Bill of the Magna Carta of Patient's Rights and

Obligations Act of 2017

Citation: SB No. 1402 of 2017; Date of Publication: 16 March 2017; Type: Federal Bill; Date of
Legislation: 16 March 2017; Source: Senate of The Philippines
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An Act proclaiming the rights and obligations of patients, providing a grievance

mechanism thereof and for other purposes.

SEVENTEENTH CONGRESS OF THE REPUBLIC OF THE PHILIPPINES

First Regular Session

SENATE

SENATE BILL NO. 1402

INTRODUCED BY SENATOR JOSEPH VICTOR G. EJERCITO

AN ACT PROCLAIMING THE RIGHTS AND OBLIGATIONS OF PATIENTS,

PROVIDING A GRIEVANCE MECHANISM THEREOF AND FOR OTHER PURPOSES

EXPLANATORY NOTE

Every person shall be given appropriate health care based on their needs and must not
be deprived of their right without discrimination regardless of their social status.

Thus, this bill seeks to ensure the rights of Filipino people to proper healthcare, protect
their wellbeing, and instill health consciousness among them. As part of the society, it is
only just to provide them with a decent quality health care they deserve without
prejudice. All patients must be treated fairly and equally, human dignity, convictions,
integrity, individual needs and culture shall be respected, especially to those who are
underprivileged who doesn't have the means to afford one. Patients' needs to be
informed as well insofar their rights and moral obligations are concerned, through the
Department of Health, upon the enactment of this act, it is their duty to conduct a
nationwide campaign to raise awareness of the people's right as patients.

Therefore, with that said being, the immediate passage of this bill is earnestly sought.

JOSEPH VICTOR G. EJERCITO

 SEVENTEENTH CONGRESS OF THE REPUBLIC OF THE PHILIPPINES

First Regular Session

SENATE

SENATE BILL NO. 1402

INTRODUCED BY SENATOR JOSEPH VICTOR G. EJERCITO

AN ACT PROCLAIMING THE RIGHTS AND OBLIGATIONS OF PATIENTS,

PROVIDING A GRIEVANCE MECHANISM THEREOF AND FOR OTHER PURPOSES

Be enacted by the Senate and House of Representatives of the Philippines in Congress

assembled:

SECTION 1. Short Title. - This Act shall be known as the "Magna Carta of Patient's
Rights and Obligations Act of 2017."

SEC. 2. Declaration of Policy. - It is hereby declared the policy of the State to promote
the right to health of the people and instill health consciousness among them, It shall
likewise protect and enhance the right of all people to human dignity thereby
establishing the Magna Carta of Patient's Rights and Obligations in order to ensure a
decent, humane and quality Health Care for all patients and Health Care Providers.

SEC. 3. Definition of Terms. - As used in this Act, the following terms shall be defined
as follows:

a. Emergency Patient- one who is in immediate threat of dying or losing life or limb;

b. Health Care- measures taken by a Health Care Provider or in a Health Care

Institution in order to determine a patient's state of health or to restore or maintain it;

c. Health Care Institution- a site devoted primarily to the maintenance and operation of
facilities for the prevention, diagnosis, treatment and care of individuals suffering from
illness, disease, injury or deformity if in need of medical and nursing care;

d. Health Care Provider- any physician, dentist, nurse, pharmacist or paramedic and
other supporting health personnel, including, but not limited to, dental and medical
technicians and technologists, nursing aides, therapists, nutritionists trained in Health
Care and/or duly registered and licensed to practice in the Philippines as well as
traditional and alternative Health Care practitioner; and
e. Patient- a person who avails of the health and medical care services.

SEC. 4. Individual Rights of Patients. - The following individual rights of Patients shall
be respected by all those involved in the delivery of Health Care services;

a. Right to Good Quality Health Care and Humane Treatment- Every person has a
right to a continuity of good quality Health Care without discrimination and within the
limits of the resources, manpower and competence available for health and medical
care. In the course of such care, his human dignity, convictions, integrity, individual
needs and culture shall be respected.

If a Patient cannot immediately be given treatment that is medically necessary, he shall

be informed of the reason for the delay and be treated in accordance with his best
interests: Provided, that the treatment applied shall be in accordance with generally
accepted medical principles.

Emergency Patients shall be extended immediate medical care and treatment without
requiring, as a prerequisite thereof, any pecuniary consideration.

b. Right to Dignity- The Patient's dignity, culture and value shall be respected at all
times in medical care and teaching. Likewise, terminally ill patients shall be entitled to
humane terminal care to make dying as dignified and comfortable as possible.

c. Right to be Informed of His Rights and Obligations as a Patient- Every person

has the right to be informed of his rights and obligations as a Patient. In line with this,
the Department of Health, in coordination with Health Care Providers, professional and
civic groups, the media, health insurance corporations, people's organizations and local
government organizations, shall launch and sustain a nationwide information and
education campaign to make known to the people their rights as Patients, as provided in
this Act. It shall also be the duty of Health Care Institutions to inform Patients of their
rights as well as of the institution's rules and regulations that apply to the conduct of the
Patient while in the care of such institution, These rights and rules and regulations shall
be posted in a bulletin board conspicuously placed in a Health Care Institution

d. Right to Choose His Physician/ Health Institution- The Patient is free to choose
the services of a physician or health institution of his choice except when he chooses to
be confined in a charity ward, In this case, the attending physician shall be the
consultant under whose service the patient was admitted as appearing in the Doctor's
Order Sheet of the Medical Record, the Patient shall have the right to seek a second
opinion and subsequent opinions, if necessary, from another physician or health
institution, and to change his physician or health institution,

e. Right to Informed Consent- The Patient has a right to self- determination and to
make free decisions regarding himself/herself, however, the attending physician shall
inform the Patient of the I consequences of his/her decisions.

A Patient who is mentally competent and is of legal age, or in his incapacity or age of
minority, his legal representative, has a right to a clear explanation, in layman's terms,
of all proposed or contemplated procedures, whether diagnostic or therapeutic,
including the identity and professional circumstances of the person or persons who will
perform the said procedure or procedures. The explanation shall include the amount of
information necessary and indispensable for him to intelligently give his consent,
including, but not limited to, the benefits, risk, side effects and the probability of success
or failure, as a possible consequence of said proposed procedure or procedures,
including the implications of withholding consent. In the explanation, the comprehensive
ability of the patient shall also be considered, taking into account his level of education,
the dialect or language that he speaks and understands, and if possible, with the use of
anatomic sketch or any materials or visual aids that may aid the Patient, or his legal
representative, in fully understanding the proposed procedure or procedures.

The right to informed consent shall likewise consider the voluntariness in which the
Patient or his/her legal representative has given his/her consent, seeing to it that the
Patient or his legal representative was allowed to ask questions, or that he/she is given
the chance to consult his/her kin, or to seek another expert opinion. If the Patient is
unconscious or is unable to express his/her will, informed consent must be obtained
whenever possible from a legal representative; Provided however, that when medical
intervention is urgently needed, the consent of the patient may be presumed; Provided
further, that a physician should always try to save the life of a Patient who is
unconscious due to suicide attempt.

In the case of a Patient who is legally incompetent or is a minor, the consent of a legal
representative is required; Provided however, that the Patient must be involved in the
decision making process to the fullest extent allowed by his mental capacity. If the
legally incompetent Patient can make rational decisions, his/her decisions must be
respected, and he/she has the right to forbid disclosure of such information to his/her
legal representative.
If the patient's legal representative forbids treatment, but, in the opinion of the physician,
it is contrary to the patient's best interest, the physician may challenge this decision in
court; Provided however, that in emergency cases, the physician shall act in the
patient's best interest; Provided further, that in emergency cases where there is no one
who can give consent on the patient's behalf, the physician can perform any emergency
diagnostic or treatment procedure in the best interest of the patient.

f. Right to Refuse Diagnostic and Medical Treatment- The Patient has the right to
refuse diagnostic and medical treatment procedures, provided that the following
conditions are satisfied;

1. The Patient is of legal age and is mentally competent;

2. The Patient is informed of the medical consequences of his/her refusal;

3. The Patient releases those involved in his care from any obligation relative to the
consequences of his/her decision; and

4. The Patient's' refusal will not jeopardize public health and safety.

g. Right to Refuse Participation in Medical Research- The Patient has the right to be
advised of plans to involve him/her in medical research that may affect the care or
treatment of his/her condition. Any proposed research shall be performed only upon the
written informed consent of the Patient.

h. Right to Religious Belief and Assistance- The Patient has the right to receive
spiritual and moral comfort, including the help of a priest or minister of his/her chosen
religion. He/she also has the right to refuse medical treatment or procedures which may
be contrary to his religious beliefs, subject to the limitations described in paragraph 6 of
this Section.

i. Right to Privacy and Confidentiality- The patient has the right to privacy and
protection from unwarranted publicity. The right to privacy shall include the patient's
right not to be subjected to exposure, private or public, either by photography,
publications, video- taping, discussion, or by any other means that would otherwise tend
to reveal his person and identity and the circumstances under which he was, he is, or
he will be, under medical or surgical care or treatment.

The Patient and his/her legal representative has the right to be Informed by the
physician or his/her legal representative of the patient's continuing Health Care
requirements following discharge, including instructions about home medications, diet,
physical activity and other pertinent information.

All identifiable information about a patient's health status, medical condition, diagnosis,
prognosis and treatment, and all other information of a personal kind, must be kept
confidential even after death; Provided, that descendants may have a right of access to
information that will inform them of their health risks.

All identifiable Patient data must also be protected. The protection of the data must be
appropriate as to the manner of its storage. Human substance from which identifiable
data can be derived must be likewise protected.

Confidential information can be disclosed in the following cases:

i. When the patient's medical or physical condition is in controversy in a court litigation

and the court, in its discretion, orders the patient to submit to physical or mental
examination of a physician;

ii. When public health or safety so demands;

iii. When the Patient, or in his incapacity, his/her legal representative, expressly gives
the consent;

iv. When the patient's medical or surgical condition is discussed in a medical or

scientific forum for expert discussion for I his/her benefit or for the advancement of
science and medicine; Provided however, that the identity of the Patient should not be
revealed; and

v. When it is otherwise required by law.

j. Right to Disclosure of, and Access to, Information- In the course of the patient's
treatment and hospital care, the Patient or his/her legal guardian has the right to be
informed of the result of the evaluation of the nature and extent of his/her disease. Any
other additional or further contemplated medical treatment on surgical procedure or
procedures shall be disclosed and may only be performed with the written consent of
the patient.

The disclosure of information may be withheld if giving the information to the Patient will
cause mental suffering or further impair his health, Provided, That such disclosure may
be withheld or deferred to some future opportune time upon due consultation with the
patient's immediate family, Provided further, That such information must be given in a
way that is appropriate to the local culture and in a manner the Patient can understand.
The Patient has the right to choose who he/she desires should be informed on his
behalf, Provided however, That the Patient also has the right not to be informed on his
explicit request, unless it is required for the protection of another person's life.

The Patient has the right to be given, and examine, an itemized bill for hospital and
medical services rendered. He is entitled to a thorough explanation of such bill.

k. Right to Correspondence and to Receive Visitors- The Patient has the right to
communicate with his/her relatives and other persons and to receive visitors subject to
reasonable limits prescribed by the rules and regulations of the Health Care Institution.

l. Right to Medical Records- The Health Care Institution and the, physician shall
ensure and safeguard the integrity and authenticity of the medical records.

The Patient, upon his/her request, is entitled to a medical certificate and clinical
abstract. He/she has the right to view, and obtain an explanation of, the contents of
his/her medical records from the attending physician, except for psychiatric notes and
other incriminating information obtained about a third party.

The Patient may also obtain from the Health Care Institution a reproduction, at his/her
expense, of his/her medical records, except for the psychiatric notes and incriminating
evidence referred to above; Provided, That any relevant document that the Patient may
require for insurance claims shall be made available to him within a reasonable period
of time.

m. Right to Health Education- Every person has the right to health education that will
assist him in making informed choices about personal health and about available health
services. The education shall include information about healthy lifestyles and about
methods of prevention and early detection of illnesses. The personal responsibility of
everybody for his own health should be stressed.

n. Right to Leave Against Medical Advice- The Patient has the right to leave a
hospital or any other Health Care Institution regardless of his physical condition;
Provided, that:

i. He/she is informed of the medical consequences of his/her decision;

ii. He/she releases those involved in his/her care from any obligation relative to the
consequences of his/her decision; and

iii. His/her decision will not prejudice public health and safety.
o. Right to Express Grievances.- Every Patient has the right to express valid
complaints and grievances about the care and services received and to know the
disposition of such complaints, in accordance with Sections 7-8 of this Act.

SEC. 5. Societal Rights of Patients. - In addition to the Individual rights of Patients,

the Patient has likewise the following societal rights:

a. Right to Health- The Patient has the right to access quality Health Care and
physicians who are free to render clinical and ethical judgment without interference or
external pressure. He has likewise the right to regain/and or acquire the highest
attainable standard of health in a non-discriminatory, gender sensitive and equal
manner which health authorities and Health Care Providers must progressively
contribute to realize.

b. Right to Access to Quality Public Health Care- The Patient has the right to a
comprehensive and integrated Health Care delivery system with the necessary
manpower and facility resources. He shall also have the right to a functioning public
health and Health Care facilities, needed programs, such as public health insurance,
goods and services in sufficient quantity. He shall likewise be provided with health
facilities and services with adequate provision for essential drugs, regular screening
programs, appropriate treatment of prevalent diseases, illnesses, injuries and
disabilities. Towards this end, the government shall approximate the international
standard allocation for the health sector as set by the World Health Organization.

c. Right to a Healthy and Safe Workplace- The Patient as the right to a healthy
natural workplace environment with adequate supply of safe and potable water and
basic sanitation, industrial hygiene, prevention and reduction of exposure to harmful
substances, preventive measures for occupational accidents and diseases, and an
environment that discourages abuse of alcohol, tobacco and drug use, and the use of
other harmful substances.

d. Right to Medical Information and Education Programs- The Patient has the right
to medical information and education programs on immunization; prevention, treatment
and control of diseases; behavior related concerns; and disaster relief and emergency
situations during epidemics and similar health hazards. The State shall endeavor to
provide these information through lectures, symposia, tri-media, posters and the like.

e. Right to Participate in Policy Decisions- The Patient has the right to participate in
policy decisions relating to patient's right to health at the community and national levels.
f. Right to Access to Health Facilities- The Patient has the right to be admitted to
primary, secondary, tertiary and other specialty hospitals when appropriate and
necessary.

g. Right to an Equitable and Economical Use of Resources- The Patient has the
right to an equitable and economical use of resources such that health institutions,
projects and programs of the State are equitably established and implemented in
various regions of the country.

h. Right to Continuing Health Care- The Patient has the right to avail of or secure
access to programs that will ensure continuity of care in the form of hospice care,
rehabilitation, chemotherapy, radiotherapy arid other similar modalities.

i. Right to Be Provided Quality Health Care in Times of Insolvency- The Patient has
the right, at all times, to access quality medical care in spite of insolvency. The State
must provide for a system of payment to Health Care Institutions and Providers for all
the valid and necessary medical expenses of the. poor and marginalized citizens.

SEC. 6. The Obligations of Patients. - The Patient shall fulfill the following obligations
and responsibilities regarding his/her medical care and/or personal behavior:

a. Know Rights- The Patient shall ensure that he knows and understands what his/her
rights as a Patient are and shall exercise those rights responsibly and reasonably.

b. Provide Adequate, Accurate and Complete Information- The Patient shall

provide, to the best of his/her knowledge, adequate, accurate and complete information
about all matters pertaining to his/her health, including medications and past or present
medical problems, ailments, medical history, consultation with other physicians, results
of diagnostic work-up and treatment, to his/her Health Care Provider.

c. Report Unexpected Health Changes - The Patient shall report unexpected changes
to his/her condition or symptoms, including pain, to his/her Health Care Provider.

d. Understand the Purpose and Cost of Treatment - The Patient shall ensure that
he/she understands the purpose and cost of any proposed treatment or procedure
before deciding to accept it. He/she shall notify his/her Health Care Provider if he/she
does not understand any information about the proposed care or treatment. The Patient
shall insist upon explanations until adequately informed and shall endeavor to make all
the necessary consultations before reaching a decision.
e. Accept the Consequences of Own Informed Consent - The Patient shall accept all
the consequences of his/her own informed consent. If he/she refuses treatment or does
not follow the instructions or advice of the Health Care Provider, he/she must accept the
consequences of such decision and relieve the Health Care Provider of any liability as a
result of the exercise of his/her right to self-determination.

f. Settle Financial Obligations. - The Patient shall ensure that the financial obligations
as a result of his/her Health Care are fulfilled as promptly as possible. Otherwise,
he/she shall make the appropriate arrangements to settle unpaid hospital bills and/or
professional fees in accordance with Republic Act No. 9439. The patient must seek
support from the State in order to establish a system of payment to Health Care
Institutions and Providers.

g. Respect the Rights of Health Care Providers, Health Care Institutions and Other
Patients - The Patient is obligated to give due respect to the rights and well-being of
Health Care Providers, Health Care Institutions and other Patients. He shall act in a
considerate and/or cooperative manner and shall give respect to the rights and
properties of others. He shall follow the policies, rules and regulations, and procedures
of Health Care Institutions.

h. Obligation to Self - The Patient shall refrain from indulging in unhealthy food
consumption; addiction forming substance foods such as tobacco, alcohol anti drugs;
lifestyles that have an adverse impact on health, such as sexual promiscuity and
reckless activities; and contamination of the environment. The Patient is obligated to
maintain a state of wellness.

i. Provide Adequate Health Information and Actively Participate in His/Her

Treatment. - The Patient shall ensure that he/she has adequate health information that
will allow him/her to actively participate in the formulation of his/her diagnostic and
treatment plans. When he/she signs an informed consent, it is assumed that he has the
necessary information.

j. Respect the Right to Privacy of Health Care Providers and Institutions. - The
Patient has the obligation to submit grievances to the proper authorities or venue and
not resort to unwarranted publicity in the media. He/she shall not disclose to the public
any alleged complaint against Health Care Providers and/or Institutions if it has not
been fully decided by a court or administrative tribunal of prosper jurisdiction.

k. Exercise Fidelity on Privileged Communication - A patient-physician relationship

is a fiduciary one where mutual trust, respect and confidence are expected. All
communications are privileged and the patient' is obliged not to breach this privileged
communication especially if it involves a third party.

l. Respect a Physician's Refusal to Treat Him - While the Patient has the right to
choose his/her physician, he/she is also obligated to respect the physician's decision to
choose whom he/she will treat.

m. Respect the Physician's Decision on Medical Reasons based on his/her

Religious Beliefs - The Patient is obliged to respect the physician's religious beliefs. If
the Patient is a minor or is legally incapacitated, his/her parents or legal representatives
are obliged to likewise respect the physician's decision on mailers relating to medical
reasons despite their religious beliefs.

n. Ensure Integrity and Authenticity of Medical Records - The Patient is obliged to

ensure the integrity and authenticity of his/her medical records. Any manner of alteration
of his/her records is a criminal offense subject to the provisions of the Revised Penal
Code.

o. Participate in the Training of Competent Future Physicians – The Patient is

obligated to participate in the training of future physicians provided that necessary
information is provided to him/her and the appropriate ethical considerations are
observed.

p. Report Infractions and Exhaust Grievance Mechanism. - The Patient shall

immediately inform his/her Health Care Provider of any perceived or alleged infraction
of his/her rights as set forth in this Act through proper channels in order to promote
mutual trust, respect and confidence, between the Provider and the and Patient. The
Patient shall exhaust the grievance mechanism mediation provided in Sections 7-8 of
this Act before filing any administrative or legal action.

SEC. 7. Grievance Mechanism. - Any written complaint arising from violation of any of
the rights of patients shall first be submitted for mediation. There shall be two (2) forms
of mediation: the hospital-based mediation and the barangay-based mediation.

The hospital-based mediation committee shall be composed of a physician who shall be

appointed by the hospital and shall act as chairperson and two other (2) physicians
recommended by the Philippine Medical Association local component society and
acceptable to both parties as members. The chairperson and the members of the
committee must be in good standing of the PMA and its local component society.
The barangay-based mediation committee shall be composed of the local health officer
as chairperson, one from the religious or duly accredited people's organization, and one
from the PMA local component society who is a member In good standing.

The mediation procedure shall not be adversarial in nature. The Patient and the Health
Care Provider shall be given the opportunity to discuss the complaint and efforts shall
be made for its amicable settlement No monetary compensation nor legal counsels shall
be involved at this stage.

The aggrieved party shall be given thirty (30) days from occurrence of the incident to file
his/her written complaint for mediation. Upon receipt of the written complaint, the
concerned mediation committee shall have ninety (90) days to resolve the complaint.

A successful mediation shall bar the filing of any judicial or administrative actions.

SEC. 8. Second-Tier Mediation. - When mediation fails or no agreement is reached

after the lapse of the ninety (90) day period, the mediation committee 14 shall refer the
complaint to the PMA through its local component society for appropriate administrative
action.

The PMA local component society shall serve as the second tier mediation. It shall be
composed of the president of the local society as the presiding officer and one
representative from each of the following: component medical society, specialty society
corresponding to the case, the People's Health Watch or other civic organizations, and
a representative from the local religious organization. The PMA component society shall
render its decision within Sixty (60) days from receipt of the complaint

In the event that the second tier medication fails, the case shall be automatically
referred to the PMA Commission on Ethics which shall likewise render its decision
within sixty (60) days from receipt of the complaint.

Resort to mediation and referral to the PMA Commission on Ethics shall be a condition
precedent to the filing of a legal action in court.

All parties to the complaint shall be bound by the rules on confidentiality on all levels of
the mediation.

All minutes of the mediation proceedings shall not be disclosed to any party unless
authorized by the court of law. Any discussion held or admissions made therein shall
not be used for or against any party in subsequent or other proceedings.
In the event there is compensation, it shall be limited to actual monetary loss due to
treatment related to physical injuries. It shall not cover for "pain and suffering" or other
explicit non-monetary loss. An award shall bar the patient from filing any other legal
actions.

SEC. 9. Prescriptive Period. - The time during which the case is submitted for
mediation shall toll the running of the prescriptive period for the filing of a civil or criminal
case under the Revised Penal Code or any administrative case under existing laws.

SEC. 10. Inclusion in School Curriculum, Licensure Examinations and Training. -

The provisions of this Act shall be considered in the medical and medical-related school
curriculum and licensure examinations, including trainings and seminars of traditional
and alternative Health Care Providers or practitioners.

SEC. 11. Rules and Regulations. - The Secretary of Health, in consultation with the
Philippine Medical Association, the Philippine Hospital Association, the Philippine
Institute of Traditional and Alternative Health Care and other concerned private
agencies, non-governmental organization and people's organizations shall promulgate
such rules and regulations as may be necessary for its implementation within One
Hundred Eighty (180) days from the effectivity of this Act.

SEC. 12. Repealing Clause. - All Acts, Executive Orders, Rules and Regulations, or
parts thereof that are inconsistent with the provisions of this Act are hereby repealed or
modified accordingly.

SEC. 13. Effectivity. - This Act shall take effect fifteen (15) days after the date of its
publication in at least two (2) major newspapers of general circulation.