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Legal Medicine & Medical Jurisprudence
August 28, 2015

Atty. Malaya Capulong, MD, LIB


OUTLINE
I. Medical Jurisprudence
A. Purposes
II. Law and Practice of the Medicine
III. Practice of Medicine
A. Physician
IV. RA 2382 (as amended) The Medical Act of 1959)
A. Board of Medical Education under the Department of
Education
- Composition
- Functions
B. The Board of Medical Examiners
- Composition
- Qualifications Of The Examiners
- Functions
V. Registration Of Physicians
A. Sec. 10 Acts constituting practice of medicine
B. SEC. 8, R.A. 2382 (as amended)
- Who may practice medicine?
- Who may take the board examinations?

Legal Medicine
Primarily
concerned
with
legal
rights
and
responsibilities of medical practitioners with
particular reference to those arising from the doctorpatient relationship.
Includes:
o Licensure and regulatory laws
o Physicianpatient-hospital together with the other
paramedical personnel, their rights, duties and
obligations
o Liabilities for non-compliance with the law

PURPOSES
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
SC placed a cap to the amount of damage to the
plaintiff.
US law firms practices contingency basis where
they will shoulder first all the expenses so that
case can push through.
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.
Law and Practice of the 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.
To guarantee the safety of the patient
Impose liability to practitioner who through his act or
omission causes damage or injury to the health and
welfare of the patient
The right to regulate the practice of medicine is based
on the police power of the state.
Police Power of the State inherent power of the
state
Government enactments which precisely interfere with
personal liberty or property in order to promote the
general welfare or the common good
Examples: Who can buy real estate in the
Philippines and Who can be granted visa

Transcribers:GONZAGAs, MONTEMAYOR

o TABLARIN vs GUTIERREZ (GR No. 78764, July 31,


1987)
o RA 2382 Board of Medical Educaiton
Sec. 5 (a) to determine and prescribe
requirements for admission into a recognized
college of medicine
Sec. 7 Admission requirements
(b) a certificate of eligibility for entrance to a
medical school from the Board of Medical
Education
o MECS Order No. 52, s. 1985 established a
uniform admission test called NMAT
Before 1985 there was no NMAT; there was no
set passing rate; there was very many applicants
in medical students but the slots were limited
A valid exercise of the police power of the state
The regulation of the practice of medicine . . . long
been recognized as a reasonable method of
protecting the health and safety of the public.
That the power to regulate and control the practice of
medicine includes . . . the admission to the ranks
of those authorized to practice of medicine
theNMAT is reasonably related to the securing of the
ultimate end . . . the protection of the public from
the potential deadly effects of incompetence and
ignorance in those who would undertake to treat our
bodies and mind
o DECS vs San Diego (GR No. 89572, Dec. 21,
1989) Roberto Rey San Diego, BS Zoology
graduate, took the NMAT 4 times, application for
5th attempt was rejected
It is the right and responsibility of the State to ensure
that the medical profession is not infiltrated by
incompetents to whom patients may unwarily entrust
their lives and health.
While every person is entitled to aspire to be a doctor,
he does not have a constitutional right to be a
doctor.
The right to quality education is not absolute . . . one
must show that he is entitled to it because of his
preparation and promise.

Practice of Medicine
It is a privilege or franchise granted by the State to
any person to perform medical acts upon.
It is diagnosing and applying and the usage of
medicine and drugs for curing, mitigating, or relieving
bodily disease or conditions.
Physician
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)
RA 2382 (as amended) The Medical Act of 1959
Regulates the practice of medicine in the Philippines
Defines what constitutes practice of medicine

Prescribes the requirements in order to be able


to practice medicine

Prescribes the composition of the Board of


Medical Education and the Board of Medical
Examiners, their functions, duties and
obligations.

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Legal Medicine & Medical Jurisprudence


Note that that the Board of Medical
Education and Board of Medical
Examiners are two different bodies.
Some overlaps may exist but their
functions are completely different.
OBJECTIVES
a. The standardization and regulation of medical
education
b. The examination for registration of physicians
c. The supervision, control and regulation of the
practice of medicine in the Philippines
o

AGENCIES
1. Board of Medical Education under the
Department of Education
2. Board of Medical Examiners under the
Commissioner of Civil Service
BOARD OF MEDICAL EDUCATION VS. BOARD
OF MEDICAL EXAMINERS
Board of Medical
Board of Medical
Education
Examiners

The primary duty of


is to prescribe the
curriculum of
medical schools. So
more of the school
itself.

1.
2.
3.
4.
5.
6.
7.
8.

The content of the

board exams are


prescribed by the
Board of Medical
Examiners. They
also decide on
malpractice cases
brought before the
PRC.

Board of Medical Education under the


Department of Education
Composition
Secretary of Education or his duly authorized
representative, as chairman;
Secretary of Health or his duly authorized
representative;
Director of the Bureau of Private Schools or his
duly authorized representative;
Chairman of the Board of Medical Examiners or
his duly authorized representatives
Representative
of
the
Philippine
Medical
Association;
Dean of the College of Medicine, University of
the Philippines;
Representative of the Council of Deans of
Philippine Medical Schools;
Representative of the Association of Philippine
Medical Colleges, as members.

Functions
1. To
determine
and
prescribe
minimum
requirements for admission into a recognized
college of medicine.
2. To determine and prescribe requirements for
minimum physical facilities of colleges of
medicine, to wit: buildings, including hospitals,
equipment and supplies, apparatus, instruments,
appliances, laboratories, bed capacity for instruction
purposes, operating and delivery rooms, facilities for
out-patient services, and others, used for didactic
and practical instructions in accordance with modern
trends;
3. To determine and prescribe the minimum number
and
minimum
qualifications
of
teaching
personnel, including student-teachers ratio;
4. To determine and prescribe the minimum required
curriculum leading to the degree of Doctor of
Medicine;
5. To
authorize
the
implementation
of
experimental medical curriculum in a medical

Transcribers:GONZAGAs, MONTEMAYOR

school that has exceptional faculty and instrumental


facilities. Such an experimental curriculum may
prescribe admission and graduation requirements
other than those prescribed in this Act; provided that
only exceptional students shall be enrolled in the
experimental curriculum.
eg. INTARMED ng UP-PGH: This is advantageous for
those people who are already sure of their plans in
life and the profession they truly want to be in.
Those taking regular bachelors degree and then
proceed to medical school, have at least 2 years to
grow and think of their career paths.
6. To accept applications for certification for
admission to a medical schooland keep a register
of those issued said certificate; and to collect from
said applicants the amount of twenty-five pesos each
which shall accrue to the operating fund of the Board
of Medical Education;
7. To select, determine and approve hospitals or
some departments of the hospitals for training
which comply with the minimum specific physical
facilities as provided in subparagraph, hereof; and
8. To promulgate and prescribe and enforce the
necessary and regulations for the proper
implementation of the foregoing functions.
The Board of Medical Examiners
Composition
6
members
nominated
by
Philippine
Medical
Association and to be appointed by the President
Qualifications Of The Examiners
1. A natural-born citizen of the Philippines,
2. A duly registered physician in the Philippines
3. Has been in the practice of medicine for at least
ten years,
4. Is of good moral character and of recognized
standing in the medical profession,
5. Is not a member of the faculty of any medical
school and has no pecuniary interest, directly
or indirectly, in any college of medicine or in
any institution where any branch of medicine is
taught, at the time of his appointment; Provided,
That of the six members to be appointed, not more
than two shall be graduates of the same institution
and not more than three shall be government
physicians.
Pecuniary interest means monetary/financial
interest
Once appointed to become part of Board of
Medical Examiners, one must resign to his
current position to prevent any conflict of
interest.
Functions
1. Promulgate such rules and regulations for proper
conduct the examinations,
2. Formulate/ make the questions for the board
examinations but each examiner shall handle the
examinations in no more than four subjects
3. Correction of examination papers,
4. Registration of physicians
5. Delibrate and approve of the grades of the
examinees
6. Submit to the president of the Philippines for
approval the names of the successful candidates
as having been duly qualified for licensure in
alphabetical order.
7. Conduct administrativeinvestigations
REGISTRATION OF PHYSICIANS
SEC. 10 ACTS CONSTITUTING PRACTICE OF
MEDICINE
a) Physically examine any person, and diagnose,
treat, operate or prescribe any remedy for human
disease, injury, deformity, physical, mental, psychical

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Legal Medicine & Medical Jurisprudence


condition or any ailment, real or imaginary, regardless
of the nature of the remedy or treatment
administered, prescribed or recommended.
b) Who shall by means of signs, cards, advertisements,
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
any human disease, injury, deformity, physical, mental
or psychical condition
o Advertising yourself as a physician.
Ex. Billboard or considered practicing medicine.
Tarpaulin in your house Nagtutuli po ako. You ara
already considered practicing medicine.
c) Who shall falsely use the title M.D. after his name.
SEC. 8, R.A. 2382 (as amended)
Who may practice medicine?
1. At least 21 years old
2. Passed the Board Examination
3. Holder of a valid Certificate of Registration
issued by the Board of Medical Examiners
Passing the board exam does not automatically
give you the Certificate of Registration. You may
pass the board exam but the Board of Medical
Examiners may choose not to issue you the
certificate of registration (e.g. incomplete
requirements)
PRC vs De Guzman (GR No. 144681, June 21, 2004)
o 79 successful examinees from Fatima College (Feb
1993)
Biochem 11 got 100%, 11 99%
OB-Gyne 10 100%, 21 99%
PRC withheld registration of Fatima examinees (July
1993, Board Resolution No. 26)
SC Mandamus will not lie, mandamus is available
only if there is legal duty not involving discretion.
Writ of Mandamus Fatima insists that they
are entitle to be given a certification, but the
Board of Medical Examiners think otherwise
because the results were doubtful.
to be granted the privilege to practice medicine, the
applicant must show that he possesses all the
qualifications and none of the disqualifications.
. . . fully complied with all the conditions and
requirements by the law and the licensing authority.
Should doubt taint or mar the compliance as being
less than satisfactory, then the privilege will not
issue.
Who may take the Board Examinations?
Candidates for board examination:
1.Citizen of the Philippines or of a country whose
laws permit Filipino citizens to practice medicine.
o For foreigners who want to take the Philippine
Medical Board exams, they must first prove that
Filipinos are also permitted and not prohibited from
practicing in their countries.
o Note that the absence of practicing Filipinos in
their respective countries does not necessarily
equate to a prohibition. This is an illogical
argument.
2.Of good moral character
3.Of sound mind
4.Has not been convicted of a crime involving
moral turpitude
o When we say convicted the person must have
been convicted by a court of competent
jurisdiction. Final conviction po ito, and there must
be no remaining avenues for appeal. When does
this occur?
When the Supreme Court gives you the verdict
of guilty. Meaning you have exhausted all your
appeals. This is equivalent to conviction by final
judgment.

Transcribers:GONZAGAs, MONTEMAYOR

Agreeing to a pardon. Implicit to agreeing to a


pardon is admittance of guilt, meaning you are
accepting that you have indeed committed the
crime. This is tantamount to conviction by final
judgment, even if your case did not reach the
Supreme Court.
Parole:Pinalabasngmaaga for good behavior.
Pardon: Youre guilty but the government
forgives you.
As long as you are still appealing your case, you
still are NOT convicted by final judgment.
Crimes involving moral turpitude are crimes
which speak of moral depravity (def: moral
corruption), lack of ethics. Examples: Rape,
Murder, Adultery, Estafa
5.The holder of the degree of Doctor of Medicine or
equivalent, conferred by a college of medicine duly
recognized by the Department of Education
6.Completed Postgraduate internship
THE MEDICAL ACT OF 1959
ARTICLE III
SEC 11 EXEMPTIONS FOR SECTION 10
Who are exempt from violating the medical act by
practicing acts constituting the practice of
medicine? (i.e. examining, treating pts etc)
1. Medical student
o duly enrolled in an approved medical college or
school under training, serving without any
professional fee, under the direct supervision and
control of a registered physician
o for as long as you do these acts under the
supervision of a licensed physician. It doesnt mean
that they have to present all the time. We are talking
about nominal supervision (eg. yung sumasama sa
mga medical missions)
2. Legally registered dentist
o engaged exclusively in the practice of dentistry;
3. Registered masseur or physiotherapist
o upon written order or prescription of a duly
registered physician, or limited to physical or
muscular development
o e.g. Physical therapists as long as they have a
prescription from a rehab physician)
4. Duly registered optometrist
5. A person who gratuitously renders service in an
emergency
6. A person who administers or recommends
household remedies
o Over the counter meds
7. A clinical psychologist or mental hygienist
o provided such performance is done in conjunction
with a duly registered physician.
8. Prosthetist
THE MEDICAL ACT OF 1959
ARTICLE III
SEC 12 LIMITED PRACTICE WITHOUT ANY
CERTIFICATE OF REGISTRATION
1. Physicians from other countries called in for
consultation on specific and definite case or attached to
international organizations.
o Visiting foreign doctors for medical missions must
secure a temporary license from PRC.
o International org e.g. WHO, Red Cross physicians
2. Commissioned medical officers of the US Armed
Forces
o E.g. US Doctors from Balikatan exercises
3. Foreign Physicians employed as exchange professors
4. Medical students who have completed first 4 years of
medical school, graduates of medicine or RNs during
epidemics or national emergencies.

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Legal Medicine & Medical Jurisprudence


WHAT REGULATES MEDICAL JURISPRUDENCE
1. Hippocratic Oath
2. Code of Ethics
CODE OF ETHICS
There are two Codes of Ethics available:
1. Board of Medicine Code of Ethics
2. Code of Ethics of the Medical Profession by the
Philippine Medical Association
HIPPOCRATIC OATH
I SWEAR by Apollo the physician and Aesculapius, and
Health, and All-heal, and all the gods and goddesses,
that, according to my ability and judgment, I will keep
this Oath and this stipulation-- to reckon him who taught
me this Art equally dear to me as my parents, to share
my substance with him, and relieve his necessities
ifrequired; to look upon his offspring in the same footing
as my own brothers, and to teach them this art, if they
shall wish to learn it, without fee or stipulation; and that
by precept, lecture, and every other mode of instruction,
I will impart a knowledge of the Art to my own sons, and
those of my teachers, and to disciples bound by a
stipulation and oath according to the law of medicine,
but to none others.
I will follow that system of regimen which, according to
my ability and judgment, I consider for the benefit of my
patients, and abstain from whatever is deleterious and
mischievous. I will give no deadly medicine to any one if
asked, nor suggest any such counsel; and in like manner
I will not give to a woman a pessary to produce abortion.
With purity and with holiness I will pass my life and
practice my Art. I will not cut persons labouring under
the stone, but will leave this to be done by men who are
practitioners of this work. Into whatever houses I enter,
I will go into them for the benefit of the sick, and will
abstain from every voluntary act of mischief and
corruption; and, further, from the seduction of females
or males, of freemen and slaves.
Whatever, in connection with my professional service, or
not in connection with it, I see or hear, in the life of
men, which ought not to be spoken of abroad, I will not
divulge, as reckoning that all such should be kept secret.
While I continue to keep this Oath unviolated, may it be
granted to me to enjoy life and the practice of the art,
respected by all men, in all times. But should I trespass
and violate this Oath, may the reverse be my lot.

PATIENTS RIGHTS
Patients should receive treatment consistent with the
dignity and respect they are owed as human beings.
Most basic tenet!
1. Equitable access to quality medical care
2. Ensuring patients privacy and the confidentiality of
their medical information
3. Informing patients and obtaining their consent
before employing a medical intervention
4. Providing a safe clinical environment
5. The right to receive information from physicians and
to discuss the benefits, risks, and costs of
appropriate treatment alternatives (Informed
consent)
6. The right to make decisions regarding the health
care that is recommended by the physician
7. The right to courtesy, respect, dignity,
responsiveness, and timely attention to health needs
8. The right to confidentiality
9. The right to continuity of health care
10. The basic right to have adequate health care
KINDS OF MEDICAL FEES
1. Simple Contractual Fee
o Specifically stating the value of such medical
service, either orally or in writing
2. Retainer fee
o Measured by the space of time rendered by patient
3. Contingent fee
o Depends upon
instituted

the

failure

of

the

treatment

4. Dichotomous fee (fee splitting)


o The physician may require the services of a person
who may act as agent to solicit patients, and the
agent will share in the medical fee.
5. Straight Fee
o For the amount tendered by the patient to the
physician, the latter shall be responsible for the
payment of hospital bill, lab fees, medicines, and
other incidental expenses
o This kind of fee is unethical because the amount
wagers with the unforeseeable contingencies.

THE MODERN HIPPOCRATIC OATH (1910)


You do solemnly swear, each by whatever he or she
holds most sacred:
o That you will be loyal to the Profession of Medicine
and just and generous to its members.
o That you will lead your lives and practice your art in
uprightness and honor.
o That into whatsoever house you shall enter, it shall
be for the good of the sick to the utmost of your
power, your holding yourselves far aloof from wrong,
from corruption, from the tempting of others to vice.
o That you will exercise your art solely for the cure of
your patients, and will give no drug, perform no
operation, for a criminal purpose, even if solicited,
far less suggests it.
o That whatsoever you shall see or hear of the lives of
men or women which is not fitting to be spoken, you
will keep inviolably secret.
o These things do you swear. Let each bow the head in
sign of acquiescence. And now, if you will be true to
this, your oath, may prosperity and good repute be
ever yours; the opposite, if you shall prove
yourselves forsworn.

Transcribers:GONZAGAs, MONTEMAYOR

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