Patient-Physician Relationship, Patient's rights, PRC, Practice of Med, Liabilities of Physician Flashcards
[Inherent Rights of a physician]
- To choose patients
- To limit practice
- Determine the appropriate management procedures
- Avail of hospital services
What are the incidental rights of a physician?
- Right of way while responding to call of emergency
- Right of exeption from execution of instruments and library
- TO hold certain public or private offices
- Right to compensation
- Right to membership in medical society
- Right to perform certain services
Way Execute, Public, Compensation, Membership, Services
What traffic rules can you violate
- Beating the red light
2. Swerving
PMA membership is ____ (voluntary/involuntary)
Voluntary
What law governs the medical practice of medical profession in the Philippines?
Medical act of 1959
[Law which is not enforced by the state]
guidance of human conduct discovered by rational thinking
natural law
[Law which is not enforced by the state]
followed to make one be closer to his creator
Divine law
[Law which is not enforced by the state]
enforceable by the dictate of conscience to be the right conduct
Moral law
[Law enforced by the state: as to purpose]
___ the rights and obligations of persons in their daily relation with each other and with society
substantive law
[Law enforced by the state: as to purpose]
Law on property and property rights
Substantive law
[Law enforced by the state: as to purpose]
mechanical rules that govern the means by which substantive rights and duties are enforced
Procedural law
[Law enforced by the state: as to purpose]
law on criminal procedure
Procedural law
[Law enforced by the state: subject matter]
concerned with the state in political and sovereign capacity
Public law
[Law enforced by the state: subject matter]
law that are punished as offenses agains the state or government
Criminal Law
[Law enforced by the state: subject matter]
regulates relationship and intercourse of the nations
International law
[Law enforced by the state: subject matter]
governs the science of politics
Political law
[Law enforced by the state: subject matter]
concerns with the definition, regulation, and enforcement of right in his relation with other persons
Private law
The right to regulate practice of medicine is based on the ____
Police power of state
The physician-patient relationship is ___, ____, ____
Contractual
Consensual
Fiduciary
[Contractual Relations]
____ the nature of the medical service to be given is stated orally or in writing
Expressed contract
[Contractual Relations]
the existence of the contract can be inferred from the acts of the contracting parties
Implied contract
What are the elements needed for a contract to be valid?
- Consensual and fiduciary
- Must contain the subject matter
- Must contain cause or consideration
Instances where there is no MD-Patient relationship
- Pre-employment PE
- Eligibility for insurance
- Performing an autopsy
- Casual question
[Psychological patterns of MD-Patient Relationship]
When patient is unconscious
Activity-passivity relation
[Psychological patterns of MD-Patient Relationship]
patient is conscious, seeks hep and ready and willing to cooperate
Guidance-cooperation relation
[Psychological patterns of MD-Patient Relationship]
MD feels patient is uncooperative while patient feels MD is unsympathetuc
Mutual participation relation
[Psychological patterns of MD-Patient Relationship]
patient thinks that he is juridically equal tot he MD and that the nature of relationship is on a negotiated agreement
Mutual participation relation
What are the duties and obligations imposed on the physician
- Possess the knowledge and skill
- Use skill and knowledge with ordinary care and diligence
- Exercise best judgement
- Duty to observe utmost good faith
The patient-physician relationship maybe terminated by ___
physician or the patient
[Liabilities of a physician]
What is the bases for criminal cases for MDs
Revised penal code (article 365)
[Liabilities of a physician]
act or omission of MD constitute a crime
Criminal case
“people of the Philippines vs ___”
[Liabilities of a physician]
Needed for conviction in a criminal case
Guilt beyond reasonable doubt
Penalty: prison/fine
[Liabilities of a physician]
What are the bases for a civil case?
Civil Code 19, 20, 21, 2176
Family code
[Liabilities of a physician]
are premised on recovery of damages for their wrongful act
civil case
Plaintiff vs Defendant
[Liabilities of a physician]
what are the bases for an administrative case?
- Medical Act of 1959
2. Code of Ethics
[Liabilities of a physician]
what is the needed item to convict a physician for civil charges
preponderance of evidence
[Liabilities of a physician]
what is the needed item to convict a patient for administrative cases?
Substantial evidence
What are the 3 types of liabilities of physician?
Civil, criminal, administrative
[Doctrine]
___ responsibility of the person who is not negligent for the wrongful conduct or negligence of another
Doctrine of Vicarious Liability
AKA doctrine of respondeat superior
[Element of Doctrine of Vicarious Liability]
pathologist, radiologist, anesthesiologist
Doctrine of Ostensible agent
Ostensible = appearing to be true but not true
[Element of Doctrine of Vicarious Liability]
Employees of the hospital are sometimes temporarily under the supervision and control of another
Borrowed Servant Doctrine
consultant = not an employee = independent contractor
[Element of Doctrine of Vicarious Liability]
the head surgeon is responsible for anything that will go wrong in the four corners of the OR
Captain of the ship doctrine
[Doctrine]
the thing speaks for itself
Doctrine of Res Ipsa Loquitor
What are the element of Doctrine of Res ipsa loquitor?
- The event doesnt normally occur unless someone has acted negligently
- The evidence rules out the possibility that the actions of the plaintiff or a third party caused the injury
- The negligence in question falls with the scope of the defendant’s duty to the plaintiff
What are the instances where the Doctrine of Res Ipsa Loquitor does not apply?
- If doctrine of calculated risk is applicable
- Bad result rule
- Honest error in judgement
- Mistakes in the diagnosis
[Doctrine]
conduct on the part of plaintiff to cause legal cause to the harm he has suffered
Doctrine of Contributory Negligence / Doctrine of Common Fault
[Doctrine]
MD has a superior knowledge over his patient
Doctrine of Superior Knowledge
[Doctrine]
MD after a prolonged treatment of the patient which normally produces alleviation of the condition, fails to investigate non-response
Doctrine of Continuing Negligence
[Doctrine]
anyone who consents to the application of a procedure involving certain risks cannot recover damages for injury resulting from inherent or ordinary risk in the procedure
doctrine of assumption of risk
[Doctrine]
a physician has the chance to avoid the damage or injury to his patient but negligently fails to do so. Physician in liable
Doctrine of last clear chance
[Doctrine]
physician cannot be held liable for negligence if the injury sustained by the patient is on account of unforseen conditions
Doctrine of forseeablility
[Doctrine]
Employee was injured on account of the negligence of his fellow employee, the employer cannot be held liable
Fellow Servant Doctrine
[Doctrine]
If a physician who went to rescue a victim of an accident was injured, the original wrongdoer must be held liable for such injury
Rescue doctrine
[Rescue Doctrine]
injury suffered by patient is attributed to the wrongful act of a person
“referral cases”
sole responsibility
[Rescue Doctrine]
if there is wrongful act of 2 or more persons
“Co-management cases”
Shared responsibility
[Immunity from suit doctrines]
contributions or donations to a hospital cannot be made available for payment damages
Trust Fund Doctrine
[Immunity from suit doctrines]
a service patient cannot sue a government hospital
Public Policy Theory
[Immunity from suit doctrines]
Charity patient upon admission to a private charitable hospital impliedly waives his or her right to claim for damages
Implied Waiver Theory
[Immunity from suit doctrines]
Consultants are liable for the mistake of the trainee
Independent Contractor Theory
____ are pecuniary compensations that may be recovered for an injury sustained or from breach of some duty
Pecuniary compensations
General Damages refer to
- Death
- Physical disability
- Loss of earning capacity
- Loss of service of the spouse
- Loss of support
Special damages refer to
- Natural but not a consequence of the accident in question
- Past and future medical, surgical, related costs
- Past and future loss of income
- Expenses for hiring a substitute
- Funeral expenses
- Unusual physical or mental consequences
___ damages
physical suffering, mental anguish, fright, serious anxiety, besmirched reputation, wounded feelings, moral shock, social humiliation
Moral damages
What are the conditions for award of moral damages?
- There must be injury
- There must be a culpable act
- Wrong doing act is the proximate cause of the injury
What are the methods utilized to determine how much damage must be assessed for pain and suffering
- Per diem method
2. Golden rule method
What is the bases for the exemplary or corrective damages?
Civil code Article 2219, 2233
[Damages]
Trifling sum awarded to the plaintiff in an action where there is no substantial loss or injury
Nominal damages
[Damages]
Those agreed by the parties to a contract to be pain in case of breach thereof; “nakasulat sa kontrata”
Liquidated damage
[Damages]
more than nominal bu less than compensatory damages; recovered when the suit finds that some pecuniary loss has been suffered
Temperate or moderate damage
[Reckless vs Simple Imprudence]
voluntarily but without malice; implies a failure in precaution or a failure to take the necessary precaution
Reckless Impridence
What are the elements of reckless imprudence
- Offender does not fail to take necessary precaution
- Doing or the failure to do an act is voluntary
- Without malice
- Material damage results
- Inexcusable lack of precaution on the part of the offender
[Reckless vs Simple Imprudence]
lack of precaution displayed; damage impending to be caused is not immediate nor the danger clearly manifest
Simple imprudence
What are the elements of simple imprudence?
- lack of precaution on the part of the offender
2. Damage impending to be caused is not immediate
___ body of rights, obligations, and remedies that is applied by courts in civil proceedings to provide relief for persons who have suffered harm from the wrongful acts of others
Tort
What are the rights of patients
- To give consent to diagnostic and treatment procedures
- Right to religious belief
- Right of privacy or confidentiality
- To disclosure of information
- To confidential information
- To choose his MD
- Right of treatment
- Refuse necessary treatments
What are the two types of consent
- Expressed
2. Implied consent
What are the contents of a written consent?
- Name of MD
- Nature and extent of the diagnostic or treatment procedure
- Nature, extent and limitations
- statement that MD is given the authority to do any procedure which may be deemed necessary
- Signature of patient and witness
What are the scope of consent
- General Consent
- Limited consent
- Non-liability or exculpatory cause in the consent
[Scope of consent]
___ gives the MD unlimited authority and discretion to apply any procedure
General or blanket
Does not relieve the MD of liability from negligence
[Scope of consent]
consent to certain medical procedure
Limited/conditional consent
[Scope of consent]
part of the consent for the purpose of making the patient assume the risk of the operation
Non-liability or exculpatory clause in the consent
Who are the people who can give consent?
- Patient
- Spouse
- Descendants
- Ascendants
- Collaterals (Siblings)
- Legally appointed guardian
___ doctrine when the state or government gives consent to theperson
Doctrine of parents patria
If the patient is less than 18 years old, consent will be obtained from
- Parents
- Paternal grandparents
- Maternal grandparents
- Eldest
- Guardians
- Teachers and Professors
- Heads of children’s homes
- Directors of trade establishments
If the child is legitimate, who shall give consent (father/mother)?
The father takes precedence over the mother in giving consent
If the child is illlegitimate or less than 7 years old, who shall give consent (Mother/fatehr)?
mother takes precedence over the father
The last resort in giving consent
court of law
