MEDJURIS TERMS

Article 1305 of the New Civil Code

Which article of the New Civil Code defines a contract as a meeting of minds between two persons whereby one binds himself to give something or render some service?

Meeting of minds between two or more persons, an exchange of promises to do or not to do, and binding force without requiring a written form

What are the defining characteristics of a contract under Philippine law?

Intelligent, free, and spontaneous

What are the three requisites laid down by the Supreme Court for valid consent in a contract?

Consensual and fiduciary

What are the two fundamental characteristics of the physician-patient contract?

It is perfected by mere mutual consent of the parties without requiring any specific formal written agreement

What does it mean that a physician-patient contract is consensual in nature?

It is founded on mutual trust and confidence where the patient relies on the integrity and skill of the physician

What does it mean that a physician-patient contract is fiduciary in nature?

Consent, Object or Subject Matter, and Cause or Consideration

What are the three essential requisites of a physician-patient contractual relationship?

The medical service to be rendered

What is the object or subject matter in a physician-patient contract?

Determinate, legal, and not outside the commerce of man

What conditions must be met regarding the object or subject matter of a physician-patient contract?

Items that cannot be delivered or exchanged in commercial trade under normal working conditions, such as a cadaver

What does the phrase outside the commerce of man mean in medical jurisprudence?

The professional fee, or non-monetary considerations such as liberality, love, affection, gratuitousness, or recognition of medical practice as a service to humanity

What constitutes cause or consideration in a physician-patient relationship?

Cause or consideration is legally presumed to exist even in the absence of explicit monetary payment

How does the law treat cause or consideration when a physician provides care without charging a fee?

Gratis et amore

What Latin phrase describes medical services rendered for free out of love, affection, or pure liberality?

Non-payment of professional fees is not a valid defense against a charge of medical negligence or malpractice

Can a physician escape liability for negligence by proving that the service was rendered free of charge?

An express contract is explicitly stated in words, either orally or in writing, whereas an implied contract is inferred from the actions and conduct of the parties

What is the difference between an express contract and an implied contract in medical practice?

An implied contract

What type of physician-patient contract is created when an unconscious patient is brought to an emergency room and treated by an attending physician?

Stipulations must not be contrary to law, morals, good customs, public order, or public policy

What are the five general limitations placed on contractual stipulations between a physician and a patient?

Provisions that encourage or mandate mercy killing or euthanasia

What is an example of a contractual stipulation that is void for being contrary to morals?

A stipulation requiring a patient to broadcast false health information that threatens public peace and safety

What is an example of a contractual stipulation that is void for violating public order?

The exact moment when consent, object, and consideration concur, whether explicitly agreed upon or implied through actions such as giving medical advice or appointments

When does a physician-patient relationship commence?

It establishes the exact point in time when legal duties, obligations, and rights arise for both parties

Why is it legally crucial to determine when the physician-patient relationship commences?

Garcia-Rueda v Pascasio

Which Supreme Court case established that a physician must use at least the same level of care that any other reasonably competent physician would use under the same circumstances?

Guarantee that treatment will be successful, guarantee that treatment will benefit the patient, guarantee that treatment will cause no harm, and guarantee that the physician will not commit honest errors of judgment

Which four terms or guarantees are impliedly excluded from a physician-patient relationship unless explicitly stipulated?

Recovery of the patient, withdrawal of the physician, discharge by the patient, death of the patient, death or incapacity of the physician, fulfillment of the contracted service, cessation of emergency, expiration of the contract period, or mutual agreement

What are the recognized ways by which a physician-patient contractual relationship is terminated?

Obtaining the patient's consent to the withdrawal, and giving the patient ample notice and reasonable time to secure another physician

What are the two legal requisites for a physician to validly withdraw from a patient's care?

Unilateral severance of the physician-patient relationship by the physician without proper notice and without giving the patient reasonable time to secure another physician while continuous care is still required

What is the legal definition of patient abandonment?

It is automatically terminated because one party to the contract ceases to exist, though prior liabilities remain enforceable

What is the legal effect of the patient's death on the physician-patient contract?

Because the relationship is fiduciary and personal in nature, based on mutual trust and confidence that cannot survive the death or incapacity of the practitioner

Why does the death or incapacity of a physician automatically terminate the physician-patient contract?

Yes, provided the patient explicitly consents to the substitution agreement

Can a contract validly stipulate that a designated successor physician will take over upon the death or incapacity of the initial physician?

Pre-employment physical examinations, insurance eligibility assessments, court-ordered medical examinations, autopsies, and casual non-diagnostic conversations in social settings

In which five specific situations is a general or long-term physician-patient relationship NOT established?

Simple contractual fee, retainer fee, contingent fee, dichotomous fee or fee-splitting, and straight fee or pakyaw system

What are the five main classifications of medical fees?

A pre-arranged contractual agreement for a specific medical service at a specified fee, agreed upon orally or in writing

What is a simple contractual fee?

A professional fee measured by space and time rather than the quantity or quality of individual medical services rendered, similar to an employer-employee relationship

What is a retainer fee?

A fee arrangement where payment depends entirely on the success or failure of the medical treatment or cure

What is a contingent fee?

It is legally valid and not against public policy if cure was made the express subject matter of the contract

Is a contingent fee agreement based on a guaranteed cure legally enforceable?

The unethical practice where a physician pays or receives a commission, referral fee, or percentage of medical fees to or from a third person for soliciting or referring patients

What is a dichotomous fee or fee-splitting?

Because non-medical practitioners are not bound by the Code of Ethics of the medical profession

Why is fee-splitting or commission sharing not considered unethical when performed strictly between non-medical practitioners without the physician's knowledge or financing?

An all-in package arrangement where the patient pays a flat sum to the physician, who then assumes full responsibility for paying hospital bills, laboratory fees, medicines, and incidental costs

What is a straight fee or pakyaw system?

Nature of the case, time consumed, value of medical equipment used, professional standing of the physician, benefit of service to the patient, customary charges in the community, and financial status of the patient

What seven factors influence the determination and reasonableness of medical fees?

A balancing principle stating that one must not enrich oneself at the expense of another, requiring that a physician's fee be commensurate with the services rendered

What is the Doctrine of Unjust Enrichment as applied to medical fees?

Judicial collection involves filing a civil action in court, whereas extra-judicial collection covers non-court methods such as direct billing or engaging collection agencies

What is the difference between judicial and extra-judicial collection of medical fees?

Article III of the 1987 Philippine Constitution

Which article of the Philippine Constitution contains the Bill of Rights?

It serves as a fundamental safeguard protecting citizens against arbitrary government action and abuse of state power

What is the primary legal significance of the Bill of Rights?

Section 1, Article III of the 1987 Constitution

Which constitutional provision mandates that no person shall be deprived of life, liberty, or property without due process of law, nor denied equal protection of the laws?

Procedural due process guarantees a fair process including notice, hearing, and an impartial decision based on evidence; substantive due process evaluates the intrinsic validity of the law itself to ensure it does not arbitrarily infringe upon fundamental rights

What is the difference between procedural due process and substantive due process?

Substantial distinction based on real facts, relevance or germaneness to the purpose of the law, applicability not limited to existing conditions only, and equal application to all members of the same class

What are the four requisites for a valid and reasonable classification under the Equal Protection Clause as stated in People v Cayat?

Section 2, Article III of the 1987 Constitution

Which constitutional provision guarantees the right of the people to be secure against unreasonable searches and seizures?

Probable cause personally determined by the judge after examination under oath, and a particular description of the place to be searched and the persons or things to be seized

What are the mandatory requisites for a valid search warrant?

Such facts and circumstances that would lead a reasonably discreet and prudent man to believe that an offense has been committed and that the objects sought are in the premises to be searched

What is the legal definition of probable cause?

Medical offices, private clinics, and professional consulting rooms

Does the constitutional protection against unreasonable searches and seizures extend beyond private residences to medical facilities?

Rule 113, Section 5 of the Rules of Court

Which rule and section governs valid warrantless arrests?

In flagrante delicto, Hot Pursuit doctrine, and arrest of an escaped prisoner or detainee

What are the three recognized instances where a warrantless arrest is legally permissible?

When the person to be arrested has just committed, is actually committing, or is attempting to commit an offense in the presence of the arresting officer

What is the in flagrante delicto rule?

When an offense has just been committed and the arresting officer has probable cause based on personal knowledge of facts or circumstances that the person to be arrested committed it

What is the Hot Pursuit doctrine?

A constitutional rule stating that any evidence obtained through an illegal search, seizure, or arrest is inadmissible in court because the source is illegal

What is the Fruit of the Poisonous Tree Doctrine?

Section 5, Article III of the 1987 Constitution

Which constitutional provision guarantees the free exercise and enjoyment of religious profession and worship without discrimination?

The patient must be of sound mind and must be of legal or majority age

What two conditions must be met for an adult patient to validly refuse life-saving medical treatment based on religious freedom?

A signed waiver or Against Medical Advice form explicitly documenting that the patient was fully informed of the material risks and repercussions and still refused treatment

How should a physician document a competent adult patient's refusal of treatment based on religious grounds?

The physician or guardian may petition the court, which may grant consent or task the Department of Social Welfare and Development to take protective custody of the child

What legal step can be taken if parents refuse necessary life-saving medical treatment for a minor child?

Right to remain silent, warning that statements can be used against the person in court, right to counsel, provision of counsel if indigent, and explicit inquiry if the person understands these rights and wishes to speak

What are the mandatory components of Miranda Rights during custodial interrogation?

Because Miranda Rights were established through Supreme Court decisions rather than directly enacted in statute books

Why are Miranda Rights classified as jurisprudential in nature?

Bill of Rights, Hippocratic Oath, Code of Medical Ethics of the Board of Medicine, Code of Ethics of the Medical Profession, and the Physician-Patient Contract

What are the five recognized sources of the rights and duties of physicians?

An inherent right recognizing that while contracting parties are generally equal, the physician possesses specialized expertise regarding diagnosis and treatment management

What is the Doctrine of Superior Knowledge?

It grants the physician authority to determine diagnostic and therapeutic procedures, subject to obtaining the patient's informed consent

What authority does the Doctrine of Superior Knowledge give to a physician?

Patient's explicit consent, requirements of the common good or public health, court orders, or when the patient sues the physician on the matter at issue

What are the four recognized exceptions to a physician's duty to withhold confidential information?

Because the physician acts as the record keeper of the patient's health history, though the patient has the right to inspect and receive copies

Why does a physician have the right to retain original medical records?

Right to reputation

Which inherent right of a physician is considered the most valuable right, protected through civil, criminal, and administrative actions?

Article II, Section 2 of the PMA Code of Ethics

Which ethical provision codifies a physician's right to freely choose patients based on the consensual nature of the contract?

Article II, Section 3 of the Code of Medical Ethics

Which provision creates an exception mandating that in emergencies presenting no risk to physician safety, the physician must administer at least first aid and refer the patient?

Specialization, religion, law, conscience, medical society rules, public interest, and professional ethics

What factors may limit a physician's right to limit their practice?

Right to compensation, right of exemption from execution of instruments and library, right of way during emergencies, right to hold public or private health positions, and right to perform exclusive services like autopsies

What are the five incidental rights of a physician?

Rule 39, Section 13 of the Rules of Court

Which rule exempts a physician's professional instruments and library from execution in debt collection suits up to a statutory limit?

Possess the knowledge and skill of an average physician, use such knowledge with ordinary care and diligence, exercise best judgment, and observe utmost good faith

What are the four fundamental duties imposed on a physician under Philippine jurisprudence?

All physicians are presumed to possess average knowledge and skill, but general practitioners are not presumed to possess the specialized skill of specialists

What is the legal distinction between an average physician and a specialist regarding expected knowledge?

The degree of care and diligence that can be expected from a reasonably prudent person under the same circumstances

What is the legal definition of ordinary care and diligence?

An honest error of judgment committed while using average skill and best judgment is not negligence, whereas negligence involves a failure to exercise ordinary care and diligence

What is the legal distinction between an honest error of judgment and medical negligence?

Truthfulness and plain dealing in discussing diagnosis, prognosis, and treatment options without exaggeration or sugarcoating

What does the duty to observe utmost good faith require of a physician?

RA 6615 Section 1

Which law mandates all licensed government and private hospitals and clinics to render immediate emergency medical assistance within their capabilities to patients in danger of dying or facing serious injury?

RA 10152

Which law mandates compulsory immunization for infants and children against vaccine-preventable diseases, overriding parental refusal?

When the procedure is life-threatening to the spouse, when it will destroy reproductive capacity, when it will impair sexual function, or when the spouse is of unsound mind

In which four specific instances is spousal consent required before performing a medical procedure on a married patient?

Providing an honest and complete medical history, reporting occurrences during treatment, exercising prudence, cooperating with treatment plans, and clarifying instructions

What are the core duties and obligations of a patient?

The voluntary and informed agreement given by a patient to a medical procedure after receiving sufficient information regarding purpose, benefits, material risks, and alternatives

What is the legal definition of informed consent?

Fraud, duress, and error or mistake

What are the three vices of consent that invalidate a patient's consent?

Deliberate deception used to procure consent

What is fraud as a vice of consent?

Consent obtained through coercion, force, or fear

What is duress as a vice of consent?

Unintentional misapprehension or accidental signing of a consent document

What is error or mistake as a vice of consent?

The Professional Practice Standard leaves disclosure to physician discretion based on custom ("physician knows best"), whereas the Prudent Patient Standard requires disclosure of all material risks that a reasonable patient would need to make an informed decision

What is the difference between the Professional Practice Standard and the Prudent Patient Standard of disclosure?

An objective standard evaluating whether a reasonable person in the patient's position would consider the risk material to making a decision

What is the threshold test for disclosure under the Prudent Patient Standard?

A legal defense allowing a physician to render immediate, life-saving emergency medical treatment to an unconscious or incapacitated patient without prior consent

What is the Doctrine of Necessity?

Duty to disclose material risks, breach or failure to adequately disclose, causation showing the patient would have refused had risks been disclosed, and actual injury resulting from the treatment

What are the four essential elements of medical malpractice based on lack of informed consent laid down in Li v Spouses Soliman?

Subpoena requires attendance to give oral testimony, whereas subpoena duces tecum requires bringing books, documents, or records to court

What is the difference between a subpoena and a subpoena duces tecum?

An ordinary witness testifies to facts personally perceived; an expert witness draws technical inferences from facts based on specialized skill; an amicus curiae is a friend of the court invited to give an expert opinion as a resource person

What are the differences between an ordinary witness, an expert witness, and an amicus curiae?

Rule 130, Section 21 of the Revised Rules on Evidence

Which rule states that all persons who can perceive and make known their perception to others may be witnesses?

Rule 130, Section 22 of the Revised Rules on Evidence

Which rule mandates that a witness can testify only to facts derived from personal knowledge and perception?

Rule 130, Section 24(c) of the Revised Rules on Evidence as amended by AM No 19-08-15-SC

Which rule governs the Physician-Patient Privileged Communication rule?

Removal of the explicit restriction to obstetricians, inclusion of psychotherapists and licensed psychologists, and extension of privilege to family members and assistants participating in diagnosis or treatment

What were the major changes introduced to the Physician-Patient Privileged Communication rule under the 2019 Evidence Amendments?

Privilege claimed in a civil case, against an authorized practitioner, regarding information acquired while attending the patient professionally, necessary for diagnosis or treatment, and kept confidential

What are the five requisites to invoke physician-patient privileged communication under Nelly Lim v CA?

Rule 130, Section 24(a)

Which provision covers Marital Privilege?

Rule 130, Section 24(b)

Which provision covers Attorney-Client Privilege?

Rule 130, Section 24(d)

Which provision covers Penitent-Priest Privilege?