Professional Adjustment

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1.

The national organization of registered


professional midwives both in
government and private sector:
A. National Federation of Filipino Midwives
B. Integrated Midwives Association of the
Philippines
C. International Confederation of Midwives
D. Philippine Midwifery Association
2. The president of Integrated Midwives
Association of the Philippines is:
A. Patricia M. Gomez
B. Lucy Torres Gomez
C. Richard Gomez
D. Angelina Ponce
3. The following should be accomplished by
Midwifery graduate before taking the
licensure examination, except:
A. 25 deliveries handled actually
B. 5 suturing
C. 5 intravenous insertion
D. 20 deliveries handled actually
4. In order to be admitted to the midwifery
examination, an applicant shall, at the
time of filing of his/ her application should
possess the following qualifications,
except:
A. Is in good health and of good moral character
B. is a graduate of midwifery in a government
recognized and duly accredited institution.
C. At the time of the issuance of a certificate of
registration, the applicant shall be a citizen of the
Philippines
D. At least twenty (20) years of age
5. What is the bed capacity of the
base hospital of a school of
midwifery?
A. At least fifty (50) maternity beds
B. At least fifty (50) beds
C. At least twenty-five (25) maternity
beds
D. At least thirty (30) maternity beds
6. The school shall have a minimum ratio of
one (1) clinical instructor to twelve (12)
students in the hospital and in the
community. The statement is:
A. True
B. False
C. Neither true nor false
D. Uncertain
7. To be qualified as having passed
the board examination for
midwives, a candidate must
obtain a general rating of:
A. 70%
B. 75%
C. 65%
D. 50%
8.What is the lowest percentage in a
subject that must be obtained by the
candidate to pass the licensure
examination?
A. 50%
B. 75%
C. 60%
D. 70%
9. This is known as the Philippine
Midwifery Act of 1992:
A. RA 7329
B. RA 7392
C. RA 7932
D. RA 7923
10. The board of Midwifery is composed of
one chairman and how many members?
A. Three
B. Four
C. Five
D. Six
11. Who is the present chairman of the
board of Midwifery?
A. Angelina Ponce
B. Alejandro San Pedro
C. Alejandro Ponce
D. Julian Felipe
12. The following are qualifications of each
member of the board, except:
A. be a citizen and resident of the Philippines
B. be of good moral character
C. be at least forty (40) years of age
D. not be a member of the faculty, whether
full time, part time or lecturer, of any
school, college or university where a
regular course in midwifery is taught
13. The chairman of the board must
be:
A. a registered pediatrician
B. a registered obstetrician
C. a nurse-midwife
D. A registered nurse
14. Three (3) members of the Board shall at
the time of their appointment possess the
following qualifications, except:
A. be registered midwives
B. be degree holders, preferably in the field of health
and social sciences
C. have at least ten (10) years practice as midwives
prior to their appointment, five (5) years of which
are in supervisory positions
D. have at least five (5) years practice as
midwives prior to their appointment, three
(3) years of which are in supervisory
positions
15. The Board shall, within______ days
after the examination, report the
ratings obtained by each candidate
to the Commissioner of the PRC.
A. 100 days
B. 120 days
C. 90 days
D. 60 days
16. The Integrated Midwives
Association of the Philippines was
accredited last:
A. September 5, 1975
B. October 5, 1976
C. September 5, 1974
D. September 15, 1975
17. The first chairman of the
Board of Midwifery was:
A. Valeriano B. Fugoso Jr.
B. Vicenta Castro-Ponce
C. Angelina I. Ponce
D. Alejandro San Pedro
18. “Medical Act of 1959” was
also known as:
A. Republic Act No. 2382
B. Republic Act No. 2644
C. Republic Act No. 7392
D. Republic Act No. 9173
19. The PHIMIDAS held its first
national convention in:
A. August 1961
B. April 1961
C. August 1971
D. April 1916
20. The first school of midwifery
opened last:
A. 1920
B. 1922
C. 1930
D. 1910
Traditional Function of the Midwife (R.A No. 7392). The
Philippine Midwifery Act of 1992 provides the midwife:

 Gives supervision care and advice to women during


pregnancy, labor and post-partum period.
 Conduct deliveries on her own responsibility
 Cares of the newborn including the detection of
abnormalities and counseling of parents or couple.
 Gives health Education
 Executive emergencies measures
 Procures medical supplies
Expanded Function of the Midwifes
 Oral and parenteral dispensing of
oxytocic drugs after delivery of the
placenta
 Suturing perineal lacerations to control
bleeding
 Giving of intravenous fluids during
obstetrical emergencies
 Injecting of vitamin K. to the Newborn
IMAP
Brief History:
 In the1961 two organization were founded the
Philippine Midwives association of the Philippines or the
PHIMIDAS with Atty. Angelina Fonce as first president and
the National Federation of Filipino Midwives or the NFFM
with Mrs. Leoncia Chuatoco as first president.

 In 1974, the two were integrated to become IMAP with Ms.


Juana Reyes as its first president. It is presently the only
professional midwives association recognized by the
Philippine Regulatory Commission (PRC)

Letter of Instruction 1980


 Compulsory membership to professional association
accredited by the professional regulations commission
QUALIFICATIONS OF BOARD OF DIRECTORS
1. An active member of 3 years standing
2. Active practice in:
 Clinical
 Domicillary
 Institutional
 Self-employed
 Administrative/Supervisory
 Projects with realm to midwifery
practice
TYPES DESCRIPTION VOTING
PRIVILEGE

ACTIVE Registered Midwife √

AFFILIATE Graduating Midwife/Students X


(only
represented)
ASSOCIATE RN, RM x

HONORARY Any person with meritorious work in the x


development of midwifery profession

CONSULTANT Husbands of lifetime members, owns at x


least 1 birthing home
1. How is the practice of Midwifery in the
Philippines defined?
2. Who are allowed to practice
midwifery in the Philippines?
3. What are the qualifications and
requirements for the examination?
4. What happens after passing the
Licensure Examination?
5. Can a Certificate of Registration be
suspended or revoked?
6. Can a revoked Certificate of
Registration be reissued?
7. What are the Guidelines for the School
of midwifery?
8. What are the composition, qualifications
and powers of the Board of Midwifery?
 Art. 3. Sec. 23. The practice of midwifery consist in performing or
rendering, or offering to perform or render, for a fee, salary, or
other reward or compensation, services requiring an
understanding of the principles and application of procedures and
techniques in the supervision and care of women during
pregnancy, labor and puerperium management of normal
deliveries, including the performance of internal examination
during labor except when patient is with antenatal bleeding;
health education of the patient, family and community; primary
health care services in the community, including nutrition and
family planning in carrying out the written order of physicians with
regard to antenatal, intra-natal and post-natal care of the normal
pregnant mother in giving immunization, including oral and
parenteral dispensing of oxytocic drug after delivery of
placenta, suturing parietal lacerations to control bleeding, to
give intravenous fluid during obstetrical emergencies provided
they have been trained for that purpose; and may inject Vitamin K
to the newborn: Provided, however, That this provision shall not
apply to students in midwifery schools who perform midwifery
service under the supervision of their instructors, nor to emergency
cases. 3
 Is the performance or offer to perform or render for a fee, salary,
or other reward or compensation of service recurring an
understanding of the principles and application of procedures
and techniques in the supervision of and care of women during
pregnancy, delivery and puerperium.
 Management of Normal Delivery
 Performance of Internal examination during Labor, except when
patient has antenatal bleeding.
 Health education of patient family and community, including
nutrition and family Planning
 Carrying out the written order of the physician with regards to
ante-natal, intra natal and post natal care of the normal pregnant
women
 Giving Immunization
 Oral and parenteral dispensing of oxytocic after the delivery of
the placenta.
 Suturing perineal laceration to control bleeding
 Giving intravenous fluid during obstetrical emergencies provided
they were trained for that purpose
 May inject vitamin K to new born
Art. 3. Sec. 11. All applicants for
registration to the practice of
midwifery in the Philippines shall
be required to undergo an
examination as required
for in this Act.
Art. 3. Sec. 13. Prerequisite and Qualifications of
Applicants for Examination. — In order to be
admitted to the midwifery examination, an
applicant shall, at the time of filing of his/her
application therefor, establish to the satisfaction
to the Board that he/she:
(a) is in good health and of good moral
character; and
(b) is a graduate of midwifery in a government
recognized and duly accredited institution.

At the time of the issuance of a certificate of


registration, the applicant shall be a citizen of the
Philippines and at least eighteen (18) years of
age.
 Section 1: “Philippine Midwifery Act
of 1992”,

 Section13: Qualification of
Applicants for Examination
1. Filipino Citizen
2. Good Moral Character
3. Graduate of midwifery in
government recognized and duly
accredited institution
4. At least 18 years old
 TOR with SO number
 Original Birth certificate (NSO)
 Marriage contract for female (if any)
 4 passport size with name tag on white
background
 Cedula
 Notarized copy of cases
 Sec. 18. Issuance of Certificate. —
Certificate of Registration as midwife shall,
upon payment of the required fees, be
issued to any applicant who passes the
examination.

 The issuance of a certificate of registration


by the Board to the registrant shall be
evidence that the person named herein is
entitled to all rights and privileges of a
registered midwife until said certificate, for
just cause, is suspended temporarily or
revoked.
 full name of registrant
 Serial number
 official seal of commission
 signature of Chairperson of
Commission
 Members of the Board
 Art. 3. Sec. 25. Revocation and Suspension of
Certificates. — The Board shall have the power to
revoke or suspend the validity of a certificate of
registration of a midwife for any of the causes
mentioned in the preceding section, or for
unprofessional conduct, malpractice,
incompetence or serious ignorance or
negligence, assisting or performing abortion in the
practice of midwifery or for making use of fraud,
deceit or false statements to obtain a certificate
of registration.

 From the decision of the Board, appeal may be


taken to the Professional Regulation Commission
which decision shall be final.
Sec. 14. Schools of Midwifery. — To be recognized as a duly
accredited and legally constituted institution for midwifery
training as provided in this Act, a school of midwifery shall have
a permit from the Department of Education, Culture and Sports
(DECS). The school shall have at least fifty (50) maternity
beds and affiliated with an accredited hospital duly
accredited by an authorized government agency or
instrumentality.

The school shall have a minimum ratio of one (1) clinical


instructor to twelve (12) students in the hospital and in
the community.

Before allowing a student to graduate, the school shall


satisfactory show to the Department of Education, Culture and
Sports (DECS) or other authorized government agencies that
the student has completed the course in midwifery as
prescribed by the DECS or other duly authorized government
agencies, and that during the training, the student has
personally attended at least a total of twenty (20) deliveries in
the hospital and in its domiciliary services. 3
Sec. 15. Qualification of Faculty. — The faculty shall
have academic preparation appropriate to
teaching assignment, as follows:
(a) At least a bachelor's degree holder or Doctor of
Medicine (M.D.);
(b) Proof of competence in the field of
specialization assigned to him; and
(c) A registered nurse or registered midwife in the
Philippines with at least one (1) year of satisfactory
teaching experience or one (1) year of efficient
performance in maternity ward/community:
Provided, That a registered midwife may be allowed
to follow-up student midwives in the community
ward provided she has at least two (2) years of
experience in the area of assignment and has
undergone training in the supervision of students.
 Art. 2. Sec. 2. Composition. — There shall be a Board of
Midwifery, hereinafter referred to as the Board, which shall be
under the direct supervision of the Professional Regulation
Commission (PRC). It shall be a collegial body composed of a
chairman and (4) members to be
appointed by the President of the Philippines from among
the recommendees of the Commissioner of the
Professional Regulation Commission.
Section 2: Composition of BOM
1 Chair/chairperson
4 members of the board

Note: 3 members shall be registered midwifes


1 Nurse-midwife

 Appointment:
By the president of the Philippines from among
the recommendees of the Commissioner of the
Professional Regulation Commission
 Art. 2. Sec. 3. Qualifications and Disqualifications of
the Board Members. —
(a) Each member of the Board shall at the time of his
appointment:
(1) be a citizen and resident of the Philippines;
(2) be of good moral character;
30
(3) be at least thirty ( ) years of age; and
(4) not a member of the faculty, whether full time, part
time or lecturer, of any school, college or university
where a regular course in midwifery is taught, and shall
not have any pecuniary interest directly or indirectly,
in such institution during his term of office as a Board
member.
(b) The Chairman of the Board shall at
the time of his appointment:
(1) be a registered obstetrician; and
(2) have at least ten (10) years
practice as an obstetrician prior to his
appointment.
(c) Three (3) members of the Board
shall at the time of their appointment:
(2) be degree holders, preferably
in the field of health and social
sciences; and
(3) have at least ten (10 ) years
practice as midwives prior to their
appointment, five (5) years of which
are in supervisory positions.
 Natural Born Filipino Citizen & resident of
the Philippines (Born in Philippines,
without taken action)
 Good Moral Character
 Thirty (30) years of age
 Not a member of the faculty whether full
time or part time in a midwifery school &
to pecuniary benefit in such during his
term (monetary interest) – (type of
disqualification)
 (d) One (1) member of the Board shall at
the time of his appointment:
(1) be a registered nurse-midwife; and (2)
10) years practice as a
have at least ten (
nurse-midwife.
 Sec. 4. Term of Office. — The Chairman
and the four (4) members of the Board
shall hold office for a term of three (3)
years or until their successors shall have
been appointed and duly qualified,
without prejudice to reappointment for
another term. Each member of the
Board shall qualify by taking his/her oath
of office before entering upon the
performance of his/her.
 Enforce provision of this act
 Administer oaths accordance to the provision of
this act
 Issue, suspend or revoke certificate of registration
 Investigate violations of the act subpoena and
subpoena duces tecum
 Conduct yearly Board examination
 Look into conditions affecting midwifery practice in
the country, maintain standards and ethics
practice
 Adopt an officials seat to authenticate it officials
documents
 Registered Nurse-Midwife
 10 years of experience & nurse-
midwife
 Natural Born Filipino Citizen
 Good Moral Character
 APPOINTMENT OF BORD OF MIDWIFERY (BOM)

 Regular Appointment – when the BOM is


appointed to serve for a period 3 years
 Ad Interim Appointment – when a board member
is appointed to fill vacancy or to continue the
unexpired period of term of regular appointee
 Hold Over – hold an office after his term of office
has expired until his successor is appointed

Section 4: Terms of Office of BOM-3 years chairman


and members may be reappointed for another
term
IMAP
(Nominating Body)

PRC
(Recommending Body)

PRES.
(Appointing Body)
APPOINTMENT OF BORD OF MIDWIFERY (BOM)

 Regular Appointment – when the BOM is


appointed to serve for a period 3 years
 Ad Interim Appointment – when a board
member is appointed to fill vacancy or to
continue the unexpired period of term of
regular appointee
 Hold Over – hold an office after his term of
office has expired until his successor is
appointed

Section 4: Terms of Office of BOM-3 years


chairman and members may be
reappointed for another term
 Quasi-legislative powers – independent body,
promulgating rules & regulation within its
jurisdiction

 Quasi-Judiciary Powers – independent body,


from regular judges, for hearing revoked
license

 Executive Powers – under the office of the


President poetically appointed, supervision of
the Board & Custodian of its RECORDS
 Article 3 Section 1. DUE PROCESS – Law
that hears first before it condemns (trial,
hearing)

 Monitor & enforce quality midwifery


practice (Examining Power, Dispensing
Power)
 Monitor & enforce quality midwifery
education

 CHED – closed midwifery school


 Neglect of Duty
 Gross incompetence/serious ignorance
 Unprofessional/Immoral or Dishonourable
conduct
 *Commision of Irregularities
 Tolerating Irregularities
 Inhibit – not participate on that particular
exam
Sec. 27. Penal Provision. — Any person who shall practice
midwifery in the Philippines within the meaning of this Act
without a certificate of registration issued in accordance
herewith, or any person presenting or using as his/her own
certificate of registration of another, or any person giving any
false or forged evidence to the Professional Regulation
Commission in order to secure a certificate of registration, or
any person using a revoked or suspended certificate of
registration or any person assuming, using or advertising, as
a registered midwife or a registered nurse-midwife or
appending to his/her name the letters "R.M." without having
been conferred such title by the Professional Regulation
Commission or advertising any title description tending to
convey the impression that he/she is a registered midwife, shall
be guilty of misdemeanor and shall, upon conviction, be
sentenced to a fine of not less than Ten thousand pesos
(P10,000.00) nor more than Thirty thousand pesos
(P30,000.00), or to suffer imprisonment for a period of
not less than two (2) years nor more than seven (7) years, or
both such fine and imprisonment at the discretion of the court.
Profession

Profession: A calling by which members


profess to have special knowledge by
training, by experience or both on that
they may guide or advice or serve other in
that field.
Adjustment: An educational process
referring to changes in behavior towards
better life, better relationships and better
contribution to society
Characteristics of a profession
Mastery of the Craft- the profession must
possess the necessary skills and attitude.
Service orientation-Hall mark of the
profession
Autonomy-reasonable independent being
(self-regulated)
Accountability-the essence of profession
Political Power- Adhere own sets of values
Professional Organization- Must be a
member of an accredited Organization (e.g
IMAP)
Juris
Means Law

 Jurisprudence
The study of Laws

 Midwifery Jurisprudence
The study of laws that affect the practice
of Midwifery
Law

Are rules and regulations established by a


governing authority (sovereign power) to
institute and maintain orderly coexistence by
commanding what is right and prohibiting
what is wrong.
Functions of Law in the Society

1. define relationships among


members of a society and state
which activities ate permissible or not
2. describe what forces maybe applied
to maintain rules and by when is to
be applied.
3. provide solutions to problems
4. refine relationship between person
and group when conditions of life
change.
Basic Principle of Law

• Based on concern for justice and


fairness
• Characterized by change
• Actions are judged on basis of
universal standards of what is similarly
trained, reasonable and prudent person
would done rather in similar
circumstances
• Each individual has right and
responsibilities
Types of Law

Law govern the relationship of private


individuals with government.

Public Law

Refers to the body of law that deals with


relationship between individual and the
government and the governmental agencies. An
important segment of public law is criminal law
which deals with actions against the safety and
welfare of the public Examples are homicide,
manslaughter and theft.
Private Law or Civil Law

Is the body of law that deals with


relationship among private
individuals. It can be categorized
into a variety of legal specialties
such as contract law and tort law
Contract law involves the
enforcement of agreements
among private individuals

Torts laws define and enforce


and enforce duties and right
among private individuals that
are not based on contractual
agreement.
Sources of Law

Constitution

The constitution of the Philippines is the


supreme law of the country. It established
the general organization of the
government, grants certain powers to the
government, and places limits on what
government may do. The constitution
created legal rights and responsibilities
and the foundation for a systems of
justice.
Legislation (Statutory law)
Laws enacted by any legislative body
are called statutory laws.

Administrative Law

When a state legislature passes a


structure, an administrative agency is given
the authority to create rules and regulation
to enforce the statutory laws.
Functions of law in the profession

Provides a framework for establishing what


nursing actions in the care of patients are legal.
Delineates the nurse’s responsibilities from
those of other professionals.

Helps to establish the boundaries of


independent nursing actions.
Assists in maintaining a standard of nursing
practice by making nurses accountable to the law.
Midwife and legal offenses

Crimes

Actions/behaviors which violate law


and is punishable by fine,
imprisonment or death

There 2 types according to severity:


felonies and misdemeanor
Felonies

Relatively serious offenses punishable


by imprisonment, fines or even death.
Offenders lose their civil rights.

Misdemeanor
Is less serious crime punishable by fine
and short-term jail sentence.
 When the law attaches the capital
punishment, the felony is considered:
a. grave
b. less grave
c. light felony
 Which of the following is a grave
felony?
a. Guilty of committing euthanasia
b. Untidy appearance while on duty
c. Reporting a wrong doing of a colleague
 Felony is considered consummated when:
a. All the elements necessary for its execution are
present
b. The offender performs all the acts of execution
which would produce the felony as a
consequence but nevertheless do not produce
it by reason of causes independent of the will
of the perpetrator
c. The offender commences the commission of a
felony and does not perform all the acts of
execution which should produce the felony
d. None of these
Criminal liabilities can be
classified according to:

Manner of commission

Dolo – deceit; deliberate intent

Culpa - fault; product of


imprudence, negligence, lack of
foresight or skills
Degree of participation

Principals – direct part in the execution of a


crime; cooperate in committing an act which
crime will not be accomplished

Accomplice – cooperate in execution of


offences by previous/stimulation acts

Accessories – profit or assist offenders to


profit from crime; conceals, destroy the body
of crime, effects, instruments to prevent
discovery of crime; harbor, conceals, and
assists in escape of principal with abuse of
authority
 Identify what is the crime being asked
 Identify characters in the crime
 When did this person participate in the
crime.
 If person participated during the crime,
he is the principal
 If person participated before the crime,
he is the accomplice
 If the person participated after the
crime, he is the accessory
 Situation: Vivian is two months pregnant.
Her friend Donna referred her to Sandra,
an abortionist. Vivian without the
consent of Carlo had an abortion.
If those involved be charged legally,
who is considered as the principal of the
crime?
a. Vivian
b. Sandra
c. Donna
 Who is to be charged as an
accomplice?
a. Donna
b. Sandra
c. Vivian
Ms. Ramos is a college student sent by her parents to the
city to study. In the middle of the semester, she got
pregnant by her boyfriend who left her upon knowing of her
condition. Ms. Ramos then asked the help of Rhona, her
classmate, who referred her to a midwife, Corina, who
performs abortion for a fee. Ms. Ramos went then to Corina,
who agreed to perform abortion on her as long as she be
paid for her services. Midwife Belle, knowing the agreement
between Ms. Ramos and Corina, provided the medical
instruments used and a room in her lying-in clinic where the
abortion was performed. After several days, Ms. Ramos
developed severe infection and was rushed to the hospital.
The doctor found out that Ms. Ramos had an abortion and
reported this to the proper authorities, including Corina,
who did the abortion. But Sally a friend of Corina helped the
latter escape in order to avoid prosecution and destroyed
all the instruments and records of the abortion in the clinic.
IDENTIFY THE FOLLOWING:
1. PRINCIPAL
a)by direct participation
b)by induction
c)by indispensable cooperation

2. Accomplice
3. Accessory
 A midwife becomes liable as an
accomplice in an abortion if she:
a. performs the act
b. refers the pregnant mother to abortionist
c. conceals the evidence of the crime
 If during the investigation, the pieces of
evidence were not found because
Carling, the maid of Juaning burned it.
Carling is considered as:
a. Accomplice
b. Accessory
c. Principal
d. Co-Principal
Contract
- An agreement between two or more persons
upon sufficient consideration to do or not to do
some lawful act.

- One binds self with respect to other give


something or to render some service.

- An agreement which creates an obligation

- Can be written or oral


1. According to Format
 Formal Contract – written down and
it follows at all times the legal
document/ long bond paper,
notarized
 Informal Contract – orally done/
written down but does not follow the
legal documents
2. According to Statement
Expressed contract

– terminal conditions are written down and the beginning and


ending of the contract are also expressed e.g. job description

Implied contract

- One in which there has been no discussions


between parties, but the law considers that a contract
exists

- Law ascribes an objective intention to enter a


contract “facio ut des” ( I do that you may give)
Elements of a valid contract

Agreement/ Mutual consent – contracts


must be binding for both parties

Legal Subject matter – nothing in the


contacts is contrary to law or public order

Cause of the obligation which is


established

Contractual capacity – parties are


eligible to enter a contract
Objects of contracts

• All things which are within the


commence of man

• All rights which are


transmissible

• Future inheritance
Prerequisites in entering a contract

 Be of legal age

 Be sound of mind

 Not under the influence of


intoxicating substances or fear of
bodily harm

 Mentally competent
Termination of Contract

Most midwife – patient contracts end


when

• Treatment is complete
• Bills
• Has been paid
• Waiver to discharge against
medical advise has been signed
 A contract is:
a. A bond gathered by a midwife from the
patient
b. A document that permits two person to offer
the same services
c. A written agreement between the midwide
and the patient
d. An agreement which creates an obligation
 When a patient enters a doctor’s clinic
for treatment, this is an example of:
a. formal contract
b. implied contract
c. single contract
 Which of the following statement is false
about an implied contact?
a. Its agreement is presumed
b. Its agreement is inferred from the acts of the
parties
c. It must still have consent by the parties
d. It is a formal contract
Legal offense

Breach of Contract

is the failure to perform an


agreement whether expressed or
implied, without cause
Legal excuse or defense

Torts

• A civil wrong committed against a


person or property, excluding breach
of contact, which calls for
compensation in damages
• The wrongdoing can be inflicted
by commission or omission
• Can be intentional or
unintentional
See Intentional Torts Table
Unintentional Torts

Negligence

Doing an act which a prudent person


would not do or not taking an act which a
prudent person would do in the same
situation
Can be considered as grave felony if
done with obvious disregard of the safety
of others, or indifference to injury that is
bound to fallow one’s act, specifically
when it results to injury or death

Nurses are liable for poor outcomes if


and only if there conduct is negligent.
Gross Negligence/ Reckless
Imprudence
Involves extreme breach of care, in
which the damage caused was
immediate or danger is evident or
manifested

Simple Negligence
Manifesting lack of precaution in which
the damage caused was not immediate
or the danger is not evident or
manifested.
Malpractice

Professional negligence
Failure to meet the standards of
acceptable care which results to harm
to other person
Negligence that occurred while the
person was performing as a
professional
Doctrines Applicable To Negligence
Suits

Respondeat Superior

“let the master answer for the


subordinates”
where an agent acts through the
agency of another (superior), the latter
is himself acting through the former
Res Ipsa Loquitor

• “ the thing speaks for itself”

• when a thing which has caused an injury is


shown to be under the management of the party
charge with negligence, the accident is as such
as in the ordinary course of thing will not happen
if those who have such management used
proper care, the accident itself affords
reasonable evidence in the absences of an
explanation by the parties charge that is those
from the want of proper care.
 Three elements

(1) the event would have not


occurred if the nurse exercised
prudent care,

(2) the accident occurred within


exclusive control of the nurse,

(3) no voluntary action was done


by the injured party.
Force Majeure

• “irresistible or superior force”

• no one shall be held liable for


negligence done due to an event that
human prudence cannot foresee,
prevent or control
• pertains to act of God and of nature
 The doctrine of respondent superior
applies:
a. Where the injury occurs while the servant is not
within the legitimate scope of his authority
b. When the injury occurred in the course of his
employment
c. When the injury occurred outside the commerce
of man
d. When the instrumentality was with in the full
control of the servant
 The test for liability under the doctrine of
respondent superior is the:
a. Power of master servant
b. Inquire itself
c. Extent of damage caused
d. Circumstances surrounding the act
 The midwives were guilty of professional
negligence, which of the following are the
elements of the act?
1. existence of a duty on the part of the person
charged
2. failure to meet standards of care
3. foreseeability of harm resulting from failure to meet
standards
4. the power to control over the circumstances
a. 1,2,4
b. 1,3,4
c. 1,2,3,4
 The following are possible penalty of the
act except:
a. revocation of license
b. life imprisonment
c. monetary penalty
 The professional license that has been
revoked means:
a. suspension to practice midwifery
b. removal of license number
c. cancellation of the license
 A midwife who executes a doctors
order, which to her honest belief or
judgment may endanger the life of the
patient can be accused of:
a. Malpractice
b. Accessory
c. Accessory
d. Criminal negligence
 Negligence means failure to:
a. Observe the behavior of an unscrupulous
person
b. Behave properly as a professional midwife
c. Carry out one’s duties and function
d. Do what is supposed to do
 a)BATTERY – The unlawful beating or
touching of another person. The
unlawful beating or use of force upon a
person without his consent.
 b)ASSAULT – An unlawful attempt or offer
to beat or to do bodily injury to another.
 c)False Imprisonment or Illegally
detention – unjustifiable detention of a
person without a legal warrant
d.) INVASION OF RIGHT TO PRIVACY AND BREACH
OF CONFIDENTIALITY
– the right to privacy is the right to be left alone, the right
to be freed from unwarranted publicity and exposure to
the public view is well as the right to live one’s life
without having anyone’s name, picture/ private affairs
made public against one’s will

e.)DEFAMATION – character assassination, be it written or


spoken
 Slander – oral defamation of a person by speaking
unprivileged or false words by which his reputation is
damaged
 Libel – defamation by written words
Definition of Terms

Murder – killing of another person other


than relative with proven malice or
premeditation

Parricide – killing of father, mother or child,


whether legitimate or illegitimate, or any of
his ascendants or descendants including the
spouse.

Homicide – killing of any human creature. It


is not necessarily a crime, committed
without criminal intent and without criminal
consequence.
Infanticide – killing a child less than 3 days
of age

Abortion – expulsion of fetus so early that it


has not yet acquired the power of sustaining
independent life

Simulation of Birth – substituting one child


to another, falsification of birth favoring
adoption

Burglary – entry into building with intent to


commit a theft or felony inside the building
Robbery – direct taking of property from another
by the use of force, intimidation or fear

Arson – burning a building or structure with


malicious intent

Rape – Forcible penetration of organ o


copulation or any inanimate object to any body
orifice of the offended party

Child molestation – engaging in any sexual act


with a person under age 18

Drug charges – possession and/or trade of


control substance
 The essential element to determine
parricide is:
a. Presence of the body of the crime
b. Kind of weapon used
c. Part of victim’s body at which the weapon is
aimed
d. The relationship of the offender with the
victim
 Infanticide is the unlawful killing of an
infant under:
a. Three days old
b. Three months old
c. Under 3 lbs. baby weight
d. Three years old
 Any person who kills his father is guilty of:
a. Parricide
b. Murder
c. Infanticide
d. Abortion
Considerations to Criminal Liability

Justifying Circumstances (there is no


crime in the eye of the law)

unlawful aggression on the part of the


offended or injured party

reasonable necessity of the means


employed by the offender

lack of sufficient provocation on the part


of the offender
Exempting Circumstances (there is
crime committed but no criminal on account of
absence of free will or voluntariness)

imbecile or insane person, unless


the latter has acted during a lucid
interval

under nine years old

over nine and under fifteen years


old (unless acted on discernment)
under the compulsion of an
irresistible force
any person who while a
performing a lawful act with due care,
causes an injury by mere accident,
without fault or intention of doing it
acting on impulse of an
uncontrollable fear of an equal or
greatly injury
failure to perform an act required
by law when prevented by some
insuperable cause
Mitigating Circumstances (penalty is
lessened)

circumstances otherwise justifying


or exempting
under 18 years of age; over 70
years old
offender had no intention to
commit so grave a wrong as that
committed
sufficient provocation or threat on
the part of the offended party
immediately preceded the act
the act was committed in the
immediate vindication of a grave
offense to the committing felony, his
spouse, relatives whether legitimate
or not

acted on impulse so powerful as


naturally to have produced passion or
obfuscation

surrendered himself or voluntarily


confessed his guilt
• deaf, dumb, blind or other physical
defects that restricts better
communication

• illness that would diminish the


exercise of his will power without
however depriving him of
consciousness of his acts
Aggravating Circumstances (penalty is
increased)

advantage taken by the offender of


his public possession
crime committed in contempt or with
insult to public authorities
act committed with abuse of
confidence or obvious ungratefulness
crime committed during
conflagration, shipwreck, earthquake,
epidemic or misfortune
crime committed in consideration
of a piece, reward, or promise

crime committed by means of


inundation, fire, poison, explosion,
standing of a vessel or anything
involving great waste or ruin

act committed with evident


premeditation

fraud or disguise are employed


 Circumstances or actions which are
said to be in accordance with law is
said to be:
a. Justifying
b. Exempting
c. Mitigating
d. Aggravating
 All of the following are exempting
circumstance except:
a. Imbecile
b. 8 years old
c. performance of a lawful act
d. offender id deaf and dumb
 When a politician takes advantage of
his power in the performance of lawful
actions this is considered as:
a. justifying circumstances
b. exempting circumstances
c. mitigating circumstances
d. aggravating circumstances
 Which of the following is a mitigating
circumstances?
a. Act committed during epidemic or calamity
b. Obeying a lawful order of the superior
c. Accidental killing
d. None of the above
Midwifery Ethics

Morality - usually refers to private,


personal standard of what is right
and wrong. Moral issues involve
important social values and norms
Ethics – refers to a method of inquiry
about the rightness or wrongness as
a human actions; the practices or
beliefs of a group; and the standards
of moral behavior described in the
group’s formal code of ethics
Bioethics – ethics as applied to
“life situations “(e.g. decisions
about euthanasia, prolonging
life, abortion)
Values - freely chosen, long-
lasting beliefs or attitudes about
the worth of something (e.g. a
person or an idea)
Value system – a personal set
of beliefs on a continuum from
most to least important, thus
providing the basis for decisions
and choices
Moral theories guide
midwives in ethical decision
making

Consequence based – judge


the rightness of the action
based on the consequences it
produces (the end justifies
the means)
Utilitarianism – views a good
act as one that brings the
least harm and the most
good to the people “choose
the lesser evil”
Principle based – emphasis
on individual rights, duties
and obligations. An action is
moral if it follows an
impartial, objective principle
Relationship based –
stresses courage, generosity,
commitment and the need to
nurture and maintain
relationships, promote the
common good or the welfare
of all group, rather than
stressing the individual
rights.
Bioethical Principles

Autonomy – from the Greek


work “autos” meaning self
and “nomos” meaning rule
or law, thus refers to self
law. Implies individual
rights, privacy and choice.

Autonomy entails the ability


to make a choice from
external constraints.
Beneficence - the duty to do
good and the active
promotion of benevolent acts
(e.g. goodness, kindness,
charity)
Confidentiality – relates the
concept of privacy.

Information obtained from


an individual will not be
disclosed to another unless it
will benefit the person or
there is a direct threat to the
social good.
Double effect – a principle
that may morally justify
some actions that some may
produce both good and evil
effect.
Fidelity – promise keeping;
duty to be faithful to one’s
commitments and promises
Justice – fair, equitable and
appropriate treatment
according to what is due or
owed to persons.
Nonmaleficence – the duty
not to inflict as well as to
prevent and remove harm.
Sanctity of Life – the
perspective of that life is the
highest good.

Thus all forms of life


,including mere biologic
existence should take
precedence over external
criteria for judging quality of
life.
Veracity – the obligation to
tell the truth and not to lie or
deceive others
 Which of the following principles apply
to the action of the midwife to refrain
from discussing the condition of the
patient with those who are not involved
in his care?
a. beneficence
b. non maleficence
c. autonomy
THE LAWS
AND THE
MIDWIFE
– an act passed by the Congress of the
Philippines, while the form of government
is Republican government.
 RA 1080- Civil Service Eligibility
 RA 1612-Privilege Tax Law
 Republic Act 2382 – Philippine Medical Act
which regulates the practice of medicines in
the Philippines
 Republic Act 2644 – Philippine Midwifery Act
 Republic Act 3573 – Law on reporting of
Communicable Diseases
 RA 4226-Hospital Licensure Act
 Republic Act 5901 – 40 hours work for
hospital workers
 Republic Act 6111 – Medicare Act
 Republic Act 6425 – Dangerous Drug Act of
1992
 Republic Act 6675 – Generics Act of 1988
 Republic Act 6713 – Code of Conduct and
Ethical Standards for Public Officials and
Employees
 RA 6758- Salary Standardization
 Republic Act 6809 – Majority age is 18 years
old
 Republic Act 7160 – Local Government
Code
 RA 7176-Increasing personal and additional
exemptions of individual tax
 Republic Act 7277 – Magna Carta of
Disabled Persons
 Republic Act 7305 – The Magna Carta of
public Health Workers
 Republic Act 7392 – Philippine Midwifery Act
of 1992
 Republic Act 7432 – Senior Citizen Act
 Republic Act 7600 – Rooming In and
Breastfeeding Act of 1992
 Single without dependents- P20,000
 Head of family w/ one ore more
dependents- P25,000
 Legally married couples-P64,000
 Legally married individuals- P32,000
 Qualified dependent children (up to 4) –
P8,000/child
 Additional health insurance- P2400
 Republic Act 7610 – Special protection of
children against abuse, exploitation and
discrimination act
 Republic Act 7658 – An act prohibiting the
employment of children below 15 years of
age
 RA 7716- EVAT Law
 Republic Act 7719 – National Blood Service
Act of 1994
 Republic Act 7875 – National Health Insurance
Act of 1995
 RA 7876- Senior Citizen Law
 Republic Act 7883 – Barangay Health
workers Benefits and Incentives Act of
1992
 Republic Act 8187 – Paternity Leave Act
of 1995
 Republic Act 8282 – Social Security Law of
1997 (amended RA 1161)
 Republic Act 8291 – Government Service
Insurance System Act of 1997 (amended
PD 1146)
 Republic Act 8344 – Hospital Doctors to
treat emergency cases referred for
treatment
 Republic Act 8423 – Philippine Institute of
Traditional and Alternative Medicine
 Republic Act 8424 – Personal tax Exemption
 Republic Act 8981 – PRC Modernization Act of
2000
 Republic Act 9165 – Comprehensive
Dangerous Drugs Act 2002
 Republic Act 9288 – Newborn Screening Act
 RA 9439- an act prohibiting the detention of
patients
– An order of the President. This power of
the President which allows him/her to act
as legislators was exercised during the
Marshall Law period.
 Presidential Decree 223 – Professional
Regulation Commission
 Presidential Decree 48 – Limits benefits of paid
maternity leave privileges to four children
 Presidential Decree 69 – Limits the number of
children to four (4) tax exemption purposes
 Presidential Decree 147 – Declares April and
May as National Immunization Day
 Presidential Decree 442 – Labor Code
Promotes and protects employees self-
organization and collective bargaining rights.
Provision for a 10% night differential pay for
hospital workers.
 Presidential Decree 603 – Child and
Youth Welfare Act / Provision on Child
Adoption
 Presidential Decree 626 – Employee
Compensation and State Insurance
Fund. Provide benefits to person covered
by SSS and GSIS for immediate injury,
illness and disability.
 Presidential Decree 651 – All births and
deaths must be registered 30 days after
delivery.
 Presidential Decree 491 – Nutrition
Program
 Presidential Decree 539 – Declaring last
week of October every as Nurse’s Week.
October 17, 1958
 Presidential Decree 541 – Allowing
former Filipino professionals to practice
their respective professions in the
Philippines so they can provide the latent
and expertise urgently needed by the
homeland
 Presidential Decree 825 – Providing penalty
for improper disposal garbage and other
forms of uncleanliness and for other purposes.
 Presidential Decree 856 – Code of Sanitation
 Presidential Decree 965 – Requiring applicants
for Marriage License to receive instruction on
family planning and responsible parenthood.
 Presidential Decree 996 – Provides for
compulsory basic immunization for children
and infants below 8 years of age.
 Presidential Decree 1636 – requires
compulsory membership in the SSS and
self-employed
 Presidential Decree 4226 – Hospital
Licensure Act
 Executive Order 51 – The Milk Code for
PRC nominees to the midwifery board
 E0 209- Family code
 EO 456-IMAP’S privilege to recommend
 LOI 949 – Act on health and health
related activities must be integrated with
other activities of the overall national
development program. Primary Health
Care (10-19-79)
 No. 557 series of 1988- Code of Ethics for
Midwives
 No. 6 series of 1985- CPE for midwives
 No. 187 series of 1991- Extension of
renewal of Professional nurses
 No. 217- Delisting of names from PRC list
of professionals who have not renewed
their license for 5 or more consecutive
years
 Proclamation No. 1275 – Declaring the
third week of October every year as
“Midwifery Week”
 Proclamation No.6 – UN’s goal of
Universal Child Immunization; involved
NGO’s in the immunization program
 Proclamation No. 118 – Professional
regulation Week is June 16 to 22
 Proclamation No. 499 – National AIDS
Awareness Day
 LOI 1000- Membership in national
organization
 LOI 949-Prmary health care expanded
functions for midwives
 LOI 47- Integration of family planning in
Midwifery curriculum
 LOI 13-Protection of Filipino children
Rural Health Physician = 1:20,000
Public Health Nurse = 1:20,000
Rural Health Midwife = 1:5,000
Rural Health Inspector = 1:20,000
Rural Health Dentist = 1:50,000

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