Midwifery law and ethics

1. PROFESSIONAL GROWTH
&
DEVELOPMENT
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

2.  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
 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
SPHERE OF MIDWIFERY PRACTICE IN THE PHILIPPINES
1. Traditional Function of the Midwife (R.A No. 7392). The Philippine Midwifery Act of
1992 provides the midwife:
a. Gives supervision care and advice to women during pregnancy, labor and post-
partum period.
b. Conduct deliveries on her own responsibility
c. Cares of the newborn including the detection of abnormalities and counseling of
parents or couple.
d. Gives health Education
e. Executive emergencies measures

3. f. Procures medical supplies
2. Expanded Function of the Midwifes
a. Oral and parenteral dispensing of oxytocic drugs after delivery of the placenta
b. Suturing perineal lacerations to control bleeding
c. Giving of intravenous fluids during obstetrical emergencies
d. Injecting of vitamin K. to the Newborn
PROFESSIONAL ORGANIZATION OF MIDWIVES
INTEGRATED MIDWIVES ASSOCIATION OF THE PHILIPPINES (IMAP)
Brief History:
In the 1961 two organization were founded the Philippine Midwives association of the
Philippines or the PHIMIDAS with Atty. Angelina Fonce as first president and the National
Federation of Filipino Midwives or the NFFM with Mrs. Leoncia Chuatoco as first president.
In 1974, the two were integrated to become IMAP with Ms. Juana Reyes as its first president. It
is presently the only professional midwives association recognized by the Philippine Regulatory
Commission (PRC)
Letter of Instruction 1980
Compulsory membership to professional association accredited by the professional
regulations commission
ETHICO-MORAL RESPONSIBILITY
Ethics – part of philosophy that deals with systematic approaches to questions of morality.
 A term for the study of how we make judgments regarding right and wrong.
 A system of MORAL PRINCIPLES or moral standards governing conduct.
Morals- Human conduct in the application of ethics. Concerned with JUDGMENT PRINCIPLES of
right and wrong in relation to human actions and character.
CODE OF ETHICS
 Fundamental responsibilities of midwife
 Render medical services regardless of the religious belief , political belief or creed
FREEDOM OF RELIGION
No law shall be made respecting the establishment of a religion or to prohibit the free
exercise there of. The fee exercise and enjoyment of religious profession and worship without
discrimination shall forever be allowed.

4. Two aspects of freedom of Religion
a. Freedom to Believe - Absolute
b. Freedom to Act – Relative (It must be in conformity to the law, morals, customs and
traditions)
 Render medical services on the ground medical neutrality – don’t take the background
of pt.
 Protect life and respect the dignity of man
Trained Worker
 Dignity – respect Bill of Rights
 One who perform lethal injection to the person found guilty
The Patients Bill of Rights (Filipino)
1. The patient has the right to considerate and respectful care, irrespective of
socioeconomic status
2. The patient has the right to obtain from his physician complete current information
concerning his diagnosis, treatment and prognosis in terms the patient can reasonably
be expected and understand. When it is not medically advisable to give such
information to the patient, the information should be made available to an appropriate
person in his behalf. He has the right to know by name and in person, the physician and
nurse responsible in coordinating his care.
3. The patient has the right to receive from his physician information necessary to give
informed consent prior to the start of any procedure and/or treatment. Except in
emergencies, such information for informed consent should include but not necessarily
limited to the specific procedure and/or treatment, the medically significant risks
involved, and the probable duration of incapacitation. Where medically significant
alternatives for care or treatment exist, or when the patient requests information
concerning medical alternatives, the patient has the right to such information. The
patient has also the right to know the name of the person responsible for the
procedures and/or treatment.
4. The patient has the right to refuse treatment/lifegiving measures, to the extent
permitted by law, and to be informed of the medical consequences of his action.
5. The patient has the right to every consideration of his privacy concerning his own
medical care program. Case discussion, consultation, examination and treatment are
confidential and should be conducted discreetly. Those not directly involved in his care
must have the permission of the patient to be present.
6. The patient has the right to expect that all communication and records pertaining to his
care should be treated confidential.
7. The patient has the right to expect that within its capacity, a hospital must make
reasonable response to the request of patient for services. The hospital must provide
evaluation, service and/or referral as indicated by the urgency of care. When medically
permissible a patient may be transferred to another facility only after he has received

5. complete information concerning the needs and the alternatives to such transfer. The
institution to which the patient is to be transferred must first have accepted the patient
for transfer.
8. The patient has the right to obtain information as to any relationship of the hospital to
other health care and educational institutions in so far as his care is concerned. The
patient has the right to obtain information as to the existence of any professional
relationship among individuals, by name, who are treating him.
9. The patient has the right to be advised if the hospital proposes to engage in or perform
human experimentation affecting his care or treatment. The patient has the right to
refuse or participate in such research project.
10. The patient has the right to expect reasonable continuity of care; he has the right to
know in advance what appointment times the physicians are available and where. The
patient has the right to expect that the hospital will provide a mechanism whereby his
physicians or a delegate of the physician of the patient’s continuing health care
requirements following discharge informs him.
11. The patient has the right to examine and receive an explanation of his bill regardless of
source of payment.
12. The patient has the right to know what hospital rules and regulations apply to his
conduct as a patient.
Bill of Rights of Patients
1. Right to informed consent
2. Right to refuse and/or withdrawal from participation or autonomy
3. Right to privacy
4. Right to confidentiality
5. Right to quality care
1. Right to Informed Consent
Conscious – all medical practice are not authorized ŝ consent
Unconscious – all medical practice are authorized as if consent is given to you
Rule in Giving Consent
 Patient her/himself
 If the Pt. is married the consent of the spouse is not necessary, provided of sound mind
and legal age.
2. Right to Make Decisions Or Autonomy
- Right to Self Determination
- Justice Cardozo
“A Person who is of a sound mind and of legal age shall have the right to determine what is
supposed to be done to his body.”
PERSONS TO MAKE DECISIONS IN CONSCIOUS PATIENT
1. parents

6. 2. grandparents
 paternal
 maternal
3. eldest brother/sister
4. relatives/guardians
5. teachers
Telephone – overheard by two credible witnesses
Fiancé – authorize to give consent for conscious if no parents, grandparents, brother/sister,
guardians.
Q: How do you respect the dignity of patient?
A: By respecting the bill of rights of patient.
Between the conflict of pt. and doctor, loyalty will always be on the patient.
3. Right to Privacy and Confidentiality
Privacy of Communication
“It shall be inviolable except upon the lawful order of the court and when public safety, public
health requires it.”
*Cannot be violated at all – SECRECY ACT LAW
Q: Who owns the medical chart?
A: Hospital
Q: Who owns the communication in the medical chart?
A: Doctor and Patient
*Duty: Keeps in proper place (medical chart rack) with honesty, confidentiality, and integrity
Relative Privacy Absolute Privacy
Doctor – Patient Midwife – Spouse
Midwife – Patient Midwife – lawyer (case)
Midwife – Priest (religion)
Husband – wife = absolute privacy; order from court, no order to divulge/ reveal or right not to
tell
Q: What is Privacy?
A: Privacy is any not related to health condition.
Q: What is Confidentiality?
A: Confidentiality is any related to health condition.

7. Breach – Violation of right, e.g. breach of confidentiality
4. Right to Quality Care
Autonomy – “Freedom to CHOOSE”
Beneficence – “Do only what’s GOOD”, respect, privacy
Nonmaleficience – “Do NO harm”, e.g. side rails up
Veracity – “Tell the TRUTH”
Justice – “Be FAIR”
Fidelity – “Keep your word”, keeping promises “LOYALTY”
MIDWIFERY ETHICS – the code governing the NURSE’S BEHAVIOR, especially towards patients,
employing authority and to the profession.
Beneficence - any action that would BENEFIT others. The principle that imposes upon the
practitioner to seek the good for the patients under all circumstances. Beneficence connotes
positive action toward preventing or removing harm and promoting good such as:
(1) One ought to prevent evil or harm
(2) One ought to remove evil or harm
(3) One ought to do or promote good.
Nonmaleficence – states the idea to REFRAIN from inflicting harm. “one ought NOT to inflict
evil or harm. The admonition of nonmaleficence is stated in the negative manner while the
beneficence is in the positive.
Justice – The basic principle that deals with FAIRNESS, just deserts, and entitlements in the
distribution of goods and services.
Some methods of distributing goods and services in our society are as follows:
(1) To each, an equal share
(2) To each, according to need
(3) To each, according to effort
(4) To each, according to contribution
(5) To each, according to merit
(6) To each, according to ability to pay
Autonomy - In health care, it means the form of personal LIBERTY, where the individual is free
to choose and implement ones’ own decisions, free from deceit, duress, constraint, or coercion.
Three Basic elements involved:
(1) ability to decide
(2) power to act upon your decisions
(3) a respect for the individual autonomy of others.

8. Stewardship – refers to the actions made for by the health practitioner IN BEHALF of the
patient and for the greater benefit of the patient.
Truth Telling/Veracity – The patient must tell the truth in order that appropriate care can be
provided. The health practitioner needs to disclose FACTUAL INFORMATION so that the patient
can exercise personal autonomy.
Confidentiality - is also known as PRIVILEGED COMMUNICATION which refers to any
information obtained by the nurse or the health team during the course of caring for the
patient. The information gathered may only be disclosed under the following:
(1) the patient agrees to divulge such information with written consent
(2) the information is material in a criminal case investigation
(3) if public safety is jeopardized (communicable disease)
(4) such information is relevant to his care to be utilized by other health team
Privileged Communication may be divided into two classes:
(1) Absolute privileged communication – is one made in the interest of the public service or
the due administration of justice and is practically limited to legislative and judicial
proceedings and other actions of the state.
(2) Qualified privileged communication – is a slanderous statement uttered in good faith,
and made on a proper occasion, from a proper motive, based upon a probable cause
and in honest belief that such statement is true.
MORAL PRINCIPLES
 GOLDEN RULE – “ Do unto others what you would like others do unto you”. It is a basic
moral principle that if you want others to respect you, you must also accord respect to
them.
 THE TWO FOLD-EFFECT - facing a situation which would have good and bad effects
requires the following basis for arriving a decision:
a. that the action must be morally good
b. that the good effect must be willed and the bad effect merely allowed
c. that the good effect must not come from an evil action but from initial action
itself directly; and
d. that the good effect must be greater than the bad effect.
THE PRINCIPLE OF TOTALITY – states that the whole is always greater than its parts. To save the
patients’ life as a whole, it is justified under this principle to surgically cut-off a disease
body part of the patient.
EPIKIA – “exception to the general rule”. It is reasonable presumption that the authority
making the law will not wish to bind a person in some particular case, even though the
case is covered by the letter of the law.
If a mentally ill patient becomes berserk and the doctor could not be contacted, the
patient may be restrained by virtue of epikia.

9. Another example of this is allowing a relative to see a seriously ill patient who expresses
the desire the relative although it is not yet visiting hours
THE END DOES NOT JUSTIFY THE MEANS – giving a sleeping tablet to a chronically ill person so
he/she can de in peace is morally wrong.
THE GREATEST GOOD FOR THE GREATEST NUMBER – during an epidemic, immunization
against communicable diseases is administered to the people. Although there may be
some who may have slight reactions to the vaccine, the greater majority of the
population shall be considered.
NO ONE IS HELD TO THE IMPOSSIBLE – the doctors and nurses are not guarantors of life. They
cannot be held liable as long as they have done everything that modern medicine can afford to
save a patient from dying.
THE MORALITY OF COOPERATION – formal cooperation in an evil act is never allowed. A nurse
shall not participate upon immoral operations such as abortion even if the doctor commands it.
PRINCIPLE RELATING TO THE ORIGIN AND DESTRUCTION OF LIFE – mercy killing or euthanasia
is not allowed because it will lessen the incentive to medical research. The state
recognizes the sanctity of life. It shall protect the life of the mother and the unborn
since conception.
Any direct attack on the life of a fetus for whatever cause is immoral. A fetus
shall be buried in consecrated grounds. If it is dead and came from dead mother, it shall
be buried with the mother.
Privacy – the right to be left alone or be apart from others. This right is guaranteed by most
civilized state laws and enshrined also in the patients’ bill of rights. The patient has the right to
every consideration of his privacy concerning his own medical care program. Case discussion,
consultation, examination and treatment are confidential and should be conducted discreetly.
Those not directly involved in his care must have the permission of the patient to be present.
This right also includes privacy of one’s thoughts, opinions and physical presence and privacy of
one’s records.
Informed Consent –The patient UNDERSTANDS the reason for the proposed intervention, with
its benefits and risks, and agrees to the treatment by affixing his signature in the consent form.
It generally contains the following elements:
(1) disclosure
(2) understanding
(3) voluntariness
(4) competence
(5) permission giving
 In our present jurisdiction under the 1987 Constitution, the age of majority is 18 years
old. It means that only 18 years old and above can sign for themselves in legal matters
such as the signing of consent (hospital admission, contracts, will etc..)
I. THE PHILIPPINE MIDWIFERY LAW

10. Section 1: “Philippine Midwifery Act of 1992”,
Section13: Qualification of Applicants for Examination
 Filipino Citizen
 Good Moral Character
 Graduate of midwifery in government recognized and duly accredited institution
Fraud/Deceit – causing someone to believe what is not true
Neosoly – place of birth (Rule of Soil)
Sanguine – blood from parents (Rule of blood)
Naturalize – change of citizenship such American to Filipino
ORGANIZATION OF THE BOARD OF MIDWIFERY
RA6809 – age of majority is 18 yrs
 All licenses can be acquired at age of majority; such in movie watching rated A, Parental
Guidance (PG), General Patronage, R18.
RA 7392/2644 – Philippine Midwifery Law
Section 2: Composition of BOM
 1 Chair/chairperson
 4 members of the board
Note: 3 members shall be registered midwifes
1 Nurse-midwife
Appointment:
By the president of the Philippines from among the recommendees of the
Commissioner of the Professional Regulation Commission
Duties and Function
 Enforce provision of this act
 Administer oaths accordance to the provision of this act
 Issue, suspend or revoke certificate of registration
 Investigate violations of the act subpoena and subpoena duces tecum
 Conduct yearly Board examination
 Look into conditions affecting midwifery practice in the country, maintain standards and
ethics practice
 Adopt an officials seat to authenticate it officials documents
Section 3: General Qualifications of BOM

11.  Natural Born Filipino Citizen & resident of the Philippines (Born in Philippines, without
taken action)
 Good Moral Character
 Thirty (30) years of age
 Not a member of the faculty whether full time or part time in a midwifery school & to
pecuniary benefit in such during his term (monetary interest) – (type of disqualification)
Citizenship – right to political community
Nationality – not change at all
*Citizenship may change if person stayed for 10 years or marry a Filipina/Filipino citizen
to reduce stayed
years
*End of term, can teach again
*Resign from any employment, as qualified & appointed as BOM
Qualifications of Chairperson
 Registered Obstetrician
 10 years of practice before appointment
 Natural born Filipino citizen
 Good Moral Character
 30 years of age
Qualifications of 3 Members of BOM
 Registered Midwife
 Degree holders preferably in the field of health and social sciences (e.g. psychology,
medtech, pharmacist)
 10 years of midwifery practice, 5 years of which is supervisory position
 30 years old
 Natural born Filipino citizen
Qualification of 1 Member of BOM
 Registered Nurse-Midwife
 10 years of experience & nurse-midwife
 Natural Born Filipino Citizen
 Good Moral Character
Steps in Appointment of BOM
IMAP
(Nominating Body)

PRC
(Recommending Body)

12. 
PRES.
(Appointing Body)
 Integrated midwives of the Philippine integrated association of Obstetrician
 PRC
 President of the Philippines
Section 5: Powers of BOM
1. Conduct the Midwifery Examination (Discretionary Power, Examining Power) duty:
preserve the integrity & honesty in Board Exam
2. Issue, suspend/revoke certificates of Registration (Discretionary Power)
PRC – release license, (as custodian of Record)
– Venue of Board Exam.
LICENSURE
Examination Requirements
Pass a written examination given by the Board of midwifery.
Section 18: License Contains / Certificate of Registration
1. full name of registrant
2. Serial number
3. official seal of commission
4. signature of Chairperson of Commission
5. Members of the Board
Scope of Examination
a. Infant care and feeding
b. Obstetrical Anatomy and physiology
c. Principles of Bacteriology
d. Obstetrics
e. Midwifery Procedures
f. Domicilliary midwifery
g. Domicilliary Hygiene and first aid
h. Nutrition
i. Ethics of midwifery practice
j. Primary Health Care
k. Professional Growth and Development
l. Family Planning
m. others That Board may seem necessary
Section 7 R.A. 8981: Grounds for the Suspension / Removal of BOM
 Neglect of Duty
 Gross incompetence/serious ignorance

13.  Unprofessional/Immoral or Dishonourable conduct
*Commision of Irregularities (revoked)
Tolerating Irregularities (releasing while arising of questions such RETAKE!
Inhibit – not participate on that particular exam
3. To administer Oath (Ministerial Power)
Oath – first action after passing board exam
Section 16. All successful candidates are required to take the oath, to BOM or Government
authorized to administer.
The oath such as ambassador, consul, mayor, vice mayor. License never is issued without
the oath.
*Newborn place of birth when in airplane is where it was registered
*Midwife can attend the delivery while in place in DOCTRINE of GOOD SAMARITAN
Article 3 Section 1. DUE PROCESS – Law that hears first before it condemns (trial, hearing)
4. Monitor & enforce quality midwifery practice (Examining Power, Dispensing Power)
5. Monitor & enforce quality midwifery education
CHED – closed midwifery school
BOM – agreed/ recommended, Memorandum of Agreement (MOA)
6. Quasi-legislative powers – independent body, promulgating rules & regulation within its
jurisdiction
7. Quasi-Judiciary Powers – independent body, from regular judges, for hearing revoked
license
8. Executive Powers – under the office of the President poetically appointed, supervision
of the Board & Custodian of its RECORDS
Section 8: Supervision of the Board and Custodian of its Record
Office of the President

PRC (Custodian of all Records)

BOM
Section 4: Terms of Office of BOM-3 years chairman and members may be reappointed for
another term
APPOINTMENT OF BORD OF MIDWIFERY (BOM)

14. Regular Appointment – when the BOM is appointed to serve for a period 3 years
Ad Interim Appointment – when a board member is appointed to fill vacancy or to continue
the unexpired period
of term of regular appointee
Hold Over – hold an office after his term of office has expired until his successor is appointed
Note: Oath is Mandatory!
License – permission to practice the profession for life not unless revoked or suspended
 Jurisdictional – applicable in the place where issued
Misdemeanor – practice without license or practice with expired licence
Misrepresentation – using of other license
Malpractice – go beyond scope
Ratings in the Board Exam
75% as general rating with no grade lower than 50%(old) 60%(new) in one subject 120
days, the BOM shall report the rating of each candidate to the PRC Commissioner.
Section 17: Report of the Results of the Examination
The Board shall, within 120 days after the examination, report the ratings obtained by each
candidate t the commissioner of PRC.
Q: When a midwife practice in another country making use of one’s license in the Phil.?
A: Section 22: Reciprocity – Latin term, re-back, pro-forward
Du Ut Des - I give that you may also give
Reciprocal Duty – Give and take
Relationship between 2 persons/states International Agreement – TREATY mostly in Middle
East
 It can only be entered into the Pres. conquer 2/3 in senate not in congress
 An international agreement whereby one country would grant to true citizens of the
other country the privilege of being admitted to practice ones profession
SPECIAL PERMITS
 Internationally recognized expert in the field of midwifery
 Medical mission
 Exchange of professor program
Section 7: Ground for the Revocation/Suspension of License
 Immoral & dishonourable conduct
 Conviction of a crime involving moral turpitude
MIDWIVES AND CRIMES

15. Criminal law – is that branch of law which defines crime and treats of their nature.
 Ignorance of the law excuses no one from compliance therewith
 Laws take effect after 15 days from the publication in the official gazette or any
newspaper of national circulation. It serves as a constructive notice to all persons so
that no one is exempted from complying with the law or to claim that he or she is
ignorant from the passage of that law.
 The power to define and punish an act is within the powers of the Legislative
Department (House of Congress) where the legislative power is vested in the
fundamental law and has the power to define and punish an act or omissions as a
crime. The Chief Executive has also the prerogative.
 Theories of Criminal Law
1. Classical Theory
a. man is essentially a moral creature with an absolutely free will to choose
between good and evil and therefore more stress is placed upon the result of the
felonious act
b. Basic criminal liability is human free will and the purpose of penalty is
retribution.
c. Crime is a juridical entity and penalty is an evil and a means of juridical tutelage
2. Positivist Theory – Man is subdued occasionally by strange and morbid phenomenon which
conditions him to do wrong in spite of or contrary to his volition. The basis of criminal
responsibility of the criminal is his dreadfulness or dangerous state.
 The major source of our criminal law is Act # 3815 otherwise known as the Revised
Penal Code of the Philippines that took effect on January 1, 1932.
 Crime consists of internal and external acts. Internal acts are not punished in our
jurisdiction.
 Voluntariness is an element of felony because if an act is committed or performed with
deliberate intent then it implies that the act is voluntary or freely committed.
 Felony is an act or omission punishable by the law
Moral Turpitude – an act of baseness, vileness or depravity in social or private duties which
man owes to his fellow or to society in general, an act contrary to the accepted customary
rule of rights & duty b/w men
– Any act that is CONTRARY to LAW, MORALS, HONESTY, & JUSTICE
1. Adultery – disloyalty of wife to her husband having other man
Paramour – Man of A Married Woman (Kabit) Mistress – Girl of a married Man (Kabit)
Cuncubinage – disloyalty of husband to his wife having other woman/ mistress
Crimes -act committed or omitted in violation of the law.

16. Felony -public offense for which a convicted person is liable to sentenced to death or to be
imprisoned in a penitentiary or prison
-committed with deceit and fault
-act is performed with deliberate intent,
-wrongful acts result from imprudence, negligence, lack of skill or foresight
Misdemeanor - criminal offense which does not in law amount to felony. Punishments is
usually a fine or imprisonment for a term of less than one year
The professional practice of a Midwife entails with it the legal responsibilities that he or she
must know and understand in order to avoid liabilities in the discharge of his/her functions.
The following are crimes that a midwife must be familiar with:
ASSAULT – An unlawful attempt or offer to beat or to do bodily injury to another.
BATTERY – The unlawful beating or touching of another person. The unlawful beating or use of
force upon a person without his consent.
MURDER – is the unlawful killing of a human being by another with intent to kill (DOLO is an
element).
hyle – soul
morfe – body
HOMICIDE – killing of a human being by another. It is committed without criminal intent by any
person who kills another, other than his father, mother, child or any of his
ascendants/descendants/his spouse. (Culpa-fault).
 death because of lack of knowledge, skill, competence and foresight.
ABORTION – Termination or expulsion of the product of conception even before the age of
viability. Abortion is a crime penalized in our jurisdiction. A nurse who advises a woman
on what drugs to take is criminally liable.
Art. II Sec. 15 the Constitution of the Philippines
-Protects life of the unborn from conception
 Intentional Abortion (Art. 256) – willful killing of the fetus in the uterus, or the violent
expulsion of the fetus from womb resulting to its death.
 Unintentional Abortion (Art. 257) – abortion by violence but unintentional
 Abortion Practiced by the woman herself (Art. 256)
 Abortion Practiced by a physician or midwife and dispensing of abortive (Art. 256)
INFANTICIDE - killing of a child less than three days of age.

17. PARRICIDE – is committed by one who kills his/her father, mother or child whether legitimate
or illegitimate, or any of his/her ascendants or his/her espouse.
*means of blood relationship
Constitute parricide:
Spouse, legally adapted children, stepbrother
Murder homicide
Example:
Parricide – when mother throw the infant after birth in the taxi
ILLEGAL DETENTION – any private individual who shall detain another or, in any other manner,
deprive him of his liberty.
ARBITRARY DETENTION – any person in authority (public officer) who shall detain another or,
in any other manner, deprive him of his liberty.
SIMULATION OF BIRTH – any person who shall substitute one child for another or who shall
conceal or abandon any legitimate child with intent to cause such child to lose its civil
status.
ROBBERY/THEFT – crime against a person/property the taking of personal property of a person
from him (preserving the privacy of patient)
Robbery – committed with FORCE upon person or thing
SEXUAL HARASSMENT – is committed by a person who, having authority, influence or moral
ascendancy over another in a work, training or education environment, demands,
requests or otherwise requires any sexual favor from the other regardless of whether
such demand, request or requirement for submission is accepted.
Rape – mere touching of the labia by the male organ
CLASSES OF FELONY:
1. Consummated- all elements executed, with successful result
2. Frustrated- all elements executed but no successful result
3. Attempted- not all elements executed
There is No rape committed such as of:
- Same sex- frustrated rape
- digital or Anal
ARSON/Conflagration (in cases of fire)
- the medical practitioner should
R-emove the patient
A-lert the fire alarm
C-onfine the fire

18. E-xtinguish the fire
- attempted arson
- consummated arson
- no frustrated arson
CRIMINAL NEGLIGENCE – is negligence of such character or occurring under such
circumstances, as to be punishable as a crime by statute.
PROFESSIONAL NEGLIGENCE – breach of professional duty. Negligence committed in the
practice of a profession.
NEGLIGENCE - is often referred to as that “doing of a thing which a reasonably prudent man
would not have done and not doing a thing which a reasonably prudent man would
have done”. It also refers to the commission or omission of an act, pursuant to a duty,
that a reasonably prudent person in the same or similar circumstance would do or
would not do, and acting or the non-acting of which is the proximate cause of injury to
another person or his property
TORTS – legal wrong, committed against a person or property, independent of a contract which
hinders the person who commit it liable for damages in a civil action
a. Assault – imminent threat of harmful or offensive bodily contact
b. Battery – unconsented touching another person
c. False Imprisonment or Illegally detention – unjustifiable detention of a person without a
legal warrant (Doctrine is liberty of abode)
Liberty of Abode/ travel
“Liberty of abode/ travel shall not be impaired except upon the lawful order of the court
and when public safety, public health requires it.”
> right where you wanted to go/ leave
d. Invasion of right to privacy and breach of confidentiality – the right to privacy is the right
to be left alone, the right to be freed from unwarranted publicity and exposure to the
public view is well as the right to live one’s life without having anyone’s name, picture/
private affairs made public against one’s will
e. Defamation – character assassination, be it written or spoken
•Slander – oral defamation of a person by speaking unprivileged or false words by which
his reputation is damaged
•Libel – defamation by written words
f. Malpractice-illegal, corrupt, or careless professional behaviour.
-any professional misconduct which involves any conduct that exceeds the limits of
one’s professional standards means going beyond the context or scope of allowed
nursing practice resulting to injurious or non-injurious consequences.
- stepping beyond one’s authority

19. Example:
a. prescribing drugs
b. giving anesthesia
c. doing surgery
ELEMENTS OF MALPRACTICE (P-R-E)
P- professional SPECIFIC standards of care is required
R- required obedience
E- exceeds the limits of the standards of care
g. Negligence- Unintentional failure of an individual person to perform an act or omission to
do something that a reasonable prudent person would do or not do
-Failure to observe the protection of one’s interest, the degree of care, and vigilance of
circumstances.
-Most common unintentional tort
Example:
a. Incorrect sponge counts
b. burns: heating pads ,solutions & steam
vaporizers
c. failure to take & observe appropriate
actions – forgetting to take vital signs to
a newly post –operative client.
d. Falls: side rails left down, baby left
unattended
e. loss of or damage to a patient’s property
f. failure or ignore to report to the superiors or
client’s family
g. mistaken identity, wrong medicine, dose &
route
ELEMENTS OF NEGLIGENCE LAWSUIT (B-R-O-D) –OR-- ELEMENTS OF PROFESSIONAL
NEGLIGENCE
B- breach of duty was the cause of the 1. Existence of Duty
R- Real or actual proof injuries 2. Foreseeable Crisis
plaintiff’s injury 3. Breach of Standard of Care
O- owed specific nursing duty 4. Present of Injury
to the standards of care 5. Procimate Cause
D- defendant breach the duty
CLASSIFICATION OF CRIMINAL LIABILITIES
Conspiracy to Commit a Crime
Principal – -take direct part in the execution of the act, who directly force or induce others to
commit it, who cooperate in the commission of the offense by another act without
which it would not have been accomplished.

20. 1. direct participation
2. inducement (order, command, influence, convince, persuade)
Accomplice (BEFORE THE FACT )– -who, not being principals, cooperate in the execution of the
offense by previous or simultaneous act, must be shown that he had knowledge of the
criminal intention of the principal, demonstrated by previous or simultaneous acts that
contribute to the commission of the offense as ais thereto, whether physical or moral.
1. Essential ,necessary, destroy materials material
Accessory –( AFTER THE FACT) - Having knowledge of the commission of the crime, either as
principals or accomplices, take part subsequent to its commission by profiting themselves
or assisting the offender to profit from the effects of the crime by concealing or destroying
the body of the crime, or the effects or instruments thereof, in order to prevent its
discovery or by harboring, concealing or assisting in the escape of the principal of the
crime, provided the accessories act with abuse of their public functions or are known to be
habitually guilty of some other crimes.
Q: Patient get out to get sunlight old woman introduce herself as a relative midwife let the
woman go inside the
room old woman get everything (theft)
A: Midwife: accomplice
Q: Midwife, Hospital – liable on what doctrine?
A: RESPONDEAT SUPERIOR (applied to employers)
(Let the master answer for the offense of their employees)
Q: The patient approaches the nurse and said that she is pregnant. The nurse said that she has
a calling card on the
table with a no. of midwife who can perform abortion. (may or may not get it). Abortion
took place.
A: Midwife: principal by direct participation
Nurse: accomplice
Patient: principal by inducement
Mother: accessory
Doctor: accomplice
Circumstances that affect Criminal Liabilities
DEATH (Capital Mngt.)
Reclusion Perpetua (>1°/ 20 – 40years)

21. Reclusion Imperal (<1°/12 – 20years)
Exempting Circumstances
 No crime at all, exempted from criminal liability
1. Imbecile or insane person, unless he acted with lucid interval
2. The person is under 9 years of age
3. Over 9 years but under 15 years unless he/she acted with discernment (know the own
consequences)
4. When it is mere accident (force majoure)
5. When the person acted under the impulse of an uncontrolled fear
6. When the person acted under the compulsion of an irrestible force e.g. in school – loco
parenti (parental authority and custody transfer in teacher)
sunera – exerting circumstances, with freewill, unvoluntaryness to act, insanity
Mitigating Circumstances
 Lowering down by 7 years (Prison Mayor)
1. When the offender is under 18 years/ over 70 years of age
2. When there is voluntary surrender
3. When there is passion/ obfuscation
4. When there is sufficient provocation (alcohol)
5. When the person is deaf, mute, dumb, and blind
6. When there is no intention to commit so grave a wrong as the one committed any kind of
mental illness that will diminished will power (bipolar)
Aggravating Circumstances
 Committed with plan, 1° higher
1. When one takes advantage of public position
2. When there is an abused of confidence
3. When the crime is committed inside the Church
4. When the crime is committed on the occasion of fire, shipwreck, epidemic/ other calamity
5. When it is committed because of a price reward
6. When it is committed in times of natural calamities
7. When it is committed with evident premeditation
8. When it is committed with craft, fraud and disguise
* One’s you commit in confidence to your patient
Justifying Circumstances
 Without 1, not justified
ELEMENTS

22. 1. When there is an unlawful aggression
2. When the person is under imminent danger
3. When there means employed in order to prevent or to repel the aggression must be
reasonable
4. Obedience to an order issued by superior for some lawful purpose
*no man apply self – defence
GUIDELINES TO PREVENT CRIMINAL LIABILITY:
1. Be very familiar with the Philippine Nursing law
2. Be familiar with the laws affecting nursing practice
3. Know agency rules, regulations, policies
4. Upgrade skills and competence
5. Develop good IPR with co-workers
6. Consult superior as needed
7. Verify vague/ erroneous orders
8. Always keep doctor updated regarding patient
9. Ensure accurate recording and reporting
10. Get informed consent
11. Do not delegate responsibilities to others
LEGAL CONSIDERATIONS IN CHARTING:
1. Don’t tamper with medical records- adding, rewriting and destroying original record
2. Observe agency’s standards on documentation
• complete, concise, specific, use standard abbreviations
• telephone orders
TIPS FOR AVOIDING LEGAL PITFALLS:
1. Patient Falls
• do proper assessment
• appropriate assistance is given
• use protective measures
• document all nursing interventions
2. Medication errors
• observe 7 R’s of drug administration
• Check dr’s order
• Understand the medication you will administer
• Consult drug handbook/ pharmacy
• Not exempt from liability for following doctors’ order
3. Equipment injuries
• refuse to use a device not know how to operate
• report adverse events to superiors
• monitor patient regularly
• bring questionable orders to the attention of the doctor or superior
• familiarize self with existing protocol
1. Failure to communicate

23. • promptly report changes in the patient’s symptoms and signs of distress to the
Doctor
• proper documentation of all assessments and telephone conversations with the
Doctor
LEGAL RESPONSIBILITIES OF MIDWIFE
1. Contract – an agreement between two people which creates an obligation recognized by the
law
Elements of Valid Contract
 Consent must be freely given (voidable)
 Competent parties (void)
 Legal objects (void)
 Valid considerations (voidable)
Valid – no question
Voidable – valid until question: force, threat, intimidation
Void – with questions arise, < 18 as incompetent
Two kinds of Contract
1. According to Format
 Formal Contract – written down and it follows at all times the legal document/ long
bond paper, notarized
 Informal Contract – orally done/ written down but does not follow the legal documents
2. According to Statement
 Expressed Contract – terminal conditions are written down and the beginning and ending
of the contract are also expressed e.g. job description
 Implied Contract – it is actually based in the reaction and behavior of contracts parties
2. WILL – an act whereby a person disposes of his property to take effect after his death
Testator/ testatrix – a person who makes the will
Probate – to prove the validity of the will in court
Testament – an act whereby a person disposes of his personal property to take effect
after his death
Escheat – when his property is transferred in the name of Republic of the Philippines
Two kinds of Will
1. Holographic Will – when the testator entirely writes down the will. Date and signed of the
testator should be indicated in the will.

24. 2. Notarial/ Nurcupative/ Authenticated Will – when the testatorally makes the will and will
ask someone to write it down or him.
TWO KINDS OF SUCCESSION
1. Testate – when there is a will executed by the testator
2. Intestate – when there is no will executed by the testator
* The Midwife serves as a witness in making a will of your patient.
* Ethical obligation – right to refuse in making patients will
* Durable Power Attorney – appointing someone if your not capable to decide
* Disinherited by parents, relatives – only when attempt to kill/ against their own life
Personal Property – movable property e.g. jewelries, given as testament
Real Property – immovable property e.g. land, house, bldgs., given as will
Will to the court (probate)
 Void from the start.
 Intestate
*Illegitimate siblings has < share of properties than legitimate siblings
*Adapted siblings has = properties to legitimate siblings
*spouse has ¼ of the properties
* ¼ free portion – for the taxes to be paid after getting the properties
*Prenuptial Agreement – agreement before marriage, which husband property different from
wife property vice versa/ have separate property even they’re married
*Conjugal Agreement – husband’s properties is also wife’s properties/ vice versa
3. Lawsuits – proceedings in court
Purpose: To enforce a right, to redress a wrong
PARTIES:
a. Criminal Action
 Complainant – person who file a case with a court against another, a concise statement
of the ultimate facts constituting cause of action.
 Respondent – the person against whom the case
b. Civil Action
 Plaintiff – person who file a case with PRC
 Defendant – the person against whom the case
Sub Poena ad testicandum/ Sub Poena – court summons is served directing a witness to
appear and give testimony on the date and time ordered
Sub poena duces tecum – served to a witness requiring him to bring records, papers or charts
Testimony of facts – testifying only on what he knows based on facts
Tesstimony of opinion – may only be given by expert witness
Expert witness – one who is qualified to testify based on special knowledge, skill and training

25. Perjury – false swearing under oath
Privileges against self – incrimination – right not to answer any questions that will incriminate
him/her
>mind/ imagination purely e.g. ejaculation to excrete sperm/semen
> not self – incrimination – mechanical e.g. pregnancy test, drug test, urine test, DNA test,
pubic hair, purgative/ laxative, blood sample
Hearsay evidence – repetition of what the witness heard others say
Ante mortem statement – dying declaration considered hearsay except when made by a victim
of a crime
You go to a Court:
 When rights are violated
 To correct a wrong and have it corrected
Remedies going to court:
 Quasi – Administration Body
 Municipal
Regional
Board of Appeal
Supreme Court