MedPers: Basic Medical Ethics and Professionalism PDF

Medical Perspectives Basic Medical Ethics and Professionalism Block 1 Module 2 COMMITMENT AS A MEDICAL STUDENT AS FUTURE CASE 1A & 1B...

Medical Perspectives Basic Medical Ethics and Professionalism Block 1 Module 2 COMMITMENT AS A MEDICAL STUDENT AS FUTURE CASE 1A & 1B PHYSICIANS TO MAINTAIN THE VALUES OF PROFESSIONALISM PROFESSIONALISM IN MEDICINE Students have an obligation, as future physicians, to maintain the According to American College of Physicians Ethics Manual values of professionalism throughout medical training and into Medicine is not a trade to be learned, but a profession to be one’s career. entered. A profession is characterized by a specialized body of Professional behavior is not only expected of students in the knowledge that its members must teach and expand, by a code of clinical setting, but is also required in the classroom, lunchroom, ethics and a duty of service that put patient care above seminar room, library, etc. self-interest, and by the privilege of self-regulation granted by Expectations at the level of undergraduate medical education are society. Physicians must individually and collectively fulfill the outlined below: duties of the profession. While outside influences on medicine ○ Respect for professors, preceptors, and peers and the patient–physician relationship are many, the ethical ○ Respect for guest speakers and visiting patients foundations of the profession must remain in sharp focus. ○ Respect for cadavers and anatomical specimens in the A medical profession is characterized by a specialized body of anatomy lab knowledge that its members must teach and expand, by a code of ○ Respect for the institution of which you are a part ethics and a duty of service that put patient care above ○ Respect for patients and their families at clinical encounters self-interest, and by the privilege of self-regulation granted by ○ Respect for patient confidentiality society. ○ Respect for all members of the health care team ○ Respect for administrative and support staff PROFESSIONALISM AS A MEDICAL STUDENT ○ Respect for the core values of professionalism For the medical student, professionalism means aspiring to an Honesty and integrity ideal and constantly reflecting on one's personal behavior and Altruism attitudes with respect to that ideal. Medicine requires one to Respect embark on a lifelong journey dedicated to learning and healing. Responsibility and accountability Upon acceptance to medical school, students enter into a Compassion and empathy profession which has promoted the health and wellbeing of fellow Dedication and self human beings for centuries; thus, professionalism essentially begins with entry into medical school. SPECIAL OBLIGATIONS OF A PHYSICIAN WITHIN THE CONTEXT For medical students in their pre-clerkship years, issues regarding OF THE PHYSICIAN-PATIENT RELATIONSHIP AND THE ETHICAL professionalism may seem rather "common sense." Encouraging PRINCIPLES VIOLATED ON POSTING PATIENT’S INFORMATION positive peer relations, presenting oneself appropriately at clinical ONLINE encounters, and arriving to class on time seemingly go The patient–physician relationship entails special obligations for hand-in-hand with medical school the physician to serve the patient’s interest because of the As medical students, understanding the values and attributes specialized knowledge that physicians possess, the confidential expected of physicians will remain most imperative throughout nature of the relationship, and the imbalance of power between one’s career. Caring for patients that are ill demands compassion, patient and physician. competence, and sound ethical values, and there is no better time Physicians publicly profess that they will use their skills for the to foster the values of the medical profession than the beginning benefit of patients, not their own benefit. of the journey. Physicians must uphold this declaration, as should their professional associations as communities of physicians that put ROLE OF PHYSICIAN AS A HEALER AND PROFESSIONAL patient welfare first. Although the primary role of the physician is undoubtedly that of The physician’s primary commitment must always be to the the healer, one must simultaneously maintain professionalism in patient’s welfare and best interests, whether in preventing or medical practice. The following diagram highlights this crucial treating illness or helping patients to cope with illness, disability, balance: and death. The physician must respect the dignity of all persons and respect their uniqueness. The interests of the patient should always be promoted regardless of financial arrangements; the health care setting; or patient characteristics, such as decision-making capacity, behavior, or social status. Although the physician should be fairly compensated for services rendered, a sense of duty to the patient should take precedence over concern about compensation. Dealing with the realities of social media, obtaining consent for use of clinical information is not burdensome and should be included in training; it reinforces the traits that engender trust and are needed to promote lifelong development of professional character. The hard task of becoming a professional requires developing the instincts, judgment, and desire to figure out not just what is permissible but what is best. The medium used makes this case ethically problematic. Facebook is a public site that often spans individuals' professional and personal lives. Even if one maintains a personal and a separate professional persona, as the American College of Physicians (ACP) and others recommend, Facebook is a public space and patient information and images are downloadable and control cannot be maintained. The recently published ACP and Federation of State Medical Boards guidance on online MedPers Block 1 Module 2 Basic Medical Ethics and Professionalism 1 of 20  professionalism highlights the risks and benefits of using online h. Personal information controller refers to a person or media particularly when it comes to privacy and confidentiality. organization who controls the collection, holding, ○ Privacy refers to a person's right to not be intruded on processing or use of personal information, including a against his or her wishes. In medicine this commitment is person or organization who instructs another person or based on respect for persons and autonomy as well as the organization to collect, hold, process, use, transfer or duty of nonmaleficence. disclose personal information on his or her behalf. The term ○ Confidentiality refers to how information will be handled. excludes: Maintaining it fosters trust and allows patients to be open in 1. A person or organization who performs such their encounters with clinicians. functions as instructed by another person or organization; and DATA PRIVACY ACT OF 2012 (RA 10173) 2. An individual who collects, holds, processes or uses Begun and held in Metro Manila, on Monday, 25th of July 2011. personal information in connection with the Republic Act No. 10173 individual’s personal, family or household affairs. An act protecting individual personal information in information i. Personal information processor refers to any natural or and communications systems in the government and the private juridical person qualified to act as such under this Act to sector, creating for this purpose a national privacy commission, whom a personal information controller may outsource the and for other purposes processing of personal data pertaining to a data subject. CHAPTER I. GENERAL PROVISIONS j. Processing refers to any operation or any set of operations performed upon personal information including, but not Sec 1. Title limited to, the collection, recording, organization, storage, This Act shall be known as the “Data Privacy Act of 2012”. updating or modification, retrieval, consultation, use, Sec 2. Declaration of Policy consolidation, blocking, erasure or destruction of data. It is the policy of the State to protect the fundamental human right k. Privileged information refers to any and all forms of data of privacy, of communication while ensuring free flow of which under the Rules of Court and other pertinent laws information to promote innovation and growth. The State constitute privileged communication. recognizes the vital role of information and communications l. Sensitive personal information refers to personal technology in nation-building and its inherent obligation to ensure information: that personal information in information and communications 1. About an individual’s race, ethnic origin, marital systems in the government and in the private sector are secured status, age, color, and religious, philosophical or and protected. political affiliations; 2. About an individual’s health, education, genetic or Sec 3. Definition of Terms sexual life of a person, or to any proceeding for any Whenever used in this Act, the following terms shall have the offense committed or alleged to have been committed respective meanings hereafter set forth: by such person, the disposal of such proceedings, or a. Commission shall refer to the National Privacy Commission the sentence of any court in such proceedings; created by virtue of this Act. 3. 3. Issued by government agencies peculiar to an b. Consent of the data subject refers to any freely given, individual which includes, but not limited to, social specific, informed indication of will, whereby the data security numbers, previous or current health records, subject agrees to the collection and processing of personal licenses or its denials, suspension or revocation, and information about and/or relating to him or her. Consent tax returns; and shall be evidenced by written, electronic or recorded 4. 4. Specifically established by an executive order or means. It may also be given on behalf of the data subject an act of Congress to be kept classified. by an agent specifically authorized by the data subject to do Sec 4. Scope so. c. Data subject refers to an individual whose personal This Act applies to the processing of all types of personal information information is processed. and to any natural and juridical person involved in personal information d. Direct marketing refers to communication by whatever processing including those personal information controllers and means of any advertising or marketing material which is processors who, although not found or established in the Philippines, directed to particular individuals. use equipment that are located in the Philippines, or those who e. Filing system refers to any act of information relating to maintain an office, branch or agency in the Philippines subject to the natural or juridical persons to the extent that, although the immediately succeeding paragraph: Provided, That the requirements of information is not processed by equipment operating Section 5 are complied with. automatically in response to instructions given for that This Act does not apply to the following: purpose, the set is structured, either by reference to a. Information about any individual who is or was an officer or individuals or by reference to criteria relating to individuals, employee of a government institution that relates to the in such a way that specific information relating to a position or functions of the individual, including: particular person is readily accessible. 1. The fact that the individual is or was an officer or f. Information and Communications System refers to a system employee of the government institution; for generating, sending, receiving, storing or otherwise 2. The title, business address and office telephone processing electronic data messages or electronic number of the individual; documents and includes the computer system or other 3. The classification, salary range and responsibilities of similar device by or which data is recorded, transmitted or the position held by the individual; and stored and any procedure related to the recording, 4. The name of the individual on a document prepared transmission or storage of electronic data, electronic by the individual in the course of employment with the message, or electronic document. government; g. Personal information refers to any information whether b. Information about an individual who is or was performing recorded in a material form or not, from which the identity of service under contract for a government institution that an individual is apparent or can be reasonably and directly relates to the services performed, including the terms of the ascertained by the entity holding the information, or when contract, and the name of the individual given in the course put together with other information would directly and of the performance of those services; certainly identify an individual. MedPers Block 1 Module 2 Basic Medical Ethics and Professionalism 2 of 20  c. Information relating to any discretionary benefit of a b. Receive complaints, institute investigations, facilitate or financial nature such as the granting of a license or permit enable settlement of complaints through the use of given by the government to an individual, including the alternative dispute resolution processes, adjudicate, award name of the individual and the exact nature of the benefit; indemnity on matters affecting any personal information, d. Personal information processed for journalistic, artistic, prepare reports on disposition of complaints and resolution literary or research purposes; of any investigation it initiates, and, in cases it deems e. Information necessary in order to carry out the functions of appropriate, publicize any such report: Provided, That in public authority which includes the processing of personal resolving any complaint or investigation (except where data for the performance by the independent, central amicable settlement is reached by the parties), the monetary authority and law enforcement and regulatory Commission shall act as a collegial body. For this purpose, agencies of their constitutionally and statutorily mandated the Commission may be given access to personal functions. Nothing in this Act shall be construed as to have information that is subject of any complaint and to collect amended or repealed Republic Act No. 1405, otherwise the information necessary to perform its functions under this known as the Secrecy of Bank Deposits Act; Republic Act Act; No. 6426, otherwise known as the Foreign Currency c. Issue cease and desist orders, impose a temporary or Deposit Act; and Republic Act No. 9510, otherwise known permanent ban on the processing of personal information, as the Credit Information System Act (CISA); upon finding that the processing will be detrimental to f. Information necessary for banks and other financial national security and public interest; institutions under the jurisdiction of the independent, central d. Compel or petition any entity, government agency or monetary authority or Bangko Sentral ng Pilipinas to comply instrumentality to abide by its orders or take action on a with Republic Act No. 9510, and Republic Act No. 9160, as matter affecting data privacy; amended, otherwise known as the Anti-Money Laundering e. Monitor the compliance of other government agencies or Act and other applicable laws; and instrumentalities on their security and technical measures g. Personal information originally collected from residents of and recommend the necessary action in order to meet foreign jurisdictions in accordance with the laws of those minimum standards for protection of personal information foreign jurisdictions, including any applicable data privacy pursuant to this Act; laws, which is being processed in the Philippines. f. Coordinate with other government agencies and the private sector on efforts to formulate and implement plans and Sec 5. Protection Afforded to Journalists and Their Sources policies to strengthen the protection of personal information Nothing in this Act shall be construed as to have amended or in the country; repealed the provisions of Republic Act No. 53, which affords the g. Publish on a regular basis a guide to all laws relating to publishers, editors or duly accredited reporters of any newspaper, data protection; magazine or periodical of general circulation protection from being h. Publish a compilation of agency system of records and compelled to reveal the source of any news report or information notices, including index and other finding aids; appearing in said publication which was related in any confidence i. Recommend to the Department of Justice (DOJ) the to such publisher, editor, or reporter. prosecution and imposition of penalties specified in Sec 6. Extraterritorial Application Sections 25 to 29 of this Act; This Act applies to an act done or practice engaged in and outside of j. Review, approve, reject or require modification of privacy the Philippines by an entity if: codes voluntarily adhered to by personal information a. The act, practice or processing relates to personal controllers: Provided, That the privacy codes shall adhere information about a Philippine citizen or a resident; to the underlying data privacy principles embodied in this b. The entity has a link with the Philippines, and the entity is Act: Provided, further, That such privacy codes may include processing personal information in the Philippines or even if private dispute resolution mechanisms for complaints the processing is outside the Philippines as long as it is against any participating personal information controller. For about Philippine citizens or residents such as, but not this purpose, the Commission shall consult with relevant limited to, the following: regulatory agencies in the formulation and administration of 1. A contract is entered in the Philippines; privacy codes applying the standards set out in this Act, 2. A juridical entity unincorporated in the Philippines but with respect to the persons, entities, business activities and has central management and control in the country; business sectors that said regulatory bodies are authorized and to principally regulate pursuant to the law: Provided, finally. 3. An entity that has a branch, agency, office or That the Commission may review such privacy codes and subsidiary in the Philippines and the parent or affiliate require changes thereto for purposes of complying with this of the Philippine entity has access to personal Act; information; and k. Provide assistance on matters relating to privacy or data c. The entity has other links in the Philippines such as, but not protection at the request of a national or local agency, a limited to: private entity or any person; 1. The entity carries on business in the Philippines; and l. Comment on the implication on data privacy of proposed 2. The personal information was collected or held by an national or local statutes, regulations or procedures, issue entity in the Philippines. advisory opinions and interpret the provisions of this Act and other data privacy laws; CHAPTER II. THE NATIONAL PRIVACY COMMISSION m. Propose legislation, amendments or modifications to Sec 7. Functions of the National Privacy Commission Philippine laws on privacy or data protection as may be necessary; To administer and implement the provisions of this Act, and to monitor n. Ensure proper and effective coordination with data privacy and ensure compliance of the country with international standards set regulators in other countries and private accountability for data protection, there is hereby created an independent body to be agents, participate in international and regional initiatives known as the National Privacy Commission, winch shall have the for data privacy protection; following functions: o. Negotiate and contract with other data privacy authorities of a. Ensure compliance of personal information controllers with other countries for cross-border application and the provisions of this Act; implementation of respective privacy laws; MedPers Block 1 Module 2 Basic Medical Ethics and Professionalism 3 of 20  p. Assist Philippine companies doing business abroad to c. Accurate, relevant and, where necessary for purposes for respond to foreign privacy or data protection laws and which it is to be used the processing of personal regulations; and information, kept up to date; inaccurate or incomplete data q. Generally, perform such acts as may be necessary to must be rectified, supplemented, destroyed or their further facilitate cross-border enforcement of data privacy processing restricted; protection. d. Adequate and not excessive in relation to the purposes for which they are collected and processed; Sec 8. Confidentiality e. Retained only for as long as necessary for the fulfillment of The Commission shall ensure at all times the confidentiality of any the purposes for which the data was obtained or for the personal information that comes to its knowledge and possession. establishment, exercise or defense of legal claims, or for legitimate business purposes, or as provided by law; and Sec. 9 Organizational Structure of the Commission f. Kept in a form which permits identification of data subjects The Commission shall be attached to the Department of for no longer than is necessary for the purposes for which Information and Communications Technology (DICT) and shall be the data were collected and processed: Provided, That headed by a Privacy Commissioner, who shall also act as personal information collected for other purposes may lie Chairman of the Commission. The Privacy Commissioner shall be processed for historical, statistical or scientific purposes, assisted by two (2) Deputy Privacy Commissioners, one to be and in cases laid down in law may be stored for longer responsible for Data Processing Systems and one to be periods: Provided, further,That adequate safeguards are responsible for Policies and Planning. The Privacy Commissioner guaranteed by said laws authorizing their processing. and the two (2) Deputy Privacy Commissioners shall be appointed The personal information controller must ensure implementation of by the President of the Philippines for a term of three (3) years, personal information processing principles set out herein. and may be reappointed for another term of three (3) years. Vacancies in the Commission shall be filled in the same manner in Sec 12. Criteria for Lawful Processing of Personal Information which the original appointment was made. The processing of personal information shall be permitted only if not The Privacy Commissioner must be at least thirty-five (35) years otherwise prohibited by law, and when at least one of the following of age and of good moral character, unquestionable integrity and conditions exists: known probity, and a recognized expert in the field of information a. The data subject has given his or her consent; technology and data privacy. The Privacy Commissioner shall b. The processing of personal information is necessary and is enjoy the benefits, privileges and emoluments equivalent to the related to the fulfillment of a contract with the data subject rank of Secretary. or in order to take steps at the request of the data subject The Deputy Privacy Commissioners must be recognized experts prior to entering into a contract; in the field of information and communications technology and c. The processing is necessary for compliance with a legal data privacy. They shall enjoy the benefits, privileges and obligation to which the personal information controller is emoluments equivalent to the rank of Undersecretary. subject; The Privacy Commissioner, the Deputy Commissioners, or any d. The processing is necessary to protect vitally important person acting on their behalf or under their direction, shall not be interests of the data subject, including life and health; civilly liable for acts done in good faith in the performance of their e. The processing is necessary in order to respond to national duties. However, he or she shall be liable for willful or negligent emergency, to comply with the requirements of public order acts done by him or her which are contrary to law, morals, public and safety, or to fulfill functions of public authority which policy and good customs even if he or she acted under orders or necessarily includes the processing of personal data for the instructions of superiors: Provided, That in case a lawsuit is filed fulfillment of its mandate; or against such official on the subject of the performance of his or f. The processing is necessary for the purposes of the her duties, where such performance is lawful, he or she shall be legitimate interests pursued by the personal information reimbursed by the Commission for reasonable costs of litigation. controller or by a third party or parties to whom the data is Sec 10. The Secretariat disclosed, except where such interests are overridden by The Commission is hereby authorized to establish a Secretariat. fundamental rights and freedoms of the data subject which Majority of the members of the Secretariat must have served for require protection under the Philippine Constitution. at least five (5) years in any agency of the government that is Sec 13. Sensitive Personal Information and Privileged Information involved in the processing of personal information including, but The processing of sensitive personal information and privileged not limited to, the following offices: Social Security System (SSS), information shall be prohibited, except in the following cases: Government Service Insurance System (GSIS), Land a. The data subject has given his or her consent, specific to Transportation Office (LTO), Bureau of Internal Revenue (BIR), the purpose prior to the processing, or in the case of Philippine Health Insurance Corporation (PhilHealth), Commission privileged information, all parties to the exchange have on Elections (COMELEC), Department of Foreign Affairs (DFA), given their consent prior to processing; Department of Justice (DOJ), and Philippine Postal Corporation b. The processing of the same is provided for by existing laws (Philpost). and regulations: Provided, That such regulatory enactments guarantee the protection of the sensitive personal CHAPTER III. PROCESSING OF PERSONAL INFORMATION information and the privileged information: Provided, further, Sec 11. General Data Privacy Principles That the consent of the data subjects are not required by The processing of personal information shall be allowed, subject to law or regulation permitting the processing of the sensitive compliance with the requirements of this Act and other laws allowing personal information or the privileged information; disclosure of information to the public and adherence to the principles c. The processing is necessary to protect the life and health of of transparency, legitimate purpose and proportionality. the data subject or another person, and the data subject is Personal information must, be: not legally or physically able to express his or her consent a. Collected for specified and legitimate purposes determined prior to the processing; and declared before, or as soon as reasonably practicable d. The processing is necessary to achieve the lawful and after collection, and later processed in a way compatible noncommercial objectives of public organizations and their with such declared, specified and legitimate purposes only; associations: Provided, That such processing is only b. Processed fairly and lawfully; confined and related to the bona fide members of these organizations or their associations: Provided, further, That MedPers Block 1 Module 2 Basic Medical Ethics and Professionalism 4 of 20  the sensitive personal information are not transferred to 1. Contents of his or her personal information that were third parties: Provided, finally, That consent of the data processed; subject was obtained prior to processing; 2. Sources from which personal information were e. The processing is necessary for purposes of medical obtained; treatment, is carried out by a medical practitioner or a 3. Names and addresses of recipients of the personal medical treatment institution, and an adequate level of information; protection of personal information is ensured; or 4. Manner by which such data were processed; f. The processing concerns such personal information as is 5. Reasons for the disclosure of the personal necessary for the protection of lawful rights and interests of information to recipients; natural or legal persons in court proceedings, or the 6. Information on automated processes where the data establishment, exercise or defense of legal claims, or when will or likely to be made as the sole basis for any provided to government or public authority. decision significantly affecting or will affect the data subject; Sec 14. Subcontract of Personal Information 7. Date when his or her personal information concerning A personal information controller may subcontract the processing of the data subject were last accessed and modified; personal information: Provided, That the personal information controller and shall be responsible for ensuring that proper safeguards are in place to 8. The designation, or name or identity and address of ensure the confidentiality of the personal information processed, the personal information controller; prevent its use for unauthorized purposes, and generally, comply with d. Dispute the inaccuracy or error in the personal information the requirements of this Act and other laws for processing of personal and have the personal information controller correct it information. The personal information processor shall comply with all immediately and accordingly, unless the request is the requirements of this Act and other applicable laws. vexatious or otherwise unreasonable. If the personal Sec 15. Extension of Privileged Communication information have been corrected, the personal information Personal information controllers may invoke the principle of privileged controller shall ensure the accessibility of both the new and communication over privileged information that they lawfully control or the retracted information and the simultaneous receipt of process. Subject to existing laws and regulations, any evidence the new and the retracted information by recipients thereof: gathered on privileged information is inadmissible. Provided, That the third parties who have previously received such processed personal information shall he CHAPTER IV. RIGHTS OF THE DATA SUBJECT informed of its inaccuracy and its rectification upon Sec 16. Rights of the Data Subject reasonable request of the data subject; e. Suspend, withdraw or order the blocking, removal or The data subject is entitled to: destruction of his or her personal information from the a. Be informed whether personal information pertaining to him personal information controller’s filing system upon or her shall be, are being or have been processed; discovery and substantial proof that the personal b. Be furnished the information indicated hereunder before the information are incomplete, outdated, false, unlawfully entry of his or her personal information into the processing obtained, used for unauthorized purposes or are no longer system of the personal information controller, or at the next necessary for the purposes for which they were collected. practical opportunity: In this case, the personal information controller may notify 1. Description of the personal information to be entered third parties who have previously received such processed into the system; personal information; and 2. Purposes for which they are being or are to be f. Be indemnified for any damages sustained due to such processed; inaccurate, incomplete, outdated, false, unlawfully obtained 3. Scope and method of the personal information or unauthorized use of personal information. processing; 4. The recipients or classes of recipients to whom they Sec 17. Transmissibility of Rights of the Data Subject are or may be disclosed; The lawful heirs and assigns of the data subject may invoke the rights 5. Methods utilized for automated access, if the same is of the data subject for, which he or she is an heir or assignee at any allowed by the data subject, and the extent to which time after the death of the data subject or when the data subject is such access is authorized; incapacitated or incapable of exercising the rights as enumerated in 6. The identity and contact details of the personal the immediately preceding section. information controller or its representative; 7. The period for which the information will be stored; Sec. 18 Right to Data Portability and The data subject shall have the right, where personal information is 8. The existence of their rights, i.e., to access, processed by electronic means and in a structured and commonly correction, as well as the right to lodge a complaint used format, to obtain from the personal information controller a copy before the Commission. of data undergoing processing in an electronic or structured format, 9. Any information supplied or declaration made to the which is commonly used and allows for further use by the data subject. data subject on these matters shall not be amended The Commission may specify the electronic format referred to above, without prior notification of data subject: Provided, as well as the technical standards, modalities and procedures for their That the notification under subsection (b) shall not transfer. apply should the personal information be needed Sec. 19 Non-Applicability pursuant to a subpoena or when the collection and The immediately preceding sections are not applicable if the processed processing are for obvious purposes, including when personal information are used only for the needs of scientific and it is necessary for the performance of or in relation to statistical research and, on the basis of such, no activities are carried a contract or service or when necessary or desirable out and no decisions are taken regarding the data subject: Provided, in the context of an employer-employee relationship, That the personal information shall be held under strict confidentiality between the collector and the data subject, or when and shall be used only for the declared purpose. Likewise, the the information is being collected and processed as a immediately preceding sections are not applicable to processing of result of legal obligation; personal information gathered for the purpose of investigations in c. Reasonable access to, upon demand, the following: relation to any criminal, administrative or tax liabilities of a data subject. MedPers Block 1 Module 2 Basic Medical Ethics and Professionalism 5 of 20  CHAPTER V. SECURITY OF PERSONAL INFORMATION CHAPTER VI. ACCOUNTABILITY FOR TRANSFER OF PERSONAL INFORMATION Sec 20. Security of Personal Information a. The personal information controller must implement reasonable Sec 21. Principle of Accountability and appropriate organizational, physical and technical measures Each personal information controller is responsible for personal intended for the protection of personal information against any information under its control or custody, including information that have accidental or unlawful destruction, alteration and disclosure, as been transferred to a third party for processing, whether domestically well as against any other unlawful processing. or internationally, subject to cross-border arrangement and b. The personal information controller shall implement reasonable cooperation. and appropriate measures to protect personal information against a. The personal information controller is accountable for complying natural dangers such as accidental loss or destruction, and with the requirements of this Act and shall use contractual or human dangers such as unlawful access, fraudulent misuse, other reasonable means to provide a comparable level of unlawful destruction, alteration and contamination. protection while the information are being processed by a third c. The determination of the appropriate level of security under this party. section must take into account the nature of the personal b. The personal information controller shall designate an individual information to be protected, the risks represented by the or individuals who are accountable for the organization’s processing, the size of the organization and complexity of its compliance with this Act. The identity of the individual(s) so operations, current data privacy best practices and the cost of designated shall be made known to any data subject upon security implementation. Subject to guidelines as the Commission request. may issue from time to time, the measures implemented must CHAPTER VII. SECURITY OF SENSITIVE PERSONAL include: INFORMATION IN GOVERNMENT 1. Safeguards to protect its computer network against accidental, unlawful or unauthorized usage or interference Sec 22. Responsibility of Head of Agencies with or hindering of their functioning or availability; All sensitive personal information maintained by the government, its 2. A security policy with respect to the processing of personal agencies and instrumentalities shall be secured, as far as practicable, information; with the use of the most appropriate standard recognized by the 3. A process for identifying and accessing reasonably information and communications technology industry, and as foreseeable vulnerabilities in its computer networks, and for recommended by the Commission. The head of each government taking preventive, corrective and mitigating action against agency or instrumentality shall be responsible for complying with the security incidents that can lead to a security breach; and security requirements mentioned herein while the Commission shall 4. Regular monitoring for security breaches and a process for monitor the compliance and may recommend the necessary action in taking preventive, corrective and mitigating action against order to satisfy the minimum standards. security incidents that can lead to a security breach. d. The personal information controller must further ensure that third Sec 23. Requirements Relating to Access by Agency Personnel to parties processing personal information on its behalf shall Sensitive Personal Information implement the security measures required by this provision. a. On-site and Online Access – Except as may be allowed through e. The employees, agents or representatives of a personal guidelines to be issued by the Commission, no employee of the information controller who are involved in the processing of government shall have access to sensitive personal information personal information shall operate and hold personal information on government property or through online facilities unless the under strict confidentiality if the personal information are not employee has received a security clearance from the head of the intended for public disclosure. This obligation shall continue even source agency. after leaving the public service, transfer to another position or b. Off-site Access – Unless otherwise provided in guidelines to be upon termination of employment or contractual relations. issued by the Commission, sensitive personal information f. The personal information controller shall promptly notify the maintained by an agency may not be transported or accessed Commission and affected data subjects when sensitive personal from a location off government property unless a request for such information or other information that may, under the transportation or access is submitted and approved by the head circumstances, be used to enable identity fraud are reasonably of the agency in accordance with the following guidelines: believed to have been acquired by an unauthorized person, and 1. Deadline for Approval or Disapproval – In the case of any the personal information controller or the Commission believes request submitted to the head of an agency, such head of (bat such unauthorized acquisition is likely to give rise to a real the agency shall approve or disapprove the request within risk of serious harm to any affected data subject. The notification two (2) business days after the date of submission of the shall at least describe the nature of the breach, the sensitive request. In case there is no action by the head of the personal information possibly involved, and the measures taken agency, then such request is considered disapproved; by the entity to address the breach. Notification may be delayed 2. Limitation to One thousand (1,000) Records – If a request is only to the extent necessary to determine the scope of the approved, the head of the agency shall limit the access to breach, to prevent further disclosures, or to restore reasonable not more than one thousand (1,000) records at a time; and integrity to the information and communications system. 3. (3) Encryption – Any technology used to store, transport or 1. In evaluating if notification is unwarranted, the Commission access sensitive personal information for purposes of may take into account compliance by the personal off-site access approved under this subsection shall be information controller with this section and existence of secured by the use of the most secure encryption standard good faith in the acquisition of personal information. recognized by the Commission. 2. The Commission may exempt a personal information The requirements of this subsection shall be controller from notification where, in its reasonable implemented not later than six (6) months after the judgment, such notification would not be in the public date of the enactment of this Act. interest or in the interests of the affected data subjects. 3. The Commission may authorize postponement of Sec 24. Applicability to Government Contractors notification where it may hinder the progress of a criminal In entering into any contract that may involve accessing or requiring investigation related to a serious breach. sensitive personal information from one thousand (1,000) or more individuals, an agency shall require a contractor and its employees to register their personal information processing system with the Commission in accordance with this Act and to comply with the other MedPers Block 1 Module 2 Basic Medical Ethics and Professionalism 6 of 20 provisions of this Act including the immediately preceding section, in years to seven (7) years and a fine of not less than Five hundred the same manner as agencies and government employees comply with thousand pesos (Php500,000.00) but not more than Two million such requirements. pesos (Php2,000,000.00) shall be imposed on persons processing sensitive personal information for purposes not CHAPTER VIII. PENALTIES authorized by the data subject, or otherwise authorized under this Sec. 25 Unauthorized Processing of Personal Information and Act or under existing laws. Sensitive Personal Information The unauthorized processing of personal information shall be Sec 29. Unintentional Access or Intentional Breach penalized by imprisonment ranging from one (1) year to three (3) The penalty of imprisonment ranging from one (1) year to three years and a fine of not less than Five hundred thousand pesos (3) years and a fine of not less than Five hundred thousand pesos (Php500,000.00) but not more than Two million pesos (Php500,000.00) but not more than Two million pesos (Php2,000,000.00) shall be imposed on persons who process (Php2,000,000.00) shall be imposed on persons who knowingly personal information without the consent of the data subject, or and unlawfully, or violating data confidentiality and security data without being authorized under this Act or any existing law. systems, breaks in any way into any system where personal and The unauthorized processing of personal sensitive information sensitive personal information is stored. shall be penalized by imprisonment ranging from three (3) years to six (6) years and a fine of not less than Five hundred thousand Sec 30. Concealment of Security Breaches Involving Sensitive pesos (Php500,000.00) but not more than Four million pesos Personal Information (Php4,000,000.00) shall be imposed on persons who process The penalty of imprisonment of one (1) year and six (6) months to personal information without the consent of the data subject, or five (5) years and a fine of not less than Five hundred thousand without being authorized under this Act or any existing law. pesos (Php500,000.00) but not more than One million pesos Sec 26. Accessing Personal Information and Sensitive Personal (Php1,000,000.00) shall be imposed on persons who, after having Information Due to Negligence knowledge of a security breach and of the obligation to notify the Commission pursuant to Section 20(f), intentionally or by Accessing personal information due to negligence shall be omission conceals the fact of such security breach. penalized by imprisonment ranging from one (1) year to three (3) years and a fine of not less than Five hundred thousand pesos Sec 31. Malicious Disclosure (Php500,000.00) but not more than Two million pesos Any personal information controller or personal information (Php2,000,000.00) shall be imposed on persons who, due to processor or any of its officials, employees or agents, who, with negligence, provided access to personal information without being malice or in bad faith, discloses unwarranted or false information authorized under this Act or any existing law. relative to any personal information or personal sensitive Accessing sensitive personal information due to negligence shall information obtained by him or her, shall be subject to be penalized by imprisonment ranging from three (3) years to six imprisonment ranging from one (1) year and six (6) months to five (6) years and a fine of not less than Five hundred thousand pesos (5) years and a fine of not less than Five hundred thousand pesos (Php500,000.00) but not more than Four million pesos (Php500,000.00) but not more than One million pesos (Php4,000,000.00) shall be imposed on persons who, due to (Php1,000,000.00). negligence, provided access to personal information without being authorized under this Act or any existing law. Sec 32. Unauthorized Disclosure Any personal information controller or personal information Sec 27. Improper Disposal of Personal Information and Sensitive processor or any of its officials, employees or agents, who Personal Information. discloses to a third party personal information not covered by the The improper disposal of personal information shall be penalized immediately preceding section without the consent of the data by imprisonment ranging from six (6) months to two (2) years and subject, shall he subject to imprisonment ranging from one (1) a fine of not less than One hundred thousand pesos year to three (3) years and a fine of not less than Five hundred (Php100,000.00) but not more than Five hundred thousand pesos thousand pesos (Php500,000.00) but not more than One million (Php500,000.00) shall be imposed on persons who knowingly or pesos (Php1,000,000.00). negligently dispose, discard or abandon the personal information Any personal information controller or personal information of an individual in an area accessible to the public or has processor or any of its officials, employees or agents, who otherwise placed the personal information of an individual in its discloses to a third party sensitive personal information not container for trash collection. covered by the immediately preceding section without the consent The improper disposal of sensitive personal information shall be of the data subject, shall be subject to imprisonment ranging from penalized by imprisonment ranging from one (1) year to three (3) three (3) years to five (5) years and a fine of not less than Five years and a fine of not less than One hundred thousand pesos hundred thousand pesos (Php500,000.00) but not more than Two (Php100,000.00) but not more than One million pesos million pesos (Php2,000,000.00). (Php1,000,000.00) shall be imposed on persons who knowingly or negligently dispose, discard or abandon the personal information Sec 33. Combination or Series of Acts of an individual in an area accessible to the public or has Any combination or series of acts as defined in Sections 25 to 32 otherwise placed the personal information of an individual in its shall make the person subject to imprisonment ranging from three container for trash collection. (3) years to six (6) years and a fine of not less than One million pesos (Php1,000,000.00) but not more than Five million pesos Sec 28. Processing of Personal Information and Sensitive (Php5,000,000.00). Personal Information for Unauthorized Purposes The processing of personal information for unauthorized purposes Sec 34. Extent of Liability shall be penalized by imprisonment ranging from one (1) year and If the offender is a corporation, partnership or any juridical person, six (6) months to five (5) years and a fine of not less than Five the penalty shall be imposed upon the responsible officers, as the hundred thousand pesos (Php500,000.00) but not more than One case may be, who participated in, or by their gross negligence, million pesos (Php1,000,000.00) shall be imposed on persons allowed the commission of the crime. If the offender is a juridical processing personal information for purposes not authorized by person, the court may suspend or revoke any of its rights under the data subject, or otherwise authorized under this Act or under this Act. If the offender is an alien, he or she shall, in addition to existing laws. the penalties herein prescribed, be deported without further The processing of sensitive personal information for unauthorized proceedings after serving the penalties prescribed. If the offender purposes shall be penalized by imprisonment ranging from two (2) is a public official or employee and lie or she is found guilty of acts MedPers Block 1 Module 2 Basic Medical Ethics and Professionalism 7 of 20  penalized under Sections 27 and 28 of this Act, he or she shall, in Sec 45. Effectivity Clause addition to the penalties prescribed herein, suffer perpetual or This Act shall take effect fifteen (15) days after its publication in at temporary absolute disqualification from office, as the case may least two (2) national newspapers of general circulation. be. CODE OF ETHICS OF THE MEDICAL PROFESSION Sec 35. Large-Scale (JOINTLY ADOPTED ON SEPT 2019 - PRC AND PMA) The maximum penalty in the scale of penalties respectively PREAMBLE provided for the preceding offenses shall be imposed when the This Code of Ethics is promulgated to provide the physicians with personal information of at least one hundred (100) persons is proper ethical and professional standards in the practice of harmed, affected or involved as the result of the above mentioned Medicine to ensure the safety and welfare of patients. This Code actions. sets forth the fundamental ethical principles and the professional Sec 37. Offense Committed by Public Officer responsibilities of physicians towards patients, the healthcare When the offender or the person responsible for the offense is a system, the community, their colleagues and the profession, allied public officer as defined in the Administrative Code of the professionals and the health products industry. On entering the Philippines in the exercise of his or her duties, an accessory profession, a physician assumes the obligation of maintaining the penalty consisting in the disqualification to occupy public office for honorable tradition that confers the well-deserved title of a “friend a term double the term of criminal penalty imposed shall he of mankind”. The physician should cherish a proper pride in the applied. calling and conduct himself/herself in accordance with this Code and in the generally accepted principles of the International Code Sec 38. Restitution of Medical Ethics. Restitution for any aggrieved party shall be governed by the provisions of the New Civil Code. ARTICLE I. FUNDAMENTAL PRINCIPLES Respect for Life CHAPTER IX. MISCELLANEOUS PROVISIONS ○ The right to life is inviolable. Life is a necessary condition Sec 38. Interpretation for all other human goods. It must be protected and fostered at all its stages beginning from conception to its Any doubt in the interpretation of any provision of this Act shall be natural end liberally interpreted in a manner mindful of the rights and interests Principle of Respect for Person of the individual about whom personal information is processed. ○ Every person has an intrinsic worth and dignity. Trust shall Sec 39. Implementing Rules and Regulations (IRR) be central to the physician-patient relationship. Physicians Within ninety (90) days from the effectivity of this Act, the shall respect patient autonomy. Commission shall promulgate the rules and regulations to Principle of social justice effectively implement the provisions of this Act. ○ All patients have a right to basic healthcare and a just process in the allocation of resources. Sec 40. Reports and Information Principle of Beneficence The Commission shall annually report to the President and ○ The interest of the patient shall be placed above those of Congress on its activities in carrying out the provisions of this Act. the physician. Societal pressures, financial gains and The Commission shall undertake whatever efforts it may administrative exigencies shall not compromise this determine to be necessary or appropriate to inform and educate principle. the public of data privacy, data protection and fair information Primum Non Nocere rights and responsibilities. ○ The foremost responsibility of the physician is to do no Sec 41. Appropriations Clause harm to the patient. The Commission shall be provided with an initial appropriation of ARTICLE II. GENERAL PRINCIPLES Twenty million pesos (Php20,000,000.00) to be drawn from the The general principles to guide the physicians in the practice of national government. Appropriations for the succeeding years their profession. shall be included in the General Appropriations Act. It shall 1. The primary objective of the practice of medicine is service likewise receive Ten million pesos (Php10,000,000.00) per year to mankind. for five (5) years upon implementation of this Act drawn from the 2. Physicians should be upright, diligent, sober, modest, national government. imbued with professionalism and well-versed in the science, Sec 42. Transitory Provision the art and the ethics of the profession. 3. Physicians shall promote the health of their patients as their Existing industries, businesses and offices affected by the primary consideration implementation of this Act shall be given one (1) year transitory 4. Physicians should fulfill the civic duties of a good citizen, period from the effectivity of the IRR or such other period as may must conform to the laws and cooperate with the proper be determined by the Commission, to comply with the authorities in the application of medical knowledge for the requirements of this Act. promotion of health and public safety. In case that the DICT has not yet been created by the time the 5. Physicians should work together in harmony and mutual law takes full force and effect, the National Privacy Commission respect. shall be attached to the Office of the President. 6. Physicians should cooperate with other healthcare Sec 43. Separability Clause professionals in the context of inter-professional and If any provision or part hereof is held invalid or unconstitutional, collaborative practice in support of better healthcare. the remainder of the law or the provision not otherwise affected 7. Physicians, although they have certain rights in relation to shall remain valid and subsisting. their patients, shall always observe the dictum service beyond call of duty. Sec 44. Repealing Clause The provision of Section 7 of Republic Act No. 9372, otherwise ARTICLE III. PROFESSIONAL RESPONSIBILITIES TO PATIENTS known as the “Human Security Act of 2007”, is hereby amended. Physicians' responsibilities to patients: Except as otherwise expressly provided in this Act, all other laws, 1. Professional Competence. Physicians shall be committed to decrees, executive orders, proclamations and administrative lifelong learning and dedicated to providing holistic, regulations or parts thereof inconsistent herewith are hereby competent, compassionate medical care while upholding repealed or modified accordingly. MedPers Block 1 Module 2 Basic Medical Ethics and Professionalism 8 of 20  the highest professional and ethical standards and respect 9. Decorum and Behavior of a Physician. for human dignity. a. he physician shall be free to choose whom they 2. Patients' Trust. Physicians shall maintain a fiduciary will serve, except in cases of emergency; relationship with their patients by displaying competence, b. The physician shall demonstrate professionalism reliability, integrity and open communication. at all times when dealing with patients; 3. Human Dignity. Physicians shall be compassionate and c. The physician shall demonstrate humility, empathy approach patients in a courteous and professional manner. and compassion toward patients; Physicians shall conduct physical examinations in a d. The physician shall attend to patients within the modest, caring and gender-sensitive manner. Physicians limits of his capabilities; shall ensure that free and informed consent by the patients e. The physician shall respect the patient's right to and precautions to preserve patients' dignity and anonymity seek a second opinion; prevail at all times. f. The physician shall not exploit patients for any 4. Professional Fees. The physician shall ensure that personal gain. professional fees are reasonable and commensurate to the ARTICLE IV. PROFESSIONAL RESPONSIBILITIES TO THE services rendered, nature of the case, time consumed, risk HEALTH CARE SYSTEM involved, professional standing of the physician, and the Physicians' responsibility to the health care system: financial status of the patient. a. Improving Quality of Care. Physicians shall be dedicated to 5. Disclosure. Physicians shall exercise good faith, honesty, continuous improvement in the quality of healthcare. This and tact in expressing opinions as to diagnosis, treatment entails maintaining clinical competence through lifelong options, risks involved and prognosis to a patient under study and working collaboratively with other professionals their care. Physician shall neither conceal, understate nor to enhance patient safety, optimize outcomes of care, and exaggerate the patient's condition. Timely notice of the the proper use of healthcare resources. Physicians shall worsening condition of the patient shall be revealed to actively participate in the development and application of him/her and/or his/her family. When foreseen and better measures of quality of care. unforeseen complications arise during treatment, patients b. Improving access to care. Physicians must contribute to should be properly informed. Analysis of the cause of the improving access to equitable healthcare by providing complication shall provide the basis for appropriate appropriate medical services within the different levels of prevention and treatment strategies. The physician shall the healthcare system, in both the public and private inform the patient about the need for referral to an sectors. appropriate specialist in serious or difficult cases, or when c. Cost-effective management of limited healthcare resources. the circumstances of the patient or the family so demand or Physicians should place paramount consideration on the justify. The physician shall make sure that all cost of diagnostic tests and procedures, and of communications regarding diagnosis and treatment are management and treatment modalities recommended. understood by the patient and accompanying relatives. Physicians shall avoid superfluous tests and procedures, Physicians shall compose, understandable, legible and unnecessary medical services, unproven remedies, which useful, written communications, i.e. chart notes, discharge expose patients to possible harm, additional expense and summaries, treatment plans, referrals and patient inappropriate utilization of limited resources. instructions. d. Research. Physicians should obtain the approval of the 6. Autonomy. A physician shall obtain voluntary informed Institutional Review Board or Institutional Ethics Board consent prior to performing any procedure or treatment. before conducting any form of research, while operating in The patient's decision must be based on his/her free will accordance with national and/or local regulations, as well and choice. The physician shall provide all relevant as with International Council on Harmonization (ICH) Good information in a simple and understandable manner leading Clinical Practices (GCPs) guidelines. The physician patients to either accept or refuse a proposed action. The participating as principal investigator shall exercise full physician shall inform the patient about the consequences disclosure and ensure that patients/participants are well of his/her choices. When a patient is incompetent to decide, informed about the difference between physician-patient the consent must be given by the next of kin, or his/her relationship in clinical practice and patient participation in legally authorized representative. any form of research. 7. Privacy and Confidentiality. The physician shall hold as The physician as a researcher should ensure that the research private and highly confidential whatever may be discovered shall be scientifically sound and must meet the following criteria: or learned pertinent to the patient even after death, except 1. The objectives of the research shall be relevant; when required by law, ordinance or administrative order in 2. There shall be sufficient proof of the concept tested; the promotion of justice, safety and public health. The 3. Results shall contribute to the solution of the research commitment extends to discussion with persons acting on a problem; patient's behalf. Safeguards shall be applied especially 4. The research design is appropriate and feasible; when using electronic information systems for compiling 5. Research subjects shall be exposed to minimal risks in patient data, and when dealing with genetic information. relation to any benefits that might result from the research; 8. Emergent Cases. In an emergency, provided there is no risk 6. Research results that improve patient care shall be shared to his or her safety, a physician shall administer at least first with colleagues in the health profession. aid treatment and then refer the patient to a more competent physician and appropriate facility if necessary. ARTICLE V. PROFESSIONAL RESPONSIBILITIES TO THE a. In emergencies, when a decision must be made COMMUNITY urgently, when the patient is not able to participate in The physicians' responsibility to the community: decision making, and the patient's kin/authorized a. Government. Physicians shall assist the State by: representative is not available, physicians may initiate 1. Participating in the formulation and proper treatment without prior informed consent in such implementation of health policies; situations provided that the physicians should inform 2. Acting as expert witness or amicus curae when the patient/authorized representative at the earliest requested in the administration of justice; opportunity and obtain consent for ongoing treatment, 3. Providing up-to-date and accurate information on and document the informed consent in the medical health issues. record of the patient. 4. Assisting in the promotion of health and safety. MedPers Block 1 Module 2 Basic Medical Ethics and Professionalism 9 of 20  b. Duly Constituted Health Authorities. Physicians shall c. Professional Decorum. A physician shall practice cooperate with the duly constituted health authorities by: self-regulation and be upright, diligent, sober, and modest 1. Educating the community, enforcing measures for the when dealing with the public. He shall be well-groomed and prevention, promotion, management, and dressed appropriately in the workplace. He shall avoid rehabilitation, in accordance with existing laws, rules, using offensive language. and regulations; ARTICLE VII. PROFESSIONAL RESPONSIBILITIES TO 2. Attending to victims in times of epidemic and COLLEAGUES IN THE MEDICAL PROFESSION calamity, except when his/her personal safety is at Physicians' responsibilities to their colleagues in the medical stake; profession. 3. Increasing the level of awareness of the public and a. Protecting the good name of a colleague. Physicians should the duly constituted health authorities on the dangers strive to protect the good name of colleagues. However, of communicable and non-communicable diseases; when complaints are brought to one's attention, the c. Protection against unlicensed practitioners. It is physician is duty bound to refer such complaints to the unprofessional for physicians to aid and abet the practice of proper forum for resolution. the medical profession by unqualified and unregistered b. Professional Courtesy to Colleagues. A physician shall individuals. Physicians have the duty and obligation to provide courtesy to colleagues and waive his professional expose and report to the proper government agencies fee when providing essential and evidence-based medical unlicensed medical practitioners, charlatans and quacks, for care to colleagues, spouse, minor and disabled children, the protection of the public. and parents. This includes waiving the professional fees in d. Promotion of Practice. Physicians shall be involved in the package deals. promotion of the medical profession. c. Conflict Management among Physicians. Whenever there is 1. Physicians shall not employ agents in the solicitation an unsettled difference of opinions or conflicts among and recruitment of patients. physicians, it should be referred to the proper forum for due 2. For the promotion of medical practice, physicians process. The conflict may be settled within the Ethics may use professional cards, internet, directories and Committee/Commission of the following: signboards. 1. Department/s; 3. Signboards shall not exceed one by two (1x2) meters 2. Institution; in size However, these signboards may be placed by 3. Philippine Medical Association; physicians within the confines of his clinic or 4. Professional Regulation Commission. residence. d. Substitution for Suspended Patient Care. In cases where a 4. Signboards and internet postings should contain only physician has to suspend service in his clinic or hospital, he the name of the physician, field of specialty, office must make sure that the reliever or substitute physician hours and/or office or hospital affiliations. shall have similar qualifications and shall treat the patients 5. The act of physicians in publishing their personal with the same dedication and quality of care extended to his superiority, special certificates or diplomas, own patients. Moreover, the patient should be duly informed postgraduate training, specific methods of treatment, of the patient consents to the substitution including operative techniques is not allowed. However, these professional fees, the care of the patient should be retu