TRIGGER 4 & 5

PROFESSIONAL ETHICS, JURISPRUDENCE, AND CULTURAL SENSITIVITY - RA 7431 & ETHICAL ISSUES IN HEALTHCARE

RA 7431

RA 7431

AN ACT REGULATING THE PRACTICE OF RADIOLOGIC TECHNOLOGY IN THE PHILIPPINES, CREATING THE BOARD OF RADIOLOGIC TECHNOLOGY DEFINING ITS POWERS AND FUNCTIONS AND FOR OTHER PURPOSES

House Bill No. 34221 Senate Bill No. 1873

This Act which is a consolidation of:

April 22, 1992

When was RA 7431 approved by the President of the Philippines?

Corazon C. Aquino

President

This Act shall be known and cited as the "Radiologic Technology Act of 1992."

Sec 1. Title

Radiologic Technology Act of 1992.

RA 7431 otherwise known as the;

Sec. 2.

Statement of Policy.

Sec. 2. Statement of Policy.

It is the policy of the State to upgrade the practice of radiologic technology in the Philippines for the purpose of protecting the public from the hazards posed by radiation as well as to ensure safe and proper diagnosis, treatment and research through the application of machines and/or equipment using radiation.

Sec. 3.

Definition of Terms

X-ray technology

Is an auxiliary branch of radiology which deals with the technical application of x-rays as aid in the diagnosis of diseases and injuries

Radiologic technology

Is an auxiliary branch of radiology which deals with the technical application of radiation, such as x-rays, beta rays, gamma rays, ultrasound and radio frequency rays, in the diagnosis and treatment of diseases

X-ray technologist

Is a bona fide holder of a certificate of registration for x-ray technology issued by the Board of Radiologic Technology in accordance with this Act

Radiologic Technologist

Is a bona fide holder of a certificate of registration for radiologic technology issued by the Board of Radiologic Technology in accordance with this Act.

Radiology

Is a branch of medical science which deals with the use of radiation in the diagnosis, treatment and research of diseases.

Radiologist

Is a licensed physician who specializes in the diagnosis or treatment of disease with the use of radiation;

Medical physicist

Is a physicist who specializes in the application of the principles and techniques of physics in medicine

Board

Refers to the Board of Radiologic Technology

Commission

Refers to the Professional Regulation Commission created under Presidential Decree Numbered Two hundred and twenty-three

To upgrade the practice of radiologic technology for public protection

What is the policy of the State regarding the practice of radiologic technology in the Philippines?

Sec. 4

Practice Xray Technology

Sec. 4. Practice Xray Technology

• That under the law or laws governing their respective professions, they may perform the said acts;

• Provided, further, That no person shall use the title "X-ray Technologist" or any other title conveying the impression that he is an x-ray technologist without having been issued a certificate of registration as x-ray technologist by the Commission in the manner provided in this Act

Sec. 5. Practice of Radiology Technology

• Provided, That under the law or laws governing their respective professions, they may perform the said acts:

• Provided, further, That no person shall use the title "Radiologic Technologist" or any other title conveying the impression that he is a radiologist technologist without having been issued a certificate of registration as radiologic technologist by the Commission in the manner provided in this Act

Section 5

Practice of Radiology Technology

Sec. 6.

Creation of the Board of Radiologic Technology.

5

How many members are there in the Board of Radiologic Technology?

Board of Radiologic Technology

• composed of a Chairman and four (4) members

• The members include three radiologic technologists, one radiologist, and one medical physicist.

• Radiologic technologists, radiologist, and medical physicist

• with at least ten years of practice in their respective fields.

• Be a citizen and resident of the Philippines

What are the qualifications for members of the Board?

Sec. 7.

Qualifications of Board Members.

What is the term of office for members of the Board?

Three (3) years

Sec. 8.

Term of Office

Sec. 9.

Duties and functions of the Boards

What is the duty of the Board in relation to the practice of radiologic technology and technology?

• To enforce the provisions of the Act

• To administer oaths in accordance with the provisions of this Act

• To issue and, after due investigation, suspend or revoke certificates of registration for the practice of radiologic technology and x-ray technology

Sec. 10.

Compensation of the Board.

Sec. 10. Compensation of the Board.

The members of the Board shall each receive the same compensation as members of other Boards under the supervision of the Commission as provided for in the General Appropriations Act.

Sec. 11. Removal of Board Members.

Any member of the Board may be removed from office by the President upon the recommendation of the Commission for neglect of duty, incompetence or unprofessional, immoral, or dishonorable conduct, or commission or toleration of irregularities in the conduct of the examinations, after having been given the opportunity to defend himself in a proper administrative investigation conducted by the Commission

Sec. 11.

Removal of Board Members

Sec. 12

Supervision of the Board and Custody of its Records

Sec. 12. Supervision of the Board and Custody of its Records

The members of the Board shall be under the general supervision of the Commission. No record shall be removed, altered or examined without the prior authorization of the Board. All records, including examination papers, examination results, minutes of deliberation, records of administrative cases and investigations of the Board shall be kept by the Commission

Who is exempt from examination in Technology?

The first members of the Board of Radiologic Technology

What are the qualifications for examination under this Act?

• Filipino citizen

• Good moral character, and

• holder of a baccalaureate degree in radiologic technology

Sec. 13.

Rules and Regulations

Sec. 13. Rules and Regulations.

the Board shall set ethical and professional standards for the practice of radiologic technology and x-ray technology and adopt such rules and regulations as may be necessary to carry out the provisions of this Act. Such standards, rules and regulations shall take effect one (1) month after publication in any newspaper of general circulation

Sec. 14.

Annual Report.

Sec. 14. Annual Report.

The Board shall, at the end of each calendar year, submit to the Commission an annual report of its activities and proceedings during the year. Other information or data may be requested by the Commission as often as may be necessary and practicable.

Sec. 15.

Requirement for the Practice of Radiologic Technology and X-ray Technology

Sec. 15. Requirement for the Practice of Radiologic Technology and X-ray Technology

Unless exempt from the examinations under Sections 16 and 17 hereof, no person shall practice or offer to practice as a radiologic and/or x-ray technologist in the Philippines without having obtained the proper certificate of registration from the Board

Sec. 16.

Exemption from Examination in X-ray Technology

What subjects are covered in the examination in Radiologic Technology?

• Radiation Physics and

• Equipment Maintenance

• Radiobiology and Radiation Protection,

• Radiographic Positioning,

• Radiographic Technique,

• Special Procedures, Anatomy, Physiology and Medical Term

What is the penalty for practicing radiologic technology in the Philippines without a certificate of registration?

Fine of not less than Ten thousand pesos nor more than Forty thousand pesos or imprisonment of not less than one (1) year nor more than six (6) years, or both

Sec. 17.

Exemption from examination in Radiologic Technology

Sec. 18.

Examination Required

Sec. 19.

Qualifications for Examination

Sec. 20.

Scope of Examination in X-ray Technology

Sec. 21.

Scope of Examination in Radiologic Technology

Sec. 22.

Report of Ratings

What is the fee for application for examination?

350.00

When does this Act take effect?

One (1) month after its publication in any newspaper of general circulation

A candidate must obtain a weighted average of at least?

• 75% with no rating below 60% in any subject

Can an examinee, who obtains an average rating of 75% or higher but gets a rating below 60% in any subject, be allowed to take a reexamination?

• Yes

• An examinee who obtains an average rating of 75% or higher but gets a rating below 60% in any subject shall be allowed to take a reexamination in only those subjects in which he obtained a rating below 60%.

• taken in the next scheduled examination

Sec. 23

Oath-taking.

Sec. 24.

Issuance of Certificates of Registration

Sec. 25.

Fees

What is the fee for application for registration after passing the board examinations?

P250.00

What is the fee for application for registration without examination?

P250.00

What is the fee for application for replacement of lost or destroyed certificate of registration?

P100.00

What is the fee for reissuance of revoked certificate?

P100.00

Sec. 26.

Penal Provisions.

Sec. 27.

Appropriations.

Sec. 28.

Repealing Clause.

Sec. 30.

Effectivity Clause.

One of the most important ethical and legal issues in the field of healthcare:

• protection of private patient information

strictly confidential

• Conversations between a physician and a patient

What are the 3 distinct steps required for access to health services?

• Access to health services requires gaining entry to the system through insurance,

• accessing needed services, and

• finding a trusted provider.

What does HIPAA stand for?

Health Insurance Portability and Accountability Act

African men with syphilis participated in the Tuskegee Study of Untreated __________ in Negro Men

Syphilis

What is the primary goal of palliative care?

Palliative care focuses on improving the patient's quality of life, regardless of their condition or need for other therapies.

What is the primary characteristic of brain death?

• Absence of brain stem reflexes or cerebral motor responses,

• in addition to apnea and is irreversible.

What is the purpose of a 'comfort measures only' order?

prioritizes the patient's comfort and alleviation of distress through medications and other measures.

What is a characteristic of a patient in a coma?

• characterized by a lack of eye opening and sleep/wake cycles,

• with intact brain stem reflex responses.

INDIVIDUAL AND SOCIETAL RIGHTS

• EXAMPLE: PATIENT PRIVACY AND CONFIDENTIALITY

• The protection of private patient information is one of the most important ethical and legal issues in the field of healthcare

CULTURAL CONSIDERATIONS

• A health system must decrease geographic inequalities and must be culturally relevant to the population it serves.

• This should incorporate beliefs and traditions.

  • Language barriers.

  • Unfamiliarity with the concept of palliative care/hospice settings.

  • Distrust of health care services/clinicians.

  • Personal experiences/past trauma.

  • Religious differences.

  • Belief in alternative medicines.

  • Fear of the unknown

TECHNOLOGY AND SCARCE RESOURCES

• Health care resources are defined as all materials, personnel, facilities, funds, and anything else that can be used for providing health care services.

• Health care has long been a limited resource for which there has been an unlimited demand; everyone needs health care.

• EXAMPLE: In a third world nation, you only get the care you can afford.

Health care services are inherently scarce:

• money for services is not unlimited,

• facilities for delivering services are finite,

• and health care professionals are limited in time, geography and skills and capacities

ACCESS TO QUALITY HEALTH CARE

Every individual should have equitable access to health services. However, inappropriate financial barriers to health care do exist

Barriers to health services include:

• High cost of care

• Inadequate or no insurance coverage

• Lack of availability of services

• Lack of culturally competent care

HUMAN EXPERIMENTATION AND RESEARCH

• TUSKEGEE STUDY OF UNTREATED SYPHILIS IN NEGRO MEN

• DRUG TESTING

END OF LIFE ISSUES

• Resuscitation status

• Withholding and withdrawing medical therapies

• Palliative care

• Coma, vegetative state, and brain death

RESUSCITATION STATUS

• Each patient has a “code status” documented officially in the medical record by the attending physician.

  • FULL CODE

  • Do not resuscitate (DNR)

  • Do not intubate (DNI)

FULL CODE

– all appropriate efforts will be made to revive a patient after cardiopulmonary arrest

Do not resuscitate

– the predetermined decision to decline cardiopulmonary resuscitation, including defibrillation and pharmacologic cardioversion in case of respiratory arrest

Do not intubate

the predetermined decision to decline intubation for the purpose of subsequent mechanical ventilation in case of respiratory arrest

DNI

Do not intubate

DNR

Do not resuscitate

Withholding support

not initiating a treatment because it is not beneficial to the patient

Withdrawing support

the discontinuation of a treatment

Forgoing treatment

– the combination of both supports, in which disease progression is allowed to take its course.

An order of “comfort measures only” (CMO)

is written by the physician which means patients with this status receives medications for pain control or sedation or to otherwise eliminate distress

PALLIATIVE CARE

• “prevent and relieve suffering, and

• to support the best possible quality of life for patients and their families, regardless of their stage of condition or the need for other therapies.

• Key components are spirituality, family involvement, and non-tradiational therapies.

COMA, VEGETATIVE STAGE, AND BRAIN DEATH

These conditions involve unconsciousness and absent self-awareness but are distinct in terms of neurologic function

Coma

• a state of unconsciousness, without arousal or awareness characterized by a lack of eye opening and sleep/wake cycles with intact brain stem reflex responses;

• however no meaningful interaction with the environment occurs