BIOETHICS

a. The Doctor’s Oath

I swear by Apollo the Healer, by Aesculapius, by Health and all the powers of healing and to call witness all the Gods and Goddesses that I
may keep this oath and promise to the best of my ability and judgment. I will pay the same respect to my master in the science as to my
parents and share my life with him and pay all my debts to him. I will regard his sons as my brothers and teach them the science, if they
desire to learn it, without fee or contract. I will hand on precepts, lectures and all other learning to my sons, to those of my master and to
those pupils duly appointed and sworn and to none other. I will use my power to help the sick to the best of my ability and judgment. I
will abstain from harming or wrong doing any man by it. I will not give a fatal draught to anyone if I am asked, nor will I suggest any such
thing. Neither will I give a woman means to procure an abortion. I will be chaste and religious in my life and in my practice. I will not cut,
even for the stone, but I will leave such procedures to the practitioners of that craft. Whenever I go into a house I will go to help the sick
and never with the intention of doing harm or injury. I will not abuse my position to indulge in sexual contacts with the bodies of women
or of men whether they be freemen or slaves. Whatever I see or hear, whether professionally or privately which ought not to be divulged
I will keep secret and tell no one. If therefore, I observe this oath and do not violate it, may I prosper both in my life and in my profession,
earning good repute among all men for all time. If I transgress and foreswear this oath, may my lot be otherwise.

b. The Nurse’s Oath

I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to
practise my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take
or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my
profession, and will hold in confidence all personal matters committed to my keeping, and all family affairs
coming to my knowledge in the practice of my calling. With loyalty will I endeavour to aid the physician in his
work, and as a 'missioner of health' I will dedicate myself to devoted service to human welfare.

c. Doctor’s Rights

d. Patient’s Bill of Rights

1. Right to Appropriate Medical Care and Humane Treatment. - Every person has a right to health and medical
care corresponding to his state of health, without any discrimination and within the limits of the resources,
manpowerand competence available for health and medical care at the relevant time. The patient has the right
to appropriate health and medical care of good quality. In the course of such, his human dignity, convictions,
integrity, individual needs and culture shall be respected. If any person cannot immediately be given treatment
that is medically necessary he shall, depending on his state of health, either be directed to wait for care, or be
reffered or sent for treatment elsewhere, where the appropriate care can be provided. If the patient has to wait
for care, he shall be informed of the reason for the delay. Patients in emergency shall be extended immediate
medical care and treatment without any deposit, pledge, mortgage or any form of advance paymentfor
treatment.
2. Right to Informed Consent. -  The patient has a right to a clear, truthful and  substantial  explanation,  in  a 
manner  and  language  understandable  to  the patient, of all proposed procedures, whether  diagnostic,
preventive, curative, rehabilitative or therapeutic, wherein the person who will perform the said procedure shall
provide  his  name  and credentials  to  the  patient,  possibilities  of  any  risk  of mortality or serious side effects,
problems related to recuperation, and probability of success  and  reasonable  risks  involved:  Provided,   That 
the  patient  will not  be subjected  to any procedure without his written informed consent, except in the
following cases:
a)  in emergency cases, when the patient is at imminent risk of physical injury, decline Of  death if treatment is
withheld or postponed. In such cases, the physician can  perform  any diagnostic  or treatment  procedure  as
good practice of medicine dictates without such consent;
b)  when the health of the population is dependent on the adoption of a mass health program to control
epidemic;
c)  when the law makes it compulsory for everyone to submit a procedure;
d)  When the patient  is either a minor, or legally incompetent, in which case. a third party consent Is required;
e)  when  disclosure  of  material  information  to  patient  will  jeopardize  the success of treatment,  in which
case, third  party disclosure  and consent shall be in order;
f)   When the patient waives his right in writing.
Informed consent shall be obtained from a patient concerned if he is of legal age and of sound mind. In case the
patient is incapable of giving consent and a third party   consent  is  required.  the  following  persons,  in  the 
order  of  priority  stated hereunder, may give consent:
i.     spouse;
ii.    son or daughter of legal age;
iii.   either parent;
iv.   brother or sister of legal age, or
v.    guardian
If a patient is a minor, consent shall be  ottained  from  his parents or legal guardian. If next of kin, parents or 
legal guardians  refuse to give  consent  to  a medical or surgical  proceoure  necessary to save the  life or limb of 
a minor or a patient incapable of giving consent, courts, upon the petition of the physician or any person
interested in the welfare of the patient, in a summary proceeding, may issue an order giving consent.
3. Right to Privacy and Confidentiality.  -  The privacy of the patients must be assured at all stages of his
treatment. The patient has the right  to be free from unwarranted public exposure, except in the  foHowing
cases: a) when his mental or physical condition is in controversy and the appropriate court, in its discretion,
order him to submit to a physical or mental examination by a physician; b) when the public health and safety so
demand; and c) when the patient waives this right in writing.
The patient has the right to demand that all information, communication  and records pertaining to his care be
treated as confidential. Any health care provider or practitioner involved in the treatment  of a patient and all
those who have legitimate access to the patient's record is not authorized to divulge any information to a third
party  who  has  no concern  with  the  care  and  welfare  of  the  patient  without  his consent, except:  a) when 
such disclosure  will benefit public  health and  safety; b) when it is in the interest of justice and  upon the order
of a competent court; and c) when the patients  waives  in writing the confidential  nature of such  information;
d) when  it is  needed  for  continued  medical  treatment  or  advancement  of  medical science subject to de-
identification  of patient and shared medical confidentiality  for those who have access to the information.
Informing the spouse or the family to the first degree of the patient's medical condition may be allowed;
Provided That the patient of legal age shall have the right to choose on whom to inform. In case the patient is
not of legal age or is mentally incapacitated, such information shall be given to the  parents, legal guardian  or
his next of kin.
 4. Right to  Information. -  In the course  of his/her  treatment  and  hospital care, the patient or his/her legal
guardian has a right to be informed of the result of the evaluation  of the nature and extent of his/her disease, 
any other additional  or further  contemplated   medical  treatment on surgical procedure or procedures,
including any other additional medicines to be administered and their generic counterpart including the possible
complications  and other pertinent facts, statistics or studies,  regarding  his/her  illness,  any  change  in the 
plan  of  care  before  the change  is  made,  the  person's  participation  in the  plan  of  care  and  necessary
changes  before its implementation, the  extent to  which payment  maybe  expected from Philhealth or any
payor and any charges for which the patient maybe liable, the disciplines of health care practitioners who will
fumish the care and the frequency of services that are proposed to be furnished.
The patient or his legal guardian has the  right to examine and  be given an itemized bill of the hospital and
medical services rendered in the facility or by his/her physician and other health care providers, regardless  of
the manner and source of payment.He is entitled to a thorough explanation of such bill.
The  patient  or  hislher  legal guardian  has the  right to  be informed  by the physician or his/her delegate of
hisJher continuing health care requirements following discharge, including instructions about home medications,
diet, physical activity and all other pertinent information to promote health and well-being.
At the  end of  his/her confinement, the patient is entitled  to a brief, written summary  of the  course  of 
his/her  illness which  shall  include  at least the  history, physical examination, diagnosis, medications, surgical
procedure, ancillary and laboratory procedures, and the plan of further treatment, and which shall be provided
by the attending physician. He/she is likewise entitled  to the explanation  of, and to view, the contents of
medical record of his/her confinement but with the presence of his/her  attending   physician  or  in  the 
absence  of  the  attending  physician,  the hospital's representative.  Notwithstanding that  he/she   may  not be
able  to  settle  his accounts   by reason of  financial   incapacity, he/she is entitled  to reproduction, at  his/her  
expense,   the pertinent   part  or  parts  of the  medical   record  the  purpose   or  purposes   of  which   he shall 
indicate  in his/her  written  request  for  reproduction.   The  patient  shall likewise  be entitled  to  medical 
certifICate, free  of  charge,  with  respect  to  his/her  previous confinement.
5. The Right to Choose  Health  Care Provider  and Facility. -  The patient is free to choose the health care
provider to serve  him as well as the facility except when he is under the care of a service facility or when public
health and safety so demands or when the patient expressly waives this right in writing.
The patient has the right to discuss his condition with a consultant specialist, at the patient's  request and
expense.  He also has the  right to seek  for a second opinion and subsequent opinions, if appropriate, from
another health care  provider/practitioner.
 6. Right to Self-Determination. - The  patient has the right to avail himself/herself of any recommended
diagnostic and  treatment  procedures.Any person of legal age and of sound mind may make an advance written
directive for physicians to administer terminal care when he/she suffers from the terminal phase of a terminal
illness:  Provided That a) he is informed of the medical consequences of his choice; b) he releases those involved
in his care from any obligation relative to the consequences of his decision; c) his decision will not prejudice
public health and safety.
7. Right to Religious  Belief. - The patient  has the  right to refuse medical treatment or procedures which may
be contrary to his religious beliefs, subject to the limitations described in the preceding subsection: Provided, 
That such a right shall not be imposed by parents upon their children who have not reached the legal age in a
life threatening situation as determined by the attending physician or the medical director of the facility.
8. Right to Medical Records. - The patient is entitled to a summary of his medical history and condition.He has
the right to view the contents  of his medical records, except psychiatric notes and other incriminatory
information obtained about third parties, with the attending physician explaining contents thereof. At his
expense and upon discharge of the patient, he may obtain from the health care institution a reproduction of the
same record  whether or not he has fully  settled  his financial obligation with the physician or institution
concerned.
The health care  institution shall safeguard  the  confidentiality  of the medical records and to likewise ensure
the integrity and authenticity of the medical records and  shall  keep the same  within  a  reasonable time  as 
may be determined  by the Department of Health.
The health care institution shall issue a medical certificate  to the patient upon request.Any other document that
the patient may require for insurance claims shall also be made available to him within forty-fIVe (45) days from
request.
9. Right to Leave. - The patient has the right  to leave hospital or any other health care institution regardless of
his physical   condition: Provided. That a) he/she is informed  of the  medical consequences  of his/her decisionl 
b) helshe  releases those involved in his/her care from any obligation relative to the consequences of his
decision; c) hislher decision will not prejudice public health and safety.
No patient shaD be  detained against hi$/her will in any health care institution on the  sole  basis  of  his failure
to  fully  settle  his  financial  obligations.  However, he/she shall only be allowed to leave the hospital provided
appropriate arrangements have been made to settle the  unpaid  bills: Provided.  further, That  unpaid  bills of
patients shall be considered as loss income by the hospital and health care provider/practitioner  and shall be 
deducted from gross income as income loss only on that particular year.
10. Right to Refuse Participation In Medical Research. - The patient has the  right to be advised if the  health
care provider  plans to  involve him in medical research, including but not limited  to  human  experimentation
which may be performed only with the written informed consent of the patient: Provided, That, an institutional
review board or ethical review board in accordance with the guidelines set in the Declaration of Helsinki be
established for research involving human experimentation:  Provided, further, That the Department of Health
 shall safeguard the continuing training  and  education  of fUture health care provider/practitioner to ensure the
development of the health care delivery in the country: Provided, fUfthermore, That the patient involved in the
human experimentation  shall be  made aware of the provisions of the Declaration of Helsinki and its respective
guidelines.
11. RIght to Correspondence and to Receive Visitors. - The patient has the  right to  communicate  with 
relatives and other  persons  and to receive visitors subject to reasonable limits prescribed by the rules and
regulations of the health care institution.
12. Right  to  Express Grievances. - The patient has the  right to  express complaints and grievances about the
care and  services received  without fear of discrimination or reprisal and to know about the disposition of such
complaints.Such a system shall afford all parties concerned with the opportunity to settle amicably all
grievances.
13. RIght to be Informed of His Rights and Obligations as a Patient. - Every person has the right to be  informed
of his rights and obligations as a patient.The Department of Health,in coordination with heath  care  providers,
professional and civic groups, the media, health insurance corporations, people's organizations,local
government  organizations,  shall launch and sustain a nationwide  information and  education  campaign  to 
make  known  to  people  their rights  as patients, as declared  in this Act  Such  rights  and obligations  of
patients  shall  be posted in a bulletin board conspicuously  placed in a health care institution.
It shall be the duty of health care institutions to inform of their rights as well as of the institution's rules and
regulations that apply to the conduct of the patient while in the care of such institution.

e. 7 Bioethics or Ethics for Medical Professionals

(non-maleficence, beneficence, veracity, respect for autonomy, justice, proportionality confidentiality, role fidelity)
ART. 2

Section 12. The State recognizes the sanctity of family life and shall protect and strengthen the family as a basic
autonomous social institution. It shall equally protect the life of the mother and the life of the unborn from
conception. The natural and primary right and duty of parents in the rearing of the youth for civic efficiency and
the development of moral character shall receive the support of the Government.

Section 13. The State recognizes the vital role of the youth in nation-building and shall promote and protect
their physical, moral, spiritual, intellectual, and social well-being. It shall inculcate in the youth patriotism and
nationalism, and encourage their involvement in public and civic affairs.

Section 14. The State recognizes the role of women in nation-building, and shall ensure the fundamental
equality before the law of women and men.

Section 15. The State shall protect and promote the right to health of the people and instill health consciousness
among them.

Section 16. The State shall protect and advance the right of the people to a balanced and healthful ecology in
accord with the rhythm and harmony of nature.

ART 111
Sec 12, 2. (2) No torture, force, violence, threat, intimidation, or any other means which vitiate the free will shall
be used against him. Secret detention places, solitary, incommunicado, or other similar forms of detention are
prohibited.

Sec 19, 2. (2) The employment of physical, psychological, or degrading punishment against any prisoner or detainee or the use of
substandard or inadequate penal facilities under subhuman conditions shall be dealt with by law.
Employer employee

Employer Employee Relationship

The agreement binding both the employer and the employee is known as an employment contract. However,
the absence of an employment contract does not indicate an absence of an employer employee relationship.
When the existence of the employer employee relationship is in question, the court has generally applied the
four fold test.

If the employer employee relationship can be established, the employer may not terminate the service of the
employee without a just or authorized cause.

4 Elements Of Employer Employee Relationship

Therefore, to determine the existence of an employer-employee relationship, the four fold test is usually
applied:

the selection and engagement of the employee;

the payment of wages;
the power of dismissal; and,
the employer’s power to control the employee on the means and methods by which the work is accomplished.

Control Test Labor Law

Of the 4 elements of employer employee relationship, the control test (#4) is generally regarded as the most
crucial and determinative indicator of the presence or absence of an employer-employee relationship. Under
this test, an employer-employee relationship is said to exist where the person for whom the services are
performed reserves the right to control not only the end result but also the manner and means utilized to
achieve the same.

However, as seen in the case of Royale Homes Marketing Corporation vs. Fidel P. Alcantara, not every form of
control is indicative of an employer-employee relationship. The subjection of the service provider to the client’s
rules, regulations, and code of ethics does not make the service provider an employee when the level of control
does not dictate the methodology in performing the tasks. The client has the right to establish guidelines
towards the achievement of a mutually desired resu

ARTICLE 19. Every person must, in the exercise of his rights and in the performance of his duties, act with justice,
give everyone his due, and observe honesty and good faith.

ARTICLE 20. Every person who, contrary to law, wilfully or negligently causes damage to another, shall indemnify
the latter for the same.

ARTICLE 21. Any person who wilfully causes loss or injury to another in a manner that is contrary to morals, good
customs or public policy shall compensate the latter for the damage

ARTICLE 1157. Obligations arise from: Liaiim

(1) Law;

(2) Contracts;

(3) Quasi-contracts;
(4) Acts or omissions punished by law; and

(5) Quasi-delicts. (1089a)

ARTICLE 2197. Damages may be:

(1) Actual or compensatory;

(2) Moral;

(3) Nominal;

(4) Temperate or moderate;

(5) Liquidated; or

(6) Exemplary or corrective.

ARTICLE 2199. Except as provided by law or by stipulation, one is entitled to an adequate compensation only for
such pecuniary loss suffered by him as he has duly proved. Such compensation is referred to as actual or
compensatory damages.

ARTICLE 2200. Indemnification for damages shall comprehend not only the value of the loss suffered, but also
that of the profits which the obligee failed to obtain. (1106)

ARTICLE 2201. In contracts and quasi-contracts, the damages for which the obligor who acted in good faith is
liable shall be those that are the natural and probable consequences of the breach of the obligation, and which
the parties have foreseen or could have reasonably foreseen at the time the obligation was constituted.

In case of fraud, bad faith, malice or wanton attitude, the obligor shall be responsible for all damages which may
be reasonably attributed to the non-performance of the obligation. (1107a)

ARTICLE 2202. In crimes and quasi-delicts, the defendant shall be liable for all damages which are the natural
and probable consequences of the act or omission complained of. It is not necessary that such damages have
been foreseen or could have reasonably been foreseen by the defendant.

ARTICLE 2203. The party suffering loss or injury must exercise the diligence of a good father of a family to
minimize the damages resulting from the act or omission in question.

ARTICLE 2204. In crimes, the damages to be adjudicated may be respectively increased or lessened according to
the aggravating or mitigating circumstances.

ACTUAL/ COMPENSATORY DAMAGES

Purpose

Actual or compensatory damages simply make good or replace the loss caused by the wrong.
Manner of Determination

Claimant must produce competent proof or the best evidence obtainable such as receipts to justify an award
therefore. Actual or compensatory damages cannot be presumed but must be proved with reasonable certainty.
(People v. Ereno, Feb. 22, 2000)

Special/Ordinary

Ordinary

NOTE: Ordinary Damages are those generally inherent in a breach of a typical contract

MORAL DAMAGES
Purpose

Awarded only to enable the injured party to obtain means, diversion or amusement that will alleviate the moral
suffering he has undergone, by reason of defendants culpable action. (Robleza v. CA, 174 SCRA 354)

Manner of Determination

No proof of pecuniary loss is necessary. The assessment is left to the discretion of the court according to the
circumstances of each case. However, there must be proof that the defendant caused physical suffering etc.
(Compania Maritima v. Allied Free Worker’s Union, G.R. No. L-31379, Aug. 29, 1988). GR: Factual basis must be
alleged. Aside from the need for the claimant to satisfactorily prove the existence of the factual basis of the
damages, it is also necessary to prove its causal relation to the defendant’s act (Raagas v. Trava, G.R. No. L-
20081, Feb. 27,1968; People v. Manero, G.R. Nos. 86883-85, Jan. 29, 1993).

Exception: Criminal cases. Moral damages may be awarded to the victim in criminal proceedings in such amount
as the court deems just without need for pleading or proof of the basis thereof (People v. Paredes, July 30,
1998).

Special/Ordinary

Special

NOTE: Special Damages are those which exist because of special circumstances and for which a debtor in good
faith can be held liable if he had been previously informed of such. circumstances.
NOMINAL DAMAGES
Purpose

Vindicating or recognizing the injured party’s right to a property that has been violated or invaded. (Tan v.
Bantegui, 473 SCRA 663)

Manner of Determination

No proof of pecuniary loss is necessary. Proof that a legal right has been violated is what is only required.
Usually awarded in the absence of proof of actual damages.

Special/Ordinary

Special

NOTE: Special Damages are those which exist because of special circumstances and for which a debtor in good
faith can be held liable if he had been previously informed of such. circumstances.

TEMPERATE DAMAGES
Purpose

When the court is convinced that there has been such a loss, the judge is empowered to calculate moderate
damages rather than let the complainant suffer without redress. (GSIS v. Labung-Deang, 365 SCRA 341)

Manner of Determination

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. No proof of pecuniary loss is necessary.

Special/Ordinary

Special

NOTE: Special Damages are those which exist because of special circumstances and for which a debtor in good
faith can be held liable if he had been previously informed of such. circumstances.
LIQUIDATED DAMAGES
Purpose

Liquidated damages are frequently agreed upon by the parties, either by way of penalty or in order to avoid
controversy on the amount of damages.

Manner of Determination

If intended as a penalty in obligations with a penal cause, proof of actual damages suffered by the creditor is not
necessary in order that the penalty may be demanded (Art. 1228, NCC). No proof of pecuniary loss is necessary.

Special/Ordinary

Special

NOTE: Special Damages are those which exist because of special circumstances and for which a debtor in good
faith can be held liable if he had been previously informed of such. circumstances.

EXEMPLARY/CORRECTIVE DAMAGES
Purpose

Exemplary or corrective damages are intended to serve as a deterrent to serious wrongdoings. (People v. Orilla,
422 SCRA 620)

Manner of Determination

1. That the claimant is entitled to moral, temperate or compensatory damages; and

2. That the crime was committed with 1 or more aggravating circumstances, or the quasi-‐delict was committed
with gross negligence, or in contracts and quasi-contracts the act must be accompanied by bad faith or done in
wanton, fraudulent, oppressive or malevolent manner. No proof of pecuniary loss is necessary.

Special/Ordinary

Special

NOTE: Special Damages are those which exist because of special circumstances and for which a debtor in good
faith can be held liable if he had been previously informed of such. circumstances.