PHYSICIAN-PATIENT
RELATIONSHIP
Atty. Misheena Joyce C. Tiatco Contoso
13 December 2019 Pharmaceuticals
page 1
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A physician-patient relationship is formed
when a patient engages the services of a
physician. (Lucas v. Tuaño, G.R. No. 178763, 586
SCRA 173, 200, Apr. 21, 2009.)
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page 2
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Four (4) elements of medical negligence:
(1) duty;
(2) breach;
(3) injury; and
(4) proximate causation.
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FIRST ELEMENT:
By accepting a case, the doctor or hospital
commenced the duty to render medical service
in favor of the patient in accordance with the
expected training and skill of a medical
practitioner
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The second element of breach is present when the
hospital or doctor does treatment in breach of
professional duties. An example of this would be a
doctor that applies treatment without consulting the
patient’s history. It is a standard operating procedure
for all doctors to apprise themselves about the
medical history of a person before they decide on
taking him/her as a patient. This process is necessary
so that the doctor can gauge whether he/she is
capable of successfully helping the patient and also
for the doctor to make the proper preparations and Contoso
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decisions with respect to how to treat said patient. page 5
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Section 2. A physician is free to choose whom he will
serve. He may refuse calls, or other medical services
for reasons satisfactory to his professional conscience.
He should, however, always respond to any request
for his assistance in an emergency. Once he
undertakes a case, he should not abandon nor neglect
it. If for any reason he wants to be released from it, he
should announce his desire previously, giving sufficient
time or opportunity to the patient or his family to
secure another medical attendant.
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The presence of the third element arises where
injury, liability or even death arises as a
consequence of a negligent medical treatment
or procedure.
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page 7
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The last element to establish medical malpractice or
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medical negligence, is however, the most difficult
one to prove. Medical procedures are fraught with
varying consequences, and affected by innumerable
factors such as the environment, personal health,
health of the other members of the family, food
intake, medicine, activities of the patient, such that
it would be difficult to establish, to a convincing
degree, whether the injury is the proximate result or
directly arose from the procedure conducted.
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page 8
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The doctrine of res ipsa loquitur, which directly
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translates to “the thing speaks for itself”, governs
cases where negligence is clear by a simple
examination of the injury or the circumstances
surrounding the medical treatment given, such as
where a gauze or a pair of scissors are left inside the
body cavity after it has been sutured, or blood of a
different type is infused to a patient.
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page 9
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Captain of the Ship Doctrine
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the operating surgeon is the person in complete
charge of the surgery room and all personnel
connected with the operation
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LIABILITIES OF
PHYSICIAN
Atty. Misheena Joyce C. Tiatco
13 December 2019
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LIABILITIES OF PHYSICIANS
1.Administrative -- revocation of
license
2.Criminal -- imprisonment
3.Civil -- monetary compensation
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Sources of Liabilities of M.D.:
1.Ethics of the Medical Profession in the
Philippines
2.Medical Act of 1959 as amended
3.Civil Code
4.Revised Penal Code
5.Special laws
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Characteristics:
1.Filed with the PRC (PMA for ethical misconduct)
2.In writing and under oath
3.Must set forth distinctly, clearly and concisely the charge
4.In six copies
5.Proof needed is convincing evidence
6.Penalty imposable is reprimand or suspension or revocation of
license
7.Rights of the accused
8.30 days reglamentary period.
9.Decision appealable to the PRC, then to the Office of the President
10. Reinstatement of license after 2 years
*Perjury can be filed against you if you are proven to have lied under Contoso
oath Pharmaceuticals
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Characteristic of Criminal case:
1.In the name of the People of the Philippines
2.Filed and tried in court
3.Instituted by filing a complaint or information with the fiscal’s
office
4.Filed by the offended party, any peace officer or other public
officer charged with the enforcement of the law violated
5.Right to bail
6.Proof beyond reasonable doubt
7.Penalty imposable is imprisonment and/or fine
8.Revocation of license if the law provides or if the crime involved
moral turpitude
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Provisions where M.D. are specifically mentioned:
1.Issuance of False medical Certificates (Art. 174, RPC)
2.Abortion (Art. 259, RPC)
3.Simulation of Births, substitution of one child for another,
and concealment or abandonment of a legitimate child (Art.
347, RPC)
4.Failure to report treatment of physical injuries (P.D. 169)
5.Refusal to render treatment in emergency cases (R.A. 6615)
6.Reporting cases of maltreated or abused children (P.D.603)
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Liabilities incidental to the practice of medicine:
1.Criminal negligence and imprudence (Art. 365, RPC)
2.Violation of the Comprehensive Dangerous Drugs
Act of 2002 (R.A.9165)
3.Violation of Pharmacy Law (R.A. 5921 as amended)
4.Liability in the issuance of Birth and death
certificates
5.Defamation (Art. 353 & 359, RPC)
6.Violation of Generic Act of 1988
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page 17
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thenPhysicians
Send to Back formust
overlaybe aware
that morphine, an easily available drug in
effect
medical practice, is specifically addressed by the law. The law states
that “[t]he penalty of life imprisonment to death and a fine ranging
from Five hundred thousand pesos (P500,000.00) to Ten million pesos
(P10,000,000.00) shall be imposed upon any person, who, unless
authorized by law [PDEA-licensed physician], shall possess “Ten grams
or more of morphine.” But if the quantity of morphine is at least five
grams or more but less than ten grams an imprisonment of 20 years
and one day to life imprisonment and a fine ranging from four hundred
thousand pesos (P400,000.00) to five hundred thousand pesos
(P500,000.00) shall be imposed. Further, if the quantity of morphine is
less than five grams an imprisonment of 20 years and one day to life
imprisonment and a fine ranging from four hundred thousand pesos
(P400,000.00) to five hundred thousand pesos (P500,000.00) shall be Contoso
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imposed. page 18
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Obligation Arises from:
1.Law;
2.Contracts;
3.Quasi-contracts;
4.Acts or omissions punished by law; and
5.Quasi-delicts
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Thank you.
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