Lecture Notes: Nursing Jurisprudence - Mariano Marcos State University PDF

MARIANO MARCOS STATE UNIVERSITY College of Health Sciences CHAPTER I. INTRODUCTION TO NURSING JURSIPRUDENCE A. NURSING AS A PROFESSION NURSING (Definition by Nightingale and Henderson)  Nursing is the diagnosis...

MARIANO MARCOS STATE UNIVERSITY College of Health Sciences CHAPTER I. INTRODUCTION TO NURSING JURSIPRUDENCE A. NURSING AS A PROFESSION NURSING (Definition by Nightingale and Henderson)  Nursing is the diagnosis and treatment of human responses to actual or potential health problems.  The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or recovery (or to peaceful death), that the individual would perform unaided if he/she had the necessary strength, will or knowledge, and to do this in such a way as to help the individual gain independence as rapidly as possible. The nurse initiates and controls this aspect of his/her work and function. In addition, the nurse helps the carry out the therapeutic plan as initiated by the physician. As a member of a medical team, the nurse helps other members, as they in turn help him/her, to plan and carry out the total program whether it be for the improvement of health, recovery form illness, or support in death. 1. Definition of Terms  Profession is a calling in which its members profess to have acquired special knowledge, by training, by experience, or by both, so that they may guide or advise, or serve others in that special field.  Nursing Profession is an occupation with a unique body of knowledge, attitude, and skills acquired through advanced training and experience in order to provide specialized service to society.  Professional Adjustment refers to the growth of the whole individual and the development of his/her physical, mental, emotional, social, and spiritual capacities.  Professional Nursing – according to the Philippine Nursing Act of 2002, a person shall be deemed to be practicing nursing within the meaning of this Act when he/she singly or in collaboration with another, initiates and performs nursing services to individuals, families, and communities in any health care setting. It includes, but not limited to, nursing care during conception, labor, delivery, infancy, childhood, toddler, pre-school, school age, adolescence, adulthood, and old age. As independent practitioners, nurses are primarily responsible for the promotion of health and prevention of illness. As members of the health team, nurses shall collaborate with other health care providers for the curative, preventive, and rehabilitative aspects of care, restoration of health, alleviation of suffering, and when recovery is not possible, towards a peaceful death. It shall be the duty of the nurse to:  Provide nursing care through the utilization of the nursing process. Nursing care includes, but not limited to traditional and innovative approaches, therapeutic use of self, executing healthcare techniques and procedures, essential primary healthcare, comfort measures, health teachings, and administration of written prescription for treatment, therapies, oral topical and parenteral medications,  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences internal examination during labor in the absence of antenatal bleeding and delivery. In case of suturing of perineal laceration, special training shall be provided according to protocol established;  Establish linkages with community resources and coordination with the health team;  Provide health education to individuals, families, and communities.  Teach, guide, and supervise students in nursing education programs including the administration of nursing services in varied settings such as hospitals and clinics; undertake consultation services, engage in such activities that require the utilization of knowledge and decision-making skills of a registered nurse; and  Undertake nursing and health human resource development training and research, which shall include, but not limited to, the development of advance nursing practice. B. SCOPE OF NURSING PRACTICE 1. When is a person deemed to be practicing nursing?  When he/she singly or in collaboration with another, initiates and performs nursing services to individuals, families and communities in any healthcare setting.  Singly refers to a nurse who is an independent practitioner.  In collaboration with another refers to a nurse who is a member of a health team.  The law does not distinguish between services for free and for fee, hence both services are included as nursing practice. 2. What nursing practice include?  Nursing practice includes but not limited to nursing care during the following:  Conception  Labor  Delivery  Infancy  Childhood  Toddler  Pre-school age  School age  Adolescence  Adulthood  Old age 3. Primary responsibility of an independent nurse practitioner?  Independent nurse practitioner is one who singly initiates and performs nursing services to individuals, families and communities in any health care setting.  Primary responsibilities of an independent nurse practitioner:  Promotion of health  Prevention of illness  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences 4. Primary responsibility of a health team member nurse?  A health team member nurse practitioner is one who, in collaboration with another, initiates and performs nursing services to individuals, families and communities in any health care setting.  Primary responsibilities of a health team member nurse practitioner:  Must collaborate with another health care providers for the following: 1. For the curative, preventive and rehabilitative aspects of care 2. For the restoration of health 3. For the alleviation of suffering, and 4. When recovery is not possible, towards a peaceful death C. JURISPRUDENCE (De Belen, 2007) Prudencia – law or legal (Juris), wisdom or prudence  Pertains to one who behaves prudently wisely because he has knowledge of the possible consequence of a particular action Juris – oral legal tradition/functional application of laws to and particular sets of facts Jurisprudence – theory and philosophy by law 1. Definition of Terms  Nursing Jurisprudence – the process of making laws for protection, promotion and improvement of the nursing practices. - Study of nursing law, lawsuits, liabilities, legal principles, doctrines and judicial precedents.  Nursing Legislation - Body of laws enacted by the constituent assembly(congress) and approved by the head of state - The act of process of making laws affecting the science, art, and practice of nursing.  Law - Comprehensive sense, it refers to rule of action/norm of conduct applicable to all objects of creation - Specific sense, is a rule of conduct, just, obligatory promulgated by legitimate authority and of common observance and benefit. - Commands us to do what is good and prohibits us to do what is wrong  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences - Kinds: 1. According to authorship 1.1 Divine Law 1.2 Human Laws 1.2.1 Public – laws that deals with the relationship between individuals and the government and government agencies a. Criminal Law b. International Law 1.2.2 Private – laws that deals with the relationship among private individuals a. Civil Law b. Contracts c. Remedial Law 2. Functions of Nursing Jurisprudence  Provides a framework for establishing which nursing actions in the care of clients are legal.  Differentiates the nurse responsibilities from that of the other health professionals.  Helps establish the boundaries of independent nursing action  Assists in maintaining a standard of nursing practice by making nurses accountable under the law.  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences CHAPTER III. ETHICO-LEGAL AND MORAL CONSIDERATIONS IN NURSING LEADERSHIP AND MANAGEMENT 1. Review of Ethico-moral Aspects of Nursing Code of Ethics for Nurses in the Philippines The professional code of ethics for Filipino nurses strongly emphasizes the fourfold responsibility of the nurse, the universality of nursing practice, the scope of their responsibilities to the people they serve, to their co-workers, to society and environment, and to their profession. The Code of Ethics used by Filipino nurses prior to 1984, was the code promulgated by the International Council for Nurses. In 1982, the PNA Special Committee developed a Code of Ethics for Filipino Nurses, but was not implemented. In 1984, the Board of Nursing adopted the Code of Ethics of the ICN, adding “promotion of spiritual environment” as the fifth-fold responsibility of the nurse. In 1989, the Code of Ethics promulgated by the PNA was approved by the Professional Regulation Commission and was recommended for use. This was approved In October 25, 1990 by the general assembly of the PNA. In July 14, 2004, a new Code of Ethics for Filipino Nurse was adopted under R.A. 9173 and was promulgated by the BON. The Code of Ethics for Filipino Nurses embodies ethical principles and guidelines to be observed, stipulated under seven (7) articles. The ethical principles are stated below. Article I – Preamble 1. Health is a fundamental right. The Filipino RN, believing in the worth and dignity of each human being, recognizes the primary responsibility to preserve health at all cost. This responsibility encompasses promotion of health, prevention of illness, alleviation of suffering, and restoration of health. However, when the foregoing is not possible, assistance towards a peaceful death shall be his/her obligation. 2. To assume this responsibility, RNs have to gain knowledge and understanding of man’s cultural, social, spiritual, psychological, and ecological aspects of illness, utilizing the therapeutic process. Cultural diversity and political and socio-economic status are inherent factors to effective nursing care. 3. The desire for the respect and confidence of clientele, colleagues, coworkers, and the members of the community provides the incentive to attain and maintain the highest possible degree of ethical conduct.  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences Article II – Registered Nurses and People 1. Values, customs, and spiritual beliefs held by individual shall be represented. 2. Individual freedom to make rational and unconstrained decisions shall be respected. 3. Personal information acquired in the process of giving nursing care shall be held in strict confidence. Article III – Registered Nurses and Practice 1. Human life is inviolable. 2. Quality and excellence in the care of patients are the goals of nursing practice. 3. Accurate documentation of actions and outcomes of delivered care is the hallmark of nursing accountability. 4. Registered nurses are the advocates of the patients: they shall take appropriate steps to safeguard their rights and privileges. 5. Registered Nurses are aware that their actions have professional ethical, moral and legal dimensions. They strive to perform their work in the best interest of all concerned. Article IV – Registered Nurses and Co-workers 1. The RN is in solidarity with other members of the health care team in working for the patient’s best interest. 2. The RN maintains collegial and collaborative working relationship with colleagues and other health care providers. Article V – Registered Nurses, Society, and Environment 1. The preservation of life, respect for human rights, and promotion of healthy environment shall be a commitment of a RN. 2. The establishment of linkages with the public in promoting local, national, and international efforts to meet health and social needs of the people as a contributing member of society is a noble concern of a RN. Article VI – Registered Nurses and the Profession 1. Maintenance of loyalty to the nursing profession and preservation of its integrity are ideal. 2. Compliance with the by-laws of the accredited professional organization (PNA) and other professional organizations of which the RN is a member is a lofty duty. 3. Commitment to continual learning and active participation in the development and growth of the profession are commendable obligations. 4. Contribution to the improvement of the socio-economic conditions and general welfare of nurses through appropriate legislation is a practice and visionary mission.  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences Article VII – Administrative Penalties, Repealing Clause and Effectivity The certificate of registration of the RN shall either be revoked or suspended for violation of any provisions of this Code pursuant to Sec. 23 (f), Art.IV of R.A. No. 9173 and Sec. 23 (f), rule III of Board Res. No. 425, Series of 2003, the IRR. * *Art. IV of R.A. 9173 – Examination and Registration Sec. 23. Revocation and Suspension of Certificate of Registration/Professional License and Cancellation of Special/Temporary Permit. – The Board shall have the power to revoke or suspend the certificate of registration/professional license or cancel the special/temporary permit of a nurse upon any of the following grounds: (a) For any of the causes mentioned in the preceding section; (b) For unprofessional and unethical conduct; (c) For gross incompetence or serious ignorance; (d) For malpractice or negligence in the practice of nursing; (e) For the use of fraud, deceit, or false statements in obtaining a certificate of registration/professional license or a temporary/special permit; (f) For violation of this Act, then rules and regulations, Code of Ethics for nurses and technical standards for nursing practice, policies of the Board and the Commission, or the conditions and limitations for the issuance of the temporary/special permit; or (g) For practicing his/her profession during his/her suspension from such practice; Provided, however, That the suspension of the certificate of registration/professional license shall be for a period not to exceed four (4) years. ** Rule III of Board Res. No. 425, Series of 2003, the IRR (Implementing Rules and Regulations o Same as rule III of Board Res. No. 425, Series of 2003, the IRR except: (f) For violation of RA No. 9173 and this IRR, Code of Ethics for nurses and Code of Technical Standards for nursing practice, policies of the Board and the Commission, or the conditions and limitations for the issuance of the special/temporary permit; or For this purpose, the suspension of the Certificate of Registration/Professional License shall be for a period not to exceed four (4) years. /Downloads/Documents/pdfcoffee.com_code-of-ethics-for-filipino-nurses-pdf-free.pdf 1.2 ICN Code of Ethics for Nurses 2012_ICN_Codeofethicsfornurses_ eng.pdf  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences 2. Legal Aspects 2.1 The Nursing Act of 2002 (RA 9173) https://www.officialgazette.gov.ph/2002/10/21/republic-act-no-9173/ 2.1.1 Legal Responsibilities of Nurses Liabilities in Nursing As nurses begin their professional obligations, their legal responsibilities begin as well. Their license to practice attests that they are qualified under the law to practice their profession. The Philippine Nursing Act of 1992 is the best guide the nurse can utilize as it defines the scope of nursing practice. There are also standards of care that may be used as criteria in evaluating their work. The nurses are enjoined to be familiar with the Philippine Nursing Law, and the standards of nursing care, other laws which affect nursing practice and their code of ethics. Responsibility and Accountability for the Practice of Professional Nursing When nurses undertake to practice their profession, they are held responsible and accountable for the quality- of performance of their duties. Nurses employed in an agency, institution, or hospitals are responsible directly to their immediate supervisors. Private duty nurses, being independent practitioners, are held to a standard of conduct that is expected of reasonably prudent nurses. The standard is clearly defined, legal expectation to which nurses are held accountable. A nurse assumes responsibility and accountability for all nursing care delivered. Responsibility - refers to the execution of duties associated with a nurse’s particular role. That is, the nurse is responsible for providing care within established standards of the profession. The responsible nurse demonstrates characteristics of reliability and dependability. Accountability - refers to the ability to answer for one’s own actions. The nurse is accountable to herself most of all. He/she also balances accountability to the patient, the profession, the employing institution, and society. Liability - an obligation one has incurred or might incur through any act or failure to act. - When the nurse fails to meet the legal expectations of care, the client can initiate action if harm or injury is incurred by the client. CONSENT  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences  A free and rational act that presupposes knowledge of the thing to which is being given by a person who is legally capable to give the consent  An authorization by a patient or person authorized by law to give the consent on the patient’s behalf that changes touching from non-consensual to consensual. Consent upon admission is secured by the nurse. Informed consent – is a written document that authorizes the medical staff to perform procedures and treatment after a through explanation of the patient’s condition and contemplated medical care. Essential elements of informed consent a) The diagnosis and explanation of the condition b) A fair explanation of the procedure to be done and used and the consequences c) A description of the alternative procedure and treatment d) A description of the benefits to be expected e) Material rights if any f) The prognosis, if the recommended care, procedure is refused Persons who can legally provide consent:  Patient-  Authorized representative of a minor, mentally ill and physically unable (Parents and Legal Guardian)  Emancipated minor-  Married minor- Purposes of consent  Protect the client  Protect the hospital and its personnel from any liability Refusal to Consent – A patient who is mentally and legally competent has the right to refuse the touching of his body or to submit to a medical or surgical procedure no matter how necessary nor how imminent the danger to his life or health if he fails to submit to treatment. Emergency situation – No consent is necessary because in action at such time may cause greater injury or a threat to life.  Consent can be secured from the next kin or two physicians will decide according to hospital policy Consent for sterilization- Sterilization is the termination of the ability to produce off spring.  Sterilization (BTL) husband and wife must consent to the procedure  Sterilization secondary to obstetric condition patient’s consent alone is sufficient. Nurse responsibility related to consent 1. Witness the signing of consent form 2. Sign name as witness  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences 3. Ascertain that the patient understood the medical care or what /she is digning 4. Document the witnessing or refusal to sign the consent form 5. Make sure that patient has free will in signing the consent 2.2 RESPONSIBILITY AND ACCOUNTABILITY FOR THE PRACTICE OF PROFESSIONAL NURSING 1. MALPRACTICE  Any professional misconduct, improper or unskillful care, or any practice contrary to law or established rules and regulations by a nurse that resulted to person’s injury.  Denotes stepping beyond one’s authority with serious consequences. Example of Malpractice  Giving anesthesia by a nurse or prescribing medicine Malpractice in Nursing Practice  Neglect of a nurse to use required skill and knowledge in the treatment of patient  Ignorance, negligence, unskillfulness resulting to injury  Omission of duty to patient that makes a nurse civilly or criminally liable  Failure to duly perform the duties required of the profession that resulted to patient’s injury Elements of Nursing Malpractice  Duty. The duty of a nurse to employ his/her training and skill in the care of the patient commences at the time his/her employment is engaged by the patients.  Breach. The breach of these professional duties, of skill and care, or their improper performance by the nurse resulting to damage or injury to the body or health of the patient constitutes an actionable nursing malpractice.  Proximate causation. The proximate causation in nursing can be divided into two injuries: (1) whether the nurse’s actions, in fact, causes harm to the patient; and (2) whether these are proximate causes of the patient’s injury. 2. NEGLIGENCE  The failure to protect the interest of another person, the degree of care, precaution and vigilance that the circumstances justly demand that can result to injury.  Performing an act that a reasonable prudent person under similar circumstances would not do  Commission or omission of an act which result to damage or damage is not evident  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences Criminal Negligence (It may be classified into reckless imprudence and simple imprudence)  Reckless imprudence occurs when a person does an act or fails to do it voluntarily but without malice from which material damage results immediately.  Simple imprudence means that the person or nurse did not use precaution and damage was not immediate or impending danger was not evident or manifest. Professional negligence  It is the failure of a nurse to behave or acts as a reasonable prudent nurse who is charge with a duty to use standard due care and to foresee harm that may result from failure to meet such standard which may be the proximate cause of injury to another person or property. Elements of professional negligence: 1. Existence of a duty on the part of the person charged to use due care under circumstances 2. Failure to meet the standard of due care 3. The fore see ability of harm resulting from failure to meet the standard 4. The breach of standard resulted in injury to the plaintiff Common acts of negligence 1. Burns resulting from hot water bags, heat lamps, vaporizers, sits bath 2. Objects left inside the patients’ body during surgery such as sponges, instrument 3. Airway obstruction from loose denture lodged in the patient’s trachea 4. Falls related to old age, confusion, unconsciousness, sedation, not fully recovered from anesthesia, failure to raise or lock side rails in children 5. Use of defective equipment 6. Injection resulting to death 7. Failing to report important observation about patient condition to attending physician 8. Mistaken identity 9. Careless execution of doctor’s orders 10. Errors due to family assistance 3. TORTS  The act committed against a person or his property that is independent of a contract  The person who has been wronged may seek compensation for the injury he has suffered from the wrong doer.  Generally, result to civil cases will settle damages with money but rarely by imprisonment  Tort may be classified as crime if serve and will be prosecuted under civil and criminal court of law Examples of torts  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences a. Assault – an imminent threat of harmful or offensive bodily contact with another person b. Battery – is an intentional, unconsented touching of another person.  An assault that is carried out willfully or violently touching another person’s body or clothes or anything attached to or held by the other person c. Defamation – character assassination; making derogatory remarks about another person’s reputation Kinds of defamation o Slander – oral statement o Libel – written statement d. Invasion of privacy  It is the right to be left alone, the right to e free from unwarranted publicity and exposure to public view as well as the right to live one’s life without having anyone’s name, picture or private affairs made public against one’s will Example:  Unnecessary exposure of client while moving her/him to the corridor or while caring for her/him in the room, he/she share with another  Pressing patient for information not necessary for his/her plan of care  Using tape recorder etc. without taking precaution to ensure patient’s confidentiality or without consent  Mentioning real name in oral or written assignment  Without patient’s consent or taking precaution to ensure anonymity  Publishing patient’s picture without consent  Permitting non-member of the health team to read patient’s charts without consent  Publishing content of privilege communication with client without consent e. False imprisonment or illegal detention  Unjustifiable retention or prevention of movement of another person without consent f. Fraud  Willful and purposeful misrepresentation that can cause or/have caused loss or harm to a person or property Elements of Torts  There must be damage to the offended party.  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences  There is a legal wrong or fault, or negligence arising from an act or omission for which the offender must account.  There is the nexus of cause and effect between such fault or negligence and the damage. 4. CRIMES  act committed/omitted in violation of the law  act contrary to law or statute; wrongs committed against the state, usually intentional and punishable by the state. ELEMENTS  Criminal act - action to execute resulting to a crime  Criminal intent - action is lawful - purpose of doing CRIMININAL ACTIONS - deals with acts or offenses against public welfare Misdemeanor is a general name for criminal offenses which does not in law amount to felony, an unlawful act of a less serious nature. Ex. User Punishment is usually a fine or imprisonment for a term of less than one year Felony is a crime of serious nature or a public offense for which the convicted person is liable to sentenced to death or be imprisoned in a penitentiary or prison Ex. Sell drug CRIMINAL INTENT - the state of mind of a person at the time the criminal act is committed, that is, he/she knows that an act is not lawful and still decided to do it anyway. Elements of deliberate intent 1) Freedom- voluntary 2) Intelligence- knowledgeable DEGREES OF EXECUTION OF A CRIME 1. CONSUMMATED- all elements necessary for the accomplishment of the crime are present 2. FRUSTRATED- all acts that would result in the crime were performed but causes independent of the will of the perpetrator prevented the accomplished of the crime. (Stab- rush to hospital)  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences 3. ATTEMPTED- offender started to commit the crime but not all elements were performed by performs of some cause/accident other than his own spontaneous desistence. CRIMINAL LIABILITY- incurred by a person committing a felony although the wrongful act done be different from that. A person who commits a crime may be held liable as: A. PRINCIPAL- direct part/execution of the act 1) principal by direct participation- takes a direct part in the execution of the act 2) principal by inducement- directly forces/induces others to commit the crime 3) principal by indispensable cooperation- cooperates in the commission of the offense of another act w/o w/c it would not have been accomplished B. ACCOMPLICE - cooperates in the execution of the crime by premiums/simultaneous acts - knowledge, the criminal intention of the principal - AKA accessories before the fact C. ACCESSORY - having knowledge of the commission of the crime but w/o participating therein as principal/accomplice, but by the ff. acts: 1) Profiting himself/assisting the offender to profit from the crime 2) concealing or destroying the body of the crime, or the effects or instruments thereof, in order prevent its discovery 2) harboring, concealing, assisting the escape of the principal where the accessory is: 1. public officer who abused his public function 2. private person in w/c the offender is guilty of treason, parricide, murder or attempt on the life of the chief executive - AKA accessories after the fact Fencing- can be prosecuted as accessory after the fact- an act of a person, who with intent to gain himself or for another to buy receive, posses, acquire, keep, conceal, sell/dispose any article/object of value from the crime by robbers/theft. CRIMINAL NEGLIGENCE  refers to negligence of such a character, or occurring under such circumstances, as to be punishable as a crime by law, or such flagrant and reckless disregard for the safety of others or willful indifference to the injury that might result, as to  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences convert an act otherwise lawful into a crime when it results in personal injury or death. Two Classes: 1. Reckless imprudence/reckless negligence occurs when a person does an act or fails to do act voluntarily but without malice, from which act or omission , a material damage results because of his/her inexcusable lack of precaution, taking into consideration his/her employment or occupation, degree of intelligence, physical condition, and other circumstances regarding person, time, and place. 2. Simple imprudence/simple negligence occurs when a person shows lack of precaution in those cases in which the damage about to be caused is not immediate or in which the impending danger is not evident or manifest. FELONIES  acts or omissions punishable by law and committed by means of deceit(dolo) but also by means of fault(culpa). INTENTIONAL FELONY o There is deceit when the act is performed with deliberate intent. Deliberate intent includes two elements without which there can be no crime arising from a criminal act or omission. a. Freedom – a person who acts without freedom cannot act with deliberation. b. Intelligence -Without intelligence, a person is incapable of distinguishing what act is good or bad and what act is right or wrong. That is why the law exempts from criminal liability an imbecile, an insane person, unless the latter acted during lucid intervals; and a child over 9 years old but under the 15, unless he has acted with discernment, revealing insight and understanding. UNINTENTIONAL FELONY o There is fault when the wrongful act resulted from imprudence, negligence, or lack of foresight or skill. FELONIES ACCORDING TO GRAVITY/DEGREE OF PUNISHMENT 1. Grave felonies – Grave felonies are those which the law attaches the capital punishment or penalties (imprisonment ranging from 6 years and one day to life imprisonment or a fine not exceeding Php 6,000)  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences Ex.  Murder- there is a plan, deliberate intent  Homicide- accidental-unplanned  Parricide-killing siblings and relatives 2. Less grave felonies – are those which the law punishment with penalties which in their maximum period are correctional (imprisonment ranging from one month and one day to six (6) year or a fine not exceeding Php 6,000.00 but not less than Php 200.00) Ex.  Infanticide- until 3 days  Abortion 3. Light felonies – are those infractions of law for the commission of which the penalty of arresto menor (imprisonment for one day to thirty days or a fine not exceeding Php 200.00 or both of which are imposed). Punishable only when they been consummated, with the exception of those committed against a person or property Ex:  Public Disturbances  Reclusion Perpetua- life imprisonment  Reclusion temporal- 12-20 years  Prison Mayor- 1 month and 1 day- 6 months  Arresto Menor- 1 DAY 1 Month CIRCUMSTANCE AFFECTING CRIMINAL LIABILITY 1. JUSTIFYING CIRCUMSTANCES - no crime was committed since the act was done in accordance with law under the ff. circumstances 1. SELF-DEFENSE- activity in defense of one’s person or right and the following documents a. unlawful aggression b. reasonable necessity of the means employment to present/repel the aggression c. lack of sufficient provocation in the part of the person defending himself 2. DEFENSE OF A RELATIVE- acting in the defense of the person or rights of a spouse, - Ascendants, descendants, or legitimate/natural/adopted brothers or sisters, uncles or aunts or first cousins provided the elements are present  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences a. unlawful aggression b. necessity of the means employment to present/repel the aggression c. in case the provocation was given by the person attached, the one making the attach has no part therein 3. DEFENSE OF A STRANGER 4. AVOIDANCE OF THE GREATER EVIL 5. FULFILLMENT OF DUTY OR LAWFUL EXERCISE OF RIGHT 6. OBEDIENCE TO A LAWFUL ORDER BY A SUPERIOR 2. EXEMPTING CIRCUMSTANCES - no criminal liability because of extra-ordinary circumstances - no element of DECEIT (freedom, intelligence, intention) a. insanity/imbecility unless the person acted during a lucid internal b. a child 15 y/o or under at the time of the commission of the offense c. a child above 15 y/o but below 18 y/o under acted and discernment d. any person who, while performing a lawful act with due care, causes an injury by mere accident, without fault or intention of causing it. e. any person who acts under the compulsion of an irresistible force f. any person who acts under the impulse of an uncontrollable fear of an equal or greater injury g. any person who fails to perform an act required by law, when prevented by some lawful or insuperable cause. 3. MITIGATING CIRCUMSTANCES - these are circumstances that may be considered as extenuating or reducing the degree or moral culpability by fairness and mercy. a. Circumstances which otherwise justifying or exempting were it not for the fact that all requisites necessary to justify the act or to exempt the offender from criminal liability in the respective cases or not attendant b. When the offender has no intention to commit so grave a wrong as the one committed c. When the offender is under eighteen years or over seventy years old d. When sufficient provocation or threat on the part of the offended party immediately precedes the act f. When the act is committed in the immediate vindication of a grave offense to the one committing the felony, his/her spouse, ascendant, legitimate, natural or adopted brothers and sisters or relative by affinity within the same degree g. When a person acts upon an impulse so powerful as naturally to have produced an obfuscation h. When offender voluntarily surrenders himself to a person in authority or his agents, or that he/she voluntarily confesses his/her guilt before the court prior to the presentation of the evidence for the prosecution  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences i. When the offender is deaf and dumb, blind or otherwise suffering from some physical defect which thus restrict his/her means of action, defense or communication with his/her fellow beings j. When the offender is suffering from such illness as would diminish the exercise of his/her willpower, without, however, depriving him/her consciousness of his/her acts 4. AGGRAVATING CIRCUMSTANCES - circumstances that tend to increase the gravity of the crime charged. Below are such circumstances: a. The offender has taken advantage of his/her public position. b. The act was committed in contempt of or with insult to public authorities. c. The act was committed with abuse of confidence or obvious ungratefulness. d. The act was committed on the occasion of a fire, shipwreck, earthquake, epidemic, or other calamities or misfortune. e. The crime was committed in consideration of a price, reward or price. f. The crime was committed by means of inundation, fire, poison, explosion, or any other means or articles involving great damage and ruin. g. The act was committed with evident premeditation. h. Craft, fraud, or disguise was employed. 5. ALTERNATIVE CIRCUMSTANCES - are those which must be taken into consideration either as aggravating or mitigating, depending on the nature and effects of the crime and on the other conditions attending the commission of the act. Below are examples: a. Relationship – Offended party is the spouse, siblings, relatives, children, etc. b. Intoxication – It is mitigating when not habitual and intentional, but aggravating when habitual and intentional. c. Degree of instruction and education of the offender. OTHER CRIMES: 1. Moral Turpitude- an act contrary to the accepted and customary rule of right duty between men 2. Murder - is the unlawful killing of a human being by another, and with any of the following qualifying circumstances: - treachery; - in consideration of a price, reward or promise; - during calamities, e.g., fire, earthquake of flood; - with evident premeditation; and - with cruelty or by deliberately and inhumanly augmenting the suffering of the victim.  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences 3. Homicide- is the crime committed by one who kills a person nit falling under the crime of parricide and without the qualifying circumstances attending the crime of murder (no criminal intent and without criminal consequences, e.g., self-defense). 4. Abortion- the expulsion of the product of conception before the age of viability (first 12-24 wks or 3-6 months). The death of a fetus of a pregnant woman may be unintentional(miscarriage) or intentional. Intentional abortion involves using any violence on a pregnant woman or administering drugs to a pregnant woman without her consent. 5. Infanticide- The killing of the child less than 3 days old. Mother of the child who commits this crime shall suffer the penalty of imprisonment ranging from 2 years, 4 years months and 1 day to 6 years 6. Parricide- a crime committed by one who kills his/her father, mother or child whether legitimate, or any of his/her ascendants or descendants or his/her Punishment convicted of this crime is life imprisonment (reclusion perpetual) to death 7. Robbery- a crime against a person or property o The taking of personal property of another person from him or in his presence constitutes robbery Controlled Substances- Republic Act of 6425 known as the Dangerous Drug Act of 1972 covers the administration and regulation of the manufacture, distribution and dispensing of controlled drugs Registration and Special License are required for this purpose Nurses may administer these drugs only upon written order of the physician duly license Violation of the law results to revocation of license aside from the imposed and imprisonment Simulation of birth, substitution of one child for another or abandonment of a legitimate child- a crime committed by one who enters in a birth certificate a birth that did not occur o A crime against a civil status of a person o Substitution of one child for another or concealing or abandoning any legitimate child with intent to cause such child to lose his/her civil status Punishment: prison mayor and a fine not exceeding one thousand pesos POINTS TO OBSERVE IN ORDER TO AVOID CRIMINAL LIABILITY: 1. be very familiar with the Philippine Nursing Law 2. Beware of laws that affect nursing practice 3. At the start of employment, get a copy of your job description, the agency’s rules, regulation and policies  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences 4. Upgrade your skills and competence 5. Accept only such responsibility that is within the scope of your employment and your job description 6. Do not delegate your responsibilities to others 7. Determine whether your subordinates are competent in the work you are assigning them 8. Develop good interpersonal relationships with your workers, whether they are your superior, peers or subordinates 9. Consult your superior for problems that may be too big for you to handle 10. Verify orders that are not clear to you or those that seem to be erroneous 11. The doctors should be informed about the patient’s conditions 12. Keep in mind the value and necessity of keeping accurate and adequate records 13. Patients are entitled to an informed consent DOCTRINES/PRINCIPIPLES APPLIED IN NURSING MALPRACTICE/NEGLIGENCE 1 Doctrine of Force Majeure– “Irresistible or Superior force  Situation that is unforeseen or inevitable  Under the civil code of the Philippines, no person shall be held responsible for those events which cannot be foreseen, or which, though foreseen, are inevitable  Under the civil code of the Philippine, no person shall be held responsible for those events which cannot be foreseen, or which, though foreseen, are inevitable, except in cases expressly specified by law 2. Doctrine of Respondeat Superior- “let the master answer for the acts of the subordinates; let the principal answer for the acts of his/her agent”.  The liability is expanded to include the master as well as the employee and not a shift of liability from subordinate to the master thus, when a person through his negligence, injuries another for him must answer for the injury which the third person sustained from it.  Private duty nurse, are considered independent contractors thus they are liable for their own negligent actions. 3. Doctrine of Res Ipsa Loquitor – “the thing speaks for itself”.  The thing causing the injury is under the management of the party charge of negligence that the accident resulted because there is lack of standard care  It shows without proving that the accident resulted because there is lack of standard care 4. Facio ut des (I do that you may give) – a valid and enforceable contract results from an implied consent where one party renders service to another and the latter accepts such service without proof that the same is given gratuitously.  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences 5. Doctrine of hold over 6. Jus sanguinis 7. Gifts causa mortis or donation causa mortis – gifts made by a person because of death or belief in approaching death. DUE PROCESS 1. Fundamental requirements 2. Definition 3. Concepts CONTRACT  a meeting of the minds between two parties wherein one binds himself/herself with respect to the other, to give something or to render some service.  an agreement which creates a valid legal obligation  When a nurse enters into a contract with an employer, it is usually an agreement to be paid a certain amount of money and be provided certain benefits in exchange for such services.  It must not be contrary to the law, morals, good customs, public order or public policy (Art. 1306, NCC)  un-emancipated minor  insane or demented persons KINDS 1. Formal Contract. Refers to an agreement among parties involved and is required to be in writing by some special laws Examples: marriage contracts, mortgages, deeds of sale or work contracts 2. Informal Contract. One which is concluded as a result of a written document or correspondence where the laws does not require the same to be in writing, or as the result of oral and spoken discussion between the parties or conduct between the parties, evidence and intention to contract. 3. Expressed Contract is one in which the agreement is formal and mentioned either verbally or in writing. Example: A nurse working in a hospital is covered by a contract stating the salary and duration among others. 4. Implied Contract is based on a concluded or inferred agreement from the overt acts or conduct of the parties which the law presumed or ascribed as the manifestation of intention of parties to enter into a contract. Example: A nurse who takes a jeepney on her way  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences to work is in an implied contract with the driver to bring her to her destination upon payment of the fare. 5. Illegal Contract. Is one that is expressly prohibited by law. Examples of void and illegal contracts are found towards the end of this chapter. ADVANTAGES OF WRITTEN CONTRACTS 1. A written contract is certain. It avoids the uncertainty of human memory 2. It can specify a definite time within which it is binding so as to protect both sides against sudden changes without notice 3. It sets a standard and relives an individual professional person from haggling over compensation 4. Open and well-known, tends to establish minimum standards for professional practitioner and to protect them against discrimination in compensation 5. Can be definite on many details that stimulate favoritism or caprice 6. It can provide a definite procedure in case of complaints about standard work 7. Creates a minimum of certainty and security for the professional employee REQUISITES OF CONTRACT 1. To have a contract, two or more persons must participate. 2. The parties involved must give consent to the contract. 3. The object which is the subject matter of the contract must be specified such as:  All things which are not outside the commerce of man  All rights which are not in transmissible  Future inheritance in cases expressly authorized by law  All services which are not contrary to law, morals, good customs, public order, and public policy 4. The cause of obligation is established 5. Contracting parties must have the legal capacity to enter into contract. They must:  Be of legal age  Be of sound mind  Not be under the influence of intoxicating drugs, or fear of bodily harm  Not be suffering from physical disability such as those who are mentally incompetent  Married women have the full capacity to go into contract  Persons under 18 years of age may not go into contracts without the consent of the parents INEXISTENT CONTRACTS 1. Those whose cause, object, or purpose is contrary to law, morals, good customs, public order, and public policy; Example: A nurse working in a hospital without compensation;  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences 2. Those which are absolutely simulated or fictitious; 3. Those whose cause or object did not exist at the time of the transaction; 4. Those whose object is outside the commerce of men; 5. Those which contemplate an impossible service; 6. Those where the intention of the parties relative to the principal object of the contract cannot be ascertained; or 7. Those expressly prohibited or declared void by law. 8. Those which are absolutely simulated or fictitious VOIDABLE/ ANNULLABLE A contract may be considered voidable or annullable: 1. When one of the parties is incapable of giving consent to contract Ex: A nurse who institutes herself as the heir in the will of a dying Patient 2. When the consent is vitiated by mistake, violence, intimidation, undue Influence or fraud. ILLEGAL CONTRACTS  Fraud (deception and trickery)  Undue (unlawful) 1. Those that are made in protection of the law. If a nurse proceeds to administer intravenous injections without special training and according to protocol established, she/he violates RA9173, the Philippine Nursing Act of 2002 2. Consent obtained by fraud. If a nurse obtained a consent of the patient or his family to be given services, through misinterpretation that she/he is licensed although she/he is not, such contract is illegal 3. Those obtained under duress. If a nurse may be forced to sign a contract under threat of dismissal 4. Those obtained under undue influence. If a nurse who has been taking care of an elderly patient uses her close relationship to acquire high salary or other options as proper, such contract is invalid as it is illegal. 5. Those obtained through material misinterpretation A midwife applied as nurse in an agency and was soon found not to be a registered nurse, the contract that she signed becomes illegal because she misled the employer that she is a nurse.  Influence or duress (coercion)  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences BREACH  A violation or non-performance of an expressed or implied agreement without valid ground or just cause. 1. Prevention of performance 2. Failure to perform because of inconvenience or difficulty 3. Failure of cooperation in performance 4. Abandonment of duty 5. Substitution of performance 6. Failure to use due care LEGAL EXCUSES IN REFUSING, NEGLECTING OR FAILURE TO PERFORM A CONTRACT 1. Discovery of material misinterpretation made and relied upon 2. Where performance will be illegal 3. Where performance is made impossible by reason of illness 4. Where performance is made impossible by death of patient or nurse 5. Where performance is made for other reasons 6. Where contract is insufficient WILLS WILL  A legal declaration of a person’s intention upon death.  A testamentary document – takes effect after the death of its maker.  An act whereby a person’s is permitted with the formalities prescribed by law to control to a certain degree the disposition of his estate, to take effect after death. (Dionisio)  Describes the wishes of a testator upon his/her death (Taylor 1. DECEDENT  Is a person whose property is transmitted through succession whether or not he left a will. 2. TESTATOR  A person who makes a will 3. TESTATRIX  woman making a will Qualification of a testator 1. Person not prohibited by the law 2. Person of either sex who are at least 18 years of age  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences 3. Person of sound mind at the time of execution of the will 4. If married – does not require husband’s consent for the preparation of the will 4. HEIR  A person called to succession either by the provision of a will or by operation of law. 5. TESTATE  A person who dies leaving a will 6. INTESTATE  A person who dies without a will 7. PROBATE  Validation of a will in court 8. ADMINISTRATOR  One who administer the provision of the will KINDS 1. Notarial Will  It is a will attested and acknowledge before a notary public by a testator and by his witness  Requires a format or formality prescribed by law PARTS OF NOTARIAL WILL 1. Will itself – provision, condition and intentions are given by the testator to his or her beneficiaries or heir 2. Attestation clause – witness declaration that the will was executed in the presence and the manner it was executed as to:  Number of pages  Date and place of preparation  Signature of the witness 3. Acknowledgement of will – lawyers declaration that testator is present in the making of Will with his witnesses  It must be read to the testator twice  If the testator is blind or mute, he should personally read the will REQUISITES OF A NOTARIAL WILL  Written with format  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences  Executed in language known to the testator  Signed by testator at the end or by testator presence and by his express direction  Attested by three or more credible witnesses in the presence of testator and of one another witnesses  Signed on the left margin on each and every page except the last page by the testator and the witnesses  All page numbered in letters placed on upper part of each page  Attestation clause state number of pages, and that testator signed the WILL and every page or caused other person to write his name under testator of express direction in the presence of the witness and the knowledge before a notary public by testator. QUALIFICATION OF WITNESS TO A WILL: 1. Sound mind 2. Not blind, deaf, dumb 3. 18 years of age 4. Literate 5. Citizen of the Philippines 6. Credible – not convicted of falsification of public document, perjury/false testimony ALLOWANCE OF A WILL 1. Will undergo probate – hearing in court to promote legality of Will 2. Testimony of witness 3. No body contest the Will 2. Holographic will  A written will that is dated and signed by the testator.  Executed without complying with the usual formalities and solemnities  No witness is needed and can be made in or outside the Philippine (Probate - one witness who knows the handwriting of the testator In case of insertion, cancellation, erasure or alternation, the testator must authenticate the same by his signature. 3. Nuncupative will or Nuncupation – an oral will  Restrictions – will is made during the person’s last illness and done in the place where he died  With one or more witness to the will  Will should be put into writing in a given number of days and  Must be offered for probate within specified time  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences ESSENTIAL ELEMENTS OF A WILL  It must be in writing  It must be executed in a language or dialect known to the testator.  It must be subscribed(signed) by the testator himself/herself at the end thereof, or by the testator’s presence and by his/her express direction.  It must be attested to and subscribed by three or more credible witnesses in the presence of the testator and of one another.  It must be signed on the left margin, on each and every page thereof, except the last, by the testator (or by the person requested by him/her to write his/her name) as well as by the instrumental witnesses.  All its pages must be numbered correlatively in letters placed on the upper part of each page.  It must contain an attestation clause which shall state the number of pages upon which the will is written and the fact that the testator signed the will and every page thereof (or caused some other person to write his/her name under his/her express direction) in the presence of the instrumental witnesses, and that the latter signed the will and all pages thereof in the presence of the testator and of one another.  It must be acknowledged before a notary public by the testator and the witnesses. NURSES OBLIGATIONS IN THE EXECUTION OF A WILL  Nurses should note the soundness of the patient’s mind  Ensure that there was freedom from fraud or undue influence  Patient is above 18 years of age  Note that the will was signed by testator and all witnesses were present at the time of signing NURSE’S PROTECTION ON WILL EXECUTION OF WILL  Make notation on the patient’s chart of the apparent mental and physical condition of the patient at the time of making the will  Facts of making the will TESTAMENTARY CAPACITY AND INTENT 1. The testator must have the expressed intention of making a will  Must be of right age  Be of sound mind and clear-thinking ability of the time of execution  Must be free from undue influence  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences 2. The testator shall name the person who will be in-charge of carrying out the provisions of the will. 3. Properties must be disposed in accordance with legal requirements 4. The will must be signed by the testator, attested and signed by at least three witnesses in his presence and of one another.  Must be in a language or dialect known to the testators 5. Every will must be acknowledged before a notary public by the testator and witnesses. 6. Witnesses to the will should be of sound mind, 18 years old or more, not blind, deaf or dumb, and able to read and right 7. A married woman may make a will without the consent of her husband and without the authority of the court  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences CHAPTER 3. 3. RELATED LAWS PRESIDENTIAL DECREE NO. 442: THE LABOR CODE OF THE PHILIPPINES Article 1: Name of Decree This decree shall be known as the “Labor Code of the Philippines”. This labor code is the principal labor law of the country, it contains most of our labor laws such as illegal recruitment, wages of workers, rights of union members, collective bargaining, and employment termination. It also deals with the rights of employees. Article 2: Date of effectivity This code shall take effect six (6) months after its promulgation. On Labor Day, May 1, 1974, a draft labor code was signed into law, with much funfare, by the martial law President Ferdinand E. Marcos as his Presidential Decree No. 442. The effectivity date was deferred to November 1, 1974. Decree No. 570-A—issued by Pres. Marcos to change numerous significant provisions of the Code. 1986- President Corazon C. Aquino did not repeal the Code but made necessary changes, especially through R.A No. 6715 (March 21, 1989). But amendments have not stopped. By end-2005, the Labor Code has been expressly amended by 18 PD, 11 EO, 4 Batas Pambansa and 17 RA. Article 3: Declaration of Policy The state shall afford protection to labor, promote full employment, ensure equal work opportunities regardless of sex, race or creed, and regulate the relations between workers and employers. The state shall assure the rights of workers to self-organization, collective bargaining, security of tenure, and just and human conditions of work. 7 basic rights of workers: The right to organize To conduct collective bargaining or negotiation with management To engage in peaceful concerted activities, including strike in accordance with law To enjoy security of tenure To work under humane conditions To receive living wage To participate in policy and decision-making processes affecting their rights and benefits as may be provided by law.  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences Art. 4. Construction in favor of labor. All doubts in the implementation and interpretation of the provisions of this Code, including its implementing rules and regulations, shall be resolved in favor of labor. Art. 5. Rules and regulations. The Department of Labor and other government agencies charged with the administration and enforcement of this Code or any of its parts shall promulgate the necessary implementing rules and regulations. Such rules and regulations shall become effective fifteen (15) days after announcement of their adoption in newspapers of general circulation. Art. 6. Applicability. All rights and benefits granted to workers under this Code shall, except as may otherwise be provided herein, apply alike to all workers, whether agricultural or non-agricultural. (As amended by Presidential Decree No. 570-A, November 1, 1974) Art. 82. Coverage. "Managerial employees" - whose primary duty consists of the management of the establishment in which they are employed or of a department or subdivision thereof, and to other officers or members of the managerial staff. "Field personnel" - non-agricultural employees who regularly perform their duties away from the principal place of business or branch office of the employer and whose actual hours of work in the field cannot be determined with reasonable certainty. Art. 83. Normal hours of work. It shall not exceed eight (8) hours a day. Health personnel in cities and municipalities with a population of at least one million (1,000,000) or in hospitals and clinics with a bed capacity of at least one hundred (100) shall hold regular office hours for eight (8) hours a day, for five (5) days a week, exclusive of time for meals, except where the exigencies of the service require that such personnel work for six (6) days or forty-eight (48) hours, in which case, they shall be entitled to an additional compensation of at least thirty percent (30%) of their regular wage for work on the sixth day. For purposes of this Article, "health personnel" shall include resident physicians, nurses, nutritionists, dietitians, pharmacists, social workers, laboratory technicians, paramedical technicians, psychologists, midwives, attendants and all other hospital or clinic personnel. Art. 84. Hours worked. Hours worked shall include (a) all time during which an employee is required to be on duty or to be at a prescribed workplace; and (b) all time during which an employee is suffered or permitted to work. Rest periods of short duration during working hours shall be counted as hours worked.  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences Art. 85. Meal periods. Subject to such regulations as the Secretary of Labor may prescribe, it shall be the duty of every employer to give his employees not less than sixty (60) minutes timeoff for their regular meals. Art. 86. Night shift differential. Every employee shall be paid a night shift differential of not less than ten percent (10%) of his regular wage for each hour of work performed between ten o’clock in the evening and six o’clock in the morning. Art. 87. Overtime work. Work may be performed beyond eight (8) hours a day provided that the employee is paid for the overtime work, an additional compensation equivalent to his regular wage plus at least twenty-five percent (25%) thereof. Work performed beyond eight hours on a holiday or rest day shall be paid an additional compensation equivalent to the rate of the first eight hours on a holiday or rest day plus at least thirty percent (30%) thereof. Art. 88. Undertime not offset by overtime. Undertime work on any particular day shall not be offset by overtime work on any other day. Permission given to the employee to go on leave on some other day of the week shall not exempt the employer from paying the additional compensation required in this Chapter. Art. 89. Emergency overtime work. Any employee may be required by the employer to perform overtime work in any of the following cases: a. When the country is at war or when any other national or local emergency has been declared by the National Assembly or the Chief Executive; b. When it is necessary to prevent loss of life or property or in case of imminent danger to public safety due to an actual or impending emergency in the locality caused by serious accidents, fire, flood, typhoon, earthquake, epidemic, or other disaster or calamity; Page 6 of 74 c. When there is urgent work to be performed on machines, installations, or equipment, in order to avoid serious loss or damage to the employer or some other cause of similar nature; d. When the work is necessary to prevent loss or damage to perishable goods; and e. Where the completion or continuation of the work started before the eighth hour is necessary to prevent serious obstruction or prejudice to the business or operations of the employer. Any employee required to render overtime work under this Article shall be paid the additional compensation required in this Chapter. Art. 90. Computation of additional compensation. For purposes of computing overtime and other additional remuneration as required by this Chapter, the "regular wage" of an employee shall include the cash wage only, without deduction on account of facilities provided by the employer.  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences Art. 91. Right to weekly rest day. a. It shall be the duty of every employer, whether operating for profit or not, to provide each of his employees a rest period of not less than twenty-four (24) consecutive hours after every six (6) consecutive normal work days. b. The employer shall determine and schedule the weekly rest day of his employees subject to collective bargaining agreement and to such rules and regulations as the Secretary of Labor and Employment may provide. However, the employer shall respect the preference of employees as to their weekly rest day when such preference is based on religious grounds. Art. 92. When employer may require work on a rest day. The employer may require his employees to work on any day: a. In case of actual or impending emergencies caused by serious accident, fire, flood, typhoon, earthquake, epidemic or other disaster or calamity to prevent loss of life and property, or imminent danger to public safety; b. In cases of urgent work to be performed on the machinery, equipment, or installation, to avoid serious loss which the employer would otherwise suffer; c. In the event of abnormal pressure of work due to special circumstances, where the employer cannot ordinarily be expected to resort to other measures; d. To prevent loss or damage to perishable goods; e. Where the nature of the work requires continuous operations and the stoppage of work may result in irreparable injury or loss to the employer; and f. Under other circumstances analogous or similar to the foregoing as determined by the Secretary of Labor and Employment. Art. 93. Compensation for rest day, Sunday or holiday work. a. Where an employee is made or permitted to work on his scheduled rest day, he shall be paid an additional compensation of at least thirty percent (30%) of his regular wage. An employee shall be entitled to such additional compensation for work performed on Sunday only when it is his established rest day. b. When the nature of the work of the employee is such that he has no regular workdays and no regular rest days can be scheduled, he shall be paid an additional compensation of at least thirty percent (30%) of his regular wage for work performed on Sundays and holidays. c. Work performed on any special holiday shall be paid an additional compensation of at least thirty percent (30%) of the regular wage of the employee. Where such holiday work falls on the employee’s scheduled rest day, he shall be entitled to an additional compensation of at least fifty per cent (50%) of his regular wage.  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences d. Where the collective bargaining agreement or other applicable employment contract stipulates the payment of a higher premium pay than that prescribed under this Article, the employer shall pay such higher rate. Art. 94. Right to holiday pay. a. Every worker shall be paid his regular daily wage during regular holidays, except in retail and service establishments regularly employing less than ten (10) workers; b. The employer may require an employee to work on any holiday but such employee shall be paid a compensation equivalent to twice his regular rate; and c. As used in this Article, "holiday" includes: New Year’s Day, Maundy Thursday, Good Friday, the ninth of April, the first of May, the twelfth of June, the fourth of July, the thirtieth of November, the twenty-fifth and thirtieth of December and the day designated by law for holding a general election. Art. 95. Right to service incentive leave. a. Every employee who has rendered at least one year of service shall be entitled to a yearly service incentive leave of five days with pay. b. This provision shall not apply to those who are already enjoying the benefit herein provided, those enjoying vacation leave with pay of at least five days and those employed in establishments regularly employing less than ten employees or in establishments exempted from granting this benefit by the Secretary of Labor and Employment after considering the viability or financial condition of such establishment. c. The grant of benefit in excess of that provided herein shall not be made a subject of arbitration or any court or administrative action. Art. 96. Service charges. All service charges collected by hotels, restaurants and similar establishments shall be distributed at the rate of eighty-five percent (85%) for all covered employees and fifteen percent (15%) for management. The share of the employees shall be equally distributed among them. In case the service charge is abolished, the share of the covered employees shall be considered integrated in their wages. Art. 118. Retaliatory measures. It shall be unlawful for an employer to refuse to pay or reduce the wages and benefits, discharge or in any manner discriminate against any employee who has filed any complaint or instituted any proceeding under this Title or has testified or is about to testify in such proceedings. Art. 119. False reporting. It shall be unlawful for any person to make any statement, report, or record filed or kept pursuant to the provisions of this Code knowing such statement, report or record to be false in any material respect.  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences Art. 132. Facilities for women. The Secretary of Labor and Employment shall establish standards that will ensure the safety and health of women employees. In appropriate cases, he shall, by regulations, require any employer to: a. Provide seats proper for women and permit them to use such seats when they are free from work and during working hours, provided they can perform their duties in this position without detriment to efficiency; b. To establish separate toilet rooms and lavatories for men and women and provide at least a dressing room for women; c. To establish a nursery in a workplace for the benefit of the women employees therein; and d. To determine appropriate minimum age and other standards for retirement or termination in special occupations such as those of flight attendants and the like. Art. 133. Maternity leave benefits. a. Every employer shall grant to any pregnant woman employee who has rendered an aggregate service of at least six (6) months for the last twelve (12)months, maternity leave of at least two (2) weeks prior to the expected date of delivery and another four (4) weeks after normal delivery or abortion with full pay based on her regular or average weekly wages. The employer may require from any woman employee applying for maternity leave the production of a medical certificate stating that delivery will probably take place within two weeks. b. The maternity leave shall be extended without pay on account of illness medically certified to arise out of the pregnancy, delivery, abortion or miscarriage, which renders the woman unfit for work, unless she has earned unused leave credits from which such extended leave may be charged. c. The maternity leave provided in this Article shall be paid by the employer only for the first four (4) deliveries by a woman employee after the effectivity of this Code. Art. 134. Family planning services; incentives for family planning. a. Establishments which are required by law to maintain a clinic or infirmary shall provide free family planning services to their employees which shall include, but not be limited to, the application or use of contraceptive pills and intrauterine devices. b. In coordination with other agencies of the government engaged in the promotion of family planning, the Department of Labor and Employment shall develop and prescribe incentive bonus schemes to encourage family planning among female workers in any establishment or enterprise. Art. 135. Discrimination prohibited.  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences It shall be unlawful for any employer to discriminate against any woman employee with respect to terms and conditions of employment solely on account of her sex. The following are acts of discrimination: a. Payment of a lesser compensation, including wage, salary or other form of remuneration and fringe benefits, to a female employee as against a male employee, for work of equal value; and b. Favoring a male employee over a female employee with respect to promotion, training opportunities, study and scholarship grants solely on account of their sexes. Art. 136. Stipulation against marriage. It shall be unlawful for an employer to require as a condition of employment or continuation of employment that a woman employee shall not get married, or to stipulate expressly or tacitly that upon getting married, a woman employee shall be deemed resigned or separated, or to actually dismiss, discharge, discriminate or otherwise prejudice a woman employee merely by reason of her marriage. Art. 137. Prohibited acts. a. It shall be unlawful for any employer: 1. To deny any woman employee the benefits provided for in this Chapter or to discharge any woman employed by him for the purpose of preventing her from enjoying any of the benefits provided under this Code. 2. To discharge such woman on account of her pregnancy, or while on leave or in confinement due to her pregnancy; 3. To discharge or refuse the admission of such woman upon returning to her work for fear that she may again be pregnant. Art. 156. First-aid treatment. Every employer shall keep in his establishment such first-aid medicines and equipment as the nature and conditions of work may require, in accordance with such regulations as the Department of Labor and Employment shall prescribe. The employer shall take steps for the training of a sufficient number of employees in first-aid treatment. Art. 157. Emergency medical and dental services. It shall be the duty of every employer to furnish his employees in any locality with free medical and dental attendance and facilities consisting of: a. The services of a full-time registered nurse when the number of employees exceeds fifty (50) but not more than two hundred (200) except when the employer does not maintain hazardous workplaces, in which case, the services of a graduate first-aider shall be provided for the protection of workers, where no registered nurse is available. The Secretary of Labor and Employment shall provide by appropriate regulations, the services that shall be  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences required where the number of employees does not exceed fifty (50) and shall determine by appropriate order, hazardous workplaces for purposes of this Article; b. The services of a full-time registered nurse, a part-time physician and dentist, and an emergency clinic, when the number of employees exceeds two hundred (200) but not more than three hundred (300); and c. The services of a full-time physician, dentist and a full-time registered nurse as well as a dental clinic and an infirmary or emergency hospital with one bed capacity for every one hundred (100) employees when the number of employees exceeds three hundred (300). In cases of hazardous workplaces, no employer shall engage the services of a physician or a dentist who cannot stay in the premises of the establishment for at least two (2) hours, in the case of those engaged on part-time basis, and not less than eight (8) hours, in the case of those employed on full-time basis. Where the undertaking is nonhazardous in nature, the physician and dentist may be engaged on retainer basis, subject to such regulations as the Secretary of Labor and Employment may prescribe to insure immediate availability of medical and dental treatment and attendance in case of emergency. (As amended by Presidential Decree NO. 570-A, Section 26) Art. 158. When emergency hospital not required. The requirement for an emergency hospital or dental clinic shall not be applicable in case there is a hospital or dental clinic which is accessible from the employer’s establishment and he makes arrangement for the reservation therein of the necessary beds and dental facilities for the use of his employees. Art. 159. Health program. The physician engaged by an employer shall, in addition to his duties under this Chapter, develop and implement a comprehensive occupational health program for the benefit of the employees of his employer. Art. 160. Qualifications of health personnel. The physicians, dentists and nurses employed by employers pursuant to this Chapter shall have the necessary training in industrial medicine and occupational safety and health. The Secretary of Labor and Employment, in consultation with industrial, medical, and occupational safety and health associations, shall establish the qualifications, criteria and conditions of employment of such health personnel. Art. 161. Assistance of employer. It shall be the duty of any employer to provide all the necessary assistance to ensure the adequate and immediate medical and dental attendance and treatment to an injured or sick employee in case of emergency.  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences Art. 163. Research. It shall be the responsibility of the Department of Labor and Employment to conduct continuing studies and research to develop innovative methods, techniques and approaches for dealing with occupational safety and health problems; to discover latent diseases by establishing causal connections between diseases and work in environmental conditions; and to develop medical criteria which will assure insofar as practicable that no employee will suffer impairment or diminution in health, functional capacity, or life expectancy as a result of his work and working conditions. Art. 168. Compulsory coverage. Coverage in the State Insurance Fund shall be compulsory upon all employers and their employees not over sixty (60) years of age: Provided, That an employee who is over (60) years of age and paying contributions to qualify for the retirement or life insurance benefit administered by the System shall be subject to compulsory coverage. Art. 169. Foreign employment. The Commission shall ensure adequate coverage of Filipino employees employed abroad, subject to regulations as it may prescribe. Art. 170. Effective date of coverage. Compulsory coverage of the employer during the effectivity of this Title shall take effect on the first day of his operation, and that of the employee, on the date of his employment. Art. 171. Registration. Each employer and his employees shall register with the System in accordance with its regulations. Art. 172. Limitation of liability. The State Insurance Fund shall be liable for compensation to the employee or his dependents, except when the disability or death was occasioned by the employee’s intoxication, willful intention to injure or kill himself or another, notorious negligence, or otherwise provided under this Title. Art. 173. Extent of liability. Unless otherwise provided, the liability of the State Insurance Fund under this Title shall be exclusive and in place of all other liabilities of the employer to the employee, his dependents or anyone otherwise entitled to receive damages on behalf of the employee or his dependents. The payment of compensation under this Title shall not bar the recovery of benefits as provided for in Section 699 of the Revised Administrative Code, Republic Act Numbered Eleven hundred sixty-one, as amended, Republic Act Numbered Forty-eight hundred sixty-four as amended, and other laws whose benefits are administered by the System or by other agencies of the government. (As amended by Presidential Decree No. 1921).  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences Art. 174. Liability of third party/ies. a. When the disability or death is caused by circumstances creating a legal liability against a third party, the disabled employee or the dependents, in case of his death, shall be paid by the System under this Title. In case benefit is paid under this Title, the System shall be subrogated to the rights of the disabled employee or the dependents, in case of his death, in accordance with the general law. b. Where the System recovers from such third-party damages in excess of those paid or allowed under this Title, such excess shall be delivered to the disabled employee or other persons entitled thereto, after deducting the cost of proceedings and expenses of the System. Art. 175. Deprivation of the benefits. Except as otherwise provided under this Title, no contract, regulation or device whatsoever shall operate to deprive the employee or his dependents of any part of the income benefits and medical or related services granted under this Title. Existing medical services being provided by the employer shall be maintained and continued to be enjoyed by their employees. Art. 185. Medical services. Immediately after an employee contracts sickness or sustains an injury, he shall be provided by the System during the subsequent period of his disability with such medical services and appliances as the nature of his sickness or injury and progress of his recovery may require, subject to the expense limitation prescribed by the Commission. Art. 186. Liability. The System shall have the authority to choose or order a change of physician, hospital or rehabilitation facility for the employee, and shall not be liable for compensation for any aggravation of the employee’s injury or sickness resulting from unauthorized changes by the employee of medical services, appliances, supplies, hospitals, rehabilitation facilities or physicians. Art. 187. Attending physician. Any physician attending an injured or sick employee shall comply with all the regulations of the System and submit reports in prescribed forms at such time as may be required concerning his condition or treatment. All medical information relevant to the particular injury or sickness shall, on demand, be made available to the employee or the System. No information developed in connection with treatment or examination for which compensation is sought shall be considered as privileged communication. Art. 188. Refusal of examination or treatment. If the employee unreasonably refuses to submit to medical examination or treatment, the System shall stop the payment of further compensation during such  MARIANO MARCOS STATE UNIVERSITY College of Health Sciences time as such refusal continues. What constitutes an unreasonable refusal shall be determined by the System which may, on its own initiative, determine the necessity, character and sufficiency of any medical services furnished or to be furnished. Art. 189. Fees and other charges. All fees and other charges for hospital services, medical care and appliances, including professional fees, shall not be higher than those prevailing in wards of hospitals for similar services to injured or sick persons in general and shall be subject to the regulations of the Commission. Professional fees shall only be appreciably higher than those prescribed under Republic Act Numbered sixty-one hundred eleven, as amended, otherwise known as the Philippine Medical Care Act of 1969. Art. 190. Rehabilitation services. a. The System shall, as soon as practicable, establish a continuing program, for the rehabilitation of injured and handicapped employees who shall be entitled to rehabilitation services, which shall consist of medical, surgical or hospital treatment, including appliances if they have been handicapped by the injury, to help them become physically independent. b. As soon as practicable, the System shall establish centers equipped and staffed to provide a balanced program of remedial treatment, vocational assessment and preparation designed to meet the individual needs of each handicapped employee to restore him to suitable employment, including assistance as may be within its resources, to help each rehabilitee to develop his mental, vocational or social potential. Art. 191. Temporary total disability. a. Under such regulations as the Commission may approve, any employee under this Title who sustains an injury or contracts sickness resulting in temporary total disability shall, for each day of such a disability or fraction thereof, be paid by the System an income benefit equivalent to ninety percent of his average daily salary credit, subject to the following conditions: the daily income benefit shall not be less than Ten Pesos nor more than Ninety Pesos, nor paid for a continuous period longer than one hundred twenty days, except as otherwise provided for in the Rules, and the System shall be notified of the injury or sickness. (As amended by Section 2, Executive Order No. 179) b. The payment of such income benefit shall be in accordance with the regulations of the Commission. (As amended by Section 19, Presidential Decree No. 850) Art. 192. Permanent total disability. a. Under such regulations as the Commission may approve, any employee under this Title who contracts sickness or sustains an injury resul