PROFESSIONAL GROWTH AND DEVELOPMENT: RUBY V.

DE LUNA RM,RN,MAN

Our Lady of the Pillar College-Cauayan

Cauayan City, Isabela
College of Nursing and Midwifery

colle

TOPIC: Ethics for Midwives & Revocation and Suspension of license

ETHICS FOR MIDWIVES

ETHICS FOR MIDWIVES

ETHICS DEFINED
- Ethics mean “character” for the ancient Greeks.
- principle of right or good conduct. (Notter and Spalding 1976).
- It is a science of the morality of human behavior, both of the human acts and the acts of man (de la torre, 1993).
Its subject matter is human action, specifically the morality human behavior.

Ethics is the philosophical study of voluntary human acts with the purpose of determining what good, right is and to be
done, and what is bad, wrong and not to be done. In short it is the study or practice of the “good life, the kind of life
people ought to live.

Human Acts are actions that involves the use of both free will and intellect, these are actions performed with the use of
reason. Human acts are performed consciously and knowingly.
Example: a midwife doing a sponge bath to a febrile patient in order to lower down the latter’s temperature is doing a
human act.

Acts of Man are actions that does not involve the use of intellect and free will, these are actions done unconsciously and
without reason. Acts of man are performed unknowingly and unconsciously.
Example: sleepwalking is an act of man.

Function of Ethics
Ethics teaches as to distinguish what is right from what is wrong.

ETHICAL SYSTEMS

Two types of Ethical Theories

1. Utilitarianism – determines what is right or wrong based on an action’s consequences.
2. Deontology – a system of ethical decision making based on moral rules and unchanging principles that centers on
duty and obligation to others.

MORES, MORALS AND MORALITY

Morals- come from the Latin word “mores” which means customs or values.
- Deal with the conduct of man, the right and wrong behavior of man in his relationship with his fellowmen.
- Fundamental standard of right and wrong.

Moral Virtues
1. Justice – “is the virtue that allows man to give his neighbor what rightfully belongs to him.”
2. Temperance – “is the virtue that moderates the possible over-indulgence of the concupiscible appetite.”
3. Fortitude – “is the virtue that gives courage to a man in times of overwhelming odds.”
4. Prudence – is the virtue of knowing how things are to be done rightly and well.

Mores- “custom enforced by social pressure”.

- They are the society’s established patterns of action to which an individual is expected to conform.
Morality-is concerned with knowing and doing what is right.
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- is a code of values to guide man’s choices and actions.

Elements Determining Morality

1. Act itself- Object
2. Purpose- Reason for which the act is performed
3. Circumstances – Situation surrounding this act itself and from the purpose which may affect the morality of the
act.

Conditions Affecting Morality

1. Ignorance- is the absence of intellectual knowledge in man.
2. Fear- is one of the passions but a very common one so it is not often given special attention. It is the agitation of
the mind caused by the apprehension of impending evil. It ranges from slight disturbance to actual panic.
3. Concupiscence- are the passions of man which include love, hatred, joy, grief, desire, aversion or horror, hope
despair, courage or daring, fear and anger which makes man frail and prone to evil.
4. Violence- or Coercion is external force applied to a person for the purpose of compelling him to perform an act
which against his will.
5. Habit- refers to the operative habit which is a lasting readiness and facility, born of frequent repeated acts, for
acting in certain manner.

THE PRINCIPLE OF DOUBLE EFFECT

Human Acts with Both Good and Bad Effect- when human act results in both good and bad consequences and wanted and
unwanted effects. It is called “double effect” and the human act to be performed becomes an ethical problem. Often, this
problem is solved using the principle of Double Effect or Principle of Two-Fold effect.

Types of Cooperation with Evil

1. Positive and negative Cooperation

o Positive cooperation- is voluntarily doing an act which contributes to the evil act of another.
 A midwife who assists an obstetrician perform an abortion is committing positive cooperation.

o Negative cooperation- is cooperation by omission in which the person did not do anything to prevent evil
act
 A midwife did not do anything to prevent another midwife in stealing medical supplies and does
not stop the latter or report the incident to her supervisor is committing cooperation by
omission.

2. Immediate/Direct or Mediate/Indirect Cooperation

 Direct cooperation happens when a person’s cooperation occur while the act is being performed. A
midwife who acts as a “watch” while the doctor injects a fatal dose of sedative to an unconscious patient
is committing direct cooperation.
 Indirect cooperation is committed before or after the evil act. However, the cooperation is not necessary
to the evil act itself. A midwife destroys all evidence of an abortion although he did not assist while the
surgical procedure was being performed.

CONSCIENCE – is a practical judgment of reason upon an individual act as good or as evil and to be avoided. It is also
referred to as the act of reasoning out the right and wrong of a situation.

ETIQUETTE
Although ethics and etiquette are interrelated, the two are quite different terms, etiquette is “a set of formal rules for
social conduct based on social consideration for others and designed to establish pleasant social relationships. Etiquette is
designed by society to guide and regulate conduct and social practices.

IDEALS
“An ideal is an idea grasped firmly in the mind. Raised to a standard of action and pursued consistently.

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VALUES
Values come from the Latin word “valere”- which means to be strong. Indeed they are strongly held beliefs or convictions
about what a person hold’s to be important and worthy in his or her life.

LAW
A law is an ordinance of reason promulgated for the common good, or to protect the society at large. Laws are specific
rules of conduct which defines which actions are legal and therefore allowed, and which actions are illegal therefore, not
allowed. To be effective, they should be applied to all members of society and enforced by authority. Thus the saying “the
law applies to all, otherwise none at all.”

OBLIGATIONS
Obligation refers to demands made on an individual, a society, a profession or government to fulfill and honor the rights
of others.

Two types of Obligation

1. Legal Obligations: required by law
a. such as the obligation of Midwife to pay professional tax when practicing her profession.
2. Moral Obligations: are obligations based on moral or ethical principles but are not enforceable under law such as

b. the moral obligation of a midwife to go on duty when the hospital is under staffed to ensure patients welfare.

RIGHTS

Right is something owed to an individual according to just claims, legal guarantees, moral and ethical principles.

Three Types of Rights

1. Welfare rights – also called legal rights. They are guaranteed by law. Example: Bill of Rights in the constitution in
which violation is punishable under law.
2. Ethical Rights – also called moral rights. They are based on moral or ethical principles and usually do not require
power of law to be enforced in reality, these are privileges. Example: the right to access to health care.
3. Option Rights – they are based on fundamental beliefs in dignity and freedom of humans. These are basic human
rights. They give individuals freedom of choice, but within boundaries. Example: in our society, we may wear
anything we like, but we must wear something.

HUMAN RIGHTS- those rights which are a person’s due as a member of the society.
Example: the patient’s bill of rights within the scope of the proposed Magna Carta of patients’ rights.

HABIT- is also called our second nature. It refers to a pattern of action which is both convenient and undeviating.

HEALTH CARE ETHICS- deals with the conduct and moral issues that arise in the practice of health care professionals.

BIOETHICS- is the study of ethics that result from technological scientific advances in the areas of biology and medicine.

ETHICAL DILEMMA- is the choice between two or more equally justifiable alternatives. When there is only one course of
action or when a conflict does not exist there is no ethical dilemma.

Ethical Decision Making Process- The ethical decision making process is systematic method of solving an ethical dilemma.

ETHICAL PRINCIPLES USED IN HEALTH CARE- derived from ethical theories. Important ethical principles used in health care
includes respect for individuals, autonomy, nonmaleficence, beneficence, justice, confidentiality, fidelity and veracity.

1. Principles of Respect for individuals

- Respect for individuals is fundamental to recognition of the autonomy of individuals as it incorporates ethical
convictions that individuals should be treated as autonomous agents, and that persons with diminished autonomy
(such as children and mentally insane) are entitled to protection. (Belmont report, 1979)

2. The Principle of Autonomy

- means that “individuals are to be permitted personal liberty to determine their own actions”
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Characteristics of Autonomy

a. Autonomy as free action –THE ABILITY TO DECIDE:

Example: when a midwife influences the client to decide in favor of a specific contraceptive method by misinforming
the client that all other contraception is not as effective and safe. The client is unable to exercise his autonomy fully.

b. Autonomy as authenticity – THE POWER TO ACT UPON YOUR DECISIONS

Example: although the client is free to decide for himself, the midwife should investigate further if she sees that the
client’s decision is not within his cultural beliefs, values and usual way of thinking.

c. Autonomy as effective deliberation. -action that is done only after giving it clear thought, giving proper
considerations to the alternatives and their consequences. When a person acts out of impulse, he engages in
thoughtless action for there is no opportunity to think
Example: to be able to exercise effective deliberation, the patient must be informed of all information necessary
for him to be able to make a decision however, during emergency situations patients or relatives must make
decisions under pressure of time and other emotions that may make decision making difficult. The supportive role
of the midwife is very important during this period so that the patient or his family can make appropriate
decisions.

d. Autonomy as moral reflection. This is the deepest and most demanding sense of autonomy for as miller has
pointed out. It involves a deeper level of self introspection which involves the ability for rigorous self analysis,
awareness of alternative set of values (personal values of the individual), commitment to a method of assessing
them and an ability to put them in place. In comparing reflection with authenticity, he says that the former will
determine the sort of person one will be, while authenticity can be judged by acts conforming to deliberated
values. (Miller, 1995).

3. The Principle of Beneficence- demands that above all, an individual should do only good and contribute to the
welfare of others.
4. The Principle of Nonmaleficence- based on a person’s rigorous obligation to avoid injuring another individual. The
principle obliges health care providers to DO NO HARM.
5. The Principle of Justice- provides the obligation to be fair to all. This principle requires that social benefits (e.g. health-
care services) and social burdens (e.g taxes) be distributed in accordance with the demands of justice. There have
been many and different analysis of justice.

6. Confidentiality
According to moral theology there are three classes of secrets
1. Natural secret – secrets which must remain hidden even if there is no obligation or promises to keep it
that way, for the revelation of it could harm the individual or society.
2. Promised secret - these are secrets that a person confides to another in exchange of a promise not to
reveal it to others. The commitment of the person entrusted the secret was gained after the secret was
known to that person.
3. Confided secret – these secrets are confided to another person only after that person has made the
commitment that it will not be made known to others.

When Confidentiality May End

 After the patient give his consent to reveal information about him or his health care.
a. For example, when a patient avails himself of medical insurance from a private company .he give
his consent for that company to obtain information about his health and treatment.
 When its revelation is for the common good.
a. If the patient is ill with a highly contagious disease, the physician has the obligation to report the
patient to proper authorities in order to take measures to protect other people.

7. Fidelity- refers to the obligation of a person to be faithful to agreements, commitments and responsibilities that he
has made to himself and to others. It is the main principle that supports the concept of accountability of midwives to
patients and employers.

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8. Veracity : refers to the principle of truthfulness. In midwifery, veracity is applied in the midwife’s responsibility never
to mislead or deceive a patient. This is observed when providing informed consent where a midwife should provide
accurate health teachings and answer patient questions as truthfully and honestly.

PROFESSIONAL ETHICS- basic principles of conduct or right actions that a licensed practitioner must at all times observe
and uphold in the practice of his profession.

MIDWIFERY ETHICS
Are principles of right conduct that a midwife must observe in the practice of her profession. It is concerned with
the moral responsibilities of the midwife towards her profession, patients, physician and superiors, co-workers and
herself.

CODE OF ETHICS
Is a public declaration of the beliefs and values of a profession and the members of that profession. This code
makes public the goals, values and morals of those who call themselves “midwives” – a statement to the public about
what the profession of midwifery defines as moral behavior for its practitioners.

REVOCATION and SUSPENSION of License

REVOCATION
Is the cancellation of the midwife’s certificate of registration or professional license.

SUSPENSION
Means temporary withdrawal of the right to practice midwifery.

GROUNDS FOR REVOCATION AND SUSPENSION

(ICU-MIN-FAGS)

 I - MMORAL AND DISHONORABLE CONDUCT

 Adultery
 Concubinage

 C - ONVICTION OF A CRIME INVOLVING MORAL TURPITUDE

Refers to any act done contrary to justice, honesty, modesty and good morals.

 U - NPROFESSIONAL CONDUCT

 M - ALPRACTICE
Means unskillful and improper discharge of one’s professional duties.

 I - NCOMPETENCE
Lack of legal qualification and lack of qualities to discharge the required duty.

 N - EGLIGENCE
Is the failure to observe for the protection of the interest of another person, the degree of care, precaution, and
vigilance which the circumstances justly demand, where by such other person suffers injury.

Negligence may be committed in two ways: by commission or by omission.

 Negligence by commission results from doing a thing which a reasonably prudent person would not do in similar
circumstances.
 Negligence by omission occurs when there is a failure to do what a reasonable prudent person would do in similar
circumstances.
Test of Negligence
a. Presence of duty
b. Failure to perform that duty which is either by act of omission or commission
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c. Damage or injury to another person

d. Failure to perform one’s duty is the direct cause of damage or injury to other person.

DOCTRINES APPLIED TO LEGAL ISSUES

1. Doctrine of Res Ipsa Loquitor means “the thing speaks for itself”
- “The thing speaks for itself”. It shows without proving that the accident resulted because there was lack of proper care.

E.g. delivering a baby with fractured clavicle.

THIS MEANS THAT THE INJURY COULD HAVE HAPPENED IF SOMEONE WAS NOT NEGLIGENT THAT NO FURTHER PROOF IS
REQUIRED.

Elements:
Accident don’t happen if there is due care.
Accident that happened is under the control of the defendant/nurse/midwife.
Accident that happened was not due to voluntary contribution of the patient.

Rule: When a thing which has caused an injury is shown to be under the management of the party charged with
negligence and the accident is such as in the ordinary course of things will not happen if those who have such
management use proper care, the accident itself affords reasonable evidence in the absence of explanation by the parties
charged, that is rose from the want of proper care.

Three conditions required to establish a defendant’s negligence without proving specific conduct.
that the injury was of such nature that it would not normally occur unless there was a negligent act on the part of
someone that the injury was caused by an agency within control of the defendant that the plaintiff himself did not engage
in any manner that would tend to bring about the injury.

Example of such case is the presence of sponges in the patient’s abdomen after an operation.
 EXAMPLES:
 A Patient came in walking in the OPD clinic for injection. Upon administering injection to his buttocks, the
patient experienced extreme pain. His leg felt weak and he was subsequently paralyzed. His sciatic nerve
was injured.

2. Doctrine of Respondeat Superior - when the midwife is only following the lawful order of a superior.
RESPONDEAT SUPERIOR- “Let the superior answer”

Elements:
The superior answers for the subordinate because the latter acted for the master.
The superior answers for the subordinate because he derived advantage from the subordinate’s actions.
The liability is expanded to include the master and employee but NOT to shift the blame from the employee to the
master. E.g. Captain of the ship principle in OR.

EXAMPLES:
The hospital will be held liable, if in an effort to cut down expenses it decides to hire under board nurses or midwives in
place of professional nurses, and these persons prove to be incompetent
The surgeon will be held responsible in case a laparotomy pack is left in patient’s abdomen.

PRIVATE DUTY midwives, HOWEVER ARE CONSIDERED INDEPENDENT CONTRACTORS. THEY ARE LIABLE FOR THEIR OWN
NEGLIGENT ACTIONS.

Rule: The masters is responsible for the want of care on the part of the servant toward those to whom the master is
under the duty to use care, provided the failure of the servant to use such care occurred in the course of his employment.

Example of this is that if the hospital will decides to hire under board nurses or midwives in place of professional nurse in
an effort to cut down on expenses and these persons prove to be incompetent then the hospital will be held liable.

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 Doctrine of FORCE MAJEURE – means an irresistible force, one that is

unforeseen or inevitable.

Rule: When a debtor is unable to comply with his obligation because of force majeure he cannot be held liable for such
performance. In the absence of stipulations to the contrary, impossibility of performance, without the negligence of the
parties, prevents the enforcement of bond or contract.

Circumstances such as floods, fire earthquakes and accidents falls under this doctrine and nurses who fail to render
service during these circumstances are not held negligent.
MIDWIVES WHO FAIL TO RENDER SERVICE DURING THESE CIRCUMSTANCES ARE NOT HELD NEGLIGENT. HOWEVER,
HABITUAL TARDINESS DUE TO HEAVY TRAFFIC IS NOT CONSIDERED AN EXCUSE FOR FORCE MAJEURE.

 F - RAUD AND DECEIT

Intentional perversion of truth, an act of deceiving, an act of misrepresenting.
 A - SSISTING OR PERFORMING ABORTION
 G - ROSS MISCONDUCT
It includes behaviors that is unbecoming of a midwife and tends to bring reproach to the profession.

 S - ERIOUS IGNORANCE
“Lack of knowledge or awareness of a particular thing”.

TOPIC: Due Process & Midwife and Crimes

DUE PROCESS
ARREST
Arrest is the taking of a person into custody in order that he may be bound to answer for the commission of an
offense.

BAIL
Bail is the security given for temporary release of a person in custody or of a person arrested.

COURT
The primary function of the court is to “decide and pronounce a judgment and carry it into effect between two
persons and parties who bring a case before it for decision.

LAW SUIT
Law suit or action means an ordinary suit in a court of justice by which one party prosecutes another for the
enforcement or protection of a right or prevention or redress of a wrong.

PLAINTIFF AND RESPONDENT

1. Plaintiff/Complaint – the person who files a case against another. The plaintiff is the accuser.
2. Respondent/defendant – the person against whom the case is filed. The respondent is the accused.

PLEADINGS
Pleadings are the written allegations of the parties for a civil or criminal case of their respective claims and
defenses submitted to the court for trial and judgment.

COMPLAINT
A civil action is commenced by filing a complaint with the court. The complaint is a concise statement of the
ultimate facts constituting the plaintiff’s cause or causes of action. It is sworn written statement charging a person of an
offense.

PLEA
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In general, plea refers to the answer of the defendant to the complaint. The defendant may plea “guilty” or “not
guilty”.

DUE PROCESS
Section 14 of the Bill of Rights of the Constitution states that “no person shall be held to answer for a criminal
offense without due process of law.”
Due process of law means “a law which hears before it condemns; which proceeds upon inquiry, and renders
judgment only after trial.”

SUBPOENA
Subpoena is the process directed to a person requiring him to attend and to testify at the hearing or the trial of an
action, or at any investigation conducted under the laws of the Philippines, or for the taking of his disposition, it may also
require him to bring with him any books, documents, or other things under his control, in which case it is called a
subpoena duces tecum.

VENUE
Venue designates the particular place in which a court having jurisdiction may in the first instance properly hear
and determine the cause (Jacinto, 1990) or the place where the case is to be heard or tried (regalado, 1986).

JURISDICTION
Jurisdiction is the authority to hear and determine issues and facts and law. The authority by which judicial
officers hear and decide legal controversy (jacinto, 1990).

EVIDENCE
Evidence is the means of ascertaining in a judicial proceeding the truth respecting the matter of fact.

KINS OF EVIDENCE
1. Object or real evidence – are objects which may be exhibited to, examined or viewed by the court.
Example: the guns used by the offender in shooting the victim.
2. Documentary Evidence – documents as evidence consist of writings or any materials containing letters, words
number, figures or the other modes of written expression.
Example: patient’s charts, birth certificate, written contracts.
3. Testimonial Evidence – this refers to the declaration of witnesses. A witness can testify only to those facts which
he has personal knowledge of hearsay evidence or repetition of what the others have said, are not dismissible.
Hearsay evidence becomes admissible when a party does not object to the hearsay evidence presented by the
opponent. Testimony of opinion can only be given by expert witness.

PRIVILEGE COMMUNICATION – a private communication made by a patient to a midwife is a privilege communication.

Dying Declaration – the declaration of a dying person, provided such person knows that he is about to die, may be
received in a case where his death is the subject of inquiry, as evidence of the cause and surroundings circumstances of
his death. It is a duty of the midwife who attended a patient and heard his dying declaration to record it in the patient’s
chart accurately and correctly.

JUDGMENT
A judgment is the decision or sentence of the law given by a court of justice or other competent tribunal as a
result of a proceeding instituted there in, or the final consideration and determination of a court on matters submitted to
it in an action or proceedings.

APPEAL
Appeal is filed by the aggrieved party to a higher court to secure the review of a judgment, order, or decree of an
inferior court. An appeal must be made within fifteen days after a judgment is rendered. The party bringing the case to
the appellate court is called the appellant and the adverse party is called the appelle.

ADMINISTRATIVE INVESTIGATIONS
Complaint
A complaint against a professional or an examinee shall be submitted in writing to the Board concerned. If the
professional is a midwife, the complaint must be submitted to the Board of Midwifery by the complainant. The complaint
against a professional can be based on any of the following grounds:
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 Immoral or dishonorable conduct

 Conviction of criminal offense involving moral turpitude
 Unprofessional or unethical conduct
 Gross negligence
 Incompetence in the practice of profession
 Use of or perpetration of fraud or deceit in the acquisition of registration certificate
 Insanity
 Or for other relevant causes.

SUMMONS
Summons shall consist of the letter-subpoena requiring appearance of the respondent at a designated time and
place or letter requiring him to answer within the period specified therein, and a copy of the complaint and its enclosures.

Petition for reconsideration

The respondent may appeal the decision of the Board within thirty (30) days from receipt thereof to the Commission
whose decision shall be final.

THE MIDWIFE AND CRIMES

CRIME is an act or Omission punishable by law.

CRIMINAL LAW is that branch of law which defines crimes, treats of their nature and provides for their punishment.

Two Kinds of Crime According to the law punishing them

1. Felony – when the law punishing the act or omission is the Revised Penal Code of the Philippines. This includes
crimes such as abortion, homicide, murder, theft, simulation of birth.
2. Offense – when the act or omission is punishable by special penal statutes or any other law but not the Revised
Penal Code. These are crimes committed in violation of residential decrees, republic acts, and executive orders
but which are not laws that amend any provision of the Revised Penal Code.

FELONIES
Felonies are crimes punished by the Revised Penal Code of the Philippines.

Essential elements of Felony

1. There must be an act or omission

Act means any bodily movement which tends to produce some effect in the external world. It is not necessary
that the effect of the act be actually produced, as the possibility of its production is sufficient.
Example: the act of taking the wallet of an unconscious patient with intent to gain constitutes the crime of
theft. The act of administering fatal dosage of sedatives to a patient with intent to kill that patient constitutes
the crime of murder.
2. That the act or omission must be punishable by the Revised Penal Code
The rule is: there is no crime when there is no law punishing the act. “Nullum Crimen, Nulla Poena sine lege”.
3. That the act is performed or the omission is incurred by means of DOLO or Malice (meaning criminal intent) or Culpa
(meaning Fault).

Omission refers to inaction or the failure to perform an act required by law to be done.
Example: failure to render assistance to any person whom a midwife finds in uninhabited place wounded and in
danger of dying constitutes the crime of abandonment of persons in danger.

DOLO means malice, criminal intent or the intent to do an evil to another, his property or his right. A crime committed by
means of DOLO or with malice is known as intentional felony.

Requisites of Dolo

 Freedom – which means that the crime was committed freely by the person and that he did not act under any
compulsion.
 Intelligence – the person must know what he is doing or what he is omitting to do..
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 Intent – the person must have a criminal intent to do an evil or cause injury to another

CULPA means fault. When the offender commits a wrongful act resulting from imprudence, negligence, lack of
foresight or lock of skill, the act is called culpable felony.

Classification of Felonies According to the Stages of Execution

1. Attempted felony – a felony is attempted when the offender commences the commission of the felony directly by
over acts, and does not perform all the acts of execution which should produce the felony by reason of some cause or
accident other than his own spontaneous desistance.
If a person does not perform all the acts of execution because of his own spontaneous desistance there is no
attempted felony.

2. Frustrated Felony – a felony is frustrated when the offender performs all the acts of execution which would produce
the felony as a consequence but which, nevertheless, do not produce it by reason of causes independent of the will of
the perpetrator.

3. Consummated felony – a felony is consummated when all the elements necessary for its execution and
accomplishment are present.

Example
With intent to kill a four year old boy under her care, a nanny prepared a bowl of cereals and laced it with poison
sufficient, if substantial amount is taken, to kill the boy
 If, after she fed the boy with the said cereals, the boy dies of the said poison, the crime is consummated (murder).
 If, despite having fed the boy with all the contents of the said bowl, the boy does not die because of timely
medical attention, the crime is frustrated (murder).
 If the boy does not die because, after she fed him a spoonful of the said cereals, he started to retch such that she
was not able anymore (although she still wanted) to feed him more of the poisoned cereals, the crime is
attempted (murder).

Classification of felonies According to their Gravity

The gravity of the felonies is determined by the penalties attached to them by law. And according to their gravity, felonies
are classified into three, namely, the Grave Felonies, the Less Grave Felonies and the Light Felonies.

1. Grave Felonies are those which the law punishes with capital punishment or any of the afflictive penalties.
a. Capital punishment is death penalty.
b. Afflictive Penalties include:
 Reclusion Perpetua which is imprisonment from twenty years and one day to forty years.
 Reclusion Temporal which is imprisonment from twelve years and one day to twenty years.
 Prison Mayor which is imprisonment from six month and one day to six years.

2. Less Grave Felonies are those which the law punishes with any of the correctional penalties.
a. Correctional Penalties include:
 Prison correctional which is imprisonment from six months and one day to six years.
 Destierro which is restriction of freedom from six months and one day to six years;
 Arresto Mayor which is imprisonment from one month and one day to six months.

3. Light Felonies are those which are punished by law with arresto menor or with a fine not exceeding Two Hundred
pesos (P200.00), or both such imprisonment and fine.
a. Arresto Menor is a light penalty which consists of an imprisonment or deprivation of freedom from one day to
thirty days.

PERSONS CRIMINALLY LIABLE

1. Principals are persons who took part in the crime by:

 Direct participation or taking a direct part in the execution of the felony
 Induction or directly forcing or inducing others to commit a crime

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 Indispensable cooperation or by cooperating in a commission of the felony by another act without which the
crime would not have been accomplished.
2. Accomplices are person who are not principal but cooperate in the execution of the felony by previous or
simultaneous acts. Also called accessory before the fact.

3. Accessory are persons who having knowledge of the commission of the crime, and without having participated
therein, either as principals or accomplices, take part after the crime was committed in any of the following manners:
 By profiting them or assisting the offender to profit by the effects of the crime.
 By concealing and destroying the body of the crime or the effects or instruments thereof, in order to prevent
its discovery
 By harboring, concealing, or assisting in the escape of the principal of the crime, provided the accessory acts
with abuse of his public function or whenever the author of the crime is guilty of treason, parricide, murder or
on an attempt to take the life of the Chief executive, or is known to be habitually guilty of some other crime.

Accessories Exempted From Criminal Liability – an accessory is exempted from criminal liability when the principal of
the felony is a spouse, ascendant, descendant, brother, sister, or relative by affinity within the same degree.

CONSPIRACY TO COMMIT A CRIME

Conspiracy exists when two or more persons come to an agreement concerning the commission of a felony and decide to
do it.
Example: the midwife and the daughter of a terminally ill patient agreed to give the patient a fatal dose of sedative in order
to end the patient’s suffering. Thirty minutes after administration of the drug, the patient died. The midwife and the patient’s
daughter are conspirators to a crime of murder.

CIRCUSTANCES AFFECTING CRIMINAL LIABILITY

1. Justifying Circumstances are those where the act of a person is said to be in accordance with law, so that such person
is deemed not to have transgressed the law and is free from both criminal and civil liability, the following are justifying
circumstances:
a. Anyone who acts in defense of his person or rights, provided that the following circumstances concur (also called self-
defense).
 There is unlawful aggression
 Reasonable necessity of the means employed to prevent or repel such aggression
 Lack of sufficient provocation on the part of the person defending himself.
b. Anyone who acts in defense of the person or rights of his spouse. Ascendants, descendants, or legitimate, natural or
adopted brothers or sisters or of his relatives by affinity in the same degrees, and those of consanguinity within the
fourth civil degree.
c. Anyone who acts in defense of the rights or persons or strangers.
d. Any person who, in order to avoid evil or injury, does an act which causes damage to another, provided that the
following requisites are present:
 That the evil sought to be avoided actually exist
 That the injury feared be greater than done to avoid it
 That there be no practical and less harmful means of preventing it.
e. Any person who acts in the fulfillment of a duty or in the lawful exercise of a right or office.
f. Any person who acts in obedience to order issued by a superior for some lawful purpose.

2. Exempting Circumstances are those grounds for exemption from punishment because of the complete absence of
intelligence or freedom of action on the part of the accused. A person who acts without intelligence, freedom of
action or intent does not act with malice. The following are exempting circumstances:
a. An imbecile or an insane, unless the latter has acted during a lucid interval
b. person nine years of age or less
c. A person over nine years of age and under fifteen unless he has acted with discernment
d. Any person while performing a lawful act with due care, causes an injury by mere accident without fault or
intention of causing it
e. Any person who acts under the impulse of an uncontrollable fear of an equal or greater injury
f. Any person who fails to perform an act required by law, when prevented by some lawful or insuperable cause.

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3. Mitigating Circumstances are those which, if present in the commission of a crime, do not free the offender from
criminal liability but serve only to reduce the penalty for the crime committed. Mitigating circumstances only reduce
the liability of the offender but do not change the nature of the crime. The following mitigating circumstances:
a. That the offender is under 18 years of age or over 70 years
b. That the offender had no intension to commit so grave a wrong as that committed
c. That sufficient provocation or threat on the part of the offended party immediately preceded the act
d. That the act was committed in the immediate vindication of a grave offense to the one committing the felony
(delito), his spouse, ascendants, descendants, legitimate, natural or adopted brothers or sisters, or relatives by
affinity within the same degrees:
e. That of having acted upon an impulse so powerful as naturally to have produced passion or obfuscation:
f. That the offender had voluntarily surrendered himself to a person in authority or his agents, or that he had
voluntarily confessed his guilt before the court prior to the presentation of the evidence of the prosecution:
g. That the offender is deaf and dumb, blind or otherwise suffering some physical defects which thus restricts his
means of action, defense, or communication with his fellow beings: and
h. Such illness of the offender as would diminish the exercise of the will power of the offender without however
depriving him of consciousness of his acts.

4. Aggravating Circumstances are those which, if attendant to the commission of the crime serve to increase the liability
of the offender.
a. That advantage be taken by the offender of his public position
b. That the crime was committed in contempt or insult to the public authorities
c. That the act be committed with abuse of confidence or obvious ungratefulness
d. That the crime be committed in the palace of the Chief Executive or in his presence or where public authorities
are engaged in the discharge of their duties or in place dedicated to religious worship
e. That the crime be committed in the nighttime or uninhabited place, or by a band, whether such circumstances
may facilitate the commission of the offense.
f. That the crime be committed in the occasion of conflagration, shipwreck. Earthquake, epidemic, or other calamity
or misfortune.
g. That the crime be committed with the aid of armed men or persons who insure or afford immunity
h. That the crime be committed in consideration of a price, reward or promise;
i. That the crime be committed by means of inundation, fire, explosion, stranding of a vessel or intentional damage
thereto, derailment of a locomotive, or by the use of any other artifice involving great waste and ruin
j. The crime be committed with evident premeditation
k. That craft, fraud or disguise be employed or the crime committed with treachery.

5. Alternative Circumstances are those which must be taken into consideration as aggravating or mitigating according to
the nature and effects of the crime and the other conditions attending its commission. They are:
a. Degree of instruction and education of the offender
 Low degree of instruction or lack of it is generally mitigating
 High degree of instruction and education is aggravating when the offender avails himself of his learning in
committing the crime
 The accused who studied up to the sixth grade has sufficient schooling
 Not mitigating in crimes against property.
b. Intoxication
 It is mitigating when intoxication is not habitual and not subsequent to the plan to commit a felony
 It is aggravating when intoxication is habitual or if it is intentional
c. Relationship – when the offended party is the spouse, descendant, ascendant, natural or adopted brother or
sister or relative by affinity in the same degree of the offender.
 Relationship is mitigating in the crimes of robbery, usurpation, fraudulent insolvency and arson
 Relationship is aggravating in crimes against person where the offended party is a relative of a higher
degree or when the offender and offended party are of the same levels
 Relationship is mitigating in trespass to dwelling
 Relationship is aggravating in crimes against chastity, murder, homicide and any of the serious physical
injuries.

TWO CLASSES OF INJURY CAUSED BY AN OFFENSE OR CRIME

1. Social Injury is the disturbance and alarm to the society caused by the crime.

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2. Personal Injury is caused to the victim of the crime who suffered damage either to his person, to his property, to
his honor or to his chastity.

PENALTY
Penalty is the suffering inflicted by the state for the violation of the law. Penalty has several purposes.

The Different Penalties

1. Capital Punishment – Death

2. Afflictive penalties
a. Reclusion Perpetua – 20 years and one day to 30 days
b. Reclusion Temporal – 12 years and one day to 20 years
c. Prison mayor – 6 years and one day to 12 years
The fine for afflictive penalties is over P6,000.00

3. Correctional Penalties
a. Prison Correctional – 6 months and one day to 6 years
b. Arresto mayor – 1 month and one day to 6 months
c. Suspension – suspension from public office
d. Destierro – banishment from the place where the crime was committed
Fine for correctional penalties is over P200.00 to P6,000.00

4. Light Penalties
a. Aresto menor – one day to one month
b. Public censure
Fine is P200.00 or less

CRIMES AGAINST PERSONS

Murder is committed by any person who kills another person with any of the following attending circumstances:
1. With treachery, taking advantage of superior strength, with the aid of armed men or employing means to weaken
the defense, or of means of persons to ensure or afford impunity.
2. In consideration of price reward or promise
3. By means of inundation, fire, poison, explosion, shipwreck, stranding of a vessel, derailment of or assault upon a
streetcar or locomotive, fall of an airship, by means involving great taste and ruin
4. With evident premeditation
5. With cruelty, by deliberately and inhumanly augmenting the suffering of the victim, or outgoing
6. Or scoffing at his person or corpse.

Homicide is the unlawful killing of another person which is neither parricide, murder nor infanticide.

Euthanasia or mercy killing means painlessly putting an end to the life of a terminally ill patient or patient suffering from
incurable disease. In euthanasia, the patient does not want to die while in giving assistance to suicide, the person wants to
die.

Giving assistance to suicide is committed either by assisting another to commit suicide (whether the suicide is
consummated or not) and by lending assistance to another to the extent of doing the killing himself.

Parricide is committed by a person who kill his father, mother, weather legitimate or illegitimate, or any of his ascendants
or descendant, or his spouse.

Infanticide is killing of a child less than three days old. The penalty is the same as that for parricide or murder.

Abortion is the expulsion of the fetus from the womb before it is capable of sustaining life (outside the womb) which
expulsion results in its death.

Dispensing of Abortive is the unlawful dispensing of any abortive by any pharmacist without the proper prescription from
a physician.
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Mutilation is the deliberate lopping or clipping off of some part of the body of another person with the purpose of
depriving the person of that part of his body. If the mutilation was committed without deliberate intent of depriving the
person of that part of his body, it will consider as physical injuries. Mutilation of the reproductive organs such as the penis
and the ovary is considered castration.

Physical injuries can be:

1. Serious physical injuries consist of wounding beating, assaulting and administering injurious substances to another
person which may be committed by reckless imprudence or negligence. The harm or injury inflicted on a person will
be considered serious physical injury when:
 The injured person becomes insane, imbecile, impotent or blind
 The injured person loses the use of speech, power to hear or smell, loses an eye, a foot, a hand, an arm or a
leg or becomes incapacitated for the work in which he/she is habitually engaged.
 The person injured becomes deformed or loses any other member of his body, becomes incapacitated or ill
for the performance of the work in which he was habitually engaged for more than 30 days.

2. Less serious physical injuries is a harm or injury inflicted on a person which incapacitates the person for labor for 10
days or more but not more than 30 days or needs medical attendance for the same period of time.

3. Slight physical injury, is an inquiry or harm inflicted on a person which incapacitates the offended party from one to
nine days or requires medical attendance during the same period. Slight physical injury may be committed by ill
treatment of another person; the evidence of actual injury may not be present.

CRIMES AGAINST LIBERTY AND SECURITY

Illegal Detention is the crime committed by a private individual who unlawfully deprives another person of liberty.

Abandonment of Persons in Danger is the crime committed by anyone who fails to render assistance to any person whom
he finds in an uninhabited place wounded or in danger of dying, when he can render assistance without detriment to
himself. It is also committed by anyone who having found an abandoned child under seven years of age, shall fail to
deliver said child to the authorities or to his family, or shall fall to take him to a safe place.

Abandonment of One’s Victims is committed by anyone who shall fail to help or render assistance to another whom he has
accidentally wounded or injured.

Light Threats means a threat to commit a wrong not constituting a crime, and that there is a demand for money or that
other condition is imposed, even though that condition is not unlawful. Thus a midwife who threatens a patient that he
will suffer severely from his disease if he will not take his medications or will not sign the consent for surgery may be liable
for light threats.

Grave threats are committed by any person who shall threaten another with the infliction upon the person, honor or
property of the latter or of his family of any wrong.
A midwife who threatens a hospital director that she will publish to a newspaper evidence of graft and corruption
committed by the hospital director if the latter does not accept her job application may be charged of grave threats.

Grave Coercions can be committed by a person either by:

1. Preventing another person by means of violence from doing something not prohibited by law
2. Compelling another by means of violence to do something against his will whether it is right or wrong.

Revelation of secrets is committed by an employee, manager or servant who learns the secret of his principal or master in
such capacity and reveals such secrets.
The midwife may reveal these secrets only with:
1. The permission of the patient
2. When its revelation is necessary for the common good
3. When there is a court order that requires her to reveal them.

CRIMES AGAINST PROPERTY

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Robbery is committed by any person who shall take the personal property belonging to another with the intent to gain by
means of force, intimidation of any person, or using force upon anything.

Theft is committed by any person who, with intent to gain but without violence against intimidation of neither persons
nor force upon things, shall take the personal property of another without the latter’s consent. A person who has found
lost property and fails to deliver the same to the local authorities or to its owner is also guilty of theft.

Swindling or Estafa is the crime committed by any person who defrauds another.

Malicious Mischief is the crime committed by any person who deliberately causes to the property of any other damage.

Destructive Arson is the crime committed by any person who burns a building, train, ship, airplane etc.

CRIMES AGAINST CHASTITY

ADULTERY is the crime committed by any married woman who has sexual intercourse with a man not her husband and by
the man who has carnal knowledge of her.

Concubinage is committed by any married man who either:

1. Keeps a mistress in the conjugal dwelling
2. Has sexual intercourse, under scandalous circumstances, with a woman who is not his wife
3. Cohabits with a woman not his wife in any other place

Abduction is the kidnapping of a woman by removing her from her home, or from whatever place she may be, to take her
to some other, with the intent to marry or corrupt her (“libidinis causa”). It may be forcible or consented:
1. Forcible abduction as a felony is the abduction of any woman against her will and with lewd designs
2. Consented abduction as a felony is the abduction of a virgin over twelve and under eighteen years of age, carried
out with her consent and with lewd designs.

CRIMES AGAINST CIVIL STATUS OF PERSONS

Simulation of Birth is committed by a woman who pretends that she is pregnant when in fact she is not, and on the day of
the supposed delivery takes the child of another as her own.

Substituting One Child for Another is committed by a person who exchanges babies without the knowledge of their
parents with the intention to cause the loss of any trace of their filiations.

Concealing or Abandoning a legitimate Child with the intent of causing such child to lose its civil status.

CRIMES AGAINST HONOR

Libel – is a public and malicious imputation of a crime, or a vice or defect, real or imaginary or any act, omission,
condition, status or circumstances tending to cause the dishonor, dis credit or contempt of a natural or judicial person or
to blacken the memory of the one who is dead. Libel is committed by means of writing, printing, lithography, engraving,
radio, phonograph, painting or theatrical or cinematographic exhibition or any similar means.

Slander is oral defamation.

QUASI OFFENSES

Simple imprudence consists in the lack of precautions displayed in those cases in which the damage impending to be
caused is not immediate nor the danger clearly manifested.

Reckless imprudence consists in voluntarily, but without malice, doing or failing to do an act from which material damage
results by reason of inexcusable lack of precaution on the part of the person performing or failing to perform such act,
taking into consideration his employment and occupation, degree of intelligence, physical condition and other
circumstances regardless of persons, time and place.

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NEGLIGENCE is lack of foresight or deficiency of perception. Negligence is avoided by paying proper attention and using
due diligence in foreseeing wrongful acts.

Example: a midwife who failed to inspect a defective side rail of a patient’s bed causing the patient to slip from that bed
during a seizure may be charged of negligence. If the midwife inspected the side rails know that the side rail are defective
but failed to report it for repair so that the patient slipped from the bed during a seizure and suffered injury due to the
fall, that midwife may be charged of reckless imprudence.

Three kinds of Negligence

1. Contractual Negligence – or Culpa Contractual – negligence that results from breach of contract.
Example: a midwife failed to observe proper care of the umbilicus of a newborn as a result, the new born suffered
from infection. There exist a contract between the midwife and the parent of the newborn.

2. Civil negligence or culpa aquiliana or tort or quasi-delict. There is no pre existing contract except that there is a
duty to be careful in all human actuations.
Example: a midwife driving her car hit a person. There is no contract existing between the midwife and the person
but the failure of the midwife to drive carefully and safely resulting in harm to another person makes her
negligent and liable.
3. Criminal negligence or culpa criminal – negligence that results in the commission of crime.
Example: a midwife who performs abortion.

TOPIC: LAW AND MIDWIFE

LAW AND MIDWIFE
“LAW defined a rule of action formally recognize as binding and enforced by controlling an authority”

CHARACTERISTICS OF LAW
 It is a rule of conduct or action which determines what can be done and what cannot be done. State law
embraces external acts only. Morality includes both internal thoughts and external acts.
 Law is obligatory which means that every person is obliged to follow the law. If a person disobeys the law, a
punishment is imposed on him. Punishments for disobedience to the law are effective way of enforcing
obedience to the law.
 It is promulgated by legitimate authority. In the Philippines, the congress, the legislative branch of the
government, is the legitimate body that enacts laws.
 It is of common observances and benefit. Law is promulgated to regulate the conduct of man and maintain
harmony in society. In order to be useful, it must be followed by everybody.

JURISPRUDENCE
Jurisprudence is the science of law. It embraces all the laws enacted by the legislative body of the state, all rules and
regulation promulgated by those in authority, court decisions and formal principles upon which laws are based (ASPER,
1990).

CLASSIFICATION OF LAW

1. Natural Laws – these are the laws that derive their authority and force from God. They are considered to be
superior to other laws and binding to the whole world. Natural laws are the Eternal law (that is, “God’s eternal plan
and providence for the universe”) as known to man by his (man’s) reason.
a.Physical Laws – they are the universal rules of action that govern the conduct and movement of material things.
They are also known as the law of nature. Example: law of Gravity.

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b.Moral Laws – they are the set of rules that establish what is wrong as dictated by human conscience and
inspired by the eternal law.

2. Positive Laws – positive laws are the laws that are promulgated expressly and directly.
A.Divine Positive Laws – they are the laws that are promulgated expressly and directly by God himself. They are
made known to man through revelation. Example: The Ten Commandments.
B.Divine – Human Positive Laws – these are the laws that are promulgated by God’s representatives on earth
under His Divine inspiration. Example: ecclesiastical laws by the church.
Human Positive Laws – these are the positive laws promulgated by man.

3. Public Law - these are the human positive laws that govern the relationship between the state and its citizens (and
also between or among states). Public Laws may be classified as follows:
- Constitutional Law – it refers to the constitution which is the supreme and fundamental law of the state. It’s
basically defines the powers of government and the rights of the citizen. Example: the 1987 constitution of
the republic of the Philippines.
- Criminal Law – it is the law that defines crimes, treats of their nature, and provides for their punishment.
Example: The Revise Penal Code of the Philippines (act no. 3815).
-Administrative Law – it is the law that governs the organization competence and function of government
administrative authorities.
Law of Public Officers – it is the law that governs the conduct of those who hold the exercise public officers
and functions.
- Election Law – it is the law that governs the exercise of the right of suffrage, especially in the selection of the
representative of the citizens in the government.
-International Law – it is the law that governs the relationship between and among states or nations.

4. Private Laws – private laws are laws that govern the relationships between members of the society among
citizens of a state. They are further classified into:
-Civil Law – these are the laws that regulate the relations that exist among members of the society for the
protection of private interest. Example: Law on succession (found in the civil code of the Philippines R.A 386).
-Commercial Law – these are the laws that regulate the commercial or business relations among members of
the society.
Remedial Law – these are the laws that prescribed the methods of enforcing rights or of obtaining redness for
their invasion. It refers to the means and methods of setting the courts in motion, making the facts known to
them, and effectuating their judgment.

SOURCES OF LAWS

1. CONSTITUTION – the constitution of the Republic of the Philippines is the fundamental and supreme law of the land
or highest law to which all the other laws must conform.
Example: the 1987 constitution of the Philippines.
2. Legislation – it consists of laws enacted by the congress, the legislative branch of the government and ordinances
enacted by local governments. Example: Midwifery Act
3.Executives Order, Administrative Orders, Regulations, and Rulings – consists of administrative orders regulations and
ruled issued by administrative officials (PRC Commissioner, Board of Midwifery, Secretary of Education) under
legislative authority, administrative rules and regulations are intended to clarify, explain the law and carry into effect
its general provisions.
4. Precedents or Judicial decisions and Jurisprudence – this legal system of the Philippines is formed in part by the
decisions of the courts, particularly the Supreme Court.
5. Customs – these are habits and practices which through long and uninterrupted usage have become acknowledged
and approved by society as binding rules of conduct.
6.Other Sources – this include principles of justice and equity decisions of foreign tribunals opinions of text writers and
religion. These sources are resorted to in the absence of other sources.

MEANING, ELEMENTS AND INHERENT POWERS OF STATE

Meaning of State
A state may be defined simply as a community of persons with a definite territory, a government of their own, and
sovereignty. Example: republic act of the Philippines.

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Elements of a State
a. People - this refers to the mass of population permanently inhabiting the territory of the state. Example: The
Filipino people.
b. Territory – this refers to the definite and fixed portion of the earth permanently inhabited by the people of the
state. Example: the territory of the Republic of the Philippines as defined (or delineated) in Article 1 of the 1987
constitution of the Republic of the Philippines.
c. Government – this refers to the agency through which the will of the people of the state is being formulated,
expressed and finally realized.
Example: the Government of the Republic of the Philippines.
d. Sovereignty – this refers to supreme and uncontrollable power by which the state is governed. [Under Art. II,
sec. 1 of the 1987 Constitution. “sovereignty resides in the (Filipino) people and all government authority
emanates from then”.]

Inherent Powers of the State

a. Police Power – this refers to the power of the state to regulate rights, privileges and property for the promotion
of the general welfare.
Example: the regulation of the practice of nursing under R.A 9173.
b. Power of eminent Domain- this refers to the power of the state to take private for public use upon payment of
just compensation.
Example: the state may take a privately-owned piece of land to be used as a public road, even against the consent
of the private owner, provided that he is paid just compensation.
c. Power of Taxation – this refers to the power of the state to demand contributions (in the form of taxes) from
the people in exchange for the protection and services it provides to them.
Example: Nurses who earn income from the practice of their profession may be required to pay income taxes.

The Three Branches of Government

a. Legislative Branch – this refers to the Congress of the Philippines, which is made up of the senate and the House
of Representatives/. The Constitution vests this branch with Legislative powers (or the power to make law).
b. Executive Branch – this refers to the executive departments and is headed by the President of the Republic of
the Philippines who is also known as the Chief Executive. (The executive Departments are headed by the
respective secretaries who are considered as the alter-egos of the president). The Constitution vests the
President with executive powers (the powers to execute or implement the laws of the land).
c. Judicial Branch – this refers to the judiciary, which is the Supreme Court of the Philippines and the other courts
established by law. The constitution vests the judiciary with judicial powers (the power to interpret and apply the
laws).

RIGHTS
“Right is a moral power residing in a person of doing possessing or requiring something, which power all others to be
bound to respect.” (Asprer, 1990)

Webster has the following descriptions of right:

-Something to which one has just claim
-The power or privilege to which one is justly entitled
-The cause of truth or justice

Executive Order
An executive order (EO) is issued by the executive branch of the government in order to implement a constitutional
mandate or a statutory provision. Eos is issued by the president of the Philippines who heads the executive branch of the
government.

LETTER OF INSTRUCTION
A letter of instruction or LOI is an order issued by the President to serve as a guide to his previous decree or order.

PRESIDENTIAL DECREE
Is an order of the President. This power of the President which allows him to act as legislator was exercise during the
martial law period.

REPUBLIC ACT
An act passed by the Congress of the Philippines, while the form of the government is a republic state.
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REPUBLIC ACT NO. 7305

THE MAGNA CARTA OF PUBLIC HEALTH WORKERS

Section 1. Title – this act shall be known as the “Magna Carta of public Health Workers”.

Section 15. Normal hours work – the normal hours of work of any public health workers shall not exceeding eight (8) hours
a day of forty (40) hours a week.
Hours work shall include: (a) all the time during which a public health worker is required to be an active duty or to be at
prescribed workplace; and (b) all the time during which a public health worker is placed on “on call” status shall not be
considered as hours worked but shall entitled the public health worker to an “on call” pay equivalent to fifty percent
(50%) of his/her regular wage.
“On Call” status refers to a condition when the public health workers are called upon to respond to urgent or immediate
need for health/medical assistance or relief work during emergencies such that he/she cannot devote the time for his/her
own use.

Section 16. Overtime Work – where the exigencies of the service so require, any public health worker may be required to
render service beyond the normal eight (8) hours a day. In such case, the worker shall be paid an additional compensation
in accordance with existing laws and prevailing practices.

Section 17. Work during Rest Day –

a. Where a public health worker is made to work on his/her scheduled rest day. He/she shall be paid an additional
compensation In accordance with existing laws.
b. Where a public health worker is made to work on any special holiday he/she shall be paid an additional
compensation in accordance with existing laws. Where such holiday work falls on the worker’s scheduled rest
day, he/she shall be entitled to an additional compensation as may be provided by existing laws.

Section 18. Night Shift Differential –

a. Every public health worker shall be paid a night-shift differential of ten percent (10%) of his/her regular wage for
each hour of work performed during the night shifts customarily adopted by hospitals.
b. Every health worker required to work on the period covered after his/her regular schedule shall be entitle to
his/her regular wage plus the regular overtime rate and an additional amount of ten percent (10%) of such
overtime rate for each hour of work performed between ten (10) o’clock in the evening to six (6) o’clock in the
morning.

Section 20. Additional Compensation – Notwithstanding section 12 of the Republic Act 6758, public health workers shall
receive the following allowances: hazard allowance, subsistence allowance, longevity pay, laundry allowance, and remote
assignment allowance.

Section 21. Hazard Allowance – public health workers in hospitals, sanitarium, rural health units, main centers, health
infirmaries, barangay health stations, clinics and other health related establishments located in difficult areas, strife-torn,
or embattled areas, distressed or isolated stations, prison camps, mental hospitals, radiation exposed clinics, laboratories
or disease infested areas or areas declared under the state of calamity or emergency for the duration thereof which
expose them to the great danger, contagion, radiation, volcanic activity/eruption, occupational risks or perils to life
determined by the secretary of Health, shall be compensated hazard allowances equivalent to at least twenty five percent
(25%) of the monthly basic salary of health workers receiving salary grade 19 and below, and five percent (5%) for health
workers with salary grade 20 and above.

Section 24. Laundry Allowance – all public health workers who are required to wear uniforms regularly shall be entitled to
laundry allowance equivalent to One hundred twenty five pesos (P125.00) per month. Provided that this rate shall be
reviewed periodically and increased accordingly by the Secretary of Health in consultation with the appropriate
government agencies concerned taking into account existing laws and prevailing practices.

Section 25. Remote Assignment Allowance – Doctors, dentist, nurses and midwives who accept assignments in such
remote areas or isolated stations which for reasons of far distance or hard accessibility, such positions had not been filled
for the last two (2) years prior to the approval of this Act, shall be entitled to an incentive bonus in the form of remote
assignment allowance equivalent of fifty percent (50%) of their basic pay and shall be entitled to reimbursement of the
cost of reasonable transportation to and from such remote post or station, upon assuming or leaving such position and
during official trips. In additional to the above, such doctors, dentist, nurses and midwives mentioned in the preceding
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paragraph shall be given priority in promotion or assignment to better areas. Their tours of duty in the remote areas shall
not exceed two (2) years, except when there are no positions for their transfer or they prefer to stay in such posts in
excess of two (2) years.

Section 30. Highest Basic Salary Upon Retirement – Three (3) months prior to the compulsory retirement, the public
health worker shall automatically be granted one (1) salary range or grade higher than his/her basic salary and his/her
retirement benefit thereafter, computed on the basis of his/her highest salary. Provided that he/she has reached the age
and fulfilled service requirements under existing laws.

Section 42. Effectivity – this Act shall take effect fifteen (15) days after its [publication in at least two (2) national
newspapers of general circulation.

REPUBLIC ACT NO. 8981

AN ACT MODERNIZING THE PROFESSIONAL REGULATION COMMISSION, REPEALING FOR THE PURPOSE PRESIDENTIAL
DECREE NUMBERED TWO HUNDRED AND TWENTY-THREE, ENTITLED “ CREATING THE PROFESSIONAL FUNCTIONS” AND
FOR OTHER PURPOSES.

Section 1. Title – this Act shall be called the “PRC Modernization Act of 2000.”

BOARD RESOLUTION NO. 100

SERIES OF 1993

Rule 2. Filling of Application of Examination. – An application for examination shall file his/her application in a form
prescribed by the Commission ten (10) days prior to the examination together with the hereunder documents to wit:

Rule 5. Delivery Requirements – the student shall perform the twenty (20) actual deliveries under the supervision of
qualified faculty of the school.

Rule 6. Suturing of Perineal Laceration Requirements – The student shall perform at least five (5) suturing perineal
lacerations under supervision of qualified faculty of the school.

Rule 7. Insertion of Intravenous Fluid Requirements. The student shall perform at least (5) insertion of intravenous fluids
under the supervision of qualified faculty of the school.

PRC RESOLUTION NO. 2004-211

NON-ADMISSION OF EXAMINEES ARRIVING LATE DURING THE CONDUCT OF LICENSURE EXAMINATION

PRC Resolution No. 2004-200

FORFEITING THE EXAMINATION FEES PAID BY EXAMINEE WHO FAILED TO REPORT AND TAKE THE SCHEDULE
EXAMINATION

LAWS AFFECTING MIDWIFERY PRACTICE:

PRESIDENTIAL DEGREES:
1. PD 223 – creation of the Professional Regulation Commission (PRC).
2. PD 856 – Code of sanitation.
3. PD 996 – Compulsory immunization for all children below 8 years old.
4. PD 651 – Birth Registration Law.
5. PD 492 – Nutrition Program Law.
6. PD 825 – penalty for Improper Garbage Disposal.
7. PD 1146- New GSIS Law – Retirement Law.
8. PD 48 – four (4) children for maternity privileges.
9. PD 69- four (4) children for tax exemption purposes (dependent children).
10. PD 965 – family Planning & Responsible instruction prior to issuance of a marriage license.
11. PD 442 – new Labor Code of the Philippines.
12. PD 603 – child & Youth welfare Development.
13. PD 626 – employee Compensation & Stage Insurance Fund Benefits for immediate injury, illness or disabilities
amended by EO 179.
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14. PD 1619 – Dangerous Drug Act (RA 6425).

15. PD 1519 – new Medicare Law episiotomy of Primigravida Benefits from Medicare.
16. PD 79 – participation of Health workers in population control.
17. PD 148 – child Labor Law – ages lower than 16 years.

EXECUTIVE ORDERS:
- Is issued by the executive branch of the government in order to implement a constitutional mandate or a
statutory provision. EO is issued by the president of the Philippines who heads the executive branch of the
government.

1. EO 456 – IMAP’S Privilege to recommend for PRC nominees to the Midwifery Board.
2. EO 209 – Family Code amended EO no. 227.
3. EO 180 – Government Workers Collective Bargaining Rights.
4. EO 51 – Milk Code
5. EO 857 – Compulsory Dollar Remittance Law
6. EO 174 – national Drug Policy on Availability, Affordability, safe, Effective & good Quality for all
7. EO 500 – retired SSS member who is partially or permanently disabled to benefit from Medicare
8. EO 566 – review center should be based or allied with a PRC – recognized professional association
9. EO 115 – safe Motherhood
10. EO 266- issued July 25, 1995 – institutionalization of CPE programs of the various Professional Regulatory Boards
under supervision of PRC.
11. EO 268 – defines composition, powers, function of the National Commission on the Role of Filipino women
12. EO 366 – directing a strategic review of the operation and organization of the executive branch and providing
options and incentives for government employees.

REPUBLIC ACT
An act passed by the Congress of the Philippines, while the form of the government is a republic state.

1. RA 1080 – Civil Service Eligibility for those who passed the Board exam
2. RA 1082 – Rural Health Law
3. RA 1612 – Privilege Tax Law, payment of Professional Tax (RA 5181)
4. RA 2382 – Philippine Medical Act
5. RA 3573 – Reporting of Communicate Disease
6. RA 4073 – Liberalized the treatment of Leprosy
7. RA 4226 – Hospital licensure Act
8. RA 5901 – Forty (40) Hours a week work
9. RA 6111 – Philippine Medicare Act/ Medicine
10. RA 6365 – National Policy on Population and Creation of Commission of Population
11. Ra 6675 – Generics Act of 1988
12. RA 6713 – Code of Conduct and Ethics Standards for public Employees
13. RA 6725 – Prohibition of Discrimination Against women on employment, promotion and training opportunities
14. RA 6809 – Amended Article 34 of the Family Code, Majority age is 18 years unless otherwise provided
15. RA 6049 – March 8 as National Women’s Day
16. RA 6955 – Legal basis for declaring the practice of “mail Order” brides illegal
17. RA 6955 – Bans marriage matching for a fee as well as exportation of domestic workers
18. RA 6972 – Total development and protection of children in the barangay level (Day Care)
19. RA 7044 – rooming – in to all mothers who deliver in Public/private
20. RA 7160 – Local Autonomy Code/Local Government Code
21. RA 7170 – Legalized donation of human body organs upon death
22. RA 7176 – Comprehensive Tax Reform Program increasing personal/individual exemptions
23. RA 7192 – Provides Women rights and opportunities equal to man in woman’s development and nation building
24. RA 7277 – Magna Carta of Disabled person
25. RA 7305 – Magna Carta of the public Health Workers
26. RA 7392 - Philippine Midwifery Act of 1992
27. RA 7600 – Rooming- in Breastfeeding Act/Baby friendly Hospital (1992)
28. RA 7610 – Protection of Children from child abuse exploitation and discrimination Act
29. RA 7624 – Drug Education Law
30. RA 7641 – Employers to pay at least ½ month salary for every year of service to retired employees
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31. RA 7655 – SSS coverage for house help- Salaries of php800 within metro manila and other highly urbanized cities
per month. Those Receiving salaries of php1, 000 and above are required of this said SSS coverage
32. RA 7658 – Prohibiting the Employment of Children below 15 years of age in public and private.
33. RA 7716 – (E-VAT Law) Equitable Value Added Tax or Expanded Added Tax
34. RA 7722 – Rationalize Midwifery Education
35. RA 7875 – National Health Insurance Act of 1995
36. RA 7876 – Senior Citizen Law/Center for Senior Citizen
37. RA 7877 – Anti-Sexual Harassment law
38. RA 7883 – Benefits/Incentives for accredited Barangay Health Workers. An approach to health development for
essential goods, health and other social services, available and affordable for needs of underprivileged, sick,
elderly and disabled women and children.
39. RA 7947 – Tax exemptions of couples of php36000 for both (if joint exemption) provided both are employed
40. RA 8171 – repatriation of Filipino Women who lost their Phil. Citizenship by marriage to aliens and natural born
Filipinos
41. RA 8203 – Special Law on Counterfeit Drugs
42. RA 8245 – Internal Revenue allotment in the national revenue taxes which benefits government employees
43. RA 8282 – SS act of 1997, Amended RA 1161
44. RA 8291 – GSIS Act of 1997 amended PD 1146
45. RA 8353 - Incest Law
46. RA 8369 – Child and Family Court Act
47. RA 8370 – National Children’s TV Act (Protecting Children from indecent TV shows)
48. RA 8423 – Traditional Alternative Medicine Act – created PITACH ( Phil. Institute for traditional and Alternative
Health Care)
49. RA 8424 – BIR Tax Regulation Special treatment of Fringe benefits
50. RA 8492 – Flag Code – Penalty of php6, 000 to Php20, 000
51. RA 8504- Promulgating policies prescribing measures for prevention and control of HIV and AIDS
52. RA 8505 – Rape Victim assistance and protection act of 1998
53. RA 8532 – Comprehensive Agrarian reform Program (CARP)
54. RA 8533 – Annulment of Marriage even after Family Code (Aug. 3, 1998) was approved for Psychological
incapacity of either spouses
55. RA 8552 – Granting adopted Filipino children equal rights and privileges enjoyed by legitimate children
56. RA 8749 – The Clear Air Act
57. RA 8976 – Food Fortification Law
58. RA 9165 – Comprehensive Dangerous Act of 2002
59. RA 9173 – Philippine Nursing Act of 2002
60. RA 9225 – Citizenship Retention & reacquisition Act of 2003
61. RA 9257 – Expanded Senior Citizen Act – amended RA 7432 Senior Citizen Act
62. RA 9262 – The Anti-violence Act Against Women and Children
63. RA 9288 – An promulgating a comprehensive policy and a National System for Ensuring Newborn Screening
64. RA 8981 – PRC Modernization Act of 2000

PRC BOARD RESOLUTION:

1. No. 557 series of 1988 – Code of Ethics for Midwives
2. No. 665 series of 1095 – Continuing Education (CPE) for midwives
3. No. 187 series of 1991 – Renewal of Professional License; extension of 20 days after Birth month
4. No. 100 – implementing Rules and Regulations of RA 7392
5. 1976 – Birth of IMAP
6. No. 217 – Delisting of names from the PRC list of Professionals who have not renewed their license for 5 or more
consecutive years
7. No. 544 – Regional Licensure Examination venue for midwifery
8. No. no. 381s. 1995 – Standardized Guidelines and Procedures for Implementation of CPE programs for all
Professionals

PROCLAMATION:
1. No. 1275 – Midwifery week; Midwifery convention 3rd week of October
2. No. 147 – Declaring April 21 and May 19 and every 3rd Wednesday of January and February for 2 years as National
Immunization Days (NIDS)
3. No. 16 – implementing United National Goal on universal Child Immunization by 1990
4. No. 124 – November 9-15, 2003 3rd week of November every year as Drug Abuse Prevention & Control Week
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5. No. 2148 – Issued on May 1, 1985 declared the month of June as Rural Workers Month

LETTER OF INSTRUCTION

-Is an order issued by the President to serve as a guide to his previous decree or order.

1. LOI 1000 – Membership in National Organization

2. LOI 949 – Primary Health Care Expanded Functions of the Midwife
3. LOI 47 – Integration of Family planning in the Midwifery Curriculum
4. LOI 13 – Protection of the Filipino Citizen

TOPIC: THE MIDWIFE AND CONTRACTS & SUCCESSION AND WILLS

MIDWIFE AND CONTRACTS
CONTRACT
The Civil Code of the Philippines defines contract as “meeting of minds between two persons whereby one binds himself,
with respect to the other, to give something or to render some services”. One or more persons binds himself or
themselves in favor of another or others, or reciprocally, to the fulfillment of the object of the contract which may consist
of giving something, doing an act or not doing an act.

“du ut des” – I give that you may give.

“du ut facias” – I give that you may do.
Facio ut des” – I do that you may give.
“facio ut facias” – I do that you may do.

OBLIGATIONS
The Civil Code of the Philippines defines obligation as “juridical necessity to give, to do, or not to do an obligation is
juridical when it can be enforced by law.

Obligations arise from:

1. Law – obligations that are required by law. Example: obligation to pay taxes or support one’s family.
2. Contracts – obligations arising from contracts. Example: contract of employment wherein the employee has obligation
to render service and the employer has an obligation to pay for the employees services.
3. Quasi – contracts – obligation that are enforceable by law based on the rule that no one shall be allowed to enrich
oneself at the expense of another. Example: is the obligation to return money paid by mistake.
4. Crimes – obligations that arise from civil liability caused by a criminal offense Example: a person who commits a crime
of arson has civil liability to pay for the destruction of properties caused by his criminal act.
5. Torts – obligation for damages caused by fault and negligence but with no contractual agreement between the two
parties. Example: the obligation to pay for damages to another person caused by one’s animal such as a dog.

RIGHT
Right is the power to demand from another person any obligation or prostration. Example: the right of the midwife to
demand compensation for services already rendered and which the patient has the obligation to pay.

FREEDOM TO CONTRACT
The constitution guarantees the right of any person to enter into contracts (art. III section 10) however, this provision of
the constitution of the right to contract is applicable only to legally valid contracts.

Stages of a Contract

1. Preparation or Conception – this includes all steps taken by the parties leading to the perfection of the contract. At this
stage the parties have not yet arrived at any definite agreement.
Example: this is a stage when a midwife applies for a position and offers her professional services to the hospital for a
fee or salary.
2. Perfection or Birth – this is when the parties have come to a definite agreement or meeting of the minds regarding the
subject matter cause of contract.

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Example: this is the stage when the prospective employer and the applicant arrives an agreement. At this stage, the
hospitals accept the application of the midwife and the midwife accepts the conditions of employment of the hospital
including salary rate and both parties sign the contract of employment.
3. Consummation or Termination – this is when the parties have performed their respective obligations and their
contract may have been fully accomplished or executed. Example: the contract of employment of a midwife with the
hospital is consummated at the expiration of her contract of employment and the hospital has paid her salary or
professional fee in return for the services she rendered.

ESSENTIAL REQUISITES OF A CONTRACT

1. Consent of Contracting Parties

a. Consent is the conformity of wills (offer and acceptance). It is manifested by the meeting of the offer and the
acceptance upon the thing and the cause which are to constitute the contract.
b. Offer is a proposal by one party to another to enter into contract. The offer must be a certain not vague or
misleading or made as a joke otherwise the contract will be void.
c. Acceptance is the manifestation by the offered of his assent the terms of the offered. The acceptance must be
absolute and unqualified that is, it must be identical in all respects with that of the offer in order to produce a
meeting of the minds.
d. Requisites of consent
 There must be two or more parties
 The parties must have legal capacity to enter into a contract.
 There must be no vitiation of consent.
e. Persons incapacitated to contract and cannot enter into a contract.
 An emancipated minor who have not yet attained the age of majority which is 18 years. Married minors
are considered emancipated and therefore can enter into a contract without need of parental consent.
 Insane or demented persons unless they acted during a lucid interval. Lucid interval means a temporary
period of sanity. Contracts entered into during lucid interval are valid.
 Those in state of drunkenness and those hypnotized because persons in these conditions have complete
loss of understanding and therefore incapable of intelligent consent.
 Deaf-mutes who do not know how to write. If a deaf mute do not know how to write but he knows how
to read, he is considered capacitated.
 Married women cannot enter transactions involving the conjugal partnership.

2. Objects of Contract – the object of a contract is the subject matter of a contract it is what the parties agreed to give,
to do or not to do.

3. The Cause of a Contract – the cause is understood to be, for each contracting party the prostration or promise of a thing
or service by the other.

CHARACTERISTICS OF CONTRACT

1. AUTONOMY (FREEDOM TO STIPULATE) – this means that the contracting parties may establish such stipulations,
clauses, terms and conditions as they may deem, convenient, provided they are not contrary to law, morals, good
customs, public order or public policy.
2. Obligatory Force of Contracts – this means that “obligations arising from contracts have the force of law between the
contracting parties and should be complied with a good faith.”
3. Co sensuality of Contracts – this means that as a general rule, contracts are perfected by mere consent of the parties.
4. Mutuality of Contracts – this means that the contract must bind both contracting parties; its validity or compliance
cannot be left to the will of one of them.
5. Relativity of Contracts – this means that “contracts take effect only between the parties, their assigns and heirs”,
except in case where the rights and obligations arising from the contract are not transmissible by their nature, or by
stipulation or by provision of law.

KINS OF CONTRACTS

1. Informal Contracts – a contract which may be entered into in whatever from provided that all requirements for their
validity are met. This type of contract may be written or oral.
Example: if a mother asks a midwife to assist her during labor and delivery and the midwife agrees, they are entering
into an informal contract. Contract of sale is another example of informal contract.
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2. Formal Contracts or Solemn Contracts – a contract with require special formalities or a certain specified form, in
addition to consent, subject matter and cause before the contract may be perfected. Example: contracts which should
be accomplished in a special form are marriage contracts, deeds of sale, contract of employment for overseas
contract workers.

3. Implied Contract – is a contract that is include as the result of acts or conduct of the parties to which the law ascribe
an objective intention to enter into contract” (venzon, p73).

Example: a husband, Mr. jimeno called miss Navarro, a registered midwife in private practice, by phone requesting her to
come to their house because his wife is in labor. Miss Navarro promise to come but after putting down the phone, she
realized that she cannot come because of a valid reason. She tried to contact Mr. Jimeno by telephone but failed. She
then asked Miss Rosario to go to Mr. Jimeno’s house to assist the latter’s wife who is in labor. Upon arriving at his house,
Mr. Jimeno’s house, Mr. Jimeno let Miss Rosario in and did not object when the lattered informed him that she came in
place of Miss Navarro. Miss Rosario proceed to attend to Mrs. Jimeno until the fourth stage of labor, in this case, the
services rendered by Miss Rosario and acceptance of Mr. and Mrs Jimeno of her services and conducts and behavior
implying that both parties entered into a contract, which is that the midwife will assist Mrs, Jimeno during her labor and
delivery and in return, the couple will pay her for her services. The Doctrine “Facio ut des” is applicable in this situation.

4. Expressed Contract – a contract in which the conditions or terms of the contract are expressed orally or in writing by
the parties concerned.
Example: if in the example in number 2 it was Miss Navarro who assisted Mrs. Jimeno during labor and delivery, the
contract between them is an example of expressed contract because the terms of the contract were expressed orally
by Mr. Jimeno and Miss Navarro in the telephone.

5. Void and Inexistent Contracts – These are contracts that have no effect at all and which cannot be ratified or validated.
The following are inexistent and void contracts:
a. Those which are absolutely simulated or fictitious.
b. Those whose cause or object did not exist at the time of transaction.
c. Those which contemplate impossible service.
d. Those where intention of the parties relative to the principal objects of the contract cannot be ascertained.
e. Those expressly prohibited or declared void by law.
f. That whose cause, object or purpose is contrary to law, morals, good customs, public order or public policy.

6. Illegal Contracts – these are contracts that are contrary to law or expressly prohibited by law:
a. Those made protection of the law.
Example: when a midwife performs episiotomy to a patient she can be charged of illegal practice of medicine or
malpractice since her professional license allows her to enter into a contract with the public needing her services
as a midwife only.
b. Consent obtained by fraud.
Example: a patient agreed to avail of the services of a midwife because the midwife led the patient to believe that
she is a registered midwife when actually she is not.
c. Those obtained under Duress. Duress means actual or threatened violence of imprisonment in order to obtain
consent.
Example: if a midwife threatens the mother that she will not be allowed to leave the hospital unless she consents
to be given tetanus toxoid immunization, the consent of the patient is obtained under duress.
d. Those obtained under undue influence.
Example: when the midwife uses her close relationship with the patient in convincing her to submit to surgery,
she is using undue influence.
e. Those obtained through material misrepresentation.
Example: if a midwife applies for a position in the hospital and was accepted and was later found not to be a
registered midwife, her contract employment with the hospital becomes void and illegal.

SUCCESSION AND WILLS

SUCCESSION
Succession is the mode of acquisition by virtue of which the property, rights and obligation to the extent of the
value of the inheritance, of a person are transmitted through his death to another by his will or by operation of law.

Kinds of Succession
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1. Testamentary succession is that which results from the designation of an heir, made in a will in a form prescribed by
law.

2. Mixed succession is that affected partly by will and partly by operation of law.

3. Intestate succession occurs when a person did not make a will before his death or if his will is void the law vests the
inheritance to the proper persons such as the legitimate and illegitimate relatives of the deceased.

A WILL is an act whereby a person is permitted, with the formalities prescribed by law, to control to a certain degree the
disposition of his estate, to take effect after his death.

A TESTAMENT disposes of personal property while a will disposes of real property

A TESTATOR is a person who makes a will.

DECEDENT – is a person whose property is transmitted to another after his death whether or not he left a will.
INHERITANCE includes all property, rights and obligations of a person which are extinguished by his death. It includes not
only the property and the transmissible rights and obligations existing at the time of his death. But also those which have
accrued thereto since the opening of the succession.

An HEIR is a person called to the succession either by the provision of a will or by operation of law.

DEVISEES and LEGATEES are persons to whom gifts of real and personal property are respectively given by virtue of a will.

A CODICIL is a supplement or addition to a will, made after the execution of a will and annexed to be taken as part
thereof, by which any disposition made in the original will explained, added to or altered.

ESSENTIAL ELEMENTS AND CHARACTERISTICS OF A WILL

1. The making of a person of a will is not a natural right but a statutory right which means granted by law and may be
limited and withdrawn by law. This is evidenced by the clause “permitted within the formalities prescribed by law to
control to a certain degree the disposition of his estate.”

2. It is a unilateral act. This means that the making of a will is the sole act of the testator and the acceptance of the
beneficiary is not necessary to make a will valid. Of course the acceptance of the beneficiary is important in order to
make him entitled to anything given to him in the will.

3. It is a solemn and formal act which means that the law requires certain formalities to be complied with to make a will
valid. Example: a holographic will must be signed written and dated by the testator.

4. There must be “anemus testandi” or intent to make a will.

5. The testator must have testamentary capacity or mentally competent.

Testamentary Capacity is the capacity to make a will provided certain conditions prescribed by law are complied with
such as:
a. Must be 18 years old and above – at this age the person is generally no longer subject to fraud, influence or
insidious machinations.
b. Of sound mind at the time the will is made – it is necessary that the testator be in full possession of all his
reasoning faculties in order to understand that he is making a will and can change his will if he so desires, so
he will be able to know the person to whom he will give his estate and understand the nature of the estate he
is giving.

6. The will is strictly a personal act in all matters that is essential. Provisions in the will should express the desires of
the testator such as the property he wants to dispose of and to whom the testator wants to give the property.
The signing of the will should be made by the testator himself.
7. It is effective “mortis causa” or after the death of the testator.
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8. It is essentially revocable. The testator can change his will anytime before his death.

9. It is an individual act. Two or more persons cannot make will jointly, or in the same instrument either for their
reciprocal benefit or for the benefit of a third person. Joint wills are those which contain in one instrument the
will of two or more persons jointly signed by them. Mutual or reciprocal wills are wills that provide that the
survivor of the testators will succeed to all or some of the properties of the decedent.

10. It is free from vitiated consent. The testator executed the will freely, knowingly and voluntarily.

11. It disposes of the testator’s estate.

FORMS OF WILL
1. Ordinary or Notarial Will
2. Holographic will

DUTY OF A CUSTODIAN OF A WILL

The person who has custody of a will shall, within twenty days (20) after he knows of the death of the testator,
deliver the will to the court having jurisdiction, or the executor named in the will. If the custodian failed to deliver the will
within twenty days, the court may fine him an amount not exceeding P2, 000.00 and/or may be committed to prison until
he delivers the will.

EXECUTOR AND ADMINISTRATOR

An executor is a person chosen by the testator to carry out the directions and request in his/her will. When the
testator did not designate an executor or the designated executor is not competent to serve as an executor. The court
appoints an administrator to settle the estate of the testator. An executor is designated by the testator while an
administrator is appointed by the court.

RESPONSIBILITY OF A MIDWIFE IN MAKING A WILL

A will is a declaration of a person’s wishes on how his/her possessions will be disposed of after his death.
Witnessing a will is a voluntary act. If a patient expresses a desire to make a will, the appropriate action of a midwife
would be to help the patient look for a legal counsel or lawyer who can assist the patient. If a midwife is asked to witness
a will, it is advisable for her to ask her superior’s permission first or to find another person competent enough to witness a
will. It is a responsibility of a midwife present during the making of a will to make sure that the patient knowingly and
willfully executed the will and to document the procedure thoroughly and accurately in the patient’s chart.

TOPIC: THE BOARD OF MIDWIFERY & PRACTICE OF MIDWIFERY

THE BOARD OF MIDWIFERY

Is an administrative body created by the government to regulate, define, and limit the practice of Midwifery in the
country.

Was originally named Board of Examiners for Midwives by the old Midwifery Law, RA 2644. It was changed by
Professional Regulation Commission in 1974 to Board of Midwifery.
The Board Examiners were appointed by the President on august 5, 1960. The first Board Examiners were:
 Chairman: Dr. Valeriano C. Fugoso Jr.
 Member: Mrs. Vicenta Castro-Ponce
 Member: Miss Angelina Ponce

COMPOSITION OF THE BOARD

 1 – Chairman
 1 – Registered Nurse – Registered Midwife
 3 – Registered Midwives

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Qualifications and Disqualifications of the Board Members:

1. Each member of the Board shall at the time of his appointment:

a. Be a citizen and resident of the Philippines;
b. Be of good moral character;
c. Be at least 30 years of age; and
d. Not be a member of faculty, whether fulltime, part time or lecturer, of any school, college or university where
a regular course in midwifery is taught and shall not have any pecuniary interest directly or indirectly, in such
institution during his term of office as a Board Member.

2. The Chairman of the Board shall at the time of his appointment:

a. Be a registered obstetrician; and
b. Have at least ten (10) years practice as an obstetrician prior to his appointment

3. Three (3) member of the Board shall at the time of their appointment:
a. Be a registered midwives;
b. Be degree holders, preferably in the field of health and social sciences; and
c. Have at least ten (10) years practice midwives prior to their appointment, five (5) years of which are in
supervisory positions.

4. One (1) member of the Board shall at the time of his appointment:
a. Be a registered nurse-midwife; and
b. Have at least ten (10) years as a nurse-midwife.

STEPS IN APPOINTMENT OF BOARD MEMBERS:

1. First step: submission to the Professional Regulation Commission (PRC) of:

A list of registered midwives and nurse-midwives by the duly accredited association of midwives in the
Philippines.
A list of obstetrician by the duly accredited association of obstetrician.

2. Second step: selection of qualified candidates and recommendation to the President of the Philippines by the
Commissioner of the PRC of:
Three registered midwives
One obstetrician
One nurse-midwife from the list submitted by the associations

3. Last step: appointment by the President of the Philippines.

“The Board of Midwifery is under the supervision of the Professional Regular Commission (PRC). The PRC is under the
supervision of the President of the Philippines.

APPOINMENT OF THE BOARD MEMBERS:

1. Regular appointment – a board member has been chosen by the President from the list submitted by the accredited
associations of midwives, nurses and obstetrician.

2. Ad Interim appointment – the Board member has been appointed to fill a vacancy during the absence of a regular
member.

3. Hold –over Doctrine - in the absence of the law to the contrary, an official is entitled to hold his office after his term of
office has expired until his successor is appointed or chosen and has qualified.

TERM OF OFFICE
The term of office of the chairman and the three members is three (3) years. In order to qualify for their positions
as Chairman and Board Members, they must first take an oath of office.

Term of office is the period of time by which an officer may claim to hold the office as prescribed by law or the
fixed period of time an official is expected to hold his position.
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Tenure
Length of actual service.

DUTIES & FUNCTIONS & POWER OF THE BOM (A-L-I-C-E)

A - Authenticate official document

A - Administered oath
L - Look, from time to time, into the condition affecting the practice of midwifery in the Philippines and adopt such
measures as may be deemed necessary for the maintenance of the standards and ethics of the profession
I - Issue subpoena, subpoena duces tecum, summons
I - Issue certificate of registration
I - Issue revocation and Suspension
I - Investigate violation
C - Conduct midwifery board examination
E - Enforce provision

GROUNDS FOR REMOVAL OF BOARD MEMBERS (D-U-I-N)

1. D - ishonorable conduct- acts, conducts or behaviors that would bring shame to the person.

2. U - nprofessional conduct- conduct or behavior which violates the Code of Ethics of Midwives. They are behaviors or
conduct considered grossly unprofessional because they are immoral and dishonorable.

3. I - ncompetence- incapacity, inability or lack of qualifications or fitness to discharge the required duty or duties
incident to the employment.

4. N - eglect of duty- Omission or failure to do an act.

Before a Board Member can be removed from office for the above grounds, the PRC must first conduct a proper
administrative investigation and the Board member in question must be given a chance to defend himself.
Administrative proceedings conducted by the commission against the Board member must be completed within the
period of (30) thirty days.

CUSTODIAN OF THE RECORDS OF THE BOARD

The Professional Regulation Commission is the custodian or keeper of all the records of the Board of Midwifery.
These records include the following: (A-M-E-R-E)

 A - pplication for the Midwifery Board Examination

 M - inutes of deliberation
 E - xamination papers
 R - ecords of administrative cases and investigations conducted by the Board.
 E - xamination result

Rules and regulations

Shall take effect thirty (30) days after publications in two (2) nationals’ newspapers of general publications.

DIFFERENT POWER OF THE BOARD

1. Discretionary Power- when the public officer is given the right to exercise his judgment or discretion of what course of
action shall be pursued, how or when the duty shall be done.

2. Ministerial Power- when the public officer performs it in a prescribed manner or in a given state of facts or in
obedience to the mandate of a legal authority without regard to the exercise of his judgment or discretion.

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3. Quasi-Legislative- the power of promulgating rules and regulations concerning subjects within its jurisdiction, such
rules and regulations should be in harmony with the provisions of the Midwifery Act. Rules and regulations
promulgated by the Board are subject to the approval of the commission and shall take effect (30) days after
publication in two national news papers.

4. Quasi- judicial Power- when the Board conduct hearings, investigate facts or ascertain the existence of facts and draw
conclusion from them as basis of their official actions.

5. Investigative or Inquisitorial Power

Issue subpoena which means an order requiring a person to act as a witness or testify in court.
Issue subpoena duces tecum which means an order requiring a person to bring something before the court and if
need be, to testify about it.
Interrogate witnesses
To call for production of books, papers to record
Required that books, papers and record be made available for inspections
Required report periodic or special
Required the filing of statements.

6. Determinative Powers
1. Enabling – allowing something which the law undertakes to regulate with approval.
2. Corrective Power or directing Power – is manifested in authority to issue certificate of registration to
applicant whose certificates are loss, destroy or mutilated.
3. Dispensing Power – consists the power of granting exceptions from the general provisions of the R.A 7392 or
from the rules and regulations it promulgate.
4. Examining Power – when the Board examines candidates desiring to become registered midwives if there are
qualified to practice midwifery.

QUORUM
When majority of its members that is fifty percent plus one of the total numbers has attended the meeting.

Members of the Board JOSEPHINE H. HIPOLITO

Member

LOLITA I. DICANG
Member
ALEJANDRO R. SAN PEDRO
Chairman
REMY B. DEQUIÑA
Member

RHODORA L. LOPEZ
Member

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PRACTICE OF MIDWIFERY

Adjustment: An educational process referring to changes in behavior towards better life, better relationships and better
contribution to society

Profession: A calling by which members profess to have special knowledge by training, by experience or both on that they
may guide or advice or serve other in that field.

CRITERIA OF A PROFESSION

1. Mastery of the Craft- the profession must possess the necessary skills and attitude.
2. Service orientation-Hall mark of the profession
3. Autonomy-reasonable independent being (self-regulated)
Accountability-the essence of profession
4. Political Power- Adhere own sets of values
5. Professional Organization- Must be a member of an accredited Organization (e.g IMAP)

EVOLUTION OF MIDWIFERY IN THE PHILIPPINES

Care of the sick in Primitive Times

 Animism. Babaylan, catalonan,
 Superstitious and mystical beliefs: wind theory, natural Order and forces (mangkukulam or manggagaway)
Spanish Period
 Individual sin (Gaba or Bad Karrma), poot and Aswang
 Materia medica (MOrga. Governador-General in 1595-1596 noted used of wine as medicine: Lambanog and Tuba)
 Fore runner of Filipino Red Cross
American Period
 Separation of Producers, distributors, and consumers of health
 Exchange calue
 Iloilo Mission Hospitals School of Nursing (1906)
Contemporary
Dr. Jose Fabella, first secretary of the department of health founded the first midwifery school in the 1922 as a
response to high infant mortality rate.

Objectives of the First Midwifery Schools:

 Train young women to replace hilots (traditional birth attendant)
 Train doctors and nurses for Rural assignments and
 Provide health service and education with emphasis on maternal and child health (MCH)
PROFESSION OF MIDWFERY

Is the performance or offer to perform or render for a fee, salary, or other reward or compensation of service
recurring an understanding of the principles and application of procedures and techniques in the supervision of and care
of women during pregnancy, delivery and puerperium.
1. Management of Normal Delivery
2. Performance of Internal examination during Labor, except when patient has antenatal bleeding.
3. Health education of patient family and community, including nutrition and family Planning
4. Carrying out the written order of the physician with regards to ante-natal, intra natal and post natal care of the
normal pregnant women
5. Giving Immunization
6. Oral and parenteral dispensing of oxytocic after the delivery of the placenta
7. Suturing perineal laceration to control bleeding
8. Giving intravenous fluid during obstetrical emergencies provided they were trained for that purpose
9. May inject vitamin K to new born

Characteristic of Profession

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 There is especial preparation and training

 With clearly defined permanent membership
 Acceptance of the service motive

Determinants of Professional Practice

 Problems and needs by the people
 Policies and regulation
 Current socio-economic political and cultural system

PROFESSION

“A calling requiring a specialized knowledge and often long and intensive academic preparation.”

PROFESSIONAL
Is a person. Who after completing the required training and preparation of a profession has passed the required
licensure examination to practice the profession.
MIDWIFE
Is a person who assists women in childbirth.

THE MIDWIFERY ACT of 1992

defines midwifery as consisting of performing or rendering or, offering to perform for a fee, salary or other reward or
compensation services requiring an understanding of the principle, procedures and techniques in the supervision and
care of Women during pregnancy, labor and puerperium:

FUNCTIONS OF MIDWIFE

1. Traditional Function
 Normal pregnancy
 Normal newborn
 Home visit

2. Expanded Functions (S-P-I-C-A-H)

 S - upervises pregnant woman from Antenatal – Intranatal – Postpartum

 S - uturing perineal laceration
 P - rimary health care service
 I - mmunization
 I - VF insertion
 I - nject oxytocin
 I - nternal Examination
 C - arry out Doctor’s order
 A - ssist / Manage normal deliveries
 H - ealth education

DIFFERENT FIELDS OF MIDWIFERY

1. Private Practice – A midwife can engage in private practice by her own lying-in clinic or day care center.

2. Institutional Midwifery – are midwives employed in hospitals, clinic, and day care centers and other institutions where
midwives are hired to render midwifery services.

3. Midwifery Education – midwives in midwifery education have a great responsibility of educating and training students
midwife to become future competent professional midwives.
a) Clinical Instructor
 A registered midwife
 At least 2 years experience in the area of assignment.
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 Has undergone training in the supervision of students.

b) Classroom Instructor –
 A registered midwife & has BS degree.
 Or she is a registered nurse-midwife.
 At least one year satisfactory teaching experience or one year efficient performance in the ward or
community.

c) Principal
 a registered nurse-midwife, or a registered midwife with a bachelors degree
 At least 3 years experience in maternity ward (one year of which in supervisory position, and with two
years teaching experience in a school of midwifery.)

4. Community or Public Health Midwifery – are midwives employed in periculture centers, rural health units and health
centers.

A MIDWIFE is not practicing her midwifery profession if she is working as a:

a. Spa attendant
b. Clinic Secretary or Receptionist
c. Nanny or Yaya
d. Caregiver
e. Nursing aide or Nursing Assistant

International Code of Ethics For Midwives

© 1996 Midwifery Today, Inc. All rights reserved.

Preamble

The aim of the International Confederation of Midwives (ICM) is to improve the standard of care provided to women,
babies and families throughout the world through the development, education, and appropriate utilization of the
professional midwife. In keeping with its aim of women's health and focus on the midwife, the ICM sets forth the
following code to guide the education, practice and research of the midwife. This code acknowledges women as persons,
seeks justice for all people and equity in access to health care, and is based on mutual relationships of respect, trust, and
the dignity of all members of society.

The Code

I. Midwifery Relationships

A. Midwives respect a woman's informed right of choice and promote the woman's acceptance of responsibility for
the outcomes of her choices.
B. Midwives work with women, supporting their right to participate actively in decisions about their care, and
empowering women to speak for themselves on issues affecting the health of women and their families in their
culture/society.
C. Midwives, together with women, work with policy and funding agencies to define women's needs for health
services and to ensure that resources are fairly allocated considering priorities and availability.
D. Midwives support and sustain each other in their professional roles, and actively nurture their own and others'
sense of self-worth.
E. Midwives work with other health professionals, consulting and referring as necessary when the woman's need for
care exceeds the competencies of the midwife.
F. Midwives recognize the human interdependence within their field of practice and actively seek to resolve
inherent conflicts.

II. Practice of Midwifery

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A. Midwives provide care for women and childbearing families with respect for cultural diversity while also working
to eliminate harmful practices within those same cultures.
B. Midwives encourage realistic expectations of childbirth by women within their own society, with the minimum
expectation that no women should be harmed by conception or childbearing.
C. Midwives use their professional knowledge to ensure safe birthing practices in all environments and cultures.
D. Midwives respond to the psychological, physical, emotional and spiritual needs of women seeking health care,
whatever their circumstances.
E. Midwives act as effective role models in health promotion for women throughout their life cycle, for families and
for other health professionals.
F. Midwives actively seek personal, intellectual and professional growth throughout their midwifery career,
integrating this growth into their practice.

III. The Professional Responsibilities of Midwives

A. Midwives hold in confidence client information in order to protect the right to privacy, and use judgment in
sharing this information.
B. Midwives are responsible for their decisions and actions, and are accountable for the related outcomes in their
care of women.
C. Midwives may refuse to participate in activities for which they hold deep moral opposition; however, the
emphasis on individual conscience should not deprive women of essential health services.
D. Midwives participate in the development and implementation of health policies that promote the health of all
women and childbearing families.

IV. Advancement of Midwifery Knowledge and Practice

A. Midwives ensure that the advancement of midwifery knowledge is based on activities that protect the rights of
women as persons.
B. Midwives develop and share midwifery knowledge through a variety of processes, such as peer review and
research.
C. Midwives participate in the formal education of midwifery students and midwives.

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