LEGAL MEDICINE CASES

Part 3 (Medical Practice as Privilege)

I. Prerequisites to the Practice of Medicine
Republic of the Philippines
BOARD OF MEDICINE ET. AL VS. OTA, G.R. NO. 166097, JULY 14, 2008 SUPREME COURT
Manila
II. Illegal Practice of Medicine
THIRD DIVISION
C. CRIMINAL IN NATURE
PEOPLE VS. QUEBRAL, (also include digest for [Illegal Practice Explained in Court Decisions]) G.R. No. 166097 July 14, 2008

D. INTENT IS IMMATERIAL BOARD OF MEDICINE, DR. RAUL FLORES (now DR. JOSE S. RAMIREZ), in his capacity as
PEOPLE VS. ANUNCIACION VDA. DE GOLEZ, JUNE 30, 1960 Chairman of the Board, PROFESSIONAL REGULATION COMMISSION, through its Chairman,
HERMOGENES POBRE (now DR. ALCESTIS M. GUIANG), Petitioners,
F. IT IS INDEPENDENT FROM OTHER CRIMES COMMITTED WITH IT vs.
PEOPLE VS. HATANI, G.R. NOS. 78813-14, NOVEMBER 8, 1993 (also include digest for [Illegal YASUYUKI OTA, Respondent.
Practice Explained in Court Decisions])
DECISION
III. Illegal Practice Explained in Court Decisions
A. PEOPLE VS. VENTURA, G.R. NO. L-15079, JANUARY 31, 1962 AUSTRIA-MARTINEZ, J.:
B. PEOPLE VS. BUENVIAJE, 47 PHIL. 536 Mel Loise Delmoro
C. CRISOSTOMO VS. SEC, G.R. NOS. 89095 & 89555, NOVEMBER 6, 1989 Before the Court is a Petition for Review on Certiorari assailing the Decision1 of the Court of Appeals
(CA) in CA-G.R. SP No. 849452 dated November 16, 2004 which affirmed the Decision 3 of the Regional
IV. Faith Healing (GR, Exemption?) Trial Court (RTC), Branch 22, Manila, dated October 19, 2003. 4
D. PEOPLE VS. HANDZIK, 102 N.E. (2D) 340 ILL. 1951.
E. PEOPLE VS. WENDEL, 68 N.Y.S. (2D) N.Y. 1946. The facts are as follows:
F. PEOPLE VS. COLE, 219 N.Y. 98, 113 N.E. 790 L.R.A. 1917 C 816 -
Yasuyuki Ota (respondent) is a Japanese national, married to a Filipina, who has continuously resided in
Part 4 (Patient-Physician Relationship) the Philippines for more than 10 years. He graduated from Bicol Christian College of Medicine on April
1. GARCIA-RUEDA VS. PASCASIO, G.R. NO. 118141, SEPTEMBER 5, 1997 21, 1991 with a degree of Doctor of Medicine. 5 After successfully completing a one-year post graduate
2. SANTIAGO A DEL ROSARIO, ET. AL., VS. HONORABLE internship training at the Jose Reyes Memorial Medical Center, he filed an application to take the medical
ALFREDO BENGZON, G.R. NO. 88265, DECEMBER 21, 1989 board examinations in order to obtain a medical license. He was required by the Professional Regulation
Commission (PRC) to submit an affidavit of undertaking, stating among others that should he successfully
IV. Duties of Physicians to their patients. pass the same, he would not practice medicine until he submits proof that reciprocity exists between Japan
CARILLO VS. PEOPLE OF THE PHILIPPINES, G.R. NO. 86890, JAN. 21, 1994 and the Philippines in admitting foreigners into the practice of medicine. 6

Not assigned yet. Respondent submitted a duly notarized English translation of the Medical Practitioners Law of Japan duly
PEOPLE VS. KLINGER, ILL. 11 N.E. 40 authenticated by the Consul General of the Philippine Embassy to Japan, Jesus I. Yabes; 7 thus, he was
STATE BOARD OF MEDICAL EXAMINERS VS. MAXWELL, N.J. 181 A. 694 allowed to take the Medical Board Examinations in August 1992, which he subsequently passed. 8

In spite of all these, the Board of Medicine (Board) of the PRC, in a letter dated March 8, 1993, denied
respondent's request for a license to

Page 1 of 39
practice medicine in the Philippines on the ground that the Board "believes that no genuine reciprocity can
be found in the law of Japan as there is no Filipino or foreigner who can possibly practice there." 9
Respondent then filed a Petition for Certiorari and Mandamus against the Board before the RTC of
Manila on June 24, 1993, which petition was amended on February 14, 1994 to implead the PRC through
its Chairman.10
In his petition before the RTC, respondent alleged that the Board and the PRC, in refusing to issue in his
favor a Certificate of Registration and/or license to practice medicine, had acted arbitrarily, in clear
contravention of the provision of Section 20 of Republic Act (R.A.) No. 2382 (The Medical Act of 1959),
depriving him of his legitimate right to practice his profession in the Philippines to his great damage and
prejudice.11
On October 19, 2003, the RTC rendered its Decision finding that respondent had adequately proved that
the medical laws of Japan allow foreigners like Filipinos to be granted license and be admitted into the
practice of medicine under the principle of reciprocity; and that the Board had a ministerial duty of issuing
the Certificate of Registration and license to respondent, as it was shown that he had substantially
complied with the requirements under the law.12 The RTC then ordered the Board to issue in favor of
respondent the corresponding Certificate of Registration and/or license to practice medicine in the
Philippines.13
The Board and the PRC (petitioners) appealed the case to the CA, stating that while respondent submitted
documents showing that foreigners are allowed to practice medicine in Japan, it was not shown that the
conditions for the practice of medicine there are practical and attainable by a foreign applicant, hence,
reciprocity was not established; also, the power of the PRC and the Board to regulate and control the
practice of medicine is discretionary and not ministerial, hence, not compellable by a writ of mandamus.14
The CA denied the appeal and affirmed the ruling of the RTC. 15
Hence, herein petition raising the following issue:
WHETHER THE COURT OF APPEALS COMMITTED A REVERSIBLE ERROR IN FINDING THAT
RESPONDENT HAD ESTABLISHED THE EXISTENCE OF RECIPROCITY IN THE PRACTICE OF
MEDICINE BETWEEN THE PHILIPPINES AND JAPAN.16
Petitioners claim that: respondent has not established by competent and conclusive evidence that
reciprocity in the practice of medicine exists between the Philippines and Japan. While documents state
that foreigners are allowed to practice medicine in Japan, they do not similarly show that the conditions
for the practice of medicine in said country are practical and attainable by a foreign applicant. There is no
reciprocity in this case, as 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, which were
not clarified by respondent, i.e., what are the provisions of the School Educations Laws, what are the
criteria of the Minister of Health and Welfare of Japan in determining whether the academic and technical
capability of foreign medical graduates are the same or better than graduates of medical schools in Japan,
and who can actually qualify to take the preparatory test for the National Medical Examination. Consul
Page 2 of 39
General Yabes also stated that there had not been a single Filipino who was issued a license to practice
medicine by the Japanese Government. The publication showing that there were foreigners practicing
medicine in Japan, which respondent presented before the Court, also did not specifically show that
Filipinos were among those listed as practicing said profession. 17 Furthermore, under Professional
Regulation Commission v. De Guzman, 18 the power of the PRC and the Board to regulate and control the
practice of medicine includes the power to regulate admission to the ranks of those authorized to practice
medicine, which power is discretionary and not ministerial, hence, not compellable by a writ
of mandamus.19
Petitioners pray that the CA Decision dated November 16, 2004 be reversed and set aside, that a new one
be rendered reinstating the Board Order dated March 8, 1993 which disallows respondent to practice
medicine in the Philippines, and that respondent's petition before the trial court be dismissed for lack of
merit.20
In his Comment, respondent argues that: Articles 2 and 11 of the Medical Practitioners Law of Japan and
Section 9 of the Philippine Medical Act of 1959 show that reciprocity exists between the Philippines and
Japan concerning the practice of medicine. Said laws clearly state that both countries allow foreigners to
practice medicine in their respective jurisdictions as long as the applicant meets the educational
requirements, training or residency in hospitals and pass the licensure examination given by either
country. Consul General Yabes in his letter dated January 28, 1992 stated that "the Japanese Government
allows a foreigner to practice medicine in Japan after complying with the local requirements." The fact
that there is no reported Filipino who has successfully penetrated the medical practice in Japan does not
mean that there is no reciprocity between the two countries, since it does not follow that no Filipino will
ever be granted a medical license by the Japanese Government. It is not the essence of reciprocity that
before a citizen of one of the contracting countries can demand its application, it is necessary that the
interested citizens country has previously granted the same privilege to the citizens of the other
contracting country.21 Respondent further argues that Section 20 of the Medical Act of 1959 22 indicates the
mandatory character of the statute and an imperative obligation on the part of the Board inconsistent with
the idea of discretion. Thus, a foreigner, just like a Filipino citizen, who successfully passes the
examination and has all the qualifications and none of the disqualifications, is entitled as a matter of right
to the issuance of a certificate of registration or a physicians license, which right is enforceable
by mandamus.23
Petitioners filed a Reply24 and both parties filed their respective memoranda 25 reiterating their
arguments.1avvphi1
The Court denies the petition for lack of merit.
There is no question that a license to practice medicine is a privilege or franchise granted by the
government.26 It is a right that is earned through years of education and training, and which requires that
one must first secure a license from the state through professional board examinations. 27
Indeed,
[T]he regulation of the practice of medicine in all its branches has 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 power to regulate admission to the ranks of those authorized to practice
medicine, is also well recognized. Thus, legislation and administrative regulations requiring those who
wish to practice medicine first to take and pass medical board examinations have long ago been
recognized as valid exercises of governmental power. Similarly, the establishment of minimum medical
educational requirements i.e., the completion of prescribed courses in a recognized medical school for
admission to the medical profession, has also been sustained as a legitimate exercise of the regulatory
authority of the state."28
It must be stressed however that the power to regulate the exercise of a profession or pursuit of an
occupation cannot be exercised by the State or its agents in an arbitrary, despotic, or oppressive manner. A
political body which regulates the exercise of a particular privilege has the authority to both forbid and
grant such privilege in accordance with certain conditions. As the legislature cannot validly bestow an
arbitrary power to grant or refuse a license on a public agency or officer, courts will generally strike down
license legislation that vests in public officials discretion to grant or refuse a license to carry on some
ordinarily lawful business, profession, or activity without prescribing definite rules and conditions for the
guidance of said officials in the exercise of their power.29
R.A. No. 2382 otherwise known as the Medical Act of 1959 states in Section 9 thereof that:
Section 9. Candidates for Board Examinations.- Candidates for Board examinations shall have the
following qualifications:
1. He shall be a citizen of the Philippines or a citizen of any foreign country who has submitted competent
and conclusive documentary evidence, confirmed by the Department of Foreign Affairs, showing that his
countrys existing laws permit citizens of the Philippines to practice medicine under the same rules and
regulations governing citizens thereof;
xxxx
Presidential Decree (P.D.) No. 22330 also provides in Section (j) thereof that:
j) The [Professional Regulation] Commission may, upon the recommendation of the Board concerned,
approve the registration of and authorize the issuance of a certificate of registration with or without
examination to a foreigner who is registered under the laws of his country: Provided, That the requirement
for the registration or licensing in said foreign state or country are substantially the same as those required
and contemplated by the laws of the Philippines and that the laws of such foreign state or country allow
the citizens of the Philippines to practice the profession on the same basis and grant the same privileges as
the subject or citizens of such foreign state or country: Provided, finally, That the applicant shall submit
competent and conclusive documentary evidence, confirmed by the Department of Foreign Affairs,
showing that his country's existing laws permit citizens of the Philippines to practice the profession under
the rules and regulations governing citizens thereof. The Commission is also hereby authorized to
prescribe additional requirements or grant certain privileges to foreigners seeking registration in the
Philippines if the same privileges are granted to or some additional requirements are required of citizens
of the Philippines in acquiring the same certificates in his country;
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xxxx
As required by the said laws, respondent submitted a copy of the Medical Practitioners Law of Japan, duly
authenticated by the Consul General of the Embassy of the Philippines in Japan, which provides in
Articles 2 and 11, thus:
Article 2. Anyone who wants to be medical practitioner must pass the national examination for medical
practitioner and get license from the Minister of Health and Welfare.
xxxx
Article 11. No one can take the National Medical Examination except persons who conform to one of the
following items:
1. Persons who finished regular medical courses at a university based on the School Education Laws
(December 26, 1947) and graduated from said university.
2. Persons who passed the preparatory test for the National Medical Examination and practiced clinics and
public sanitation more than one year after passing the said test.
3. Persons who graduated from a foreign medical school or acquired medical practitioner license in a
foreign country, and also are recognized to have the same or more academic ability and techniques as
persons stated in item 1 and item 2 of this article. 31
Petitioners argue that while the Medical Practitioners Law of Japan allows foreigners to practice medicine
therein, said document does not show that conditions for the practice of medicine in said country are
practical and attainable by a foreign applicant; and since the requirements are practically impossible for a
Filipino to comply with, there is no reciprocity between the two countries, hence, respondent may not be
granted license to practice medicine in the Philippines.
The Court does not agree.
R.A. No. 2382, which provides who may be candidates for the medical board examinations, merely
requires a foreign citizen to submit competent and conclusive documentary evidence, confirmed by the
Department of Foreign Affairs (DFA), showing that his countrys existing laws permit citizens of the
Philippines to practice medicine under the same rules and regulations governing citizens thereof.
Section (j) of P.D. No. 223 also defines the extent of PRC's power to grant licenses, i.e., it may, upon
recommendation of the board, approve the registration and authorize the issuance of a certificate of
registration with or without examination to a foreigner who is registered under the laws of his country,
provided the following conditions are met: (1) that the requirement for the registration or licensing in said
foreign state or country are substantially the same as those required and contemplated by the laws of the
Philippines; (2) that the laws of such foreign state or country allow the citizens of the Philippines to
practice the profession on the same basis and grant the same privileges as the subject or citizens of such
foreign state or country; and (3) that the applicant shall submit competent and conclusive documentary
evidence, confirmed by the DFA, showing that his country's existing laws permit citizens of the
Philippines to practice the profession under the rules and regulations governing citizens thereof.
The said provision further states that the PRC is authorized to prescribe additional requirements or grant
certain privileges to foreigners seeking registration in the Philippines if the same privileges are granted to
or some additional requirements are required of citizens of the Philippines in acquiring the same
certificates in his country.
Nowhere in said statutes is it stated that the foreign applicant must show that the conditions for the
practice of medicine in said country are practical and attainable by Filipinos. Neither is it stated that it
must first be proven that a Filipino has been granted license and allowed to practice his profession in said
country before a foreign applicant may be given license to practice in the Philippines. Indeed, the phrase
used in both R.A. No. 2382 and P.D. No. 223 is that:
[T]he applicant shall submit] competent and conclusive documentary evidence, confirmed by the
Department of Foreign Affairs, showing that his country's existing laws permit citizens of the Philippines
to practice the profession [of medicine] under the [same] rules and regulations governing citizens thereof.
x x x (Emphasis supplied)
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.
While it is true that respondent failed to give details as to the conditions stated in the Medical Practitioners
Law of Japan -- i.e., the provisions of the School Educations Laws, the criteria of the Minister of Health
and Welfare of Japan in determining whether the academic and technical capability of foreign medical
graduates are the same as or better than that of graduates of medical schools in Japan, and who can
actually qualify to take the preparatory test for the National Medical Examination respondent, however,
presented proof that foreigners are actually practicing in Japan and that Filipinos are not precluded from
getting a license to practice there.
Respondent presented before the trial court a Japanese Government publication, Physician-Dentist-
Pharmaceutist Survey, showing that there are a number of foreign physicians practicing medicine in
Japan.32 He also presented a letter dated January 28, 1992 from Consul General Yabes, 33 which states:
Sir:
With reference to your letter dated 12 January 1993, concerning your request for a
Certificate of Confirmation for the purpose of establishing a reciprocity with Japan in
the practice of medical profession relative to the case of Mr. Yasuyuki Ota, a Japanese
national, the Embassy wishes to inform you that inquiries from the Japanese Ministry
of Foreign Affairs, Ministry of Health and Welfare as well as Bureau of Immigration
yielded the following information:
Page 4 of 39
1. They are not aware of a Filipino physician who was granted a license by the
Japanese Government to practice medicine in Japan;
2. However, the Japanese Government allows a foreigner to practice medicine in
Japan after complying with the local requirements such as holding a valid visa for the
purpose of taking the medical board exam, checking the applicant's qualifications to
take the examination, taking the national board examination in Japanese and filing an
application for the issuance of the medical license.
Accordingly, the Embassy is not aware of a single Filipino physician who was issued
by the Japanese Government a license to practice medicine, because it is extremely
difficult to pass the medical board examination in the Japanese language. Filipino
doctors here are only allowed to work in Japanese hospitals as trainees under the
supervision of a Japanese doctor. On certain occasions, they are allowed to show their
medical skills during seminars for demonstration purposes only. (Emphasis supplied)
Very truly yours,
Jesus I. Yabes
Minister Counsellor &
Consul General
From said letter, one can see that the Japanese Government allows foreigners to practice medicine therein
provided that the local requirements are complied with, and that it is not the impossibility or the
prohibition against Filipinos that would account for the absence of Filipino physicians holding licenses
and practicing medicine in Japan, but the difficulty of passing the board examination in the Japanese
language. Granting that there is still no Filipino who has been given license to practice medicine in Japan,
it does not mean that no Filipino will ever be able to be given one.
Petitioners next argue that as held in De Guzman, its power to issue licenses is discretionary, hence, not
compellable by mandamus.
The Court finds that the factual circumstances of De Guzman are different from those of the case at bar;
hence, the principle applied therein should be viewed differently in this case. In De Guzman, there were
doubts about the integrity and validity of the test results of the examinees from a particular school which
garnered unusually high scores in the two most difficult subjects. Said doubts called for serious inquiry
concerning the applicants satisfactory compliance with the Board requirements. 34 And as there was no
definite showing that the requirements and conditions to be granted license to practice medicine had been
satisfactorily met, the Court held that the writ of mandamus may not be granted to secure said privilege
without thwarting the legislative will. 35
Indeed, to be granted the privilege to practice medicine, the applicant must show that he possesses all the
qualifications and none of the disqualifications. It must also appear that he has fully complied with all the
conditions and requirements imposed by the law and the licensing authority. 36
In De Guzman itself, the Court explained that:

A careful reading of Section 20 37 of the Medical Act of 1959 discloses that the law uses the word "shall"
with respect to the issuance of certificates of registration. Thus, the petitioners [PRC] "shall sign and issue
certificates of registration to those who have satisfactorily complied with the requirements of the Board."
In statutory construction the term "shall" is a word of command. It is given imperative meaning. Thus,
when an examinee satisfies the requirements for the grant of his physician's license, the Board is obliged
to administer to him his oath and register him as a physician, pursuant to Section 20 and par. (1) of
Section 22 of the Medical Act of 1959.38
Republic of the Philippines
In this case, there is no doubt as to the competence and qualifications of respondent. He finished his SUPREME COURT
medical degree from Bicol Christian College of Medicine. He completed a one-year post graduate Manila
internship training at the Jose Reyes Memorial Medical Center, a government hospital. Then he passed the
Medical Board Examinations which was given on August 8, 1992 with a general average of 81.83, with EN BANC
scores higher than 80 in 9 of the 12 subjects.
G.R. No. 46094 September 27, 1939
In fine, the only matter being questioned by petitioners is the alleged failure of respondent to prove that
there is reciprocity between the laws of Japan and the Philippines in admitting foreigners into the practice THE PEOPLE OF THE PHILIPPINES, plaintiff-appellee,
of medicine. Respondent has satisfactorily complied with the said requirement and the CA has not vs.
committed any reversible error in rendering its Decision dated November 16, 2004 and Resolution dated FERNANDO C. QUEBRAL, defendant-appellant.
October 19, 2003.

Mabanag, Primicias, Abad and Mencias for appellant.

WHEREFORE, the petition is hereby DENIED for lack of merit. Office of the Solicitor-General Ozaeta and Assistant Attorney Kapunan, Jr., for appellee.

SO ORDERED. MORAN, J.:

In June, 1937, the provincial fiscal of Pangasinan filed an information against the accused, Fernando C.
Quebral, for violation of section 770 of the Administrative Code. The pertinent portion of the information
reads as follows:

Que en o hacia y desde el ao de 1930 en adelante hasta el mes de mayo de 1937, inclusive, en los
municipios de San Jacinto, Mapandan, Mangaldan y Dagupan, Provincia de Pangasinan, Filipinas, y
dentro de la jurisdiccion de este Juzgado, el acusado arriba nombrado voluntaria, ilegal y criminalmente y
sin haber obtenido previamente el certificado de registro correspondiente, expedido por la Junta
Examinadora de Medicos, ejercio la maedicina dentro de los terminos del articulo 770 del Codigo
Administrativo Revisado, . . ..

There is no question that the accused diagnosed, treated and prescribed for certain diseases suffered by
certain patients, from whom he received money as compensation; but it is contended that no evidence has
been adduced to the effect that the accused had thus practiced medicine "without having previously
obtained the proper certificate of registration issued by the Board of Medical Examiners," as provided in
section 770 of the Administrative Code.

As to this question, the lower court said:

Page 5 of 39
No hay cuestion alguna en cuanto al hecho de que los actos del acusado probados por la acusacion
constituyen un ejercicio de la medicina. La unica cuestion, por tanto, a determinar es la de si o no
incumbia a la acusacion probar que dicho acusado habia ejercido la profesion medica sin estar
previamente registrado como tal medico.
Teniendo en cuenta lo dispuesto en el articulo 297 del Codigo de Procedimiento Civil y la doctrina
enunciada por nuestra Honorable Corte Suprema en las causas Estados Unidos contra Gonzalez (10 Jur.
Fil., 67); Estados Unidos contra Co Pinco (10 Jur. Fil., 370); Estados Unidos contra Tria (17 Jur. Fil.,
304); y Estados Unidos contra De la Torre (42 Jur. Fil., 65), el Juzgado cree que noe es necesario que la
accusacion prueba que el acusado no estaba previamente registrado como medico antes de ejercer la
profesion medica, pues, si el acusado lo estaba, y funda su defensa en tal hecho, a el incumbre probarlo.
entry of a specified tenor and has been unable to find it ought to be usually as satisfactory for evidencing
its non-existence in his office as his testimony on the stand to this effect would be." (3 Wigmore on
Evidence, p. 561.) Furthermore, Exhibit H-3 is also mentioned in the decision of the lower court, which is
a letter of the accused to the President of the Philippines, quoting approvingly an article published in
the Philippine Herald, wherein it is said that Fernando Quebral is not a holder of a doctor of medicine
degree. These Exhibits, F-2 and H-3, are sufficient evidence to show that the accused has been practicing
medicine without the required certificate of registration issued by the Board of Medical Examiners.
Judgment is affirmed, with costs against appellant.

The accused was found guilty of the offense charged and was sentenced to pay a fine of two hundred
pesos (P200) with subsidiary imprisonment in case of insolvency. He appealed, and, in this court, he
reiterates his contention that it is incumbent upon the prosecution to prove that he practiced medicine
without the proper certificate, and that there being no evidence to that effect, he should be acquitted.

The rule is, and has always been, that, if the subject of the negative avernment, like, for instance, the act
of voting without the qualifications provided by law, inheres in the offense as an essential ingredient
thereof, the prosecution has the burden of proving the same. (Sec. 297, Act No. 190; U.S. vs. Tria, 17
Phil., 303, 306, 307.) In view, however, of the difficult office of proving a negative allegation, the
prosecution, under such circumstance, need do no more than make a prima facie case from the best
evidence obtainable. (U.S. vs. Tria, supra.) It would certainly be anomalous to hold ". . . that mere
difficulty in discharging a burden of making proof should displace it; and as a matter of principle the
difficulty only relieves the party having the burden of evidence from the necessity of creating positive
conviction entirely by his own evidence; so that, when he produces such evidence as it is in his power to
produce, its probative effect is enhanced by the silence of his opponent. (22 C.J., pp. 81, 82.)

The rule, however, is different when the subject of the negative avernment does not constitute an essential
element of the offense, but is purely a matter of defense. In such case, the burden of proof is upon the
defendant. As to whether or not a negative avernment is a matter of defense, is a question which we have
fully discussed in United States vs. Chan Toco (12 Phil., 262).

Section 770 of the Administrative Code provides that "no person shall practice medicine in the Philippine
Islands without having previously obtained the proper certificate of registration issued by the Board of
Medical Examiners . . .." This provision clearly includes the want of certificate as an essential element of
the offense charged. The negative fact is not separable from the offense as defined. It is, therefore,
incumbent upon the prosecution to prove that negative fact, and failure to prove it is a ground for
acquittal.

In the instant case, however, the decision rendered by the lower court makes mention of Exhibit F-2 as
showing that the accused is not a registered physician. That document is signed by Jose Ma. Delgado,
chairman of the Board of Medical Examiners, wherein it is stated, in part, that "there is nothing in the
records of this Board to show that Mr. Fernando C. Quebral is a registered physician." This document is
admissible as evidence of its contents, under one of the exceptions to the hearsay rule, regarding official
written statements. "The certificate of a custodian that he has diligently searched for a document or an

Page 6 of 39
 In view of the foregoing manifestation of the Fiscal, the Court finds that the information is fatally
defective and, therefore, should be dismissed under Par. (a), Sec. 2 of Rule 113 of the Rules of Court
inasmuch as the facts charged do not constitute the offense of homicide thru reckless imprudence because
illegal practice of medicine is malicious per se, and when the accused practiced medicine without
academical preparation and without a license to do so, then she is per se committing a criminal act for
which the criminal intent is presumed. Although the crime of homicide thru reckless imprudence can be
committed by a duly licensed physician when in the practice of his profession he fails to exercise due care
Republic of the Philippines and diligence from which the criminal act arises, this crime cannot be imputed to a person who has no
SUPREME COURT authority to practice this profession, which act is malicious per se. The crime described in Article 365 of
Manila the Revised Penal Code results from the performance of a lawful act which was done without exercising
the care and diligence that is required by the circumstances, and not from the performance of an unlawful
EN BANC act which is the subject of the information in this case because a quack doctor who practices medicine
does so against the law, and, therefore, his act is necessarily malicious and criminal.

G.R. No. L-14160 June 30, 1960

PEOPLE OF THE PHILIPPINES, plaintiff-appellant,
vs.
ANUNCIACION VDA. DE GOLEZ, defendant-appellee.
Assistant Solicitor General Antonio A. Torres and Solicitor Jorge R. Coquia for appellant.
Aniceto V. Zezobrado for appellee.
REYES, J. B. L., J.:
On October 2, 1957, the provincial fiscal of Negros Occidental filed an information in the Court of First
Instance of that province charging Anunciacion Vda. de Golez with the crime of homicide through
reckless imprudence, as follows:
That on or about the period comprised from December 12, 1956 to December 24, 1956, in the
municipality of San Carlos, province of Negros Occidental, Philippines, and within the jurisdiction of this
Honorable Court, the herein accused, without being duly licensed to practice medicine and with reckless
negligence and without taking due precaution, did, then and there, wilfully, unlawfully, and feloniosly
diagnose, prescribe, and treat one Susana Tam, who had been suffering for sometime with bodily ailment,
knowing fully well that she is incompetent and not possessing the necessary technical or scientific
knowledge or skill, and as a consequence of such negligence and carelessness and lack of medical skill,
said Susana Tam died thereafter.
The accused pleaded not guilty to the information.
When the case was called for trial, the assistant fiscal made a manifestation that the accused had also been
charged with the crime of illegal practice of medicine before another sala of the same court. In view of
this manifestation, the trial court motu proprio dismissed the information for being fatally defective,
without prejudice to the filing of the proper information against the same accused. The grounds given for
the dismissal were the following:
From the above order, the provincial fiscal appealed to this Court, and, through the Solicitor General,
urges that the court below erred in dismissing the information for being fatally defective because the facts
charged therein allegedly do not constitute the crime of homicide thru reckless imprudence.
We agree with appellant that the order of dismissal is erroneous, in that the crime of illegal practice of
medicine is a statutory offense wherein criminal intent is taken for granted, so that a person may be
convicted thereof irrespective of his intention and in spite of his having acted in good faith and without
malice; i.e., even if he was not motivated by an evil desire to injure or hurt another, but by an honest
desire to cure or alleviate the pain of a patient. In fact, as defined by Section 2678 of the Revised
Administrative Code (the law then in force), the offense consists in the mere act of practicing medicine in
violation of the Medical Law, even if no injury to another, much less death, results from such malpractice.
When, therefore, the patient dies, the illegal practitioner should be equally responsible for the death of his
patient, an offense independent of and distinct from the illegal practice of medicine.
The allegations in the information in this case that the accused acted with reckless negligence in
diagnosing, prescribing for, and treating the deceased Susana Tam, knowing that she did not possess the
necessary technical knowledge or skill to do so, thus causing her death, sufficiently charge the crime of
homicide through reckless imprudence, since ordinary diligence counsels one not to tamper with human
life by trying to treat a sick man when he knows that he does not have the special skill, knowledge, and
competence to attempt such treatment and cure, and may consequently reasonably foresee harm or injury
to the latter, said accused was found guilty and convicted by this Court of physical injuries through
imprudence under the old Penal Code (U. S. vs. Feliciano Divino, 12 Phil., 175).
However, in view of the error of the lower court in dismissing the information, we cannot sustain this
appeal for the reason that it would place the accused in double jeopardy. The present information being
valid and sufficient in form and substance to sustain a conviction, the dismissal thereof by the court after
the accused had pleaded not guilty to the charge and without his consent constitutes jeopardy as to bar
further proceedings upon the case (U. S vs. Yam Tung Way, 21 Phil., 67; People vs. Hernandez, 94 Phil.,
49; 49 Off. Gaz. No. 12, 5342; People vs. Ferrer, 100 Phil., 124; 55 Off. Gaz. [4] 620). The failure of the
accused to file a brief and raise the question of double jeopardy in this appeal does not mean that section
2, Rule 118, providing that the People can not appeal if the defendant would be placed in double jeopardy
would no longer apply (People vs. Bao, 106 Phil., 243; 56 Off. Gaz. [51] 7768).

Page 7 of 39
The unfortunate result in this case could have been avoided if the trial court had proceeded more
deliberately, without allowing its judgment to be influenced by preconceived notions or undue haste in
dispatching cases.
The appeal is, therefore, dismissed, with costs de oficio.
Republic of the Philippines
SUPREME COURT
Manila
FIRST DIVISION
G.R. Nos. 78813-14 November 8, 1993
PEOPLE OF THE PHILIPPINES, plaintiff-appellee,
vs.
FARHAD HATANI y ABOLHASSAN, accused-appellant.
QUIASON, J.:
This is an appeal from the decisions of the Regional Trial Court, Branch 105, Quezon City, convicting
appellant in Criminal Cases No. Q-11867 and No. Q-11868.
The dispositive portion of the decision in Criminal Case No. Q-11867 reads as follows:
WHEREFORE, premises considered, the Court finds the accused Farhad Hatani y Abolhassan, GUILTY
beyond reasonable doubt of illegal practice of medicine in violation of R.A. 2382 otherwise known as the
Medical Act of 1959 (Secs. 8, 10) penalized by Section 28 thereof with "a fine of not less than one
thousand pesos nor more than ten thousand pesos with subsidiary imprisonment in case of insolvency, or
by imprisonment of not less than one year nor more than five years, or by both such fine and
imprisonment, in the discretion of the court; and considering the circumstances of the case and the
ignominy caused by him to his two teen-aged, female, then unmarried victims, this Court exercising its
discretion granted under said Section 28 of the law, hereby SENTENCES said accused FARHAD
HATANI Y ABOLHASSAN to pay a fine of ten thousand pesos (P10,000.00) with subsidiary
imprisonment in case of insolvency AND to suffer imprisonment of five (5) years; and to pay the costs.
This Court further recommends that after service of his sentence the accused be deported as undesirable
alien (Rollo, p. 35).
The dispositive portion of the decision in Criminal Case No. Q-11868 reads as follows:
Page 8 of 39
WHEREFORE, premises considered, the Court finds the accused, FARHAD HATANI y ABOLHASSAN,
GUILTY beyond reasonable doubt of the crime of rape punishable under Article 335 of the Revised Penal
Code and hereby SENTENCES said accused to suffer life imprisonment or reclusion perpetua; and to
indemnify the complainant, Precila Borja, in the sum of fifty thousand pesos (P50,000.00) and to pay
costs (Rollo, p. 41).
The information in Criminal Case No. Q-11867 charged appellant with illegal practice of medicine, in
violation of R.A. No. 2382, otherwise known as the Medical Act of 1959, committed as follows:
That on or about the 6th day of July, 1979, in Quezon City, Philippines the above named accused,
knowing fully well that he has not satisfactorily passed the corresponding Board Examination, neither is
he a holder of a valid Certificate of Registration duly issued by the Board of Medical Examiners, as in fact
he does not even appear to have taken or completed the course leading to a medical degree, did, then and
there, willfully, unlawfully and feloniously for compensation, fee and salary, paid to him directly,
physically examined Priscila (sic) Borja Y Loquero and Wilma Borja Y Loquero, diagnosed, treated and
administer injections on the persons of Prescila (sic) Borja Y Loquero and Wilma Borja Y Loquero, in
Violation of Section 10, in relation to Section 28, Republic Act No. 2382 (Records, Vol. I, p. 1).
The information in Criminal Case No. Q-11868, charged appellant with Rape, committed as follows:
That on or about the 6th day of July, 1979, in Quezon City, Philippines, the above-named accused, with
lewd designs, and while she was deprived of reason or unconscious after having been drugged or
administered medicine, did, then and there, willfully, unlawfully and feloniously have sexual intercourse
with the undersigned PRECILA BORJA Y LOQUERO without her consent and against her will, to her
damage and prejudice in such amount as may be awarded under the provisions of the Civil Code
(Records, Vol. II, p. 1).
It appears that in the morning of July 6, 1979, Agustina Borja visited her comadre, Maura Fontreras, and
requested malunggay leaves as medication for her 16-year old daughter, Precila, who had high fever and
loose bowel movement. Upon learning that Precila was sick, Marita, Maura's daughter, introduced
Agustina to her husband, appellant herein, whom she said was a medical doctor. Marita suggested that her
husband treat Precila and Agustina agreed.
Appellant and Marita went to the Borja residence, where he examined Precila. He gave her tablets to take
and administered two injections (to her), one in the morning and the second at noon. After each injection,
Precila would feel dizzy and fall asleep.
It was appellant's diagnosis that Precila was a drug addict and required further observation and treatment.
Appellant offered to attend to Precila at his house and again, Agustina agreed in the belief that her
daughter was a drug addict.
In the evening of the same day, Precila was fetched by appellant and Marita and was brought to appellant's
house. Again, Precila was given an injection which caused her to sleep. When she awoke, she realized that
she was naked and her entire body was in pain. Appellant was seated on the bed and was fondling her
private parts. Shocked, Precila called for her mother and tried to get up. Appellant, however, punched her
on the chest and forced her to lie down. He pressed a pillow on her face and injected her again, causing
her to fall asleep.
When Precila awoke the second time, she found appellant in bed with her. He was naked and fondling her
private parts. The pain all over her body lingered. When Precila touched her private parts, she saw blood
stains on her hand. She tried to stand up but she was too weak. Appellant gave her another injection
rendering her unconscious.
The following morning, Agustina went to fetch Precila. Upon reaching the Fontreras' residence, she went
straight to the bedroom, where, to her great dismay, she found Precila and appellant both asleep and
naked. She hurriedly dressed up Precila and brought her home.
When Precila woke up, she noticed she was already home and her mother was crying. Precila remained
dizzy, with throbbing pains all over her body. When talked to, she was incoherent.
That evening, Precila's oldest sister, Josefina, a nurse by profession, came home and saw Precila looking
very weak. Her mother, who was crying narrated what she had witnessed that morning. She also told
Josefina that appellant was in the other bedroom, treating another sister, Wilma whom he also diagnosed
as a drug addict. Josefina immediately proceeded to the bedroom and saw appellant about to inject Wilma.
Josefina saw the open bag of appellant, which contained empty capsules of dalmane and empty vials of
valium. She inquired on the need of the injection and appellant replied that a second shot of plain distilled
water was required to cure Wilma of her drug addiction. Josefina told appellant to stop but he persisted.
Only upon threat that she would call the police did appellant stop. Appellant and his wife then left the
Borja residence.
The following day, Agustina and Josefina brought Precila and Wilma to the Philippine Constabulary
Headquarters at Camp Crame, Quezon City, where Josefina and Wilma gave their statements (Exhs. "D"
and "F"). Precila was physically examined by a doctor, whose medical report stated that Precila's hymen
and "deep, healing lacerations" and that "subject is in non-virgin state physically" (Exh. A). Several needle
puncture marks were also found on Precila's arms and buttocks.
A physical examination was likewise done on Wilma, which showed that she too had a needle puncture, as
shown in the Medico-Legal Report (Exh. "L").
Acting on the complaint filed before the Constabulary Anti-Narcotics Unit (CANU), a surveillance of
appellant's residence was conducted. Subsequently, a search warrant was secured from Judge Jose P.
Castro of the Court of First Instance of Quezon City. Armed with the warrant, CANU agents raided
appellant's residence on July 15, 1979.
Page 9 of 39
Assorted drugs, such as dalmane, valium and mogadon, as well as prescription pads in the name of Dr.
Jesus Yap (Exhs. "H" "H-4") and other medical instruments, such as a "thermometer, a "hygomonometer
(sic), stethoscope, syringes and needles, were seized.
The Handwriting Identification Report (Exh. "I") on the prescription slips showed that these were written
by the appellant himself. The report on the chemistry examination of the seized tablets and capsules
(Exhs. "J" "J-1") confirmed the presence of mogadon, dalmane and valium.
After the preliminary investigation, separate informations for rape and violation of R.A. No. 2382 were
filed. Appellant pleaded not guilty to both crimes.
The defense's version is that in the evening of July 6, 1976, Agustina and Precila Borja visited the mother-
in-law of the appellant, Maura Fontreras. In the course of the conversation, Agustina asked Marita if she
could help Precila. Marita obliged and agreed to take care of Precila for the night and allow her to sleep in
her bedroom.
Precila and Marita chatted the whole night. Accordingly, Precila confessed that she was not really sick.
She merely related her personal problems, involving her parents. She also admitted her vice, such as
drinking, smoking and taking drugs.
Their talk lasted until the wee hours of the morning and during their conversation, appellant would
occasionally enter the room but he never joined their discussion.
Precila and Marita shared the same bed. Appellant; who was wearing only his pajama pants, slept on the
floor at the opposite end of the room.
The following morning Agustina arrived and Marita related some of Precila's problems. Nothing untoward
happened that day and Agustina headed for home while Precila and Marita followed later.
At past midnight of July 15, 1979, a raid was conducted by CANU agents in the house of the appellant
under the supervision of C1C Agustin Timbol, Jr. The raid was made upon Josefina's complaint for illegal
possession of drugs.
Appellant and his wife were driven out of their bedroom, while three-men remained. Later, appellant was
called to join them in the bedroom and he was shocked to see assorted drugs scattered around. Appellant
denied owning them. Photographs were taken of him with the drugs. A barangay official was called to
attest to the list of the confiscated drugs. Appellant, however, refused to sign the said list.
C1C Timbol offered to fur the case in exchange of money. Instead of acceding, appellant demanded to see
the search warrant. C1C Timbol failed to show a warrant on the pretext that they were military men
without need of any identification or search warrant. Appellant, his wife and brother-in-law were forced to
join C1C Timbol for questioning in Camp Crame. Upon boarding the van, appellant saw Josefina aboard
kissing C1C Timbol and both exchanged victory signs.
The trial court rendered two separate decisions and convicted the appellant of both crimes. In finding
appellant guilty of illegal purchase of medicine, considerable weight was given to the prosecution's
exhibits.
The Professional Regulation Commission certified that appellant is not among the list of registered
physicians nor among those with special permit to practice medicine in a limited scope (Exh. "K").
Appellant failed to refute the Handwriting Identification Report (Exh. "I") released by the PC Crime
Laboratory showing that the signature of Dr. Jesus D. Yap (Exhs. "H" "H-4") prescribing medicine
belonged to him. The pictures also taken during the raid (Exhs. "G" - "G-8'" undeniably reveal several
medical equipment used by practicing physicians.
Notwithstanding the trial court's finding that there was no direct evidence of rape, it concluded that
circumstantial evidence indicate that rape was consummated by appellant considering the following:
1. The medico-legal examination of victim Precila, taken on July 8, 1979 at 10:25 in the morning or less
than 48 hours from the evening of July 6, 1979 found "hymen with deep, healing lacerations at 4, 6 and 9
o'clock position"; thus indicating that the lacerations were recent as they are in the process of healing;
(Exh. "A-1")
2. The above undeniable findings of the expert confirms the statement of the victim, a young girl of 16 or
17 years of age, that when she held private parts which were painful then, she noticed blood. (tsn. Alma,
Feb. 9, 1984, pp. 4-5).
The fresh laceration of the hymen further confirms the carnal assault. (People vs. Ocampo, L-47335, Aug.
13, 1986)
3. In the two short waking moments of the victim she noticed she was naked and beside her on the same
bed was the accused, also naked. (tsn. Alma, Feb. 9, 1984, pp. 3-5)
4. The accused, then 21 years of age was in the prime of youth, and the unconscious girl beside him was
just 16 or 17 years of age, thus in the full bloom of womanhood. The sexual excitement on the part of the
accused was therefore exceedingly great.
5. When the mother, Agustina, came into the room of the accused that early morning of July 7, 1979 she
saw her daughter and the accused on the same bed and both naked. (tsn., Rogato, Jan. 27, 1981, p. 9)
6. The medico-legal found several needle puncture marks on the arms and buttocks of Precila (Exh. "A");
thus confirming Precila's testimony that she had been injected by the accused, rendering her unconscious
(tsn. Alma, Feb. 9, 1984, pp. 4-5; tsn., Nenita, May 21, 1984, pp. 3-6; also pp. 29-30).
7. The medico-legal found the victim "in non-virgin state physically." (Exh; "A-i")
Page 10 of
39
8. At the time of the medico-legal examination, i.e. morning of July 8, 1979, the victim was found to be
"incoherent." (Exh. A) after effect of the injections or drugs.
9. At the time of the incident (July 6, 1979) the Borjas and Frontreras (sic) were "comadres" and
neighbors. There is no enmity between and among them.
10. Between accused and Marita on one hand, and the victim, her mother, and sisters, on the other hand,
there was no misunderstanding before the incident. There is absolutely absence of any ulterior motive for
the teen-aged victim or her family to file the serious charge of rape which would expose her to
embarrassment of examination of her private parts and public trial (Rollo, pp. 38-39).
In his first assignment of error, appellant questions the credibility of the prosecution witnesses.
Appellant faults complainant for recounting her ordeal only after four years when she took the witness
stand. This argument is misleading. The record shows that the day after the rape, Josefina and Wilma
Borja, accompanied by their mother, Agustina, issued their statements at Camp Crame. Agustina gave her
statement twice on separate days. Precila did not give any statement due to her weak condition but it
cannot be denied that she was instead physically examined. Suffice it to say, the Medico Legal Report
(Exh. "A") indicates swellings and lacerations and concludes that Precila was no longer a virgin. Although
the records fail to show any sworn statement by Precila, such is not fatal where the sworn affidavits of her
mother, her two sisters and the medico-legal report are sufficient to show probable cause of rape (People
v. Yambao, 193 SGRA 571 [1991]).
Precila was either dizzy or unconscious at the time she was sexually abused. We find her testimony
consistent and credible. While her testimony is limited to the times when she would gain her
consciousness, it is not unlikely that such traumatic incidents would still be engraved on her mind even
four years after.
Appellant's assertion that Precila failed to inform her family of his misdeeds is explainable. As correctly
pointed out by the Solicitor General, Precila was still dizzy and incoherent as a consequence of the
injections administered by appellant. In fact, when Precila was physically examined by the doctor the day
after, she was still sleepy and groggy (TSN, March 31, 1980, pp. 7-8).
Appellant also finds it strange that considering the acts allegedly committed by him against Precila, the
medico-legal report fails to specify any injuries on the body of Precila. Appellant need not inflict heavy
blows on Precila for the simple reason that she was under sedation. The absence of the injuries does not
negate the commission of rape (People v. Torrevillas, 203 SCRA 576 [1991]; People v. Arenas, 198 172
[1991]) for rape may be committed after rendering a woman unconscious (Art. 335, Revised Penal Code;
People v. Gerones, 193 SCRA 263 [1991]).
Appellant alleges that Precila was no longer a virgin on that fateful day and that her bleeding was actually
the start of her menstrual cycle. It is settled jurisprudence that virginity is not an essential element of rape
(People v. Corro, 197 SCRA 121 [1991]; People v. Banayo, 195 SCRA 543 [1991]). To claim that Precila's
menstrual cycle began on that day is highly speculative.
Appellant claims that the sworn statements of the Borjas (Exhs. "D", "E" and "F") were antedated and
were prepared after the illegal search was conducted in his residence. He also cites some inconsistencies
in said statements. We find the claim to be devoid of merit. It is only now on appeal that appellant disputes
the execution of these affidavits. When they were presented and offered as evidence, appellant failed to
raise such objections and to refute them.
The alleged inconsistencies in the testimony of the prosecution witnesses merely refer to minor details,
which cannot destroy their credibility (People v. Doctolero, 193 SCRA 632 [1991]). This is also true
where statements made while on the witness stand are claimed to be inconsistent with the affidavit, which
are generally incomplete (People v. Lagota, 194 SCRA 92 [1991]; People v. Avanzado, 158 SCRA 427
[1988]).
With regard to the second assignment of error, appellant insists that his conviction arose from insufficient
evidence and his failure to prove his innocence.
Indeed, the circumstantial evidence established at the trial are more than sufficient to prove the guilt of
appellant. The Medico-Legal Report on Precila, taken within 48 hours from the commission of rape
confirmed that her hymen had "deep, healing lacerations at 4, 6 and 9 o'clock position" and Precila was
"in non-virgin state physically" (Exh. "A"). Furthermore, the report confirms that Precila had at least six
needle puncture marks and swellings, which confirm that appellant had injected her several times.
On the two occasions that Precila woke up, she positively stated that appellant was with her on the bed
and that they were both naked. She also tried to free herself on both attempts from accused, but, he made
her unconscious through injections (TSN, February 9, 1984, pp. 3-5). This is corroborated by the
testimony of Agustina, who saw her daughter and accused together naked on bed (TSN, January 27, 1981,
p. 9). These unbroken chain of events leads one to a fair and reasonable conclusion that accused actually
raped Precila.
As held in People v. Yambao, supra, credence is given to the findings of the trial court where the rape
victim's testimony is buttressed by the corroborative testimony of the mother and the medico-legal report,
as well as the report of the police investigator.
It must also be borne in mind that at the time of the commission of the crime, Precila was just sixteen
years old. No young lady at the prime of her youth would concoct a story of defloration, allow an
examination of her intimate parts and later bare herself to the disgrace brought to her honor in a public
trial unless she was motivated solely by a desire to have the culprit apprehended and brought to justice
(People v. Patilan, 197 SCRA 354 [1991]; People v. Yambao, 193 SCRA 571 [1991]).
Appellant claims that his right to be presumed innocent was violated. He cites the trial court's decision
holding that it.
. . . finds that with these circumstantial evidences (sic) pieced together the prosecution has proved the
crime of rape, and the burden shifted on the defense to show the contrary (Rollo, p. 40).
Page 11 of
39
Appellant was afforded a fair trial and in fact he availed of surrebuttal evidence. The statement of the trial
court, as correctly argued by the Solicitor General, implies that the circumstantial evidence is sufficient to
support appellant's conviction unless the defense is able to provide evidence to the contrary.
With respect to his conviction of illegal practice of medicine, appellant presented inconsistent claims. On
one hand, he claims that the drugs and other paraphernalia were planted by the raiding team; while on the
other hand, he claims that these were seized without any warrant.
If indeed the evidence were all planted, how can appellant explain his handwriting on the prescription
pads in the name of Dr. Jesus Yap? A perusal of the photographs showing accused during the raid, fails to
indicate any protestation by him. In fact, the other photographs (Exhs. "G-l", "G-2", "G-4" "G-8") do
not bear any sign of disorder, in contrast to appellant's testimony that his room was made into a mess
during the raid.
The records fail to disclose a copy of a search warrant. However, the prosecution was able to present its
return (Exh. "ZZ") and we are satisfied that indeed a lawful search warrant was obtained. Besides, the
judge who granted the search warrant was the same judge who initially heard both criminal cases. It can
therefore be presumed, that the search was made with a search warrant and absent of any showing that it
was procured maliciously, the items seized are admissible in evidence (People v. Umali, 193 SCRA 493
[1991]).
The evidence is overwhelming that appellant actually treated and diagnosed Precila and Wilma Borja. The
positive testimony of Agustina, Precila, Wilma and Josefina Borja; the medico-legal reports (Exhs. "A",
"A-7", "C", "L" and "L-1") which attest to the needle marks; the Handwriting Identification Report (Exh.
I); the photographs (Exhs. "G-l "G-8") showing assorted drugs and medical equipment in appellant's
room; and the chemistry reports (Exhs. "J" "J-1") prove that appellant was engaged in the practice of
medicine. And as to his allegation that there was no proof of payment, the law specifically punishes said
act whether or not done for a fee.
Appellant claims that Precila admitted in her cross-examination that she was in school the whole day of
July 6, 1979 and it was therefore impossible for him to have treated and diagnosed her on that date. An
accurate reading of the transcript, however, will show that Precila's testimony was in response to a
question regarding her school schedule for that day.
Finally, appellant claims that the ponente of both decisions was not the trial judge, ergo said judge was
thus deprived of the opportunity to assess the credibility of the prosecution witnesses.
Admittedly, the ponente's participation was limited to the resolution of the cases. The fact that the judge
who heard the evidence is not the one who rendered the judgment, and for that reason the latter did not
have the opportunity to observe the demeanor of the witnesses during the trial but merely relied on the
records of the case, does not render the judgment erroneous (People v. Ramos, Jr., 203 SCRA 237 [1991];
People v. Villamayor, 199 SCRA 472 [1991]), especially where the evidence on record is sufficient to
support its conclusion.
WHEREFORE, the judgments appealed from are AFFIRMED in toto. Costs de oficio.
SO ORDERED. their ailments, diseases, pains, and physical defects from which they are suffering and by holding out
himself to the public by means of signs, advertisements, and other means, to be a Doctor of Medicine."

Facts. lower court found, as facts, the following:

"... in the year 1949, the accused herein, Guillermo I. Ventura, was convicted by the court of first instance
of Rizal of a 'similar offense' or illegal practice of medicine in the municipality of Pasay, now Pasay City
and sentenced to pay a fine of P200.00 under the same legal provisions, or Section 770 in connection with
Section 2678 of the Revised Administrative Code.

"... by reason of certain complaints the National Bureau of Investigation had received from the President
of the Philippine Federation of Private Medical Practitioners and from the Chairman of the Board of
Medical Examiners, the National Bureau of Investigation on December 16, 1955, sent its morgue
attendant Jose Natayan to the clinic of the accused at No. 2454 M. de la Cruz Street, Pasay City. Natayan
was at that time suffering from pains in his back and he asked the accused to see his sickness. The accused
attended to Natayan; wrote something on a piece of paper; and then he told him that he (Natayan) 'was
sick of lumbago'. Thereupon, the accused asked Natayan to pay P5.00 and then asked him to pay the
amount to a lady employee in the clinic which Natayan did. At the request of the accused, Natayan, then
Republic of the Philippines went around the other side of the clinic where he was given an enema of hot water by a male attendant.
SUPREME COURT Then Natayan was asked to lie down on a table where his back was exposed to a big bulb for around
Manila fifteen minutes and afterwards to a red colored bulb for another ten minutes. Thereafter Natayan went
back to the accused, who told him to come back to his clinic for six consecutive days. After that Natayan
EN BANC went back on the same day or December 16, 1955 to his office in the National Bureau of Investigation.

G.R. No. L-15079 January 31, 1962 The following day, Natayan returned to the clinic of the accused with the National Bureau of Investigation
raiding party composed of two agents, two attorneys and one photographer. After he was dropped by the
THE PEOPLE OF THE PHILIPPINES, plaintiff-appellee, National Bureau of Investigation agents about seven meters away from the clinic of the accused, Natayan
vs. proceeded to the office of the accused, who then and there told him that another treatment would be
GUILLERMO I. VENTURA, defendant-appellant. applied to him and that he would pay P3.00. After paying this amount and while Natayan was lying on a
table about to be given treatment the National Bureau of Investigation agents raided the place.

Office of the Solicitor General for plaintiff-appellee.

Claro M. Recto for defendant-appellant. The accused herein, Guillermo I. Ventura, is not a duly registered masseur or a physician qualified to
practice medicine.

BENGZON, C.J.:
Statement. This is an appeal from the decision of the Court of First Instance of Rizal finding Guillermo
I. Ventura guilty of illegal practice of medicine under Section 770 in connection with Section 2678 of the
Revised Administrative Code, and sentencing him, this being his second offense, to pay a fine in the sum
of P500.00, with the corresponding subsidiary imprisonment in case of insolvency and to pay costs.
Appellant, the accused, was charged with the above offense in an information which alleged that in
February, 1955, he did, .
"willfully, unlawfully and feloniously, and for compensation and reward, practice medicine in the said
City (Pasay) by treating and applying electrical appliances to patients for the purpose of curing them with
Issues. Appellant seeks a reversal here of aforementioned judgment of conviction on the grounds: (1)
that the offense charged in the information had already prescribed; (2) that the laws involved are
unconstitutional and void; (3) that granting that the said laws are valid, the accused should not have been
prosecuted thereunder because he was not engaged in the practice of medicine; (4) that Congress, in
passing House Bills Nos. 2405 and 357 recognized and believed in the efficacy of the drugless systems of
healing and although said bills were vetoed by the President of the Philippines and thereby did not become
regular statutes, they may be considered as concurrent resolutions formally establishing the drugless
system of healing as a separate and distinct profession, not covered by Section 770 of the Medical Law;
(5) that the complainants and the Government are estopped from prosecuting the accused under Section
770 because they were the ones who induced him to practice drugless healing after his conviction in 1949;
and (6) that the accused has an implied license to practice drugless healing from the people of the
Philippines and the Chairman of the Medical Board of Examiners.

Page 12 of
39
Discussion. Appellant, testifying on his behalf admitted that for the past 35 years, he had been
practicing as a naturopathic physician, "treating human ailments without the use of drugs and medicines"
and employing in his practice "electricity, water and hand" without a license to practice medicine; that
during this time he had treated 500,000 patients, more or less about 90% of whom were healed, and that
he had studied drugless healing in the American University, Chicago, Illinois for about four years.
Invoking prescription, he argues that in view of the fact that he had begun the alleged practice of medicine
thirty five years ago without the required license, the crime charged in the information had already
prescribed.1
The records reveal that the accused began practicing his method of drugless healing 35 years ago. This
practice was first discovered by the authorities in 1949. He was prosecuted and convicted therefor the
same year. Sometime after he again set up a clinic. He had a lucrative clientele and nobody bothered
him.1wph1.t
which the community may confidently rely, their possession being generally ascertained in an
examination of parties by competent persons, or inferred from a certificate to them in the form of a
diploma or license from an institution established for instruction on the subjects, scientific or otherwise,
with which such pursuits have to deal.3
Appellant claims that his act of stimulating the affected nerves of the patients without use of any drug or
medicine is not practice of medicine; that "practice of medicine" is confined only to the systems taught by
the medical schools, namely, the regular, the homeopathic and the eclectic schools or systems.
Section 770 of the Revised Administrative Code in no uncertain terms covers appellant's acts. The
statutory definition as to what acts constitute illegal practice of medicine its provided in said Section 770
includes the acts and practices performed by appellant, By his own statements, he admitted to have
continuously diagnosed and treated more or less 500,000 instances of different kinds of human ailments
and to have prescribed remedies therefor.

However, at about February, 1955, the President of the Philippine Federation of Private Medical
Practitioners, complained to the National Bureau of Investigation that appellant was advertising himself as
capable of treating human ailments without drugs. Upon investigation, appellant was found to be without
certificate of registration to practice such profession either from the Board of Medical Examiners or from
the Committee of Examiners of Masseurs. So, this prosecution started in 1956. It is clear that the four-year
period of prescription of the offense charged should be computed from February, 1955 when the National
Bureau of Investigation discovered appellant's alleged illegal practice of Medicine.
Appellant also questions the constitutionality of Section 770 in relation to Section 775 of the Revised
Administrative Code. It is appellant's theory that to require, of any person whose business is merely to
stimulate by mechanical means the nerves of the body, many years of study in medical schools, taking up
obstetrics, general surgery, gynecology, bacteriology and many other sciences, is curtailment of the
exercise of one's calling, a violation of the constitutional principle that all men have the right to life,
liberty, and the pursuit of happiness and are entitled to the equal protection of the law. It is furthermore
theorized that inasmuch as drugless healing is not taught in any of the medical schools prescribed, how
could the members of the Medical Board of Examiners pass on the competence of these drugless
healers? .
This same contention was presented to and settled by this Court in the case of People vs. Buenviaje who
was convicted of illegal practice of medicine for practicing chiropractor. 2 It held:
There is very little force in this argument. The subjects in which an examination is required relate to
matters of which a thorough knowledge seems necessary for the proper diagnosis of diseases of the human
body and it is within the police power of the State to require that persons who devote themselves to the
curing of human ills should possess such knowledge.
In the instant case, we must again uphold these immutable concepts of the police power of the State.
Under this power, the State may prescribe such regulations as in its judgment will secure or tend to secure
the general welfare of the people, to protect them against the consequences of ignorance and incapacity as
well as of deception and fraud. As one means to this end, it has been the practice of different States, from
time immemorial to exact in any pursuit, profession or trade, a certain degree of skill and learning upon
As regards the contention that there are at least two concurrent resolutions declaring formally that
Congress has recognized the drugless methods of healing, we need not elaborate further than to say that
not until such recognition is actually embodied in a statute, shall we extend consideration of such method.
Appellant pleads that the lower court erred in not holding that the complainants and the government are
estopped from prosecuting him because they were the ones who induced him to practice drugless healing
after his conviction in 1949. He tried to show that medical practitioners, members of Congress, provincial
governors, city mayors and municipal board members wrote to him requesting his help for persons
suffering from all kinds of ailments; that municipal ordinances and resolutions were also passed
authorizing him not only to practice his method of healing but also to put up clinics in some of
municipalities; that he was even extended free transportation facilities to work in the Central Luzon
Sanitarium in Tala, Caloocan, Rizal.
Above plea cannot be sustained by this Court. The doctrine of estoppel does not apply to the
government.4 It is never stopped by mistakes or errors on the part of its agents, even assuming without
conceding that said municipalities had encouraged appellant's practice. We cannot allow the bargaining
away of public health and safety for the semblance of benefit to a few government officials, people or
even municipalities.
Similarly, there is no such thing as implied license to practice drugless healing by the mere fact that the
Chairman of the Board of Medical Examiners had permitted appellant to serve free in the Central Luzon
Sanitarium in Tala, Caloocan, Rizal, or that countless people persisted in engaging his services. For one
thing, these people might have contracted his services on the mistaken notion that he was duly licensed to
practice his profession; for another, a repetition of illegal acts can never make them legal.
As additional argument, appellant urges acquittal under the new Medical Act of 1959 5 wherein the practice
of physiotherapy is recognized as a distinct science. He claims coverage of said law on the ground that he
practices physiotherapy by massage through physical devices and upon the recommendation of duly
registered physicians.

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The above argument has no merit because there is strong evidence to the effect that appellant alone
diagnoses his patients' ailments and applies the remedies therefor 6 without written order or prescription by
a registered physician.
Judgment. Wherefore, the decision appealed from is hereby affirmed in all parts and respects. Costs
against appellant.
Republic of the Philippines
SUPREME COURT
Manila
EN BANC
G.R. No. L-22945 March 3, 1925
THE PEOPLE OF THE PHILIPPINE ISLANDS, plaintiff-appellee,
vs.
JOVITA V. BUENVIAJE, defendant-appellant.
OSTRAND, J.:
The defendant is accused of the violation of the Medical Act, the information alleging "that on or about
the first day of June, 1923, and for some time prior to said date, the said accused without having obtained
from the Board of Medical Examiners the corresponding certificate of registration for the practice of
medicine in the Philippine Islands, voluntarily, illegally and criminally and for compensation, practiced
medicine in the City of Manila, Philippine Islands, assisting, treating and manipulating the head and body
of Regino Noble for the purpose of curing him of the ailments, diseases, pains and physical defects from
which he pretended to suffer, and advertising and offering her services as a physician, by means of cards
which she distributed and by letterheads and signs which she exposed on the door of her office, situated at
No. 712 Calle Asuncion, and in newspapers which are published and circulated in the City of Manila, in
which cards, letterheads, signs and advertising she added and prefixed to her name the letters `Dra.,' which
is the abbreviation of the word `doctor,' for the purpose of causing the public to believe that she, the said
defendant, had received the corresponding title of doctor."
To this information the defendant demurred in the court below on the grounds: (1) That it stated more than
one offense, and (2) that it was not drawn in accordance with the form prescribed by law. The demurrer
was overruled and the defendant pleaded not guilty.
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At the trial of the case the defendant made the following admissions: "That on the first of June, 1923, she
had no certificate from the Board of Medical Examiners authorizing her to practice medicine in the
Philippine Islands; that on that day she treated and manipulated the head and body of Regino Noble in
order to cure him of ailments from which he pretended to suffer, the treatment consisting in a `thrust' by
means of the application of the hand to the spinal column; that she for such treatment received and
collected from said Regino Noble the sum of P1; that the said treatment took place in her office situated at
No. 712 Calle Asuncion, District of Binondo, City of Manila, Philippine Islands; that she on or about the
first day of June, 1923, and for some time prior to that date, advertised herself as a `doctor of chiropractic,'
in said City of Manila, said advertisement appearing upon her business cards and in the newspaper `El
Debate,' in its issue of April 29, 1923, edited and published in Manila and in which cards and newspaper
advertisement the defendant prefixed the abbreviation `Dra.' to her name; that she was graduated a doctor
in chiropractic on the 13th day of August, 1919, as evidenced by a certificate marked Exhibit I and issued
by the American University School of Chiropractic of Chicago, Illinois."
Upon this admission and some other evidence to the same effect, the trial court found the defendant guilty
as charged in the information and, in accordance with section 2678 of the Administrative Code, sentenced
her to pay a fine of P300, with subsidiary imprisonment in case of insolvency and to pay the costs. From
this judgment the defendant appeals to this court and presents four assignments of error.
I. In the first assignment of error counsel contends that the demurrer to the information should have been
sustained on the ground that said information charged more than one offense. The Medical Law is
contained in sections 758 to 783 of the Administrative Code and it is argued that inasmuch as some of the
illegal acts with which the defendant is charged are prohibited by section 770 of the Code and others by
section 783, the defendant is in reality accused of two separate and distinct offenses, namely, illegal
practice of medicine and illegally representing oneself as a doctor.
We cannot accept this view. It may be noted that the Medical Law itself, as it appears in the
Administrative Code, does not declare any of the therein prohibited acts penal offenses. The penal
provisions relating thereto are contained in section 2678 of the Code, which reads as follows:
SEC. 2678. Violation of Medical Law. A person violating any provision of the Medical Law shall, upon
conviction, be punished by a fine of not more than three hundred pesos or by imprisonment for not more
than ninety days, or both, in the discretion of the court.
The offense here penalized is "violation of the Medical Law." The statute makes no distinction between
illegal practice of medicine and illegally advertising oneself as a doctor. Both are in violation of the
Medical Law and carry the same penalty. They are merely different ways or means of committing the
same offense and both of these means are closely related to each other and usually employed together.
In these circumstances and where, as alleged in the information in the present case, the various violations
have taken place simultaneously, we do not think it was the intention of the legislator that each single act
should be regarded as a separate offense and separate informations presented for each. The language of
this court in the case of United States vs. Poh Chi (20 Phil., 140), in regard to the Opium Law, is opposite
to the present case.
It is true that the Commission has provided a certain punishment for the possession of a pipe used in the
smoking of opium, for the smoking of opium, as well as a punishment for the illegal possession of opium,
but it is not believed that it was the intention of the legislature to have separate complaints filed against a
person who was found in the illegal possession of opium and a pipe at the same time. If that were true
then every person who was found to be smoking opium could be charged in three different
complaints: First, with the illegal possession of the pipe; second, the illegal possession of the opium;
and third, for smoking the opium. Certainly the legislature did not intend any such consequences.
In the case of United States vs. Douglass (2 Phil., 461), the court said:
It is not objectionable, when a single offense may be committed by the use of different means, to charge,
in the alternative, the various means by which the crime may have been committed. (U.S. vs. Potter, 27
Fed. Cases, 604; Bishop's New Criminal Procedure, sec. 434.)
The same rule was followed in the case of United States vs. Dorr (2 Phil., 332); United States vs.
Tolentino (5 Phil., 682); and United States vs. Gustilo (19 Phil., 208) and is in harmony with the views of
the courts in other jurisdictions. That the various means of committing the offense is described in more
than one section of the statute does not necessarily effect the general principle involved; the subdivision of
a statute into section is merely a matter of convenience and while it sometimes may be of some aid in
ascertaining the legislative intent, it is, of course, not conclusive thereof.
II. Under the second assignment of error the appellant argues in substance that chiropractic has nothing to
do with medicine and that the practice of that profession can therefore not be regarded as practice of
medicine. There is no merit whatever in this contention. Assuming without conceding that chiropractic
does not fall within the term "practice of medicine" in its ordinary acceptation, we have the statutory
definition contained in section 770 of the Administrative Code and which clearly includes the
manipulations employed in chiropractic. The statutory definition necessarily prevails over the ordinary
one.
Under the same assignment of error the defendant also argues that the examination prescribed by section
776 of the Administrative Code for admission to the practice of medicine, embraces subjects which have
no connection with chiropractic and that to require chiropractors to take that examination is unreasonable
and, in effect amounts to prohibition of the practice of their profession and therefore violates the
constitutional principle that all men have the right to life, liberty and the pursuit of happiness and are
entitled to the equal protection of the law.
There is very little force in this argument. The subjects in which an examination is required by section 778
of the Administrative Code, as amended by Act No. 3111, relate to matters of which a thorough
knowledge seems necessary for the proper diagnosis of diseases of the human body and it is within the
police power of the State to require that persons who devote themselves to the curing of human ills should
possess such knowledge. (State vs. Edmunds, 127 Iowa, 333; 69 L.R.A., 504; Underwood vs. Scott, 43
Kan., 714; People vs. Blue Mountain Joe, 129 Ill., 370; State vs. Mylod, 20 R. I., 632; 41 L.R.A., 428;
Stewart vs. Raab, 55 Minn., 20; Matthei vs. Wooley, 69 Ill. App., 654; State vs. Buswell, 40 Neb., 158; 24
L.R.A., 68; O'Connor vs. State, 46 Neb., 157; U. S. vs. Gomez Jesus, 31 Phil., 218.)
Page 15 of
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III. The third assignment of error is closely related to the foregoing. The appellant contends that the
prohibition in section 783 against the unauthorized use of the title "doctor" must be understood to refer to
"Doctor of Medicine" and has no application to doctors of chiropractic. Under different circumstances that
might possibly be so, but where, as here, chiropractic is by statute made a form of the practice of
medicine, it necessarily follows that a person holding himself out as a doctor of chiropractic in legal effect
represents himself as a doctor of medicine.
IV. In her fourth assignment of error the appellant attacks the constitutionality of Act No. 3111, amending
section 770 of the Administrative Code, on the ground that the subject of the Act is not sufficiently
expressed in its title and that it embraces more than one subject. There is no merit in this contention. The
title of Act No. 3111 reads as follows:
An Act to amend sections seven hundred and fifty-nine, seven hundred and sixty, seven hundred and
sixty-one, seven hundred and sixty-two, seven hundred and sixty-five, seven hundred and sixty-seven,
seven hundred and seventy, seven hundred and seventy-four, seven hundred and seventy-five, seven
hundred and seventy-six, seven hundred and seventy-eight, seven hundred and eighty, seven hundred and
eighty-two, seven hundred and eighty-three, and twenty-six hundred and seventy-eight of Act Numbered
Twenty-seven hundred and eleven, known as the Administrative Code, increasing the number of the
members of the Board of Medical Examiners, conferring upon the same certain additional powers and
responsibilities and for other purposes.
All of the sections enumerated in the title quoted relate to the same general subject, namely, defining and
regulating the practice of medicine, and section 770 is expressly mentioned as one of the sections
amended.
This is sufficient. Under constitutional provisions similar to ours the general rule is that a title which
declares the amendatory statute to be an act to amend a designated section or the like of a specified Code
is sufficient and the precise nature of the amendatory Act need not be further stated. (Ross vs. Aguirre, 191
U.S., 60; Udell vs. Citizens Street R. Co., 152 Ind., 507; McGuire vs. Chicago, etc., R. Co., 131 Iowa,
340; Lankford vs. County Commissioners of Somerset County, 73 Md., 105; Tabor vs. State, 34 Tex.
Crim., 631; Com. vs. Brown, 91 Va., 762.) For a full and authoritative discussion of this subject, see Note
to Lewis vs. Dunne, 55 L.R.A., 833. See also Government of the Philippine Islands vs. Municipality of
Binalonan and Roman Catholic Bishop of Nueva Segovia (32 Phil., 634) and Yu Cong Eng vs. Trinidad
(p. 385, ante).
We find no error in the judgment appealed from and the same is therefore affirmed, with the costs against
the appellant. So ordered.
Malcolm, Villamor, and Johns, JJ., concur.
Separate Opinions
ROMUALDEZ, J., dissenting:
I believe that the complaint charges more than one offense, and that the demurrer interposed on that
ground should have been sustained. For that reason I dissent from the opinion of the majority.
Republic of the Philippines
SUPREME COURT
Manila
FIRST DIVISION
G.R. Nos. 89095 & 89555 November 6, 1989
SIXTO P. CRISOSTOMO, petitioner,
vs.
SECURITIES AND EXCHANGE COMMISSION, SPOUSES SHOJI YAMADA and MICHIYO
YAMADA and SPOUSES TOMOTADA ENATSU and EDITA ENATSU, respondents.
GRIO-AQUINO, J.:
In his petition for certiorari, 1 the petitioner seeks to annul and set aside the en banc resolution dated
February 14, 1989 of the Securities and Exchange Commission in SEC EB Case No. 191 and the
concurring opinions thereto (Annexes F, G, and H, pp. 39-62, Rollo), as well as its orders dated June 27,
1989 and July 21, 1989 (Annexes M and 0, pp. 83-86, Rollo) directing the corporate secretary of the
United Doctors Medical Center, Inc. (hereafter "UDMC") to call a special meeting of the stockholders to
elect the officers and directors in the implementation of the SEC's aforementioned en banc resolution of
February 14, 1989, which the Court of Appeals affirmed in its decision dated June 8, 1989 in CA-G.R. SP
No. 17435, entitled "Sixto Crisostomo, petitioner vs. Securities and Exchange Commission, Spouses Dr.
Shoji Yamada and Michiyo Yamada, and Spouses Dr. Tomotada Enatsu and Edita Enatsu, respondents."
On August 1, 1989, the Court of Appeals denied Crisostomo's motion for reconsideration of its decision.
On August 24, 1989, he filed a petition for review of said decision in this Court (G.R. No. 89555) which
was originally assigned to the Third Division, but was later consolidated with G.R. No. 89095.
At first blush, the petitions sound like a patriotic defense of the Constitution, but, at bottom they are only
an artful scheme to defraud a group of foreign investors who had been persuaded by the officers of
UDMC to invest P57 million to save the corporation (its assets as well as those of the Crisostomo's) from
imminent foreclosure by the Development Bank of the Philippines (DBP) to which UDMC was indebted
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in the sum of P55 million. It is the kind of operation that sullies our collective image as a people and sets
back our government's heroic efforts to attract foreign investments to our country.
The antecedent facts, culled from the decision of the Court of Appeals, are as follows:
Sixto Crisostomo, Felipe Crisostomo (deceased), Veronica Palanca, Juanito Crisostomo, Carlos
Crisostomo, Ricardo Alfonso, Regino Crisostomo and Ernesto Crisostomo (known as the Crisostomo
group) were the original stockholders of the United Doctors Medical Center (UDMC) which was
organized in 1968 with an authorized capital stock of P1,000,000 (later increased to P15,000,000 in 1972).
They owned approximately 40% of UDMC's outstanding capital stock, while the 60% majority belonged
to the members of the United Medical Staff Association (UMSA), numbering approximately 150 doctors
and medical personnel of UDMC.
Despite their minority status, the Crisostomo group has managed UDMC from its inception, with Juanito
Crisostomo as president, Ricardo Alfonso, Sr. as chairman of the board, Carlos Crisostomo as corporate
secretary and Sixto Crisostomo as director and legal counsel.
In 1988, UDMC defaulted in paying its loan obligation of approximately P55 million to the DBP. In the
last quarter of 1987, UDMC's assets (principally its hospital) and those of the Crisostomos which had
been given as collateral to the DBP, faced foreclosure by the Asset Privatization' rust (APT), which had
taken over UDMC's loan obligation to the DBP.
To stave off the threatened foreclosure, UDMC, through its principal officers, Ricardo Alfonso and Juanito
Crisostomo, persuaded the Yamadas and Enatsu (Shoji Yamada and Tomotada Enatsu are Japanese
doctors) to invest fresh capital in UDMC. The wife of Tomotada Enatsu, Edita Enatsu, is a Filipina. They
invested approximately P57 million in UDMC.
The investment was effected by means of: (1) a Stock Purchase Agreement; and (2) an Amended
Memorandum of Agreement whereby the group subscribed to 82.09% of the outstanding shares of
UDMC.
Both transactions were duly authorized by the board of directors and stockholders of UDMC. They were
submitted to, scrutinized by, and, finally, approved by the Board of Investments, the Central Bank of the
Philippines, and the Securities and Exchange Commission. The elaborate governmental approval process
was done openly and with full knowledge of all concerned, including Sixto Crisostomo, the corporate
legal counsel. Upon the completion of the governmental approval process, shares of stock, duly signed by
UDMC's authorized officers, were issued to the Yamadas and Enatsus.
This capital infusion not only saved the assets of the UDMC (especially the hospital) from foreclosure but
also freed the Crisostomos from their individual and solidary liabilities as sureties for the DBP loan.
As it had been agreed in the Amended Memorandum of Agreement between UDMC and the Japanese
group that upon the latter's acquisition of the controlling interest in UDMC, the corporation would be
reorganized, a special stockholders' meeting and board of directors' meeting were scheduled to be held on
August 20, 1988.
However, on the eve of the meetings, i.e., on August 19, 1988, Sixto Crisostomo, supposedly acting for
himself, filed SEC Case No. 3420 against Juanito Crisostomo, Ricardo Alfonso, Shoji Yamada, Michiyo
Yamada, Tomotada Enatsu and Edita Enatsu, praying, among other things, (1) to stop the holding of the
stockholder's and board of directors' meetings; (2) to disqualify the Japanese investors from holding a
controlling interest in UDMC and from being elected directors or officers of UDMC; and (3) to annul the
Memorandum of Agreement and Stock Purchase Agreement because they allegedly did not express the
true agreement of the parties (pp. 194-203, Rollo).
Two weeks later, on September 2, 1988, Crisostomo filed Civil Case No. 88-1823 in the Regional Trial
Court of Makati, Metro Manila, where he also sought a preliminary injunction and the Identical reliefs
prayed for by him in SEC Case No. 3420 (pp. 317-335, Rollo). It was dismissed by the trial court for lack
of jurisdiction and is pending appeal in the Court of Appeals where it is docketed as CA-G.R. No. 20285-
CV.
On September 13, 1988, the hearing officer, Antonio Esteves, granted the application for a writ of
preliminary injunction enjoining the respondents
... from holding the special meeting of the stockholders and of the Board of Directors of United Doctors
Medical Center, [Inc.] (UDMC) scheduled on August 20, 1988 or any subsequent meetings; from adopting
resolutions to elect new directors and appoint new officers; from approving resolutions directly or
indirectly affecting the operations, organizational structure, and financial condition of the corporation, ...
and from disbursing funds of the said corporation except those ordinary day-to-day expenses pending the
final termination of this case. (p. 30, Rollo.)
The private respondents' motion for reconsideration of this order was denied by the hearing officer on
November 16, 1988. In the same order, he created a management committee to administer UDMC (pp. 32-
35, Rollo).
The respondents appealed by certiorari to the SEC en banc. On February 14,1989, Commissioner Jose C.
Laureta, with whom Commissioners Rosario N. Lopez and Gonzalo T. Santos separately concurred, set
aside the preliminary injunction issued by Esteves and the management committee which he created. The
dispositive part of the decision reads:
Wherefore, premises considered, the instant petition for certiorari is GRANTED and the Commission en
banc ORDERS:
1. That the questioned orders of the hearing officer in SEC Case No. 3420 of September 13, 1988 and
November 16, 1988, be immediately vacated;
2. That a special stockholders' meeting of UDMC be held for the purpose of allowing the stockholders of
record of the corporation to elect a new board of directors, which special meeting is hereby directed to be
scheduled within 10 days from receipt of a copy of this resolution by the incumbent corporate secretary or
acting corporate secretary of UDMC, and to this end, that such officer be, as he hereby is, directed: (a) to
issue a call for such special meeting and serve notice thereof on all stockholders of record of the
corporation, in accordance with section 6 of article VII of UDMC's by-laws; and (b) to submit to the
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39
Commission, through the Commission Secretary, a written report of his compliance with this particular
order of the Commission, not later than 5 days prior to the scheduled date of the proposed UDMC special
stockholders' meeting;
3. That upon the election of a new board of directors of UDMC, that such board be, as it hereby is,
enjoined to meet as promptly as possible for the purpose of electing a new set of officers of the
corporation in order to ensure its proper management;
4. That the hearing officer be, as he hereby is, directed to continue with the proceedings of SEC Case No.
3420, and to do so with all deliberate speed, for the purpose of resolving the alleged violation of certain
rights of Sixto Crisostomo, as a stockholder of UDMC particularly, his right to inspect the corporate
books and records of UDMC, his preemptive right to subscribe to the P60 million increase in the
authorized capital of UDMC, and his appraisal rights; and
5. That the board of directors and officers of UDMC be, as they hereby are, ordered to submit to the
Commission, through the Chairman, a written report as to its plans as regards its nursing school, such
report to be submitted at least one month prior to the commencement of the school year 1989-1990.
SO ORDERED. (pp. 49-50, Rollo.)
Sixto Crisostomo sought a review of the SEC's en banc resolution in the Court of Appeals (CA-G.R. SP
No. 17435).
On June 8, 1989, the Court of Appeals dismissed his petition and lifted the temporary restraining order
that it had issued against the SEC's resolution (Annex K, pp. 65-81, Rollo). Petitioner filed a motion for
reconsideration (pp. 418-434, Rollo). The Court of Appeals required the private respondents to comment
but it denied the petitioner's motion to reinstate the writ of preliminary injunction (Annex L, p. 82, Rollo),
On motion of the private respondents (Annex K, p. 413, Rollo), the SEC en banc issued an order on June
27, 1989 directing the secretary of UDMC to call a special stockholders' meeting to elect a new board of
directors and officers of the corporation (Annex F). Petitioner asked the SEC to recall that order on
account of his pending motion for reconsideration in the Court of Appeals. The motion was opposed by
the private respondents. On July 21, 1989, the SEC denied petitioner's motion (p. 86, Rollo). Whereupon,
he filed this petition for certiorari and prohibition with a prayer for preliminary injunction alleging that the
SEC en banc abused its discretion:
1. in setting aside Esteves' orders
2. in allowing the Japanese group to have control of UDMC for it will result in culpable violation of
Section 7, Article XII of the 1987 Constitution which provides that no private lands shall be transferred or
conveyed except to individuals or corporations qualified to acquire or hold land of the public domain,
meaning corporations at least sixty per centum of whose capital is owned by Filipino citizens (Sec. 2,
Article XII, 1987 Constitution); and
3. in allowing the Japanese investors to own more than 40% of the capital stock of UDMC (which
operates a nursing and midwifery school) in violation of Section 4 (2) Article XIV of the 1987
Constitution which provides that educational institutions ... shall be owned solely by citizens of the
Philippines or corporations or associations at least sixty per centum of the capital of which is owned by
such citizens.
The public and private respondents, in their comments on the petition, asked that the petition be dismissed
and that the petitioner be cited for contempt for forum-shopping.
We find no merit in the petition. The first allegation that the SEC en banc erred in reversing the orders of
the hearing officer, Esteves, is the same ground raised by the petitioner in CA-G.R. No. SP 17435. The
issue is frivolous for the authority of the SEC en banc to review, revise, reverse, or affirm orders of its
hearing officers is too elementary to warrant any debate.
Equally unmeritorious are the second and third grounds of the petition that the P57 million investment
of the Japanese group in UDMC violates the constitutional provisions restricting the transfer or
conveyance of private lands (Art. XIII, Sec. 7, 1987 Constitution) and the ownership of educational
institutions (Art. XVI, Sec. 14[a], 1987 Constitution), to citizens of the Philippines or corporations at least
60% of the capital of which is owned by Filipino citizens. While 82% of UDMC's capital stock is indeed
subscribed by the Japanese group, only 30% (equivalent to 171,721 shares or P17,172.00) is owned by the
Japanese citizens, namely, the Yamada spouses and Tomotada Enatsu. 52% is owned by Edita Enatsu, who
is a Filipino. Accordingly, in its application for approval/registration of the foreign equity investments of
these investors, UDMC declared that 70% of its capital stock is owned by Filipino citizens, including
Edita Enatsu. That application was approved by the Central Bank on August 3, 1988 (p. 249, Rollo,).
The investments in UDMC of Doctors Yamada and Enatsu do not violate the Constitutional prohibition
against foreigners practising a profession in the Philippines (Section 14, Article XII, 1987 Constitution)
for they do not practice their profession (medicine) in the Philippines, neither have they applied for a
license to do so. They only own shares of stock in a corporation that operates a hospital. No law limits the
sale of hospital shares of stock to doctors only. The ownership of such shares does not amount to engaging
(illegally,) in the practice of medicine, or, nursing. If it were otherwise, the petitioner's stockholding in
UDMC would also be illegal.
The SEC's orders dated June 27, 1989 and July 21, 1989 (directing the secretary of UDMC to call a
stockholders' meeting, etc.) are not premature, despite the petitioner's then pending motion for
reconsideration of the decision of the Court of Appeals. The lifting by the Court of Appeals of its writ of
preliminary injunction in CA-G.R. SP No. 17435 cleared the way for the implementation by the SEC's en
banc resolution in SEC EB Case No. 191. The SEC need not wait for the Court of Appeals to resolve the
petitioner's motion for reconsideration for a judgment decreeing the dissolution of a preliminary
injunction is immediately executory. It "shall not be stayed after its rendition and before an appeal is
taken or during the pendency of an appeal." (Sec. 4, Rule 39, Rules of Court; Marcelo Steel Corp. vs.
Court of Appeals, 54 SCRA 89 [1973]; Aguilar vs. Tan, 31 SCRA 205 [1970]; Sitia Teco vs. Ventura, 1
Phil. 497 [1902]; Watson & Co., Ltd. vs. M. Enriquez, I Phil. 480 [1902]).
We now address the public and private respondents' separate motions to dismiss the petition and to cite
Crisostomo and his counsel for contempt of court for forum-shopping. The records show that Crisostomo
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39
had two actions pending in the Court of Appeals (CA-G.R. No. SP 17435 and CA-G.R. No. 20285 CV)
when he filed the petition for certiorari (G.R. No. 89095) in this Court on July 27, 1989. The case
docketed as CA-G.R. No. 20285-CV, is his appeal from the decision of the Regional Trial Court of
Makati, dismissing his complaint for annulment of the Memorandum of Agreement and the Stock
Purchase Agreement between UDMC and the Japanese investors. CA-G.R. No. SP 17435 is his petition
for certiorari to review the SEC's en banc resolution upholding those transactions and ordering the holding
of a stockholders meeting to elect the directors of the UDMC, and of a board of directors meeting to elect
the officers.
Notwithstanding the pendency of those two cases in the Court of Appeals, Crisostomo filed this petition
for certiorari 1 and prohibition on July 27, 1989 where he raises the same issues that he raised in the Court
of Appeals.
The prayer of his petition in CA-G.R. No. SP 17435 reads thus:
3) After hearing on the merits, judgment be rendered:
a) Annulling and setting aside the questioned rulings of the respondent COMMISSION 2for having been
issued with grave abuse of discretion tantamount to lack or excess of jurisdiction; and
b) Making permanent the preliminary injunction issued in this case against the respondents. (p. 241,
Rollo.)
In his petition for certiorari (G.R. No. 89095), he also prays that
1. Upon the filing of this petition, a temporary restraining order issue enjoining respondents, their
representatives or agents from implementing or executing the SEC opinions (Annexes "F", "G" and "H")
and its June 27 and July 21,1989 orders (Annexes "M" and "O") until further orders from the Honorable
Court.
xxx xxx xxx
3. After notice, this petition be given due course and a writ of preliminary injunction be issued for the
same purpose and effect upon such terms and conditions the Honorable Court may impose; and thereafter,
judgment be rendered granting the writ prayed for and annulling and setting aside the said opinions
rendered by the SEC in their stead, affirming the orders of the Hearing Officer (Annexes "A" and "B").
(pp. 27-28, Rollo.)
Additionally, in his petition for review (G.R. No. 89555) he prays this Court to giant "all the reliefs"
prayed for by him in CA-G.R. SP No. 17435. Here is a clear case of forum-shopping.
There is forum-shopping whenever as a result of an adverse opinion in one forum, a party seeks a
favorable opinion (other than by appeal or certiorari) in another. The principle applies not only with
respect to suits filed in the courts but also in connection with litigations commenced in the courts while an
administrative proceeding is pending, as in this case, in order to defeat administrative processes and in
anticipation of an unfavorable administrative ruling and a favorable court ruling. This is specially so, as in
this case, where the court in which the second suit was brought, has no jurisdiction. (Villanueva vs. Adre,
G.R. No. 8063, April 27, 1989.) (p. 303, Rollo)

Forum-shopping is prohibited by the Interim Rules of Court for it trifles with the courts and abuses their
processes (E. Razon, Inc. vs. Phil. Port Authority, 101 SCRA 450). Section 17 of the Interim Rules of
Courts provides:

17. Petitions for writs of certiorari, etc., No petition for certiorari, mandamus, prohibition, habeas
corpus or quo warranto may be filed in the Intermediate Appellate Court if another similar petition has
been filed or is still pending in the Supreme Court. Nor may such petition be filed in the Supreme Court if
a similar petition has been filed or is still pending in the Intermediate Appellate Court, unless it be to
review the action taken by the Intermediate Appellate Court on the petition filed with it. A violation of this
rule shall constitute contempt of court and shall be a cause for the summary dismissal of both
petitions, without prejudice to the taking of appropriate action against the counsel or party concerned.
(Interim Rules of Court.)

Forum-shopping makes the petitioner subject to disciplinary action and renders his petitions in this Court 410 Ill. 295 (1951) - 102 N.E.2d 340
and in the Court of Appeals dismissible (E. Razon, Inc. vs. Philippine Port Authority, et al., G.R. No.
75197, Resolution dated July 31, 1986; Buan vs. Lopez, Jr., 145 SCRA 34, 38-39; Collado vs. Hernando, THE PEOPLE OF THE STATE OF ILLINOIS, Defendant in Error,
L-43886, May 30, 1988). For this reason, if not for their lack of merit, the petitions should be, as they are
hereby, dismissed. v.

WHEREFORE, these petitions are dismissed for lack of merit. The temporary restraining order which this E.O. HANDZIK, Plaintiff in Error.
Court issued on August 7, 1989 in G.R. No. 89095 is hereby lifted. The Court of Appeals is ordered to
immediately dismiss CA-G.R. CV No. 20285. The petitioner and his counsel are censured for engaging in
forum-shopping. The petitioner is further ordered to pay double costs in this instance. FREDERICK J. BERTRAM, of Chicago, for plaintiff in error.

SO ORDERED. Mr. JUSTICE MAXWELL, delivered the opinion of the court:

Plaintiff in error, E.O. Handzik, also known as Esther O. Hankzik, was tried and convicted of a violation
of the Medical Practice Act upon information filed in the county court of Cook County. She comes here
directly from that court by writ of error to review the verdict of the jury and the sentence to pay a fine of
$500. Direct review lies to this court because she directly challenged the constitutionality of sections 24,
36, and 37 of this act in the lower court and has properly preserved those questions for review here.

It appears from the evidence that plaintiff in error, who will be hereinafter referred to as defendant, was a
woman about 60 years old at the time of the hearing, was a native of Sweden, had been in this country
about 27 years and was a citizen. She resided in her second-floor apartment in the city of Chicago with her
husband, Frank Handzik. She claimed to be a faith healer or healing minister ordained by the Central
Baptist Church of Chicago and was a member of a sect which believed in and practiced divine or faith
healing. The prosecuting witness, Mrs. Frances Dickerson, was an investigator for the Department of
Registration and Education of the State of Illinois. She testified that on November 15, 1949, she went to
the defendant's apartment to investigate a complaint which the Department had received about one Dr.
Frank Handzik; that defendant answered the door, witness gave her the alias of Bertha Baker, and asked to

Page 19 of
39
see Dr. Frank Handzik; that defendant advised her that Dr. Frank Handzik was not in and asked her if she
wanted a treatment; that she replied in the affirmative and defendant then told the witness that she was Dr.
E.O. Handzik, that she did the same kind of work as Dr. Frank Handzik and invited her into the apartment;
that defendant then asked her where she had her pain and the witness told her it was between her
shoulders, *299 and defendant told her she had arthritis; that defendant then asked her if she believed in
God and when witness replied that she did defendant requested a donation of $4 for her church and told
witness that she would give her a treatment, that she too had had arthritis and had cured herself. The
witness then described the treatment given to her which consisted of rapid inhaling, exhaling, and drinking
two glasses of water, one described as "holy" water and the other as "atomic" water; that defendant also
went through the rapid breathing process and stated that the purpose was to make one hot and make
contact with God easier; that defendant placed her hands on the witness and prayed; that defendant told
the witness that she also had machines, the "Estemeter" and "Vita Ray" machines, and if witness did not
get relief from the treatment that she would apply "hot wires." The witness also testified that defendant
gave her a printed card bearing the names of Dr. Esther O. Handzik and Dr. Frank A. Handzik, underneath
which names was printed "Christian Psychophysicians," and showing the address, phone number and
office hours. This card was introduced in evidence. The defendant testified that she believed in, had
studied and practiced divine healing through prayer as a minister of her church. She denied charging a fee
but admitted that she accepted a donation for her church and stated that this donation was usually divided,
10 per cent to the church and 90 per cent to her. She denied making any physical examination or
diagnosis. She denied giving the witness the card but stated that she knew they were in the house. She
stated that she was employed as a tailor to earn her living and did not depend upon any income from
healing treatments for that purpose.
The jury found her guilty under counts 3, 4, and 5 of the information and made no finding under counts 1
and 2. Count 3 charged that defendant, on November 15, 1949, in the city of Chicago, County of Cook,
"not then and *300 there possessing in full force and virtue a valid and existing license issued by the
authority of the State of Illinois to practice the treatment of human ailments in any manner, * * * did then
and there unlawfully suggest, recommend and prescribe the loud and rapid inhaling and exhaling and the
drinking of water for the relief and cure of the supposed ailment of Frances Dickerson, also known as
Bertha Baker, with the intention of receiving therefor a fee in the sum of four ($4.00) dollars." Count 4
alleged that the defendant, on November 15, 1949, not possessing a license of the State of Illinois to
practice the treatment of human ailments in any manner, did then and there "within the said County of
Cook, unlawfully attach the title Doctor, Physician, Surgeon, M.D. or some other words or abbreviation to
his name indicative that he was engaged in the treatment of human ailments as a business, to wit: Did then
and there unlawfully attach the title `Doctor' to her name, indicative that she was engaged in the treatment
of human ailments as a business, by informing patient that she was `Dr. E.O. Handzik,' all in violation of
Section 24 of an Act," etc. Count 5 alleged that the defendant, on November 15, 1949, not possessing a
license of the State of Illinois to practice the treatment of human ailments in any manner, did then and
there "within the said County of Cook unlawfully maintain an office for examination or treatment of
persons afflicted * * * with any ailment, to wit: Did then and there unlawfully maintain an office for the
examination and treatment of persons afflicted and supposed to be afflicted with any ailments, at 2573
Lyndale Avenue, Chicago, Illinois, all in violation of Section 24 of an Act," etc.
Defendant's written motions to quash the information, for a directed verdict, in arrest of judgment and for
a new trial were all overruled by the court.
Page 20 of
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Defendant first contends that section 24 of the Medical Practice Act (Ill. Rev. Stat. 1949, chap. 91, par.
16i,) is *301 unconstitutional because (1) the general language used in section 24 is restricted in its
operation by the exceptions made by section 37 of the same act and is therefore void, and also because
section 24 provides for punishment for "any" person, which term includes those exempted by section 37;
(2) the subject matter of section 24 is not embraced or expressed in the title of the act; (3) the penalties
authorized by section 24 inure to the Department (section 36) which is in effect an appropriation or
diversion of public funds in violation of sections 16 to 20, article IV of the Illinois constitution; (4) the
provisions of section 24, providing punishment for any person using the titles "Doctor" and "Physician,"
violate the due process clause and constitute an abridgement of the privileges of citizens of the United
States; (5) section 24 violates and infringes upon religious freedom.
Section 24 of this act provides, in substance, that if any person shall hold himself out to the public as
being engaged in the diagnosis or treatment of human ailments; or shall suggest, recommend or prescribe
any form of treatment with the intention of receiving any fee or gift, or any compensation whatsoever; or
shall profess to heal any ailment or supposed ailment of another; or shall maintain an office for
examination or treatment of any persons afflicted with any ailment; or shall attach the title Doctor,
Physician, Surgeon, M.D. or any other word or abbreviation to his name, indicative that he is engaged in
the treatment of human ailments as a business; and shall not then possess in full force and virtue a valid
license issued by authority of this State, shall be guilty of a misdemeanor, and upon conviction shall be
punished by a fine or imprisonment in the county jail, or by both fine and imprisonment.
Section 36 provides that all such fines shall inure to the Department.
Section 37 provides that this act shall not apply to certain named classes of persons, including "persons
treating *302 human ailments by prayer or spiritual means as an exercise or enjoyment of religious
freedom."
Defendant's contention that section 24 is invalid because the general language used therein is repugant to
section 37 is untenable. It is an elementary rule of statutory construction that all the parts of an act relating
to the same subject should be considered together and not each alone, so that the purpose and intent of the
whole act can be ascertained and given effect as consistent provisions to accomplish the purpose intended.
The provisions of section 37 merely constitute exceptions to the general provisions of section 24, and
when the whole act is read together there is no inconsistency or repugnancy. Mason v. Finch, 2 Scam, 223;
Burke v. Monroe County, 77 Ill. 610; Thompson v. Bulson, 78 Ill. 277.
There is no merit in the contention that the subject matter of section 24 is not embraced or expressed in
the title of the act. The object of the provisions of section 13 of article IV of the constitution, requiring the
subject to be expressed in the title of all acts of the General Assembly, is to give information as to the
subject with which the act deals, and to prevent joining in one act incongruous or unrelated matters.
(People v. McBride, 234 Ill. 146; People v. Williams, 309 Ill. 492; People v. Jiras, 340 Ill. 208.) The title
should express in general terms the purpose of the act, and any provisions germane to that purpose may be
inserted so long as they are not inconsistent with or foreign to the general subject. The title of an act is not
required to be an index of all its provisions. (People v. Sisk, 297 Ill. 314.) Where there is any doubt, it
should be resolved in favor of the validity of the act. (Ritchie v. People, 155 Ill. 98; Fuller v. People, 92
Ill. 182.) The title of the Medical Practice Act is "An Act to revise the law in relation to the practice of the
treatment of human ailments for the better protection of the public health and *303 to prescribe penalties
for the violation hereof." Section 24 provides that the doing of certain specified acts for the purpose of
treating human ailments, without a valid license, constitutes a misdemeanor, and provides penalties upon
conviction thereof. The purpose and object of the act, as set out in the title, is to regulate the practice of
treating human ailments. The power to license is a common and established method of regulating. The
specific acts prohibited by section 24 are all methods of treating human ailments. Prohibiting certain
methods of treatment without a license is clearly not inconsistent with or foreign to regulating the practice
of the treatment of human ailments, but is germane to, and in furtherance of, the purposes of the act for the
better protection of the public health.
Defendant's contention that the act is invalid because section 36 provides that all fines shall inure to the
Department of Registration and Education, instead of providing for such fines to be paid to the State or the
county for public use and benefit, in violation of sections 16 to 20 of article IV of the constitution, cannot
be sustained. We are unable to see how sections 16, 17, 18 and 19 of article IV could be interpreted to
apply in any manner to a statute making disposition of fines. Sections 16, 17, and 18 apply only to
appropriations made by the General Assembly out of the State treasury and section 19 deals with extra pay
for persons or on contracts. Defendant's contention would have to be based on the provisions of section 20
of this article, which provides that the State shall never pay, assume, or become responsible for the debts
or liabilities of, or in any manner give, loan or extend its credit to or in aid of any public or other
corporation, association or individual. In People v. Heise, 257 Ill. 443, the defendant challenged the
constitutionality of a statute which provided that the court which convicted a defendant of wife and child
abandonment could order the fine paid, in whole or *304 in part, to the wife or guardian of the child. The
defendant there contended that this statute violated section 2 of the schedule and sections 1, 16, 17, 20 and
22 of article IV. We there held, as to sections 16 and 17, that they applied only to appropriations from the
State treasury, and that it was not intended that section 20 of article IV should apply in any manner to the
disposition to be made of fines and penalties for the violation of our criminal statutes. The General
Assembly has the power to impose penalties and the power to dispose of them, and section 36 of the
Medical Practice Act does not violate any of the constitutional provisions relied on by defendant.
The defendant's contention that section 24 provides punishment for any person using the titles "Doctor"
and "Physician" without a valid license ignores the plain language of the statute. Not every use of the titles
is punishable, but only the use of the titles in an unlawful manner "indicative that he is engaged in the
treatment of human ailments." (People v. DeYoung, 378 Ill. 256.) The licensing and control of persons
who represent to the public that they are trained and qualified to treat human ailments is a valid and
essential exercise of the police power of the State for the better protection of the public health. (People v.
Walder, 317 Ill. 524.) Within constitutional limits the General Assembly is the sole judge of the laws that
shall be enacted for the protection of the public health, and so long as such laws do not invade inherent or
constitutional rights the determination of the General Assembly is conclusive. The use of these titles is not
an inherent or constitutional right in everyone and the General Assembly may regulate their use in the
treating of human ailments. It is common knowledge that these titles, in general use as applied to human
ailments, have a connotation indicating special qualifications and training to diagnose and treat afflicted
persons, and the misuse of such titles could cause deceptions, frauds and practices dangerous to the public
*305 health. Laws regulating the use of these titles where health and even life itself are involved are not
unreasonable or arbitrary. We think the prohibition of the use of such titles "indicative that he is engaged
in the treatment of human ailments as a business" is reasonably necessary and appropriate to accomplish
the legitimate objects and purposes of the Medical Practice Act and within the police power of the State.
Page 21 of
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The validity of the Medical Practice Act of 1923 has been repeatedly affirmed by this court and we have
found that section 24 does not violate the due process clause of the constitution. People v. DeYoung, 369
Ill. 341, and cases cited.
Defendant's contention that section 24 violates and infringes upon religious freedom is likewise untenable.
As heretofore pointed out, section 24 must be read in conjunction with section 37, and that section
specifically exempts "persons treating human ailments by prayer or spiritual means as an exercise or
enjoyment of religious freedom."
Defendant contends that counts 3, 4, and 5 of the information were legally insufficient to charge a crime
or offense against the State of Illinois, were insufficient to inform her of the nature and cause of the
accusation, and failed to negative that she was exempt from the act, and that therefore the trial court erred
in overruling her motions to quash the information and in arrest of judgment. The three counts all charged
defendant with the crimes in the language of the statute and then, under a videlicet, with specific acts
constituting violations of the act. Section 24 prescribes the precise acts which constitute violations, and
the information is predicated upon these precise acts. Both the statute and the information are clear and
unambiguous and informed the defendant of the exact nature of the offense. Informations in similar
language have been upheld in People v. Shaver, 367 Ill. 339; People v. Paderewski, 373 Ill. 197; People v.
Moe, 381 Ill. 235; People v. Rongetti, 395 Ill. 580; People v. DeYoung, 378 Ill. 256; *306 and People v.
Kabana, 388 Ill. 198. Failure to negative that defendant was one of the exempted class does not make the
information insufficient. We have frequently held that such exemptions or exceptions are not a part of the
description of the offense and therefore need not be negatived in the information. (People v. Boyden, 400
Ill. 409; People ex rel. Courtney v. Prystalski, 358 Ill. 198; People v. Talbot, 322 Ill. 416; People v. Green,
362 Ill. 171.) Such exemptions or exceptions are matters of defense. People v. Allen, 360 Ill. 36; People v.
Saltis, 328 Ill. 494; Sokel v. People, 212 Ill. 238.
The defendant contends the court erred in overruling the motion for a directed verdict on the grounds that
all the evidence, both for the State and the defendant, shows that this was purely a case of faith healing
and was an exercise of her right of religious freedom. An examination of the instructions reveals that the
jury was adequately instructed in regard to defendant's claimed exemption, it heard the evidence and
observed the witnesses, and by its verdict found the defendant was not one of the exempted class. We
cannot say that the evidence here, with the legitimate inferences deducible therefrom, is insufficient to
support that verdict.
The defendant further contends that the prosecution failed to prove that she had no license, an essential
allegation of the information, and that the court erred in instructing the jury that "It is not incumbent upon
the People to prove that allegation of the information; if the defendant did not have such a license, it is a
matter of defense and you should not find the defendant not guilty solely by reason of the fact that there is
no proof of evidence as to whether the defendant did or did not have such a license." The wording of this
instruction is garbled and confused but, if it says anything, it says that the People are not required to prove
the allegation of the information that the defendant did not have a license.
Failure to have a license is an essential part of the description of the offense, and if that was not alleged
the information would be vulnerable to a motion to quash and would not support a conviction. (People v.
Prystalski, 358 Ill. 198.) As a general rule, it is elementary that the State is required to prove every
essential averment of the charge against the defendant. There usually is no burden upon a defendant to
disprove any averment or even to make a defense. However, there is an exception to this rule in this type
of case. In prosecutions for doing an act which the State prohibits to be done by any person except those
who are duly licensed, the negative averment that defendant had no license, being an averment peculiarly
within the knowledge of the defendant, is taken as true, unless disproved by the defendant. (Kettles v.
People, 221 Ill. 221; Noecker v. People, 91 Ill. 468; Williams v. People, 121 Ill. 84; People v. Frankowsky,
371 Ill. 493; People v. Hollenbeck, 322 Ill. 443.) Under the law as established by these cases the State was
not required to prove that defendant had no license and the instruction was not prejudicial error.
Furthermore, we are unable to see any unfairness or harm in applying this rule here, where defendant took
the stand and testified.
In her 25 assignments of error the defendant has raised objections to the court's rulings on the evidence,
the giving and refusing of various instructions, the court's refusal to excuse one of the jurors, and alleged
prejudicial conduct of the prosecuting attorney. The merit or weight of none of these objections justifies
extending this opinion by a separate discussion of each of them. Each has been carefully examined and
none is found to be prejudicial error. It appears from the entire record that defendant has had a fair and
impartial trial in every respect.
Finding no prejudicial error in the record, the judgment is affirmed.
Judgment affirmed.
PEOPLE v. WENDEL
68 N.Y.S.2d 267; 1946 N.Y. Misc. LEXIS 3358
December 10, 1946
Page 22 of
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PROCEDURAL POSTURE: Defendant was convicted of the unlawful practice of medicine in violation
of N.Y. Educ. Law 1250, 1251 and 1263. He filed a motion to set aside the verdict of the jury.
OVERVIEW: The People claimed that the actions of defendant were in violation of N.Y. Educ. Law
1250, subd. 7, in that defendant by some means or method undertook to and did diagnose and treat and
prescribe for a physical condition. Defendant maintained that he was entitled to the exemption provided
by N.Y. Educ. Law 1262, subd. 1(8) in that he was practicing the religious tenets of his church. He
claimed to be a Doctor of Divinity and a minister of the Lutheran Church. His further contention was that
all he did to the People's witnesses was to lay his hands on that portion of the body where the witness
complained of pain, and that he asked the witness to pray in silence while he did the same and thus bring
about relief. The court found that defendant had distributed literature in which he claimed to be a doctor of
various specialties, but did not claim to be a Doctor of Divinity. Further, the court found that it was not
necessary to lay hands upon the naked body of a person in order to cure an ailment through prayer. The
court found that defendant was not engaged in the practice of his religion, but was claiming the cloak of
religion to hide his illegitimate practices.
OUTCOME: The court denied defendant's motion.
CORE TERMS: doctor', church, indictment, religion, divine, tenets, bail, chiropractic, healing,
embezzlement, prescribe, religious, indicted, cure, practicing, profession, diagnose, pain, prayer, physical
condition, physiotherapy, certificate, exemption, medicine, disrobe, relieve, healer, practice of law, good
faith, deformity
LexisNexis(R) Headnotes
Constitutional Law > Bill of Rights > Fundamental Freedoms > Freedom of Religion > Free Exercise
of Religion
Governments > State & Territorial Governments > Police Power
Healthcare Law > Business Administration & Organization > Licenses > General Overview
[HN1] The religious tenets of a church must be practiced in good faith to come within the exception of
N.Y. Educ. Law 1262, subd. 1(8); that is, the tenets of a church are the beliefs, the doctrines and the
creeds of the church. A person should not be allowed to assume to practice the tenets of any church as a
shield to cover a business undertaking. The profession and practice of religion must be itself the cure.
Constitutional Law > Bill of Rights > Fundamental Freedoms > Freedom of Religion > Free Exercise
of Religion
Governments > State & Territorial Governments > Police Power
Healthcare Law > Business Administration & Organization > Licenses > General Overview

[HN2] The tenets to which the law accords freedom, alike of practice and of profession, are not merely the
tenets, but the religious tenets, of a church. The profession and the practice of the religion must be itself
the cure. The sufferer's mind must be brought into submission to the infinite mind, and in this must be the
healing. The operation of the power of spirit must be, not indirect and remote, but direct and immediate. If
that were not so, a body of men who claimed divine inspiration might prescribe drugs and perform
surgical operations under cover of the law. While a healer inculcates the faith of the church as a method of
healing, he is immune. When he goes beyond that, puts his spiritual agencies aside, and takes up the
agencies of the flesh, his immunity ceases. He is then competing with physicians on their own ground,
using the same instrumentalities, and arrogating to himself the right to pursue the same methods, without
the same training. The law exacts no license for ministration by prayer or by the power of religion. But
one who heals by other agencies must have the training of the expert.
OPINION GOLDSTEIN, Judge.
This is a motion made by the defendant to set aside the verdict of the Jury, finding him guilty of the first
count of this indictment.
This defendant was charged with the unlawful practice of medicine in violation of Sections 1250, 1251
and 1263 of the Education Law of the State of New York, and that he held himself out as being able to
diagnose, treat, operate or prescribe for a human disease, pain, injury, deformity or physical condition of
certain persons named in the indictment, and that he offered to and undertook to treat aforesaid persons for
various human diseases, pains, injuries, deformities or physical conditions.
Briefly, the People's case consisted of testimony offered by two Special Investigators who testified to
several visits made by them to the defendant's offices, at which time they were asked to disrobe and don a
white gown which opened in the back; that the defendant made an examination of their persons and made
certain diagnoses, namely, curvature of the spine, causing a pressure of the nerve in the sacro-iliac;
kyphosis of the back; constipated condition due to certain foods, and prescribed a diet to relieve this
condition; prescribing yarrow and horehound to relieve a cold and slippery elm tablets to relieve a cold
and sore throat. In addition, People's witnesses testified that defendant pressed and prodded with his hands
along the back and spine of the witnesses, and various other portions of the body; that he used a heating
lamp, violet-ray lamp and electric vibrator.
The third witness called by the People was Bertha Huber, who was employed in the Board of
Transportation, and who testified to making two visits to defendant's premises, at which time he examined
her 'like a doctor' and that he placed his hands on her stomach, back and other parts of the body and gave
her a massage.
All of these acts the People claim are in violation of Section 1250, Subdivision 7 of the Education Law, in
that the defendant by some means or method undertook to and did diagnose and treat and prescribe for a
physical condition.
Page 23 of
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Defendant maintains that he is entitled to the exemption provided by Section 1262, Subdivision 1(8) of the
Education Law in that he was practicing the religious tenets of his church. He claims to be a Doctor of
Divinity by reason of a certificate issued by Union College in Illinois in 1944 and a certificate of Doctor
of the Divine Metaphysics received from the Church of Divine Metaphysics in 1944. Defendant further
contends that he is a Minister of the Lutheran Church, having been duly ordained as such by the American
Council of Churches in Chicago. His further contention was that all he did to the People's witnesses was
to lay his hands on that portion of the body where the witness complained of pain, and that he asked the
witness to pray in silence while he did the same and thus bring about relief.
The defendant further admitted that he was a graduate of the Philadelphia College of Pharmacy in 1908
and that he took a four-year course from 1914 to 1918 in the New Jersey College of Osteopathy, a Post-
Graduate Course at the American School of Chiropractic, a two-year course in physiotherapy at the
Metropolitan School of Physiotherapy and a Post-Graduate Course in said subject at said school. In an
affidavit submitted in connection with a motion to transfer this case from the Court of Special Sessions to
the County Court, defendant further admitted that for one year he attended Jefferson Medical College and
that he was licensed by the State of Vermont as a chiropractic physician.
My investigation further discloses the fact that for some years the defendant was associated with one
Benedict Lust who in 1933 was convicted of violation of Section 66 of the Education Law in that he
fraudulently dispensed diplomas in violation of the law. In connection with [*269] his association with
Lust, this defendant gave certain lectures, speaking on the following subjects: Herbs and Constipation;
Ulcers of the Stomach; Arthritis and Muscular Pains; Hardening of the Arteries; Intestines and Gall
Bladder. Then he wrote articles for a magazine known as 'Nature's Path' which is published by the said
Lust; one of those articles appeared in the September, 1944 issue, entitled 'Magnetopathy and Magnetized
Water' and which article concluded with the following statement: 'Magnetic Healing is the Answer of the
Day.' In a letter written by the defendant to the witness Huber, defendant signed his name with the
following initials:
D.C., which means Doctor of Chiropractic
D.O., which means Doctor of Osteopathy
D.P., relating to his Doctor of Pharmacy Degree received in 1908.
On other literature printed by this defendant, there appeared the following: Spinal Analysis; Spinal
Adjustments; Chiropractic Health Building System; the name Dr. Paul Wendel; Science of Chiropractic,
Licensed Chiropractic Physician in the State of Vermont, and in the lower left-hand corner of the same
card lists the following degrees:
Doctor of Chiropractic
Doctor of Osteopathy
Doctor in Pharmacy
Doctor of Science
In none of the literature that he gave in connection with his association with Lust did the defendant ever
state that he was a Doctor of Divinity or a Doctor of Divine Metaphysics, or that he was a divine healer; in
none of the printed literature under his name does this defendant make any claim to being a divine healer
or a Doctor of Metaphysics. I strongly question the validity of the so-called certificates of Doctor of
Divinity that this defendant claims to have received from Union College in 1944 and from the Church of
Divine Metaphysics, because on cross-examination this defendant admitted that at no time did he ever
undertake [**6] any course in any seminary or any theological studies.
Of course, in the practice of any religion it may not be important to determine whether or not a person
claiming to be a priest or a minister had any education in theological studies. Under our form of
government and under our Constitution, all of the people of this country are entitled to worship their God
in their own manner.
But one claiming the exemption provided by law may prove that claim. The issue in such a claim is one of
legitimacy. Is the defendant practicing a religion in good faith? Does he have a congregation or church?
Does he administer only prayer and refrain from the use of physical means? Does he prescribe medicine
or diets? Does he undertake examinations and give physical treatments? These are some of the [*270]
issues which determine whether or not he is exempt from the operation of the statute.
In the case of People v. Cole, 219 N.Y. 98, 113 N.E. 790, L.R.A.1917C, 816, it was held that [HN1] the
religious tenets of a church must be practiced in good faith to come within the exception; that is, the tenets
of a church are the beliefs, the doctrines and the creeds of the church. A person should not [**7] be
allowed to assume to practice the tenets of any church as a shield to cover a business undertaking. The
profession and practice of religion must be itself the cure. The latest case to come to the Court of Appeals
on this point is that of People v. Vogelgesang, 221 N.Y. 290, 116 N.E. 977, 978. There Judge Cardozo
wrote the prevailing opinion, of which the following is a part:
'The law, in its protection of believers, has other cures in mind. [HN2] The tenets to which it accords
freedom, alike of practice and of profession, are not merely the tenets, but the religious tenets, of a church.
The profession and the practice of the religion must be itself the cure. The sufferer's mind must be brought
into submission to the infinite mind, and in this must be the healing. The operation of the power of spirit
must be, not indirect and remote, but direct and immediate. If that were not so, a body of men who
claimed divine inspiration might prescribe drugs and perform surgical operations under cover of the law.
While the healer inculcates the faith of the church as a method of healing, he is immune. When he goes
beyond that, puts his spiritual agencies aside, and takes up the agencies of [**8] the flesh, his immunity
ceases. He is then competing with physicians on their own ground, using the same instrumentalities, and
arrogating to himself the right to pursue the same methods, without the same training.
'The law exacts no license for ministration by prayer or by the power of religion. But one who heals by
other agencies must have the training of the expert.'
Page 24 of
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The People maintain that what this defendant did in treating the People's witnesses was to give both a
chiropractic adjustment and the use of modalities in physiotherapy treatment. The jury passed on the
question of fact as to whether or not the People's witnesses were to be believed or whether or not the
defendant's version of what took place was to be believed. They had before them not only the testimony of
the witnesses called by both sides, but countless exhibits, and by their verdict of guilty they resolved that
the defendant did violate Section 1251 of the Education Law in practicing medicine without a license.
The Court recognizes all forms of religion, as well as the religious tenets of any church and that there may
be those who have the divine power of healing and that as long as those who claim to have [**9] that
power conduct themselves within the meaning of the decision of Judge Cardozo in the Vogelgesang case,
namely, 'The profession and the practice of the religion must be itself the cure. The sufferer's mind must
be brought into submission to the infinite mind, and in this must be the healing' -- that they would then be
entitled to the exemption provided by the Education Law.
This prosecution against this defendant is not a prosecution against religion, but rather a prosecution
against a faker and quack who claims the cloak of religion to hide his illegitimate practices. The
authorities must at all times be aware of such individuals and to root them out from the real and legitimate
practice of religion. The authorities must at all times be ready not only to protect the public, but the
Church itself and the different forms of religion that are practiced in this country of ours.
Further investigation by the Attorney General and State Education Department as to the activity of this
defendant reveals the following:
That he was admitted to practice law in the State of New Jersey about 1918; that in 1920 he was indicted
on a charge of perjury; that after trial defendant [**10] was found guilty and sentenced to serve nine
months; that on appeal this conviction was affirmed. 96 N.J.L. 495, 115 A. 390. Thereafter, and in 1922,
the defendant was disbarred from practice as an attorney.
That some time in 1924, the defendant secured a pardon from the Governor of the State of New Jersey and
was re-admitted to the practice of law. 128 A. 249, 3 N.J.Misc. 312.
That some time in 1930, this defendant resigned from the practice of law in the State of New Jersey; that
at the time of this resignation complaint had been lodged against the defendant with the Ethics Committee
of the Bar Association by one Peter Hawes, of Tom's River, New Jersey, who claimed that the defendant
had received a check for $ 2,100 in settlement of an action with the Indemnity Company of North
America; that the check was received by the defendant on April 28, 1930 and made payable both to
Wendel as attorney and to Peter Hawes, individually and as husband of Edith Hawes; that the defendant
attempted to cash said check by signing both his own and Peter Hawes' names in endorsement; that the
check was cashed by the defendant about April 30, 1930; that on June 14, 1930, the defendant gave a
check [**11] for $ 1,154.17, payable to Edith Hawes and Peter Hawes and payment of this check was
stopped; that on June 17, 1930, the defendant sent to Peter Hawes the sum of $ 500; that the Ethics
Committee of the Bar Association sent the defendant a notice to appear before it on June 27, 1930; that a
short time before the time of hearing the defendant paid an additional sum of $ 41.67 in cash and the
check of a third party to cover the balance due his client. Our investigation with the Ethics Committee
reveals the fact that this defendant admitted in their presence on June 27 that he had forged the
endorsement of Peter Hawes on the check. The defendant failed to [*272] appear at the second meeting of The motion is denied.
the Ethics Committee on July 17, at which time his letter of resignation was submitted.

The further results of our investigation reveal the following:

January, 1931, Indictment No. 75. Defendant was indicted on a charge of uttering. Released in bail of $
200;

Mercer County, N. J., Indictment No. ___. Indicted on March 31, 1936, on a charge of embezzlement --
Bail $ 500.

Mercer County, N. J., Indictment No. 3. January 1931 indicted on a charge of embezzlement -- Bail $ 500.

Mercer [**12] County, N. J., Indictment No. 74. Indicted in January, 1931. Charge of embezzlement --
Bail $ 1,000.

Trenton, N. J., Indictment No. 2. January 1931 False Pretenses -- Bail $ 1,000.

Mercer County, N. J., Indictment No. 248. October 1930. Charge of embezzlement -- Bail $ 2,000.

Mercer County, N. J., Indictment No. 249. October 1930. Charge of embezzlement -- Bail $ 500.

Trenton, N. J., Indictment No. 250. October 1930. Charge of embezzlement -- Bail $ 500.

Trenton, N. J. Indictment No. 251. January 1931. False pretenses -- Bail $ 500.

Defendant has used several aliases during his lifetime, among them the names of Mr. Albert and Chris
Knorr.

It must not be forgotten that this defendant had the three witnesses for the People disrobe and that he
placed his hands upon their naked body. Surely, by no stretch of the imagination can it be urged that in
order to cure a person of any ailment by means of prayer that it becomes necessary for the person to
disrobe. The Court recalls that the witness Huber was requested to remove her corset, because, as the
defendant put it, his magnetic power could not penetrate through the corsets. This is only one instance of
revealing [**13] the sham and falsity of the defendant's claim to practicing the religious tenets of his
church in bringing about divine healing by means of prayer.

The State Education Department through its Executive Secretary, C. Everts Mangan, to whom credit
should be given for investigating and collecting the evidence in this prosecution against this defendant, People v. . Cole, 113 N.E. 790 (NY 1916)
feels very strongly about this case. It is Mr. Mangan's belief that this defendant is one of a group who prey
upon a gullible public, lulling them into a false sense of security, into having the public believe that they New York Court of Appeals
were doctors efficiently able to treat, diagnose and prescribe for human ills.
Precedential Status: Precedential

Page 25 of
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Citations: 113 N.E. 790, 219 N.Y. 98
Judges: CHASE, J.
On February 18, 1911, on an application therefor by the New York County Medical Society, a warrant was
obtained against the defendant charging him with practicing medicine as defined by section 160 of the
Public Health Law of the state of New York, without being duly licensed therefor. (People v. Cole, 25 N Y
Crim. Rep. 350.) On March 21, 1911, he was indicted by a grand jury of the county of New York. The
indictment charges him with the crime of practicing medicine without lawful authorization and
registration and alleges that such unlawful practicing of medicine occurred on the 19th day of January,
1911, and continually thereafter to and including the 28th day of January, 1911. The defendant was tried
on such indictment in the New York Supreme Court Criminal Term, but the jury failed to agree and was
discharged. Another trial was had in the same court and resulted in a verdict of guilty and a judgment was
accordingly entered against the defendant on the 30th day of March, 1912. He appealed from *Page 101
such judgment to the Appellate Division where it was affirmed by a divided court. (People v. Cole, 163
App. Div. 292.) An appeal was then taken from such judgment of affirmance to this court.
Practicing medicine when unaccompanied by acts that are in themselves evil, vicious and criminal, is not
a crime at common law. Practicing medicine is not malum in se. It is important in the interest of public
health and public welfare that a person holding himself out as a physican or healer of diseases, should
have the education, training, skill and knowledge adequate for such purposes. Statutes designed to protect
public health and general welfare by regulating the practice of medicine, in some part or all of the territory
constituting this state, have been enacted from time to time since 1760.
When a person is charged with practicing medicine without a license it is necessary to examine the acts of
the legislature to ascertain whether the practices complained of are in violation of the statute law.
The Public Health Law (Cons. Laws, ch. 45) of this state provides, and did provide at all the times
mentioned in the indictment, that "No person shall practice medicine, unless registered and legally
authorized prior to September first, eighteen hundred and ninety-one, or unless licensed by the regents and
registered under article eight of chapter six hundred and sixty-one of the laws of eighteen hundred and
ninety-three and acts amendatory thereto, or unless licensed by the regents and registered as required by
this artiele. * * *" (Public Health Law, 161.) "The practice of medicine is defined as follows: A person
practices medicine within the meaning of this article, except as hereinafter stated, who holds himself out
as being able to diagnose, treat, operate or prescribe for any human disease, pain, injury, deformity or
physical condition, and who shall either offer or undertake, by any means or method, to diagnose, treat,
operate or prescribe for any human disease, pain, injury, *Page 102 deformity or physical condition."
(Public Health Law, 160, subd. 7.)
The statute also provides: "This article shall not be construed to affect * * * the practice of the religious
tenets of any church * * *." (Public Health Law, 173.)
Our Constitution provides: "The free exercise and enjoyment of religious profession and worship, without
discrimination or preference, shall forever be allowed in this state to all mankind; * * * but the liberty of
conscience hereby secured shall not be so construed as to excuse acts of licentiousness, or justify practices
Page 26 of
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inconsistent with the peace or safety of this state." (Constitution of the State of New York, article 1,
section 3.)
The defendant was never registered or licensed as a practitioner of medicine. He is a member of the
Christian Science church and a recognized practitioner within the rules of that church. For about seven
years he maintained an office in the city of New York. At the times mentioned in the indictment, his office
was on the ninth floor of a building at Fifth avenue and Madison square. It consisted of two rooms; one, a
reception room containing chairs, tables, a clock and literature; and an inner office containing a desk, two
chairs, and a telephone. On the door of his office were the words: "Willis Vernon Cole, Christian
Scientist."
The evidence taken on the trial consisted of the testimony of a woman who for seven years had been
employed by and under the direction of the New York County Medical Society as an investigator, and the
testimony of the defendant.
The investigator testified that at her first interview with the defendant on January 19, 1911, she waited in
the reception room of his office with others until an opportunity arrived to see him and she then went into
the inner office. She further testified as follows:
"I asked him if he was Dr. Cole. And he said he was *Page 103 Mr. Cole, a Christian Science healer. * * *
I said * * * that I read about him in the newspapers; that I called to see if he could cure my eyes, I had
been troubled with eye trouble. And he said, `How long have you been wearing glasses?' And I said, `Ten
years.' He said, `You understand I do not give any medicine, I only give Christian Science treatment.' * * *
I said to him, `What is Christian Science?' And he said, `I cure by prayer.' He said that `You must have
faith in God; that God don't make us to have any disease; that we must be all love and all kindness and
that God would cure the infidel as well as the confirmed believer in his Divine Power.' And I said what
would be the fee? And he said $2 for the first treatment and all subsequent treatments $1. * * * The
defendant then said, `I will give you a treatment.' So Mr. Cole had his chair facing mine, and he closed his
eyes and raised his hands up to his face and remained in perfect silence for fifteen or twenty minutes. * *
* He said, `That will do for to-day's treatment. * * * You come back on Friday any time.'" On Friday, the
next day, she returned to his office. Her testimony as to what occurred is as follows:
"I went in and he said to me, `Why, you are looking very well.' And I said, `I feel about the same.' And
after that, why, he spoke about God is good and we must have love and faith in God. And then he says,
why, he will give me a treatment. So that Mr. Cole placed his chair facing mine again, closed his eyes and
put his hands up to his face and we remained in perfect silence there for about fifteen or twenty minutes."
She further testified that before the treatment she said to him, "`Mr. Cole, I have a pain in my back.' * * * I
then said that I had a porous plaster on my back at that time; and I said to him what did he think about the
pain I had in my back. He said it was some kind of disease, but he could not tell what kind it was; he said.
*Page 104 `I can cure it.' * * * He said, `You must now take off that porous plaster because Christian
Science cannot cure with plasters on.' * * * He said that I must take off my glasses as well as remove the
plaster from my back * * * That I should have more faith and understanding; that I must have courage;
that I should remove the glasses. * * * I said I must keep my glasses as I cannot go without them. * * * He
said if I wanted to be cured by Christian Science I must remove the glasses. * * * I said, `How can you
cure locomotor ataxia?' He said, `Just by prayer and having faith in God.' He said, `When patients are
given up by physicians they always turn to Christian Science for help.'" He told her to come back on
Monday, January 23. She did so. She said to him, "`I removed the plaster that was on my back as you told
me to.' And he said, `I want you also to remove the glasses.' I says, `I have to keep the glasses on.' * * * I
said, `* * * when I eat bread and potato I would distress my stomach very much,' He said, `Leave your
stomach alone; you go home and eat anything you want to.' * * *"
She returned again on January 27 and brought her little girl with her. The little girl wore glasses. She
further testified, "I said to Mr. Cole that the child has been wearing glasses and she also has a cold. I said,
`Can you cure her by Christian Science?' and he said, `Absolutely.' I said, `Well, will you cure her?' And
he replied, `Absolutely.' So I said that the child had a pair of roller skates, and wearing glasses, why, if she
should fall she would injure herself. And he said, `You take the glasses off and let the child run and romp
like other children;' that mothers should not put such fear in children. * * *" He gave them treatment
similar to the one he had given her before.
The defendant during the interviews stated to the witness that she had as much power to heal disease as he
had, and could do so as well if she would study the Bible and *Page 105 rely upon its promises and offer
the prayer of understanding and faith. She understood him when he asserted that he could cure disease as
saying that he could bring about the cure by means of prayer to Almighty God. He said to her that all
diseases are alike to a Christian Scientist.
The defendant testified that at the first interview with the investigator "She told me that she had come to
be treated for trouble with her eyes and stomach trouble. I informed her that Christian Science treatment
was prayer to God, we did not believe in drugs, medical treatment, anything like that, and she asked me to
give her treatment. Something was said in regard to the basis of Christian Science, and I told her
substantially that Christian Science was the truth about God, and the truth about man and the truth about
man's relationship to God and the truth of his birthright as a result of this relationship, which is the
foundation of what we teach, and I told her that on this basis disease was no part of her birthright, or
inharmony, and when she realized her oneness with God, and got in harmony with God that this was the
treatment and was what we would do. She sat there for about fifteen minutes. I covered my face with my
hands, or sat with my head partially bowed for fifteen minutes," in prayer.
He testified that at the second interview "She spoke to me about taking off her glasses and I told her that
there was no reason that she should not take off her glasses, and I casually spoke of my own healing, that I
had worn glasses for many years * * * and taken them off. * * * I told her I had trouble with my eyes and
had several other diseases and that I had been to a number of physicians and that I had been healed by
Christian Science." He further testified that on the second visit he told her "That Christian Science
treatment was prayer to God. I told her that Christian Science realized that God was omnipotent, or all
powerful; that He was omniscient, or all knowing; that he was omnipresent, or ever present; *Page 106
and that because God was omnipotent and omniscient, and omnipresent, and God was good, that it must
follow that evil, disease, inharmony, sin and discord were no part of His Being and had no real existence,
and I told her that man was the image and likeness of God, and was entitled to dominion, and that his
birthright was dominion and that he had the right to affirm and secure immunity from discord of whatever
name and nature, and that disease was like a shadow that flees before the light."
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He says he told her that this result would follow from spiritual understanding. He says he spoke to her
about keeping her life pure and Christ-like and loving and good, and just and free from error. He says he
then prayed again, and that prayer is a synonym for treatment.
He further testified that at the first interview "I told her I could not cure her, that I had no more power to
cure her than any one else, that God was the only power, and the only healer. * * * I told her that she
could cure herself just as much as I could if she would study and purify her life and her thoughts and
cleanse from her consciousness fear and inharmony and false thoughts. I told her that by studying and
gaining an understanding that she could apply the principle and law of Christian Science as well as anyone
else, as well as I could. * * * I told her that I was nothing and that she was nothing, it was God."
His testimony as to what was said at the third interview is as follows: "We discussed Christian Science
and I picked up Science and Health with Key to the Scriptures by Mrs. Eddy which is recognized in
Christian Science as the standard text book; it is the original Christian Science text book which we accept
with the Holy Scriptures of which it is explanatory as the basis of our great religious truth. I asked her to
procnre a copy of this book." He testified that he read to her from that book. "To be `present with the Lord'
is to *Page 107 have, not mere emotional ecstasy or faith, but the actual demonstration and understanding
of Life as revealed in Christian Science. To be `with the Lord' is to be in obedience to the law of God, to
be absolutely governed by Divine Love, by Spirit, not by matter.
"Become conscious for a single moment that Life and intelligence are purely spiritual neither in nor of
matter, and the body will then utter no conscious complaints. If suffering from a belief in sickness, you
will find yourself suddenly well. Sorrow is turned into joy when the body is controlled by spiritual life,
Truth and Love. * * *
"Entirely separate from the belief and dream of material living, is the Life Divine, revealing spiritual
understanding and the consciousness of man's dominion over the whole earth. This understanding casts
out error and heals the sick, and with it you can speak `as one having authority.'"
He testified that he was practicing Christian Science as laid down by the church. He denied that he was
practicing medicine.
It was conceded on the trial that Christian Science is a religion based upon the Scriptures and founded by
Mary Baker Eddy in 1866 and that the church has about a million members. The alleged healing of moral,
mental and physical diseases by prayer was practiced by Christian Scientists in New York for more than
twenty years before the times mentioned in the indictment. It was also conceded that in order to obtain
entry upon the list of practitioners of the Christian Science church proof must be furnished satisfactory to
the church of the character and qualifications of the applicant, but that the education and experience of the
applicant is not an element in his qualifications. The church relies wholly upon the sincerity of the
applicant and his reliance and faith in the power and efficacy of prayer to heal diseases.
It appears from the statute that we have quoted that a *Page 108 person practices medicine when he "holds
himself out as being able to diagnose, treat, operate or prescribe for any human disease, pain, injury,
deformity or physical condition, and who shall either offer or undertake, by any means or method, to
diagnose, treat, operate, or prescribe for any human disease, pain, injury, deformity or physical condition."
The language of the statute is very general. It bears evidence in itself that the words were chosen for the
express purpose of prohibiting, except upon registration and authorization of the practitioner, as by the
statute provided, every means and method that could thereafter be used or claimed to be used to relieve or
cure disease and infirmity by any person individually, or as a representative of a school, religious body or
other organization.
It does not appear that the defendant attempted to diagnose the diseases which the investigator stated to
him that she had; he not only in substance denied that she had any disease, but asserted that they rested in
her imagination or were mere evidence of a lack of true relation to her God. There was no inquiry on his
part into the symptoms which the investigator claimed that she had as indicating the diseases. There was
no laying on of hands, manipulation, massage, or outward ceremonial. His direction to her to remove her
glasses and take off a porous plaster which she asserted she had upon her back were, as also asserted by
him, simply to bring about complete reliance by her upon the power and willingness of God to heal her
diseases. Such directions were not, he asserts, intended as a prescription or as advice. It was a test of her
faith. He, however, testified that prayer was a synonym for treatment. He habitually termed his
interposition by prayer a treatment and such it would seem to have been in the ordinary meaning of the
word. He had a place where interposition by prayer to God could be sought through him at a price, either
as a compensation or as an honorarium. He asserts that he made *Page 109 interposition with God by
prayer to take away diseases or what he alleges to be wrong relationships between persons having diseases
and their God. His interposition with God as explained by him was to obtain such Divine action that the
inharmony between the Divine Being and the person who sought to be relieved of diseases and infirmities
might be adjusted. The duties of the defendant as a practitioner would seem to have been to handle the
claim of those that came to him with their ills with a view to obtaining a Divine cure. Such interposition
under such circumstances was, in the language of the defendant himself, a "treatment."
We are of the opinion that the defendant did "treat" the investigator by "any (some) means or method," as
the word is used in the general prohibition contained in the statute.
The general and comprehensive definition of a person who practices medicine has an express exception.
The descriptive words are preceded by the phrase "except as hereinafter stated." The exception concededly
refers to the words in section 173 of the Public Health Law as follows: "This article shall not be construed
to affect * * * the practice of the religious tenets of any church." The exception includes every person in
the practice of the religious tenets of any church and it is not in any way in conflict with the Federal or
State Constitution. The language quoted from said section 173 is not in any sense an affirmative license. It
is, we repeat, an exception to the general prohibition. Whether the practice of the religious tenets of any
church should have been excepted from the general prohibition against the practice of medicine unless the
practitioner is registered and authorized so to do, or whether the exception should be continued therein, is
a question for the legislature and not for the courts. The purpose of the general statute is to protect citizens
and others of the state from being treated in their physical ailments and diseases by persons *Page 110
who have not adequate or proper training, education or qualifications to treat them.
The tenets of a church are the beliefs, doctrines and creeds of the church. The exception relates to the
tenets of the church as an organized body as distinguished from an individual. It does not relate to or
except persons practicing in accordance with individual belief.
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It appears from the record that it is a tenet of the Christian Science church that prayer to God will result in
complete cure of particular diseases in a prescribed, individual case. Healing would seem to be not only
the prominent work of the church and its members, but the one distinctive belief around which the church
organization is founded and sustained.
It is claimed that the church extends its influence and spreads knowledge of its power by practical
demonstration on the part of its sincere practitioners in securing the overthrow of moral, mental and
physical disease. It disclaims any reliance upon skill, education or science. In view of the tenets of the
Christian Science church the exception to the prohibition in the statute is broader than the provision of the
Constitution of this state which we have quoted and which permits the free exercise and enjoyment of
religious profession and worship without discrimination or preference.
The exception in the statute is not confined to worship or belief but includes the practice of religious
tenets. If it was the intention of the legislature to relieve members of the Christian Science and other
churches from the provisions of sections 160 and 161 of the Public Health Law to the extent of permitting
them within the rules, regulations and tenets of a church to maintain an office and there offer prayer for
the healing of the diseases of those that might come to such church members for treatment, and the
defendant has in good faith acted in accordance therewith, he is not guilty of the crime alleged in the
indictment. *Page 111
The Christian Science church is in terms expressly excepted from the prohibition contained in the medical
practice acts of many of the states. It is so expressly excepted in the statutes of Maine, New Hampshire,
Massachusetts, Connecticut, North Carolina, North and South Dakota, Kentucky, Tennessee and
Wisconsin.
We think the exception in the statute in this state is broad enough to permit offering prayer for the healing
of disease in accordance with the recognized tenets of the Christian Science church. It may be said that if
the exception is so construed, it will lead to numberless persons assuming to cure diseases in the name of
a church for the purpose of thereby maintaining a business and securing a livelihood. The religious tenets
of a church must be practiced in good faith to come within the exception. When such practice is a fraud or
pretense it is not excepted from the general prohibition. When wrong is practiced in the name of religion it
is not protected by Constitution or statute. (Reynolds v. U.S., 98 U.S. 145; Davis v. Beason,133 U.S. 333;
Mormon Church v. U.S., 136 U.S. 1.) Many of the decisions referred to by counsel may be explained by
the fact that the persons therein severally considered were frauds and shams. (See People v. Spinella, 150
App. Div. 923; affd.,206 N.Y. 709.)
A person should not be allowed to assume to practice the tenets of the Christian Science or any church as
a shield to cover a business undertaking. When a person claims to be practicing the religious tenets of any
church, particularly where compensation is taken therefor and the practice is apart from a church edifice
or the sanctity of the home of the applicant, the question whether such person is within the exception
should be left to a jury as a question of fact. In this case the court charged the jury: "If you find from the
evidence in this case that this defendant did engage in the practice of medicine as alleged in the
indictment, within the definition which I *Page 112 have given to you, it is no defense that he did what he
did from any sense of duty, or that he did these acts in the practice of the religious tenets of the Christian
Science church." We are of the opinion that the court was in error in so charging the jury. The exception
was intended by the legislature to exclude from the prohibition the practice of the religious tenets of the
Christian Science and other churches. It was necessary as we have seen that the practice be of the tenets of
a recognized church and the court, instead of charging the jury as stated, should have left to the jury, the
question whether the defendant was in good faith practicing the tenets of such a church within the
meaning of the statutory exception.
The judgment should be reversed and a new trial ordered.
CUDDEBACK and CARDOZO, JJ., concur; WILLARD BARTLETT, Ch. J., concurs in the following
memorandum: I concur in Judge CHASE'S construction of the statute. But I would go farther. I deny the
power of the legislature to make it a crime to treat disease by prayer; COLLIN, J., not voting; HOGAN J.,
absent; SEABURY, J., not sitting.
Judgment reversed, etc.
Republic of the Philippines
SUPREME COURT
Manila
SECOND DIVISION
G.R. No. 118141 September 5, 1997
LEONILA GARCIA-RUEDA, petitioner,
vs.
WILFRED L. PASCASIO, RAUL R. ARNAU, ABELARDO L. APORTADERA JR., Honorable
CONRADO M. VASQUEZ, all of the Office of the Ombudsman; JESUS F. GUERRERO,
PORFIRIO MACARAEG, and GREGORIO A. ARIZALA, all of the Office of the City Prosecutor,
Manila, respondents.
ROMERO, J.:
May this Court review the findings of the Office of the Ombudsman? The general rule has been
enunciated in Ocampo v. Ombudsman 1 which states:
In the exercise of its investigative power, this Court has consistently held that courts will not interfere with
the discretion of the fiscal or the Ombudsman to determine the specificity and adequacy of the averments
of the offense charged. He may dismiss the complaint forthwith if he finds it to be insufficient in form and
substance or if he otherwise finds no ground to continue with the inquiry; or he may proceed with the
investigation of the complaint if, in his view, it is in due and proper form.
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39
Does the instant case warrant a departure from the foregoing general rule? When a patient dies soon after
surgery under circumstances which indicate that the attending surgeon and anaesthesiologist may have
been guilty of negligence but upon their being charged, a series of nine prosecutors toss the responsibility
of conducting a preliminary investigation to each other with contradictory recommendations, "ping-pong"
style, perhaps the distraught widow is not to be blamed if she finally decides to accuse the City
Prosecutors at the end of the line for partiality under the Anti-Graft and Corrupt Practices Act. Nor may
she be entirely faulted for finally filing a petition before this Court against the Ombudsman for grave
abuse of discretion in dismissing her complaint against said City Prosecutors on the ground of lack of
evidence. Much as we sympathize with the bereaved widow, however, this Court is of the opinion that the
general rule still finds application in instant case. In other words, the respondent Ombudsman did not
commit grave abuse of discretion in deciding against filing the necessary information against public
respondents of the Office of the City Prosecutor.
The following facts are borne out by the records.
Florencio V. Rueda, husband of petitioner Leonila Garcia-Rueda, underwent surgical operation at the UST
hospital for the removal of a stone blocking his ureter. He was attended by Dr. Domingo Antonio, Jr. who
was the surgeon, while Dr. Erlinda Balatbat-Reyes was the anaesthesiologist. Six hours after the surgery,
however, Florencio died of complications of "unknown cause," according to officials of the UST
Hospital. 2
Not satisfied with the findings of the hospital, petitioner requested the National Bureau of Investigation
(NBI) to conduct an autopsy on her husband's body. Consequently, the NBI ruled that Florencio's death
was due to lack of care by the attending physician in administering anaesthesia. Pursuant to its findings,
the NBI recommended that Dr. Domingo Antonio and Dr. Erlinda Balatbat-Reyes be charged for
Homicide through Reckless Imprudence before the Office of the City Prosecutor.
During the preliminary investigation, what transpired was a confounding series of events which we shall
try to disentangle. The case was initially assigned to Prosecutor Antonio M. Israel, who had to inhibit
himself because he was related to the counsel of one of the doctors. As a result, the case was re-raffled to
Prosecutor Norberto G. Leono who was, however, disqualified on motion of the petitioner since he
disregarded prevailing laws and jurisprudence regarding preliminary investigation. The case was then
referred to Prosecutor Ramon O. Carisma, who issued a resolution recommending that only Dr. Reyes be
held criminally liable and that the complaint against Dr. Antonio be dismissed.
The case took another perplexing turn when Assistant City Prosecutor Josefina Santos Sioson, in the
"interest of justice and peace of mind of the parties," recommended that the case be re-raffled on the
ground that Prosecutor Carisma was partial to the petitioner. Thus, the case was transferred to Prosecutor
Leoncia R. Dimagiba, where a volte face occurred again with the endorsement that the complaint against
Dr. Reyes be dismissed and instead, a corresponding information be filed against Dr. Antonio. Petitioner
filed a motion for reconsideration, questioning the findings of Prosecutor Dimagiba.
Pending the resolution of petitioner's motion for reconsideration regarding Prosecutor Dimagiba's
resolution, the investigative "pingpong" continued when the case was again assigned to another
prosecutor, Eudoxia T. Gualberto, who recommended that Dr. Reyes be included in the criminal
information of Homicide through Reckless Imprudence. While the recommendation of Prosecutor
Gualberto was pending, the case was transferred to Senior State Prosecutor Gregorio A. Arizala, who
resolved to exonerate Dr. Reyes from any wrongdoing, a resolution which was approved by both City
Prosecutor Porfirio G. Macaraeg and City Prosecutor Jesus F. Guerrero.
Aggrieved, petitioner filed graft charges specifically for violation of Section 3(e) of Republic Act No.
3019 3against Prosecutors Guerrero, Macaraeg, and Arizala for manifest partiality in favor of Dr. Reyes
before the Office of the Ombudsman. However, on July 11, 1994, the Ombudsman issued the assailed
resolution dismissing the complaint for lack of evidence.
In fine, petitioner assails the exercise of the discretionary power of the Ombudsman to review the
recommendations of the government prosecutors and to approve and disapprove the same. Petitioner
faults the Ombudsman for, allegedly in grave abuse of discretion, refusing to find that there exists
probable cause to hold public respondent City Prosecutors liable for violation of Section 3(e) of R.A. No.
3019.
Preliminarily, the powers and functions of the Ombudsman have generally been categorized into the
following: investigatory powers, prosecutory power, public assistance function, authority to inquire and
obtain information, and function to adopt, institute and implement preventive measures. 4
As protector of the people, the Office of the Ombudsman has the power, function and duty "to act
promptly on complaints filed in any form or manner against public officials" and "to investigate any act or
omission of any public official when such act or omission appears to be illegal, unjust, improper or
inefficient." 5
While the Ombudsman has the full discretion to determine whether or not a criminal case should be filed,
this Court is not precluded from reviewing the Ombudsman's action when there is an abuse of discretion,
in which case Rule 65 of the Rules of Court may exceptionally be invoked pursuant to Section I, Article
VIII of the 1987 Constitution. 6
In this regard, "grave abuse of discretion" has been defined as "where a power is exercised in an arbitrary
or despotic manner by reason of passion or personal hostility so patent and gross as to amount to evasion
of positive duty or virtual refusal to perform a duty enjoined by, or in contemplation of law. 7
From a procedural standpoint, it is certainly odd why the successive transfers from one prosecutor to
another were not sufficiently explained in the Resolution of the Ombudsman. Being the proper
investigating authority with respect to misfeasance, non-feasance and malfeasance of public officials, the
Ombudsmans should have been more vigilant and assiduous in determining the reasons behind the
"buckpassing" to ensure that no irregularity took place.
Whether such transfers were due to any outside pressure or ulterior motive is a matter of evidence. One
would have expected the Ombudsman, however, to inquire into what could hardly qualify as "standard
operating procedure," given the surrounding circumstances of the case.
While it is true that a preliminary investigation is essentially inquisitorial, and is often the only means to
discover who may be charged with a crime, its function is merely to determine the existence of probable
Page 30 of
39
cause. 8 Probable cause has been defined as "the existence of such fact and circumstances as would excite
the belief, in a reasonable mind, acting on the facts within the knowledge of the prosecution, that the
person charged was guilty of the crime for which he was prosecuted." 9
"Probable cause is a reasonable ground of presumption that a matter is, or may be, well founded, such a
state of facts in the mind of the prosecutor as would lead a person of ordinary caution and prudence to
believe, or entertain an honest or strong suspicion, that a thing is so." The term does not mean actual and
positive cause nor does it import absolute certainty. It is merely based on opinion and reasonable belief.
Thus, a finding of probable cause does not require an inquiry into whether there is sufficient evidence to
procure a conviction. It is enough that it is believed that the act or omission complained of constitutes the
offense charged. Precisely, there is a trial for the reception of evidence of the prosecution in support of the
charge. 10
In the instant case, no less than the NBI pronounced after conducting an autopsy that there was indeed
negligence on the part of the attending physicians in administering the anaesthesia. 11 The fact of want of
competence or diligence is evidentiary in nature, the veracity of which can best be passed upon after a
full-blown trial for it is virtually impossible to ascertain the merits of a medical negligence case without
extensive investigation, research, evaluation and consultations with medical experts. Clearly, the City
Prosecutors are not in a competent position to pass judgment on such a technical matter, especially when
there are conflicting evidence and findings. The bases of a party's accusation and defenses are better
ventilated at the trial proper than at the preliminary investigation.
A word on medical malpractice or negligence cases.
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: duty, breach, injury and proximate
causation.
Evidently, when the victim employed the services of Dr. Antonio and Dr. Reyes, a physician-patient
relationship was created. In accepting the case, Dr. Antonio and Dr. Reyes in effect represented that,
having the needed training and skill possessed by physicians and surgeons practicing in the same field,
they will employ such training, care and skill in the treatment of their patients. 13 They have a duty to use
at least the same level of care that any other reasonably competent doctor would use to treat a condition
under the same circumstances. The breach of these professional duties of skill and care, or their improper
performance, by a physician surgeon whereby the patient is injured in body or in health, constitutes
actionable malpractice. 14Consequently, in the event that any injury results to the patient from want of due
care or skill during the operation, the surgeons may be held answerable in damages for negligence. 15
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: evidence as to the
recognized standards of the medical community in the particular kind of case, and a showing that the
physician in question negligently departed from this standard in his treatment. 17
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. 18 Indeed here, a causal connection is discernible from the occurrence of the victim's death after the
negligent act of the anaesthesiologist in administering the anesthesia, a fact which, if confirmed, should
warrant the filing of the appropriate criminal case. To be sure, the allegation of negligence is not entirely
baseless. Moreover, the NBI deduced that the attending surgeons did not conduct the necessary interview
of the patient prior to the operation. It appears that the cause of the death of the victim could have been
averted had the proper drug been applied to cope with the symptoms of malignant hyperthermia. Also, we
cannot ignore the fact that an antidote was readily available to counteract whatever deleterious effect the
anaesthesia might produce. 19 Why these precautionary measures were disregarded must be sufficiently
explained.
The City Prosecutors were charged with violating Section 3(e) of the Anti-Graft and Corrupt Practices Act
which requires the following facts:
1. The accused is a public officer discharging administrative or official functions or private persons
charged in conspiracy with them;
2. The public officer committed the prohibited act during the performance of his official duty or in relation
to his public position;
3. The public officer acted with manifest partiality, evident bad faith or gross, inexcusable negligence; and
4. His action caused undue injury to the Government or any private party, or gave any party any
unwarranted benefit, advantage or preference to such parties. 20
Why did the complainant, petitioner in instant case, elect to charge respondents under the above law?
While a party who feels himself aggrieved is at liberty to choose the appropriate "weapon from the
armory," it is with no little surprise that this Court views the choice made by the complainant widow.
To our mind, the better and more logical remedy under the circumstances would have been to appeal the
resolution of the City Prosecutors dismissing the criminal complaint to the Secretary of Justice under the
Department of Justice's Order No. 223, 21 otherwise known as the "1993 Revised Rules on Appeals From
Resolutions In Preliminary Investigations/Reinvestigations," as amended by Department Order No. 359,
Section 1 of which provides:
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39
Sec. 1. What May Be Appealed. Only resolutions of the Chief State Prosecutor/Regional State
Prosecutor/Provincial or City Prosecutor dismissing a criminal complaint may be the subject of an appeal
to the Secretary of Justice except as otherwise provided in Section 4 hereof.
What action may the Secretary of Justice take on the appeal? Section 9 of Order No. 223 states: "The
Secretary of Justice may reverse, affirm or modify the appealed resolution." On the other hand, "He
may motu proprio or on motion of the appellee, dismiss outright the appeal on specified grounds." 22
In exercising his discretion under the circumstances, the Ombudsman acted within his power and authority
in dismissing the complaint against the Prosecutors and this Court will not interfere with the same.
WHEREFORE, in view of the foregoing, the instant petition is DISMISSED, without prejudice to the
filing of an appeal by the petitioner with the Secretary of Justice assailing the dismissal of her criminal
complaint by the respondent City Prosecutors. No costs.
SO ORDERED.
Republic of the Philippines
SUPREME COURT
Manila
EN BANC
G.R. No. 88265 December 21, 1989
SANTIAGO A. DEL ROSARIO, GEORGE G. GACULA, EDGARDO G. SANTOS, ALBANO S.
SIBAL, ALBERTO C. REYES, NONITO P. ARROYO, EMMANUEL F. TERENCIO, DOMINGO
S. DE LEON, MODESTO O. LLAMAS, FARIDA U. ALONTO, ZENAIDA A. FLOIRENDO,
ISABEL A. MEJIA, LUZ P. MABANAG, RAMON H. RABAGO, JR., SAMUEL D. TROCIO and
OSCAR M. BRION, petitioners,
vs.
HON. ALFREDO R. BENGZON, in his capacity as Secretary of the Department of
Health, respondent.
GRIO-AQUINO, J.:
This is a class suit filed by officers of the Philippine Medical Association, the national organization of
medical doctors in the Philippines, on behalf of their professional brethren who are of kindred persuasion,
wherein this Court is asked to declare as unconstitutional, hence, null and void, some provisions of the
Generics Act of 1988 (Rep. Act No. 6675), and of the implementing Administrative Order No. 62 issued
pursuant thereto, specifically:
(a) Section 6, Pars. (a) and (b) of the Generics Act which provide: 4.3.1 When the brand name precedes the generic name.

a) All government health agencies and their personnel as well as other government agencies shall use 4.3.2 Where the generic name is the one in parenthesis.
generic terminology or generic names in all transactions related to purchasing, prescribing, dispensing and
administering of drugs and medicines. 4.3.3 Where the brand name in (sic) not in parenthesis.

b) All medical, dental and veterinary practitioners, including private practitioners, shall write prescriptions
using the generic name. The brand name may be included if so desired. (p. 6, Rollo.)
(b) Section 12, Pars. (b), (c) and (d) of the same law which provide:
b) For the second conviction, the penalty of file 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.
4.3.4 Where more than one drug product is prescribed in one prescription form.
4.4 What to do with erroneous prescriptions.
Erroneous prescriptions shall be filled. Such prescriptions shall also be kept and reported by the
pharmacist of the drug outlet or any other interested party to the nearest DOH Office for appropriate
action.

c) For the third conviction, the penalty of fine in the amount of not less than five thousand pesos xxx xxx xxx
(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.
Section 7. Timetable of Implementation.
d) For the fourth and subsequent convictions, the penalty of fine of 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 In order to give all affected parties adequate time for learning and adjustment, the implementation of these
discretion of the court. (pp. 6-7, Rollo.) and Rules and Regulations shall be in three phases, as follows:

(c) Sections 4 and 7, Phase 3 of Administrative Order No. 62, Series of 1989 dated March 9, 1989, of the Phase 1 Education Drive ...
respondent Secretary of Health, which read as follows:
Phase 2 Monitoring of Compliance
Section 4. Violative Erroneous, and Impossible Prescriptions.
xxx xxx xxx
4.1. Violative Prescriptions:
Phase 3 Implementation.
4.1.1 Where the generic name is not written;
Beginning September 1, 1989 the DOH and the other relevant agencies of government shall monitor
4.1.2 Where the generic name is not legible and a brand name which is legible is written; compliance with these Rules and Regulations and all violations shall be subject to the appropriate
sanctions and penalties provided for under these Rules and Regulations and the Generics Act of 1988. (pp.
7-9, Rollo.)
4.1.3 Where the brand name is indicated and instructions added, such as the phase 'No Substitution' which
tend to obstruct, hinder or prevent proper generic dispensing.
On March 15, 1989, the full text of Republic Act No. 6675 was published in two newspapers of general
circulation in the Philippines. The law took effect on March 30, 1989, fifteen (15) days after its
4.2 What to do with Violative Prescriptions. publication, as provided in Section 15 thereof.

Violative prescriptions shall not be filled. They shall be kept and reported by the pharmacist of the drug
outlet or any other interested party to the nearest DOH Officer for appropriate action. The pharmacist shall
advise the prescriber of the problem and/or instruct the customer to get the proper prescription.
4.3 Erroneous Prescriptions:
Section 7, Phase 3 of Administrative Order No. 62 was amended by Administrative Order No. 76 dated
August 28, 1989 by postponing to January 1, 1990 the effectivity of the sanctions and penalties for
violations of the law, provided in Sections 6 and 12 of the Generics Act and Sections 4 and 7 of the
Administrative Order.

Page 32 of
39
The petitioners allege that "as of this date, there is no breach or violation yet" of the law (p. 9, Rollo),
which took effect on March 30, 1989. However, as the penal provisions will only take effect on January 1,
1990, it would have been more accurate to state that "as of this date, no breaches or violations of the law
have been punished yet" (p. 9, Rollo).
The petition is captioned as an action for declaratory relief, over which this Court does not exercise
jurisdiction. Nevertheless, in view of the public interest involved, we decided to treat it as a petition for
prohibition instead.
The petitioner's main argument against paragraphs (a) and (b), Section 6 of the law, is the alleged unequal
treatment of government physicians, dentists, and veterinarians, on one hand, and those in private practice
on the other hand, in the manner of prescribing generic drugs, for, while the former are allegedly required
to use only generic terminology in their prescriptions, the latter may write the brand name of the drug in
parenthesis below the generic name. The favored treatment of private doctors, dentists and veterinarians
under the law is allegedly a specie of invalid class legislation.
There is no merit in that argument for it proceeds from a misreading and misinterpretation of the letter and
intent of paragraphs (a) and (b), Section 6 of the Generics Act. Indeed, as explained by the public
respondent:
... while paragraph (a) enumerates the government transactions ('Purchasing, prescribing, dispensing and
administering of drugs and medicines') where the sole use of generic terminology has been required, the
'prescription' of drugs is further governed by paragraph (b). And the use of the word 'all' in the latter
provision emphasizes the absence of any distinction between government and private physicians. In other
words, in prescribing drugs, physicians, whether in government service or in private practice, are both
governed by exactly the same rules, and thus, are both authorized to include the brand name in their
respective prescriptions. (p. 44, Rollo.)
Furthermore, it may be observed that while paragraph (a) refers to "all government health agencies, and
their personnel as well as other government agencies" (not necessarily physicians, dentists and
veterinarians), paragraph (b) refers to "all medical, dental and veterinary practitioners, including private
practitioners."
Petitioners concede that the requirement for doctors, dentists, and veterinarians to use the generic
terminology in writing their prescriptions, followed by the brand name in parenthesis, is "well and good"
(p. 12, Rollo). However, they complain that under paragraph (d) of the law which reads:
(d) Drug outlets, including drugstores, hospital and non-hospital pharmacies and non-traditional outlets
such as supermarkets and stores, shall inform any buyer about any and all other drug products having the
same generic name, together with their corresponding prices so that the buyer may adequately exercise his
option. Within one (1) year after approval of this Act, the drug outlets referred to herein, shall post in
conspicuous places in their establishments, a list of drug products with the same generic name and their
corresponding prices. (Annex A, p. 23, Rollo.)
Page 33 of
39
the salesgirl at the drugstore counter is authorized to "substitute the prescribed medicine with another
medicine belonging to the same generic group." Since doctors are not allowed to instruct the druggist not
to substitute the prescription, or to "Dispense only as Prescribed" (per Sec. 4, Adm. Order No. 62), the
petitioners argue that "the act of prescribing the correct medicine for the patient becomes the act of the
salesgirl at the drugstore counter, no longer the act of the physician, dentist, or veterinarian" (p. 12, Rollo).
Here again, the petitioners have distorted the clear provisions of the law and the implementing
administrative order. For it is plain to see that neither paragraph (d) of Section 6 of the Generics Act, nor
Section 4 of Administrative Order No. 62, gives the salesgirl and/or druggist the discretion to
substitute the doctor's prescription.
On the contrary, Section 4, par. 4.1, of Administrative Order No. 62 directs the pharmacist not to
fill "violative prescriptions" (where the generic name is not written, or illegibly written, and the
prescription of a brand name is accompanied by the doctor's instruction not to substitute it), as well
as "impossible prescriptions" (par. 4.5). Even a doctor's "erroneous" prescriptions "shall be filled," not
substituted (par. 4.3, Adm. Order No. 62). And, Sections 3 and 5 of Adm. Order No. 63 enjoin the drug
outlets not (to) favor or suggest" or "impose" a particular brand or product on the customer. The
administrative older provides:
In order to ensure the informed choice and use of drugs by the patient/ buyer, the drug outlet is required
to:
3.1.1 Inform the patient/buyer of all available drug products generically equivalent to the one prescribed
with their corresponding prices. In so doing, the drug outlet shall not favor or suggest any particular
product so that the patient/buyer may fully and adequately exercise his option to choose (Sec. 3, Adm.
Order No. 63 s. 1989).
xxx xxx xxx
The following acts or omissions are considered violations of these rules and regulations:
5.1 Imposing a particular brand or product on the buyer. ... (pp. 46-47, Rollo.)
The salesgirl at the drugstore counter, merely informs the customer, but does not determine (for she is
incompetent to do so) all the other drug products or brands that have the same generic name, and their
corresponding prices. That information she may obtain from the list of drug products determined by the
Bureau of Food and Drugs to have the same generic name, or which are the chemical, biological, and
therapeutic equivalent of the generic drug. All drugstores or drug outlets are required by the law to post
such list in a conspicuous place in their premises for the information of the customers, for the choice of
whether to buy the expensive brand name drug, or the less expensive generic, should be exercised by the
customer alone.
The purpose of the Generics Act is to carry out the policy of the State:
To promote, encourage and require the use of generic terminology in the importation, manufacture,
distribution, marketing, advertising and promotion, prescription and dispensing of drugs;
To ensure the adequate supply of drugs with generic names at the lowest possible cost and endeavor to
make them available for free to indigent patients;
To encourage the extensive use of drugs with generic names through a rational system of procurement and
distribution;
To emphasize the scientific basis for the use of drugs, in order that health professionals may become more
aware and cognizant of their therapeutic effectiveness; and
To promote drug safety by minimizing duplication in medications and/or use of drugs with potentially
adverse drug interactions. (pp. 3839, Rollo.)
or, as stated by the public respondent, "to promote and require the use of generic drug products that are
therapeutically equivalent to their brand-name counter-parts" (p. 39, Rollo) for "the therapeutic effect of a
drug does not depend on its 'brand' but on the 'active ingredients' which it contains." The medicine that
cures is the "active ingredient" of the drug, and not the brand name by which it has been baptized by the
manufacturer.
The public respondent points out that the institution of generics in the Philippines will compel physicians
to prescribe drugs based on their therapeutic or "active ingredient," instead of their well-known brand
names. Multiple medications which may produce potentially adverse, even lethal, chemical reactions in
the patient will thereby be avoided. Patients with limited means will be able to buy generic drugs that cost
less but possess the same active ingredients, dosage form, and strength as brand names, many of which are
priced beyond the reach of the common tao because the high costs of advertising, packaging, royalties,
and other inputs of production determine their pricing for the market.
The Court has been unable to find any constitutional infirmity in the Generics Act. It, on the contrary,
implements the constitutional mandate for the State "to protect and promote the right to health of the
people" and "to make essential goods, health and other social services available to all the people at
affordable cost" (Section 15, Art. II and Section 11, Art. XIII, 1987 Constitution).
The prohibition against the use by doctors of "no substitution" and/or words of similar import in their
prescription, is a valid regulation to prevent the circumvention of the law. It secures to the patient the right
to choose between the brand name and its generic equivalent since his doctor is allowed to write both the
generic and the brand name in his prescription form. If a doctor is allowed to prescribe a brand-name drug
with "no substitution," the patient's option to buy a lower-priced, but equally effective, generic equivalent
would thereby be curtailed. The law aims to benefit the impoverished (and often sickly) majority of the
population in a still developing country like ours, not the affluent and generally healthy minority.
There is no merit in the petitioners' theory that the Generics Act impairs the obligation of contract between
a physician and his patient, for no contract ever results from a consultation between patient and physician.
A doctor may take in or refuse a patient, just as the patient may take or refuse the doctor's advice or
Page 34 of
39
prescription. As aptly observed by the public respondent, no doctor has ever filed an action for breach of
contract against a patient who refused to take prescribed medication, undergo surgery, or follow a
recommended course treatment by his doctor ( p. 53, Rollo). In any event, no private contract between
doctor and patient may be allowed to override the power of the State to enact laws that are reasonably
necessary to secure the health, safety, good order, comfort, or general welfare of the community. This
power can neither be abdicated nor bargained away. All contractual and property rights are held subject to
its fair exercise (Anglo-Fil Trading Corporation vs. Lazaro, 124 SCRA 495.)
Petitioners have also assailed Section 12, paragraphs b, c and d, of the Generics Act prescribing graduated
penalties (ranging from a reprimand to a fine of not less that P10,000 and the suspension of the physician's
license to practice his profession for one [1]) year or longer, at the discretion of the court) for violations of
its provisions. Petitioners' allegation that these penalties violate the constitutional guarantee against
excessive fines and cruel and degrading punishment, has no merit. Penal sanctions are indispensable if the
law is to be obeyed. They are the "teeth" of the law. Without them, the law would be toothless, not worth
the paper it is printed on, for physicians, dentists and veterinarians may freely ignore its prescriptions and
prohibitions. The penalty of suspension or cancellation of the physician's license is neither cruel, inhuman,
or degrading. It is no different from the penalty of suspension or disbarment that this Court inflicts on
lawyers and judges who misbehave or violate the laws and the Codes of Professional and Judicial
Conduct.
We hold that the Generics Act and the implementing administrative orders of the Secretary of Health are
constitutional. In light of its beneficial provisions, we cannot heed the petitioners' plea to kill it aborning,
i.e., before it has had a chance to prove its value to our people as envisioned by its makers.
WHEREFORE, the petition is dismissed for lack of merit. Costs against the petitioners.
SO ORDERED.
Fernan, C.J., Narvasa, Cruz, Paras, Feliciano, Gancayco, Padilla, Bidin, Sarmiento, Cortes, Medialdea
and Regalado, JJ., concur.
Melencio-Herrera, J., concurs in the result.
Separate Opinions
Gutierrez, Jr., J., concurring:
I concur in the result only because of the failure to overcome the presumption of constitutionality and not
because the respondent's arguments are valid.
 reckless, careless and imprudent manner and neglected to exercise their respective medical knowhow and
tasks and/or departed from the recognized standard in their treatment, diagnosis of the condition, and
operation of the patient, one Catherine Acosta, 13 years old, which negligence caused the death of the said
Catherine Acosta. 2

Petitioner and Dr. Emilio Madrid entered pleas of not guilty at arraignment and the case proceeded to trail
with Judge Job B. Madayag presiding. 3

Republic of the Philippines
SUPREME COURT
Manila
THIRD DIVISION
G.R. No. 86890 January 21, 1994
LEANDRO CARILLO, petitioner,
vs.
PEOPLE OF THE PHILIPPINES, respondent.
FELICIANO, J.:
Petitioner Dr. Leandro Carillo, an anesthetist, seeks review of the Decision of the Court of Appeals dated
28 November 1988, which affirmed his conviction by the Regional Trial Court of the crime of simple
negligence resulting in homicide, for the death of his thirteen (13) year old patient
Catherine Acosta. The trial court had sentenced him to suffer the penalty of arresto mayor in its medium
period (four [4] months' imprisonment), as well as to pay the heirs of his patient an indemnity of
P30,000.00 for her death, P10,000.00 as reimbursement for actual expenses incurred, P50,000.00 as moral
damages and to pay the costs of the suit. 1
The information filed against petitioner and his co-accused, the surgeon Dr. Emilio Madrid, alleged the
following:
That on or about the 31st of May 1981, in the municipality of Paraaque, Metro Manila, Philippines and
within the jurisdiction of this Honorable Court, the above-named accused, conspiring and confederating
together and mutually helping and aiding with one another, without taking the necessary care and
precaution to avoid injury to person, did then and there willfully, unlawfully and feloniously operate, in a
The prosecution presented as its principal evidence the testimony of four (4) witnesses, namely: 1)
Yolanda Acosta, Catherine's mother, who was able to observe the conduct of the accused outside the
operating theater before, during and after the appendectomy procedure carried out on her daughter; 4 2)
Domingo Acosta, Catherine's father, who corroborated some parts of his wife's
testimony; 5 3) Dr. Horacio Buendia, an expert witness who described before the trial court the relationship
between a surgeon and an anesthetist in the course of a surgical operation, as well as define the likelihood
of cardiac arrest as a post operative complication; 6 and 4) Dr. Nieto Salvador, an expert witness who
analyzed and explained the significance of the results of the pathological study and autopsy conducted on
Catherine's body by one Dr. Alberto Reyes. 7
After the prosecution had rested its case, the defense was granted leave to file a demurrer to the
evidence. 8 After failing to file the demurrer within the reglementary period, Judge Manuel Yuzon, who
had in the meantime taken over as presiding judge of the sala where this case was pending, denied the
defense motion for extension of time to file demurrer and declared the case submitted for decision. 9
On 19 September 1985, the trial court promulgated its decision convicting both the accused of the crime
charged. 10
On appeal, the Court of Appeals affirmed the judgment of conviction, and specified that the civil liability
of the two (2) accused was solidary in nature. 11
Petitioner Dr. Carillo alone filed the present Petition for Review with the Court, seeking reversal of his
conviction, or in the alternative, the grant of a new trial. Dr. Madrid did not try to appeal further the Court
of Appeals Decision. Accordingly, the judgment of conviction became final insofar as the accused surgeon
Dr. Madrid is concerned.
The facts of the case as established by the Court of Appeals are as follows:
The deceased, Catherine Acosta, a 13 year old girl, daughter of spouses Domingo and Yolanda Acosta,
complained to her father at about 10:30 o'clock in the morning of May 31, 1981 of pains in the lower part
of her abdomen. Catherine was then brought to Dr. Elva Pea. Dra. Pea called for Dr. Emilio Madrid and
the latter examined Catherine Acosta. According to Dr. Madrid, his findings might be appendicitis. Then
Dr. Pea told Catherine's parents to bring the child to the hospital in Baclaran so that the child will be
observed.

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At the Baclaran General Hospital, a nurse took blood sample form the child. The findings became known Q What else happened?
at around 3:00 o'clock in the afternoon and the child was scheduled for operation at 5:00 o'clock in the
afternoon. The operation took place at 5:45 p.m. because Dr. Madrid arrived only at that time. Q I noticed that the heartbeat of my daughter was not normal. And I noticed that her hospital gown is
rising up and down.
When brought inside the operating room, the child was feeling very well and they did not subject the child
to ECG (electrocardiogram) and Q What transpired after that?
X-ray.
A I asked Dr. Madrid why it was like that, that the heartbeat of my daughter is not normal.
The appellant Dr. Emilio Madrid, a surgeon, operated on Catherine. He was assisted by appellant, Dr.
Leandro Carillo, an anesthesiologists.
Q And did the doctor make any reply?
During the operation, while Yolanda Acosta, Catherine's mother, was staying outside the operating room,
she "noticed something very unfamiliar." The three nurses who assisted in the operation were going in and A The doctor said because of the lesion of the child.
out of the operating room, they were not carrying anything, but in going out of the operating room, they
were already holding something. Q What else happened?

Yolanda asked one of the nurses if she could enter the operating room but she was refused. A After they have revived the heartbeat of the child, Dr. Carillo and Dr. Madrid left.

At around 6:30 p.m., Dr. Emilio Madrid went outside the operating room and Yolanda Acosta was allowed
to enter the first door.
The appendicitis (sic) was shown to them by Dr. Madrid, because, according to Dr. Madrid, they might be
wondering because he was going to install drainage near the operating (sic) portion of the child.
Q Now do you remember what time was it when Dr. Carillo stepped out?
A Only a minute after they have transferred the child to the bed.
Q What happened later on after Dr. Carillo and Dr. Madrid stepped out of the hospital?

When asked, the doctor told them the child was already out of danger but the operation was not yet A After 15 or 30 minutes has lapsed at about 7:15 or 7:30, the child had developed convulsion and
finished. stiffening of the body.

It has also been established that the deceased was not weighed before the administration of anesthesia on Q When you observed convulsion and stiffening of the body, did you do anything?
her.

A We requested the nurse who was attending to her to call for a doctor.
The operation was finished at 7:00 o'clock in the evening and when the child was brought out from the
operating room, she was observed to be shivering (nanginginig); her heart beat was not normal; she was
asleep and did not wake up; she was pale; and as if she had difficulty in breathing and Dr. Emilio Madrid Q And the nurse who was attending to the patient called for a doctor?
suggested that she placed under oxygen tank; that oxygen was administered to the child when she was
already in the room. A They called for Dra. Pea, their family physician.

Witness Yolanda Acosta further testified that shortly before the child was transferred from the operating Q What transpired afterwards?
room to her room, she (witness) was requested by the anesthesiologist to go home and get a blanket.
A portion of Yolanda Acosta's testimony on what happened when she returned to the hospital are A What Dra. Pea did was call for Dr. Madrid and the cardiologist.
reproduced hereunder as follows:

Q Did this doctor arrived?

Q What happened afterward?

A Yes.
A When I arrived in the hospital, my child was being transferred to her bed.

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Q What transpired after the doctor arrived?
A They examined the child.
Q After they examined the child, did they inform you of the result of the examination?
A The cardiologist was the one whom informed us after he stepped out of the room when we followed
him. The doctor told us that she suffered severe infection which went up to her head.
Q After you were informed of the result of his examination, what transpired next?
A According to them, they will do their best for the child and that they will call for Dr. Carillo.
Q Did Dr. Carillo arrived?
A At around 10:30 in the evening.
Q Did Dr. Carillo do anything when he arrived on 31 May 1981?
A When he arrived, he noticed that there were two small bottles and big bottles of dextrose which were
hanging above the bed of the child. Then he said, "What is this? Christmas tree or what?" He told us that
one bottle of dextrose be removed. And the big one will remain.
Q What happened after that?
A After that we talked to Dr. Carillo and asked him how did this happen to the child.
Q What did Dr. Carillo reply (sic) to you?
A He answered "that is nothing, the child will regain consciousness and if the child will not regain
consciousness, I will resign (sic) as a doctor." 12
(Emphasis supplied)
When Catherine remained unconscious until noontime the next day, a neurologist examined her and she
was diagnosed as comatose. 13 Three (3) days later, Catherine died without regaining consciousness. 14
The Court of Appeals held that Catherine had suffered from an overdose of, or an adverse reaction to,
anesthesia, particularly the arbitrary administration of Nubain, a pain killer, without benefit of prior
weighing of the patient's body mass, which weight determines the dosage of Nubain which can safely be
given to a patient. 15 The Court of Appeals held that this condition triggered off a heart attack as a post-
operative complication, depriving Catherine's brain of oxygen, leading to the brain's hemorrhage. 16 The
Court of Appeals identified such cardiac arrest as the immediate cause of Catherine's death. 17
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The Court of Appeals found criminal negligence on the part of petitioner Dr. Carillo and his co-accused
Dr. Madrid, holding that both had failed to observe the required standard of diligence in the examination
of Catherine prior to the actual administration of anesthesia; 18 that it was "a bit rash" on the part of the
accused Dr. Carillo "to have administered Nubain without first weighing Catherine"; 19 and that it was an
act of negligence on the part of both doctors when, (a) they failed to monitor Catherine's heartbeat after
the operation and
(b) they left the hospital immediately after reviving Catherine's heartbeat, depriving the latter
of immediate and expert medical assistance when she suffered a heart attack approximately fifteen (15) to
thirty (30) minutes later. 20
Since neither petitioner nor his co-accused presented evidence in their own behalf, the present Petition
seeks to question the soundness of the factual conclusions drawn by the Court of Appeals, upon which the
affirmance of petitioner's conviction was based.
Close examination of the instant Petition for Review shows that petitioner's main arguments are two-fold:
(1) the Court of Appeals "completely brushed aside" and "misapprehended" Catherine's death certificate
and biopsy report which allegedly showed that the cause of death was a ruptured appendix, which led to
blood poisoning, 21 rather than faulty anesthetic treatment;
and (2) there was no direct evidence of record showing that Nubain was administered to Catherine
either during the appendectomy procedure or after such operation. 22
Two (2) related issues are thus posed for the Court's consideration. The first is whether the Court of
Appeals so drastically "misapprehended" the relevant, operative facts in this case as to compel this Court
to examine and resolve question(s) of fact which would have a decisive significance for the disposition of
the case. The rule is too firmly settled to require much documentation that only questions of law may be
raised before this Court in a petition for review on certiorari, subject to certain well-known
exceptions. 23 After careful scrutiny of petitioner's contentions before us and the record of this case, we do
not believe that petitioner has shown "misapprehension of facts" on the part of the Court of Appeals which
would require this Court to overturn the judgment reached by the former.
The second issue is whether or not the findings of fact of the Court of Appeals adequately support the
conclusion that petitioner Dr. Carillo was, along with Dr. Madrid, guilty of simple negligence which
resulted in homicide. Our review of the record leads us to an affirmative answer.
Petitioner contends that the Court of Appeals seriously erred in finding that an overdose of, or an allergic
reaction to, the anesthetic drug Nubain had led to the death of Catherine Acosta and that the true cause of
Catherine's death was that set out in the death certificate of Catherine: "Septicemia (or blood poisoning)
due to perforated appendix with peritonitis." 24 The concept of causation in general, and the cause of death
in human beings in particular, are complex and difficult notions. What is fairly clear is that death,
understood as a physical condition involving cessation of vital signs in the brain and heart, is preceded by
a series of physiological events, any one of which events can, with equal cogency, be described as a
"cause of death". The Court of Appeals found that an overdose of, or an adverse reaction to, Nubain, an
anesthetic or
pain-killing drug the appropriate dose of which depends on the body weight or mass of the patient, had
generated or triggered off cardiac arrest, which in
turn led to lack of oxygen in Catherine's brain, which then brought about hemorrhaging in the brain. Vital
activity in the brain thereupon ceased. The medical evidence presented at the trial was quite consistent
with the findings of the Court of Appeals which concluded that cardiac arrest was the cause of Catherine's
death. 25
For his part, petitioner insists that cardiac arrest is not the only cause of oxygen-starvation of the brain,
that septicemia with peritonitis or severe infection which had "gone up to the head" of Catherine was an
equally efficient cause of deprivation of the brain of oxygen and hence of brain hemorrhage. The medical
testimony of the expert witnesses for the prosecution on which petitioner relies is also consistent with
petitioner's theory that septicemia with peritonitis was, or at least could have been, the cause of
Catherine's death. 26
Indeed, it appears to the Court that there was no medical proof submitted to the trial court to show that one
or the other "cause" was necessarily an exclusive cause of death in the case of Catherine Acosta; that an
overdose or allergic reaction to Nubain could not have combined with septicemia and peritonitis in
bringing about Catherine's death.
What is of critical importance for present purposes is not so much the identification of the "true cause" or
"real cause" of Catherine's death but rather the set of circumstances which both the trial court and the
Court of Appeals found constituted simple (as distinguished from reckless) negligence on the part of the
two accused Dr. Madrid and Dr. Carillo leading to the death of Catherine.
When the patient was wheeled out of the operating room after completion of surgery, she manifested signs
of medical instability (i.e., shivering, paleness, irregular breathing and weak heart beat). 27 She was not
brought to a properly equipped recovery room, or intensive care until which the hospital lacked. 28 Such
facilities and their professional staffs, of which an anesthetist is commonly a part, are essential for
providing close observation and patient care while a post-surgery patient is recovering from the effects of
anesthesia and while the normal protective mechanisms are still dull or obtunded. 29 Instead, the patient
was merely brought to her assigned hospital bed and was provided oxygen on the instructions of Dr.
Madrid then "revived" her heartbeat. 30 Both doctors then left their patient and the hospital; approximately
fifteen minutes later, she suffered convulsions and cardiac arrest. 31
The conduct of Dr. Madrid and of the petitioner constituted inadequate care of their patient in view of her
vulnerable condition. Both doctors failed to appreciate the serious condition of their patient whose adverse
physical signs were quite manifest right after surgery. And after reviving her heartbeat, both doctors failed
to monitor their patient closely or extend further medical care to her; such conduct was especially
necessary in view of the inadequate,
post-operative facilities of the hospital. We do not, of course, seek to hold petitioner responsible for the
inadequate facilities of the Baclaran General Hospital. We consider, however, that the inadequate nature of
those facilities did impose a somewhat higher standard of professional diligence upon the accused surgeon
and anesthetist personally than would have been called for in a modern fully-equipped hospital.
While Dr. Madrid and a cardiologist were containing the patient's convulsions, and after the latter had
diagnosed that infection had reached the patient's head, these two (2) apparently after consultation,
decided to call-in the petitioner. 32 There is here a strong implication that the patient's post-operative
condition must have been considered by the two (2) doctors as in some way related to the anesthetic
treatment she had received from the petitioner either during or after the surgical procedure.
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Once summoned, petitioner anesthesiologist could not be readily found. When he finally appeared at
10:30 in the evening, he was evidently in a bad temper, commenting critically on the dextrose bottles
before ordering their removal. 33 This circumstance indicated he was not disposed to attend to this
unexpected call, in violation of the canons of his profession that as a physician, he should serve the
interest of his patient "with the greatest of solicitude, giving them always his best talent and
skill." 34 Indeed, when petitioner finally saw his patient, he offered the unprofessional bluster to the
parents of Catherine that he would resign if the patient will not regain consciousness. 35 The canons of
medical ethics require a physician to "attend to his patients faithfully and conscientiously." He should
secure for them all possible benefits that may depend upon his professional skill and care. As the sole
tribunal to adjudge the physician's failure to fulfill his obligation to his patient is, in most cases, his own
conscience, violation of this rule on his part is "discreditable and inexcusable". 36
Nubain was an experimental drug for anesthesia and post-operative pain and the medical literature
required that a patient be weighed first before it is administered and warned that there was no (or
inadequate) experience relating to the administration thereof to a patient less that eighteen (18) ears of
age. 37 Yet, the doctor's order sheet (Exhibit "C") did not contain this precaution but instead directed a
reader to apply the drug only when warranted by the circumstances. 38 During the offer of Exhibit "C" by
the prosecution, Dr. Madrid admitted that this prescription, which was unsigned, was made in his own
handwriting. 39 It must be observed that the instruction was open-ended in that some other individual still
had to determine if circumstances existed warranting administration of the drug to the patient. The
document thus indicated the abdication of medical responsibility on an extremely critical matter.
Since petitioner anesthesiologist entered subsequent prescriptions or orders in the same order sheet, which
were signed by him, at 7:15 p.m. on the same evening of 31 May 1981, he was in a position to appreciate
the dangers inherent in the prior prescription, which was within his (petitioner's) area of specialization ,
and to order measures to correct this anomaly and protect his patient's well-being. So far as the condition
of the evidence shows, he failed to do so. In sum, only a low level of diligence was exhibited by petitioner
and Dr. Madrid in the prescription of medication for their patient.
As noted earlier, petitioner relied heavily in this proceeding on the testimony on cross-examination of the
expert witnesses for the prosecution to show that blood poisoning resulting from a ruptured
appendix could also be responsible for the patient's death.
No suggestion has been made that the rupture of the patient's occurred prior to surgery. After her blood
sample was examined, the patient was merely diagnosed as a case of appendicitis, without further
elaboration. 40 No intensive preoperative preparations, like the immediate administration of antibiotics,
was thereafter undertaken on the patient. This is a standard procedure for patients who are, after being
diagnosed, suspected of suffering from a perforated appendix and consequent peritonitis. 41 The mother
also testified that petitioner anesthesiologist merely injected a drug, "pre-anesthesia" intended to put the
patient to sleep, into the container of fluids being administered to her daughter intravenously at her room,
prior to surgery. 42 We note further that the surgeon Dr. Madrid was forty-five minutes late in arriving at
the operating theater. 43 Considering that delay in treatment of appendicitis increases the morbidity of the
patient, 44 Dr. Madrid's conduct can only be explained by a pre-operative diagnosis on his part that the
condition of appendicitis was not yet attended by complications (i.e., a ruptured appendix and peritonitis).
The above circumstances do strongly indicate that the rupture of the patient's appendix
occurred during the appendectomy procedure, that is, at a time and place the operating room where
the two (2) accused were in full control of the situation and could determine decisively what needed to be
done in respect of the patient. 45 This circumstance must be considered in conjunction with other related
circumstances which the prosecution had proven: that the patient was ambulatory when brought to the
operating room; 46 that she left the operating room two (2) hours later in obviously serious condition; and
that an appendectomy accompanied or followed by sustained antibiotic treatment is a fairly common and
generally accepted medical procedure for dealing with ruptured appendix and peritonitis, 47 a fact of which
judicial note may be taken.
As early as in People v. Vistan, 48 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 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. Such failure to exercise the necessary degree of care and diligence is a negative ingredient of the
offense charged. The rule in such cases is that while the prosecution must prove the negative ingredient of
the offense, it needs only to present the best evidence procurable under the circumstances, in order to shift
the burden of disproving or countering the proof of the negative ingredient to the accused, provided that
such initial evidence establishes at least on a prima facie basis the guilt of the accused. 49 This rule is
particularly applicable where the negative ingredient of the offense is of such a nature or character as,
under the circumstances, to be specially within the knowledge or control of the accused. 50 In the instant
case, the Court is bound to observe that the events which occurred during the surgical procedure
(including whether or not Nubain had in fact been administered as an anesthesia immediately before or
during the surgery) were peculiarly within the knowledge and control of Dr. Carillo and Dr. Madrid. It
was, therefore, incumbent upon the two (2) accused to overturn the prima facie case which the
prosecution had established, by reciting the measures which they had actually taken to prevent or to
counter the obviously serious condition of Catherine Acosta which was evident right after surgery. This
they failed or refused to do so.
Still another circumstance of which account must be taken is that both petitioner and Dr. Madrid failed to
inform the parents of their minor patient of the nature of her illness, or to explain to them either during the
surgery
(if feasible) or at any time after the surgery, the events which comprised the dramatic deterioration of her
condition immediately after surgery as compared with her pre-surgery condition. To give a truthful
explanation to the parents was a duty imposed upon them by the canons of their profession. 51 Petitioner
should have explained to Catherine's parents the actual circumstances surrounding Catherine's death, how,
in other words, a simple appendectomy procedure upon an ambulatory patient could have led to such fatal
consequences.
By way of resume, in the case at bar, we consider that the chain of circumstances above noted, namely: (1)
the failure of petitioner and Dr. Madrid to appreciate the serious post-surgery condition of their patient and
to monitor her condition and provide close patient care to her; (2) the summons of petitioner by Dr.
Madrid and the cardiologist after the patient's heart attack on the very evening that the surgery was
completed; (3) the low level of care and diligence exhibited by petitioner in failing to correct Dr. Madrid's
prescription of Nubain for post-operative pain; (4) the extraordinary failure or refusal of petitioner and Dr.
Madrid to inform the parents of Catherine Acosta of her true condition after surgery, in disregard of the
requirements of the Code of Medical Ethics; and (5) the failure of petitioner and Dr. Madrid to prove that
Page 39 of
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they had in fact exercised the necessary and appropriate degree of care and diligence to prevent the sudden
decline in the condition of Catherine Acosta and her death three (3) days later, leads the Court to the
conclusion, with moral certainty, that petitioner and Dr. Madrid were guilty of simple negligence resulting
in homicide.
In addition to the main arguments raised by petitioner earlier, he also raised an ancillary, constitutional
claim of denial of due process. He contends that he was deprived of his right to have competent
representation at trial, and to have his cause adequately heard, because his counsel of record, Atty. Jose B.
Puerto, was "incompetent" and exhibited "gross negligence" by manifesting an intent to file a demurrer to
the evidence, in failing to present evidence in his behalf and in omitting to file a defense memorandum for
the benefit of
Judge Yuzon, after the latter took over the case at the end of trial and before the Judge rendered his
decision. 52Petitioner submits he is entitled to a new trial. 53
These contentions do not persuade. An examination of the record indicates that Atty. Puerto represented
petitioner during trial with reasonable competence. Except for the two hearing sessions when witnesses
Domingo Acosta was cross-examined and recross-examined by Atty. Puerto, petitioner was present during
all the sessions when the other prosecution witnesses were presented and during which Atty. Puerto
extensively cross-examined them in behalf of petitioner and Dr. Madrid. This counsel elicited from the
two (2) expert witnesses for the prosecution testimony favorable to petitioner and which was relied upon
by the latter in this proceeding. 54 The record further indicates that if petitioner indeed entertained
substantial doubts about the capability of Atty. Puerto, he could have easily terminated the services of that
counsel and retained a new one, or sought from the trial court the appointment of counsel
de oficio, during the ample opportunity given from the time Atty. Puerto manifested his intent to file a
demurrer on 16 October 1985, to the submission of the case for decision on 25 June 1986 and before the
promulgation of judgment on 19 September 1986. 55 During all this time, petitioner could have obtained
leave of court to present evidence in his behalf in lieu of a demurrer, or to submit a memorandum for the
defense. After promulgation of the judgment of conviction, petitioner did not seek a new trial, but
permitted Atty. Puerto to obtain leave from the trial court to continue on bail during the pendency of the
proceedings before the Court of Appeals. 56 Indeed, petitioner replaced
Atty. Puerto as counsel only upon institution of the present petition. 57
Petitioner's constitutional objection is plainly an afterthought.
WHEREFORE, the Decision of the Court of Appeals dated 28 November 1988 is hereby AFFIRMED,
subject only to the modification that the indemnity for the death of Catherine Acosta is hereby increased to
P50,000.00, in line with current jurisprudence. 58
SO ORDERED.