Law and Jurisprudence Criteria

Atty. Vincent Q. Piga, MAN, RN, LPT 1. Satisfy an indispensable social need and must
be based upon well established and socially
Law accepted scientific principles
 System of rules and guidelines that are created 2. Demand adequate pre professional and
and enforced through social or govt. Institutions cultural training
to regulate conduct 3. Demand possession of a body of specialized
 "An ordinance of reason for the common good, and systematized training.
made by him who has care of the community." St. 4. Give credence of needed skills which the
Thomas Aquinas public does not possess; that is, skills that are
 St. Thomas - law is made by reason, made by one partly inherent and partly acquired
who is in charge by a group or community and is 5. Scientific technique which is the result of
always promulgated for the good of the tested experience
community 6. Required exercise of discretion and
judgement as to time and manner of the
Jurisprudence performance of duty
 Science and philosophy of law 7. Has group consciousness designed to extend
 Application of law to a particular set of facts by scientific knowledge in technical language
the supreme court 8. Has sufficient self-impelling power to retain
 Decision of the supreme court on a specific case the members throughout life. Must not be
while applying the law used as a stepping stone to other occupations
9. Must recognize its obligations to socially by
RN JURISPRUDENCE insisting that its members live up to an
 branch of law which comprises all legal rules and established code of ethics.
principles affecting the practice of RNs
 Includes the study and interpretation of rules and Therefore
principles and their application in the regulation Professional nurse is one who has completed
of the practice of RNs basic nursing education programs and is licensed
in his country to practice professional nursing.
Function of law
 Provides a framework for establishing what nurse Scope of nursing practice
actions in the care of patients are legal. We are Defined by RA 9173 (Phil Nursing act of 2002), Art
guided as to what actions are legal when we VI, Sec.28
practice our specific profession.
 Delineates the rns responsibilities from those of Qualifications and abilities of a professional
other professionals nurse
 Helps establish the boundaries of independent
nursing actions. What a nurse can do without a A. Professional Preparation
physician
 Assists in maintaining a standard of nursing 1. Has license to practice nursing
practice by making rns accountable to law. 2. With a BSN degree
3. Physically and mentally ill
Rn as a profession
 Profession - an occupation or calling requiring B. Personal qualifications and professional
advanced training and experience in some proficiencies
specific or specialized body of knowledge which
provides service to society in the special field 1. Interest and willingness to work and learn with
individuals/groups in a variety of settings
2. Warm personality and concern for people
3. Resourcefulness and creativity as well as a well-
balanced emotional condition

June Sams
4. Capacity and ability to work cooperatively with BSN PROGRAM GOALS
others To produce graduates who exhibit the following
5. Initiative to improve self and service behaviors:
6. Competence in performing work through the use
of nursing process  Caring behavior (compassionate, competent, and
7. Skill in decision making, communicating, and committed)
relating with others and being research oriented  Ability to practice legal, ethico-moral, social
8. Active participation in issues confronting nurses responsibilities/accountabilities
and nursing.  Critical and creative thinking
 Skill in practicing KSA and values for the
Competences of a BSN grad promotion of health, prevention of illness
1. Utilize nursing process in the care of  Restoration of health, alleviation of suffering,
individuals, families, and community by assisting....
1.1 assessing the client's healthcare status
1.2 planning with client and/or SO the RN Ethics
nursing action based on identified needs and
problems Ethics
1.3 implementing appropriate nursing
interventions (wholly compensatory,  From the Greek Ethos meaning MORAL DUTY
partially compensatory, supportive,  Standard to examine and understand moral life
educative)  Studies how people make judgement in regard to
1.4 modifying interventions right or wrong
1.5 evaluating the results of nursing  Is about making choices that is best for the
interventions accordingly based on criteria individual or society at certain times and in
established particular situations and then evaluating such
2. Communicate effectively at all levels of choices and outcomes
healthcare in various settings by  Determined by what is right and wrong; critical
2.1 Applying "therapeutic use of self" reflection of morality and the rational process
2.2 documenting and reporting observations, about it
responses to nursing actions
2.3 relating with clients, families, Morals
communities, and groups and members of the
health team  Specific ways of behaviors or accomplishing
ethical practices
3. Utilize the elements of mgt in any healthcare  Morality (Gk. MORALIS) refers to social consensus
setting by about moral conduct for human beings and
3.1 utilizing mgt process in the delivery of society
health care  Determined by society
3.2 participating in the formulation and  Morality is what you believe is right and good
implementation of policies while ethics is the critical reflection about
3.3 working independently and/or in morality and rational analysis about it
collaboration with others on matters
promoting a better quality of life. Fields of ethics
4. Utilize research findings in the care of clients
5. Assume responsibility for personal and  Professional ethics - branch of moral science
professional growth and development by concerned with the obligations that a member of
5.1 promoting professional and personal the profession owes to the public
growth  Health care ethics - relates to human health. It
5.2 accepting accountability for professional resides in the realm of human values, morals,
action customs, personal belief and faith.
5.3 participating in the solution of  Bio-ethics - focuses on moral issues in the field of
health/social problems health care. Systemic study of human behavior in
June Sams
 the field of life science and health care in the light B. Deontological Approach
of moral values and principles  Gk deon which means duty
 Rn ethics is related to all principles of right  Basic righteousness or wrongness of an act
conduct as they apply to the profession. Nursing depending on the intrinsic nature rather than
ethics reinforces the nurses’ ideals and motives in upon the situation of its consequences
order to maximize the effectivity of their service  Immanuel kant: a person is morally good and
admirable if his actions are done from a sense of
Nursing ethics is also the “examination of all duty and reason. It is only through dutiful actions
ethical and bioethical issues from the perspective that people have moral worth.
of nursing theory and nursing ethics” (Johnstone)  Act only in the maxim through which you can and
the same time you will....
Emphasizes that the field of nursing ethics be
focused on the needs and exp of practicing C. Virtue ethics approach
nurses, the exploration of its meaning and that of Aka aretaic ethics (gk arete)
ethical practice in terms of perception of these Focused primarily on the heart of the person
rules performing the act. Focuses on the traits and
virtues of a good person such as courage,
Ethical principles temperance, wisdom. And justice
A. Teleological approach
 Greek for telos - goal or end Doing the right thing is not enough. One must
 "Right thing to do is the good thing to do" also possess
 Aka act of utilitarianism (the good resides in the  Right motivation
promotion of happiness or the greatest net  Right disposition
increase of pleasure over pain)  Right traits (courage, magnamity, honesty,
justice, and beneficence)
Fletcher's guidelines in making ethical decisions
1. Consideration of people as human beings D. Divine command ethics
2. Consideration of consequences Based on the theory that there is a supreme
3. Proportionate good to come from the choices being that sets down the rules to provide
4. Propriety of actual needs over ideal or potential guidance to moral decisions
needs
5. The desire to enlarge choices and reduce chance
(chance, you don't know the consequences of the Universal principles of biomedical ethics
action. We must know the consequences and
understand our choices) 1. Autonomy
6. Courageous acceptance of the consequences of  Gk. Autos - self. Nomos - governance
the decision  Involves self-determination and freedom to
choose and implement one's decision, free from
Situation ethics of joseph fletcher deceit, duress, constraint, or coercion
Course of the action depends on the (INFORMED CONSENT)
circumstances  Includes: refusal of pt to avail of treatments if he
There is no such thing as absolutes so decides, disclosure to hid ailment, prognosis,
mode of treatment, and confidentiality
4 presuppositions  The person making the decision must be:
1. Pragmatism - course of action must be practical - competent. I.d. has intellectual capacity to
and effective make rational decision and of legal age
2. Relativism - rejects absolutes - Free will
3. Positivism - love is the only criteria
4. Personalism - people first policy

June Sams
 Therapeutic privilege  Sec.30 compulsory HIV testing
 Legal exception to informed consent a.
 Allows caregiver to proceed with the care in case b.
of emergency, incompetence, waiver or implied c.
consent (EWII)
 Sec 27 testing of organ donation
2. Veracity a.
 To promote efficiency in health care, pts, and b.
HCPs are bound to tell the truth
 Pt or SO must provide a complete hx of his  Sec 44 confidentiality
condition as possible a.
 MD must tell pt and family his dx, plan of care, b.
treatment and risks involved, length of
treatment, expenses and other options  Sec 45 exceptions
a.
Benevolent Deception Doctrine b.
 Withholding the information when such c.
revelation would do more harm than good.
 E.g. withholding the info to an 80 y/o woman  Sec 49 discriminatory acts and practices
who has been dx with terminal stage IV lung CA a.
(cancer) who also has a heart condition b.

Art. 46, Family Code (FC) RA 10173 (DPA)

Any of the ff instances constitutes to FRAUD -Sensitive personal information
which would be ground for annulment of
marriage: a. Race, rthnic origin, marital status, age,
 Non-disclosure of the previous conviction by final color, and religious, philosophical or
judgement of the other party of a crime involving political affiliations;
moral turpitude b. Health, education, genetic or sexual life of
 Concealment by the wife of the fact that at the
a person;
time of the marriage. She was pregnant by a man
other than her husband c. Civil, criminal or administrative
 Concealment of a STD regardless of its nature, proceedings;
existing at the time of marriage d. Unique identifiers issued by government
 Concealment of drug addictions, habitual agencies peculiar to an individual;
alcoholism, homosexuality or lesbianism existing e. Specifically established by law as classified
at the time of marriage.
Sec. 284, PD 442 as amended
RA 11166 PHL HIV and AIDS policy act Disease as a ground for termination

-Repealed the Philippine AIDS prevention and Fuji vs Espiritu (G.R. No 204944-45) 3 Dec. 2014
control act of 1998 (RA 8504)

 Sec. 47. Disclosure to persons with potential

exposure to HIV

 Sec. 29 HIV testing

a.
b.
c.

June Sams
3. Beneficence 5. Justice
Refers to the act of kindness and mercy that In HC. Justice refers to the right to demand and
directly benefit the patient. These acts promote be treated justly, fairly and equally.
health of the pt, prevent illness or complications,
alleviate suffering, and assist towards peaceful -health is a basic human right. The Government
death.... must ensure that all citizens have access to
affordable, quality health care.
Patient's bill of rights
Responsibilties of nurses and midwives to
1. Considerate and respectful care patients
2. Relevant, Current, and understandable  Provide care based on what the pt needs
info concerning dx, ttt prognosis, specific  No discrimination in the provision of care
procedures, ttt, risks involved, medically  To not accept tips and gifts from pts
reasonable alternative benefits needed to  Loyalty to one's duty
make informed consent
3. Make decisions regarding his plan of care Confidentiality of information
in case of the refusal, he is entitled to  Aka privileged communication
other appropriate care and service or be  All information about the pt should be treated
transferred to another hospital with utmost confidentiality
4. Have advance directive (e.g. a living will)  Nurses must reveal info to the pt only with the
concerning ttt or designating a surrogate consent of the MD
decision maker.
5. Every consideration of his privacy such as Exceptions
in case discussion, consultation and 1. Patients themselves permit such
treatment
revelation as in the case of claim for
6. Confidentiality of communications and
records hospitalization, insurance benefits, among
7. Review his records concerning his medical others;
care and have these explained to him 2. The case is medico-legal such as
except when restricted by law. attempted suicide, gunshot wounds which
8. Be informed of business relationship have to be reported to the local police or
among the hospital, educational NBI
institution, health care providers that may 3. The patients are ill of communicable
influence the pts ttt and care.
disease and public safety may be
9. Consent or decline to participate in
experimental research affecting his care jeopardized;
10. Reasonable continuity of care when 4. Given to members of the health team if
appropriate and be informed of other information is relevant to his care
care options when hospital care is no
longer appropriate
11. Be informed of hospital policies and Patient's responsibilities
practices that relate to patient care
1. Providing Information

4. Non-maleficence

Similar to beneficence only that it is stated in the 2. Complying with instructions

negative, to do no HARM

June Sams
3. Informing the MD of refusal to ttt 7. Nurses have the right to negotiate conditions of
their employment either as individuals or
collectively in all practice settings.
4. Paying hospital charges

Responsibilities of RN to MD
Art. VI, Sec 28 of RA 9173
RA 10932
-Anti-hospital deposit law
Sec 1: Duties to the MD
Sec 5: 1. Carry out md orders
2. Help plan and implement care
RA 9439 3. Report pt’s condition including outcomes of
-Prohibits the detention of pts in hospital and therapies so that mgt of care can be properly
medical clinics on grounds of nonpayment of monitored and modified as necessary
hospital bills or medical expenses 4. Notify MD if orders are not carried out and the
Sec 1: reason thereto
Sec 2: 5. Explore reasons for refusal of pt. To take/follow
Sec 3: orders
6. Clarify misconceptions
7. Familiarize with the various routines, methods, or
5. Following hospital rules and regulations idiosyncrasies of MDs to maintain smooth
relationships
8. Report cases of incompetent or unethical practice
by any HCP to the attention of appropriate
6. Showing respect and consideration authority within the institution
9. Note that any medical act relegated to them is
illegal even if supervised.

Responsibilities of RNs to colleagues

Bill of Rights for RNs 1. Get along smoothly with colleagues
1. Nurses have the right to practice in a manner that 2. Blends in any situation
fulfills their obligations to society and to those 3. Adjust to org and know its policies and
who receive nursing care procedures
2. Nurses have the right to practice in accordance 4. Know place in the org to foster cooperation,
with professional standards and legally coordination and maximize work potentials.
authorized scoped of practice.
3. Nurses have the right to work in an environment Responsibilities of RNs to themselves
that supports and facilitates ethical practice, in 1. Develop nursing skills (attend seminars)
accordance with the code of ethics for nurses and 2. Conduct oneself professionally
its interpretive statements 3. Practice compassion and decency
4. Nurses have the right to freely and openly
advocate for themselves and their patients, Advance directives/living will
without fear of retribution. -Patient designates another person to make
5. Nurses have the right to fair compensation for decisions for him when she is unable
their work, consistent with their knowledge, exp,
and professional responsibilities Requirements:
6. Nurses have the right to a work environment that -signed by pt
is safe for themselves and their patients. -witnessed by 2 persons (18yo above)
-Attached to pt’s chart

June Sams
 Legal concepts for nurses
Code of ethics for filipino nurses
Negligence
Code of ethics  Refers to the commission or omission of an act,
-Are systematic guides for developing ethical pursuant to a duty, that a reasonably prudent
behavior person in the same or similar circumstance would
-Answer normative questions of what beliefs and or would not do, and acting or the non-acting of
values should be morally accepted. which is the proximate cause of injury to another
person or his property
Ethics reflects what good life is about, morals are  Failure to do what should be done
imposed by society.
Elements of Negligence
Code of governance 1. Existence of a duty on the part of the person
charged to use due care under circumstances
-Adopted by the PRC on July 23 2. Failure to meet the standard of due care
-States that all professionals should be willing to 3. The foreseeability of harm resulting from failure
accept a set of professional and ethical principles to meet the standard
-Acceptance of these standards requires the 4. The fact that the breach of this standard resulted
maintenance of a standard conduct higher than in an injury to the plaintiff
what is required by the law
Samples of negligent acts
General principles 1. Failure to report observations to the attending
1. Service to others. MD
2. Failure to exercise the degree of diligence which
the circumstances of the particular case demands
2. Integrity and objectivity 3. Mistaken identity
4. Wrong medicine, wrong concentration, wrong
route, wrong dose
3. Professional competence 5. Defects in the equipment such as stretchers and
wheelchairs may lead to falls thus injuring the
patients
4. Solidarity and teamwork 6. Error due to family assistance
7. Administration of medicine without MD's rx

5. Social and civic responsibility Doctrine of res ipsa loquitur

 Literally the "thing speaks for itself"
 Injury could not have happened if someone was
6. Global competitiveness not negligent that no further proof is required.

Elements of res ipsa loquitor:

7. Equality of all professions 1. The injury was of such nature that it would not
normally occur unless there was a negligent act
on the part of someone
New code of ethics for nurses 2. That the injury caused by an agency within
(different file) control of the defendant
3. That the plaintiff himself did not engage in any
Patient’s Bill of Rights manner that would tend to bring about the injury
(different file)

June Sams
 Malpractice Liability for the work of nursing students
 In the usual sense it implied the idea of improper
or unskillful care of a pt by a nurse.
 Negligent professional
 Denotes stepping beyond one's authority
stepping beyond one’s authority with serious
consequences.
 Is the term for negligence or carelessness of a
professional personnel
 Also refers to negligent act committed in the
course of professional performance (Lesnik,
1962)

Doctrine of force majeure

 Literally irresistible force
 One that is unforeseen or inevitable. Under the
civil code of the phil., no person shall be
responsible for those events which cannot be
foreseen, in which, though foreseen are
inevitable, except in cases expressly specified by
law (e.g., floods, earthquake)

Doctrine of respondeat superior

 Literally let the master answer for the acts of the
subordinate
 The liability is expanded to include the master ad
well as the employee and not a shift of liability
from the subordinate to the master. Therefore,
when a person, through his negligence injures
another, he remains fully responsible. This
doctrine applies only to those acts performed
within the scope of his responsibilities.

Incompetence
 Lack of ability, lack of legal qualifications and
being unfit to discharge the required duty.
 Can be ground for revocation or suspension of
license.

Deceit
• Exists when the act is performed with deliberate
intent and there is fault when the wrongful acts
result from imprudence, negligence, or lack of
skill or foresight

Fraud
• Deception

June Sams