NCM 103 FUNDAMENTALS IN NURSING PRACTICE I Week 8
LEGAL ASPECTS AND THE NURSE cont.
Mr. Andre De Veyra | May 5, 2022
OUTLINE:
I. LIABILITY OF NURSES FOR THE WORK OF
NURSING AIDES
II. MEDICAL ORDERS, DRUGS, AND MEDICATIONS
III. INTRAVENOUS THERAPY AND LEGAL
IMPLICATIONS
IV. TELEPHONE ORDERS
V. CONSENT TO MEDICAL AND SURGICAL
PROCEDURES
VI. MEDICAL RECORDS
VII. CHARTING DONE BY NURSING STUDENTS
VIII. MEDICAL RECORDS IN LEGAL PROCEEDINGS
IX. LEGAL RISKS FOR DEFECTIVE EQUIPMENT
X. INTENTIONAL WRONGS
XI. TORTS
XII. CRIMES, MISDEMEANORS, AND FELONIES
XIII. CIRCUMSTANCES AFFECTING CRIMINAL
LIABILITY
XIV. POINTS TO OBSERVE IN ORDER TO AVOID
CRIMINAL LIABILITY
XV. WILLS
XVI. TESTAMENTARY CAPACITY AND INTENT
XVII. THE NURSE’S OBIGATIONS IN THE EECUTION
OF A WILL
XVIII. GIFTS
XIX. LEGAL PROCEDURE AND TRIAL
XX. COMMENCEMENT OF THE ACTION
XXI. STATUES OF LIMITATION
XXII. COMMENCEMENT OF LEGAL PROCEEDINGS
XXIII. PLEADING
XXIV. FUNDAMENTAL REQUIREMENTS OF DUE
PROCESS
XXV. PRE-TRIAL PROCEDURES
XXVI. TRIALS
XXVII. WITNESS
XXVIII. APPEALS
XXIX. EXECUTION OF JUDGEMENT
XXX. REFERENCES
LEGEND:
Black for PowerPoint, red for audio lecture, blue for book
LIABILITY OF NURSES FOR THE WORK OF
NURSING AIDES
• Nursing aides perform selected nursing activities
under the direct supervision of nurses.
• Nurses should not delegate their functions to nursing
aides since the Philippine Nursing Act specifies the
scope of nursing practice of professional nurses.
• Nurses should not delegate ATE (Assessment,
Teaching, and Evaluation) to nursing aides.
MEDICAL ORDERS, DRUGS, AND MEDICATIONS
• Republic act 6675
o only validly registered medical, dental, and
veterinary practitioners, whether in private
institution/corporation or in the government, are
authorized to prescribe drugs.
o requires that the drugs be written in their
generic names so that the patient will have the
liberty whatever brand it is, based on their
budget.
RELLIN-RODRIGUEZ
• R.A. 2832 or the Medical Act of 1959,
R.A, 4419 or the Dental Act, and
R.A. 382 or the Veterinary Act
o Prescriptions made by unauthorized persons
constitute illegal practice of medicine, dentistry
or veterinary medicine and is punishable under
these laws.
• Republic act 5921,19 or the Pharmacy Act
o 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 and sex.
• Over-the-counter (OTC) drugs
o It does not need doctor’s prescription for you to
be able to procure or buy that drug e.g.
paracetamol, supplements, vitamin C, and all
other drugs
INTRAVENOUS THERAPY AND LEGAL
IMPLICATIONS
• Philippine Nursing Act of 1991 Section 28
o Nurses must remember that their legal right to
give intravenous injection is based on this law
which states that “in the administration of
intravenous injections, special training shall be
required according to protocol established.”
• Nurses should use the Intravenous Nursing
Standards of Practice developed by the Association
of Nursing Service Administrators of the Philippines
(ANSAP).
• The ANSAP usually conducts the training but today,
it was removed because the order is that the IV
therapy may/should be incorporated in the nursing
curriculum.
• IV Therapy should never be the basis for hiring and
promotion in the hospital. It is the job of the hospital
to train the nurses.
• In giving intravenous injections, nurses should also
follow the policies of their agencies. Even if nurses
have formal training on intravenous therapy, if the
hospital does not allow them to do so, then they may
not do the procedure.
• Board of Nursing Resolution No. 8 states that any
registered nurse without such training and who
administers intravenous injections to patients, shall
be held liable, either criminally under Sec. 30 (c) Art.
VII of said law or administratively under Sec. 21 Art.
III or both (whether causing or not an injury or death
to the patient).
SCOPE OF DUTIES AND RESPONSIBILITIES IN
INTRAVENOUS THERAPY
• Before the administration of blood transfusion,
Resident on Duty, the Head Nurse or Senior Nurse,
and the Staff Nurse should check that the blood is of
the correct type and is properly crossmatched. They
should sign their names as they attest to these.
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 NCM 103 FUNDAMENTALS IN NURSING PRACTICE I Week 8
LEGAL ASPECTS AND THE NURSE cont.
Mr. Andre De Veyra | May 5, 2022
TELEPHONE ORDERS
• There are legal risks in telephone orders:
o These may be misunderstood or misinterpreted
by the receiving nurse
o Sometimes, messages from telephones may
sound unclear or garbled because of some
trouble in the telephone lines or
mispronunciation of words by the caller.
o Hand writing of the physician may be illegible,
his signature is not present and this order may
later be denied in case errors happen or court
litigations arise.
• Doctors should limit telephone orders to extreme
emergency situations where there is no alternative.
• 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 received and written on the patients’ chart.
• Such order should be signed by the physician on
his/her net visit within 24 hours.
• The nurse should sign the name of physician per her
own and note the time the order was received.
• Should any problem arise, the order should be
referred back to the ordering physician.
• It is safer that when a telephone order is given,
another resident physician or intern in the same
service receive it since the latter can discuss with the
former the actual condition of the patient.
• It is in the interest of safety that only those who have
more experience and a greater knowledge of drugs
should receive the order.
• In this connection, there should be a clear hospital
policy that is within the bounds of the medical and the
nursing laws regarding telephone orders to avoid
misunderstanding not only for the individuals
concerned but also for the hospital as well.
CONSENT TO MEDICAL AND SURGICAL
PROCEDURES
• Consent
o a free and rational act that presupposes
knowledge of the thing to which consent is
being given by a person who is legally capable
to give consent.
Nature of Consent
• Consent is an authorization, by a patient or a person
authorized by law to give the consent on the patient’s
behalf, that changes touching, for example, from
non-consensual to consensual.
Informed Consent
• The client knows the pros and cons because in
nursing and medicine, we are not supposed to
impose something on the client. We just present to
them what the available options are and the client
would choose. It’s their right to know what are the
alternatives.
RELLIN-RODRIGUEZ
• It is established principle of law that every human
being of adult years and sound mind has the right to
determine what shall be done with his own body
(Hayt and Hayt).
• He may choose whether to be treated or not and to
what extent, no matter how necessary the medical
care, or how imminent the danger to his life or health
if he fails to submit to treatment.
• It is the physician who explains everything to the
patient and secures the informed consent. The nurse
only serves as a witness.
• The essential elements of informed consent include:
1. The diagnosis and explanation of the condition
2. A fair explanation of the procedures to be done
and used and the consequences
3. A description of alternative treatments or
procedures
4. A description of the benefits to be expected
5. Material rights is any; and
6. The prognosis, if the recommended care,
procedure, is refused.
Proof of Consent
• A written consent should be signed to show that the
procedure is the one consented to and that the
person understands the nature of the procedure, the
risks involved and the possible consequences.
• A signed special consent is necessary before any
medical or surgical treatment is done such as x-rays,
special laboratory tests, blood transfusions,
operations, cobalt therapy or chemotherapy, and the
like.
Who Must Consent
• The patient is the one who gives the consent in his
own behalf.
• However, if he is incompetent (such as in the case
of minors or the mentally ill) or physically unable and
is not an emergency case, consent must be taken
from another who is authorized to give it in his
behalf.
Consent of Minors
• Parents, or someone standing in their behalf, give
the consent to medical or surgical treatment of a
minor.
• Parental consent is not needed, however, if the
minor is married (or have a live-in partner since
minors can’t get married) or otherwise emancipated.
Consent of Mentally Ill
• A mentally incompetent person cannot legally
consent to medical or surgical treatment.
• The consent must be taken from the parents or legal
guardian.
Emergency Situation
• When an emergency situation exists, no consent is
necessary because inaction at such time may cause
greater injury.
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Mr. Andre De Veyra | May 5, 2022
• A mother, who is in the advanced stage of labor, or
a patient, who goes to the emergency room, gives
an implied consent to an immediate treatment or
attendance.
• However, if time is available and an informed
consent is possible, it is best that this be taken for
the protection of all the parties concerned.
• The Good Samaritan Law – those who are trying to
help or rescue will be protected by this law.
Refusal to Consent
• A patient who is mentally and legally competent
(sane mind and of legal age) has the right to refuse
the touching of his body or to submit to a medical or
surgical procedure no matter how necessary, nor
how imminent the danger to his life or health if he
fails to submit to treatment.
• Examples are patients who, because of their
religious beliefs, may refuse blood transfusion as in
the case of Jehovah’s witness.
• As stated earlier a patient may refuse to consent due
to inadequate information regarding the procedure to
be done.
• If after the explanation, he still refuses to sign the
consent form he should be made to fill out the
release form any liability that may result from his
refusal.
• If he refuses to sign the release form, this should be
noted in his chart.
• The competent person has a legal and ethical right
to refuse treatment, and this right is formally
established.
Consent for Sterilization
• Sterilization – termination of the ability to produce
offsprings.
• The husband and the wife must consent to the
procedure if the operation is primarily to accomplish
sterilization.
• When the sterilization is medically necessary and the
sterilization is an incidental result such as in cases
of:
o abruptio placentae
o ectopic pregnancies or ruptured uterus
the patient’s consent alone is sufficient.
MEDICAL RECORDS
• The value of medical records is both scientific and
legal.
• As a record of illness and treatment, it saves
duplication in future cases and aids in prompt
treatment.
• The record supplies rich material for medical and
nursing research.
• It serves as a legal protection for the hospital, doctor,
and nurse by reflecting the disease or condition of
the patient and his management.
• Nurses must remember the rule, “If it was not
charted, it was not observed or done.”
• In the performance of their duties, nurses are
expected to record fully, accurately, legibly, and
RELLIN-RODRIGUEZ
promptly their observations from admission to the
time of the patient’s discharge.
• Daily notes should include not only medications and
treatments given or rendered but also the physical
and emotional symptoms exhibited by the patient.
• The nurses’ notes are aids to medical diagnosis and
in understanding the patient’s behavior.
• Since patients have the right to confidentiality of
these records, nurses are legally and ethically bound
to protect the patient’s chart from unauthorized
persons.
• Permission has to be taken from the hospital
authorities for authorization to secure any
information from the patient’s chart.
• Nurses are responsible for safeguarding the patient’s
record from loss or destruction or from access by
persons who are not legally authorized to read such.
CHARTING DONE BY NURSING STUDENTS
• When a nurse or a clinical instructor countersigns the
charting of a nursing student, he/she attests that
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.
MEDICAL RECORDS IN LEGAL PROCEEDINGS
• Medical records are usually used to give important
evidence in legal proceedings, such as police
investigations, determining cause of death, extent of
injury incurred by the patient, among others.
• It is usually the medical records of librarian, by virtue
of a subpoena duces tecum, who testifies that the
patients’ records are kept and protected from
unauthorized handling and change.
• Only complete accurate records are accepted in
court.
LEGAL RISKS FOR DEFECTIVE EQUIPMENT
• One important duty of the nurse is to make sure that
the equipment used in procedures and treatments is
not defective.
• While the nurse may not or may not be responsible
for inspecting the equipment for optimum functioning,
she should see to it that all pieces of equipment are
regularly inspected, maintained and are functioning
properly.
• She should document the times she requested these
to show that she was able to foresee the improper
functioning of equipment which might cause possible
injury to patients.
• Such equipment includes:
o Wheelchairs
o Stretchers
o Suctions machines
o Anesthesia apparatus
o X-ray tables, among others
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 NCM 103 FUNDAMENTALS IN NURSING PRACTICE I Week 8
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Mr. Andre De Veyra | May 5, 2022
INTENTIONAL WRONGS
• A nurse may be held liable for intentional wrongs.
• Intentional tortuous acts may arise in the
performance of her duties.
TORTS
• Tort – 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
cation.
• The person who has been wronged seeks
compensation for the injury or wrong he has suffered
from the wrongdoer.
• Examples of torts are:
1. Assault and Battery
• Assault is the imminent threat of harmful
or offensive bodily contact.
o It is unjustifiable to touch another
person, or to threaten to do so in such
circumstances as to cause the other
to reasonably believe that it will be
carried out.
• Battery is an intentional, unconsented
touching of another person.
o It is, therefore, important that before a
patient can be touched, examined,
treated or subjected to
medical/surgical procedures, he must
have given a consent to this effect.
o If consent has not been secured, the
person performing the procedure may
be liable for battery.
o When a person comes to the hospital,
it is implied that he consents to be
treated.
o However, he may refuse certain
contacts.
o If he refuses an injection and the
nurse gives it anyway, the latter can
be charged for battery.
2. False Imprisonment or Illegal Detention
• False imprisonment means the
unjustifiable detention of a person without
a legal warrant within boundaries fixed by
the defendant by an act or violation of duty
intended to result in such confinement.
o If the patient has a communicable
disease, however, the hospital cannot
be charged for false imprisonment if it
compels the patient to stay in the
hospital.
o Mentally-ill patients may also be kept
in the hospital if there is danger that
they may take their own lives or
jeopardize the lives and property of
others.
o Patients insisting on leaving the
hospital cannot be detained, instead,
the probable consequences of their
actions must be explained by a
competent doctor or medical staff.
RELLIN-RODRIGUEZ
o Notation in their chart should be made
and a release form should be signed
by the patient and/or his guardian.
3. Invasion of Right to Privacy and Breach of
Confidentiality
• The right to privacy is the right to be left
alone, the right to be free from
unwarranted publicity and exposure to
public view as well as the right to live one's
life without having anyone's name, picture
or private affairs made public against one's
will.
• Nurses may become liable for invasion of
right to privacy if they divulge information
from a patient's chart to improper sources
or unauthorized persons.
• Publication of any picture of a patient or a
malformed baby without the consent of the
parents or revelation of the contents of the
records of the patient without his consent
constitute tort.
• Another example is when a nurse permits
a non-professional person (usually a male
helper) to view a woman in labor inside the
delivery room.
4. Defamation
• In general, character assassination, be it
written or spoken, constitutes 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 tend to injure him in his
work.
• The exchange of remarks between two
persons does not constitute defamation.
• There must a third person who hears or
reads the comment before it can be
considered defamation.
• Nurses should be careful in their
statements especially regarding their
patients and their co-workers.
• If the statements are, however, for a
justifiable and not a malicious purpose,
truth is an available defense.
• An example is when a head nurse tells the
chief nurse her opinion regarding the
inefficiency of one of the staff nurses who
has not been doing well in her job.
CRIMES, MISDEMEANORS, AND FELONIES
• Crime - an act committed or omitted in violation of
the law.
• Criminal offenses are composed of two elements:
1) criminal act and
2) evil/criminal intent.
• In criminal action, the state seeks the punishment of
the wrongdoers.
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Mr. Andre De Veyra | May 5, 2022
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.
• Persons who commit felonies are either principals,
accomplices or accessories.
• Principals are those:
o who take a direct part in the execution of the act;
o who directly force or induce others to commit it;
o 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 of the offense
by previous or simultaneous act.
o To hold the person liable as an accomplice, it
must be shown that he had knowledge of the
criminal intention of the principal.
o This may be demonstrated by previous or
simultaneous acts that contribute to the
commission of the offense as aid thereto,
whether physical or moral.
• Accessories are those who,
o 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,
o 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.
Criminal actions
• Criminal actions deal with acts or against public
welfare.
• These vary from minor offenses and misdemeanors
to felonies.
• Misdemeanor is a general name for a criminal
offense which does not in law amount to felony.
o Punishment is usually a fine or imprisonment for
a term of less than one year.
• 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.
o It is far more atrocious in nature than
misdemeanor.
• Felony is committed with deceit and fault.
o A deceit exists when the act is performed with
deliberate intent and there is fault when the
wrongful acts result from imprudence,
negligence, or lack of skill or foresight.
Criminal negligence
RELLIN-RODRIGUEZ
• Criminal negligence may be classified into reckless
imprudence and simple imprudence.
• 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 the damage was not
immediate or the impending danger was not evident
or manifest.
Criminal intent
• Criminal intent is the state of mind of a person at
the time the criminal act is committed, that is, he/she
knows that an act is not lawful and still decided to do
it anyway.
• To be criminal, an act must be defined as a crime.
• Deliberate intent includes two other elements
without which there can be no crime. These are:
o freedom
o intelligence
• However, when a person accused of the crime offers
evidence showing insanity, necessity, compulsion,
accident, or infancy the court will decide if he did not
commit a criminal offense and will declare the person
not guilty.
Classes of Felonies
• Felonies are classified according to the degree of
the acts of execution which produces the felony into
consummated, frustrated, and attempted felonies.
o Felony is consummated when all the elements
necessary for its execution and
accomplishment are present.
o It is frustrated when the offender performs all
the acts or execution which will produce the
felony as a consequence but which
nevertheless, do not produce it by reason of
causes independent of the will of the
perpetrator.
o There is an attempt to commit a felony when
the offender commences the commission of the
same directly by overt (open or manifest) acts,
and does not perform all the acts or execution
which shall produce the felony, by reason of
some cause or accident other than his own
spontaneous desistance.
• Consummated felonies, as well as those which are
frustrated and attempted, are punishable.
• Felonies are also classified according to the degree
of punishment attached to the felony whether
grave, less grave, or light felony.
• Grave felonies are those to which the law attaches
the capital punishment (death) or penalties which in
any of their periods are afflictive
o imprisonment ranging from six (6) years and
one (1) day to life imprisonment or a fine not
exceeding P6,000.00
• Less grave felonies are those which the law
punishes with penalties which in their maximum
period are correctional
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Mr. Andre De Veyra | May 5, 2022
o imprisonment ranging from one month and one
day to six (6) years, or a fine not exceeding
P6,000.00 but not less than P200.00
• Light felonies are those infractions of law for the
commission of which the penalty of arresto menor
o imprisonment for one (1) day to thirty (30) days
or a fine not exceeding P200.00 or both of which
are imposed
o Light felonies are punishable only when they
have been consummated, with the exception of
those committed against a person or property.
CIRCUMSTANCES AFFECTING CRIMINAL LIABILITY
1. Justifying Circumstances - A person may not incur
criminal liability under the following circumstances:
1.1. when he/she acts in defense of his/her person
or rights provided that –
a. there is an unlawful aggression on the part
of the offended or injured party.
b. there is reasonable necessity for the
means employed by the person defending
himself/herself to prevent such
aggression; and
c. there is lack of sufficient provocation on the
part of the person defending himself.
1.2. when he/she acts in defense of the person or
the rights of his/her spouse, ascendants,
descendants, or legitimate or natural or adopted
brothers or sisters, or relatives by affinity in the
same degrees and those by consanguinity
within the fourth civil degree, provided that the
first and second requisites prescribed in the
next preceding circumstance are present, and
further requisite, in the case of provocation was
given by the person attacked, that the one
making defense had no part therein.
1.3. when he/she acts in defense of the person or
rights of a stranger provided that the first and
second requisites mentioned in the first
circumstance and that the person defending is
not induced by revenge, resentment or other
evil motives.
1.4. when any person who, in order to avoid an evil
or injury does an act which causes damage to
another provided that the evil sought to be
avoided actually exists, the injury feared is
greater than that done to avoid it and there is no
other practical and less harmful means to
prevent it.
1.5. when he/she acts in the fulfillment of a duty or
in lawful exercise of a right or office.
Anyone who acts in defense of the person
or the rights of his/her spouse does not likewise
incur any criminal liability.
Any person who acts in the fulfilment of a
duty or in the lawful exercise or right of office
shall not also incur any criminal liability where
such acts result in the commission of a crime.
When a nurse is under an order from his/her
superior, he/she shall be able to discern
whether the order is lawful or not, because if
RELLIN-RODRIGUEZ
such order will result in the commission of a
crime, he/she shall be criminally liable.
2. Exempting Circumstances
• there are certain circumstances under which
the law exempts a person from criminal liability
for the commission of a crime. The following
persons under the circumstances stated are
expressly exempted by law from criminal
liability for the crime they may have committed:
a. an imbecile or an insane person, unless
the latter has acted during a lucid interval;
b. a person under nine years of age;
c. a person over nine years of age and under
fifteen unless he/she acted with
discernment;
d. any person who, while performing a lawful
act with due care, causes an injury which
is merely an accident without fault or
intention of causing it;
e. any person who acts under the compulsion
of an irresistible force;
f. any person who acts under the impulse of
an uncontrollable fear of an equal or
greater injury; and
g. any person who fails to perform an act
required by law, when prevented by some
lawful or insuperable cause.
3. Mitigating Circumstances
• 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 or
reducing the degree of moral culpability.
• Following are some of the circumstances
considered by law to be mitigating and, as such,
lessen the criminal liability of the offenders.
a. Circumstances which are otherwise
justifying or exempting were it not for the
fact that all requisites necessary to justify
the act or to exempt the offender from
criminal liability in the respective cases are
not attendant.
b. When the offender has no intention to
commit so grave a wrong as the one
committed.
c. When the offender is under eighteen years
of age or over seventy years old.
d. When sufficient provocation or threat on the
part of the offended party immediately
precedes the act.
e. When the act is committed in the immediate
vindication of a grave offense to the one
committing the felony, his/her spouse,
ascendants, descendants, legitimate,
natural or adopted brothers or sisters, or
relative by affinity within the same degree.
f. When a person acts upon an impulse so
powerful as naturally to have produced an
obfuscation.
g. When the offender voluntarily surrenders
himself to a person in authority or his
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agents, or that he/she voluntarily confesses
his/her guilt before the court prior to the
presentation of the evidence for the
prosecution
h. When the defender is deaf and dumb, blind
or otherwise suffering from some physical
defect which thus restricts his/her means of
action, defense or communication with
his/her fellow beings.
4. Aggravating Circumstances
• Aggravating Circumstances are those attending
the commission of a crime and which increase
the criminal liability of the offender or make his
guilt more severe. Some of the circumstances
considered by law as aggravating the guilt of
the offender are the following:
a. when an offender takes advantage of his
public position
b. when the crime is committed in contempt of
or with insult to public authorities;
c. when the act is committed with insult or in
disregard of the respect of the offended
party on account of his/her rank, age, or sex
or that it is committed in the dwelling of the
offended party, if the latter has not given
provocation.
d. when the act is committed with abuse or
confidence of obvious ungratefulness:
e. when the crime is committed in a place of
worship.
f. when the crime is committed on the
occasion of a conflagration, shipwreck,
earthquake, epidemic or other calamity or
misfortune;
g. when the crime is committed in
consideration of a price, reward, or
promise:
h. when the crime is committed by means of
inundation, fire, poison, explosion,
standings of a vessel or intentional damage
thereto, derailment of a locomotive, or the
use of any other artifice involving great
waste and ruin;
i. when the act is committed with evident
premeditation or after an unlawful entry;
j. when craft, fraud, or disguise is employed;
and
k. when the wrong done in the commission of
the crime is deliberately augmented by
causing other wrongs not necessary for its
commission.
5. Alternative Circumstances
• 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 its
commission.
• These are the relationship, intoxication and
degree of instruction and education of the
offender.
RELLIN-RODRIGUEZ
• The alternative circumstance of relationship
shall be taken into consideration when the
offended party is the spouse, ascendant or
descendant, legitimate, natural or adopted
brother or sister, or relative by affinity in the
same degree of the offender.
• Relationship is aggravating in physical injuries
inflicted by a descendant upon an ascendant.
• It is mitigating when an accused aided his/her
brother in the fight against the offended party.
• Relationship is inherent in parricide or
infanticide.
• The intoxication of the offender shall be taken
into consideration as a mitigating circumstance
when the offender has committed a felony in a
state of intoxication, if the same is not habitual
or subsequent plan to commit said felony.
• When the intoxication is habitual or intentional,
it shall be considered as an aggravating
circumstance.
• Illiteracy is not in itself sufficient to be
considered mitigating. There must be lack of
sufficient intelligence and knowledge of the full
significance of one's act.
Lack of Education is not mitigating in:
1. Rape;
2. Forcible abduction;
3. Arson;
4. Treason;
5. In crimes against chastity like seduction and acts of
lasciviousness; and
6. Those acts committed in a merciless or heinous
manner.
• Moral Turpitude – an act of baseness, vileness or
depravity in social or private duties which a man
owes to his fellow man or to society in general, an
act contrary to the accepted and customary rule of
right and duty between men.
• Murder – is the unlawful killing of a human being
with intent to kill.
o It is a very serious crime.
o Nurses should keep in mind that death resulting
from a criminal abortion is murder.
o Euthanasia is also considered murder.
• Homicide - the killing of a human being by another.
It may be committed without criminal intent, by any
person who kills another, other than his father,
mother, or child or any of his ascendants or
descendants, or his spouse, without any of the
circumstances attendant the crime of murder
enumerated above being present.
• Abortion – the expulsion of the product of
conception before the age of viability.
o In law, any person who, with the intention of
prematurely ending a pregnancy, willfully and
unlawfully does any act to cause the same is
guilty of procuring abortion.
o The Constitution of the Philippines protects
the life of the unborn from conception (Art. II
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Mr. Andre De Veyra | May 5, 2022
Sec. 15). In the United States legal abortion is
practiced under certain conditions, but not in the
Philippines which considers abortion as illegal.
• Infanticide - the killing of a child less than three (3)
days of age.
o The mother of the child who commits this crime
shall suffer the penalty of imprisonment ranging
from two (2) years four (4) months and one (1)
day to six (6) years.
• Parricide – a crime committed by one who kills
his/her father, mother or child whether legitimate or
illegitimate, or any of his/her ascendants or
descendants or his/her spouse.
o A person who is convicted of this crime shall be
imposed a penalty of from life imprisonment
(reclusion perpetual) to death.
• Robbery – a crime against a person or property. The
taking of personal property of another person from
him or in his presence constitutes robbery.
o An example would be when a nurse takes the
patient's cash or jewelry while the latter is
sleeping.
• Controlled Substances
o Republic Act 6425 known as the Dangerous
Drugs Act of 1972 covers the administration
and regulation of the manufacture, distribution,
and dispensing of controlled drugs.
▪ Persons authorized to prescribe or
dispense these drugs are required to
register and have a special license for this
purpose.
▪ Doctors with such license prescribe these
drugs in a yellow form.
▪ Nurses may administer these drugs only
upon the written order of a physician duly
licensed to prescribe such.
o Controlled drugs are kept locked in cabinets
and only authorized persons shall have access
to them.
▪ These are counted and endorsed every
shift.
▪ A safer method is to order in unit doses
from the pharmacy so that there is no
danger of these drugs being pilfered.
▪ Nurses who violate this law are in danger
of having their licenses revoked aside from
the imposed fine and/or imprisonment.
Simulation of Birth, Substitution of One Child For
Another, or Abandonment of a Legitimate Child
• Simulation of birth is a crime committed by one
who enters in a birth certificate a birth that did not
occur. It is a crime against the civil status of a person.
• Substitution of one child for another or
concealing or abandoning any legitimate child
with intent to cause such child to lose his/her civil
status shall be punishable for simulation of birth, by
prison mayor and a fine not exceeding one thousand
pesos.
RELLIN-RODRIGUEZ
POINTS TO OBSERVE IN ORDER TO AVOID
CRIMINAL LIABILITY
1. Be very familiar with the Philippine Nursing Law.
• It is your guide in practicing nursing.
• It specifies the scope of nursing practice.
2. Be aware of laws that affect nursing practice.
• Ignorance of the law excuses no one.
3. At the start of employment, get a copy of your
job description, the agency’s rules, regulations
and policies.
• Know your place in the organizational structure
so that you will know your relationship with the
various positions and departments to whom you
are responsible and the people you are
responsible for.
4. Upgrade your skills and competence.
• Be sure that these are always on a high level.
• Such will enable you not only to give the best
nursing care but will also give you the
satisfaction of a job well done.
5. Accept only such responsibility that is within the
scope of your employment and your job
description.
• Determine whether you are competent to do the
job assigned to you.
• If you are not, be honest in admitting so and try
your best to learn it.
6. Do not delegate your responsibility to others.
• You are accountable for them.
• If the person to whom you delegated the
responsibility makes a mistake, you are legally
liable.
7. Determine whether your subordinates are
competent in the work you are assessing them.
• This will show whether an in-service training is
needed.
• Supervise them well so that the danger of
committing mistakes will be avoided.
8. Develop good interpersonal relationships with
your coworkers, whether they be your
supervisors, peers or subordinates.
• Good interpersonal relationships breed good
working relationships and many problems a
detected, solved or eliminated.
9. Consult your superiors for problems that may be
too big for you to handle.
• Just like a fire, problems are best put out in the
early stages before they become too big to
handle.
10. Verify orders that are not clear to you or those
that seem to be erroneous.
• Physicians' orders should be clearly written to
avoid misunderstanding.
• It is better to be safe than to be sorry.
11. The doctors should be informed about the
patient’s conditions,
• the effects of medications and treatments, or
the patient's lack of progress.
12. Keep in mind the value and necessity of keeping
accurate and adequate records.
• These will show the quality of care that you give.
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13. Patients are entitled to an informed consent.
• The initial consent on admission is usually for
the initial diagnosis and laboratory work-up and
treatment.
• Should an operation or a special procedure be
needed or done, the patient and his family are
entitled to know what it is for and the
consequences of such actions on his health.
• This will guide them in making an intelligent and
shared decision. Another consent is needed.
WILLS
• Will – a legal declaration of a person’s intentions
upon death.
• Testamentary document – a will is called
testamentary document because it takes effect after
the death of its maker.
• A will is an act whereby a person is permitted with
the formalities prescribed by law, to control to a
certain degree the deposition of his estate, to take
effect after his death.
• Decedent – a person whose property is transmitted
through succession whether or not he left a will. If he
left a will, he is also called a testator.
• Testator – the person making a will is a man
• Testatrix – the person making a will is a woman
• Heir – a person called to succession either by the
provision of a will or by operation of law.
• Testate – a person who dies leaving a will
• Intestate – a person who dies without leaving a will
• Probate – validation of a will in court
• Administrator – one who administers the provision
of the will
• Holographic will – a will which is written, dated and
signed by the testator.
o It is subject to no other form and may be made
in or out of the Philippines and need not be
witnesses.
o In the probate of a holographic will, it is
necessary that at least one witness who knows
the handwriting and signature of the testator
explicitly declares that the will and the signature
are in the handwriting of the testator.
• Oral will – is called a nuncupative will or
nuncupation.
o Restrictions to the oral will are that such will be
made during the person’s last illness, that it be
done in the place in which he died, that he
asked one or more witnesses to the will, that the
will be put in writing within a given number of
days, and that it be offered for probate within a
specified time.
o COMMENCEMENT OF THE ACTION
TESTAMENTARY CAPACITY AND INTENT
Following are the essentials of will to meet legal
requirements:
1. The testator must have the expressed intention of
making a will. He must be of right age. A person
under 18 years of age cannot make a will. He is
required to be sound mind and to have clear
RELLIN-RODRIGUEZ
thinking ability at the time of its execution. He must
be free from undue influence.
2. The testator shall name the person who will be in
charge of carrying out the provisions of the will.
3. Properties must be disposed in accordance with
legal requirements.
4. The will must be signed by the testator, attested
and signed by at least three witnesses in his
presence and of one another. It must be in a
language or dialect known to the testators.
5. Every will must be acknowledged before a notary
public by the testator and witnesses.
6. Witnesses to the wills shall be of sound mind, 18
years of age or more, not blind, deaf or dumb, and
able to read and write.
7. A married woman may make a will without the
consent of her husband and without the authority
of the court. She may dispose by will all of her
separate property as well as her share conjugal
partnership or absolute community property.
.
THE NURSE’S OBIGATIONS IN THE EXECUTION OF
A WILL
• The nurse should note the soundness of the patient’s
mind (that he/she understood the act of making a
will) at the time he created the will and that you
testify.
• You serve as a witness and that there was a freedom
from fraud or undue influence (he/she was not
induced to make someone the beneficiary of the will)
and that the patient was above 18 years of age.
• He/ She should note that the will was signed by the
testator, that the witnesses were all present at the
same time and signed the will in the presence of the
testator.
GIFTS
Four legal requirements for a gift are:
1. The gift must consist of personal property;
2. There must be an intention to make the gifts;
3. There must be an indication of transfer of control
over such property; and
4. There must be acceptance by the recipient.
• Gifts made by a person because of anticipation of
death or belief in approaching death are called gifts
causa mortis or donatio causa mortis
LEGAL PROCEDURE AND TRIAL
• In trial, the judicial procedure is to ascertain facts by
hearing evidence, determine which facts are
relevant, apply the appropriate principle of law, and
pass judgement.
• The first step in trial process is to determine what
kind of legal action to take. If the action relates to
negligence, the correct action should be in
negligence; and if it relates to contact, the proper
action would be for breach of action.
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Mr. Andre De Veyra | May 5, 2022
STATUES OF LIMITATION
• Complaint must be made within a specific time or the
right to complain may be lost forever.
• Claims for negligence or malpractices vary from two
(2) to three (3) years. In criminal cases, statutes of
limitation vary from two (2) to (6) years except in
cases where murder is committed in which there is
no time limit.
COMMENCEMENT OF LEGAL PROCEEDINGS
• The primary function of the court is to determine a
controversy two (2) disputants, technically called
litigants. The accuser is also known as the
complainant or plaintiff, whereas the accused is
known as the respondent or defendant.
PLEADING
• Each party present a statement of facts or pleading
to the court. First pleading is generally known as a
complaint or petitions. In less serious crimes
known as misdemeanor, these pleadings are called
complaints.
• In crimes of more serious nature known as felonies,
the pleadings are called indictments.
FUNDAMENTAL REQUIREMENTS OF DUE
PROCESS
• The fundamental requirements of due process as
per Article III, Bill of Rights of the New
Constitution are as follows:
o Sec. 12.
▪ Any person under investigation for the
commission of an offense shall have the
right to be informed of his right to remain
silent and to have competent and
independent counsel preferably of his own
choice. If the person cannot afford the
services of a counsel, he must be provided
with one. These rights cannot be waived
except in writing and in the presence of a
counsel.
▪ (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,
incommunicable, or other similar forms of
detention are prohibited.
▪ (3) Any confession or admission obtained
in violation of these or Section 17 hereof
shall be inadmissible in evidence against
him.
▪ (4) The law shall provide for penal and civil
sanctions for violations of this section as
well as compensation to and rehabilitation
of victims of torture or similar practices,
and their families.
o SEC. 13.
▪ All persons, except those charged with
offenses punishable by reclusion
perpetua when evidence of guilt is strong,
shall, before conviction, be bailable by
RELLIN-RODRIGUEZ
sufficient sureties, or be releases on
released on recognizance as may be
provided by law.
▪ The right to bail shall be impaired even
when the privilege of the writ of habeas
corpus is suspended. Excessive bail shall
not be required.
o SEC. 14.
▪ (1) No person shall be held to answer for
criminal offense without due process of
law.
▪ (2) In all criminal prosecutions, the
accused shall be presumed innocent until
the contrary is proved, and shall enjoy the
right to be heard by himself and counsel,
to be informed of the nature and cause of
the accusation against him, to have
speedy, impartial and public trial, to meet
the witnesses face to face, and to have
production of evidence in his behalf.
However, after arraignment, trial may
proceed notwithstanding the absence of
the accused provided that he has been
duly notified and his failure to appear is
justifiable.
PRE-TRIAL PROCEDURES
• This is an informal discussion between the judge and
attorney to eliminate matters not in dispute, agree on
issues and settle procedural matters relating to the
trail. Cases are often settled at this point.
TRIALS
• At the trail, facts of the case are determined, the
principles of law relating to those facts are applied
and a conclusion as to liability is reached.
• The judge determines the facts and applies the law.
WITNESS
• The necessity of testimony by any person in a legal
proceeding is determined by the attorneys for the
parties.
• A subpoena or a court summons is served directing
a witness to appear and give testimony on the date
and time ordered.
• Subpoena duces tecum is served to a witness
requiring him to bring records, papers and the like
which may be in his possession and which may help
clarify the matter in issue.
• In the witness stand, she should face the judge or
jury and speak clearly, adequately, and intelligently.
She should testify only on what she knows based on
facts. This is called testimony of facts.
• Testimony of opinion may only be given by expert
witnesses.
• Perjury or false swearing under oath.
• The witness should neither hesitate to say she does
not know, nor answer any question that might
incriminate her. This is known as the privilege
against self-incrimination.
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• Hearsay evidence, or repetition of what the witness

has heard other say, is not admissible in court.
• Privileged communications are statements uttered
in good faith. These are not permitted to be divulged
in a court of justice.
• Dying declaration or ante-mortem statements are
considered hearsay evidence except when made by
a victim of a crime.
o If possible, the statements are to be signed by
the person making the declaration. After all
evidences of either party have been presented,
then the judge is directed to render a verdict to
that effect. The judge renders a judgement
based on the verdict.
o We can appeal with the court’s decision. We
have what we called court of appeals.

APPEALS
• An appellate court reviews the case, and when the
case is decided by it, the final judgement results and
the matter is ended.

EXECUTION OF JUDGEMENT
• Generally, lawsuits against hospitals or physicians
and nurses involve recovery of money damages. The
defendant is compelled to execute the judgement.
• Failure to obey will be regarded as contempt of court
and will result in fine or imprisonment.
• If the judgment is for payment of money, the plaintiff
may cause the sheriff to sell so much of the
defendant’s property as is necessary to pay the
costs.

END OF TRANSCRIPTION

REFERENCES
• Professional Nursing in the Philippines twelfth
edition by Lydia M. Venzon and Ronald M. Venzon

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 NCM 103 FUNDAMENTALS IN NURSING PRACTICE I Week 8
LAWS GOVERNING THE PRACTICE OF NURSING
Mr. Andre De Veyra | May 6, 2022
OUTLINE:
I. PROHIBITIONS IN THE PRACTICE OF NURSING
II. LAWS
III. PENALTIES
IV. REFERENCES
LEGEND:
Black for PowerPoint, red for audio lecture, blue for book
PROHIBITIONS IN THE PRACTICE OF NURSING
1. Practicing without Certificate of Registration
2. Invalid COR
3. Uses COR of another
4. Falsely poses and advertises as RN
5. Appends RN
6. Fraud, deceit and False statements
7. RN assist a non- RN Function
LAWS
• RA 1054 – requires all employers to give medical
services to employees
o Companies should give free medical services.
However, the company is not obliged to pay for
the hospitalization of the employee if it is not job
related.
• RA 1080 – Civil Service exams
o Passers of Civil Service Exam are eligible for
government employment. However, for those
who passed Licensure Examination are
automatically eligible for government
employment.
• RA 1082 – Creation of RHU in the entire Phil
o The creation of RHU (Rural Health Unit) in the
entire Philippines in order to link health care
services more accessible to the people.
• RA 2382 – Philippine Medical Act
o If we have Nursing Act/ Philippine Nursing Law,
doctors have Philippine Medical Act
• RA 3573 – Communicable diseases reported to
the nearest health center
• RA 4073 – domically treatment of leprosy
o Leprosy may already be treated at home with
oral medications.
• RA 4226 – Hospital licensure Act
• RA 6365 – National Policy on Population which
led to the creation of Population Commission
o The Population Commission is under the
Department of Health that take charge in terms
of responsible parenting programs, family
planning programs. They also address
reproductive health of the people and teenage
pregnancy.
• RA 6675 – Generics Act
o When a doctor prescribes a medication, it
should be in a generic name.
• RA 6713 – Code of Conduct and Ethical
standards for Public Officials and Office
o Public Officials and Office are expected to
maintain the highest professional standard all
the time.
RELLIN-RODRIGUEZ
• RA 6758 – Salary standardization law. All
government employees legislated. Nurse-Salary
Grade 15
o The entry level of nurses is in Salary Grade 15.
• RA 7160 – Local Government Code. Devolution
and decentralization
o It is the creation of LGU but before, everything
was centralized. But with the creation of LGU
mayda na kita devolution which was signed by
President Marcos.
o Devolution has good and bad sides. The good
side is, it is easier to manage because it is in
the grassroot level. The downside, there is
more avenue for corruption.
• RA 7170 – Organ donation Act
• RA 7277 – Magna Carta, disabled persons
o Meaning, people with disability are given special
consideration.
• RA 7305 – Magna Carta for Public Health
Workers
o Signed by President Cory Aquino to protect the
health care workers and to elevate their
standard of living.
• RA 7392 – Midwifery Law
• RA 7600 – Breast feeding- Rooming-in law
o Upon birth we have to initiate early breast
feeding, bring the child to the room for breast
feeding.
o We have baby friendly hospital; it is a hospital
which promotes breast feeding.
• RA 7719 – Blood donation act
o Of which, if you are a regular blood donor, you
will also be a priority in the event that a family
member or in the event you yourself need blood.
• RA 7846 – Compulsory immunization of Hepatitis
B
o Upon birth, Hepatitis B immunization is given (3
doses)
• RA 7877 – Anti sexual Harassment
• RA 8976 – Food Fortification Law
• RA 8749 – Clean Air Act
• RA 9165 – Dangerous Drugs Act of 2022
• RA 9710 – Magna Carta for Women
• RA 9994 – Senior citizen law 20% discount
• PD 48
o Limits maternity leave privileges to up to the 4th
child
• PD 69
o Limits to 4 children for tax exemption purposes
• PD 148 – Employable age at 16
o amending R.A. 679 (Woman and Child Labor
Law), states that the employable age shall be
16 years.
o This decree provides for the minimum
employable age and for privileges of working
women.
• PD 166 – Strengthening of Family Planning
Programs by participation of private organizations
o amending Presidential Decree No. 791. This
decree strengthens family planning programs
through participation of private organizations
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 NCM 103 FUNDAMENTALS IN NURSING PRACTICE I Week 8
LAWS GOVERNING THE PRACTICE OF NURSING
Mr. Andre De Veyra | May 6, 2022

and individuals in the formulation and o Effective January 1980, requires compulsory
implementation of the program planning membership in the GSIS or SSS retirement
policies. Fund. (p.s. PD 1636 it nakabutang ha book)
• PD 442 – Labor Code of the Philippines • LOI 47 – Integration of Family Planning into the
o right to self-organization and collective curricula in Nursing and other allied medical
bargaining Professions
o It promotes the rights and welfare of workers. o directs all schools of medicine, nursing,
• PD 603 – Child and Youth Welfare Code midwifery and allied medical professions and
o protects and promotes the rights and welfare of social work to prepare, plan, and implement the
children and youth. integration of family planning in their curricula
o Employment of children below 16 years of age and to require from their graduates sufficient
is limited to performing light work not harmful to appropriate licensing examination.
their safety, health or normal development and • LOI 949 – Primary Health Care
which is not prejudicial to their studies. o To make health care accessible, affordable,
• PD 626 – Employee Compensation and State attainable
Insurance Fund o The goal is more on health promotion and
o provides benefits to workers covered by SSS or disease prevention
GSIS for immediate injury, illness or disabilities.
o Salient aspects in the Constitution of the PENALTIES
Philippines affecting the practice of nursing • Reclusion Perpetua – 20-40 years and 1 day
include: • Reclusion Temporal – 12 and 1 day – 20 years
▪ full respect for human rights; • Prison mayor – 6 and 1 day – 12 years
▪ recognition of the sanctity of family life, • Prison Correcional, suspension, destierro – 6
protection and promotion of the rights to months and 1 day – 6 years
form unions, associations or societies; • Arresto Mayor – 1 month – 6 months and 1 day
▪ making health services available to the • Arresto Menor from 1 day – 30 days
people at affordable cost;
▪ protection of working women;
▪ rights of people's organizations; and
▪ recognition of the family as the foundation END OF TRANSCRIPTION
of the nation.
• PD 651 – Birth Registration Law
o decrees the registration of birth of a child within REFERENCES
30 days with the Civil Registrar. • Professional Nursing in the Philippines twelfth
• PD 825 – Penalty for Improper Garbage Disposal edition by Lydia M. Venzon and Ronald M. Venzon
o provides penalty for improper disposal of
garbage and other forms of uncleanliness.
• PD 856 – Code of Sanitation
o provides for control of all factors in man's
environment that affect health including the
quality of water, food, milk, control of insects,
animal carriers, transmitters of disease,
sanitary and recreation facilities, noise,
unpleasant odors and control of nuisance.
• PD 965 – Family Planning Seminar and
Responsible Parenthood
o requires that couples intending to get married
must first undergo a family planning and
responsible parenthood instruction prior to the
issuance of a marriage license.
• PD 996 – Compulsory Immunization
o Requires compulsory immunization for all
children below eight years of age against
communicable disease.
o Circular No. 14 of 1965 requires health
examination and immunization of all
prospective Grade I pupils against smallpox,
diphtheria and tuberculosis as a pre-requisite
for enrollment.
• PD 1638 – Compulsory membership to GSIS or
SSS
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