Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)
I. RA 8344 DEMAND OF DEPOSITS
Is it unlawful to demand a deposit?
NO. It becomes unlawful when the deposit/advance
payment is demanded as a prerequisite for
confinement or medical treatment of a patient in
such hospital or medical clinic or to refuse to
administer medical treatment and support as
dictated by good practice of medicine to prevent
death or permanent disability
Is refusal unlawful?
NO. If there is strict compliance with the procedure
on transfer, it is not construed as refusal.
Procedure / Requisites for valid transfer:
1. there is inadequacy of medical capabilities of
the hospital
2. the patient or his next of kin consents to the
transfer, provided that if the patient is
unconscious, incapable of giving consent
and/or unaccompanied, the physician can
transfer the patient even without his consent
3. The receiving hospital or medical clinic
agrees to the transfer
4. such transfer shall be done only after
necessary emergency treatment and support
have been administered to stabilize the patient
5. that it has been established that such transfer
entails less risks than the patient's continued
confinement
No hospital or clinic, after being informed of the
medical indications for such transfer, shall refuse
to receive the patient nor demand from the patient
or his next of kin any deposit or advance payment
Transfer of Patients
After the hospital or medical clinic mentioned above
shall have administered medical treatment and
support, it may cause the transfer of the patient to an
JOSE J.
appropriate hospital consistent with the needs of the
patient, preferably to a government hospital,
especially in the case of poor or indigent patients
(Sec. 3, RA 8344)
Item 3 of IRR of RA 8344 provides:
1. The transferring and receiving hospital, shall
be as much as practicable, be within ten (10)
kilometer radius of each other.
2. The transfer of patients contemplated under
this Act shall at all times be properly
documented.
3. Hospitals may require a deposit or advance
payment when the patient is no longer under
the state of emergency and he/she refuses to
be transferred.
When are hospitals required to extend medical
services?
Hospitals are required to render immediate medical
assistance and provide facilities and medicine within
its capabilities on emergency cases, where patients
are in danger of dying and/or suffering
serious physical injuries, (Sec. 1, RA 6615)
Note: Doctrine of Reasonable Reliance Hospital
without emergency services allowed; Provided, that
there is an announcement to the community that such
hospital has no emergency services, so the people in
the community will not rely on the hospital for such
emergency services.
II. RA 9439 DETENTION OF PATIENTS
(NOTE: The provisions of RA 9439 is NOT
APPLICABLE to patients who stayed in private
rooms)
Is it unlawful to detain patients for non-payment
of hospital bills/medical expenses?
1
 Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)
YES. Sec. 1 provides that it shall be unlawful for any
hospital or medical clinic in the country to detain or
to otherwise cause, directly or indirectly, the
detention of patients who have fully or partially
recovered or have been adequately attended to, or
who may have died, for reasons of non-payment in
part or in full of hospital bills or medical expense.
Rights of patients that have fully or partially
recovered, and already wish to leave the hospital or
medical clinic, BUT financially incapable to settle
medical expenses
1. right to leave the hospital or medical clinic
2. right to demand the issuance of the
corresponding medical certificate and other
pertinent papers required for the release of the
patient from the hospital or medical clinic
upon the execution of a promissory note
covering the unpaid obligation
3. In case of a deceased patient, any surviving
relative has the right to demand the
corresponding death certificate and other
documents required for interment and other
purposes. (Also, under PD 651, hospitals are
required to issue a death certificate even
if hospital bills are not yet paid)
Execution of promissory note is required
The rights of the patients can only be exercised after
executing and securing a promissory note, either by a
mortgage or by a guarantee of a co-maker, who
will be jointly and severally liable with the patient
for the unpaid obligation.
The hospital can choose the guarantor or the comaker.
It has the right to make sure that the comaker is
capable of paying or fulfilling the obligation.
Case: Manila Doctors v. Chua and Ty
Ruling: The operation of private pay hospitals and
medical clinics is impressed with public interest and
2
JOSE J.
imbued with a heavy social responsibility. But the
hospital is also a business, and, as a business, it has a
right to institute all measures of efficiency
commensurate to the ends for which it is designed,
especially to ensure its economic viability and
survival. And in the legitimate pursuit of economic
considerations, the extent to which the public may be
served and cured is expanded, the pulse and life of
the medical sector quickens, and the regeneration of
the people as a whole becomes more visibly
attainable. In the institution of cost-cutting measures,
the hospital has a right to reduce the facilities and
services that are deemed to be nonessential, such that
their reduction or removal would not be detrimental
to the medical condition of the patient.
For the moment, the question to be considered is
whether the subject facilities are indeed nonessential
- the air-conditioner, telephone, television, and
refrigerator the removal of which would cause the
adverse health effects and emotional trauma the
respondents so claimed. Corollary to this question is
whether the petitioner observed the diligence of a
good father of the family in the course of ascertaining
the possible repercussions of the removal of the
facilities prior to the removal itself and for a
reasonable time thereafter, with a view to prevent
damage.
After an extensive analysis of the record, it becomes
rather worrisome to this Court that the courts a quo
unreservedly drew their conclusions from the
selfserving and uncorroborated testimonies of the
respondents the probative value of which is highly
questionable. We hold that the respondents failed to
prove the damages so claimed.
The evidence in the record firmly establishes that the
staff of the petitioner took proactive steps to inform
the relatives of respondent Chua of the removal of
facilities prior thereto, and to carry out the necessary
precautionary measures to ensure that her health and
well-being would not be adversely affected.
 Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)
A patient cannot be detained in a hospital for
nonpayment of the hospital bill The form of restraint
must be total; movement must be restrained in all
directions. If restraint is partial, e.g., in a particular
direction with freedom to proceed in another, the
restraint on the person's liberty is not total.
However, the hospital may legally detain a patient
against his will when he is a detained or convicted
prisoner, or when the patient is suffering from a
very contagious disease where his release will be
prejudicial to public health, or when the patient is
mentally ill such that his release will endanger
public safety, or in other exigent cases as may be
provided by law.
Authorities are of the view that, ordinarily, a hospital,
especially if it is a private pay hospital, is entitled to
be compensated for its services, by either an express
or an implied contract, and if no express contract
exists, there is generally an implied agreement that
the patient will pay the reasonable value of the
services rendered; when a hospital treats a patient's
injuries, it has an enforceable claim for full payment
for its services, regardless of the patient's financial
status.
III. PRC IDENTIFICATION
Powers, Functions, and Responsibilities of the
Commission (Sec. 7)
PRC upon recommendation of the PR Board
concerned has power to approve the registration
and authorize issuance of certificate or license of
registration and professional ID card
To supervise foreign nations who are authorized by
existing laws to practice their professions either as
holders of a certificate of registration and a
professional identification card or a temporary
special permit in the Philippines;
3
JOSE J.
To supervise professionals who were former citizens
of the Philippines and who had been registered and
issued a certificate of registration and a professional
identification card prior to their naturalization as
foreign citizens, who may, while in the country on a
visit, sojourn or permanent residence, practice their
profession:
Provided, that prior to the practice of their
profession they shall have first been issued a
special permit and updated professional
identification card by the Board concerned
subject to approval by the Commission and
upon payment of the permit and annual
registration fees
IV. RECIPROCITY
The registration or issuance of license of a foreigner
professional rests in the PRC. The requirements for
registration or licensing, however, must be
substantially the same as those required and
contemplated by the laws of the Philippines. It is
further required that the laws of the foreign start
allow the citizens of the Philippines to practice their
profession on the same basis, grant, and privileges as
those enjoyed by the citizens of the foreign country.
Case: Board of Medicine v. Ota
Facts: Ota is a Japanese national, married to a
Filipina, has been residing in the PH for more than 10
years, and graduated Doctor of Medicine. He filed an
application to take the board exams. PRC requires
him to submit affidavit stating that if he passes the
boards, he cannot practice medicine until he submits
proof that reciprocity exists between Japan and the
Philippines in admitting foreigners into the practice
of medicine. Ota submitted a duly notarized English
translation of the Medical Practitioners Law of Japan
duly authenticated by the Consul General of the
Philippine Embassy to Japan. He was allowed to take
the boards and he passed. In spite of all these, the
Board of Medicine denied Otas request for a license
 Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)
to practice medicine in the Philippines on the ground
that no genuine reciprocity can be found in the law of
Japan, as there is no Filipino or foreigner who can
possibly practice there. Ota filed petition before the
RTC. RTC ruled in favor of Ota stating that there is
adequate proof that there exists a principle of
reciprocity and ordering PRC to issue the license.
PRC appealed to CA. CA affirmed RTC Ruling.
Issue: Whether or not the principle of reciprocity
exists.
Held: Yes. The contention of the PRC that the
requirements to practice medicine in Japan are
practically impossible for a Filipino to comply with,
there are also ambiguities in the Medical
Practitioners Law of Japan, and there had not been a
single Filipino who was issued a license to practice
medicine by the Japanese Government is untenable.
What the law requires is for the foreigner to show
proof that a Filipino can practice in his foreign
country. It is enough that the laws in the foreign
country permit a Filipino to get license and practice
therein. Requiring respondent to prove first that a
Filipino has already been granted license and is
actually practicing therein unduly expands the
requirements provided for under R.A. No. 2382 and
P.D. No. 223.
V. PRIVILEGED COMMUNICATION
Sec. 24, RRE. Disqualification by reason of
privileged communication. The following persons
cannot testify as to matters learned in confidence in
the following cases:
xxx
(c) A surgeon authorized to practice medicine,
surgery or obstetrics cannot in a civil case, without
the consent of the patient, be examined as to any
advice or treatment given by him or any
information which he may have acquired in
attending such patient in a professional capacity,
4
JOSE J.
which information was necessary to enable him to act
in that capacity, and which would blacken the
reputation of the patient
Case: Lim v. CA
Facts: Petitioner Nelly Lim and Respondent Juan
Lim are lawfully married to each other. Juan filed a
petition for annulment of marriage in the ground that
Nelly has been suffering from schizophrenia before,
during, and even after their marriage.
He presented three witnesses, one of which is the
Chief of the Female Services of National Mental
Hospital, Dr. Acampado. The counsel for Juan orally
applied for the issuance of subpoena ad testificandum,
the counsel for Nelly opposed the motion on the
ground that the testimony sought to be elicited from
the witness is privileged since the latter had
examined the petitioner in a professional capacity
and had diagnosed her to be suffering from
schizophrenia. Nevertheless, the subpoena was
issued. Counsel for Nelly filed an urgent motion to
quash the subpoena. Respondents counsel claimed
that the witness will testify as an expert witness and
would not testify on any information acquired while
attending to the petitioner in a professional capacity.
Lower Court ruled in favor of Juan. CA also ruled in
favor of Juan stating that Nelly failed to establish the
confidential nature of the testimony given by Dr.
Acampado.
Issue: Whether or not there is breach of
confidentiality clause
Held: No. In order that the privilege may be
successfully claimed, the following requisites must
concur:
1. the privilege is claimed in a civil case;
2. the person against whom the privilege is
claimed is one duly authorized to practice
medicine, surgery or obstetrics;
 Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)
3. such person acquired the information
while he was attending to the patient in his
professional capacity;
4. the information was necessary to enable
him to act in that capacity; and
5. the information was confidential, and, if
disclosed, would blacken the reputation
(formerly character) of the patient.
These requisites conform with the four (4)
fundamental conditions necessary for the
establishment of a privilege against the disclosure
of certain communications, to wit:
1. The communications must originate in a
confidence that they will not be disclosed.
2. This element of confidentiality must be
essential to the full and satisfactory
maintenance of the relation between the
parties.
3. The relation must be one which in the
opinion of the community ought to be
sedulously fostered
4. The injury that would inure to the relation
by the disclosure of the communications
must be greater than the benefit thereby
gained for the correct disposal of litigation.
The physician may be considered to be acting in his
professional capacity when he attends to the patient
for curative, preventive, or palliative treatment. Thus,
only disclosures which would have been made to the
physician to enable him "safely and efficaciously to
treat his patient" are covered by the privilege.
It is to be emphasized that "it is the tenor only of the
communication that is privileged. The mere fact of
making a communication, as well as the date of a
5
JOSE J.
consultation and the number of consultations, are
therefore not privileged from disclosure, so long as
the subject communicated is not stated. One who
claims this privilege must prove the presence of these
aforementioned requisites. Petitioner failed to
discharge that burden. Dr. Acampado was presented
and qualified as an expert witness. She did not
disclose anything obtained in the course of her
examination, interview and treatment of the
petitioner; moreover, the facts and conditions alleged
in the hypothetical problem did not refer to and had
no bearing on whatever information or findings the
doctor obtained while attending to the patient.
The statutory physician-patient privilege, though
duly claimed, is not violated by permitting a
physician to give expert opinion testimony in
response to a strictly hypothetical question in a
lawsuit involving the physical mental condition of a
patient whom he has attended professionally, where
his opinion is based strictly upon the hypothetical
facts stated, excluding and disregarding any personal
professional knowledge he may have concerning
such patient.
Case: Krohn v. CA
Facts: A confidential psychiatric evaluation report is
being presented in evidence before the trial court in a
petition for annulment of marriage grounded on
psychological incapacity. The witness testifying on
the report is the husband who initiated the annulment
proceedings, not the physician who prepared the
report. The subject of the evaluation report is the wife,
who invokes the rule on privileged communication
between physician and patient, and seeks to enjoin
her husband from disclosing the contents of the
report. RTC allowed the admission of the psychiatric
evaluation report as evidence because it is material to
the case and because there was no objection on the
part of the wife during the time it was referred to in
the complaint. CA affirmed.
Issue: Whether or not the presentation of the report
 Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)
is a breach of the privileged communication rule
Held: No. It does not fall under the requisites laid
down in the case of Lim v. CA. Moreover, the person
against whom the privilege is claimed is not one duly
authorized to practice medicine, surgery or obstetrics.
He is simply the patient's husband who wishes to
testify on a document executed by medical
practitioners. Plainly and clearly, this does not fall
within the claimed prohibition. Neither can his
testimony be considered a circumvention of the
prohibition because his testimony cannot have the
force and effect of the testimony of the physician who
examined the patient and executed the report.
VI. MEDICAL ACT OF 1959, AS
AMENDED and other related provisions and
concepts
LEGAL MEDICINE
Branch of medicine that deals with the application of
medical knowledge to the purposes of law and in the
administration of justice.
MEDICAL JURISPRUDENCE
Deals with the aspect of law and legal concepts in
relation with the practice of medicine
MEDICAL JURISPRUDENCE includes:
- Licensure and regulatory laws;
- Physician-patient-hospital relationship
together with the other paramedical personnel,
their rights, duties and
obligations;
- Liabilities for non-compliance with the law.
PURPOSES OF LEGAL MEDICINE
- To protect the public from charlatans;
- To promote professionalism and foster
professional interrelationship;
6
JOSE J.
- To develop awareness of the rights, duties and
obligations of the patient, physician, and the
hospital;
- To control the increasing number of medical
malpractice suits against physicians;
- To explain the purpose and procedure of
certain legislation;
- To study the need to amend, repeal our health
care laws in harmony with the recent
scientific and social development.
ADVERSARIAL TRIAL SYSTEM
- Philippine courts is a court litigation where
there is competition of inconsistent version of
facts and theories in law during trial;
- Each party to the contest is given equal
opportunity to investigate the case, gather and
present all proofs in support of his allegation,
and give argument that his contention is
correct;
- Ultimate purpose is for a just solution.
- it often undermines the pursuit of truth as the
opposing parties seek to win at all cost
without the obligation to reveal the facts
which may be detrimental to their case. The
lawyer aims to win the fight not to help the
court discover facts or establish the truth.
SOURCES OF LAW
- Constitution
- Laws enacted by the legislative body
- Decrees, Orders, Proclamation, Letters, CA,
BP, RA
- Administrative acts, orders, Rules and
Regulation
- Local customs
- Generally accepted principles
of
International law
LAW AND THE PRACTICE OF MEDICINE
 Legal Medicine (Atty. Capule) Midterm Notes (As per pointers) JOSE J.

The State must maintain high standard of practice by 4. To determine and prescribe the minimum
setting up rules and regulations with regards to required curriculum;
qualifications and procedure for the admission to the 5. To authorize the implementation of
profession. These are legal safeguards to guarantee experimental curriculum;
the safety of the patient and impose liability to the 6. To accept applications for admission to a
practitioner who through his act or omission causes medical school;
damage or injury to the health and welfare of the 7. To select, determine and approve hospitals for
patient. training;
8. To promulgate, prescribe and enforce the
The right to regulate the practice of medicine is based necessary rules and regulations.
on the police power of the state.
2. PROFESSIONAL REGULATIONS
LICENSURE AND REGULATORY LAWS COMMISSION (PRC)

ADMINISTRATIVE BODIES To have general supervision and regulation of all

professions requiring examinations which includes
1. BOARD OF MEDICAL EDUCATION the practice of medicine.

Primarily concerned with the standardization and Composition:

regulation of medical education.
Commissioner
Composition: Two Associate Commissioner

Chairman - Secretary of Education Functions:

Members: Exercise general administrative, executive and

1. Secretary of Health
2. Director, Bureau of Private Schools
3. Chairman, Board of Medicine
4. Representative, PMA
5. Council of Deans, APMC
6. Dean, UP-College of Medicine
Functions:
1. To determine and prescribe the requirements
for admission into a recognized college of
Medicine;
2. To determine and prescribe requirements for
the minimum physical facilities;
3. To determine and prescribe the minimum
number and qualifications of teaching
personnel;
policy-making functions for the whole agency.
3. BOARD OF MEDICINE
Its primary duties are to give examinations for the
registration of physicians and supervision, control
and regulation of the practice of medicine.
Composition:
Six members appointed by the president from a list
submitted by the Executive Council of the PMA.
Qualifications:
- Natural-born citizen;
- Duly registered physician;

7
 Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)
- In the practice of medicine for at least 10
years;
- Of good moral character and of recognized
standing in the medical profession as certified
by PMA;
- Not a member of any faculty of any medical
school (including any pecuniary interest)
Powers, Functions and Responsibilities:
1. To determine and prepare the contents of the
licensure examinations;
2. To promulgate such rules and regulations for
the proper conduct of the examinations,
correction and registration;
3. To administer oath;
4. To study the conditions affecting the practice
of medicine;
5. To investigate violations, issue summons,
subpoena and subpoena duces tecum;
6. To conduct hearings or investigations of
administrative cases filed before them;
7. To promulgate decisions on such
administrative cases subject to the review of
the Commission;
8. To issue certificate of registration;
9. To suspend, revoke or reissue certificate of
registration for causes provided by law or by
the rules and regulations promulgated;
10. To promulgate, with the approval of PRC,
rules and regulations in harmony with the
provisions of the Medical Act of 1959 and
necessary for the proper practice of medicine.
ADMISSION TO THE PRACTICE OF
MEDICINE
Prerequisites:
1. Minimum age requirement
- at least 21 years of age
2. Proper Educational Background
8
JOSE J.
- -Requirements for Admission in the College
of Medicine
- -Holder of a Bachelors degree;
- -Not convicted of any crime involving moral
turpitude;
- -Certificate of Eligibility from the Board of
Medical Education;
- -Good moral character
3. Examination Requirements
- must have passed the corresponding Board
Examination
- Preliminary Examination
- -At least 19 years of age;
- -Of good moral character;
- -Have completed the first two years of the
medical course;
- -Final or Complete Examination
- -Citizen of the Philippines or of any country
who has submitted competent and
conclusive
- Documentary evidence confirmed by the
DFA showing that his countrys existing laws
permit citizens of the Philippines to practice
medicine under the same rules and regulations
governing citizens thereof (RECIPROCITY
RULE).
4. Holder of certificate of registration
No issuance to any candidate who has been:
- -Convicted by a court of competent
jurisdiction of any crime involving moral
turpitude;
- -Found guilty of immoral or dishonorable
conduct after investigation by the Board of
Medicine;
- -Declared to be of unsound mind.
Scope of Examination:
Preliminary - Anatomy and Histology
Physiology
 Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)
Biochemistry
Microbiology and Parasitology
Final - Pharmacology and Therapeutics
Pathology
Medicine
Obstetrics and Gynecology
Pediatrics and Nutrition
Surgery and Ophthalmology,
Otorhinolaryngology
Preventive Medicine and Public Health
Legal Medicine, Ethics and Medical
Jurisprudence
PRACTICE OF MEDICINE
What is the practice of medicine?
It is a privilege or franchise granted by the State to
any person to perform medical acts upon compliance
with law, that is, the Medical Act of 1959 as amended
which has been promulgated by the State in the
exercise of police power to protect its citizenry from
unqualified practitioners of medicine.
It is diagnosing and applying and the usage of
medicine and drugs for curing, mitigating, or
relieving bodily disease or conditions.
ACTS CONSTITUTING THE PRACTICE OF
MEDICINE (pursuant to Sec.10, Art. III of the
Medical Act of 1959 as amended):
1. who shall for compensation, fee, reward in
any form paid to him directly or through
another, or even without the same, physically
examine any person, and diagnose, treat,
operate or prescribe any remedy for human
disease, injury, deformity, physical, mental,
psychical condition or any ailment, real or
imaginary, regardless of the nature of the
remedy or treatment administered, prescribed
or recommended;
9
JOSE J.
2. who shall by means of signs, cards,
advertisement, written or printed matter, or
through the radio, television or any other
means of communication, either offer or
undertake by any means or method to
diagnose, treat, operate, or prescribe any
remedy for human disease, injury, deformity,
physical, mental or psychical condition;
3. who shall falsely use the title of M.D. after his
name, shall be considered as engaged in the
practice of medicine.
By DECISIONS OF COURTS, the following are
not considered to constitute practice of medicine:
1. One who takes BP reading;
2. Application of medicated massage;
3. Hospital;
4. Nurse anesthetist
Exemptions:
By PROVISIONS OF LAW, the following are not
considered to constitute practice of medicine
(Sec.11, Art. III, Medical Act of 1959 as amended):
1. Any medical student duly enrolled in an
approved medical college;
2. dentist;
3. physiotherapist;
4. optometrist;
5. Any person who renders any service
gratuitously in cases of emergency or in
places where the services of a physician,
nurse or midwife are not available;
6. Any person who administers or recommends
any household remedy as per classification of
existing Pharmacy Laws;
7. Clinical psychologist with the prescription
and direct supervision of a physician; 8.
Prosthetist
Note: Faith Healing
 Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)
There is nothing in the Medical Act of 1959
exempting it from the definition of the acts which
constitute practice of medicine;
Related to constitutional guarantee to religious
freedom (freedom to believe and freedom to act in
accordance with ones belief);
Acted in pursuance of his religious belief and with
the tenets of his church he professes, not deemed to
be a practice of medicine but part of his religious
freedom.
ILLEGAL PRACTICE OF MEDICINE
Practice of medicine by any person not qualified and
not duly-admitted to perform medical acts in
compliance with law.
Penalties
Pursuant to Sec.28, Art. IV, Medical Act of 1959 as
amended Any person found guilty of illegal
practice shall be punished by a fine of not less than
one thousand pesos or more than ten thousand pesos
with subsidiary imprisonment in case of insolvency
or by imprisonment of not less than one year no more
than five years, or by both such fine and
imprisonment, in the discretion of the court.
Qualified to practice medicine in the Philippines
1. Those who have complied with the prerequisites
to the practice of medicine in accordance with
Sec. 8, Art. III, Medical Act of 1959 as
amended;
2. Those who can have limited practice without any
certificate of registration in accordance with
Sec.12, Art. III, Medical Act of 1959 as
amended:
- Exclusive consultation in specific and definite
cases;
10
JOSE J.
- Attached to international bodies to perform
certain definite work in the Philippines;
- Commissioned medical officers stationed in
the Philippines in their own territorial
jurisdiction;
- Exchange professors in special branches of
medicine;
- Medical students who have completed the
first four years of medical course, graduates
of medicine and registered nurses who may be
given limited and special authorization by
the DOH;
3. Balikbayan Physicians pursuant to PD 541,
Allowing Former Filipino Professionals to
Practice Their Respective Professions in the
Philippines, proviso:
- Of good standing prior to their departure and
in their adopted country;
- Have registered with PRC and paid their
professional fee;
- Pay the corresponding income tax;
4. Foreign physicians qualified to practice by
Reciprocity Rule or by endorsement;
5. Medical Students pursuant to Sec.11(a) and
Sec.12(d), Art.III, Medical Act of 1959 as
amended;
6. Limited practitioners of medicine
- Those that are governed by specific licensure
laws
Rationale why artificial persons cannot practice
medicine
- Cannot be subjected to licensure
examinations as required by law;
- Practice of medicine may be employed and
controlled by unqualified physicians;
- Professional relationship between the patient
and the physician will be impaired;
- Deprivation of free choice of physicians.
 Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)
ADDITIONAL NOTES
PHYSICIAN
He is a person who after completing his secondary
education follows a prescribed course of medicine at
a recognized university or medical school, at the
successful completion of which, is legally licensed to
practice medicine by the responsible authorities and
is capable of undertaking the prevention, diagnosis,
and treatment of human illness by the exercising
independent judgment and without
supervision. (WHO)
RIGHTS OF PHYSICIAN
INHERENT RIGHTS
- to choose patients (except in emergency
cases)
- to limit practice of medicine
- to determine appropriate
management procedures
- to avail of hospital services
INCIDENTAL RIGHTS
- right of way while responding to emergency
- right of exemption from execution of
instruments and
- Library to hold certain public/private offices
to perform certain services to compensation
right to membership in medical societies
RIGHTS GENERALLY ENJOYED BY EVERY
CITIZEN
- Pursuant to the provisions of Art. III, bill of
rights, Philippine Constitution 1987
RIGHTS OF PATIENTS
- Right to give consent to diagnostic and
treatment procedures
- Right to religious belief
11
JOSE J.
- Right of privacy
- Right to disclosure of information
- Right to confidential information
- Right to choose his physician
- Right of treatment
- Right to refuse necessary treatments
Basis of Consent
1. The physician-patient relationship is fiduciary
in nature.
2. Patients right to self-determination.
3. Contractual relationship.
Purposes
1. To protect the patient from
unnecessary/unwarranted procedure applied
to him without knowledge
2. To protect the physician from any
consequences for failure to comply with
legal requirements
Instances When Consent Is Not Necessary
1. In cases of emergency, there is an implied
consent or the physician is privilege
because he is reasonably entitled to assume
consent
2. When the law made it compulsory for
everyone to submit to the procedure
MEDICAL MALPRACTICE
Failure of a physician to properly perform the duty
which devolves upon him in his professional relation
to his patient which results to injury. It may be
defined as bad or unskillful practice of medicine
resulting to injury of the patient or failure on the part
of the physician to exercise the degree of care, skill
and diligence, as to treatment in a manner contrary to
 Legal Medicine (Atty. Capule) Midterm Notes (As per pointers)
accepted standards of medicine resulting to injury to
the patient.
Elements of Medical Malpractice
1. The physician has a duty to the patient;
2. The physician failed to perform such duty
to his patient;
3. As a consequence of the failure, injury was
sustained by the patient;
4. The failure of the physician is the
proximate cause of the injury sustained by
the patient.
Criminal medical malpractice, the act or omission
complained of must be punishable by law at the time
of commission or omission.
Proximate Cause
that cause, which, in natural continuous sequence,
unbroken by an efficient intervening cause, produces
the injury and without which the result would not
have occurred.
1. There must be a direct physical connection
between the wrongful act of the physician and
the injury sustained by the patient.
2. The cause or the wrongful act of the physician
must be efficient and must not be
too remote from the development of the injury
suffered by the patient.
3. The result must be the natural continuous and
probable consequences.
DOCTRINE OF EFFICIENT INTERVENING
CAUSE
In the causal connection between the negligence of
the physician and the injury sustained by the patient,
Some cases wherein the Doctrine of Res Ipsa
Loquitor has been applied:
1. Objects left in the patients body at the time of
caesarian section;
12
JOSE J.
there may be an efficient intervening cause which is
the proximate cause of the injury.
DOCTRINE OF VICARIOUS LIABILITY
Doctrine of Imputed Negligence/Command
Responsibility.
Vicarious liability means the responsibility of a
person, who is not negligent, for the wrongful
conduct or negligence of another.
CAPTAIN-OF-THE-SHIP DOCTRINE
This doctrine innunciates liability of the surgeon not
only for the wrongful acts of those who are under his
physical control but also those wherein he has
extension of control.
DOCTRINE OF RES IPSA LOQUITOR
The thing speaks for itself; nature of the wrongful
act or injury is suggestive of negligence. General
rule: expert testimony is necessary to prove that a
physician has done a negligent act or that has
deviated from the standard of medical practice.
Requisites of Res Ipsa Loquitur Doctrine:
1. The accident must be of a kind which
ordinarily does not occur in the absence of
someones negligence;
2. It must be caused by an agency or
instrumentality within the exclusive control
of the defendant;
3. It must not have been due to any voluntary
action or contribution on the part of the
plaintiff.
 Legal Medicine (Atty. Capule) Midterm Notes (As per pointers) JOSE J.

2. Injury to a healthy part of the body;

3. Removal of a wrong part of the body when another
part wad intended;
4. Infection resulting from unsterilized
instruments;
5. Failure to take radiographs to diagnose a possible
fracture;

Instances where the Doctrine of Res Ipsa Loquitor does not

apply:

1. Where the Doctrine of Calculated Risk is applicable;

2. When an accepted method of medical treatment involves hazards which may produce injurious
results regardless of the care exercised by the physician.
3. Bad Result Rule;
4. Honest Errors of judgment as to
Appropriate Procedure;
5. Mistake in the Diagnosis

In most medical malpractice suits, there is a necessity

for a physician to give his expert medical opinion to
prove whether acts or omissions constitute medical
negligence. This doctrine has been regarded as rule
of sympathy to counteract the
conspiracy of silence

13