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RESOURCE UNIT IN NURSING ETHICS & JURISPRUDENCE NF Cañizares, BSN, RN, MAN
NURSING ETHICS Main Concept: •
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Nursing Ethics is concerned with the principles and right conduct as they apply to the nursing profession. It reinforces the nurses’ ideals and motives in order to maximize the affectivity of their service. Nursing Nursing Jurispruden Jurisprudence ce is that department of law which comprises all the legal rules and principles principles affecting the practice of nursing. nursing. It also includes the the interp interpret retati ation on of all these these rules rules and princi principle ples s and their their applic applicati ation on to the regulation of the practice of nursing.
Course Objectives: At the end of 20 hours, the students should: 1. Be sens sensiitive tive to ethi ethic cal consi onside dera rati tion ons s and and fac face ethi thical cal issu issue es and and responsibility in health care, community work, and public issues. Specifically, the student will be able to: a. Expl Explai ain n bi bioe oeth thic ical al conc concep epts ts and and p pri rinc ncip iple les s and and iint nteg egra rate te them them in clinical practice. b. Apply the steps in ethical decision-making when given an ethical issue c. Anal An alyz yze e comm common on bioe bioeth thic ical al issue issues s aff affec ecti ting ng nurs nursin ing g pra pract ctic ice e 2. Be able to integrate integrate a basic understa understanding nding of nursing nursing law, develop develop skills skills in the applic applicati ation on of legal, legal, ethico ethico-mo -moral ral princi principle ples s in nursin nursing g practi practice ce and recognize the importance of these principles in the nursing profession.
DEFINITION OF TERMS 1. Profession – an occu occupa pati tion on or call callin ing g requ requir irin ing g adva advanc nce e trai traini ning ng and
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expe experi rien ence ce in some some speci specifi fic c or sp spec ecia iali lize zed d body body of know knowle ledg dge e whic which h provides service to society in that specific field. Vocation – an occupation of calling. Ethics – refers to a standard to examine and understand moral life. Morality – refe refers rs to soci social al cons consen ensu sus s about about mora morall cond conduc uctt for for huma human n beings and society. Profession Professional al Ethics – a bran branch ch of mora morall sc scie ienc nce e conc concer erne ned d with with the the obligations that a member of the profession owes to the public. Health Care Ethics – the division of ethics that relates to human health. Bio-Ethics – a specific domain of ethics that focuses on moral issues in the field of health care. Nursing Ethics – related to all the principles of right conduct as they apply to the profession. Nursing Profession – the performance for a fee, salary or other reward or compensation or professional nursing service to individuals, families and communities in various stages of development. The promotion of health,
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prevention of diseases, restoration of health and alleviation of suffering thru: Utilization of Nursing Process Establishment of connection with community resources Motivation of individuals, families and communities Participation in teaching guidelines and supervision Undertaking nursing and health manpower development • • • • •
ETHICAL APPROACHES A. Teleological Approach or Act of Utilitarianism Teleology comes from the Greek word “ telos” or “goal or end.” This is expressed as “the right thing to do is the good thing to do.” The teleological approach is also termed as act utilitarianism where the good resides in the promotion of happiness or the greatest net increase of pleasure over pain. Guidelines for making ethical decisions: 1. Consideration for people as human beings; 2. Consideration of consequences; 3. Proportionate good to come from choices; 4. Propriety of actual needs over ideal or potential needs; 5. A desire to enlarge choices and reduce chance; and 6. A courageous acceptance of the consequence of the decision. •
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B. Deontological Approach or Duty-Oriented Theory •
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The basic rightness or wrongness of an act depends on the intrinsic natures rather than upon the situation or its consequences. The word deontology came from the Greek word “deon” which means duty.
C. Virtue Ethics Approach •
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Virtue Ethics, known as aretaic ethics (from the Greek word “ arête”) is focused primarily on the heart of the person performing the act. It focused on the traits and virtues of a good person such as courage, temperance, wisdom and justice. Intellectual virtue is the power to deliberate about things good for oneself. Moral virtues must be lived over time in order to be learned.
D. Divine Command Ethics •
Is based on the theory that there is a Supreme or Divine being that sets down the rules to provide guidance to moral decisions.
UNIVERSAL PRINCIPLES OF BIOMEDICAL ETHICS NFC JUNE 2010
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A. Autonomy Comes from the Greek word “autos” meaning self and “nomos” meaning governance. It involves self-determination and freedom to choose and implement one’s decision, free from deceit, duress, constraint or coercion. B. Veracity To maximize the efficiency of health care, the patient and the health care providers are bound to tell the truth. The patient has the responsibility to provide, to the best of his knowledge, accurate and complete information about his complaints, past illness, previous hospitalizations, medications taken, allergies, religious restrictions, and other matters relevant to his health. C. Beneficence / Peace Education The principle of beneficence promotes doing acts of kindness and mercy that directly benefit the patient. These acts promote the health of the patient, prevent illness or complications, alleviate suffering and assist towards peaceful death if the inevitable comes. D. Nonmaleficence Is stated as an admonition in the negative form to remind health practitioners to do no harm. E. Justice Refers to the right to demand to be treated justly, fairly and equally. •
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IMPORTANCE OF ETHICAL CODES 1. It is a systematic guide for developing ethical behavior. 2. It answers normative questions of what beliefs and values should be morally accepted.
NURSING CODE OF ETHICS 1. Importance: It strongly emphasizes the four-fold responsibility of nurse, the universality of the nursing practice, the scope of their responsibilities to the people they serve, to their co-workers, to society and environment, and to their profession.
2. Brief History: a. 1982 The Philippine Nurses Association Special Committee, under the chairmanship of Dean Emeritus Julita V. Sotejo, developed a Code of Ethics for Filipino nurses. •
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The Board of Nursing, Professional Regulation Commission adopted the Code of Ethics of the International Council for Nurses through Board Resolution No. 633 adding “promotion of spiritual environment” as the fifth-fold responsibility of the nurse. This was enforced up to 1989. c. 1989 The Code of Ethics promulgated by the Philippine Nurses Association was approved by the Professional Regulation Commission and through Board Resolution No. 1955 was recommended for use. This was approved by the general assembly of the Philippine Nurses Association during the Nurses Week convention on October 25, 1990. •
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3. Amended Code of Ethics for Nurses a. Pursuant to Section 3 of Republic Act No. 877, known as the Philippine Nursing Law, and Section 6 of PD No. 233, the amended Code of Ethics for Nurses recommended and endorsed by the Philippine Nurses Association was adopted to govern the practice of nursing in the Philippines. b. The Code was adopted under Republic Act 9173 and promulgated by the Board of Nursing under Resolution No. 220 Series of 2004 last July 14, 2004.
PRINCIPLES: 1. 2. 3. 4.
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Nurses and People Nurses and Practice Nurses and Co-Workers Nurses and the Society a. Contributing members of the society b. Awareness for the call for change Nurses and the Profession Responsibility of the Nurse to Patient Responsibility of the Nurse to the Physician Responsibility of the Nurse to her Colleagues Responsibility of the nurse toward themselves
THE ICN CODE FOR NURSES [2006] & THE UNIVERSAL PRINCIPLES IN NURSING 1. Nurses and People • •
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Nursing care Environment that respects the rights, values, and spiritual beliefs of patients Informed consent/ information dissemination Confidentiality
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Responsibility and accountability for nursing practice and the maintenance of competence Standard of care wherein the ability to provide care is not compromised Assess individual competency Maintain standards of personal conduct Client safety with regard to the use of technology and scientific advances 3. Nurses and the Profession Assume the major role in determining and implementing acceptable standards in practice, management, education and research Be active in developing of core of research-based professional knowledge Participate in creating and maintaining safe, equitable, social, and economic working conditions in nursing through professional organization 4. Nurses and Co-Workers Cooperation and collaboration Patient Protection from co-worker or other individuals •
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IMPLEMENTING RULES IN THE ICN CODE OF ETHICS 1. Nurses shall perform professional duties in conformity with the existing laws
and generally accepted principles of moral and ethical conduct and proper decorum 2. Nurses must know responsibilities in the practice of the profession 3. Solicitation, direct or indirect from patients is repugnant to the honor and dignity of nursing profession that constitutes unethical conduct 4. Nurses must not allow the use of their names in the promotion of any commercial products or service
RESPONSIBILITIES OF THE NURSE TO THE PATIENTS 1. Give him/her the kind of care his/her condition needs regardless of his/her
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race, creed, color, nationality or status. The patient’s care shall be based on needs, the physician’s orders, and the ailment. The nurse shall involve the patient and/or his/her family so that he/she or any of the family can participate in his/her care. Know the patient’s Bill of Rights. Be patient advocate. Treat patient in a manner that will show concern whether the patient is rich or poor. Nurses should not leave a patient or any agency without proper permission or resignation or without relief. Nurses should commit themselves to the welfare of those entrusted to their care.
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PATIENT’S BILL OF RIGHTS 1. The patient has the right to considerate and respectful care. 2. The patient has the right to obtain from his physician complete and current information concerning his diagnosis, treatment, and prognosis in terms the patient can be reasonably expected to understand. 3. The patient has the right to receive from his physician information necessary to give informed consent prior to the start of any procedure and/or treatment. 4. The patient has the right to refuse treatment and to be informed of the medical consequences of his action. 5. The patient has the right to every consideration of his privacy concerning his own medical care program. 6. The patient has the right to expect that all communications and records pertaining to his care should be treated as confidential. 7. The patient has the right to expect within its capacity, a hospital must make reasonable response to the request of a patent for services. 8. The patient has the right to obtain information as to any relationship his hospital has to other health care and educational institutions insofar as his care is concerned. 9. The patient has the right to be advised if the hospital proposes t engage in or perform human experimentation affecting his care or treatment. 10. The patient has the right to expect reasonable continuity of care. 11. The patient has the right to examine and receive an explanation of his bill. 12. The patient has the right to know what hospital rules and regulations apply to his conduct as a patient.
PATIENT’S RESPONSIBILITIES 1. 2. 3. 4. 5. 6.
Providing information Complying with instructions Informing the physician of refusal to treatment Paying hospital charges Following hospital rules and regulations Showing respect and consideration
NURSES’ BILL OF RIGHTS 1. Nurses have the right to practice in a manner that fulfills their obligations to society and to those who receive nursing care. 2. Nurses have the right to practice in environments that allow them to act in accordance with professional standards and legally authorized scopes of practice. 3. Nurses have the right to a work environment that supports and facilitates ethical practice, in accordance with the Code of Ethics for Nurses and its interpretative statements. 4. Nurses have the right to freely and openly advocate for themselves and their patients, without fear of retribution. NFC JUNE 2010
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5. Nurses have the right to fair compensation for their work, consistent with their knowledge, experience and professional responsibilities. 6. Nurses have the right to a work environment that is safe for themselves and their patients. 7. Nurses have the right to negotiate the conditions of their employment, either individuals or collectively, in all practice settings.
NURSES’ RESPONSIBILITIES IN RESEARCH ON HUMAN SUBJECTS 1. Employment in settings where research is conducted. 2. Vigilant protection of human subjects’ rights 3. Scope of Application 4. Supporting accrual of knowledge 5. Informed consent 6. Representation of Human Rights Committee
BASIC HUMAN RIGHTS OF RESEARCH SUBJECTS 1. 2. 3. 4. 5.
Right to informed Consent The right to refuse and/or withdraw from participation Right to privacy Right to confidentiality or anonymity of data Right to be protected from harm
EXPERIMENTAL SUBJECT’S BILL OF RIGHTS 1. To be told about the nature and purpose of the study. 2. To be told about the procedures to be followed in the research study, and whether any of the drugs, devices, or procedures is different from what would be used in standard practice. 3. To receive a description of any side effects, discomforts, or risks that you can reasonably expect to occur during the study. 4. To be told of any benefits that you may reasonably expect to from the participation in the study, if applicable. 5. To receive a description of any alternative procedures, drugs, or devices that might be helpful, and their risks and benefits compared to the proposed, drugs or devices. 6. To be told of what sort of medical treatment, if any, will be available if any complications should arise. 7. To be given a chance to ask any questions concerning the research study both before agreeing to participate and at any time during the course of the study. 8. To refuse to participate in the research study. Participation is voluntary. You may refuse to answer any question or discontinue your involvement at any time without penalty or loss of benefits to which you might otherwise be entitled. Your decision will not affect your right to receive the care you would receive if you were not in the experiment. 9. To receive a copy of signed and dated written consent form and a copy of this form. NFC JUNE 2010
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10. To be given the opportunity to freely decide whether or not to consent to the research study without any force, coercion, or undue influence.
RESPONSIBILITIES OF THE NURSE TO THE PHYSICIAN •
Section 28(a) of RA 9173 states that: It shall be the duty of the nurse to: (a) Provide nursing care through utilization of the nursing process. Nursing care includes, but not limited to, traditional and innovative approaches, therapeutic and innovative approaches, therapeutic use of self, executing health care techniques and procedures, comfort measures, health teachings, and administration of written prescription for treatment, therapies, oral, topical and parental medications, internal examination during labor in the absence of antenatal bleeding and delivery. In case of suturing or perineal laceration, special training shall be provided according to protocol established.
RESPONSIBILITIES OF NURSES TO THEIR COLLEAGUES 1. Establish good working relationships with co-workers. 2. Nurses shall adjust themselves to the organization and know its policies and procedures.
RESPONSIBILITIES OF NURSES TO THEMSELVES 1. 2. 3. 4.
Develop their own skills. Their conduct must bring credit to the profession. They shall endeavor to live a life that will uphold their self-respect. Wear uniform with respect and dignity (clean, neat hair style, moderate make-up, without jewelries) 5. Must act in a manner that is worth emulating especially while they are on duty.
Special Concepts and Principles which Guide Client-health Professional Relationship 1. 2. 3. 4. 5.
Right to Health Care Right to Informed Consent Promise Keeping (Fidelity) Truth-Telling (Veracity) Confidentiality
MORAL PRINCIPLES 1. 2. 3. 4. 5. 6.
The Golden Rule The Two-fold Effect The Principle of Totality Epikia One who acts through an agent is himself responsible No one is obliged to betray himself/herself
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7. The end does not justify the means 8. Defects of nature may be corrected 9. If one is willing to cooperate in the act, no justice is done to him/her 10. A little more or less does not change the substance of an act 11. The greatest good for the greatest number 12. No one is held to the impossible 13. The morality of cooperation 14. Principle relating to the origin and destruction of life
The Good Samaritan Law It is based on the biblical story of a man who aided an injured person who was waylaid by thieves and was left half-dead. A nurse, therefore, who renders first aid or treatment at the scene of an emergency and who does so within the standard of care, acting in good faith, is relieved of the consequences of the act.
LAWS AND ORGANIZATIONS PROTECTING NURSES: 1. 2. 3. 4. 5. 6. 7.
International Labor Organization Convention 149 ILO Recommendation 1977 International Council of Nurses Code of Ethics for Nurses Magna Carta for Health Workers (RA 7305) Philippine Nursing Law Philippine Constitution
JURISPRUDENCE A. Definition of Terms 1. Law – the sum total of rules and regulations by which society is governed. 2. Jurisprudence – the science of law. 3. Nursing Jurisprudence – that department of law which comprises all
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the legal rules and principles affecting the practice of nursing. It also includes the interpretation of all these rules and principles and their application to the regulation of the practice of nursing. Plaintiff – the party to a civil suit who brings the suit seeking damages or other legal relief; complainant. (ACCUSER) Defendant – (In criminal case) the person accused of committing a crime; (In civil suit) the party against whom suit is brought demanding that he pays the other party legal relief. Subpoena – a court order requiring one to appear in court to give testimony. Summons – a notice to a defendant ordering him to speak in a court at a specified time and date to answer a complaint against him.
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Witness – one who is called to give testimony in a court of law. Felony – a crime of a serious nature usually punishable for a period of
longer than one year or by death. 10. Principal – a person who takes direct part in the execution of the act. 11. Accomplice - those people who not being principals, cooperate in execution of the offense by previous simultaneous acts. 12. Legal Right – a right or claim which can be enforced by legal means against the person of the community. 13. Jurisdiction – the legal right or authority of a court to hear and decide on a legal case or controversy. 14. Legislation – the act or process of making laws.
Aspects of the Profession with Provisions with Provisions of the Law: 1. 2. 3. 4. 5.
Examination and registration of applicants. Professional conduct of practitioners. Maintenance of ethical and technical standards of the profession. Illegal practice of unregistered persons. Exercise of powers and duties to examine applicant and administer the law regulating the profession.
CLASSIFICATION OF LAWS: A. According to Source of Authority 1. Divine Law – laws authored by God 2. Human Law – laws authored by men
B. Groups of Human Law 1. Public Law – department of law which is concerned with the state in its
political or sovereign capacity. It is a law that applies generally to people of the state adopting or enacting it. 1.1Criminal Law – treats the nature, extent and degree of every crime and adjusts to it the adequate and necessary penalty. 1.2International Law – the law which regulates the intercourse of nations 1.2.1 Public International Law – control the conduct of independent state in their relation to each other. 1.2.2 Private International Law – conflict law 1.3Political Law – Threats the science of politics (Government) Regulates the relation between the state and individuals that compose it. 1.3.1 Constitutional Law - law that relates the constitution, as a permanent system of political and juridical government, as distinguished from statutory and common law, which relate to matters subordinate to such constitution. NFC JUNE 2010
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orders and decisions created by administrative agencies of government. 1.3.3 Law of Public Administration 1.3.4 Law of Public Corporation Private Law – law that relates the private matters which do not 1.4 concern the public at large (Administrative between citizen and citizen) 1.4.1 Civil Law – organizing the family and regulating property. 1.4.2 Commercial Law – relates to the rights of property and the relations of persons engaged in commerce. 1.4.3 Remedial Law – methods of enforcing rights or obtaining redress (correcting the wrong)
THE EVOLUTION OF THE PHILIPPINE NURSING LAW Republic Act No. 2493 dated February 5, 1915 – The first law affecting the practice of nursing in the Philippines. It consists of two sections: a. Sec. 7 – states that every person desiring to practice nursing in the Philippines shall apply to the Director of Health for a Certificate of registration as a nurse. b. Sec. 8 – states that it shall be unlawful for any person to practice as a nurse in any of its branches in the Phil. until the proper certificate of registration has been obtained. This is also an act that provides for the examination and registration of nurses in the Philippines. Republic Act No. 2808 dated March 1, 1919 – an act regulating the practice of nursing profession in the Philippines otherwise known as the Nursing Law (this is first considered as the first Nursing Law). Significance of this Law The first board of examinees for nurses was created composed of three members appointed by the Secretary of Interior (one doctor of medicine as chairman and two members who are registered nurses, had experience in the nursing profession for at least five years of reputable character) •
The Board has the following powers: 1. Issue and revoke certificates of registration for practitioners of the nursing profession. 2. Study the conditions affecting the practice of the nursing profession in all parts of the Philippines. 3. Exercise the power conferred by the law to maintain efficient, ethical and technical standards in nursing profession. 4. Promulgate regulations governing the nurse examination and standards to be attained.
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Republic Act No. 4007 dated December 5, 1931 (Reorganization Law) – took effect the conduct of board examination and placed the direct supervision of the Bureau of Civil Service.
NURSING LAWS PASSED IN JUNE 1950 • •
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RA 465 – standardized the fees charge by the examining board. RA 546 – reorganized and placed all the board examinees under the direct supervision of the Pres. of the Phil. RA 877 dated June 19, 1953 – was enacted as an entirely new law created by the Filipino Nurses associated (NOW PNA) namely: Ms. Obdulia Kabigting as chairman; Dean JV Sutejo and Conchita Ruiz. The act was sponsored by Sen. Geronima Pecson. The purpose is to “regulate the practice of nursing in the Philippines and to set up provisions for the registration of the nurses for the establishment and maintenance of standards of nursing education and practice.” RA 1080 dated June 15, 1954 – An act declaring the BAR and BOARD OF EXAMINATION as “Civil Service Examniation”
Cognizant of the complexities in the Nursing Profession on 1970, the nursing leader mad steps to re-align the nursing law a tuned times. The following event took place: 1975 – Dean JV Sotejo called on then Pres. Marcos for the revision of the Nursing Law to enable nurses to practice more effectively and with legal protection with in the framework of an expanding and changing health care delivery system (this did not materialized). July 1977 – Dr. R. Diamante worked for the decree instituting a professional regulation code and the proposed amendments of the Nursing Law. May 13, 1982 – Coping of the propose amendment of the Philippine Nursing Act of 1982 was submitted to health minister Azurin for him to sponsor at Batasan Pambansa. These events laid the foundation for RA 7164 with Senator Heherson Alvarez as primary sponsor. It was finally passed in the lower house and appraisal in November 21, 1991 by Pres. Corazon Aquino “Nursing as a dynamic profession continues to seek ways and means to make it more responsive and relevant. This is the prime motive for the birth of RA 9173 – sponsored by Hon. Carlos M. Padilla of the House of Representatives. Said bill was approved on the third meeting by the low House on August 22, 2000 but was not acted upon by the Senate. The counterpart bill in the Senate (SB No. 2292) with Senator Flavier as sponsor. The BM and PNA and Legislation Committee worked and put the bill in its final form. The Pres. GM Arroyo during the 80th Anniversary of the Nurses Week celebration on October 21, 2002 in Manila Midtown Hotel.
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RA 9173 October 21, 2002 – an act providing for a more responsive nursing profession repealing for the purpose RA # 7164, otherwise known as the Philippine Nursing Act of 1991.
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PHILIPPINE NURSING LAW (RA 9173)
Title of the law and its provision (Article I) Declaration of Policy (Article II) Organization of the Board of Nursing (Article III) Examination and Registration (Article IV) Nursing Education (Article V) Nursing Practice (Article VI) Health Human Resources Production, Utilization and Development (Article VII) Penal and Miscellaneous Provisions (Article VIII)
Reference for RA 9173 – Primer of RA 9173, Twelfth Congress, Second Regular Session – Board of Nursing Resolution No. 425, Series of 2003, Implementing Rules and Regulation of the Philippine Nursing Act of 2002.
ELEMENTS INVOLVED IN LEGAL LIABILITY: 1. Negligence – refers to the commission or omission of an act, pursuant to a
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duty, that a reasonably prudent person in the same or similar circumstance would or would not do, and acting or non-acting of which is the proximate cause of injury to another person or his property. Malpractice – The ideas of improper or unskillful care of a patient by a nurse; denotes stepping beyond one’s authority with serious consequences. It is the term for negligence or carelessness of professional personnel. Incompetence – the lack of ability, legal qualifications or fitness to discharge the required duty. Ignorance – means want of knowledge. Moral Turpitude – an act of baseness, vileness or depravity in social or private duties. Fraud – a wrong doing or misconduct, an act resulting from a willful act to deceive; deceitful practice, rules of common honesty. Deceit – any act. Declaration or practice which misleads a person or which causes him to believe what is false. False Statement – an allegation or statement that is deceitful with intention to commit a fraud.
PROFESSIONAL NEGLIGENCE A. Elements of Professional Negligence 1. Existence of duty on the part of the person charged to use due care under circumstances. 2. Failure to meet the standard of due care. 3. The foreseeability of harm resulting from failure to meet the standard. 4. The fact that the breach of this standard resulted in an injury to the plaintiff. NFC JUNE 2010
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B. Five Legal Doctrines to Describe Professional Negligence
1. Res Ipsa Loquitor – three conditions are required to establish a defendant’s negligence without proving specific conduct. 2. Doctrine of Force Majeure - means an irresistible force, one that is unforeseen or inevitable. 3. Doctrine of Respondeat Superior – “let the master answer for the acts of the subordinate.” 4. Captain of the Ship Doctrine 5. Doctrine of Corporate Liability
TORTS – a legal wrong, committed against a person or property independent of a contract which renders the person who commits it liable for damages in a civil action.
Examples of Torts: 1. Assault – the imminent threat of harmful or offensive bodily contact. 2. Battery – an intentional, unconsented touching of another person. 3. False Imprisonment or Illegal Detention – means the unjustifiable
detention of a person without a legal warrant within boundaries fixed by the defendant by an act or violation of duty intended to result in such confinement. 4. Invasion of Right to Privacy and Breach of Confidentiality 5. Defamation Slander – oral defamation of a person by speaking unprivileged or false words by which his reputation is damaged. Libel – defamation by written words, cartoons or such representations that cause a person to be avoided, ridiculed or held in contempt or tend to injure him in his work. •
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CRIMES, MISDEMEANORS AND FELONIES 1. Crimes – an act committed or omitted in violation of the law.
2. Elements of Criminal Offenses: a. Criminal Act b. Evil/ Criminal Intent • • • •
Conspiracy to commit a crime Criminal Actions Criminal Negligence Criminal Intent
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CLASSIFICATION OF FELONY: A. According to Degree of the acts of Execution: 1. Consummated – when all the elements necessary for its execution and
accomplishment are present. 2. Frustrated – when the offender performs all the acts or execution which will produce the felony as a consequence but which nevertheless, do not produce it by reason of causes independent of the will of the perpetrator. 3. Attempt – when the offender commences the commission of the same directly overt (open or manifest) acts, and does not perform all the acts or execution which shall produce the felony, by reason of some cause or accident other than his own spontaneous desistance.
B. According to Degree of Punishment: 1. Grave
Felonies – those to which the law attaches the capital punishment (death) or penalties which in any of their periods are afflictive (imprisonment ranging from six (6) years and one (1) day to life imprisonment not exceeding P6,000.00). 2. Less Grave Felonies – those which the law punishes with penalties which in their maximum period are correctional (imprisonment ranging from one month and one day to six (6) years, or a fine not exceeding P6,000.00 but not less than P200.00). 3. Light Felonies – those infractions of law for the commission of which the penalty of arresto menor (imprisonment for one (1) day to thirty (30) days or a fine not exceeding P200.00 or both of which are imposed). This is punishable only when they have been consummated, with the exception of those committed against a person or property.
CIRCUMSTANCES AFFECTING CRIMINAL LIABILITY 1. 2. 3. 4. 5.
Justifying Circumstances Exempting Circumstances Mitigating Circumstances Aggravating Circumstances Alternative Circumstances
CRIMES WHICH CONCERNS NURSES 1. Parricide – a crime committed by one who kills his/her father, mother, or
child whether legitimate or illegitimate, or any of his/her ascendants or descendants of his/her spouse. 2. Murder – the unlawful killing of a human being with intent to kill. 3. Homicide – the killing of a human being by another. 4. Infanticide – the killing of a child less than three (3) days of age. 5. Abortion – the expulsion of the product of conception before the age of viability. 6. Giving assistance to suicide 7. Illegal Detention – unlawful taking of a person or property as in the case of forcible entry or detention. NFC JUNE 2010
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8. Simulation of birth, substitution of one child for one another, or abandonment of a legitimate child. 9. Criminal Negligence Reckless Imprudence – when a person does an act or fails to do it voluntarily but without malice, from which material damage results immediately. Simple Imprudence – when the person or nurse did not use precaution and the damage was immediate or the impending danger was not evident or manifest.
Legal Responsibilities of Nurses into the Following Areas: A. B. C. D. E. F. G.
Contracts Informed Consent Wills Nursing Care Operation of Patients Abortion Cases Unauthorized Discharge of Patient
Points to Observe by Nurses in Order to Avoid Criminal Liability 1. Be very familiar with the Philippine Nursing Law. 2. Beware of laws affect nursing practice. 3. At the start of employment, get a copy of your job description, the agency’s rules, regulations and policies. 4. Upgrade your skills and competence. 5. Accept only such responsibility that is within the scope of your employment and job description. 6. Do not delegate your responsibility to others. REFERENCES: 1. Lydia M. Venzon, RN, MAN, PhD, FPCHA and Ronald M. Venzon Professional Nursing in the Philippines 11th Edition, C&E Publishing Corp., 2010 10th Edition, C&E Publishing Corp., 2005 2. Rustico T. De Belen and Donna Vivian De Belen Nursing Law, Jurisprudence & Professional Ethics 1st Edition, C&E Publishing Corp., 2007 3. DOH Nursing Service Manual, 2005 4. Kozier, Erb, Berman and Snyder Fundamentals of Nursing: Concepts, Process and Practice 8th Edition, C&E Publishing Corp 5. Commission on Higher Education CHED Memorandum Order (CMO) no. 14, S. 2009 6. Commission on Higher Education CHED Memorandum Order (CMO) no. 30, S. 2001
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