“Health is wealth” and “An apple a day keeps the doctor away” are some of the usual mantras or lines that people use when tackling health. These lines remind people, especially those who neglect their health, to give importance to their overall well-being. One of the ways to do this is to seek medical assistance and consultation with health professionals. Patients become vulnerable and lay down their trust to doctors, nurses, and other similar professionals to take care of them and improve their health. With that, these professionals must provide service in the best interest of their patients. However, there are unfortunately some healthcare workers who do not give premium to the lives they are obliged to care for. This is where medical malpractice comes into play.
Medical malpractice, as defined under Philippine laws, is professional negligence by a healthcare provider. It involves acts that are not adherent to the laws and ethical codes which bring about negligence, errors, and inability to solve a patient’s health concern.
Legal Basis
Medical malpractice is governed by the civil code, revised penal code, and even PRC rules. The constitution also holds precedence over these laws. Article II Section 11 of the 1987 constitution holds that respect for the dignity of every person must be observed. Article XIII Section 11 also states that each individual has the right to health, to be cared for and be given cure.
Article 1170 of the Civil Code tackles the fault or negligence in obligations. Provisions of the civil code also governs on fault or negligence in obligations – such as the obligation of a health professional to provide service and care to patients. It also tackles on quasi-delict, an instance that may cause harm to patients. Article 365 of the Revised Penal Code is also a legal basis of medical malpractice. It criminalizes such acts considered reckless imprudence and negligence.
Elements
Medical malpractice is not the same as simple negligence, or not just simply not being able to provide satisfactory services to the people. There are 4 elements of medical malpractice: existence of duty, breach of duty, damage, and causation. Existence of duty is being able to establish a patient-physician relationship through providing, generally, competent medical services. Breach of duty is when the healthcare professional fails to comply with the standard of care expected from him or her. It is when one deviates from the accepted standard of care through commission or omission. Instances of this are misdiagnosis, surgical error, medication error, and even failure to obtain informed consent. Causation is the direct or proximate casual link between an act and the injury. Under proximate cause, it discusses that the injury was a foreseeable consequence of negligence. The cause-in-fact on the other hand discusses that the injury only occurred because of the defendant’s negligence. Damage is the result of the malpractice done by the professionals. This can be in terms of physical, emotional, or economic distress.
Penalties
Penalties for medical malpractice are provided under the revised penal code, civil code, and the rules of the professional regulations commission (PRC). The criminal penalty awarded to offenders is reckless imprudence causing injury or death. They are penalized for a maximum six (6) years of imprisonment, and they could also be eligible for probation – suspended jail sentence in favor of community supervision. The criminal liability would depend whether the patient met serious injury, or less serious injury, or death.
Civil penalties for malpractice are governed by the civil code; where it obligates the offender to pay for the damages the patient endured. They are required to pay for the actual damages which are the verifiable expenses like the hospital bills, medical care, and lost earning capacity. Moral damages must also be compensated for the mental and emotional distress the victim and their family has experienced. When the patient dies, the healthcare professional is required to pay for indemnity for death which can be around Php100,000 to Php200,000 which are on top of the funeral expenses. Lastly, they can also be asked to settle or reimburse the attorney’s fees and litigation costs incurred by the patient and their family.
Administrative penalties are controlled by the Professional Regulations Commission and Board of Medicine. If found guilty, they can suspend the license of the healthcare professional; making them unable to practice in their field for a while. At most, these licenses can be revoked for serious cases such as gross negligence and repeated offenses. Once revoked, one cannot practice their profession permanently and effectively barring them.
Remedies and Procedure
Complaints by the aggrieved can be filed in the regular courts, professional regulation commission, or with the DOH or CHR for administrative or rights violation. The role of witnesses and documentary evidence are important when seeking remedies. In relation to this the burden of proof in civil matters must be preponderance of evidence, and beyond reasonable doubt.
In the case of Elpidio Que v. Philippine Heart Center, Dr. Avelino P. Aventura, and First Associated Medical Distribution Co., Inc., Elpidio’s father died after undergoing a novel stenting procedure. With that, he sued the institution and medical practitioners involved for medical negligence due to defective device, lack of competence, and improper risk disclosure. The court ruled there was no liability found since the patient and his family had been well-informed about the risks of the procedure. The court also ruled that the elements for the complaint’s defense was not sufficiently established1.
Defenses Available
Defenses are also available to medical practitioners when they have been accused. Some of the defenses are as follows:
- Absence of physician-patient relationship, especially if there has been no rapport established
- Contributory negligence of patient, if they did not follow through with the doctor’s orders
- Compliance with standard of care.
- Informed consent
- Elpidio Que v. Philippine Heart Center, Dr. Avelino P. Aventura, and First Associated Medical Distribution Co., Inc., G.R. No. 268308, April 2, 2025 ↩︎
