2. What is the relationship between
ETHICS and the LAW?
Are all laws ethical and just?
3. System of process for of
A formal binding rules
makingor conduct that
action logical and
Individuals’ cognitive
consistent decisions of
governs the behavior
examination of right
people in respect to
based upon moral
and wrong & good
relationships with others
beliefs.
and with thebad.
and government.
4. FUNCTIONS OF LAW IN
SOCIETY
• To define relationships
among members and to
declare which actions are
permitted and not
permitted
Latin: Lex • To describe what
constraints may be applied
to maintain rules, and by
whom they maybe applied
• To furnish solutions to
problems
• To redefine relationships
between people when
circumstances of life
change.
5. CHARACTERISTICS OF LAW
1. Authority or the
right to declare the
rule exists
2. That such rule is
Latin: Lex pronounced or
expressed and that
its source can be
identified
3. Right to enforce
DECLARED IN
WRITING & is
OBLIGATORY
6. CHARACTERISTICS OF LAW
• The law establishes
1. Authority or the
rules that define our
right to declare the
rights and
rule exists
obligations, and sets
2. That such rule is
penalties for those
Latin: Lex pronounced or
who violate them.
expressed and that
its source can be
• Law can serve as the
identified
public’s instrument
3. Right to enforce
for converting
DECLARED IN
morality into clear-
WRITING & is
cut social guidelines.
OBLIGATORY
8. Hindi
makatao
ang batas! Hindi
makatarungan
ang batas!
What is the relationship between
ETHICS and the LAW?
Are all laws ethical and just?
9. DEONTOLOGY vs. UTILITARIANISM: TRIAGE
Is the law dealing with expectant tags ethical?
“Do your sworn duty. “Do the greatest good
The rightness & for the greatest number
wrongness of an act of people.”
depends upon the nature
of the act, rather than
the consequences.”
10. Are all laws ethical?
REASONS FOR THE
DISCREPANCY:
Differences between
ethical points of view:
Usually… but not deontology & utilitarianism.
necessarily true. Some Human behavior and
laws can be considered to motivation are more
be unethical and some complex than can be fairly
illegal acts are considered reflected by law.
by many to be ethical. The legal system judges
action rather than
motivation.
Laws change (ex. Rape –
RA 8353 & DofD, RH Bill,
Abortion).
11. To ensure that the nurse’s decision and actions are
consistent with current legal principles.
To protect the nurse from liability.
FUNCTIONS OF LAW IN NURSING YES!
It provides a framework for establishing which nursing actions in the care of
clients are legal.
It differentiates the nurse’s responsibilities from those of other health
professionals.
It helps establish the boundaries of independent nursing action.
It assists in maintaining a standard of nursing practice by making nurses
accountable under the law.
12. NURSING JURISPRUDENCE
JURISPRUDENCE
Juris + Prudentia
is defined as a branch of law
Latin which deals with the study of
nursing laws, lawsuits,
Juris
Law or liabilities, legal principles,
legal knowledge rules and regulations, case
laws and doctrines affecting
Prudentia
one who behaves the nursing practice.
prudently or wisely
because he has
knowledge of the
possible consequences
of a particular action
13. General or Individual or
KINDS OF LAW Public Law Private Law
International
Civil Law
Law
Divine Law
Law promulgated Constitutional Mercantile
by our Creator Law Law
Administrative Procedural
Law Law
Human Law
Law promulgated
by man to
regulate human Criminal Law
relations
Religious Law
14. “Ignorance of the law
excuses no man;
Not that all men know
the law, but because „tis
an excuse every men
will plead, and no man
can tell how to confute John Selden
him.”
Ignorantia legis neminem excusat
15. Sources of law in the Philippines
Constitution
Legislations or statutes
Regulations issued by the Executive Branch of the government
Case decisions or judicial opinions / Common Law
Presidential Decrees – Examples:
PD 651 – Birth Registration within 30 Days.
PD 996 – Compulsory Immunization of children below 8 yrs old against
Preventable Diseases.
PD 442 – New Labor Code
Letters of Instructions – Ex. LOI 1000 – Members of accredited
professional organizations are given preference in hiring or
attendance to seminars.
Administrative law – “Implementing Rules and Regulations”
RA 9173 – Philippine Nursing Act of 2002
RA 6758 – Salary Standardization of Government Employees (SG: 15)
16. Branches of Law that are directly applicable
to Filipino nurses
Constitutional Constitutional Law
Criminal Criminal Law
Civil Civil Law
Labor Labor Law
Administrative Administrative Law
Civil Service Civil Service Law
Case Case Law
17. Branches of Law that are directly applicable
to Filipino nurses
Constitutional Constitution of the Philippines or
Saligang Batas ng Pilipinas (1987)
Criminal Supreme law of the Philippines
Divided into 18 parts called
Civil ARTICLES.
Article III – Bill of Rights
Labor Article IX – Constitutional
Commissions
Administrative Article XI – Accountability of Public
Officers
Civil Service
Article XIII – Social Justice and
Human Rights.
Case
18. Branches of Law that are directly applicable
to Filipino nurses
ARTICLE III. BILL OF RIGHTS
Constitutional
Section 1. No person shall be deprived of life,
liberty, or property without due process of
Criminal law, nor shall any person be denied the equal
protection of the laws. (CRIMINAL LAW, ex.
Homicide, murder)
Civil
Section 2. The right of the people to be secure
in their persons, houses, papers, and effects
Labor against unreasonable searches and seizures of
whatever nature… (Civil Law, Ex. Assault,
Battery, etc)
Administrative Section 5. No law shall be made respecting an
establishment of religion, or prohibiting the
Civil Service free exercise thereof. (Transcultural Nursing)
Section 8. The right of the people, including
Case those employed in the public and private
sectors, to form unions, associations, or
societies for purposes not contrary to law shall
not be abridged. (PNA)
19. Branches of Law that are directly applicable
to Filipino nurses
Constitutional ARTICLE IX. CONSTITUTIONAL
COMMISSIONS
Criminal 1. Common Provisions
2. The Civil Service Commission
Civil 3. The Commission on Elections
4. The Commission on Audit
Labor
ARTICLE XI – ACCOUNTABILITY OF
Administrative PUBLIC OFFICERS
Board of Nursing
Civil Service
RA 9173 – Philippine Nursing Act of
2002
Case
Roles of BON
Leakage NLE NLE
20. Branches of Law that are directly applicable
to Filipino nurses
Constitutional ARTICLE XIII. SOCIAL JUSTICE &
HUMAN RIGHTS
Criminal
1. Labor
Civil 2. Agrarian and Natural Resources
Reform
Labor
3. Urban Land Reform and Housing
Administrative 4. Health
5. Women
Civil Service
6. Roles & Rights of People’s
Case Organization
7. Human Rights
21. Branches of Law that are directly applicable
to Filipino nurses
Constitutional branch of law that governs and
regulates the relationship of
Criminal employers and employees. The
Labor Code must be read with
Civil
caution because it is one of the
Labor most frequently amended laws in
the country.
Administrative P.D. 442- Labor Code
Civil Service Defines among other things, hours of
work, contract and nurse staffing in
Case industrial clinics
Lawyers Labor
22. Branches of Law that are directly applicable
to Filipino nurses
Constitutional branch of law which deals with the
activities or functions of executive or
Criminal administrative agencies such as the
departments, bureaus, boards, or
Civil commissions or all other offices under
the administrative supervision of the
Labor
office of the President. An example of
Administrative this – Professional Regulations
Commission (PRC).
Civil Service
Case
23. Branches of Law that are directly applicable
to Filipino nurses
Constitutional branch of law which deals with the civil
service in all branches, subdivisions,
Criminal instrumentalities and agencies of the
government, including government
Civil owned and controlled corporations
(GOCC).
Labor
Related to HIRING OF QUALIFIED
Administrative APPLICANTS (TPH)
Civil Service
Case
24. Branches of Law that are directly applicable
to Filipino nurses
Constitutional that body of the prevailing
jurisprudence or decisions of the
Criminal
Supreme Court interpreting the
Civil laws or the Constitution or
applying them to certain sets of
Labor facts or actual cases of
Administrative controversies.
Civil Service
Case
25.
26. DEFINITION
CIVIL LAW CRIMINAL LAW
branch of law that pertains branch of law which
to the “organization of the defines crimes, their
family and the regulation of nature and punishment.
property. “ (Tolentino, Criminal law covers
1990). offenses resulting to
Republic Act 386 – New injuries or death of the
Civil Code (NCC) or the Civil patient.
Code of the Philippines, is
the principal legal The principal legal
document in the study of document in the study of
civil law in the Philippines Criminal Law in the
EO 209 – The Family Code Philippines is Act No.
related to Informed 3815 – Revised Penal
Consent. Code (RPC)
27. General or Individual or
KINDS OF LAW Public Law Private Law
International
Civil Law
Law
Divine Law
Law promulgated Constitutional Mercantile
by our Creator Law Law
Administrative Procedural
Law Law
Human Law
Law promulgated
by man to
regulate human Criminal Law
relations
Religious Law
30. LAWSUIT – court proceedings
CRIMINAL CASE CIVIL CASE
Regular Court > judge WHERE PRC > BON
MoralTurpitude GROUND Sec. 23: Revocaion or
suspension of license
Conviction VERDICT Guilty
Imprisonment PUNISHMENT Revocation/suspension
Respondent NURSE Defendant
Complainant PATIENT Plaintiff
• Subpoena Ad Nurse is called to: • Summon
Testificandum • Summon
• Subpoena Duces Tecum
31. is a civil wrong committed against a person or a person’s property.
Torts are usually litigated in court by civil action between
individuals.
32. What is the difference between
Intentional Tort Unintentional Tort
the act was done on do not require intent
purpose or with intent; but do require the
no harm, injury or element of harm.
damage is needed to Ex. Negligence and
be liable. malpractice
Ex. Assault & Battery
33. Intentional Torts
What is the Assault - an attempt or threat
difference between to touch another person
ASSAULT unjustifiably; mental or physical
& threat
BATTERY Ex. forcing a pt. to take his
medication or treatment, even
simple gestures
Battery - physical harm
through willful touching of
person or clothing without
consent.
Ex. giving of injection without pt’s
consent
34. Informed Consent
What is free and rational act that
Informed Consent presupposes knowledge of the
thing to which consent is being
given by a person who is legally
capable to give consent.
signed by the patient or his
authorized representative/legal
guardian upon admission is for
initial diagnosis and treatment.
Subsequent treatments or
operations require individual
informed consent, except for
emergencies.
35. Informed Consent
What are the Express Consent – obtained by
TYPES of having or requiring a patient to sign a
written consent, whether in his/her
Informed Consent own statement or in a prescribed legal
document, or thru an oral agreement.
Whether oral or written, consent
must be understood by the patient
and witnessed by another person to
comply with the requirements of law.
Implied Consent – arise by
implication of certain circumstances.
This is manifested in case of medical
emergency (Doctrine of Emergency –
administrative consent by physician in
charge)
36. Informed Consent
What are the 1. The diagnosis and explanation
Essential Elements of the condition
of Informed Consent 2. A fair explanation of the
(to be done by the procedures to be done and used
MD & witnessed by and the consequences
RN)
3. A description of alternative
treatments or procedures
4. A description of the benefits to
be expected
5. Material rights if any
6. The diagnosis if the
recommended care, procedure
is refused.
37. Informed Consent
WHO should give THE PATIENT HIMSELF
the CONSENT AUTHORIZED REPRESENTATIVE
IF:
Minor
Mentally ill
Physically unable
If a nurse is uncertain if the client
is competent or not – consult
supervisor or physician.
Determination of competency is
not only a medical decision, it is
one made through court hearings.
38. Informed Consent
WHO are authorized Minor – RA 6809: 21> 18
to represent the Parents
patient if –
Grandparents
MINOR or paternal (1st priority)
mentally Ill maternal (2nd priority)
Eldest brother or sister who is not a
minor
Guardians
Relatives
Godparents
Fiancé (man)/fiancée (woman)
Best friend
Teacher (Doctrine of Loco Parentis)
39. Informed Consent
WHO are For married minors or emancipated
EXEMPTED minors (free from restrictions), the
From Parental husband/wife has the legal right to
Consent give consent.
EO No. 209 Family Code of RP - Art.
236. Emancipation for any cause shall
terminate parental authority over the
person and property of the child who
shall then be qualified and responsible
for all acts of civil life.
40. Informed Consent
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
he should be made to fill out the
release form to protect the hospital
and/or agency and its personnel from
any liability
41. Informed Consent
Consent for Sterilization is the termination of the
Sterilization ability to produce offspring. The
husband and wife must consent to the
procedure if the operation is primarily to
accomplish sterilization. When it is
medically necessary, the patient’s
consent alone is sufficient.
Ex. Tubaligation:
Wife -Yes
Husband – No
You cannot follow both so ??
You get consent only for
MARITAL HARMONY
42. Intentional Torts
What is Doctrine is Liberty of Abode
FALSE the unjustifiable detention of a
IMPRISONMENT person without legal warrant to
confine. A client must not be
detained against his will.
occurs when the person is not
allowed to leave a health care
facility when there is no legal
justification to detain the client.
occurs when restraining devices
are used without an appropriate
clinical need.
43. Intentional Torts
What is Right to privacy is the right
Invasion of to be left alone
Privacy &
Right to be free from
Breach of
Confidentiality unwarranted publicity
Exposure to public view
Divulge information from
patient’s chart to improper
sources or unauthorized
person
44. Intentional Torts
Exceptions Confidential information can be
revealed if:
Patient consent
Inform HCT (HIV Counseling and
Testing) for precautionary
measures
Crimes, child abuse, BWS
(Battered Woman Syndrome)
Communicable disease- R.A.
3573 (Law on Notifiable
Diseases)
Ethics – Utilitarian Principle
45. SITUATION:
BREACH OF
INVASION OF PRIVACY CONFIDENTIALITY
Nurse to another nurse: Nurse to another nurse:
“Alam mo bang second wife “Do you know STD pala yung
pala ni mayor yung nasa sakit nung nasa room 69?”
room 143?”
Camera inside the hotel
room?
Camera inside the
Operating Room?
46. Intentional Torts
What is
Character assassination
Defamation
There must be a third
person who hears or read
the comment before it can
be considered defamation
TYPES:
Slander - oral defamation
Libel - written words
47. QUESTIONS:
The nurse writes the Two janitors are having a
following note in the client’s heated argument as to who
chart, “the physician is shall dispose the waste of a
patient with typhoid fever. The
incompetent because he first one called the other
ordered the wrong drug “lazybone” and “pain in the
dosage.” This statement neck” within the hearing of the
may lead to a charge of: rest of the nurses. The case is:
A. Assault A. Libel
B. Slander B. Slander
C. Libel C. Invasion of privacy
D. Invasion of privacy D. Negligence
48. QUESTIONS:
Who OWNS the
Which of the following
persons cannot have the MEDICAL CHART?
access to the patient record? A. Patient
B. Doctor
C. Nurse
A. physical therapist
D. Hospital
B. lawyer of the family
Who OWNS the
C. the patient COMMUNICATION?
D. speech therapist A. Patient
B. Doctor
C. Nurse
D. Hospital
49. MEDICAL CHART
What is
Arrange and organize the
DUTY of the chart
nurse
Ex. If the chart was not
arranged properly and
someone was able to read
the contents:
A. Invasion of Privacy
B. Breach of Confidentiality
C. Negligence
50. Unintentional Tort
What is Failure of perception.
Negligence? Failure to do something which a
reasonable and prudent person
should have done.
2 TYPES:
Commission – wrong doing
Omission – total neglect of
care (didn’t do anything)
Example: Banana peal
Gross Negligence – involves extreme
lack of knowledge, skill, or decision
making. Ex. Position during NGT
Feeding
51. Unintentional Tort
What are the 1. Existence of a duty on the part
4 Elements of of the person charged to use
Negligence? due care under circumstances
2. Failure to meet the standard
of due care
3. The foreseeability of harm
resulting from failure to meet
the standard
4. The fact that the breach of this
standard resulted in an injury
to the plaintiff
52. Unintentional Tort
What are the RES IPSA LOQUITUR
“The thing speaks for itself.”
Doctrines of
The injury is enough proof of negligence.
Negligence? In the absence of 1 – it will not apply:
The nurse failed to make use of appropriate
judgment (Common Sense)
The instrument used is within the exclusive
control of the nurse
There is lack of voluntary participation on the
part of the patient.
RESPONDEAT SUPERIOR
“Let the master answer for the acts/liability of the
employee/subordinate.”
The liability is expanded to include the master
as well as the employee.
There must be an employer-employee
relationship.
53. Unintentional Tort
What are the FORCE MAJURE - irresistible force;
Doctrines of unforeseen or inevitable. No person
Negligence? shall be responsible for those events
which cannot be foreseen.
Examples: Fire, Flood, Typhoon, Earthquake
CAPTAIN-OF-THE-SHIP DOCTRINE
wherein the surgeon is presumed to
be the responsible for everything
that happens within the confines of
the OR.
54. Unintentional Tort
What are some Burns resulting from hot water bags, heat
lamps, vaporizers, sitz bath
Examples Objects left inside the patient’s body;
sponges suction tips
of Negligence?
Falls of the elderly, confused, unconscious,
sedated patients
Falls of children whose bed rails were not
pulled up and locked
Mistaken identity- drug given to the
wrong patient
Wrong medicine, wrong concentration,
wrong route, wrong dose
Defects in the equipment
Administration of medicine without
doctor’s prescription.
55. Unintentional Tort
What is Failure of action.
Malpractice? Doing acts or conducts that are not
authorized or licensed or
competent or skilled to perform,
resulting to injuries.
Stepping beyond one’s authority
Negligent act committed in the
course of professional performance
Ex. RN exceeding the Scope of
Nursing Practice.
56.
57.
58. CRIME
Definition it an act committed in violation
of public (criminal) law and
punishable by fine or
imprisonment.
A crime does not have to be
intended in order to be a crime.
For example – a nurse may
accidentally give a client an
additional and lethal dose of a
narcotic to relieve discomfort
Two elements:
Criminal act - action
Evil/criminal intent – plan/motive
59. Felony vs. Misdemeanor
Differentiate FELONY - a public offense
committed with deceit and
fault.
crime of a serious nature, such
as murder, punishable by a
term in prison.
MISDEMEANOR - offense of
a less serious nature and is
usually punishable by fine or
short term jail sentence, or
both.
Ex. A nurse who slaps a
patient’s face.
60. Classification of Felony
According to
DEGREE OF Capital above P6k
grave
PUNISHMENT punishment
or >6yrs & 1
day
Less 1 month and not > P 6 K
1 day to 6 but not
grave years <P200
Light 1 day to 30 fine not >
felony days P 200
61. Classification of Felony
According to
DEGREE OF 1. Consummated all elements
EXECUTION executed, with
successful result
2. Frustrated all elements
executed but no
successful result
3. Attempted not all elements
executed, no
successful result
62. Nursing Liability
According to PRINCIPAL a. By direct participation-
Primary author doer of the act
DEGREE OF b. By inducement - directly
PARTICIPATION force or induce others
c. By cooperation-
indispensable
ACCOMPLICE “cooperates before the
A person who act” BUT absent at the
cooperates time crime is committed.
ACCESSORY “cooperates after the
fact”
Profits
Conceals/ destroys evidence
Assists in the escape of the
principal
63. Moral Turpitude
Define is the act of baseness or vileness or
depravity in social order. It is any act
contrary to law, morals, honesty &
justice (Black’s Law Dictionary).
Chances are, nurses may be called on
to testify on the matter of injuries or
death of the patient.
Subpoena Duces Tecum – order of the
court requiring you to bring the chart in
the court proceeding
Subpoena Ad Testificandum – order to
appear in court (to testify)
64. Useful pieces of evidence for criminal
offenses resulting to Death of Patient
Body
Object on or with the body
Injuries sustained
Tissues and body fluids
Other medical evidences or
findings
65. Murder vs. Homicide
Differentiate Murder - unlawful &
intentional (planned) killing of
the human being
Homicide - unintentional
killing of another person;
committed without criminal
intent.
HUMAN BEING = body + soul
Desecration of the Dead
66. Parricide
Define killing by reason of blood
relationship in a direct line.
It takes precedence over
murder.
Inclusion to the rule: Spouse &
legally adopted child.
Direct line: Grandparents
father mother Children
Collateral line: brothers &
sisters (not parricide but
homicide or murder)
67. Infanticide & Abortion
Define Infanticide - killing of an infant
less than 3 days or 72 hours.
If EXACTLY 3 days it will now be
considered murder or homicide.
The number of days is more legal
and binding than the intention.
Abortion - termination of product
of conception before the age of
viability.
Considered a grave felony.
68. Robbery & Theft
Define Robbery - with force
Anyone who gets a personal
property of another with the
use of force, violence or
intimidation.
Theft - without force.
Anyone who gets the
personal property of another
without permission.
69. QUESTIONS
The hospital research team
offered Nica the opportunity A client in your med-surg
to participate in research on unit has a cousin who is a
a new therapy. The nurse- physician and wants to see
researcher asked you to the chart. Which of the
obtain consent. What is the following is the best
most appropriate nursing response of the nurse?
action?
A. Be sure Nica understands A. Hand over the chart, anyway the
the project before she signs cousin is a doctor
B. Read the consent from to B. Call the attending physician and
have the doctor speak with the
Nica and allow her to ask Qs cousin (Dr – Dr)
C. Refuse to be the one to C. Ask the client to sign an
obtain Nica’s consent authorization and have someone
review the chart with the cousin.
70. QUESTIONS
The nurse caring for an older adult
tears the skin of the patient while
removing a piece of tape. The skin In which circumstance/s may
is attached to the upper arm and the nurse legally and
to the tape. The nurse cuts the
attached part of the skin with ethically disclose
scissors in order to remove the confidential information
tape. The nurse fails to
understand that if harm comes to about a client?
the client during the act of cutting
the skin with scissors, which of
the following could the nurse be
charged with? A. HIV – Status of a single male client to
his family members
A. Malpractice B. The Dx of a pancreatic CA to the
client’s SO
B. Assault
C. The Dx of uncontrolled seizure
C. Negligence disorder of a taxi driver to the
concerned government unit
D. Acceptable practice
D. All of the above
71. QUESTIONS
Which of the following
A hospital filed a case of situations would possibly
damages against a nurse for cause a nurse to be sued due
breach of contract. Who is to negligence?
the nurse in the case? A. Nurse gave a client wrong
medication, and an hour later, client
complained of dyspnea
B. B. While preparing a medication, the
nurse notices that instead of 1 tablet,
she put two tablets into the client’s
medicine cup
C. As the nurse was about to administer
A. complainant medication, the client questioned
why the medication is still given
B. accused when in fact the physician
discontinued it.
C. defendant D. Nurse administered 2 tablets of
analgesic instead of 1 tablet as
D. plaintiff prescribed. Patient noticed the error
and complained.
72. QUESTIONS
Wilfred, 30 years old male, was
brought to the hospital due to A telephone order is given
injuries sustained from a
vehicular accident. While being for a client in your ward.
transported to the X-ray What is your most
department, the straps
accidentally broke and the client appropriate action?
fell to the floor hitting to his
head. In this situation, the nurse
is: A. Copy the order on to the chart and
sign the physician’s name as close
A. not responsible because of the to his original signature as possible
doctrine of respondent superior B. Repeat the order back to the
physician, copy onto the order
B. free from any negligence that sheet and indicate that it is a
caused harm to pt. telephone order
C. liable along with the employer for C. Write the order in the client’s chart
the use of a defective equipment and have the head nurse co-sign it
that harms the client D. Tell the physician that you can not
D. totally responsible for the take the order but you will call the
nurse supervisor
negligence
73. QUESTIONS
Ivy is two-months pregnant.
The nurse out of pity Her parents do not know this.
unhooked the patient She informed her friend Noemi
from a respirator. The about the problem. Noemi
then referred Ivy to Nica, an
patient died after 15 abortionist. Ivy had an
minutes. This type of abortion. If those involved will
felony is: be charge legally, who is
considered the principal?
A. Consummated A. Ivy
B. Frustrated B. Noemi
C. Attempted C. Nica
D. Murder D. All of them