PROFESSIONAL GROWTH 3.

Health education of patient family and

& community, including nutrition and family
DEVELOPMENT Planning
Prepared by: Eduard E. “Kuya” Gandul Jr., R.M,R.N 4. Carrying out the written order of the physician
with regards to ante-natal, intra natal and post
Adjustment: An educational process referring to changes natal care of the normal pregnant women
in behavior towards better life, better relationships 5. Giving Immunization
and better contribution to society 6. Oral and parenteral dispensing of oxytocic after
the delivery of the placenta
Profession: A calling by which members profess to have 7. Suturing perineal laceration to control bleeding
special knowledge by training, by experience or both 8. Giving intravenous fluid during obstetrical
on that they may guide or advice or serve other in emergencies provided they were trained for
that field. that purpose
9. May inject vitamin K to new born
CRITERIA OF A PROFESSION
Characteristic of Profession
1. Mastery of the Craft- the profession must  There is especial preparation and training
possess the necessary skills and attitude.  With clearly defined permanent membership
2. Service orientation-Hall mark of the profession  Acceptance of the service motive
3. Autonomy-reasonable independent being (self-
regulated) Determinants of Professional Practice
Accountability-the essence of profession  Problems and needs by the people
4. Political Power- Adhere own sets of values  Policies and regulation
5. Professional Organization- Must be a member of  Current socio-economic political and cultural
an accredited Organization (e.g IMAP) system

EVOLUTION OF MIDWIFERY IN THE PHILIPPINES SPHERE OF MIDWIFERY PRACTICE IN THE PHILIPPINES

Care of the sick in Primitive Times 1. Traditional Function of the Midwife (R.A No.
 Animism. Babaylan, catalonan, 7392). The Philippine Midwifery Act of 1992
 Superstitious and mystical beliefs: wind theory, provides the midwife:
natural Order and forces (mangkukulam or a. Gives supervision care and advice to
manggagaway) women during pregnancy, labor and
Spanish Period post-partum period.
 Individual sin (Gaba or Bad Karrma), poot and b. Conduct deliveries on her own
Aswang responsibility
 Materia medica (MOrga. Governador-General in c. Cares of the newborn including the
1595-1596 noted used of wine as medicine: detection of abnormalities and
Lambanog and Tuba) counseling of parents or couple.
 Fore runner of Filipino Red Cross d. Gives health Education
American Period e. Executive emergencies measures
 Separation of Producers, distributors, and f. Procures medical supplies
consumers of health
 Exchange calue 2. Expanded Function of the Midwifes
 Iloilo Mission Hospitals School of Nursing (1906) a. Oral and parenteral dispensing of
Contemporary oxytocic drugs after delivery of the
Dr. Jose Fabella, first secretary of the placenta
department of health founded the first midwifery school in b. Suturing perineal lacerations to control
the 1922 as a response to high infant mortality rate. bleeding
c. Giving of intravenous fluids during
Objectives of the First Midwifery Schools: obstetrical emergencies
 Train young women to replace hilots (traditional d. Injecting of vitamin K. to the Newborn
birth attendant)
 Train doctors and nurses for Rural assignments PROFESSIONAL ORGANIZATION OF MIDWIVES
and
 Provide health service and education with INTEGRATED MIDWIVES ASSOCIATION OF THE
emphasis on maternal and child health (MCH) PHILIPPINES (IMAP)

PROFESSION OF MIDWFERY Brief History:

In the 1961 two organization were founded the
Is the performance or offer to perform or render Philippine Midwives association of the Philippines or the
for a fee, salary, or other reward or compensation of PHIMIDAS with Atty. Angelina Fonce as first president and
service recurring an understanding of the principles and the National Federation of Filipino Midwives or the NFFM
application of procedures and techniques in the with Mrs. Leoncia Chuatoco as first president.
supervision of and care of women during pregnancy,
delivery and puerperium. In 1974, the two were integrated to become IMAP with
1. Management of Normal Delivery Ms. Juana Reyes as its first president. It is presently the
2. Performance of Internal examination during only professional midwives association recognized by the
Labor, except when patient has antenatal Philippine Regulatory Commission (PRC)
bleeding.
Letter of Instruction 1980 “A Person who is of a sound mind and of legal age shall
Compulsory membership to professional have the right to determine what is supposed to be done
association accredited by the professional regulations to his body.”
commission
PERSONS TO MAKE DECISIONS IN CONSCIOUS PATIENT
ETHICO-MORAL RESPONSIBILITY 1. parents
2. grandparents
Ethics – part of philosophy that deals with systematic  paternal
approaches to questions of morality.  maternal
 A term for the study of how we make judgments 3. eldest brother/sister
regarding right and wrong. 4. relatives/guardians
 A system of MORAL PRINCIPLES or moral 5. teachers
standards governing conduct. Telephone – overheard by two credible witnesses
Fiancé – authorize to give consent for conscious if no
Morals- Human conduct in the application of ethics. parents, grandparents, brother/sister, guardians.
Concerned with JUDGMENT PRINCIPLES of right and wrong
in relation to human actions and character. Q: How do you respect the dignity of patient?
CODE OF ETHICS A: By respecting the bill of rights of patient.
 Fundamental responsibilities of midwife Between the conflict of pt. and doctor, loyalty will
 Render medical services regardless of the always be on the patient.
religious belief , political belief or creed

FREEDOM OF RELIGION 3. Right to Privacy and Confidentiality

No law shall be made respecting the Privacy of Communication
establishment of a religion or to prohibit the free exercise “It shall be inviolable except upon the lawful order of the
there of. The fee exercise and enjoyment of religious court and when public safety, public health requires it.”
profession and worship without discrimination shall *Cannot be violated at all – SECRECY ACT LAW
forever be allowed.
Q: Who owns the medical chart?
Two aspects of freedom of Religion A: Hospital
a. Freedom to Believe - Absolute
b. Freedom to Act – Relative (It must be in conformity Q: Who owns the communication in the medical chart?
to the law, morals, customs and traditions) A: Doctor and Patient
 Render medical services on the ground medical
neutrality – don’t take the background of pt. *Duty: Keeps in proper place (medical chart rack) with
 Protect life and respect the dignity of man honesty, confidentiality, and integrity

Trained Worker Relative Privacy

 Dignity – respect Bill of Rights Absolute Privacy
 One who perform lethal injection to the person Doctor – Patient
found guilty Midwife – Spouse
Midwife – Patient
Bill of Rights of Patients Midwife – lawyer (case)
1. Right to informed consent
2. Right to refuse and/or withdrawal from Midwife – Priest (religion)
participation or autonomy
3. Right to privacy
4. Right to confidentiality Husband – wife = absolute privacy; order from court, no
5. Right to quality care order to divulge/ reveal or right not to tell

1. Right to Informed Consent Q: What is Privacy?

Conscious – all medical practice are not A: Privacy is any not related to health condition.
authorized ŝ consent
Unconscious – all medical practice are Q: What is Confidentiality?
authorized as if consent is given to you A: Confidentiality is any related to health condition.

Breach – Violation of right, e.g. breach of confidentiality

4. Right to Quality Care

Autonomy – “Freedom to CHOOSE”
Beneficence – “Do only what’s GOOD”, respect,
Rule in Giving Consent privacy
 Patient her/himself Nonmaleficience – “Do NO harm”, e.g. side rails
 If the Pt. is married the consent of the spouse is up
not necessary, provided of sound mind and legal Veracity – “Tell the TRUTH”
age. Justice – “Be FAIR”
Fidelity – “Keep your word”, keeping promises
2. Right to Make Decisions Or Autonomy “LOYALTY”
- Right to Self Determination
- Justice Cardozo MIDWIFERY ETHICS – the code governing the NURSE’S
BEHAVIOR, especially towards patients, employing
authority and to the profession.
Beneficence - any action that would BENEFIT others. The MORAL PRINCIPLES
principle that imposes upon the practitioner to seek the
good for the patients under all circumstances. Beneficence  GOLDEN RULE – “ Do unto others what you
connotes positive action toward preventing or removing would like others do unto you”. It is a basic
harm and promoting good such as: moral principle that if you want others to respect
(1) One ought to prevent evil or harm you, you must also accord respect to them.
(2) One ought to remove evil or harm  THE TWO FOLD-EFFECT - facing a situation which
(3) One ought to do or promote good. would have good and bad effects requires the
following basis for arriving a decision:
Nonmaleficence – states the idea to REFRAIN from a. that the action must be morally good
inflicting harm. “one ought NOT to inflict evil or harm. The b. that the good effect must be willed
admonition of nonmaleficence is stated in the negative and the bad effect merely allowed
manner while the beneficence is in the positive. c. that the good effect must not come
from an evil action but from initial
Justice – The basic principle that deals with FAIRNESS, just action itself directly; and
deserts, and entitlements in the distribution of goods and d. that the good effect must be greater
services. than the bad effect.

Some methods of distributing goods and services in our THE PRINCIPLE OF TOTALITY – states that the whole is
society are as follows: always greater than its parts. To save the
(1) To each, an equal share patients’ life as a whole, it is justified under this
(2) To each, according to need principle to surgically cut-off a disease body part
(3) To each, according to effort of the patient.
(4) To each, according to contribution EPIKIA – “exception to the general rule”. It is reasonable
(5) To each, according to merit presumption that the authority making the law
(6) To each, according to ability to pay will not wish to bind a person in some particular
case, even though the case is covered by the
Autonomy - In health care, it means the form of personal letter of the law.
LIBERTY, where the individual is free to choose and If a mentally ill patient becomes berserk and the
implement ones’ own decisions, free from deceit, duress, doctor could not be contacted, the patient may
constraint, or coercion. Three Basic elements involved: be restrained by virtue of epikia.
Another example of this is allowing a relative to
(1) ability to decide see a seriously ill patient who expresses the
(2) power to act upon your decisions desire the relative although it is not yet visiting
(3) a respect for the individual autonomy of others. hours

Stewardship – refers to the actions made for by the health

practitioner IN BEHALF of the patient and for the greater
benefit of the patient.
THE END DOES NOT JUSTIFY THE MEANS – giving a
Truth Telling/Veracity – The patient must tell the truth in sleeping tablet to a chronically ill person so
order that appropriate care can be provided. The health he/she can de in peace is morally wrong.
practitioner needs to disclose FACTUAL INFORMATION so THE GREATEST GOOD FOR THE GREATEST NUMBER –
that the patient can exercise personal autonomy. during an epidemic, immunization against
communicable diseases is administered to the
Confidentiality - is also known as PRIVILEGED people. Although there may be some who may
COMMUNICATION which refers to any information have slight reactions to the vaccine, the greater
obtained by the nurse or the health team during the majority of the population shall be considered.
course of caring for the patient. The information gathered NO ONE IS HELD TO THE IMPOSSIBLE – the doctors and
may only be disclosed under the following: nurses are not guarantors of life. They cannot be held
(1) the patient agrees to divulge such information liable as long as they have done everything that modern
with written consent medicine can afford to save a patient from dying.
(2) the information is material in a criminal case THE MORALITY OF COOPERATION – formal cooperation in
investigation an evil act is never allowed. A nurse shall not participate
(3) if public safety is jeopardized (communicable upon immoral operations such as abortion even if the
disease) doctor commands it.
(4) such information is relevant to his care to be PRINCIPLE RELATING TO THE ORIGIN AND DESTRUCTION
utilized by other health team OF LIFE – mercy killing or euthanasia is not
allowed because it will lessen the incentive to
medical research. The state recognizes the
Privileged Communication may be divided into two sanctity of life. It shall protect the life of the
classes: mother and the unborn since conception.
(1) Absolute privileged communication – is one Any direct attack on the life of a fetus
made in the interest of the public service or the for whatever cause is immoral. A fetus shall be
due administration of justice and is practically buried in consecrated grounds. If it is dead and
limited to legislative and judicial proceedings and came from dead mother, it shall be buried with
other actions of the state. the mother.
(2) Qualified privileged communication – is a
slanderous statement uttered in good faith, and Privacy – the right to be left alone or be apart from others.
made on a proper occasion, from a proper This right is guaranteed by most civilized state laws and
motive, based upon a probable cause and in enshrined also in the patients’ bill of rights. The patient
honest belief that such statement is true.
has the right to every consideration of his privacy  Investigate violations of the act subpoena and
concerning his own medical care program. Case discussion, subpoena duces tecum
consultation, examination and treatment are confidential  Conduct yearly Board examination
and should be conducted discreetly. Those not directly  Look into conditions affecting midwifery practice
involved in his care must have the permission of the in the country, maintain standards and ethics
patient to be present. This right also includes privacy of practice
one’s thoughts, opinions and physical presence and  Adopt an officials seat to authenticate it officials
privacy of one’s records. documents

Informed Consent –The patient UNDERSTANDS the reason Section 3: General Qualifications of BOM
for the proposed intervention, with its benefits and risks,  Natural Born Filipino Citizen & resident of the
and agrees to the treatment by affixing his signature in the Philippines (Born in Philippines, without taken
consent form. It generally contains the following elements: action)
(1) disclosure  Good Moral Character
(2) understanding  Thirty (30) years of age
(3) voluntariness  Not a member of the faculty whether full time or
(4) competence part time in a midwifery school & to pecuniary
(5) permission giving benefit in such during his term (monetary
interest) – (type of disqualification)
 In our present jurisdiction under the 1987
Constitution, the age of majority is 18 years old. Citizenship – right to political community
It means that only 18 years old and above can Nationality – not change at all
sign for themselves in legal matters such as the *Citizenship may change if person stayed for 10
signing of consent (hospital admission, contracts, years or marry a Filipina/Filipino citizen to reduce stayed
will etc..) years
*End of term, can teach again
I. THE PHILIPPINE MIDWIFERY LAW *Resign from any employment, as qualified &
appointed as BOM
Section 1: “Philippine Midwifery Act of 1992”,
Qualifications of Chairperson
Section13: Qualification of Applicants for Examination  Registered Obstetrician
 Filipino Citizen  10 years of practice before appointment
 Good Moral Character  Natural born Filipino citizen
 Graduate of midwifery in government  Good Moral Character
recognized and duly accredited institution  30 years of age

Fraud/Deceit – causing someone to believe what is not Qualifications of 3 Members of BOM

true  Registered Midwife
Neosoly – place of birth (Rule of Soil)  Degree holders preferably in the field of health
Sanguine – blood from parents (Rule of blood) and social sciences (e.g. psychology, medtech,
Naturalize – change of citizenship such American to pharmacist)
Filipino  10 years of midwifery practice, 5 years of which
is supervisory position
ORGANIZATION OF THE BOARD OF MIDWIFERY  30 years old
 Natural born Filipino citizen
RA6809 – age of majority is 18 yrs
 All licenses can be acquired at age of majority; Qualification of 1 Member of BOM
such in movie watching rated A, Parental  Registered Nurse-Midwife
Guidance (PG), General Patronage, R18.  10 years of experience & nurse-midwife
 Natural Born Filipino Citizen
RA 7392/2644 – Philippine Midwifery Law
 Good Moral Character
Section 2: Composition of BOM
Steps in Appointment of BOM
 1 Chair/chairperson
 4 members of the board IMAP
(Nominating Body)
Note: 3 members shall be registered midwifes

1 Nurse-midwife PRC
(Recommending Body)
Appointment:

By the president of the Philippines from among
PRES.
the recommendees of the Commissioner of the
(Appointing Body)
Professional Regulation Commission
 Integrated midwives of the Philippine integrated
Duties and Function
association of Obstetrician
 Enforce provision of this act
 PRC
 Administer oaths accordance to the provision of
 President of the Philippines
this act
 Issue, suspend or revoke certificate of
Section 5: Powers of BOM
registration
 1. Conduct the Midwifery Examination 6. Quasi-legislative powers – independent body,
(Discretionary Power, Examining Power) duty: promulgating rules & regulation within its
preserve the integrity & honesty in Board Exam jurisdiction
2. Issue, suspend/revoke certificates of Registration 7. Quasi-Judiciary Powers – independent body,
(Discretionary Power) from regular judges, for hearing revoked license
PRC – release license, (as custodian of Record) 8. Executive Powers – under the office of the
– Venue of Board Exam. President poetically appointed, supervision of
LICENSURE the Board & Custodian of its RECORDS

Examination Requirements Section 8: Supervision of the Board and Custodian of its

Pass a written examination given by the Board of Record
midwifery.
Office of the President
Section 18: License Contains / Certificate of Registration 
1. full name of registrant PRC (Custodian of all Records)
2. Serial number 
3. official seal of commission BOM
4. signature of Chairperson of Commission Section 4: Terms of Office of BOM-3 years chairman and
5. Members of the Board members may be reappointed for another term
Scope of Examination
a. Infant care and feeding APPOINTMENT OF BORD OF MIDWIFERY (BOM)
b. Obstetrical Anatomy and physiology
c. Principles of Bacteriology Regular Appointment – when the BOM is appointed to
d. Obstetrics serve for a period 3 years
e. Midwifery Procedures Ad Interim Appointment – when a board member is
f. Domicilliary midwifery appointed to fill vacancy or to continue the unexpired
g. Domicilliary Hygiene and first aid period
h. Nutrition of term of regular appointee
i. Ethics of midwifery practice Hold Over – hold an office after his term of office has
j. Primary Health Care expired until his successor is appointed
k. Professional Growth and Development
l. Family Planning Note: Oath is Mandatory!
m. others That Board may seem necessary
License – permission to practice the profession for life not
Section 7 R.A. 8981: Grounds for the Suspension / unless revoked or suspended
Removal of BOM  Jurisdictional – applicable in the place where
 Neglect of Duty issued
 Gross incompetence/serious ignorance
 Unprofessional/Immoral or Dishonourable Misdemeanor – practice without license or practice with
conduct expired licence
Misrepresentation – using of other license
*Commision of Irregularities (revoked) Malpractice – go beyond scope
Tolerating Irregularities (releasing while arising of
questions such RETAKE! Ratings in the Board Exam
Inhibit – not participate on that particular exam 75% as general rating with no grade lower than
50%(old) 60%(new) in one subject 120 days, the BOM
3. To administer Oath (Ministerial Power) shall report the rating of each candidate to the PRC
Oath – first action after passing board exam Commissioner.

Section 16. All successful candidates are required to take Section 17: Report of the Results of the Examination
the oath, to BOM or Government authorized to The Board shall, within 120 days after the examination,
administer. report the ratings obtained by each candidate t the
The oath such as ambassador, consul, mayor, vice commissioner of PRC.
mayor. License never is issued without the oath.
Q: When a midwife practice in another country making use
*Newborn place of birth when in airplane is of one’s license in the Phil.?
where it was registered A: Section 22: Reciprocity – Latin term, re-back, pro-
*Midwife can attend the delivery while in place forward
in DOCTRINE of GOOD SAMARITAN Du Ut Des - I give that you may also give
Reciprocal Duty – Give and take
Article 3 Section 1. DUE PROCESS – Law that hears first Relationship between 2 persons/states International
before it condemns (trial, hearing) Agreement – TREATY mostly in Middle East
 It can only be entered into the Pres. conquer 2/3
4. Monitor & enforce quality midwifery practice in senate not in congress
(Examining Power, Dispensing Power)  An international agreement whereby one
5. Monitor & enforce quality midwifery education country would grant to true citizens of the other
country the privilege of being admitted to
CHED – closed midwifery school practice ones profession
BOM – agreed/ recommended, Memorandum of
Agreement (MOA) SPECIAL PERMITS
  Internationally recognized expert in the field of – Any act that is CONTRARY to LAW, MORALS,
midwifery HONESTY, & JUSTICE
 Medical mission
 Exchange of professor program 1. Adultery – disloyalty of wife to her husband having
other man
Section 7: Ground for the Revocation/Suspension of Paramour – Man of A Married Woman (Kabit) Mistress
License – Girl of a married Man (Kabit)
 Immoral & dishonourable conduct Cuncubinage – disloyalty of husband to his wife having
 Conviction of a crime involving moral turpitude other woman/ mistress

MIDWIVES AND CRIMES Crimes -act committed or omitted in violation of the law.
Felony -public offense for which a convicted person is
Criminal law – is that branch of law which defines crime liable to sentenced to death or to be imprisoned in a
and treats of their nature. penitentiary or prison
-committed with deceit and fault
 Ignorance of the law excuses no one from -act is performed with deliberate intent,
compliance therewith -wrongful acts result from imprudence,
 Laws take effect after 15 days from the negligence, lack of skill or foresight
publication in the official gazette or any
newspaper of national circulation. It serves as a Misdemeanor - criminal offense which does not in law
constructive notice to all persons so that no one amount to felony. Punishments is usually a fine or
is exempted from complying with the law or to imprisonment for a term of less than one year
claim that he or she is ignorant from the passage
of that law. The profe ssional practice of a Midwife entails with it the
 The power to define and punish an act is within legal responsibilities that he or she must know and
the powers of the Legislative Department (House understand in order to avoid liabilities in the discharge of
of Congress) where the legislative power is his/her functions.
vested in the fundamental law and has the The following are crimes that a midwife must be familiar
power to define and punish an act or omissions with:
as a crime. The Chief Executive has also the ASSAULT – An unlawful attempt or offer to beat or to do
prerogative. bodily injury to another.
 Theories of Criminal Law
BATTER Y – The unlawful beating or touching of another
1. Classical Theory person. The unlawful beating or use of force
a. man is essentially a moral creature upon a person without his consent.
with an absolutely free will to choose
between good and evil and therefore MURDER – is the unlawful killing of a human being by
more stress is placed upon the result another with intent to kill (DOLO is an element).
of the felonious act hyle – soul
b. Basic criminal liability is human free morfe – body
will and the purpose of penalty is
retribution. HOMICIDE – killing of a human being by another. It is
c. Crime is a juridical entity and penalty is committed without criminal intent by any person
an evil and a means of juridical who kills another, other than his father, mother,
tutelage child or any of his ascendants/descendants/his
spouse. (Culpa-fault).
2. Positivist Theory – Man is subdued occasionally by  death because of lack of knowledge, skill,
strange and morbid phenomenon which conditions him to competence and foresight.
do wrong in spite of or contrary to his volition. The basis of
criminal responsibility of the criminal is his dreadfulness or ABORTION – Termination or expulsion of the product of
dangerous state. conception even before the age of viability.
Abortion is a crime penalized in our jurisdiction.
 The major source of our criminal law is Act # A nurse who advises a woman on what drugs to
3815 otherwise known as the Revised Penal take is criminally liable.
Code of the Philippines that took effect on Art. II Sec. 15 the Constitution of the Philippines
January 1, 1932. -Protects life of the unborn from conception
 Crime consists of internal and external acts.  Intentional Abortion (Art. 256) – willful killing of
Internal acts are not punished in our jurisdiction. the fetus in the uterus, or the violent expulsion
 Voluntariness is an element of felony because if of the fetus from womb resulting to its death.
an act is committed or performed with  Unintentional Abortion (Art. 257) – abortion by
deliberate intent then it implies that the act is violence but unintentional
voluntary or freely committed.  Abortion Practiced by the woman herself (Art.
 Felony is an act or omission punishable by the 256)
law  Abortion Practiced by a physician or midwife and
dispensing of abortive (Art. 256)
Moral Turpitude – an act of baseness, vileness or
depravity in social or private duties which man owes INFANTICIDE - killing of a child less than three days of
to his fellow or to society in general, an act contrary age.
to the accepted customary rule of rights & duty b/w
men
PARRICIDE – is committed by one who kills his/her father, prudent man would have done”. It also refers to
mother or child whether legitimate or illegitimate, or any the commission or omission of an act, pursuant
of his/her ascendants or his/her espouse. to a duty, that a reasonably prudent person in
the same or similar circumstance would do or
*means of blood relationship would not do, and acting or the non-acting of
Constitute parricide: which is the proximate cause of injury to another
Spouse, legally adapted children, stepbrother person or his property
Murder homicide
TORTS – legal wrong, committed against a person or
Example: property, independent of a contract which
Parricide – when mother throw the infant after hinders the person who commit it liable for
birth in the taxi damages in a civil action
a. Assault – imminent threat of harmful or offensive
ILLEGAL DETENTION – any private individual who shall bodily contact
detain another or, in any other manner, deprive b. Battery – unconsented touching another person
him of his liberty. c. False Imprisonment or Illegally detention –
ARBITRARY DETENTION – any person in authority (public unjustifiable detention of a person without a legal
officer) who shall detain another or, in any other warrant (Doctrine is liberty of abode)
manner, deprive him of his liberty.
SIMULATION OF BIRTH – any person who shall substitute Liberty of Abode/ travel
one child for another or who shall conceal or “Liberty of abode/ travel shall not be impaired
abandon any legitimate child with intent to except upon the lawful order of the court and
cause such child to lose its civil status. when public safety, public health requires it.”
ROBBERY/THEFT – crime against a person/property the > right where you wanted to go/ leave
taking of personal property of a person from him
(preserving the privacy of patient) d. Invasion of right to privacy and breach of
Robbery – committed with FORCE upon person or confidentiality – the right to privacy is the right
thing to be left alone, the right to be freed from
unwarranted publicity and exposure to the
SEXUAL HARASSMENT – is committed by a person who, public view is well as the right to live one’s life
having authority, influence or moral ascendancy without having anyone’s name, picture/ private
over another in a work, training or education affairs made public against one’s will
environment, demands, requests or otherwise
requires any sexual favor from the other e. Defamation – character assassination, be it written
regardless of whether such demand, request or or spoken
requirement for submission is accepted. • Slander – oral defamation of a person by
speaking unprivileged or false words by which
Rape – mere touching of the labia by the male organ his reputation is damaged
• Libel – defamation by written words
CLASSES OF FELONY: f. Malpractice-illegal, corrupt, or careless professional
1. Consummated- all elements executed, with successful behaviour.
result -any professional misconduct which involves any
2. Frustrated- all elements executed but no successful conduct that exceeds the limits of one’s
result professional standards means going beyond the
3. Attempted- not all elements executed context or scope of allowed nursing practice
resulting to injurious or non-injurious
There is No rape committed such as of: consequences.
- Same sex- frustrated rape - stepping beyond one’s authority
- digital or Anal Example:
a. prescribing drugs
ARSON/Conflagration (in cases of fire) b. giving anesthesia
- the medical practitioner should c. doing surgery

R-emove the patient ELEMENTS OF MALPRACTICE (P-R-E)

A-lert the fire alarm P- professional SPECIFIC standards of care is
C-onfine the fire required
E-xtinguish the fire R- required obedience
E- exceeds the limits of the standards of care
- attempted arson g. Negligence- Unintentional failure of an individual
- consummated arson person to perform an act or omission to do
- no frustrated arson something that a reasonable prudent person would
do or not do
CRIMINAL NEGLIGENCE – is negligence of such character -Failure to observe the protection of one’s interest, the
or occurring under such circumstances, as to be degree of care, and vigilance of circumstances.
punishable as a crime by statute. -Most common unintentional tort
PROFESSIONAL NEGLIGENCE – breach of professional
duty. Negligence committed in the practice of a Example:
profession. a. Incorrect sponge d. Falls: side rails left
NEGLIGENCE - is often referred to as that “doing of a thing counts down, baby left
which a reasonably prudent man would not have unattended
done and not doing a thing which a reasonably b. burns: heating e. loss of or damage to a
pads ,solutions & patient’s property
 steam f. failure or ignore to table with a no. of midwife who can perform abortion.
vaporizers report to the superiors or (may or may not get it). Abortion took place.
client’s family A: Midwife: principal by direct participation
c. failure to take & observe g. mistaken identity, Nurse: accomplice
appropriate wrong medicine, dose & Patient: principal by inducement
actions – forgetting to route Mother: accessory
take vital signs to Doctor: accomplice
a newly post –operative
client. Circumstances that affect Criminal Liabilities

ELEMENTS OF NEGLIGENCE LAWSUIT (B-R-O-D) –OR-- DEATH (Capital Mngt.)

ELEMENTS OF PROFESSIONAL NEGLIGENCE
B- breach of duty was the cause of the
1. Existence of Duty Reclusion Perpetua (>1°/ 20 – 40years)
R- Real or actual proof injuries
2. Foreseeable
Crisis Reclusion Imperal (<1°/12 – 20years)
plaintiff’s injury
3. Breach of Standard of Care Exempting Circumstances
O- owed specific nursing duty  No crime at all, exempted from criminal liability
4. Present of Injury
to the standards of care 1. Imbecile or insane person, unless he acted with lucid
5. Procimate Cause interval
D- defendant breach the duty 2. The person is under 9 years of age
3. Over 9 years but under 15 years unless he/she acted
CLASSIFICATION OF CRIMINAL LIABILITIES with discernment (know the own consequences)
4. When it is mere accident (force majoure)
Conspiracy to Commit a Crime 5. When the person acted under the impulse of an
Principal – -take direct part in the execution of the act, uncontrolled fear
who directly force or induce others to commit it, 6. When the person acted under the compulsion of an
who cooperate in the commission of the offense irrestible force e.g. in school – loco parenti (parental
by another act without which it would not have authority and custody transfer in teacher)
been accomplished.
1. direct participation sunera – exerting circumstances, with freewill,
2. inducement (order, command, influence, unvoluntaryness to act, insanity
convince, persuade)
Mitigating Circumstances
Accomplice (BEFORE THE FACT )– -who, not being  Lowering down by 7 years (Prison Mayor)
principals, cooperate in the execution of the offense
by previous or simultaneous act, must be shown 1. When the offender is under 18 years/ over 70 years of
that he had knowledge of the criminal intention of age
the principal, demonstrated by previous or 2. When there is voluntary surrender
simultaneous acts that contribute to the commission 3. When there is passion/ obfuscation
of the offense as ais thereto, whether physical or 4. When there is sufficient provocation (alcohol)
moral. 5. When the person is deaf, mute, dumb, and blind
1. Essential ,necessary, destroy materials 6. When there is no intention to commit so grave a wrong
material as the one committed any kind of mental illness that will
diminished will power (bipolar)
Accessory –( AFTER THE FACT) - Having knowledge of the
commission of the crime, either as principals or Aggravating Circumstances
accomplices, take part subsequent to its commission  Committed with plan, 1° higher
by profiting themselves or assisting the offender to
profit from the effects of the crime by concealing or 1. When one takes advantage of public position
destroying the body of the crime, or the effects or 2. When there is an abused of confidence
instruments thereof, in order to prevent its 3. When the crime is committed inside the Church
discovery or by harboring, concealing or assisting in 4. When the crime is committed on the occasion of fire,
the escape of the principal of the crime, provided shipwreck, epidemic/ other calamity
the accessories act with abuse of their public 5. When it is committed because of a price reward
functions or are known to be habitually guilty of 6. When it is committed in times of natural calamities
some other crimes. 7. When it is committed with evident premeditation
8. When it is committed with craft, fraud and disguise
Q: Patient get out to get sunlight old woman introduce * One’s you commit in confidence to your patient
herself as a relative midwife let the woman go inside the
room old woman get everything (theft) Justifying Circumstances
A: Midwife: accomplice  Without 1, not justified
ELEMENTS
Q: Midwife, Hospital – liable on what doctrine? 1. When there is an unlawful aggression
A: RESPONDEAT SUPERIOR (applied to employers) 2. When the person is under imminent danger
(Let the master answer for the offense of their employees) 3. When there means employed in order to
prevent or to repel the aggression must be reasonable
Q: The patient approaches the nurse and said that she is 4. Obedience to an order issued by superior for
pregnant. The nurse said that she has a calling card on the some lawful purpose
*no man apply self – defence  Formal Contract – written down and it follows at
all times the legal document/ long bond paper,
GUIDELINES TO PREVENT CRIMINAL LIABILITY: notarized
1. Be very familiar with the Philippine Nursing  Informal Contract – orally done/ written down
law but does not follow the legal documents
2. Be familiar with the laws affecting nursing 2. According to Statement
practice  Expressed Contract – terminal
3. Know agency rules, regulations, policies conditions are written down and the beginning and
4. Upgrade skills and competence ending of the contract are also expressed e.g. job
5. Develop good IPR with co-workers description
6. Consult superior as needed  Implied Contract – it is actually based
7. Verify vague/ erroneous orders in the reaction and behavior of contracts parties
8. Always keep doctor updated regarding patient
9. Ensure accurate recording and reporting 2. WILL – an act whereby a person disposes of his property
10. Get informed consent to take effect after his death
11. Do not delegate responsibilities to others Testator/ testatrix – a person who makes the
will
LEGAL CONSIDERATIONS IN CHARTING: Probate – to prove the validity of the will in
1. Don’t tamper with medical records- adding, court
rewriting and destroying original record Testament – an act whereby a person disposes
2. Observe agency’s standards on documentation of his personal property to take
• complete, concise, specific, use standard effect after his death
abbreviations Escheat – when his property is transferred in the
• telephone orders name of Republic of the Philippines

TIPS FOR AVOIDING LEGAL PITFALLS: Two kinds of Will

1. Patient Falls
• do proper assessment 1. Holographic Will – when the testator entirely writes
• appropriate assistance is given down the will. Date and signed of the testator should be
• use protective measures indicated in the will.
• document all nursing interventions
2. Medication errors 2. Notarial/ Nurcupative/ Authenticated Will – when the
• observe 7 R’s of drug administration testatorally makes the will and will ask someone to
• Check dr’s order write it down or him.
• Understand the medication you will
administer TWO KINDS OF SUCCESSION
• Consult drug handbook/ pharmacy 1. Testate – when there is a will executed by the
• Not exempt from liability for following testator
doctors’ order 2. Intestate – when there is no will executed by
3. Equipment injuries the testator
• refuse to use a device not know how to
operate * The Midwife serves as a witness in making a will of your
• report adverse events to superiors patient.
• monitor patient regularly * Ethical obligation – right to refuse in making patients will
• bring questionable orders to the attention * Durable Power Attorney – appointing someone if your
of the doctor or superior not capable to decide
• familiarize self with existing protocol * Disinherited by parents, relatives – only when attempt to
1. Failure to communicate kill/ against their own life
• promptly report changes in the patient’s
symptoms and signs of distress to the Personal Property – movable property e.g. jewelries, given
Doctor as testament
• proper documentation of all assessments Real Property – immovable property e.g. land, house,
and telephone conversations with the bldgs., given as will
Doctor
Will to the court (probate)
 Void from the start.
LEGAL RESPONSIBILITIES OF MIDWIFE  Intestate
*Illegitimate siblings has < share of properties than
1. Contract – an agreement between two people which legitimate siblings
creates an obligation recognized by the law *Adapted siblings has = properties to legitimate siblings
*spouse has ¼ of the properties
Elements of Valid Contract * ¼ free portion – for the taxes to be paid after getting the
 Consent must be freely given (voidable) properties
 Competent parties (void) *Prenuptial Agreement – agreement before marriage,
 Legal objects (void) which husband property different from wife property
 Valid considerations (voidable) vice versa/ have separate property even they’re married
Valid – no question *Conjugal Agreement – husband’s properties is also wife’s
Voidable – valid until question: force, threat, intimidation properties/ vice versa
Void – with questions arise, < 18 as incompetent
3. Lawsuits – proceedings in court
Two kinds of Contract Purpose: To enforce a right, to redress a wrong
1. According to Format
PARTIES:
a. Criminal Action
 Complainant – person who file a case with a
court against another, a concise statement of
the ultimate facts constituting cause of action.
 Respondent – the person against whom the case
b. Civil Action
 Plaintiff – person who file a case with PRC
 Defendant – the person against whom the case

Sub Poena ad testicandum/ Sub Poena – court summons

is served directing a witness to appear and give
testimony on the date and time ordered
Sub poena duces tecum – served to a witness requiring
him to bring records, papers or charts
Testimony of facts – testifying only on what he knows
based on facts
Tesstimony of opinion – may only be given by expert
witness
Expert witness – one who is qualified to testify based on
special knowledge, skill and training
Perjury – false swearing under oath
Privileges against self – incrimination – right not to
answer any questions that will incriminate him/her
>mind/ imagination purely e.g. ejaculation to excrete
sperm/semen
> not self – incrimination – mechanical e.g. pregnancy
test, drug test, urine test, DNA test, pubic hair,
purgative/ laxative, blood sample
Hearsay evidence – repetition of what the witness heard
others say
Ante mortem statement – dying declaration considered
hearsay except when made by a victim of a crime

You go to a Court:
 When rights are violated
 To correct a wrong and have it corrected
Remedies going to court:
 Quasi – Administration Body
 Municipal
 Regional
 Board of Appeal
 Supreme Court