the gravamen of the offense of simple negligence is the failure to exercise the diligence necessitated or called for by the situation which was not immediately life-destructive but which culminated, in the present case, in the death of a human being three (3) days later” (LEANDRO CARILLO, petitioner, vs. PEOPLE OF THE PHILIPPINES, respondent. [G.R. No. 86890.January 21, 1994.]) Test for negligence: ➪ Would a prudent man, in the position of the person to whom negligence is attributed, foresee harm to the person injured as a reasonable consequence of the course about to be pursued?

2. Violation of R.A. No. 9165 (Dangerous Drugs Act of 2002) ➪ Provisions incidental to the practice of medicine: ➪ Section 18. Unnecessary Prescription of Dangerous

Drugs. – The penalty of imprisonment ranging from twelve (12) years and one (1) day to twenty (20) years and a fine ranging from One hundred thousand pesos (P100,000.00) to Five hundred thousand pesos (P500,000.00) and the additional penalty of the revocation of his/her license to practice shall be imposed upon the practitioner, who shall prescribe any dangerous drug to any person whose physical or physiological condition does not require the use or in the dosage prescribed therein, as determined by the Board in consultation with recognized competent experts who are authorized representatives of professional organizations of practitioners, particularly those who are involved in the care of persons with severe pain. ➪ Section 19. Unlawful Prescription of Dangerous Drugs. – The penalty of life imprisonment to death and a fine ranging from Five hundred thousand pesos (P500,000.00) to Ten million pesos (P10,000,000.00) shall be imposed upon any person, who, unless authorized by law, shall make or issue a prescription or any other writing purporting to be a prescription for any dangerous drug.

*In prescribing opioids, it is essential that you get an S2 number and a yellow prescription from the Dangerous Drugs Board.

3. R.A. 5921.(as amended) Prohibition of sale of sample ➪ Acts punishable: ➪ Selling of sample (Sec. 26) ➪ Penalty:

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d. for the fourth and subsequent conviction, the penalty of fine

one thousand –four thousand pesos or 6 mos and 1 day – four years or both (Sec. 2 E.O. 174)

not less than ten thousand pesos (P10,000.00) and suspension of his license to practice his profession for one year or longer at the discretion of the court.

4. R.A.

3753. Criminal liabilities in the issuance of Birth and Death Certificate ➪ Acts punishable relating to Birth Certificate:

1. Any person who shall knowingly make false statement in the Certificate of live birth and shall present the same for entry in the Civil Registrar.

2. Any person whose duty is to report any fact concerning the civil

status of persons and who knowingly fails to perform such duty.

➪ Penalty: ➪ For #1, 1 mo.- 6mos. Or fine 100 to 500 pesos or both. ➪ For #2, fine of 10 – 200 pesos. ➪ Acts punishable relating to Death Certificate: 1. Any person who shall knowingly make false statement in the form furnished for Death certificate and shall present the same for entry in the Civil Registrar.

2. Burial without the proper Death Certificate ➪ Penalty: ➪ For #1, 1 mo. - 6mos. Or fine 100 to 500 pesos or both. ➪ For #2, fine of 10 – 200 pesos. 5. Defamation ➪

Procedure in Criminal Suit

1. Filing of complaint or information 2. Preliminary investigation 3. Arraignment 4. Pre-trial 5. Trial 6. Judgment 7. MR 8. Appeal C. CIVIL LIABILITIES OF PHYSICIANS ➪ “if a person acts with abuse, his right to act ceases, and his act becomes illicit, giving rise to liability” ➪ Every person must, in the exercise of his rights and in the performance of his duties, act with justice, give everyone his due, and observe honesty and good faith.

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1. There must be an imputation of a crime, or a vice or defect, real

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or imaginary, or any act, omission, condition, status, or circumstance;

2. That the imputation must be made publicly; 3. That it must be malicious; 4. That the imputation must be directed at a natural or juridical person, or one who is dead; and

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5. The imputation must tend to cause the dishonor, discredit, or contempt of the person defamed. *The cuss word “putang ina mo” is not considered as defamatory. *Homines qui gestant, qui qui auscultant crimina, si me arbitration liceat, omnis pendeat, gestores linguis, auditores - Your tittle-tattlers, and those who listen to slander, by my good will should all be hanged--the former by their tongues, the latter by the ears

6. Violation of REPUBLIC ACT NO. 6675 (AN ACT TO PROMOTE, REQUIRE AND ENSURE THE PRODUCTION OF AN ADEQUATE SUPPLY, DISTRIBUTION, USE AND ACCEPTANCE OF DRUGS AND MEDICINES IDENTIFIED BY THEIR GENERIC NAMES) ➪ Act punishable: ➪ Not using Generic name or terminology in prescribing drug. ➪ Sec. 12. Penalty. - A) Any Person who shall violate Section 6(a) or 6(b) of this Act shall suffer the penalty graduated hereunder, viz:

a. for the first conviction, he shall suffer the penalty of reprimand

which shall be officially recorded in the appropriate books of the Professional Regulation Commission.

b. for the second conviction, the penalty of fine in the amount of

not less than two thousand pesos (P2,000.00) but not exceeding five thousand pesos (P5,000.00) at the discretion of the court.

c. for the third conviction, the penalty of fine in the amount of

not less than five thousand pesos (P5,000.00) but not exceeding ten thousand pesos (P10,000.00) and suspension of his license to practice his profession, for thirty (30) days at the discretion of the court.

Transcribed by: KC

How commenced. Complaint Who can file. ➪ Plaintiff – claimant, natural or juridical person Where to file. ➪ RTC or MTC depending on the nature or amount Venue. ➪ Resident of the plaintiff or defendant Jurisdiction over plaintiff, how acquired. ➪ Summons Evidence needed. ➪ Preponderance of evidence

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“Homines qui gestant, qui qui auscultant crimina, si me arbitration liceat, omnis pendeat, gestores linguis, auditores” ➪ Elements:

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Obligation under Art. 1156 of Civil Code. “An obligation is a juridical necessity to give, to do or not to do.” ➪ By Arias Ramos. ➪ “An obligation is a juridical relation whereby a person may demand from another the observance of a determinate conduct, and in case of breach, may obtain satisfaction from the assets of the latter. Obligation Arises from:

1. Law; 2. Contracts; 3. Quasi-contracts; 4. Acts or omissions punished by law; and 5. Quasi-delicts 1. Breach of Contract ➪ Contract defined. ➪ A contract is a meeting

of the minds between 2 persons whereby one binds himself, with respect to the other, to give something or to render some service. (Art. 1305) ➪ Freedom to Contract. ➪ The contracting parties may establish such stipulations, clauses, terms and conditions as they may deem convenient, provided they are not contrary to law, morals, good customs, public order, or public policy. (Art. 1306) ➪ Art. 1159. Obligations arising from contracts have the force of law between the contracting parties and should be complied with in good faith.

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treatment is beyond his capacity he should summon another doctor who has the necessary ability. ➪ A doctor shall preserve absolute secrecy on all he knows about his patient because of the confidence entrusted in him. ➪ A doctor must give emergency care as a humanitarian duty unless he is assured that others are willing and able to give such care.”

2. Tort (Quasi – delict or Breach of legal duty, culpa aquilana) ➪ Art. 2176. Whoever by act or omission causes damage to another, there being fault or negligence, is obliged to pay for the damage done. Such fault or negligence, if there is no preexisting contractual relation between the parties, is called a quasidelict. ➪ Art. 20. Every person, who, contrary to law, willfully or negligently causes damage to another, shall indemnify the latter for the same ➪ Basis of the liability. ➪ EQUITY

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Art. 1 Sec. 3 In his relation to his patients, he shall serve their interest with the greatest solitude, giving them always his best talent and skill.

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Art. II Sec. 1. Attend to his patients faithfully and conscientiously. Secure for them all possible benefits that may depend upon his professional skill and care. ➪ Sec. 2 Respond to any request for his assistance in an emergency. ➪ Sec. 3. Administer at least first aid treatment in emergency cases ➪ Sec. 4. Assistance of his colleagues in consultation ➪ Sec. 5. Complete disclosure ➪ Sec. 6. Privileged communication ➪ Sec. 7. Exhorbitant or excessive fees

G.R. No. 118141 September 5, 1997 LEONILA GARCIA-RUEDA, petitioner, v. Pascasio et,al In its simplest terms, the type of lawsuit which has been called medical malpractice or, more appropriately, medical negligence, is that type of claim which a victim has available to him or her to redress a wrong committed by a medical professional which has caused bodily harm. In order to successfully pursue such a claim, a patient must prove that a health care provider, in most cases a physician, either failed to do something which a reasonably prudent health care provider would have done, or that he or she did something that a reasonably prudent provider would not have done; and that that failure or action caused injury to the patient. 12 Hence, there are four elements involved in medical negligence cases:

1. Duty; 2. Breach; 3. Injury; and 4. Proximate causation. Duties of M.D. to his patient

1. Under the Hippocratic Oath 2. Under the Ethics of Medical Profession 3. Under the Law 4. Under Solis’ book One of the impeachment lawyers said: “When Joseph Ejercito Estrada took his oath of office, at high noon of June 30, 1998, he said “I, Joseph Ejercito Estrada, do solemnly swear that I will faithfully and conscientiously fulfill my duties as President of the Philippines, preserve and defend its Constitution, execute its laws, do justice to every man and consecrate myself to the service of the Nation. So help me God.” Except for his name, he violated every word of his oath.” (Dec.7, 2000, Pasay City)

1. Duties of M.D. to his patient under the Hippocratic Oath: ➪ “……..I will practice medicine with conscience

and dignity. The health of my patient will be my first consideration. I will hold in confidence all that my patients confide me.………”

1. Practice with conscience and dignity 2. Health of patient as the first consideration 3. Confidentiality

2. Duties of M.D. to his patient under the Ethics of Med. Prof. 2.1 Art. I Sec. 2, last sentence. “..Adhere to the generally accepted

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principles of the International Code of Medical Ethics by the Third General Assembly of the World Medical Association at London, England in October, 1949 as part of his professional conduct.” “Duties of Doctors to the Sick ➪ A doctor must always bear in mind the obligation of preserving human life from conception. Therapeutic abortion may only be performed if the conscience of the doctors and the national laws permit. ➪ A doctor owes to his patient complete loyalty and all the resources of his science. Whenever an examination or

Transcribed by: KC

3. Duties of M.D. to his patients under the Law: ➪ Art. 1173 2nd par. “……If the law or contract does not

state the diligence which is to be observed in the performance, that which is expected of a good father of a family shall be required’ *this father role of physicians is termed: ordinary diligence

4. Duties of M.D. under Solis’ Book: 1. Duty to posses knowledge and skill of the profession 2. Duty to utilize such knowledge and skill with care and diligence 3. Duty to exercise the best judgment 4. Duty to observe utmost good faith to his patient Breach of Duty by:

1. Violation of positive law 2. Negligence ➪ NCC “Art. 1173. The fault or negligence of the obligor consists in the omission of that diligence which is required by the nature of the obligation and corresponds with the circumstances of the person, of the time and of the place. …..”

3. Ignorance ➪ Absence of knowledge 4. Departure from accepted practice

“Moreover, in malpractice or negligence cases involving the administration of anaesthesia, the necessity of expert testimony and the availability of the charge of res ipsa loquitur to the plaintiff; have been applied in actions against anaesthesiologists to hold the defendant liable for the death or injury of a patient under excessive or improper anaesthesia. 16 Essentially, it requires two-pronged evidence:

1. evidence as to the recognized standards of the medical community in the particular kind of case, and

2. a showing that the physician in question negligently departed from this standard in his treatment.”

G.R. No. 118141 September 5, 1997 LEONILA GARCIA-RUEDA, petitioner, v. Pascasio et,al *res ipsa loquitur – the things speak for itself.

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Injury. As early as 1939, in People vs. Faller, 67 Phil. 529, the Supreme Court held that “Imprudence or negligence becomes punishable only when it results in a crime”.

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Which means, even if the doctor was very negligent or ignorant or was very careless in treating his or her patient that even a person of common knowledge would know that the doctor was in fact negligent, if no injury resulted from his act, there is no medical malpractice

“Another element in medical negligence cases is causation which is divided into two inquiries: whether the doctor's actions in fact caused the harm to the patient and whether these were the proximate cause of the patient's injury. G.R. No. 118141 September 5, 1997 LEONILA GARCIA-RUEDA, petitioner, v. Pascasio et,al Proximate cause, defined. ➪ That cause, which, in the natural continuous sequence unbroken by an efficient intervening cause, produces the injury and without which the result would not have occurred. ➪ “the cause of the cause is the cause of the evil caused” Chapter 3 of the Revised Penal Code of the Philippines Section One. — Duration of Penalties Art. 27. ♥ Reclusion perpetua. — Any person sentenced to any of the perpetual penalties shall be pardoned after undergoing the penalty for thirty years, unless such person by reason of his conduct or some other serious cause shall be considered by the Chief Executive as unworthy of pardon. ♥ Reclusion temporal. — The penalty of reclusion temporal shall be from twelve years and one day to twenty years. ♥ Prision mayor and temporary disqualification. — The duration of the penalties of prision mayor and temporary disqualification shall be from six years and one day to twelve years, except when the penalty of disqualification is imposed as an accessory penalty, in which case its duration shall be that of the principal penalty. ♥ Prision correccional, suspension, and destierro. — The duration of the penalties of prision correccional, suspension and destierro shall be from six months and one day to six years, except when suspension is imposed as an accessory penalty, in which case, its duration shall be that of the principal penalty. ♥ Arresto mayor. — The duration of the penalty of arresto mayor shall be from one month and one day to six months. ♥ Arresto menor. — The duration of the penalty of arresto menor shall be from one day to thirty days. ♥ Bond to keep the peace. — The bond to keep the peace shall be required to cover such period of time as the court may determine. References ➪ Atty. Daguplo’s Power Point ➪ KC’s Notes ➪ http://www.batasnatin.com

END OF TRANS Guys, sinama ko na yung definition ng penalties as reference na din for succeeding lectures. Thank you. 

Transcribed by: KC

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