ALE-ethics-CEFI PDF - Administration, Leadership & Entrepreneurship

Administration, Leadership & Entrepreneurship Lecturer: Hariette A. Wendam, RRT, MMEM, PhD  Management & Human Resource Administration  to coordinate the efforts of people to accomplish goals and objectives using available resources efficiently and effectively comprises p...

Administration, Leadership & Entrepreneurship Lecturer: Hariette A. Wendam, RRT, MMEM, PhD  Management & Human Resource Administration  to coordinate the efforts of people to accomplish goals and objectives using available resources efficiently and effectively comprises planning, organizing, staffing, leading or directing, and controlling an organization or initiative to accomplish a goal PHILOSOPHIES INVOLVED IN MANAGEMENT  Adam Smith division of labor Karl Emil Maximilian "Max" Weber Bureaucracy suitable for government organizations but not for business organizations  The word bureaucracy is defined as follows: It is the most efficient form of organization. The organization has a well-defined line of authority and has clear rules and regulations which are strictly followed. Bureaucracy has an informal usage. This informal usage describes a set of characteristics or attributes such as "red tape" or "inflexibility" that frustrate people who deal with or who work for organizations they perceive as "bureaucratic."  Six Major Principles of Bureaucracy Hierarchy The first principle of bureaucracy states that a formal hierarchy must exist. The hierarchy consists of power levels that control each subsequent level. The top person in power controls all levels. Common practice entails appointment by a superior rather than election. Rules The next characteristic of the bureaucratic form regards rules and decisions. The strict structure of power requires plenty of control by rules and regulations. The top power figures in the bureaucracy make the rules and decisions which must be followed consistently throughout all levels of the structure.  Function The third principle of bureaucracy relates to organization and order. Organization remains key to proper functioning of a bureaucracy. This principle maintains that members organize by function and skill as to keep similar individuals together. Focus Defining the focus of the structure rests the fourth principle of bureaucracy as outlined by Weber. An "in focus" form serves to fulfill the needs of members. Goals of an in focus bureaucracy relate to market share and high profits. Opposed to in focus is up focus. An up focus structure serves to profit stockholders and similarly powerful people.  Impersonal Weber's fifth characteristic relates to the treatment of all employees, members and clients of the bureaucracy. Impersonality rests paramount to the success of the structure. Equal treatment and uniform policies and procedures allow for uniformity and impersonality. Qualification The final characteristic of bureaucracies relates to employment standards. Similar to impersonality, employment within the bureaucracy relies on qualifications rather than connections and relationships. This characteristic also relates to protection from dismissal without just cause.  Frederick Winslow Taylor father of scientific management work deserves systematic observation and study  Elton Mayo Hawthorne Studies at Harvard managers deal with emotional needs of employees at work Chester Irving Barnard effectiveness and efficiency – criteria to survive two ways of convincing subordinates to cooperate: 1.tangible incentives 2.persuasion Henri Fayol father of the Universal process or Operational management or Administrative management theory  Six Major Industrial Activities Identified by Fayol 1. Technical (production and manufacturing); 2. Commercial (buying, selling and exchanging); 3. Financial (search for an optimum use of capital); 4. Security (safeguarding property and people); 5. Accounting (including statistics); and 6. Managerial  Frederick Herzberg two factor content theory also referred to as the two need system. 1.Hygiene factors 2.Motivation factors. Abraham Harold Maslow David Clarence McClelland Achievement Motivation Theory referred to as need achievement or n-achievement theory 3 needs 1. Achievement 2. Power 3. Affiliation  Need for achievement: The drive to excel, to achieve in relation to a set of standards, to strive to succeed Need for power: The need to make others behave in a way that they would not have behaved otherwise Need for affiliation: The desire for friendly and close interpersonal relationships  Victor Vroom Expectancy theory employee will be motivated to exert a high level of effort leading to a good performance appraisal good appraisal of performance will lead to organizational rewards (bonus, salary increase, promotion) rewards will satisfy the employee’s personal goals. Mary Parker Follett motivate employees on their job performance, a "pull" rather than a "push" strategy. 4 Principles of Coordination  Douglas McGregor Theory X and Theory Y  Personality pattern of behaviors, feelings, and thoughts exhibited by an individual affected primarily by nature (genetic factors) and nurture (upbringing and life experiences) Personalities in the Organization Big Five: Modeling Traits and Personalities 1.Extroversion 2.Neuroticism 3.Agreeableness 4.Conscientiousness 5.Openness  Neuroticism aka negative affectivity a measure of how often people experience negative thoughts opposite of extroversion correlated with stress and occasionally anger People who are highly “neurotic” in the psychological context often have a drive to improve themselves – a quality shared by many very successful people  Agreeableness: Likability ✓trustworthy, ✓cooperative, ✓helpful, and ✓generally caring important in careers and situations that require gaining the confidence of others – for example, when seeking venture capital or trying to bring a new client on board  Conscientiousness a person who is very: ✓self-disciplined ✓organized, and ✓persevering  Openness being open to new ideas important in creative or innovative disciplines  Organizational Chart often called organization chart, org chart, organigram or organogram a diagram that shows the structure of an organization and the relationships and relative ranks of its parts and positions/jobs  shows relationships between staff in the organization which can be: Line - direct relationship between superior and subordinate. Lateral - relationship between different departments on the same hierarchical level. Staff - relationship between a managerial assistant and other areas. Functional - relationships between specialist positions and other areas. Hospital Administration  Hospital health care institutions that have an organized medical and other professional staff, and inpatient facilities, and deliver medical, nursing and related services 24 hours a day, 7 days a week  Types of Hospitals in the Philippines 1. Ownership 2. Scope of Services  According to Ownership Government a hospital owned, established and created by law; facility may be under the national government like the Department of Health (DOH), Department of National Defense (DND), Philippine National Police (PNP), Department of Justice (DOJ), State Universities and Colleges (SUCs), Government Owned or Controlled Corporations (GOCC) or Local Government Units (LGUs). Private a hospital owned, established and operated with funds through donation, principal investment or other means by any individual, non-government corporation, association or organization.  According to Scope of Services General a hospital that provides services for all kinds of illnesses, diseases, injuries or. a general hospital shall provide medical and surgical care to the sick and injured, as well as maternity, newborn and child care. Specialized General Hospitals According Functional Capacity Levels of Management Managerial Skills  TECHNICAL SKILL involves understanding and demonstrating proficiency ✓First-level managers may engage in the actual operations of the organization; they need to have an understanding of how production and service occur in the organization in order to direct and evaluate line employees. ✓Middle managers use more technical skills related to planning and organizing. ✓Top managers need to have skill to understand the complex financial workings of the organization.  INTERPERSONAL SKILL involves human relations manager's ability to interact effectively with organizational members. Communication is a critical part of interpersonal skill Managers who have excellent technical skill, but poor interpersonal skill are unlikely to succeed in their jobs.  CONCEPTUAL SKILL manager's ability to see the organization as a whole, as a complete entity the ability to see "the big picture" involves understanding how organizational units work together and how the organization fits into its competitive environment.  DIAGNOSTIC SKILL used to investigate problems, decide on a remedy, and implement a solution. involves other ✓First-level managers may deal primarily with issues of motivation and discipline, (determining why a particular employee's performance is flagging and how to improve it) ✓Middle managers are likely to deal with issues related to larger work units. (a middle-level manager may have to diagnose why sales in a retail location have dipped) ✓Top managers diagnose organization-wide problems, and may address issues such as strategic position, the possibility of outsourcing tasks, or opportunities for overseas expansion of a business.  POLITICAL SKILL involves obtaining power and preventing other employees from taking away one's power. cannot stand alone as a manager's skill Top managers may find that they need higher levels of political skill in order to successfully operate in their environments. Interacting with competitors, suppliers, customers, shareholders may require political skill. Liabilities of a Hospital  A. Corporate Liabilities arising from failure of the hospital to furnish accommodations and facilities necessary to carry out its purpose failure to follow in a given situation, the established standard of conduct to which the corporation should conform.  Corporate liabilities may arise from: Failure to furnish safe and well-maintained buildings and ground. Failure to furnish safe and reliable equipment.  B. Vicarious Liabilities Acts of Hospital Employees Elements of Hospital Administration  Elements of Administration 1. Planning 2. Organizing 3. Staffing 4. Budgeting 5. Supervising 6. Motivation 7. Evaluation  1. Process of Systematic Planning the most important determines What, When, Where, How, Why, and by whom things will be done. involves “decision making for future events”.  2. Principles of Organizing Departmentalization Acquisition of human and non-human resources Specialization and division of labor Coordination Authority and responsibility Unity of command  3. Staffing 2nd most important Identifying the type and number of personnel Recruitment Selection and appointment Orientation  4. Budgeting Accounting -It is the recording assembly and summarization of financial effects of executive action. Auditing - It is the investigation and report on the fidelity and legality of all financial transactions. Purchasing - It is the acquisition of the property and materials needed in administration.  5. Supervising day-to-day relationship between an executive and his immediate subordinates  6. Motivation defined as “an externally induced behavior which occurs in order to bring about or maintain need fulfillment”  7. Evaluation systemic collection of information about the activities, characteristics and outcomes of programs, personnel, and products Supervision What does it take to become a supervisor? A supervisor oversees the day-to-day performance of employees. Depending on the company, a supervisor may manage a team, a shift or an entire department. Successful supervisors have excellent organizational and communication skills. These skills help them transfer information from upper management to employees and communicate their teams’ performance or needs to high-level managers. In most cases, supervisors are experts in their field and can efficiently manage daily operations as a result. What does it take to become a supervisor? Excellent communication skills Expertise in team or department Ability to remain calm under pressure Firm grasp of company policies Strong work ethic Punctuality and time management skills Professionalism and a positive attitude Organizational abilities Interest in leadership opportunities  Levels of Supervision Direct Supervision General Supervision Intermittent Supervision Administrative Supervision General Direction: Long-Range Administrative Direction  Direct Supervision : The supervisor gives specific instructions on all assignments. Work is reviewed for completeness and accuracy, or the employee performs tasks which provide inherent checks built into the nature of the work. General Supervision : The supervisor provides continuing or individual assignments by indicating generally what is to be done, limitations, quality and quantity expected, deadlines and priorities. Additional, specific instructions are given for new, difficult, or unusual assignments. The employee uses initiative in carrying out recurring assignments. The supervisor assures that the work is technically accurate and in compliance with instructions or established procedures. Intermittent Supervision The supervisor makes assignments by defining objectives, priorities and deadlines, and assists the employee with unusual situations that do not have clear objectives. The employee plans and carries out successive steps and resolves problems and deviations in accordance with instructions, policies, and accepted practices. The supervisor reviews the work for technical adequacy and conformance with practice and policy. Administrative Supervision : The supervisor sets the overall objectives and resources available. Supervisor and employee, in consultation, develop deadlines, projects, and work to be done. The employee plans and carries out the assignment, resolves most of the conflicts, coordinates work with others and interprets policy on own initiative. The employee keeps the supervisor informed of progress, potentially controversial matters, or far-reaching implications. General Direction: Assignments are made in terms of broad practice, precedents, policies, and goals. Work may be reviewed for fulfillment of program objectives and conformance with departmental policy and practice. Long-Range Administrative Direction The employee generally proceeds independently in accordance with general plans, policies and purposes of the department. Results of work are considered technically authoritative and are normally accepted without significant change.  Types of Supervision Close Supervision Supervision General Supervision Direction General Direction Close Supervision indicates that the incumbent is assigned duties according to specific procedures. Work is checked frequently, and in addition there may be formal training. Supervision indicates that the incumbent performs a variety of routine duties within established policies and procedures or by referral to the supervisor’s guidelines. General Supervision indicates that the incumbent develops procedures for performance of variety of duties; or performs complex duties within established policy guidelines. Direction indicates that the incumbent establishes procedures for attaining specific goals and objectives in a broad area of work. Only the final results of work done are typically reviewed. Incumbent typically develops procedures within the limits of established policy guidelines. General Direction indicates that the incumbent receives guidance in terms of broad goals and overall objectives and is responsible for establishing the methods to attain them. Generally the incumbent is in charge of an area of work, and typically formulates policy for this area but does not necessarily have final authority for approving policy.  RADIOGRAPHER SUPERVISOR This is supervisory radiological work supervising the provision of diagnostic radiology services for the district health centers. The employee in this class supervises a group of radiographers engaged in the operation of radiological equipment to produce radiographs of the body for diagnostic purposes. Work includes planning, organizing and assigning work and modifying procedures to improve workflow and increase efficiency. Work also includes the responsibility for the accurate and complete processing of records. Contact with patients, physicians and other medical and administrative professionals are significant aspects of the work. Work is performed under the general supervision of an administrative superior.  REQUIRED KNOWLEDGE, SKILLS AND ABILITIES RADIOGRAPHER SUPERVISOR KNOWLEDGE OF: rules and regulations governing occupational hazards and safety precautions in radiographic work principles, practices, methods and new developments in the field of diagnostic radiology technology methods and practices in health services delivery principles, practices, materials, and equipment used in diagnostic radiological procedures, including positioning patients, adjusting and operating equipment, and processing films  REQUIRED KNOWLEDGE, SKILLS AND ABILITIES RADIOGRAPHER SUPERVISOR KNOWLEDGE OF: anatomical terminology and the human anatomy with emphasis on anatomical postures occupational hazards and safety precautions of radiological work proper procedures and techniques for handling patients with a variety of physical injuries standards of the American Registry of Radiologic Technologists principles and processes for providing customer and personal services including customer needs assessment and meeting quality standards for services  REQUIRED KNOWLEDGE, SKILLS AND ABILITIES RADIOGRAPHER SUPERVISOR SKILL IN: operating radiological equipment taking and developing films  REQUIRED KNOWLEDGE, SKILLS AND ABILITIES RADIOGRAPHER SUPERVISOR ABILITY TO: supervise a group of radiographers engaged in the operation of x-ray equipment for diagnostic purposes make recommendation to improve services and implement those changes for more efficient operations learn departmental functions and organization make judgmental decisions where several courses of action are presented assess staff training needs and develop in service training as needed position patients properly to obtain optimum view of specific area of the body practice radiation protection techniques to minimize exposure to patients schedule patients for diagnostic x-rays  REQUIRED KNOWLEDGE, SKILLS AND ABILITIES RADIOGRAPHER SUPERVISOR ABILITY TO: explain purpose and procedure for breast self-examination to patients ensure the maintenance of radiological equipment and supplies maintain records and prepare activity reports understand and follow oral and written instructions establish and maintain effective working relationships with physicians, associates, and the public operate an interactive computer terminal, entering and retrieving data, if required by work assignment film complex x-ray studies, including mammography studies Duties and Responsibilities 1. Managing workflow 2. Training new hires 3. Creating and managing team schedules 4. Reporting to HR and senior management 5. Evaluating performance and providing feedback 6. Identifying and applying career advancement opportunities 7. Helping to resolve employee issues and disputes  Managing workflow One of a supervisor’s most important responsibilities is managing a team. Often, supervisors create and oversee their team’s workflow, or the tasks required to complete a job. Supervisors must define goals, communicate objectives and monitor team performance.  Training new hires When a new employee joins the team, their supervisor should help them understand their role and support them during their transition. This might include providing workplace orientation and explaining company policies or job duties. The supervisor may manage all onboarding activities, or they may work with the human resources department to make sure the new hire receives the guidance and information they need.  Creating and managing team schedules In some cases, organizations have set hours for their entire workforce, and supervisors won’t need to adjust them. However, when team members work in shifts, supervisors are usually responsible for creating schedules. For example, if you are a supervisor of restaurant waitstaff, you will want to make sure you have an appropriate number of servers scheduled for each shift. This usually means scheduling more people during the busiest time of day and balancing shifts so that the staff does not feel overworked. Managing employee schedules also means being flexible and prepared when employees need to make changes, such as requesting a day off, calling in sick or handling a family emergency.  Reporting to HR and senior management As a supervisor, you’ll often be responsible for reporting team and individual performance to human resources and senior management. You may need to evaluate each member of your team and record employee punctuality, performance on goals, professionalism, disciplinary issues, adherence to company policies and more. You may also be required to develop and administer performance improvement plans.  Evaluating performance and providing feedback Supervisors are often tasked with developing or executing employee feedback and recognition programs. This responsibility might include setting employee and team goals and choosing appropriate rewards for achievements. For example, if a salesperson exceeds their monthly quota, they may be eligible for a bonus. This time should also be used to provide both positive and constructive feedback.  Identifying and applying career advancement opportunities Because supervisors work closely with employees, they often help decide who is eligible for promotions. In some cases, supervisors may directly award promotions. However, even when supervisors don’t have the authority to directly promote employees, senior management professionals often consult supervisors during the promotion process. Helping to resolve employee issues and disputes When employees are unhappy with their workplace experience, they may approach their supervisor before speaking with HR. Supervisors must use active listening skills to understand employee complaints and to work with them to reach a solution. If an employee complains that another employee or member of management has violated company policies, the supervisor will likely need to report the issue to HR for an investigation. In the case of minor disagreements between employees, supervisors may act as mediators and help the two parties come to a resolution.  Span of Control Span of control refers to the number of subordinates that can be managed effectively and efficiently by supervisors or managers in an organization. Typically, it is either narrow or wide resulting in a flatter or more hierarchical organizational structure. Each type has its inherent advantages and disadvantages.  Span of Control Narrow Span Wide Span Optimal span of control Narrow Span of Control Wide Span of Control  Optimal span of control some experts with a more traditional focus believe that 5-6 subordinates per supervisor or manager is ideal. In general, however, optimum span of control depends on various factors including: Optimal span of control Leadership  6 Leadership Styles Coercive Authoritative Affiliative Democratic Pacesetting Coaching  Coercive The coercive style is the least effective in most situations as it is based on terror. The leader's extreme top-down decision-making kills new ideas on the vine. People feel so disrespected that they think, " I won't even bring my ideas up- they'll only be shut down.“ Likewise, people's sense of responsibility evaporates: unable to act on their own initiative, they loose their sense of ownership and feel little accountability for their performance.  Coercive Some become so resentful they adopt the attitude, " I'm not going to help this bastard." Coercive leadership also has a damaging effect on the reward system. Most high-performing workers are motivated by more than money-they look for satisfaction of work well done. The style undermines one of the leader's prime tools- motivating people by showing them how their job fits into a grand, shared mission. The coercive style should be used only with extreme caution and in the few situations when it is absolutely imperative, such as during a turnaround or when a hostile takeover is looming.  Authoritative style most effective The authoritative leader is a visionary, It motivates people by making clear to them how their work fits into a larger vision for the organization. People who work for such leaders understand that what they do matters and why. Authoritative leadership also maximizes commitment to the organization's goals and strategy. The standards for success are clear to all, as are the rewards.  Authoritative style An authoritative leader states the end but generally gives people plenty of leeway to device their own means, gives them freedom to innovate, experiment, and take calculated risks. Because of its positive impact, this style works well in almost any business situations, mostly when a business is adrift.  Affiliative style Affiliative style revolves around people - its proponents value individuals and their emotions more than tasks and goals. The affiliative leader strives to keep employees happy and to create harmony among them. He manages by building strong emotional bonds and then reaping the benefits of such an approach, namely fierce loyalty. The style also has a markedly positive effect on communication as people talk more and share more ideas and thoughts.  Affiliative style The style drives up flexibility because the affiliative leader doesn't impose unnecessary strictures on how employees get their work done. As for a sense of recognition and reward for work well done, the affiliative leader offers ample positive feedback. Despite its benefits, the style should not be used alone. Its exclusive focus on praise can allow poor performance to go uncorrected, employees may perceive that mediocrity is tolerated. It is recommended to use this style in combination with authoritative style.  Democratic style the democratic leader drives up flexibility and responsibility. By spending time getting people's ideas and buy-in, a leader builds trust, respect and commitment. And by listening to employees' concerns, the democratic leader learns what to do to keep morale high. people operating in a democratic system tend to be very realistic about what can and cannot be accomplished. The style can escalate conflicts.  Democratic style This approach is ideal when a leader is uncertain about the best direction to take and needs ideas and guidance from able employees. And even if a leader has a strong vision, the democratic style works well to generate fresh ideas for executing that vision. This style makes less sense when employees are not competent or informed enough to offer sound advice.  Pacesetting style the leader sets extremely high performance standards and exemplifies them himself. He is obsessive about doing things better and faster, and he asks the same of everyone around him. He quickly pinpoints poor performers and demands more from them. If they don't rise to the occasion, he replaces them with people who can. You would think such an approach would improve results, but it doesn’t. In fact, the pacesetting style destroys climate.  Pacesetting style Many employees feel overwhelmed by the pacesetter's demands for excellence, and their morale drops. Guidelines for working might be clear in the leader's head, but he does not state them clearly and expects people to know what to do and even thinks, " If I have to tell you, you're the wrong person for the job." Works becomes a second-guessing of what the leader wants. At the reward level, the pacesetter either gives no feedback on how people are doing or jumps in to take over when he thinks they're lagging. As for commitment, the levels are low as people have no sense of how their personal efforts fit into the big picture. This style should never be used on its own.  Coaching style Coaching leaders help employees identify their unique strengths and weaknesses and tie them to their personal and career aspirations. They encourage employees to establish long-term development goals and help them conceptualize a plan for attaining them. They make agreements with their employees about their role and responsibilities in enacting development plans, and they give plentiful instruction and feedback. Coaching leaders excel at delegating; they give employees challenging assignments, even if that means the tasks won't be accomplished quickly.  Coaching style these leaders are willing to put up with short-term failure if it furthers long-term learning. This style improves results because it requires constant dialogue, and that dialogue has a way of pushing up every driver of climate. When an employee knows his boss watches him and cares about what he does, he feels free to experiment as he's sure to get quick and constructive feedback. The dialogue helps people understand better what is expected of them and how their work fit into a larger vision and strategy. The style works well in many business situations, mostly when people on the receiving end are "up for it".  6 Leadership Styles Coercive leaders demand immediate compliance. Authoritative leaders mobilize people toward a vision. Affiliative leaders create emotional bonds and harmony. Democratic leaders build consensus through participation. Pacesetting leaders expect excellence and self-direction Coaching leaders develop people for the future. Characteristics of a Leader  Leadership Leadership is the art of motivating a group of people to act toward achieving a common goal. In a business setting, this can mean directing workers and colleagues with a strategy to meet the company's needs Leadership is a process of social influence, which maximizes the efforts of others, towards the achievement of a goal. Leadership is a process of social influence, which maximizes the efforts of others, towards the achievement of a goal. How do you define leadership in your own words? Leadership is the ability of an individual or a group of individuals to influence and guide followers or other members of an organization. Ability to Delegate Communication  A Brief History of Leadership Leaders in the past have generally belonged to one of three categories: political, military or religious. Political: Around 1790 BC, Babylonian ruler Hammurabi created the codified laws, which unified his empire in what was seen as a fair order as all people were subject to the same rules. Military: Sun Tzu was a military general in China from 500 BC. He wrote the Art of War, and, although he was a great military leader, his book is actually about how to not use armies except as a last resort, focusing more on wise political policies and strategies to prevent war. Religious: It may be said that religious leaders have had the greatest impact on their societies, with results that last for centuries. Historical Leaders Mahatma Gandhi George Washington Abraham Lincoln Adolf Hitler Muhammad Mao Zedong Nelson Mandela Julius Caesar Fidel Castro Winston Churchill Modern Day Leaders The Great Man Theory  The Trait Theory It has often been said, “Great leaders are born, not made.” Trait theory takes this saying literally: if you have the ability to lead, you were born with it, with no way to learn those skills. This theory expands on the great man theory by defining what makes great leaders “great”.  Transformational Leadership In 1978, James MacGregor Burns introduced the idea of transformational leadership as he researched political leaders. Burns theorized that “transformational leadership” is actually a process where leaders interact with their followers and inspire each other to advance together. Bernard M. Bass, in 1985, added to Burns’ transformational leadership theory by shifting the focus to the followers. If followers feel they can trust a leader (or better yet, if they admire a leader who can stimulate a sense of loyalty and respect) they will go beyond what was originally expected of them and will do so happily. As a result, productivity and unity increases. The followers are transformed by a charismatic, motivational leader. Leadership Practices  The SWOT Analysis Strengths: characteristics of the business or project that give it an advantage over others. Weaknesses: characteristics that place the business or project at a disadvantage relative to others. Opportunities: elements that the project could exploit to its advantage. Threats: elements in the environment that could cause trouble for the business or project.  Set Leadership Goals Determine your goals. Analyze your goals with the S.M.A.R.T system. Determine priority goals. Announce your goals to the team. Administration of a Radiological Facility  Location Easily accessible should always be on the ground floor unless a reliable lift (elevator) can be provided radiation protection is not a major factor in making the choice of location, convenient access is more important. route to the X-ray room should preferably be protected from both the sun and the rain, even when it is windy. There must be no steps or other obstacles that would impede trolleys or wheelchairs. Administrative Order No. 35, Series of 1994 Requirements for the Control of the Radiation Hazards from Clinical Diagnostic X-ray Facilities Basic Licensing Requirements  Personnel Requirements a. Head of the X-ray facility shall be a qualified physician who shall be the person in charge of the activities in the facility b. A radiologic or x-ray technologist duly licensed by the Professional Regulation Commission c. A Radiation Safety Officer (RSO) who is either a Medical Physicist, a qualified physician or a chief radiologic or x-ray technologist with at least 10 years experience and who had attended a course on radiation protection conducted by BHDT d. Each x-ray facility shall have at least one radiologic or x-ray technologist e. For third level and specialized facilities, the services of a medical physicist should be made available X-ray Machine Requirements: Total filtration 0.3 mm Al for 40 kVp and less 1.5 mm Al from 40 to 80 kVp 2.5 mm Al from 80 to 150 kVp Beam limiting device Focal spot marking Control console/panel Radiographic exposure switch  X-ray room specifications 2.5m x 3.0m if not equipped with table; 3.5m x 4.0m if with stationary patient table; 4.5m x 4.5m if equipped with tilting patient table; Special facilities, size is in accordance with the specification of the x-ray equipment manufacturer. Door leading to the x-ray room must be lined with at least 1.5 mm thick lead sheet Height of at least 2m from the floor/ground outside;  A red warning light bulb; A warning notice (trefoil sign, etc); Adequate ventilation; Adequate shielding from scattered and transmitted x-ray; Protective barrier;  Each x-ray room shall be provided with the following radiological accessories; A caliper; A gonadal shield with minimum lead equivalence of 0.5 mm lead; ❖A contact shield for: male adult; female adult; infant male; infant female.  An upright gonadal shield for chest examinations for radiographic equipment using fixed diaphragm and cones as beam limiting devices A pair of lead rubber gloves or a lead hand protector with minimum lead of 0.25 mm lead A lead apron with minimum lead of 0.25 mm lead.  Separate darkroom must be constructed near x-ray examination room: Well ventilated, light tight w/ minimum dimension of 1.5 x 2.0 m; Provided with air inlet and outlet with exhaust fan; Adequate supply of water; Standard safe light; Thermometer and timer.  Facilities shall have the following: Waiting area Dressing area Film storage area Film reading room Toilet for patient with opening directly to x-ray room;  Administrative Requirements: The owner/licensee shall ensure that the facility complies with requirements; The owner/licensee shall provide film badges or thermoluminiscent (TLD) dosimeter badges for all radiation workers in the facility; The head of the facility shall establish quality control program for the x-ray facility in accordance with the BHDT of the DOH protocol on quality control; The RSO shall ensure that no worker shall exceed the dose limit of 20 mSv/yr averaged over a period of 5 years.  The head of the facility shall ensure that no unlicensed person operates the x-ray equipment; The radiation safety officer (RSO) shall be responsible for the conduct of radiation safety program in the facility; The RSO shall keep record of occupational radiation doses received by the radiation workers in the facility;  Two Radiation Regulatory Agencies in the Philippines 1.Philippine Nuclear Research Institute (PNRI) of the DOST (former name : Philippine Atomic Energy Commission) - radiation from radioactive substances 2. Bureau of Health Devices & Technology (BHDT) of the DOH (former name: Radiation Health Service) - radiation from electronic and electrical devices  Relative Administrative Orders 1. A.O. No. 124, s. 1992 : “Rules and Regulations Governing the Establishment, Operation and Maintenance of an X- ray Facility in the Philippines” 2. A.O. No. 35,s. 1994: “Requirements for the Control of Radiation Hazards from Clinical Diagnostic X- ray Facilities” 3. A.O. No. 40 s. 1996: “ Requirements for the Control of Radiation Hazards from Industrial and Anti-Crime X- ray Facilities” 4. A.O. No. 41, s. 1996: “Requirements for the Control of Radiation Hazards from X- ray Devices used in Veterinary Medicine” 5. A.O. No. 2-A, s. 1996: “ Requirements for the Control of Radiation Hazards from Dental X-ray Facilities 6. A.O. No. 149, s. 2004: “ Basic Standards on Radiation Protection and Safety Governing the Authorization for the Introduction and Conduct of Practices Involving X- ray Sources in the Philippines 7. A.O. No. 175, s. 2004: “ Radiation Protection Standards for Radiofrequency Radiation in the Frequency Range 3kHz to 300GHz”  IMPORTANT DISTINCTION The requirement for a license to operate an x-ray facility only applies to free standing x-ray facilities. For hospital based x-ray facilities, no separate hospital x-ray license is issued. The one-stop-shop hospital licensing system is followed A single hospital license is issued.  One-Stop-Shop DOH System for Hospital Licensing OSS Administrative Order’s: A0 No. 2007-0021: “Harmonization and Streamlining of the Licensure System for Hospitals” A0 No. 2007-0022: “Violations Under One-Stop Shop Licensure System for Hospitals” A0 No. 2007-0023: “Schedule of Fees of the Licensure System for Hospitals” A0 No. 2007-0024: “Guidelines for the Licensure of Department of Health Hospitals”  Ethics & Jurisprudence Professional Ethics  Ethics Greek word ethos which means “a characteristic way of acting”. The Ancient Romans translated the Greek word ethos as mos/mores, from which we get our English word "morality." The Latin word, mos/mores, means "manners, customs or practices of a land or people." the study of right and wrong and how to tell the difference between them.  Basic Ethical Philosophies 1. Utilitarianism 2. Deontology 3. Virtue.  Utilitarianism often called consequentialism advocates that actions are morally correct or right when the large number of person is benefited by the decision made. A large accident occurs and a number of persons are critically injured. The triage team assigns a higher priority to the less injured patients and attends last to those who are critically injured, since the chance of survival is less for the most severely injured.  Deontology rules are to be followed at all times means “duty” health care provider has the duty to “do not harm,” then assigning a low priority number to the most critical patients would be wrong. deontology and utilitarianism are more or less opposite  Virtue focuses on using wisdom rather than emotional and intellectual solving. How the family and friends of the victims would be affected by the triage decisions would be the deciding factor in who gets first treatment  Terms Related to Ethics Habit acquired mode of behavior involving the tendency to repeat and to reproduce certain actions act which has been repeated frequently; it is done almost automatically without much conscious effort Custom ordinary or usual manner of doing or acting, or the habitual practice of a community or people ways and acts which are approved by the group  Ideals pertains to perfection. conceived as perfect, supremely excellent, very desirable. Etiquette French word meaning “ticket”. “manners” and “etiquette” are frequently used synonymously. refers to a form of ceremony or decorum and social graces. Tradition Transmission of knowledge, opinions, doctrines, customs and practices from generation to generation.  Ethical and Legal Issues Autonomy Person’s self-reliance, independence, liberty, right, privacy, individual choice, freedom of the will, and the self-contained ability to decide. Beneficence Doing good; active promotion of good, kindness and charity. Confidentiality Belief that health-related information about individual patients should not be revealed to others. It implies privacy.  Double Effect some actions may produce both a good and a bad effect. Four criteria must be fulfilled before this type of action is ethically permissible: 1.The act is good or morally neutral. 2.The intent is good, not evil, although a bad result may be foreseen. 3.The good effect is not achieved by means of evil effect. 4.The good effect must be more important than the evil effect, or at least there is favorable balance between good over bad.  Fidelity Strict observance of promises or duties, loyalty and faithfulness to others. refers to the obligation not to divulge any information given by the patient to anyone who does not have any concern with the patient Justice Equitable, fair or just conduct in dealing with others.  Morals Generally accepted customs, principles, or habits of right living and conduct in a society and the individual’s practice in relation to these. Nonmaleficence Ethical principle that places high value on avoiding harm to others.  Paternalism Refers to the attitude that sometimes prompts health care workers to make decisions regarding a person’s care without consulting the person affected. Professional etiquette Manners and attitudes generally accepted by members of a profession.  Respect for Property keeping the belongings of patients safe and taking care not to intentionally damage or waste equipment or supplies Rights Justified claims that an individual can make Divided into legal rights and moral rights.  Sanctity of Life Refers to the belief that life is the highest good and nobody has the right to judge that another person’s quality of life is so poor that his or her life is not of value and should be terminated. You cannot make life-and-death decisions for your patients based on your personal values. Stewardship Do not harm our body because it is God’s Totality The body must function as a whole.  Values Ideals and customs of a society toward which the members of a group have an affective regard A value may be a quality desirable as an end in itself Veracity Duty to tell the truth and avoid deception Virtue Trait of character that is socially valued, such as courage  Radiologic Technologists’ Code of Ethics Source: American Society of Radiologic Technologists 1.The Radiologic Technologist conducts herself or himself in a professional manner, responds to patient needs and supports colleagues and associates in providing quality patient care. 2.The Radiologic Technologist acts to advance the principal objective of the profession to provide services to humanity with full respect for the dignity of mankind. 3. The Radiologic Technologist delivers patient care and service unrestricted by concerns of personal attributes or the nature of the disease or illness, and without discrimination on the basis of sex, race, creed, religion or socio-economic status. 4. The Radiologic Technologist practices technology founded upon theoretical knowledge and concepts, uses equipment and accessories consistent with the purpose for which they were designed and employs procedures and techniques appropriately. 5. The Radiologic Technologist assesses situations; exercises care, discretion and judgment; assumes responsibility for professional decisions; and acts in the best interest of the patient. 6. The Radiologic Technologist acts as an agent through observation and communication to obtain pertinent information for the physician to aid in the diagnosis and treatment of the patient and recognizes that interpretation and diagnosis are outside the scope of practice for the profession. 7. The Radiologic Technologist uses equipment and accessories, employs techniques and procedures, performs services in accordance with an accepted standard of practice and demonstrates expertise. 8. The Radiologic Technologist practices ethical conduct appropriate to the profession and protects the patient’s right to quality radiologic technology care. 9. The Radiologic Technologist respects confidences entrusted in the course of professional practice, respects the patient’s right to privacy and reveals confidential information only as required by law or to protect the welfare of the individual or the community. 10.The Radiologic Technologist continually strives to improve knowledge and skills by participating in continuing education and professional activities, sharing knowledge with colleagues and investigating new aspects of professional practice. Code of Professional Ethics for Radiologic Technologists and X-Ray Technologists Source: Philippine Board of Radiologic Technology  Article I RELATION WITH THE STATE AND SOCIETY Section 1. Radiologic technologists and X-ray technologists should be aware of the supreme authority of the state and should adhere to the Constitution, R.A. No. 7431 and other laws, the rules and regulations promulgated pursuant to such laws. Section 2. They should, above all, consider the welfare and well-being of the public and the interest of the state. Section 3. They are encouraged to involve themselves in civic affairs and cooperate with other organizations to promote the growth and welfare of the community.  Article II RELATION WITH PATIENTS/CLIENTS Section 1. Patients/clients are the focus in the practice of Radiologic Technology and X-Ray Technology. Hence, Radiologic Technologists and X-Ray Technologists must at all times act with dignity and sincerity and must express genuine concern in the discharge of their work. Section 2. They should keep in confidence any data or findings obtained in the performance of their duty. Disclosure, if warranted, should be done by the Radiologists concerned. Section 3. They should not discriminate against anybody and should attend to all patients/clients regardless of creed, race, belief, or political affiliation.  Section Section 4. 4. They They should shouldprovide provide thethe highest highestlevel of of level technical technical Know-how Know-how in in thethe performance performance of of their work, their work, employing employing courtesy, courtesy, empathy, empathy, compassion, compassion, andandprivacy privacy to to thethe patient/ patient/ client and client hishis and family. family.They Theyshould shouldtrytry to to perform perform thethe examination examination within withinreasonable reasonable time to to time avoid avoidthethe risk of of risk repetition repetitionto to minimize minimizethethe radiation radiation exposure exposure to to thethe patient. patient.  Article III RELATION WITH OTHER ALLIED PROFESSION Section 1. Radiologic Technologists and X-Ray Technologists should bear in mind that their profession is a public trust, and that they at all times maintain and uphold the dignity and integrity of their profession and protect it from misinterpretation. Section 2. They should not directly or indirectly assist in any unauthorized practices of the profession. They should report any violations of R.A. 7431, the rules and regulations and this Code of Ethics for registered Radiologic Technologists and X- Ray Technologists to the Board of Radiologic Technology.  Section 3. They should share information and experiences with their fellow paramedical professionals, participate, and be active members of the accredited association of Radiologic Technologists and X-Ray Technologists. Schools and Colleges with courses on Radiologic Technology and X-Ray Technology should be encouraged to conduct research to enhance the growth and advancement of the profession. Section 4. They should observe punctuality and keep appointments, particularly in the discharge of their duties with patients/clients. Section 5. They should avoid instances where their personal interest and financial gains will be in conflict with those of their patients/clients, colleagues or employers.  Section 6. They should at all times perform their tasks with honor and dignity and should be fair and impartial to all. Section 7. They should at all times keep their reputation above reproach and conduct themselves with proper decorum to gain public esteem and respect for the profession. Section 8. They should at all times strive to enhance professional growth through continuing education and subscriptions for professional journals Section 9. They should not degrade the reputation, competence, and capability of a colleague to aggrandize themselves.  Section 10. They should encourage and provide opportunities for professional development and advancement of their colleague. Section 11. They should adhere to the principles of due process and equality of opportunity in peer relationship and personnel actions. Section 12. They should align personal philosophies and attitudes with those of the institutions they serve. Section 13. They should help to create and maintain conditions under which scholarship can exist, like freedom of inquiry, thoughts and expressions. Section 14. They should be receptive to new ideas, knowledge, and innovations that contribute to the development and growth of the profession.  Article IV RELATION TO AGENCY Section 1. Radiologic Technologists and X-Ray Technologists should assist in the improvement of governmental Agencies’ functions and the lightening of their patient’s work load. Section 2. They should be vigilant in the protection of equipment and materials needed to perform their duties.  Section 3. They should perform the tasks assigned them by their governmental agency employer in good faith and to the best of their abilities utilizing their technical skills and diligence, particularly in instances where the patients safety maybe jeopardized by their neglect. Section 4. They should help promote, support, assist, and establish goodwill and camaraderie towards their peer employees in the paramedical professions.  Article V RELATIONSHIP WITH ONESELF Section 1. Radiologic Technologists and X-Ray Technologists should always be honest, dependable, levelheaded, and morally upright. Section 2. It is incumbent for them to provide for their professional growth through continuing education, attendance in seminars or subscriptions for professional journals and research materials.  Section 3. They should be entitled to a just and fair compensation for services rendered. Section 4. They should not allow their names to be advertised by any person or organization, unless they are employed therein.  Jurisprudence is the knowledge of the origin and interpretation of laws. Legal Nomenclatures Relevant to Medical Practice  Nomenclature a system or set of terms or symbols especially in a particular science, discipline, or art Law a rule of conduct or action prescribed the legal consideration is in any given situation. Medical practice the learned profession that is mastered by graduate training in a medical school and that is devoted to preventing or alleviating or curing diseases and injuries the practice of medicine Primary Sources of Law in the Philippines 1. Constitution Expresses the categorical laws of the country. Is a body of rules, formal or informal which regulates the government of a state. 2. Statutory Law Refers to the laws enacted by congressional, state or local legislative bodies. The enforcement of statutory laws is frequently delegated to administrative bureaus such as the Dept. of Health, Food and Drug Administration. It is the responsibility of these agencies to enact rules and regulations that will serve to implement the statutory law.  3. Court decisions Involve the interpretation of statutes and various regulations in decision involving individuals. Example, The decision of an administrative bureau can be appealed and the court would decide if the agency acted appropriately and correctly. Court decisions are referred to as common law.  Two Basic Kinds of Law 1. Public law 2. Private (civil) law Public laws are any that regulate the relationship between individuals and government. Private, or civil law includes laws that regulate the relationships among people. Litigation (a legal proceeding in a court) involving a radiographer’s professional practice is most likely to involve the latter.  Tort a private/civil injustice reparation can be sought is either intentional or unintentional (negligent) Intentional torts include False imprisonment Assault Battery Defamation Invasion of privacy 1. False imprisonment is the illegal restriction of an individual’s freedom. ✓Holding a person against his or her will or using unauthorized restraints can constitute false imprisonment. 2. Assault is to threaten harm 3. Battery is the carrying out of the threat 4. Defamation a) Slander – spoken defamation b) Libel – written defamation 5. Invasion of privacy - disclosing confidential information to unauthorized individuals  3 areas of frequent litigation in radiology 1. Patient falls and positioning injuries 2. Pregnancy 3. Errors or delays in diagnosis.  For Negligent Tort Liability, Four Elements Must Be Present 1. Duty (what should have been done) 2. Breach (deviation from duty) 3. Injury sustained 4. Cause (as a result of breach)  Malpractice and Negligence Malpractice claims are lawsuits by a patient against a medical practitioner for errors in diagnosis or treatment. Negligence cases are those in which a person believes that a medical professional did not perform an essential action or performed an improper one, thus harming the patient.  Examples of Malpractice Postoperative complications. For example, a patient starts to show signs of internal bleeding in the recovery room. The incision is reopened, and it is discovered that the surgeon did not complete closure of all the severed capillaries at the operation site. Res ipsa loquitur. This Latin term, which means “The thing speaks for itself,” refers to a case in which the doctor’s fault is completely obvious. For example, if a lung cancer patient has to have the right lung removed and the surgeon instead removes the left lung, the patient will most likely sue the surgeon for malpractice.  Examples of Negligence: Abandonment. A health-care professional who stops care without providing an equally qualified substitute can be charged with abandonment. For example, a labor and delivery nurse is helping a woman in labor. The nurse’s shift ends, but all the other nurses are busy and her replacement is late for work. Leaving the woman would constitute abandonment. Delayed treatment. A patient shows symptoms of some illness or disorder, but the doctor decides, for whatever reason, to delay treatment. If the patient later learns of the doctor’s decision to wait, the patient may believe he has a negligence case.  Negligence cases are sometimes classified using the following three legal terms: 1.Malfeasance refers to an unlawful act or misconduct. 2.Misfeasance refers to a lawful act that is done incorrectly. 3.Nonfeasance refers to failure to perform an act that is one’s required duty or that is required by law.  Gross Negligence Acts that demonstrate reckless disregard of life or limb  Contributory Negligence Instance in which the injured person is a contributing part to the injury.  4 conditions needed to establish malpractice 1. Establishment of standard care 2. Demonstration that standard of care was violated by the radiographer 3. Demonstration that loss or injury was caused by radiographer who is being sued 4. Loss or injury actually occurred and is a result of the negligence  Patient’s Rights Every patient should be treated with consideration of his or her worth and dignity. Patients must be provided confidentiality and privacy. They have the right to be informed, to make informed consent, and to refuse treatment.  Bill of Rights/Patient Care Partnership The American Hospital Association’s (AHA) Management Advisory presented a Patient’s Bill of Rights in 1973, then revised and approved by the AHA Board of Trustees in October of 1992. The 1992 Patient’s Bill of Rights The patient has the right to: 1.Considerate and respectful care; 2.Be informed completely and understandably; 3.Refuse treatment; 4.Have an advance directive (e.g., a living will, health care proxy), describing the extent of care desired; 5.Privacy; 6.Confidentiality; 7.Review his or her records (access to his/her health care information); 8.Request appropriate and medically indicated care and services; 9.Know about institutional business relationships that could influence treatment and care; 10.be informed of, consent to, or decline participation in proposed research studies; 11.Continuity of care; 12.Be informed of hospital policies and procedures relating to patient care, treatment, and responsibilities.  Legal Doctrines Applied to Medical Malpractice IMPUTED NEGLIGENCE OR COMMON RESPONSIBILITIES The responsibility of a person, who is negligent, for the wrongful conduct or negligence of another. CONTRIBUTORY NEGLIGENCE Careless act or omission on the part of the complaining party which, concerning with the defendant’s negligence, is the proximate cause of injury. ASSUMPTION OF RISK When one assumes voluntary risk of injury from a known danger, then he is barred from recovery; that person who asserts and was injured is not regarded injured.  LAST CLEAR CHANCE Implies thought, appreciation, mental direction and lapse of sufficient time to effectively act upon impulse to save the life or prevent injury to another. Snitch Law Imposed on radiographers who do not report deaths, and serious injuries or illnesses caused by defects in medical products DOCTRINE OF FORESEEABILITY The facility to perceive, know in advance, or reasonably anticipate that damage or injury will probably ensue from acts or omissions.  DOCTRINE OF CONTINUING NEGLIGENCE Contemplates of an unfailing duty of a defendant RT/XRT to appraise, make necessary investigation or examination of his patient’s injury with reasonable care and skill, failure of whom constitutes a continuing act of negligence. FELLOW SERVANT If a servant is injured on account of the negligence of his fellow servant, the master cannot be held liable. RESCUE DOCTRINE Provides that a person who goes to the rescue of a victim in an accident is injured, the original wrongdoer must be held liable for such injury.  DOCTRINE OF RES IPSA LOQUITOR “The thing speaks for itself.” For instance, objects left in a patient’s body, injury to a healthy part of the body, removal of the wrong part of the body, teeth dropped down the windpipe, burns, disability resulting from injection of drugs to the body, infection resulting from unsterilized instruments, fracture on a newly- delivered baby born by breech presentation, IM injections which resulted to leg paralysis. GOOD SAMARITAN LAW A radiographer who renders first aid or treatment at the scene of an emergency and who does so within the standard of care, acting in good faith, is relieved of the consequences  DOCTRINE OF FORCE MAJEURE No person shall be responsible for those events which cannot be foreseen and are inevitable, such as floods, fire earthquakes, and accidents. However habitual tardiness due to heavy traffic is not considered an excuse for force majeure. DOCTRINE OF RESPONDEAT SUPERIOR “Let the master answer for the acts of the subordinates”. This applies only to actions performed by the employee within the scope of the employment. For instance, hiring of underboard Radiologic Technologists/X-ray Technologists who consequently committed errors in practice  Written Orders Issued by the Court Summon – Written order to appeal in court as a respondent or defendant. Subpoena – Written order to appeal as a witness. Subpoena Duces Tecum – Written order to appeal as a witness with the necessary document. Search Warrant –Written order to inspect one’s property. Warrant of Arrest – Written order to obtain a person  Legal Terms Plaintiff/Complainant – a person who sues or file a case against a person or group of people Defendant/Accused/Respondent – a person being sued or filed a case against Accomplice – a person that helps, in any way, the criminal in committing the crime Witness – a person who was present during the commission of a crime and saw the crime being committed Legal right ❑A claim which can be enforced by legal means against a person whose duty is to respect it. Lawsuit ❑ proceeding in court for a purpose. Purpose: 1. To enforce right 2. To redress a wrong  Civil case- complainant/defendant Criminal case- plaintiff/accused Due process- is fair and orderly process which aims to protect and enforce a person’s right Trial- facts are presented and determined Perjury is the willful telling of a lie under oath. Hearsay evidence- rumors not admissible in evidence Dying declaration- considered hearsay unless the dying person is a victim of a crime  Crimes against Persons 1. Parricide - Any person who kill his father, mother or child, whether legitimate or illegitimate, or any of his ascendants or descendants, or his spouse. 2. Murder - person, not falling within the provisions of parricide, shall kill another. 3. Homicide - unlawful killing of any person, which is neither parricide, murder or infanticide. 4. Death/Injuries caused in a Tumultuous Affray (rumble)- attacking each other reciprocally, quarrel and assault each other in a confused and tumultuous manner, and in the cause of the affray someone is killed, and it cannot be ascertained who inflicted serious physical injuries.  Felony - acts and omissionspunishable by law Stages of Execution 1. Consummated Felony - a felony is consummated when all the elements necessary for its execution and accomplishment are present. 2. Frustrated Felony - it is frustrated when the offender performs all the acts of execution which would produce the felony as a consequence but which, nevertheless, do not produce it by reason of causes independent of the will of the perpetuator. 3. Attempted Felony - there is an attempt when the offender commences the commission of a felony directly by overt acts. He does not perform all the acts of execution which should produce the felony.  Crime - An act committed or omitted in violation of a law forbidding or commanding it. Ways by which Felonies may be committed 1. Deceit (dolo) - when the act is performed with deliberate intent 2. Fault (culpa) - when the wrongful act results from imprudence, negligence, lack of foresight, or lack of skill  Conspiracy - exists when two or more persons come to an agreement concerning commission of a felony and decide to commit it. Persons involved in a Conspiracy 1. Principal - one who actually performs the crime 2. Accomplice - one who willingly and knowingly participates or assists in performing the crime. 3. Accessories - before the fact – one, who, without participating, contributes or cooperates in performing the crime. -after the fact – one who cooperates in performing the criminal act by concealing or destroying the evidence of the crime or by assisting a criminal to escape. Justifying Circumstances and Circumstances which are Exempted from Criminal Liabilities I. Justifying Circumstances - (Justified – means lawful, rightful) 1. Self -- defense - defense of one’s property, defense of another 2. Defense of relatives 3. Defense of a stranger 4. Avoidance of greater evil or injury 5. Fulfillment of a lawful duty 6. Obedience to a lawful order  II. Exempting Circumstances - are those grounds for exemption from punishment because there is waiting in the agent of the crime any of the conditions which make the act voluntary, or negligent. 1. An imbecile or an insane person. 2. A person under 9 years of age 3. A person over nine years of age and under fifteen. 4. Any person who, while performing a lawful act with due care, causes an injury by mere accident without fault or intention of causing it. 5. Any person who act under the compulsion of irresistible force. 6. Any person who acts under the impulse of an uncontrollable fear of an equal or greater injury. 7. Any person who fails to perform an act required by law, when prevented by some lawful insuperable cause. III. Mitigating Circumstances - are those which, if present in the commission of the crime, do not entirely free the actor from criminal liability, but serve only to reduce the penalty. 1. That the offender had an intention to commit the wrong. 2. That the offender is under eighteen years of age or over seventy years. 3. That the offender was provoked or threatened by the offended party. 4. That the offender voluntarily surrendered to the authorities. 5. That the offender acted under passion or obfuscation. 6. That the offender was suffering from a physical defect which restricted his means of action or communication. IV. Aggravating Circumstances - are those which, if attendant in the commission of the crime, serve to increase the penalty without, however, exceeding the maximum of the penalty provided by law for the offense. To cite a few examples: 1. That advantage be taken by the offender of his public position. 2. That the crime be committed in contempt of or with insult to the public authorities. 3. That the act be committed with abuse of confidence or obvious ungratefulness. 4. That the act be committed in consideration of a price, reward or promise. 5. That the act be committed with evident premeditation.  V. Alternative Circumstances - are those which must be taken into consideration as aggravating or mitigating according to the nature and effects of the crime and the other conditions attending its commission. - they are the relationship, intoxication, and the degree of instruction and education of the offender. The following are criminally liable for light felonies: 1. principal 2. accomplice Article 9 classifies felonies according to their gravity. The gravity of the felonies is determined by the penalties attached to them by law. Grave felonies are those to which the law attaches the capital punishment or penalties which in any of their periods are afflictive, in accordance with article 25 of this code. Less grave felonies are those which the law punishes with penalties which in their maximum period are correctional. Light felonies are those infractions of law, the commission of which has the penalty of arresto menor or a fine not exceeding 200 pesos or both is provided.  Classification of Felonies According to their Gravity Capital Punishment : Death Afflictive Penalties : Reclusion perpetua, Reclusion temporal, Perpetual or temporary absolute disqualification, Perpetual or temporary special disqualification, Prison mayor Correctional penalties : Prison Correctional, Arresto mayor, Suspension, Destierro Light Penalties : Arresto Menor, Public censure Accessory Penalties : Perpetual or temporary absolute disqualification, Perpetual or temporary special disqualification, Suspension from public office, the right to vote and be voted for the profession or calling, Civil interdiction, Indemnification, Forfeiture or confiscation of instruments and proceeds of the offense. Payment of cost Fine. Afflictive - over P6,000 Correctional - P200 to P6000 Light Penalty - less than P200 PENALTIES - The suffering weather corporal or otherwise which the state inflicts on those who violate its laws. Classification of Penalties: a. Capital - Death b. Afflictive - b.1. Reclusion Perpetua b.2. Reclusion Temporal b.3. Temporary / Permanent or Absolute Disqualification b.4. Temporary / Permanent Special Disqualification b.5. Prison Mayor c. Corrective - c.1. Prison Correctional c.2. Arresto Mayor c.3. Suspension c.4. Destierro d. Light - d.1. Arresto Menor d.2. Public Censure e. Pecuniary - e.1. Fine e.2. Bond to keep the Peace f. Accessory - f.1. Absolute Disqualification f.2. Special Disqualification f.3. Suspension from Public Office / Right of Suffrage f.4. Civil Interdiction (Civil interdiction shall deprive the offender during the time of his sentence of the rights of parental authority, or guardianship) f.5. Indemnification (Indemnification refers to the broad concept of one party compensating another for losses, damages, or liabilities, usually due to third-party claims) f.6. Forfeiture or Confiscation of Proceeds f.7. Payment of Cost Professional Negligence Sources of Civil Liability 1. Contracts 2. Crimes 3. Torts Torts From the Latin “tortus” meaning twisted or crooked. A class of legal wrong. An unlawful violation of a private right not created by contract which give rise to a common law action for damages. Tortuous liability arises from the breach of a duty primarily fixed by law. The law or torts is concerned with the compensation of losses suffered by private individuals in their legally protected interest, through conduct of others which regarded as socially unreasonable. Tort Distinguish from Crime A crime is an offense against the public at large for which the state will bring proceedings. An action for tort is commenced and maintained by the injured person himself.  History of the Radiologic Technology Board The Board of Radiologic Technology (BORT) was created on February 27, 1992 by virtue of Republic Act No. 7431 Republic Act No. 7431 is also known as the “Radiologic Technology Act of 1992”  BORT is composed of 5 persons; 1 Chairman and 4 members The first Board was composed of the following: Dr. Fortunato C. Gabon Jr. - Chairman Dr. Jose T. Gaffud, Ms. Editha C. Mora, Mr. Dexter R. Rodelas and Ms. Eulinia M. Valdezco  The Rules and Regulations governing the examination, registration, licensure and practice of radiologic and x-ray technology was promulgated on September 20, 1993. The Board conducted its first fully computerized licensure examinations on December 27, 1993, the results of which were released on April 9, 1994. 1997 – 1998 Chairman – Nicomedes M. Gopez Members - Dexter R. Rodelas - Edith C. Maru - Dr. Jose T. Gaffud, FPCR - Euilinia M. Valdezco 1998 – 2000 Chairman – Nicomedes M. Gopez Members - Mario Chavez Lorenzo Reveldez Dr. Orestes Monzon FPCR Euilinia M. Valdezco 2000 – 2006 – Chairman – Nicomedes M. Gopez Members - Wilhelmina M. Gana Jacinto C. Lappay Dr. Orestes M. Monzon, FPCR Euilinia M. Valdezco 2006 – 2014 – Chairman – Wilhelmina M. Gana Member – Zaldy Ambon Cecilia Mananghaya Dr. Orestes M. Monzon, FPCR Engr. Bayani San Juan 2014 – Present – OIC Chairman – Reynaldo Apolonio S. Tisado Member – Ma. Jesette Canales Dr. Orestes M. Monzon, FPCR Engr. Bayani San Juan  Preamble We, the Radiologic Technologist/X-ray Technologists, having agreed to organized an association in order to embody our ideals, establish cooperation among ourselves, the physicians, radiologists, hospital authorities and other paramedical professions, to ensure and promote common bond of love for a better health service to the public.  Creed I solemnly pledge myself before God and to the presence of this assembly, that we may serve humanity with fidelity, honor and objective of the Radiologic Technology profession to the best of one’s ability and render service without any mental reservations to the practice of Radiologic Technology.  Timeline of Philippine Association of Radiologic Technologists The Association of X-Ray Technicians in the Philippines was conceived in 1954 The President of the first association was then a MSGT Gilberto Palomique from (1954 to 1957) 1958 to 1963, the association became inactive 1964-1966, MSGT Gilberto Palomique was again elected as president  1966-1967, Mr. Jose Querido 1967, SSGT Norberto A. Palomo - 1st RadTech School in the Philippines - the Family Clinic and Hospital School of Radiologic Technology (FCHSRT) - 2nd school is EAC  In 1973, three different societies of Radiologic Technologists emerged and they were: The Philippine Society of Medical Radiologic Technologists (PHISMERT) with Mr. Norberto A. Palomo as President, The Philippine Society of Radiologic Technologists (PSRT) with Mr. Gilberto Palomique as president and The Philippine Institute of Radiologic Technologists (PIRT) with Mr. Almario Lutap as the President Later, the three conflicting societies of Radiologic Technology were fused into one and became the Philippine Association of Radiologic Technologists, Inc. (PART) were Mr. Gilbert Palomique acted as the president.  1974-1975, Mr. Jose Cervantes 1975-1976, Mr. Santos Ragasa 1976-1977, Mr. Alfonso Abrigo 1977-1978, Mr. Benito Ringor 1978-1980, Mr. Gabriel Mendoza 1980-1981, Mr. Bernardo Ramos 1981-1982, Mr. Felix Castillo 1982-1983, Mr. Norberto P. Daan, 1983-1985, Mr. Jose Cervantes 1986-1988, Mr. Santos Ragasa 1989 - 2000, Mr. Jack C. Lappay 2001- present -Mr. Rolando Banares PRC Most Outstanding Professional Awardees in the Field of Radiologic Technology  2014 2015 - Cecilia Mananghaya 2016 – Rufo Aggarao 2017 - Lilia C. Suaiso 2018 – Dexter Rodelas 2019 – Rogelio Montemayor Lugtu 2020 – Joel T. Casaruran 2021 – Dolores C. Pambid 2022 – Dr. Edzen A. Espina, Rrt, Lpt 2023 – Dr. Jerry Cabinan 2024 - 𝗗𝗶𝗼𝗻𝗶𝘀𝗶𝗼 𝗡𝗼𝗲𝗹 𝗧. 𝗩𝗮𝗹𝗯𝘂𝗲𝗻𝗮 1969 – The founding & creation of the Radiologic Technology Schools at the Family Clinic headed by Mr. Norberto A. Palomo 1970 – School of Radiologic Technology opened at Marian College now Emilio Aguinaldo College headed by Mr. Norberto A. Palomo 1973 – Creation of the Radiation Health Office through Presidential Decree signed by President Ferdinand E. Marcos. The department headed by Dr. Tranquilino Elicanio Jr. REPUBLIC ACT NO. 7431  REPUBLIC ACT NO. 7431 AN ACT REGULATING THE PRACTICE OF RADIOLOGIC TECHNOLOGY IN THE PHILIPPINES, CREATING THE BOARD OF RADIOLOGIC TECHNOLOGY DEFINING ITS POWERS AND FUNCTIONS AND FOR OTHER PURPOSES. Section 1. Title. — This Act shall be known and cited as the "Radiologic Technology Act of 1992." Sec. 2. Statement of Policy. — It is the policy of the State to upgrade the practice of radiologic technology in the Philippines for the purpose of protecting the public from the hazards posed by radiation as well as to ensure safe and proper diagnosis, treatment and research through the application of machines and/or equipment using radiation. Sec. 3. Definition of Terms. — As used in this Act the following terms and shall mean: (a) "X-ray technology" is an auxiliary branch of radiology which deals with the technical application of x-rays as aid in the diagnosis of diseases and injuries; (b) "Radiologic technology" is an auxiliary branch of radiology which deals with the technical application of radiation, such as x- rays, beta rays, gamma rays, ultrasound and radio frequency rays, in the diagnosis and treatment of diseases; (c) "X-ray technologist" is a bona fide holder of a certificate of registration for x-ray technology issued by the Board of Radiologic Technology in accordance with this Act; (d) "Radiologic Technologist" is a bona fide holder of a certificate of registration for radiologic technology issued by the Board of Radiologic Technology in accordance with this Act; (e) "Radiology" is a branch of medical science which deals with the use of radiation in the diagnosis, treatment and research of diseases; (f) "Radiologist" is a licensed physician who specializes in the diagnosis or treatment of disease with the use of radiation; (g) "Medical physicist" is a physicist who specializes in the application of the principles and techniques of physics in medicine; h) "Board" refers to the Board of Radiologic Technology; and (i) "Commission" refers to the Professional Regulation Commission created under Presidential Decree Numbered Two hundred and twenty-three.  Sec. 4. Practice X-ray Technology. — The practice of x-ray technology shall include any and all acts by which one renders, furnishes, or contracts to render or furnished professional service as an x-ray technologist. An x-ray technologist shall also be considered in the practice of his profession if the nature and character of his employment requires professional knowledge in the art and science of x-ray technology and such employment or position requires that the holder thereof be an x-ray technologist. Nothing in this Act shall be construed to disqualify other professionals duly registered with the Professional Regulation Commission from performing any of the acts abovementioned; Provided, That under the law or laws governing their respective professions, they may perform the said acts; Provided, further, That no person shall use the title "X-ray Technologist" or any other title conveying the impression that he is an x-ray technologist without having been issued a certificate of registration as x-ray technologist by the Commission in the manner provided in this Act. Sec. 5. Practice of Radiology Technology. — The practice of radiologic technology shall include any and all acts by which one renders, furnishes, or contracts to render or furnish professional service as a radiologic technologist. A radiologic technologist shall also be considered in the practice of his profession if the nature and character of his employment requires professional knowledge in the art and science of radiologic technology, and such employment or position requires that the holder thereof be a radiologic technologist. Nothing in this Act shall be construed to disqualify other professionals duly registered with the Professional Regulation Commission from performing any of the acts abovementioned: Provided, That under the law or laws governing their respective professions, they may perform the said acts: Provided, further, That no person shall use the title "Radiologic Technologist" or any other title conveying the impression that he is a radiologist technologist without having been issued a certificate of registration as radiologic technologist by the Commission in the manner provided in this Act. Sec. 6. Creation of the Board of Radiologic Technology. — There is hereby created a Board of Radiologic Technology which shall be composed of a Chairman and four (4) members, all of whom shall be appointed by the President of the Philippines upon the recommendation of the Professional Regulation Commission. The Commission shall recommend three (3) radiologic technologists from a list to be submitted by the Association of radiologic technologists; one (1) radiologist from a list to be submitted by the association of radiologists; and one (1) medical physicist from a list to be submitted by the association of medical physicists: Provided, however, That the said associations are accredited in accordance with Presidential Decree Numbered Two hundred and twenty-three: Provided, further, That each person whose name is submitted shall possess the qualifications prescribed in Section 7 of this Act.  Sec. 7. Qualifications of Board Members. — (a) Each member of the Board shall at the time of his appointment: (1) Be a citizen and resident of the Philippines; (2) Be of good moral character; (3) Be at least thirty (30) years of age; and (4) Is neither a member of the faculty, whether full time, part time or lecturer, of any school, college or university where a regular course in radiologic technology is taught, nor has any pecuniary interest, directly or indirectly, in such institution during his term of office as a Board member. (b) Three (3) members of the Board, including the Chairman, shall at the time of their appointment: (1) Be radiologic technologist; and (2) Have at least ten (10) years practice as radiologic technologists prior to their appointment; Provided, that the three (3) radiologic technologists appointed as members of the first Board shall be deemed automatically registered as radiologic technologists upon assumption of their duties as members. (c) One (1) member of the Board shall at the time of his appointment: (1) Be a radiologist; and (2) Has at least ten (10) years practice as a radiologist prior to his appointment. (d) One (1) member of the Board shall at the time of his appointment: (1) Be a medical physicist; and (2) Has at least ten (10) years practice as a medical physicist. Sec. 8. Term of Office. — The members of the Board shall hold office for a term of three (3) years from the date of their appointment until their successors shall have been appointed and duly qualified; Provided, That the first appointees to the Board shall hold office for the following terms: the Chairman for three (3) years; two (2) members for two (2) years and two (2) members for one (1) year. Vacancies shall be filled only for the unexpired term.  Sec. 9. Duties and functions of the Boards. — The Board shall have the following duties and functions: (a) To enforce the provisions of this Act; (b) To administer oaths in accordance with the provisions of this Act; (c) To issue and, after due investigation, suspend or revoke certificates of registration for the practice of radiologic technology and x-ray technology; (d) To investigate any violation of this Act of the rules and regulations issued there under, as may come to the knowledge of the Board and, for this purpose, to issue subpoena and subpoena duces tecum to alleged violators or witnesses to secure their attendance in investigations or hearings, and the production of books, papers and documents in connection therewith and compel their attendance by the power to cite and punish for contempt; (e) To conduct yearly board examinations to radiologic technology and x-ray technology examinees under the supervision of the Professional Regulation Commission; (f) To look, from time to time, into the condition affecting the practice of radiologic technology and x-ray technology in the Philippines, and adopt such measures as may be deemed necessary for the maintenance of the standards and ethics of the profession; (g) To promulgate such rules and regulations as may be necessary to carry out the provisions of this Act: Provided, That the same shall be issued only after the approval thereof by the Commission; and (h) To adopt a seal to authenticate its official documents. The Board shall exercise these powers and duties in accordance with Presidential Decree Numbered Two Hundred and twenty-three. Sec. 10. Compensation of the Board. — The members of the Board shall each receive the same compensation as members of other Boards under the supervision of the Commission as provided for in the General Appropriations Act. Sec. 11. Removal of Board Members. — Any member of the Board may be removed from office by the President upon the recommendation of the Commission for neglect of duty, incompetence or unprofessional, immoral, or dishonorable conduct, or commission or toleration of irregularities in the conduct of the examinations, after having been given the opportunity to defend himself in a proper administrative investigation conducted by the Commission. Sec. 12. Supervision of the Board and Custody of its Records. — The members of the Board shall be under the general supervision of the Commission. No record shall be removed, altered or examined without the prior authorization of the Board. All records, including examination papers, examination results, minutes of deliberation, records of administrative cases and investigations of the Board shall be kept by the Commission. Sec. 13. Rules and Regulations. — Subject to the approval of the Commission, the Board shall set ethical and professional standards for the practice of radiologic technology and x-ray technology and adopt such rules and regulations as may be necessary to carry out the provisions of this Act. Such standards, rules and regulations shall take effect one (1) month after publication in any newspaper of general circulation. Sec. 14. Annual Report. — The Board shall, at the end of each calendar year, submit to the Commission an annual report of its activities and proceedings during the year. Other information or data may be requested by the Commission as often as may be necessary and practicable. Sec. 15. Requirement for the Practice of Radiologic Technology and X-ray Technology. — Unless exempt from the examinations under Sections 16 and 17 hereof, no person shall practice or offer to practice as a radiologic and/or x-ray technologist in the Philippines without having obtained the proper certificate of registration from the Board.  Exemption from Examination in X-ray Sec. 16. Technology. — Examination shall not be required of the following persons: (a) The first members of the Board of Radiologic Technology as provided in Section 7(b) hereof; and (b) Those who, prior to the approval of this Act, have passed the Civil Service examination for x-ray technicians, or the examination for the private sector x-ray technicians, or the examination for chest x-ray technicians, or the proficiency examination for medical radiation technicians administered by the Department of Health through its Radiation Health Office, Radiological Health Service, aforementioned categories shall register with the Board after they shall have complied with the requirements for registration as radiologic technologists. Sec. 17.Exemption from examination in Radiologic Technology. —Examination shall not be required of the following persons: (a) The first members of the Board of Radiologic Technology as provided in Section 7(b) hereof, (b) Radiologists from other countries invited for lectures of consultation or as visiting or exchange professors to colleges or universities duly recognized by the Government: Provided, That such radiologic technologists are legally qualified to practice as such in their own state or country: Provided, further, That they shall first secure a special permit from the Board which shall be valid as the Board may determine: Provided, finally, That the privilege granted in this subsection shall be given only to radiologic technologists from countries giving similar privilege to their Filipino counterparts; (c) Those who, prior to the approval of this Act, have passed the proficiency examination for medical radiation technologists administered by the Department of Health through its Radiation Health Office, Radiological Health Service, or Radiation Health Service; and (d) Those who prior to the approval of this Act, have passed the Civil Service examination for x-ray technicians, or the examination for private sector x-ray technicians, or the proficiency examination for medical radiation technicians administered by the Department of Health through its Radiation Health Office, Radiological Health Service or Radiation Health Service, with ten (10) years continuous practice of radiologic technology after passing one of these aforementioned examinations. Those falling under categories (a), (c) and (d) shall register with the Board after they shall have complied with the requirements for registration as radiologic technologists. Sec. 18. Examination Required. — Except as otherwise specifically allowed under the provisions of this Act and other exiting laws, all applicants for registration as radiologic technologists and x-ray technologists shall be required to undergo an examination which shall be given once a year by the Board, through the Commission, according to its rules and regulations and at such time and place as may be determined by the Commission. Sec. 19. Qualifications for Examination. — Every applicant for examination under this Act shall, prior to admission for examination establish to the satisfaction of the Board that he: (a) Is a Filipino citizen: (b) Is of good moral character and has not been convicted of a crime involving moral turpitude; and (c) Is a holder of a baccalaureate degree in radiologic technology from a school, college or university recognized by the Government if he applies for the radiologic technology examination or is a holder of an associate in radiologic technology diploma from a school, college or university recognized by the Government if he applies for the x-ray technology examination.  Sec. 20. Scope of Examination in X-ray Technology. — Unless changed or modified by the Board, the examination in x-ray technology shall cover the following subjects with the corresponding weights as follows: (a) Radiation Physics 10% Radiology and Radiation Protection 10% Equipment Maintenance 10% (b) Radiographic Positioning 10% Radiographic Technique 10% Special Procedures 10% (c) Anatomy, Physiology and Medical 15% Terminology (d) Photochemistry and Darkroom Procedures 10% (e) Film Analysis 5% (f) Nursing and Departmental 5% Procedures in Radiology (g) Professional Ethics 5% 21. Scope of Examination in Sec. Radiologic Technology. — Unless changed or modified by the Board, the examination in radiologic technology shall cover the following subject with the corresponding weights as follows: (a) Radiation Physics and Equipment Maintenance 10% Radiobiology and Radiation Protection 10% (b) Radiographic Positioning 10% Radiographic Technique 10% Special Procedures