Legalities 2013

LEGAL ASPECTS OF
NURSING
Nelia B. Perez RN, MSN
PCU – Mary Johnston
College of Nursing

BSN 2013

LAW
• Etymology : lex
• A set of rules established by a governing
power to guide actions, regulate conduct
of the people and impose sanctions for
violation or non-compliance thereof.
• Obligatory upon the people because it
commands the people to do right and
prohibits them to do wrong.

Sources of Law
• The Constitution
• Statutes
• Administrative Law

Major Groups of Law
• Criminal laws
• Regulate public conduct and set out
duties owed to society
• Civil laws
• Regulate relations between individuals
or groups of individuals

Criminal Laws
• Legal action brought by the government
against a defendant (person charged with
committing a crime)
• …have penalties
• Imprisonment, fines, probation (placed
under supervision)
• Divided into felonies
and misdemeanors

Difference in criminal offenses
• FELONY • MISDEMEANOR
• Penalty is a term of • Penalty is a prison
more than one term of one year or
year in prison less
• Murder, robbery, • Simple assault,
rape, possession minor theft,
with intent to possession
distribute

Kinds of Laws - Criminal
• Duties to society
• Cases brought by gov.
• Types –
• Felony
• Summary
• Misdemeanor

“beyond a reasonable doubt”
• the standard of proof required in most
criminal cases within an adversarial
system
• Means that if a jury (or a judge in a bench
trial) has ANY reasonable doubts about
the defendant’s guilt – then it MUST vote
not to convict

“preponderance of evidence”
• standard of proof that must be
met by a plaintiff if he or she is
to win a civil action
• The jury (or judge) needs only
to decide if it is more likely than
not that the plaintiff’s complaint
is true.
• Lower requirement for proof –
Why?

Jurisprudence
• Etymology : juris (oral legal tradition and to
functional applications of Law, to and in
particular sets of facts ans circumstances);
prudentia (one who behaves prudently or
wisely because he has knowledge of the
possible consequences of a particular
action).

Jurisprudence (cont)
• Denotes or pertains to the judicial
precedent or the course or established
decisions of the Supreme Court.

Difference in criminal offenses

• FELONY • MISDEMEANOR
• Penalty is a term of • Penalty is a prison
more than one year term of one year or
in prison less
• Murder, robbery, • Simple assault,
rape, possession minor theft,
with intent to possession
distribute

“beyond a reasonable doubt”
• the standard of proof
required in most criminal
cases within an adversarial
system
• Means that if a jury (or a
judge in a bench trial) has
ANY reasonable doubts
about the defendant’s guilt
– then it MUST vote not to
convict

“preponderance of evidence”
• standard of proof that must be met by a
plaintiff if he or she is to win a civil action
• The jury (or judge) needs only to decide if
it is more likely than not that the plaintiff’s
complaint is true.
• Lower requirement for proof –
Why?

Civil Laws
• Civil action
• Lawsuit that can be brought by a
plaintiff (person) who feels wronged or
injured by another person
• Courts may award the injured person
money for the loss or order the one who
committed the wrong to make amends
in
some other way
• Automobile accident

Civil Laws
• Regulate many everyday situations
• Marriage
• Divorce
• Contracts
• Real estate
• Insurance
• Negligence

Kinds of Laws - Civil
• Regulates relations b/w
individuals or groups
• Brought by people for injury
by another person

General Divisions of Law
• Natural Law – an integral part of
nature because it is immutable
and inherent in the nature of
man or every element or part of
the universe.
• Positive Law – a precept made
and imposed by someone in
authority.
* divisions
- divine law
- human law

Applicable laws and
jurisprudence in nursing
practice 1. Constitutional Law is that
branch of the science of laws
which treats of the nature of
constitutions, their adoptions
and amendments, their
construction and interpretation
and of the validity of legal
enactments as tested by the
criterion of their conformity to
the law of the land.

Kinds of Constitution
• Cumulative or evolved
constitution is one that
originates in customs,
common law principles,
decisions or courts, etc.
• Conventional constitution is
an enacted constitution
because it is deliberately
passed by a representative
body or a ruler.

Kinds of Constitution (cont)

• Written constitution is one where the
provisions are embodied in one
document or sets of documents while
an unwritten constitution is one where
most of the provisions are not in a
single document but scattered in
various sources such as customs and
traditions, statutory enactments of a
fundamental character, judicial
decisions and certain common law
principles.

Kinds of Constitution (cont)

• Rigid constitution is one that
can be amended only by a
formal and usually difficult
process, whereas a flexible
constitution is one that can
be changed by ordinary
legislation.

2. Criminal Law – the branch of law
which defines crimes, treats of
their nature and provides for their
punishment.
- Aptly described as the
instrument of criminal policy for it
is in criminal law that are found
- it covers offenses resulting to
injuries or death of the patients.

Prosecution of a criminal offense
resulting to injuries…
• Nature • Color
• Location • Number, and
• Size, shape • Other
and incursion appearances

Re: Death of a patient..
• Natural
• Suicide
• Homicide / murder / parricide
• Accident
• undetermined

Useful pieces of evidences
for the criminal offenses
• Body
• Objects on or with the body
• Injuries sustained
• Tissues and body fluids
• Other medical evidence or
findings

R.A. 3815 – otherwise known as
Revised Penal Code (RPC) which
was approved on December 8,
1930 which defines crimes, treats
of their nature and provides for
their punishment.

3. Civil Law - the branch of Law that pertains to
the organization of the family and the
regulation of property. It has been defined as
the mass of precepts which determine and
regulate the relations of assistance, authority
and obedience among the members of a
family, and those which exist among members
of a society for the protection of private
interests.

R.A. 386, popularly known as the New Civil
Code (NCC) or the Civil Code of the
Philippines took effect on August 30, 1950
and covers the following aspects of human
life; persons and family relations, property
rights and ownership, the modes of
acquiring ownership, obligations and
contracts and special contracts.

One important amendment to this code is
EO 209, the Family Code, amending its
provisions on marriage and family relations.

4. Labor Law is that branch of Law that
governs and regulates the relationship of
employers and employees. Broadly
called “labor legislation” , it consists of
statutes, regulations and jurisprudence
governing the relations between capital
and labor, by providing for certain
employment standards and legal
framework for negotiating, adjusting and
administering those standards and other
incidents of employment.

Labor Law (CONT)
• Labor Standards Law – “that which
sets out the minimum terms,
conditions and benefits of
employment must provide or comply
with and to which employees are
entitled as a matter of right.
• Labor Relations Law – defines the
status, rights and duties and the
institutional mechanisms, that
govern the individual and collective
interactions of employers,
employees or their representatives.

Labor Code
• Promulgated as P.D. No 442 on
May 1 1974 and took effect on
November 1, 1974 except
portions on Book IV whose
effectivity was deferred to
January 1, 1976 by P.D. No.
608.

5. Administrative Law is that branch
of law which deals with the
activities or functions of executive
or administrative agencies such
as the “departments”, bureaus,
boards or commission or all other
offices under the administrative
supervision of the office of the
President, which are created and
vested by Law with qusi-judicial,
quasi-legislative and executive
powers.

Administrative Law (cont)
• Executive Order No. 292 is the principal
law in the study of administrative laws in
the Philippines and was promulgated by
then President Corazon Aquino dated July
25, 1987, otherwise known as the
“Administrative Code of 1987”, which
incorporated in a single document the
major structural, functional and procedural
guidelines of governance.

Administrative Law (cont)
• Professional Regulation Commission
(PRC)
• Three main functions
• Executive
• Quasi-judicial
• Quasi-legislative

Functions of the PRC
• To investigate and decide cases against
erring examinees and professionals;
• To formulate and promulgate policies and
guidelines on administrative investigation
and professional regulations.
• To implement the laws, regulatory policies
and standards; and
• To maintain and promote professional and
occupational standards and ethics.

6. Civil Service Law is that branch of law
which deals with the civil service in all
branches, subdivisions, instrumentalities
and agencies of the government
including government-owned or
controlled corporations with an original
charter.

Civil Service Law (cont)
• Primary purpose is to establish and
maintain a merit system in the selection
of public officers and employees without
regard to sex, color, social status or
political affiliation.
• General purpose is to ensure and
promote the constitutional mandate
regarding appointments, particularly
according to the merit and progressive
system of personnel administration to
ensure the maintenance of an honest,
efficient, progressive and courteous civil
service in the Philippines.

Civil Service Commission
• P.D. No. 110 dated January 26, 1973,
created the Civil Service Commission
(CSC), replacing the CSC established
under R.A. no 2260.
• repealed by PD No. 807 otherwise known
as the Civil Service Decree of the
Philippines, which was superceded by
Subtitle A, Title I, Book V of E.O. No 292,
the Administrative Code of 1987, E.O. No
292, which codified the major structural,
functional and procedural principles of
governance, is the basic legal document in
the study of civil service law.

7. Case is that body of the prevailing
jurisprudence or decisions of the
Supreme Court interpreting the laws or
the Constitution or applying them to
certain sets of facts or actual cases and
controversies.

Definition
• A tort is a legal wrong,
committed against a person or
property independent of a
contract which renders the
person who commits it liable for
damages in a civil action.

• A tort in common
law is defined as a
civil wrong that
involves a breach of
civil duty owed to
someone else. This
is in exception to
contractual duty.

• A tort is similar to crime
but crimes involve breach
of duties toward the
society in general.
• The aggrieved party who
has been injured due to a
tort may bring a lawsuit.

• One who commits a tort is
called tortfeasor. A person
who suffers a tortuous act is
entitled to receive damages,
usually monetary
compensation, from the
person or people
responsible or liable for
those injuries.

• Tort law defines what a
legal injury is and
therefore, a person may
be held for an injury that
was caused.

• Legal injuries are not
limited to physical
injuries. They may also
include emotional,
economic, or
reputational injuries as
well as violations of
privacy, liability.

• For defective consumer
products, copyright
infringement and
environmental pollution
among many others.

• In the law world, the
most prominent tort
liability is negligence.

• If the injured party can
prove that the person
believed to have caused
the injury acted negligently.

• That is without taking a
reasonable care to avoid
injuring others- tort law will
allow compensation.

Torts are categorized into negligence torts,
intentional torts and standard torts.

• Negligence torts: The standard action
in tort is negligence. The tort of
negligence provides a cause of action
leading to damages, to belief, in each
case designed to protect legal rights,
including those of personal safety,
property and in some cases, intangible
economic interests.

• Intentional torts: include
those torts arising from
the occupation or use of
land. The torts of
nuisance, trespass, etc
come under this
category. Intentional torts
also include false
imprisonment.

• The tort of illegally
arresting or detaining
someone and
defamation, broadcasting
false information
damaging the plaintiff’s
reputation.

• Statutory torts: Statutory
torts are like any other,
expect for the fact that these
have been enacted by the
legislature and not by
courts.

• Examples include
consumer protection
laws, labor laws
governing safety and
health of workers, etc.

• The burden to prove a tort
vests with the plaintiff. It is
his duty to prove the
defendant’s negligent tort or
intentional tort.

• The plaintiff owns a duty of
care. A duty of care is a
relationship which exists
between a plaintiff and the
defendant.

• There must be a breach of that
duty and the plaintiff suffered
damages as a result of that
breach.

• The defendant has to take
proper care not to damage
or cause injury to the
property, emotion,
reputation and to the person
himself. And lastly, the
damage must be significant
and not remote.

• Nuisance: Legally, the term
nuisance is used in three
ways, to describe an activity
or condition that is harmful
or annoying to others.

• To describe the harm caused by
the before mentioned activity or
condition and to describe a legal
liability that arises from the
combination of the two.
• Defamation: Defamation is
tarnishing the reputation of
someone. They are of two types.
One is slander and the other is
libel.
• Slander is spoken defamation and
libel is printed or broadcast
defamation.

• Assault and Battery.
Examples
• Assault is the imminent threat
of a harmful or offensive
bodily contact.
• Battery is an intentional,
unconsented touching of
another person.

• False Imprisonment or Illegal
Detention.
• It means that the unjustifiable
detention of a person without
legal warrant within boundaries
fixed by the defendant by an act
or violation of duty intended to
result in such confinement.

• Defamation.
• Slander is oral defamation of a
person by speaking unprivileged
or false words by which his
reputation is damaged.

• Libel is defamation by written
words, cartoons or such
representations that cause a
person to be avoided,
ridiculed, or held in contempt
or to tend to injure him in his
work

LAWS RELEVANT TO
NURSING PRACTICE

1. PD 48 – four (4) children with paid
maternity leave privilege
2. PD 69 – four (4) children for
personal tax exemption
3. PD 79 – Revised the Population
Act; Defines the objectives, duties
and functions of POPCOM
4. PD 223 – Creation of Professional
Regulation Commission (PRC) in
1973

5. PD 442 – New Labor code
6. PD 491 – Nutrition program
7. PD 541 – Former Filipino professionals
allowed to practice their respective
professions in the Philippines
8. PD 568 – Role of Public health
midwives expanded under the RHCDS;
Restructuring of the Philippine Health
Care Delivery System; Deployment of
midwives to improve rural situation (1
PHMid = 5,000 pop.; 1 PHNurse = 10,000
pop;1 RHPhysician = 20,000 pop)

• 9. PD 603 – Child and Youth Welfare
Code
• 10. PD 628 – Employee Compensation &
State Insurance Fund
• 11. PD 651 – Birth registration following
delivery (all health workers shall identify
and encourage the registration of all births
within 30 days following delivery)
• 12. PD 825 – Anti- improper garbage
disposal (provides penalty for improper
disposal of garbage)

• 13. PD 851 – 13th month pay
• 14. PD 856 – Code of Sanitation – provides
for the control of all factors in man’s
environment that affect health including
thequality of water, food, milk, control of
insects, animal carriers, transmitters of
diseases, sanitary and recreation facilities,
noise,pollution, unpleasant odors and
control of nuisance.
• 15. PD 965 – Family Planning and
responsible parenthood instructions prior to
issuance of marriage license
• 16. PD 996 September 16, 1976 –
Compulsory immunization for all children
below eight (8) years old against six
(6)immunizable diseases

17. PD 1063 – Muslim Holidays
18. PD 1204 – Amends PD # 79B.
ADMINISTRATIVE ORDERS1. A.O. No.
114 s. 1991 – Revised/updated the roles
and functions of the Municipal Health
Officers, Public Health Nurses and Rural
Health Midwives

19. Dept. Circular Order No. 75 –
Reinstitution of Tetanus Toxoid among
Pregnant Women
20. Min. Circ. No. 2 s. 1986 – Includes AIDS
as a notifiable disease

D. EXECUTIVE ORDERS
• EO 51 – Milk Code
• 2. EO 85 – Integration of Public Health
and Hospital Services

• 21. EO 119 – Reorganization of
Department of Health
• 22. EO 180 – Guidelines on the right to
organize of government employees

• 5. EO 203 – List of regular holidays &
special days
• 6. EO 209 – Family Code of the
Philippines (amended by RA 6609)
• 7. EO 226 - Command Responsibility
• 8. EO 503 – Provides for the Rule and
Regulation Implementing the Transfer of
Personnel Assets, Liabilities and Records
of National Government

E. HOUSE BILLS
• 1. HB # 16 – Two-Child Policy
• 2. HB # 3773 – Responsible
Parenthood and Population
Movement Act

F. PRESIDENTIAL PROCLAMATIONS /
PRONOUNCEMENTS
1. Proc. # 4 – Philippine Measles
Elimination Campaign – Declaring the
period of September 16 – October 14,
1998 as the“Ligtas Tigdas Month”
2. Proc. # 6 April 3, 1986 – United Nations
- Universal Goal on Child Immunization
by 1990
3. Proc. # 46 September 16, 1992 –
Reaffirming the commitment of the
Philippines to the Universal Child and
Mother Immunization Goal of the World
Health Assembly

4. Proc. # 118 – Professional
regulation Week – June 16-22
5. Proc. # 539 - Nurse week – every
last week of October
6. Proc. # 1275 - Midwifery week –
every third week of October
7. Proc. # 147 March 3, 1993 –
Declares April 21 and May 19, 1993
and every 3rd Wednesday of
January and February and
thereafter for 2 years as National
Immunization Days

8. Proc. # 773 March 28, 1996 –
Every 3rd Wednesday of April and
May as the “Knock-out Polio Day”
9. Proc. # 1064 August 27, 1997 –
Enjoining all sectors of society to
participate in the Acute Flaccid
Paralysis (AFP)surveillance
component of polio eradication
campaign
10. Proc. # 1066 – Declaring a
National Neonatal Tetanus
Elimination Campaign starting 1997

LETTERS OF INSTRUCTIONS
• 1. LOI # 149 October 19, 1979 -
Adoption of Primary Health Care;
Legal basis of primary health care
• 2. LOI #1000 – Members of accredited
professional organizations given
preference in hiring or attendance to
seminars
• 3. ILO convention #149- Improvement
of life and work conditions of nursing
personnel (ILO Recommendation #
157)

H. REPUBLIC ACTS

1. RA 491 - Nutrition Law (July month)
2. RA 611 – MediCare – an employee
becomes automatically a member;
“Public office is a public trust”
3. RA. 1054 – Free emergency
medical & dental attendance to
employees/laborers of any
commercial; industrial or agricultural
establishments

• 4. RA. 1080 – Civil Service eligibility for all
degrees with licensure examinations
• 5. RA. 1082 – Creation of 1st Rural Health
Act in 1953 - The employment of more
physicians, dentists, nurses, midwives and
sanitary inspectors who will live in the rural
areas where they are assigned to help
raise the health condition of the barrio
people and thus help abate the still high
incidence of preventable diseases in the
country. It created the first 81 Rural
HealthUnits.
• 6. RA. 1136 – Tuberculosis Law (August
Month)

• 7. RA. 1612 – Privilege Tax /
Professional Tax
• 8. RA. 1891 – Strengthening Health
and Dental services in the rural
areas and providing funds thereto;
amended RA 1082
• 9. RA. 2382 – Philippine Medical Act
• 10. RA. 3573 – Reporting
communicable Disease (all
communicable diseases should be
reported to the nearest health
stationand that any person maybe
inoculated, administered or injected)

• 11. RA. 4073 – Liberalized the
treatment of Leprosy - Except
where the patient requires
institutional treatment, no
persons afflicted with leprosy
shall be confined in a
leprosarium. The shall be
treated in a government skin
clinic, rural health unit or by a
duly licensed physician
(February – as Leprosy Month).

• 12. RA. 4226 – Hospital licensure
• 13. RA. 5181 – Permanent
residence & reciprocity
qualifications for examinations/
registration
• 14. RA. 5901 – Working hours &
compensation in agencies with
100 bed capacity
• 15. RA. 6365 – Established a
National Policy on Population and
Created the Commission of
Population

16. RA. 6425 – Dangerous Drug
Act – the sale, administration,
delivery, distribution and
transportation of prohibited drugs
is punished by law.
17. RA. 6675 – Generics Act of
1988 – this promotes, requires
and ensures the production of an
adequate supply, distribution, use
an acceptance of drugs and
medicines identified by their
generic names.

• 18. RA. 6713 – Code of Conduct and
Ethical Standards for Public Officials and
Employees. This Code upholds a time-
honored principle that public office is a
public trust. It the policy of the state to
promote high standards of ethics in
public office of public officials and
employees shall at all times be
accountable to the people and shall
discharge their duties with utmost
responsibility, integrity, competence and
loyalty, act with patriotism and justice,
lead model lives and modest living and
uphold public interest over personal
interest.

• 19. RA. 6715 – Senior Citizen Center
for every Barangay
• 20. RA. 6725 – Prohibition on
discrimination vs. women
• 21. RA. 6727 – Wage Rationalization
• 22. RA. 6758 – Salary Standardization
of Government employees that
includes nurses
• 23. RA. 6972 – Day Care Center in
every BarangaY

• 24. RA. 7160 – Local
Government/Autonomy Code
(the devolution of powers,
functions and responsibility to
the local government units)
• 25. RA. 7170 – Legacy of
donation of all or part of a
human body after death
• 26. RA. 7192 – Women in
development & Nation Building

• 27. RA. 7277 – Magna Carta for
Disabled persons
• 28. RA. 7305 – Magna Carta for Public
Health workers – this Act aims to
promote and improve the socio-
economic well-being of health workers,
their living and working conditions and
terms of employment; to developed their
skills and capabilities in order that they
will be more responsive and better
equipped to deliver health project and
programs; and to encourage those with
proper qualifications and excellent
abilities to join and remain in government
service.

• 29. RA. 7432 – Senior Citizen Benefits &
Privileges
• 30. RA. 7600 – Rooming –In and Breast
feeding Act of 1992
• 31. RA. 7610 – Anti-Child Abuse Law
(Special Protection of Children against
Child abuse, Exploitation & Discrimination)
• 32. RA. 7641 – New Retirement Law of
employees in the Private Sector
• 33. RA. 7719 – National Blood Service Act
of 1994

• 34. RA. 7846 – Requires
compulsory immunization against
Hepatitis B among infants and below
8 years old
• 35. RA. 7875 – National Health
Insurance Act of 1995
• 36. RA. 7876 – Senior Citizen
Center for Every Barangay
• 37. RA. 7877 – Anti- sexual
harassment Act of 199538. RA.
7883 – Barangay Health workers
Benefits & Incentives Act of 1992

39. RA. 8042 – Migrant workers &
Overseas Filipinos Act of 1992
40. RA. 8172 – Asin Law / Iodize Salt
Law
41. RA. 8187 – Maternity Leave Act
of 1995
42. RA. 8282 – Social Security Law
of 1997 (amended RA 1101)

43. RA. 8291 – Government
Service Insurance System Act
of 1997 (amended PD 1146)
44. RA. 8344 – Hospitals/ doctors
to treat emergency cases
referred for treatment
45. RA. 8353 – Anti-Rape Law
46. RA. 8423 – Traditional and
Alternative Medicine Act of
1997 (“Gamot na Mabisa sa
Abot Kayang Halaga”)

47. RA. 8424 – Personal Tax
Exemptions
48. RA. 8479 – Clean Air Act
49. RA. 8504 – Philippine AIDS
Prevention and Control Act of 1998
50. RA. 8972 – Nationwide
Iodination Law
51. RA. 8976 – Food Fortification
Act

52. RA. 8981 – PRC
Modernization Act of 2000
53. RA. 9173 – The Nursing Act
of 2002
54. RA. 9211 – No Smoking Act
55. RA. 9257 – Expanded Senior
Citizen Act of 2003
56. RA. 9262 - Domestic Violence
Act

BOARD OF NURSING
RESOLUTIONS
• 1. BON # 557 Series 1988 – Code of
Ethics
• 2. BON # 100 Series 1993 – Implementing
Rules & Regulations of RA 7392
• 3. BON # 633 Series 1964 – ICN Code of
ethics
• 4. BON # 1955 Series 1989 – PNA Code
of Ethics
• 5. BON # 08 Series 1994 – Special
Training on intravenous injections for the
R.N.

• 6. BON # 20 Series 1994 – Implementing
Rules & Regulations of RA 7164
• 7. BON # 110 Series 1994 – Guide to
Evaluate Compliance with Standards for
Safe Nursing Practice

J. SALIENT ASPECTS IN THE 1987
CONSITUTION OF THE PHILIPPINES
1. Article II – Declaration of Principles &
State Policies
Sector 11 – Human Dignity and right
12 – Sanctity of family, equal
protection of the life of the mother and the
unborn from conception
13 – Role of the youth in nation
building
15 – Right to health
16 – Right to a balanced & healthy
ecology

2. Article III – Bill of Rights
Section 1 – Equal protection of laws & the
due Process of Law
3 – Privacy of Communication and
Correspondence
8 – Formation of unions, associations
or societies
12 – To remain silent
6 have counsel when under
investigation
14 – The accused person is presumed
innocent until the contrary is proved

3. Article IV – Citizenship
• Sector 3 – Philippine
citizenship may be lost or
re-acquired in the manner
provide by law.

4. Article XIII – Social Justice &
Human Rights Sector
3 – Right of all workers to self-
organization, collective bargaining and
negotiations and peaceful concerted
activities.
11 – Priority for the needs of the
under- privileged, sick, elderly,
disabled, woman and children.
13 – Special agency for disabled
persons
14 – Protection of working women

5. Article XV – The
Family
• Sector 1 – Filipino family as the
foundation of the nation
• 2 – Marriage, as an inviolable
social institution, is the
foundation of the family
• 4 – The family has the duty to
care for its elderly members

LEGAL PROTECTIONS
IN NURSING

• Labor Law
• Magna Carta (R.A. 7305)
• Nursing Education
• Drug Education Law
• The Good Samaritan Law

LEGAL BASES OF
NURSING EDUCATORS,
NURSING REGULATION
AND NURSING PRACTICE

R.A. 9173
• AN ACT PROVIDING FOR A MORE
RESPONSIVE NURSING PROFESSION,
REPEALING FOR THE PURPOSE
REPUBLIC ACT NO. 7164, OTHERWISE
KNOWN AS "THE PHILIPPINE NURSING
ACT OF 1991" AND FOR OTHER
PURPOSES

R.A. No. 9173 – Nursing Law
• Aims to provide a sound general
and professional foundation for the
practice of nursing through quality
nursing education.
• The first policy encourages nursing
schools and colleges to implement
some standards for admission,
qualifying exams for 3rd year level
promotion and quality part indices
for the continuance of nursing
student in their respective nursing
degree programs to ensure the
quality of their nursing graduates.

R.A. No, 9173 – Nursing Law (cont)
• The 2nd policy – total quality education can
only be achieved when the government
makes it accessible to all who are fit and
prepared for it.
• Uplift standard of nursing education for this
country to produce quality nursing
graduates and ultimately globally
competitive Filipino Nurses.
• Not to discriminate against student where
spirits are willing but in intellectual, they are
wanting.
• Every Filipino has the right to education
however; every Filipino has the
responsibility to know his limitation and to
change the course for which he is suited.

• Nursing Education and nursing
practice are constantly interacting
while in the process of rapid
change to adopt to the existing
demands and condition of the
health care delivery system.
• They are complimenting each
other.
• The success of nursing practice
rest upon a sound educational
foundation of the nurse.
• The goal of nursing education is
to prepare the nursing student for
nursing practice.

• Goal of nursing practice is to
provide quality nursing service
and improve nursing care.
• This is when nursing regulation
comes into play.
• Everyone has a right to nursing
education as a constitutionally
guaranteed right.

Art. XIV, Sec. 1 of the 1987
Constitution
• To protect and promote the right
of all citizen to quality education
at all level and to take all
appropriate steps to make such
education accessible to all.

NURSING EDUCATION
• R.A. 7164
Required a certification by the school that the
applicant belong to the upper 40% of the
graduating class, as a general requirement to
the nursing degree course.
• R.A. 9173
> deletion of said admission requirement
> one high school performance is not an
accurate basis for college admission and
students’ mental competence and
psychological preparedness for college
education.
> More nursing students because more
graduating students will be eligible to enroll in
nursing degree program and more nursing
schools will be opened and offer the degree of
BSN.

NURSING EDUCATION (Cont)
• R.A. 7722 – CHED
Provide standard or minimum
requirement for the operation
and regulation of educational
institution offering tertiary
courses such as BSN.

•Duly authorized government agency that
approves the opening and regulates the
operation of nursing schools all over the
country.
•Created through R.A. 7722, May 18, 1994

CHED Memo Circular No. 30, s. 2001
• Updated policies and standards for
nursing education.
• New policy directing the CHED to regulate
the establishment and operation of review
center.

CHED Policy on Nursing schools and
colleges
• Nurses are needed in every part
of the world, with the
tremendous global demand,
nursing schools and colleges
are sprouting everywhere like
mushrooms.
• Authority to open and close
nursing schools / colleges

CMO No. 30
• The authorization to open a nursing school
shall be based upon:
1. written recommendation of BON,
PRC and NSA (National Student
Affiliation), DOH
2. approval of CHED
• The power of BON as to authorization of
opening or closing nursing schools is
recommendatory pursuant to COM No. 30
and RA 9173.

B. ADMINISTRATION AND FACULTY
• Fulltime Dean and Faculty
Qualification of Dean
• Perform vital role and function in nursing
school, required to work fulltime because
she is in charge to administer and manage
the nursing school, faculty and staff, the
nursing student and degree program.
• Filipino Citizen
• Currently registered nurse in the
Philippines
• Holder of Master’s Degree in Nursing
• 5 years of competent teaching and
supervisory experience in college or
institute of nursing.
• Member of good standing (ADPCN) and
accredited national nursing organization
(PNA)

Qualification and Rank of Faculty Members
• A Filipino Citizen
• Currently RN in the Philippines
• Holder of Master’s degree
• At least 3 years of Clinical
experience
• Member of good standing
accredited national nursing
organization.

NURSING REGULATION
• Professional Regulatory Board of Nursing
* created under new nursing law (RA
9173)
* Primary agency responsible for the
regulation of the admission, registration
and practice of nursing profession in the
Philippines.
* Composition of BON
* one Chairperson
* Six Members
* Appointed by the President of
the Philippines

Qualification of Chairperson
and Members of BON
• Representative of 3 areas of nursing
(education, service and community health
nursing)
• Natural born citizen and resident of the
Philippines.
• Member of good standing accredited
professional organization of nurses.
• Registered nurses and holder of Master’s
Degree
• 10 years of continuous practice of the
profession prior to appointment
• No conviction of any offense involving
sound turpitude.

Powers, Duties and
Responsibilities of the BON
• Conduct licensure examination for nurses
(R.A. 8981)
• Prepare adopt and issue the syllabi or
tables of specification of the subject for
examination in consultation with the
academe.
• Determine and prepare the questions
for the licensure examinations which
shall strictly be within the scope of
syllabi or table of specification of the
subject for examination.

Conduct licensure examination
for nurses (R.A. 8981)-Cont
• To score and rate the examination papers
with the name and signature of the board
members concerned appearing thereon
and sublit the result in all subjects duly
signed by the members of the board to the
commission within 10 days from the last
day of examination unless extended by the
commission for justifiable cause and
subject to the approval of the commission.
• Determine the appropriate passing general
average rating in an examination if not
provided for in the law regulatory thru
profession.

Definition
• It refers to the commission or
omission of an act, pursuant to
a duty, that a reasonably
prudent person in the same or
similar circumstances would or
would not do, and acting or the
non-acting of which is the
proximate cause of injury to
another person or his property.

Civil Code, Article 19
• One shall act with justice, give
every man his due, observe
honesty and good faith.

Civil Code, Article 20
• Those who, in the performance
of their obligations through
negligence cause any injury to
another, are liable for damages.

Common Acts of Negligence
• Burns
• Objects left inside the patient’s
body
• Falls of elderly
• Falls of children
• Failure to observe and take
appropriate action as needed

Specific Examples
• Failure to report observations to
attending physicians
• Failure to exercise the degree
of diligence which the
circumstances of the particular
case demands
• Mistaken identity
• Wrong medicine, wrong
concentration, wrong route,
wrong dose

Conditions for Res ipsa loquitor
• That the injury was of such nature that it
would 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

• Implies the idea of improper or
Definition unskillful care of a patient by a
nurse
• Denotes stepping beyond one’s
authority with serious
consequences
• Is a term for negligence or
carelessness of professional
personnel
• Refers to a negligent act
committed in the course of
professional performance (1962)

MEDICAL ORDERS,
DRUGS, and
medications.

• Only validly registered
RA 6675
medical, dental and
veterinary
practitioners, whether
in private institution,
corporation or in the
government, are
authorized to
prescribed drugs.

RA 5921 (PHARMACY ACT)
• All prescriptions must contain the following
information:
• Name of the prescriber
• Office address
• professional registration number
• Professional tax receipt number
• Patient’s/client’s name, age , sex
• Date of prescription.

RA 6675
• Requires that the drug be written in their
generic names.

• Only when these orders are legal
writing and bear the doctor’s signature
thus the nurse have the legal right to
follow them
• The nurse must not execute an order if
she is reasonably certain it will result in
harm to the patient.

INTRAVENOUS THERAPY AND LEGAL
IMPLICATIONS
• Philippine nursing act of 1991 section 28
• “ in the administration of intravenous
injections, special training shall be
required according to protocol
established”.
• Basis of nurses legal right to give IV
injection.
Board of nursing resolution no. 8 states
that any registered nurse without such
training and who administers IV
injections to patients should be held
liable, either criminally or
administratively or both.

TELEPHONE ORDERS
• Only in an extreme emergency and when
no other resident or intern is available
should a nurse receive telephone orders.
• The nurse should read back such order to
the physician to make certain the order
has been correctly written.
• Such order should be sign by the
physician on his next visit within 24 hours.

MEDICAL RECORDS
• Supplies rich material for medical and
nursing research
• Serves as a legal protection for the
hospital, doctor, and nurse by reflecting
the disease or condition of the patient and
his management.
• “if it was not charted, it was not observed
or done”.

CONTINUATION..
• Nurses are expected to record fully,
accurately, legibly and promptly their
observations from admission to the time of
the patient’s discharge.
• Nurses are legally and ethically bound to
protect the patient’s chart from
unauthorized person.

CHARTING DONE BY STUDENT
NURSES
• When a nurse or clinical instructor counter
signs the charting of the nursing student,
he/she has personal knowledge of
information and that such is accurate and
authentic.
• Anyone who countersigns without
verification commits herself to possible
legal risks.

Liabilities of nurses for the work of nursing
aides
• Nurses should not delegate their
functions to nursing aides since the
Philippine nursing act specifies the
scope of nursing practice of
professional nurses.
• Nurses are enjoined to supervise
their subordinates and see to it that
they perform only those which they
been taught to do and those which
they are capable of doing.

• Nursing aids are responsible for
their actions.

• Nurses should not delegate their
functions to nursing aides.
• Nursing aides perform selected
nursing activities under the direct
supervision of nurses.

LIABILITY FOR THE WORK OF
NURSING STUDENTS
• RA 9173 – nursing students do not
perform professional nursing duties.
• Nursing students should be under
supervision of their clinical instructors.
• In order that the errors committed by
nursing students will be avoided or
minimized, the following measures should
be taken:
• Nursing students should always be
under supervision of their clinical
instructors.

• They should be given assignments that
are their level of training experience and
competency.
• They should be advised to seek
guidance if they are performing a
procedure for the first time.
• They should be oriented to the policies
where they are assigned.
• Their performance should be assessed
frequently to determine their strength
and weaknesses.

Crime defined
• It is an act committed or omitted
in violation of the law. It is
composed of two elements: (1)
criminal act and (2) evil/criminal
intent

Conspiracy to commit a crime
• A conspiracy to commit a crime
exists when two or more
persons agree to commit a
felony and decide to do it.

Criminal Liability
• nurse may incur criminal liability or subject
herself to criminal prosecution either by
committing a felony or by performing an
act which would be an offense against
person or property.

• Ignorance of the law is not an
excuse for failure to comply
therewith.
• Violators of the criminal law cannot
escape punishment on the ground
of ignorance of the law

Circumstances affecting criminal liability
• Justifying circumstances
• Exempting circumstances
- an imbecile or insane person, unless
the latter has acted during a lucid interval.
-below 9 years old
-over 9 years of age and under fifteen
unless he/she acted with discernment

- causes an injury which is merely an accident
without fault or intention or causing it
-acts under the compulsion of an irresistible force
-acts under the impulse of an uncontrollable fear
of an equal or greater injury

• Mitigating circumstances

Are those which do not
constitute justification or
excuse of the offense in
question, but which in fairness
and mercy, may be considered
as extenuating degree of moral
culpability.

• Aggravating circumstances
• Are those attending the commission of
crime and which increase the criminal
liability of the offender or make his guilt
or more severe.
• Some of the ff circumstances:
• When the offender takes advantages of
his public position.
• When the crime is commited in place of
worship
• When the act is committed with evident
premeditation or after an unlawful entry.

• Alternative circumstances
-are those which must be taken into consideration as
aggravating or mitigating according to the nature and
effects of the crime and other conditions attending in
commission.

Should be taken consideration when the offended party
is the spouse, ascendant or descendant, legitimate,
natural or adopted or relatives.

Points in order to avoid criminal liability:
1. Be very familiar with the Philippine nursing
law.
2. Beware of laws that affecting nursing
practice
3. At the start of employment, get a copy of
your job description, the agency’s rules,
regulations and policies.
4. Upgrade you skills and competence

5. Accept only such responsibility that is within the
scope of your employment and your job description.
6. Do not delegate your responsibilities to others.
7. Determine whether your subordinates are competent
in the work you are assigning them.
8. Develop good interpersonal relationships with your
co-workers, whether they be your supervisors, peers
or subordinates.

9. Consult your superior for problems that maybe too
big for you to handle.
10. Verify orders that are not clear to you or those that
seem to be erroneous.
11. The doctors should be informed about the patients
conditions
12. Keep in mind the values and necessity of keeping
accurate and adequate records
13. Patients are entitled to an informed consent.

Examples liabilities of Nursing:
• Liability for injury to patient
• Liability for sponge left in the patient’s abdomen
• Liability for a safety pin left in patient’s abdomen
• Liability for defective equipment
• Liability for death for patient who jump from window
of his room

• Liability for negligence of surgical nurse
• Liability for rapture of surgical wound.
• Liability for burns for suffered by patient
• Liability for burns from hot water bags
• Liability for negligence of nurse
employees
• Liability fro death of infant resulting from
injection of digitalis
• Liability of nurse performing
administrative work

Conspiracy
• an agreement between two or more
persons to break the law at some time in
the future.

Principals
• Are those who take a direct part in the
execution of the act; who directly force or
induce others to commit; or who cooperate
in the commission of the offense by
another act without which it would not
have been accomplished.

Accomplices
• Are those persons who, not being
principals, cooperate in the execution in
the offense by previous or simultaneous
act.

Accessories
• Are those who, having knowledge of the
commission of the crime, either as
principals or accomplices, take part in the
subsequent to its commission by profiting
themselves or assisting the offender to
profit from the effects of the crime.

Criminal Actions

• Deal with acts or offenses
against public welfare.

Misdemeanor
• Is a general name for a
criminal offense which does
not in law amount to felony.

Felony
• Is a public offense for which
a convicted person is liable
to be sentenced to death or
to be imprisoned in a
penitentiary or prison.
• Is committed with deceit and
fault.

Criminal negligence
• Reckless imprudence – when a person
does an act or fails to do it voluntarily but
without malice, from which material
damage results immediately.
• Simple imprudence means that the person
or nurse did not use precaution and
damage was not immediate or the
impending danger was not evident or
manifest.

Criminal intent
• Is the state of mind of a
person at the time the
criminal act is committed.
• Two elements of deliberate
intent: freedom and
intelligence

Lawsuits • Actions brought to the court or
tribunal.
• Any action, complaint, charge, case
or legal proceeding brought before
the court of law, tribunal or quasi-
judicial body, in which the party
commencing the case seeks a legal
remedy.
• It is initiated by any person who is
called the plaintiff in civil action or
the complainant in other lawsuits,
against another who is called the
defendant in civil actions or the
respondent in administrative case
or the accused in criminal case.

Lawsuits (cont)
• Three (3) basic lawsuits are civil, criminal
and administrative.
• The parties in a lawsuit:
a. Civil actions, the plaintiff against the
defendant.
b. Criminal Actions , the people against
the accused.
c. Administrative cases, the complainant
against respondent.

Liability
• An obligation or duty which is owed by one
person to another to refrain from some
course or conduct injurious to the latter or
to perform some act or to do something for
the benefit of the latter and for breach of
which the law gives the remedy to the
latter as damages, restitution, specific
performance, and / or injunction.

Liability (cont)
• Simply the legal responsibility for acts or failure to act
according to standards, protocols or policies of the
hospital, resulting in another person’s injury or death.
• It means legal accountability or obligation to pay money,
do or refrain to do something, and / or serve penalty as
adjudged by the court or administrative body.

Legal Doctrine
• A framework, set of rules, procedural
steps, or test, often established through
precedent in the common law through
which judgments can be determined in a
given legal case or lawsuit.
• Generally accepted principle of law which
is being used or applied in the resolution
of cases, be it administrative, civil or
criminal.

Kinds of Civil Liability
• Actual or compensatory damages
pertain to losses that are actually
sustained by the plaintiff. These are
“such compensation or damages for
an injury and will put the injured
party in the position in which he was
before he was injured.
• Moral Damages are awarded by
reason of physical suffering, mental
anguish, fright, serious anxiety,
besmirched, reputation, wounded
feelings, moral shock, social
humiliation and similar injury.

• Nominal damages are awarded for vindication or
recognition of a legal right.
• Temperate or moderate damages are those damages
which are more than nominal but less than
compensatory damages which may be recovered when
the court finds that some pecuniary loss has been
suffered but its amount cannot, from the nature of the
case, be proved with certainty.

• Liquidated damages are those damages agreed upon by
the parties to a contract, to be paid in case of breach
thereof.
• Exemplary or corrective damages are those imposed by
way of example or correction for the public good, in
addition to the moral, temperate, liquidated or
compensatory damages.

Lawsuits in Nursing Practice
• Felony - RPC
• Offense - special law
• Infraction - ordinance

Criminal Negligence, mala
in se and mala prohibita
• Criminal Negligence – committed by
means of faulty (culpa); deceit (dolo) (mala
in se) and those which are punished by
special law (mala prohibita).

Kinds of criminal negligence
• Reckless imprudence – doing or failing to
do an act resulting to injuries or death due
to an inexcusable lack of precaution.
• Simple imprudence - mere lack of
precaution in a situation where threatened
harm is not immediate or the impending
danger is not openly visible or manifest.

• Culpa Contractual (breach of Contract) – when a nurse
is contractually obligated to perform a particular health
service or intervention to a patient and he/she causes
death or injuries to the latter.
• Culpa aquiliana a tortous liability which arises from the
breach of a professional duty to any person fixed by the
laws and such breach constitutes violation of a private
legal right, not created by any contract.

Nurses And Crimes
• Parricide
• Murder
• Homicide
• Infanticide
• Abortion
• Illegal Detention
• Simulation of Births

End of Life Decisions and the
Law
• Do Not Resuscitate Orders
• Advance Directives
• Contracts/ wills/ testaments
• Durable Power of Attorney
• Incident Report

Our duty is to be useful, not
according to our desires but
according to our powers.

Legalities 2013

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Editor's Notes