MT6313 RA7170 & RA9288 Flashcards
What RA is Newborn Screening Act of 2004?
RA 9288
procedure to find out if a baby has a congenital disorder that may lead to mental retardation or even death if left untreated.
Newborn Screening (NBS)
Why is Newborn Screening (NBS) important?
Most babies with metabolic disorders look “normal” at birth. By doing NBS, metabolic disorders may be detected even before clinical signs and symptoms are present. As a result of this, treatment can be given early to prevent consequences of untreated conditions.
What are some of the inborn errors of metabolism?
Organic Acid Disorders
Endocrine DIsorders
Fatty Acid Oxidation Disorder
Hemoglobinopathies
Urea Cycle Defect
Amino Acid Disorders
What was integrated as part of the country’s public health delivery system with the enactment of the Republic Act no. 9288 otherwise known as Newborn Screening Act of 2004?
The Comprehensive Newborn Screening (NBS) Program
________ acts as the lead agency in the implementation of the law and collaborates with _______ to ensure early detection and management of several congenital metabolic disorders.
The Department of Health (DOH)
other National Government Agencies (NGA) and key stakeholders
Newborn screening program in the Philippines currently includes screening of six disorders, which are?
- congenital hypothyroidism (CH)
- congenital adrenal hyperplasia (CAH)
- phenylketonuria (PKU)
- glucose-6-phosphate dehydrogenase (G6PD) deficiency
- galactosemia (GAL)
- maple syrup urine disease (MSUD)
POLICIES AND LAWS in RA7170?
▪ Republic Act No. 9288 or the Newborn Screening Act of 2004
▪ Administrative Order No. 2018-0025: National Policy and Strategic Framework on Expanded Newborn Screening for 2017-2030
▪ Administrative Order No. 2014-0045 or the Guidelines on the Implementation of the Expanded Newborn Screening Program
The expanded screening will include 22 more disorders, some of which are?
▪ hemoglobinopathies and
▪ additional metabolic disorders, namely, organic acid, fatty acid oxidation, and amino acid disorders.
The RA 9288 defines the establishment and accreditation of?
Newborn Screening Centers (NSC).
What are the six operational NSCs in the country?
NIH at the University of the Philippines Manila
Visayas located at West Visayas State University Medical Center, Iloilo City
Mindanao located at the Southern Philippines Medical Center, Davao City
Central Luzon in Angeles City, Pampanga (Angeles University Foundation & Medical Center)
Southern Luzon in Tanauan City, Batangas (Daniel Mercado Medical Center)
Northern Luzon in Batac City, Ilocos Norte (Mariano Marcos Memorial Hospital & Medical Center)
When is NBS done?
ideally done immediately after 24 hours from birth
How is NBS done?
A few drops of blood are taken from the baby’s heel, blotted on a special absorbent filter card and then sent to Newborn Screening Center (NSC).
Who will collect the sample for NBS?
physician, nurse, medical technologist or trained midwife.
What proclamation was associated with Declaring the 1st Week of October of Each Year as “National Newborn Screening Week”?
Proclamation No. 540 dated January 20, 2004
When is “National Newborn Screening Week”?
1st Week of October
Proclamation No. 540 dated January 20, 2004 was approved by?
President Gloria Macapagal-Arroyo
How many sections in 9288?
19
9288 approved by? And on?
President Gloria Macapagal-Arroyo
April 7, 2004
RA 9288 title?
“Newborn Screening Act of 2004“
Section 2 of 9228 is?
❑ Section 2 – Declaration of Policy
What is the Declaration of Policy of 9288?
State shall institutionalize a national newborn screening system that is comprehensive, integrative and sustainable, and will facilitate collaboration among government and non-government agencies at the national and local levels, the private sector, families and communities, professional health organizations, academic institutions, and non-governmental organizations.
National Newborn Screening System shall ensure that every baby born in the Philippines is offered the opportunity to undergo newborn screening and thus be spared from heritable conditions that can lead to mental retardation and death if undetected and untreated.
What is the title of section 3 of 9288?
Objectives
What are the objectives of 9288?
- To ensure that every newborn has access to newborn screening for certain heritable conditions that can result in mental retardation, serious health complications or death if left undetected and untreated
- To establish and integrate a sustainable newborn screening system within the public health delivery system
- To ensure that all health practitioners are aware of the advantages of newborn screening and of their respective responsibilities in offering newborns the opportunity to undergo newborn screening; and
- To ensure that parents recognize their responsibility in promoting their child’s right to health and full development, within the context of responsible parenthood, by protecting their child from preventable causes of disability and death through newborn screening.
What is section 4 title of 9288?
Definition
What is section 5 title of 9288?
Obligation to Inform
What is the Obligation to Inform?
Any health practitioner who delivers, or assists in the delivery, of a newborn in the Philippines shall, prior to delivery, inform the parents or legal guardian of the newborn of the availability, nature and benefits of newborn screening
What is section 6 title of 9288?
Performance of Newborn Screening
NBS shall be performed after _____ of life but not later than ________ of the newborn
twenty-four (24) hours
three (3) days from complete delivery
_____________ in order to ensure survival may be exempted from the 3-day requirement but must be tested by ________ of age.
Newborn that must be placed in intensive care
seven (7) days of age
What is needed to ensure that newborn screening is performed?
joint responsibility of the parent(s) and the practitioner or other person delivering the newborn
What is the title of section 7 of 9288?
Refusal to be Tested
T or F: A parent or legal guardian may refuse testing
T
When can a parent or legal guardian refuse testing?
on the grounds of religious beliefs
How should parents who refuse testing acknowledge their understanding that refusal for testing places their newborn at risk for undiagnosed heritable conditions?
In writing
What is the title of section 8 of 9288?
Continuing Education, Re-education and Training Health Personnel
The DOH, with the assistance of the NIH and other
government agencies, professional societies and non-
government organizations, shall?
- conduct continuing information, education, re-education and training programs for health personnel on the rationale, benefits, procedures of newborn screening; and
- disseminate information materials on newborn screening at least annually to all health personnel involved in material and pediatric care
What is the title of section 9 of 9288?
Licensing and Accreditation
Who shall require health institutions to provide newborn screening services as a condition for licensure or accreditation?
The DOH and the Philippine Health Insurance Corporation
What is the title of section 10 of 9288?
Lead Agency
Who is the lead agency in implementing RA 9288?
DOH
For purposes of achieving the objectives of this RA 9288, the DOH shall?
- Establish the Advisory Committee on Newborn Screening
- Develop the implementing rules and regulations for the immediate implementation of a nationwide newborn screening program within one hundred eighty (180) days from the enactment of this Act;
- Coordinate with the Department of the Interior and Local Government (DILG) for implementation of the newborn screening program;
- Coordinate with the NIH Newborn Screening Reference Center for the accreditation of Newborn Screening Centers and preparation of defined testing protocols and quality assurance programs.
What is the title of section 11 of 9288?
Advisory Committee on Newborn Screening
What is the purpose of the Advisory Committee on Newborn Screening?
To ensure sustained inter-agency collaboration, the Advisory Committee on Newborn Screening is hereby created and made an integral part of the Office of the Secretary of the DOH
To review annually and recommend conditions to be included in the newborn screening panel of disorders;
To review and recommend the newborn screening fee to be charged by Newborn Screening Centers;
To review the report of the Newborn Screening Reference Center on the quality assurance of the National Screening Centers and
To recommend corrective measures as deemed necessary.
How many members and who in the Advisory Committee on Newborn Screening?
8
o Secretary of Health - Chairman
o Executive Director of the NIH - Vice Chairperson
o Undersecretary of the DILG
o Executive Director of the Council for the Welfare of Children
o Director of the Newborn Screening Reference Center
o three (3) representatives appointed by the Secretary of Health who shall be a pediatrician, obstetrician, endocrinologist, family physician, nurse or midwife, from either the public or private sector
According to Section 11 – Advisory Committee on Newborn Screening of RA 9288, The three (3) representatives shall be appointed for a term of ___ years, subject to their being reappointed for additional ____ years period for each extension.
3; 3
What is the title of section 12 of 9288?
Establishment and Accreditation of Newborn Screening Centers
According to Section 12 of RA 9288, Newborn Screening Centers shall have what facilities, services, and personnel?
- have a certified laboratory performing all tests included in the newborn screening program,
- have a recall/follow up programs for infants found positive for any and all of the heritable conditions;
- be supervised and staffed by trained personnel who have been duly qualified by the NIH; and
- submit to periodic announced or unannounced inspections by the Reference Center in order to evaluate and ensure quality Newborn Screening Center performance.
What is the title of section 13 of 9288?
Establishment of a Newborn Screening Reference Center
The ___ shall establish a Newborn Screening Reference Center, which shall be responsible for the _______, ________, ________ for laboratory staff in all Newborn Screening Centers
NIH
national testing database and case registries, training, technical assistance and continuing education
What is the title of section 14 of 9288?
Quality Assurance
The NIH Newborn Screening Reference Center shall be responsible for?
- drafting and ensuring good laboratory practice standards for newborn screening centers,
- establishing an external laboratory proficiency testing and certification program.
- act as the principal repository of technical information relating to newborn screening standards and practices,
- provide technical assistance to newborn screening centers
What is the title of section 15 of 9288?
Database
According to Section 15, who shall maintain a national database of patients tested and a registry for each condition?
NIH Newborn Screening Reference Center
According to section 15, the NIH should also submit reports to who, about what, and how often?
To Committee and to the DOH
About the status of and relevant health information derived from the database
Annually
In section 15, the NIH also plans for?
long-term outcome evaluation of newborn screening
What is the title of section 16 of 9288?
Newborn Screening Fees
For the newborn screening fees, this will be divided and set aside for?
at least four percent (4%) to the DOH’s Centers for Health Development or its future equivalent to be spent solely for follow-up services, education and other activities directly related to the provision of newborn screening services
at least four percent (4%) to the Newborn Screening Centers for human resource development and equipment maintenance and upgrading
at least four percent (4%) to the NIH Newborn Screening Reference Center for overall supervision, training and continuing education, maintenance of national database, quality assurance program and monitoring of the national program
and the balance for the operational and other expenses of the Newborn Screening Center
What is the title of section 17 of 9288?
Repealing Clause
What is the title of section 18 of 9288?
Separability Clause
What is section 19 of 9288?
Effectivity Clause
What is AN ACT AUTHORIZING THE LEGACY OR DONATION OF ALL OR PART OF A HUMAN BODY AFTER DEATH FOR SPECIFIED PURPOSES?
Republic Act No. 7170
What is the rationale of 7170?
to protect the rights of both donor and recipient from any unethical or illegal practice such as human trafficking and selling of organs for money
What is the significance of 7170?
to authorize and regulate the legacy or donation of human body or its parts after death or a specified condition thereby securing the safety of the recipient and providing means for transfer.
How many sections in 7170?
19
When was 7170 approved?
January 7, 1992
Who approved 7170?
President Corazon C. Aquino
What repeals 7170?
RA7885– Corneal Transplantation
Section 1: Title of 7170 is?
“Organ Donation Act of 1991.”
Title of Section 2 of 7170?
Definition of Terms
What is a facility licensed, accredited or approved under the law for storage of human bodies or parts thereof?
Organ Bank Storage Facility
What is an individual who makes a legacy of all or part of his body?
Testator
What is a deceased individual, and includes a still born infant or fetus?
Decedent
What is an individual authorized under this Act to donate all or part of the body of decedent?
Donor
What is the irreversible cessation of circulatory and respiratory functions or the irreversible cessation of all functions of the entire brain, including the brain stem?
Death
In the opinion of the _______, based on the ________, there is an absence of ________ and, attempts resuscitation would not be successful in restoring those functions. In this case, death shall be deemed to have occurred at the time these function ceased.
attending physician
acceptable standards of medical practice
natural respiratory and cardiac function
In the opinion of the _______, concurred in by the _______, that on the basis of acceptable standards of medical practice, there is an _________; and considering the absence of such functions, furthers attempts at resuscitation or continued supportive maintenance would not be successful in restoring such natural functions. In this case, death shall be deemed to have occurred at the time when these conditions first appeared.
consulting physician
attending physician
irreversible cessation of all brain functions
Who is considered as Immediate Family of the decedent?
1) Spouse;
2) Son or Daughter of legal age;
3) Either parent;
4) Brother or sister of legal age;
5) Guardian over the person of the decedent at the time of his death
What is a gift; something transmitted; bequeathed?
LEGACY
Who is the LEGACY bequeathed to (refers to an heir or recipient of a gift)?
LEGATEE OR DONEE
What is the process of administering an estate?
PROBATE (OF THE WILL)
What is the title of section 3 of 7170?
Person Who May Execute Legacy
Who May Execute Legacy?
Any individual, at least eighteen (18) years of age and of sound mind , may give by way of legacy, to take effect after his death, all or part of his body for any purpose specified in [ Section 6 hereof – Persons who may become Legatees or Donees].
What is the title of section 6 of 7170?
Person Who May Execute a Donation
Who are the People Who May Execute a Donation? (by order of priority)
1) Spouse;
2) Son or Daughter of legal age:
3) Either parent;
4) Brother or sister of legal age;
5) Guardian over the person of the decedent at the time of his death.
In what circumstances can a person execute a donation?
In the absence of actual notice of contrary intentions by the decedent or actual notice of opposition by the member of the immediate family of the decedent, may donate all or any part of the decedent’s body
In section 4 of 7170, The person authorized by subsection (a) of this section may make donation when?
after or immediately before his death.
What is the title of section 5 of 7170?
Examination of Human Body or Part thereof
In section 5 of 7170, A legacy or donation of all or part of a human body authorizes?
any examination necessary to assure medical acceptability of the legacy or donation for the purpose(s) intended.
For purposes of this Act, ______ shall be conducted on the cadaver of accident, trauma, or other medico-legal cases _______, to ______ and/or to ______.
an autopsy
immediately after the pronouncement of death
determine qualified and healthy human organs for transplantation and/or in furtherance of medical science .
What is the title of section 6 of 7170?
Persons Who May Become Legatees or Donees.
Who are the Persons Who May Become Legatees or Donees?
(a) Any hospital, physician or surgeon.
(b) Any accredited medical or dental school, colleges or university.
(c) Any organ bank storage facility.
(d) Any specified individual .
Identify the type of legatee: for medical or dental education, research, therapy, or transplantation
Any organ bank storage facility.
Identify the type of legatee: For therapy or transplantation needed by him.
Any specified individual .
Identify the type of legatee: For education,
research, advancement of medical or dental science or therapy
Any accredited medical or dental school, colleges or university
Identify the type of legatee: For medical or dental education, research, advancement of medical or dental science, therapy or transplantation
Any hospital, physician or surgeon
What is the title of section 7 of 7170?
Day of Hospitals
According to section 7 of 7170, A hospital authorized to receive organ donation or to conduct transplantation shall?
train qualified personnel and their staff to handle the task of introducing the organ donation program
In section 7 of 7170, how should a hospital train their staff to introduce the organ donation program?
in a humane anddelicate manner to the relatives
In section 7 of 7170, The hospital shall accomplish the _______ as ________ with the training of the staff.
necessary form or document as proof of compliance
What is section 8 of 7170?
Manner of Executing a Legacy.
According to section 8 of 7170, Legacy of all or part of the human body under Section ___ hereof maybe made by_____. The legacy becomes effective upon the death of the testator without _______
3
will
waiting for probate of the will
In section 8 of 7170, if the will is not probated , or it is a declared invalid for testamentary purposes, to the extent that it was _______, is nevertheless _________.
executed in good health, is nevertheless valid and effective.
In 7170, A legacy of all part of the human body under Section 3 hereof may also be made in any document other than the will. The document, which maybe _________, must be signed by _______________.
a card or any paper designed to be carried on a person
he testator in the presence of two witnesses who must sign the document in his presence.
In section 8 of 7170, If the testator cannot sign, the documents may be _________, ___________.
signed for him at his direction and in his presence
in the presence of two witnesses who must, likewise, sign the document in the presence of the testator
T or F: In RA7170, delivery of the document of legacy during the testator’s lifetime is not necessary to make the legacy valid.
T
T or F: The legacy may be made to specify the legatee or
without specifying the legatee.
T
In section 8 of 7170, If the legacy is made to specify a legatee who is not available at the time and place of the testator’s death , the _____________, in the absence of any expressed indication that the testator desired otherwise, may accept the legacy as legatee.
attending physician or surgeon
In section 8 of 7170, If the legacy does not specify a legatee , the legacy may be accepted by the __________ upon or following the testator’s death.
attending physician or surgeon as legatee
The physician may become a legatee under this subsection shall not participate in?
the procedures for removing or transplanting. a part or parts of the body as decedent .
What should the testator designate in his will, card or other document?
the surgeon or physician who will carry out the appropriate procedures.
In the absence of the designation, or if the designee is not available, who may authorize any surgeon or physician for the purpose of executing legacy?
legatee or other persons authorized
What is the title of section 9 of 7170?
Manner of Executing a Donation.
In section 9 of 7170, any donation by a person authorized
under subjection (a) of Section ____
hereof shall be sufficient if it complies
with the formalities of a donation of a
movable property.
4
In the absence of any of the person specified under Section 4 hereof and in the absence of any document of organ donation ,________ in charge of ______________
the physician
the patient, the head of the hospital or a designated officer of the hospital
__________ may authorize in a public document the removal from such body for the purpose of transplantation of the organ to the body of a living person
Who has custody of the body of the deceased classified as accident, trauma, or other medico-legal cases,
Provided, that the ___________ has exerted reasonable efforts, within________, to locate the nearest relative [listed in Section 4 hereof] or guardian of the decedent at the time of death.
physician, head of hospital or officer designated by the hospital for this purpose
forty-eight (48) hours
In all donations, the death of a person from whose body of an organ will be removed after his death for the purpose transplantation to a living person, shall be ______ and ________ by _______________
diagnosed separately and certified
two (2) qualified physicians
Transplantation to a living person, shall be diagnosed separately and certified by two (2) qualified physicians NEITHER OF WHOM SHOULD BE?
(a) A member of the team of medical
practitioners who will effect the removal of the organ from the body; NOR
(b) The physician attending to the recipient of the organ to be removed; NOR
(c) The head of hospital or the designated officer authorizing the removal of the organ.
What is the title of section 10 of 7170?
Person(s) Authorized to Remove Transplantable Organs.
Who is able to remove and/or transplant any organ which is authorized to be removed and/or transplanted pursuant to Section ____?
authorized medical practitioners in
a hospital
5 hereof– [Examination of Human Body or Part Thereof] .
What is section 11 of 7170?
Delivery of Document of Legacy or Donation
If the legacy or donation is made to a _______ , ______, may be delivered by the ______ , to the legatee or donee to expedite the appropriate procedures immediately after death.
specified legatee or donee
the will, card or other document, or an executed copy thereof
testator or donor, or his authorized representative
________, may be deposited in any ________ that accepts it for safekeeping or for facilitation or procedures after death.
The will, card or other document, or an executed copy thereof,
hospital or organ bank storage facility
On the other request of any interested party upon or after the testator’s death, ________ shall produce _____________ for verification.
the person in possession
the document of legacy or donation for verification.
What is section 12 of 7170?
Amendment or Revocation of Legacy or Donation.
In section 12 of 7170, if the will, card or other document, or an executed copy thereof, has been delivered to a specific ________, the ________ may ______________
legatee or donee
testator or donor
amend or revoke the legacy or donation
In section 12 of 7170, the testator or donor may amend or revoke the legacy or donation either by?
(1) The execution and delivery to the legatee or donee of signed statement to that effect; or
(2) An oral statement to that effect made in the presence of two or other persons and communicated to the legatee or donee ; or
(3) A statement to that effect during a terminal illness or injury addressed to an attending physician and communicated to the legatee or donee ; or
(4) A signed card or document to that effect found on the person or effects of the testator or donor.
_______, which has not been delivered to the legatee or donee may be _______ by _______ in the manner provided in the subsection ____ of this Section or by ____________ thereof.
Any will, card or other document, or an executed copy thereof,
revoked by the testator or donor
(a)
destruction, cancellation or mutilation of the document and all executed copies
Any _____ made by a will also be _____ or _______ in the manner provided for amendment or revocation of wills, or as provided in subsection (a) of this Section.
legacy
amended or revoked
What is the title of section 13 of 7170?
Rights and Duties after Death.
T or F: The legatee or donee may accept or reject the legacy or donation as the case may be.
T
If the legacy or donation is ______, the _______, upon the death of testator and prior to embalming, shall _____________.
a part of the body
legatee or donee
effect the removal of the part, avoiding unnecessary mutilation.
In section 13 of 7170, after removal of the part, custody of the remainder of the body vests in who?
in the surviving spouse, next of the kin or other persons under obligation to dispose of the body of the decedent.
Any ________ in accordance with the terms of this Act __________ in any civil action or subject to prosecution in any criminal proceeding of this Act.
person who acts in good faith
shall not be liable for damages
What is the title of section 14 of 7170?
International Sharing of Human Organs or Tissues.
Sharing of human organs or tissues shall be made only through?
exchange programs duly approved by the Department of Health
In section 14 of 7170, _________ grant reciprocal rights to their Philippine counterparts to _______.
foreign organs or tissue bank storage facilities and similar establishments
draw human organs or tissues at any time.
What is section 15 of 7170 called?
Information Drive
In order that the public will obtain the maximum benefits from this Act, the ______, in cooperation with institutions, such as the ___________, SHALL UNDERTAKE A _________.
Department of Health
National Kidney Institute, civic and non- government health organizations and other health related agencies, involved in the donation and transplantation of human organs
PUBLIC INFORMATION PROGRAM.
In section 15 of 7170, _________, after consultation with all health professionals, both government and private, to make an _________.
The Secretary of Health
appeal to human organ donation.
What is section 16 of 7170 called?
Rules and Regulations
What does section 16 of 7170 state?
The Secretary of Health, after consultation with all health professionals, both government and private, and non-government health organizations shall promulgate such rules and regulations as may be necessary or proper to implement this Act.
What is SEC. 19. Effectivity?
This Act shall take effect after fifteen (15) days following its publication in the Official Gazette or in at least two (2) newspapers of general circulation.
When was RA 7170 approved?
January 7, 1992
RA 7785 is named?
AN ACT TO ADVANCE CORNEAL TRANSPLANTATION IN THE PHILLIPINES
How many sections RA 7885?
6
When was 7885 approved?
February 20, 1995
Who approved 7785?
President Fidel V. Ramos
What does section 1 of 7170 amend in 7170?
SECTION 9: Manner of Executing a Donation
In section 1 of 7785, it renews section 9 of 7170:
The said _________ of any government agency which has custody of such body may authorize the removal of the cornea or corneas of the decedent within _____ and upon the request of ___________
physician, head or designated officer of the hospital, or the medico-legal officer
twelve ( 12 ) hours after death
qualified legatees or donees for the sole purpose of transplantation
In section 1 of 7785, it renews section 9 of 7170:
Provided, That such removal of the cornea or corneas will ________ by such means as placing eye caps after the said cornea or corneas have been removed.
not interfere with any subsequent investigation or alter the post- mortem facial appearance of the decedent
What section of 7170 does section 2 of 7785 amend?
Section 2: Amendment to Section 10 ( Person (s) Authorized to Remove and Transplant Organs and Tissues) of RA 7170
In Section 2: Amendment to Section 10 of RA 7170:
Provided , however , that the removal of corneal tissues shall be performed only by ____________ of such procedure and duly certified by ________
ophthalmic surgeons and ophthalmic technicians trained in the methodology
the accredited National Association of Ophthalmologists.”
What is section 3 of 7785?
IRR
What is section 4 of 7785?
Separability Clause
What is section 5 of 7785?
Repealing Clause
What is section 6 of 7785?
Effectivity
When was 7785 approved and by whom?
Approved: February 20, 1995
President Fidel V. Ramos
