Escolar Documentos
Profissional Documentos
Cultura Documentos
MEDICAL
JURISPRUDENCE
A/y.
Edwin
L.
Dimatatac,
MD
7/30/14
Health
Professions
under
PRC
Health
Professions
under
PRC
Pharmacy
(R.A.
No.
5921)
Physical
Therapy
and
OccupaDonal
Therapy
(R.A.
5680)
Radiologic
and
X-Ray
Technology
(R.A.
No.
7431)
Sanitary
Engineering
(R.A.
No.
1364)
Social
Workers
(R.A.
No.
4373)
Veterinary
Medicine
(R.A.
9268)
7/30/14
PRIVACY/MEDICAL
PRIVACY/
CONFIDENTIALITY
7/30/14
MEDICAL
PRIVACY
Privacy
-
the
state
of
being
free
from
intrusion
or
disturbance
in
one's
private
life
or
aairs
Conden.ality
-
privacy
of
informaDon
and
its
protecDon
against
unauthorized
disclosure
Medical
or
Health
Privacy
protecDon
of
the
condenDal
nature
of
personal
health
informaDon,
includes
communicaDons
between
health
provider
and
paDent,
personal
data
and
informaDon
about
disease
or
paDents
condiDon
as
contained
in
medical
records
7/30/14
Medical Records
7/30/14
Medical
Records
Medical
Records
owned
by
hospital
or
physician
but
personal
data
contained
therein
belongs
to
paDent
Custodian
of
records
have
a
duty
not
to
disclose
or
release
contents
of
medical
records
unless
authorized
by
law
or
ordered
by
court
unless
paDent
consents
Electronic
Medical
Records,
Telemedicine
poses
challenges
to
health
informaDon
privacy
7/30/14
7/30/14
7/30/14
SOURCES OF OBLIGATION
7/30/14
Sources of ObligaDon
Delict
Quasi-delict
Contract
Quasi-contract
10
7/30/14
PracDce of Medicine
11
7/30/14
12
7/30/14
Physician
Liability
Administra@ve
Liability
Civil
Liability
Criminal
Liability
13
7/30/14
DUTIES OF PHYSICIANS TO
THEIR PATIENTS
Competence based on current
standards
Free to choose patients except if
emergency
Refer when needed
Good faith and Strict honesty
Preserve confidential information
Reasonable fees
14
7/30/14
DUTIES OF PHYSICIANS TO
THEIR COLLEAGUES AND TO
THE PROFESSION
Gratuitous service to a colleague, his or her spouse,
children and parents
Consultation with colleague when necessary,
Observe proper protocol of referral system
Full Disclosure of any pharmaceutical support in case
of articles and presentations
Report corrupt or dishonest conduct to proper forum
May accept funds for CME but CME should be free
from commercial influence
DUTIES OF PHYSICIANS TO
ALLIED PROFESSIONALS
No payment of receipt of commissions
from allied health worker for cases
referred
15
7/30/14
RELATIONSHIP OF PHYSICIANS
WITH THE HEALTH PRODUCTS
INDUSTRY
No
material
gain
from
product
samples
by
may
try
new
products
on
paDents
provided
they
consent
Giqs
of
reasonable
value
that
would
benet
paDent
may
be
accepted
from
health
product
company;
donaDons
for
charitable
purpose
may
be
requested
Research
acDviDes
should
be
ethical,
responsible
and
valid
16
7/30/14
17
7/30/14
18
7/30/14
AdministraDve
Liability
ViolaDon
of
Code
of
Ethics
ViolaDon
of
Medical
Act
of
1959
Sec.
24
(but
some
of
those
enumerated
are
also
grounds
for
civil
and/or
criminal
liability)
E.O.
No.
212
(July
10,
1987)
ReporDng
of
treatment
of
Serious
and
Less
Serious
Physical
Injuries
to
nearest
government
health
authority
PRC
Procedure
Formal
complaints
should
be
submi/ed
in
person
at
the
PRC
oce.
Formal
complaints
undergo
four
stages:
Docke@ng
and
Calendar
-
this
starts
from
the
date
of
ling
of
the
complaint
to
when
the
noDce
of
pre-trial
is
sent
to
the
parDes.
Pre-trial
and
Deposi@ons
covers
the
pre-trial,
deposiDons,
and
other
pracDces
designed
to
dispense
with,
or
limit
Dme
for
the
recepDon
of
evidence
19
7/30/14
PRC
Procedure
Recep@on
of
Evidence
evidence
for
both
the
complainant
and
for
the
respondent
are
presented
as
well
as
the
rebu/al
evidence.
Decision-making
discussions
and
vote
on
the
case
and
the
preparaDon
and
signing
of
the
decision.
CRIMINAL LIABILITY
20
7/30/14
CRIMINAL
LIABILITY
*
Degree
of
InstrucDon
as
an
AlternaDve
Circumstance
Illegal
PracDce
of
Medicine
False
Medical
CerDcate
AborDon
pracDced
by
a
physician
or
midwife
SimulaDon
of
births,
subsDtuDon
of
one
child
for
another
and
concealment
or
abandonment
of
a
legiDmate
child.
Criminal
Negligence
21
7/30/14
Reckless
Imprudence
The
elements
of
reckless
imprudence
are:
(1)that
the
oender
does
or
fails
to
do
an
act;
(2)that
the
doing
or
the
failure
to
do
that
act
is
voluntary;
(3)that
it
be
without
malice;
(4)that
material
damage
results
from
the
reckless
imprudence;
and
(5)that
there
is
inexcusable
lack
of
precauDon
on
the
part
of
the
oender,
taking
into
consideraDon
his
employment
or
occupaDon,
degree
of
intelligence,
physical
condiDon,
and
other
circumstances
regarding
persons,
Dme
and
place.
Reckless Imprudence
22
7/30/14
23
7/30/14
Negligence
of
a
doctor
resulDng
to
injury
to
a
paDent
may
be
ground
for
criminal
liability.
It
is
also
basis
for
civil
liability
and
award
of
damages
under
what
law?
24
7/30/14
Civil
Liability
Direct
Liability
under
arDcle
2176
Vicarious
Liability,
arDcle
2180
in
relaDon
to
arDcle
2176
25
7/30/14
26
7/30/14
duty
breach
injury
proximate
causaDon
27
7/30/14
28
7/30/14
Burden
of
Proof
Proof
Required
29
7/30/14
Burden
of
Proof
BURDEN
OF
PROOF:
duty
of
a
party
to
present
evidence
on
the
facts
in
issue
necessary
to
establish
his
claim
or
defenses
by
the
amount
of
evidence
required
by
law
Plain@
alleging
DAMAGE
because
of
the
negligent
act
of
defendant
has
the
burden
of
proving
such
negligence
It
is
even
presumed
that
a
person
takes
ordinary
care
of
his
concerns
Quantum
of
proof
required
is
preponderance
of
evidence
Excep@on:
when
rules
or
the
laws
provide
for
cases
when
negligence
is
presumed
30
7/30/14
31
7/30/14
duty
breach
injury
proximate
causaDon
32
7/30/14
33
7/30/14
VICARIOUS
LIABILITY
ArDcle
2180
-
The
obligaDon
imposed
by
ArDcle
2176
is
demandable
not
only
for
one's
own
acts
or
omissions,
but
also
for
those
of
persons
for
whom
one
is
responsible.
Xxx
The
owners
and
managers
of
an
establishment
or
enterprise
are
likewise
responsible
for
damages
caused
by
their
employees
in
the
service
of
the
branches
in
which
the
la/er
are
employed
or
on
the
occasion
of
their
funcDons.
Employers
shall
be
liable
for
the
damages
caused
by
their
employees
and
household
helpers
acDng
within
the
scope
of
their
assigned
tasks,
even
though
the
former
are
not
engaged
in
any
business
or
industry.
34
7/30/14
VICARIOUS
LIABILITY
Employers
shall
be
liable
for
the
damages
caused
by
their
employees
and
household
helpers
acDng
within
the
scope
of
their
assigned
tasks,
even
though
the
former
are
not
engaged
in
any
business
or
industry.xxx
The
responsibility
treated
of
in
this
arDcle
shall
cease
when
the
persons
herein
menDoned
prove
that
they
observed
all
the
diligence
of
a
good
father
of
a
family
to
prevent
damage.
Give
an
Example
of
a
Doctrine
that
makes
a
physician
vicariously
liable
35
7/30/14
VICARIOUS
LIABILITY
Captain
of
Ship
Doctrine
Borrowed
Servant
Doctrine
36
7/30/14
to Operation.
Both release forms consist of two parts. The first
part gave CMC permission to administer to Corazon
any form of recognized medical treatment which the
CMC medical staff deemed advisable. The second
part of the documents, which may properly be
described as the releasing part, releases CMC and its
employees from any and all claims arising from or
by reason of the treatment and operation.
37
7/30/14
Hospital
Liability
Direct
Liability
under
arDcle
2176
Corporate
liabiliDes
-
those
arising
from
the
failure
of
hospitals
to
furnish
accommodaDons
and
faciliDes
necessary
to
carry
out
its
purpose
or
to
follow
the
established
standard
of
conduct
to
which
it
should
conform.
Vicarious
Liability
38
7/30/14
duty
breach
injury
proximate
causaDon
39
7/30/14
40
7/30/14
41
7/30/14
Corporate
Negligence
(1)
A
duty
to
use
reasonable
care
in
the
maintenance
of
safe
and
adequate
faciliDes
and
equipment;
(2)
A
duty
to
select
and
retain
only
competent
physicians;
(3)
A
duty
to
oversee
all
persons
who
pracDce
medicine
within
its
walls
as
to
paDent
care;
and
(4)
A
duty
to
formulate,
adopt
and
enforce
adequate
rules
and
policies
to
ensure
quality
care
for
the
paDents
42
7/30/14
Vicarious
Liability
1.
vicarious
liability
for
acts
of
an
employee
2.
the
doctrine
of
apparent
authority
or
agency
by
estoppel
43
7/30/14
44
7/30/14
CASE 1
13/F underwent an appendectomy.
Apparently, patient was not weighed
prior to the operation.
The Operation was scheduled at 5PM
but started 5:45PM because the surgeon
arrived only at that time. Patient was
finally brought out of the OR at 7PM and
brought back to her room. Patient did
not wake up and had a weak
heartbeat but was apparently revived.
Surgeon and anesthesiologist then left.
45
7/30/14
CASE 2
Elderly male consulted clinic and found to
have BP 210/100 and HR 112. Patient was
given Capoten 25mg and advised to go to
a hospital. Physician instructed clinic
ambulance to stand-by for conduction.
After resting for a few minutes, patient said
that he will just look for a companion. A
nurse was asked to look for the patient but
he could not be found. After a few minutes,
the doctor left.
46
7/30/14
CASE 3
A video was uploaded in YouTube showing
an operation wherein medical staff
extracted a can of body spray lodged in a
patients rectum. Throughout the entire
operation, the staff were seen to laugh and
jeer, and several of them exclaimed, baby
out! when the spray can was finally
removed. The hospital apparently asked
the patients permission to take the video of
the unusual case, and the patient agreed.
47
7/30/14
CASE 4
Several sex videos found their way in
the internet showing a physician
having sex with various female
partners. Videos were apparently
taken without the knowledge and
consent of the women, some of whom
were his patients. Immorality
complaints were filed against the
physician before the Professional
Regulations Commission.
48
7/30/14
THANK YOU
49