EXAMINING

IN
NURSING PRACTICE

Ethics is a system of principles

(fundamental truths) a society
develops to guide decision
making what is right from
wrong.
Nursing
Nursing Ethics

(8) GUIDING PRINCIPLES/FUNDAMENTAL

LAWS of HEALTH CARE ETHICS

1. Preserve Life

2. Do Good

3. Respect Autonomy

Contract is a meeting of minds between two persons

whereby one binds himself, with respect to the other, to give
something or render some service.
When a nurse enters into a contract with an employer, it Is
usually an agreement to be paid a certain amount of money
and be provided certain benefits in exchange for such
services.
Elements: Offer, Object, Acceptance,
Obligation

Requisites of a Contract:
*Two or more person must participate.
ELEMENTS of CONTRACT
1. Two parties involved must give consent to the
contract.
2. The object/acceptance which is the subject matter
of the contact must be specified.
3. The cause of obligation/consideration is
established. The time, price and subject matter are
to be expressed.

* Contracting parties must be of legal age; be

of sound mind; not under the influence of
drugs, or fear of bodily harm; and not

Kinds of Contract
1. Formal Contract refers to an agreement
among parties involved and is required to be
in writing by some special laws. Ex: marriage
contract, mortgages, deeds of sale, work
contracts.

Kinds of Contract
2. Informal Contract is one which is concluded
as a result of oral and spoken discussion
between the parties concerned.

Kinds of Contract
3. Express Contract is one in which the conditions
and terms of the contract are given orally or in
writing by the parties concerned.
***kind of services offered, salary, date and time
of effectivity including fringe benefits are specified.
Ex: a private duty nurse is asked by the physician to
go on special duty for his patient.

4. Implied Contract is one that is concluded

as a result of acts of conduct of the parties
to which the law ascribes an objective
intention to enter into contract.
To avoid subsequent problems, nurses are
advised to clarify the terms and conditions of
employment before assumption of work with
the prospective employer.

5. Void Contract is one that is inexistent from

the very beginning and therefore may not be
enforced.

6. Illegal Contract is one that is expressly

prohibited by law.
7. Breach of Contract
* Four ELEMENTS of CONTRACT *

Veracity
To maximize the efficiency of
health care, the patient and the
health care providers are bound
to tell the truth.
The nurse has the responsibility to provide,
an accurate and complete information about
his patients complaints, past illness, previous
hospitalizations, medications taken, allergies,
religious restrictions, and other matters
relevant to his health.

1. Principle of Confidentiality any information

gathered by nurses during the course of caring
for their patients should always be treated
confidential.

Confidential information is also termed as

privileged communication because it is
given based on trust.

2. Principle of Privacy the rights to privacy includes

privacy of ones thoughts, opinions, and physical
presence and privacy of ones records.
The subject has the
freedom to decide
the time, the extent
and circumstances
he/she will willingly
share his/her presence,
thoughts, beliefs,
attitudes and behavior
with others.

3. Fidelity loyalty, truthfulness (promise

keeping)

4.
Upholds
Justice

5. Be Honest

6. Be Discreet

7. Keep Promise

8. DO NO HARM

DEFINITION OF TERMS
1.Profession - an occupation or calling requiring
advance training and experience in some
specific or specialized body of knowledge
which provides service to society in that
specific field.

2. Vocation - an occupation of calling.

DEFINITION OF TERMS
3. Ethics - refers to a standard to examine and
understand moral life
4. Health Care Ethics - the division of ethics that
relates to human health.

DEFINITION OF TERMS:
5. Morality - refers to social consensus about
moral conduct for human beings and society.
6. Professional Ethics - a branch of moral
science concerned with the obligations that a
member of the profession owes to the public.

7. Nursing Ethics - related to all the principles of

right conduct as they apply to the profession.
8. Nursing Jurisprudence - that department of
law which comprises all the legal rules and
principles affecting the practice of nursing..

9. Law - the sum total of rules and regulations by

which people live/society/countryf is governed.
10. Justice In health care, justice refers to the
right to demand to be treated justly, fairly and
equally.

 Professional Nurse is a person who has

completed a basic nursing education
program and is licensed in his/her
country or state to practice professional
nursing.

Prerequisite before license*

 License - is a legal document given by the

government that permits a person to
offer to the public his/her skills and
knowledge in a particular jurisdiction.

REGISTRATION

 Registration is the recording of

names of persons who have qualified
under the law to practice their
respective professions.

 Licensure Examination All applicants for

registration as a nurse and issuance of
professional ID card to practice nursing shall
be required to pass a written examination
which shall be given by the Board of Nursing

 Renewal of Nurses License Every registered

nurses shall renew his/her license every three
years with the PRC, not later than the due
date indicated in the PRC license card and pay
the prescribed fee.

REVOCATION & SUSPENSION

Suspension means that the nurse is not
allowed to practice temporarily until final
judgment of the case against him/her is
rendered.
Revocation means that the license to
practice is confiscated permanently.

The Board of Nursing and the Professional

Regulation Commission shall have the power to revoke
professional license upon the following grounds:
For any of the causes mentioned in Section 22 of RA
9173
For unprofessional and unethical conduct
For gross incompetence and serious ignorance
Malpractice or serious negligence
Use of fraud, deceit, or false statements in obtaining
certificate of registration or professional license.
Violation of Code of Ethics, Standard for Nursing
Practice
For practicing his/her profession during the time of
I.Dcard suspension.

RA 9173 - Sec 22. Non- registration and Non-Issuance of COR,/

Professional License or Special/ Temporary Permit.
Grounds For Non- Registration PL, or Special/Temporary Permit

If he has been convicted by final judgment of a criminal offense

involving moral turpitude/wickedness.

If he is guilty of immoral or dishonorable conduct

If he has been declared by the court to be of unsound mind

UNSOUND MIND refers to one who is incapable of managing himself

or his affairs & that includes insane people..

 Re-issuance of Revoked Certification/

Replacement the Board may, after the
expiration of a minimum of (4) years
from the date of revocation of a
certificate when the cause of revocation
has been cured or corrected. License
may be reissued upon payment of fees.

Due process
is defined as law which
hears before it condemns,
which proceeds upon
inquiry and renders
y
judgment only after trial.

THE LICENSING BOARD

1. Power to regulate the Profession
2. Organization & Composition
3.Qualification of Members of the Board

The Board has the following powers:

Issue and revoke certificates of registration for
practitioners of the nursing profession.
Study the conditions affecting the practice of
the nursing profession in all parts of the
Philippines.
Exercise the power conferred by the law to
maintain efficient, ethical and technical
standards in nursing profession.
Promulgate regulations governing the nurse
examination and standards to be attained.

DIFFERENT FIELDS OF NURSING

1. Military Nursing (services)
2. Hospital/Institutional Nursing (areas &
specialization)
3. Private Duty Nurse/Special Duty Nursing
4. Company/ Industrial Health Nursing (Airlines,
Occupational Health)
5. Public Health Nursing/ Community Health Nursing
6. Hospital/Institutional Nursing:
ChiefNurse.Nursing Education,,FEU
7. School Nursing
8. Independent Nursing Practice

Military Nursing (Nurse Corps, AFP)

Functions of the Nurse Corps
The AFP Nurse Corps provides comprehensive
and quality nursing care to all military
personnel, their legal dependents and
authorized relatives.

Military Nursing (Nurse Corps, AFP)

(services)
Functions of the Nurse Corps
To meet the nursing needs of todays patients
(soldiers) in AFP medical facilities.
1. To prepare each nurse corps officer (regular and
reserve) for future assignments at the higher level
of responsibility in the different stations and
general hospitals in times of peace and war;
2. To teach and train enlisted personnel who perform
nursing functions under supervision.

Qualifications of the
Military Nurse
1.
2.
3.
4.
5.

6.
7.
8.
9.

BSN, RN
Natural born Filipino citizen
Single, never been married (Male & Female)
Mentally and physically fit and cleared by appropriate
agency
With pleasing personality and have a good moral
character
Skillful in applying nursing process in various setting
Communicating and relating with others, and have sound
judgment
Interested and willing to work in both peaceful and
wartimes condition
Not more than 32 years of age
Minimum height of 62 inches for males, and 60 inches for
females

Hospital/Institutional Nursing
(areas & specialization)
Nursing in hospitals and related health facilities
such as extended care facilities, nursing homes, and
neighborhood clinics, comprises all of the basic
components of comprehensive patient care and
family health. Basic Qualification: BSN, RN

Advantage of Staff Nurse in the Hospital:

1. There is always a supervisor whom one can consult
if problem exists.
2. Nurses are updated with new trends in medicine
and in nursing care of patients.
3. They undergo rotation to different units and have
the chance to determine their choice area
4. They have 8 hours/day and 40 hours/week which
provides 2 days rest day.

Advantage of Staff Nurse in the Hospital:

5. They have the chance to get promoted to a higher
position if they are qualified.
6. Salary increases are given periodically according to
merit.
7. They are important members of the health team in
providing care to patients.
8. More staff development programs are available in
hospitals.

Private Duty Nurse/Special Duty

Nursing
A registered nurse who undertakes to give
comprehensive nursing care to a client on a one-toone ratio.
Nurses in private practice are expected to be
expert clinicians as well as expert generalists in
nursing.

Company/ Industrial Health Nursing

(Airlines, Occupational Health)
Occupational Health Nursing is the special practice
that provides and delivers health care services to
workers. The practice focuses on the health
promotion, protection, and supervision of workers
health within the context of safe and healthy work
environment.

Company/ Industrial Health Nursing

(Airlines, Occupational Health)
Occupational health nursing is autonomous
and occupational health nurses make
independent nursing judgments in providing
health services. This field of nursing requires
special skills especially in emergency nursing.

Public Health Nursing/ Community

Health Nursing
Public Health Nursing refers to the practice of
nursing in the local, national, and city health
departments which include health centers and
public schools. It is community health nursing
practice in the public sector.
Community Health Nursing is broader as it
encompasses nursing practice in a variety of
roles, which at times include independent nursing
practice. The term use for CHN includes parish
nursing, community mental health nursing, and
school nursing.

Advantage of CHN
1. The focus of nursing care is on family and community
health rather than on an individual basis.
2. It gives nurse a better perspective of health
conditions of the community, health programs of the
government, and to appreciate the nurses role in
nation building.
3. It maximizes efforts to improvise where there are no
sufficient facilities, supplies and equipment.
4. It enables the nurse to utilize various community
resources and maximize coordination with other
members of the health team.
5. Focus of care is more on educational and promotive
and preventive aspects.
6. Individuals families and communities are motivated to
assume responsibility for their own health care.

Nursing Education
Nurses who would like to consider teaching as their
field of expertise. The career ladder in nursing education
starts with a Clinical Instructors position up to that of the
Dean of the College of Nursing.
Qualification:
1. BSN, RN
2. Have at least 2 years of clinical practice in the field of
specialization
3. Member of good standing in the accredited professional
organization
4. Holder of Master of Arts in Nursing, education or other
allied, medical and health sciences, preferably, Doctor of
Education& Doctor of Philosophy conferred by a
reputable college or university duly recognized by the
government.

School Nursing
School nurse is responsible
for the schools activities in the areas
of health service, health education, and
environmental health and safety.
Responsibilities of a school nurse:
1. Organizing and implementing the
school health program;
1. Coordinating school health program
2. Undertaking functions directly related
to pupils health
3. Evaluating school health programs; and
4. Carrying out functions related to health
of school personnel.

Independent Nursing Practice

The nurse is self employed and provides
professional nursing services to clients and
their families.
Most of them are community based. They
perform both independent and collaborative
functions. They make referrals and collaborate
with physicians and other disciplines as
needed by the client or family.
ARH

MORAL & SPIRITUAL RESPONSIBILTIES

OF NURSES

Golden Rule
Two-Fold Effect
Principle of Totality
Epikia
The end does not justify the means
The greatest good for a greatest number

NURSING CODE OF ETHICS

Amended Code of Ethics for Nurses
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.
( slide;document)

NURSING CODE OF ETHICS

PRINCIPLES:
1. Nurses and People
2. Nurses and Practice
3. Nurses and Co-workers
a. Nurses and the Society
b. Contributing members of the society
4. Awareness for the call of change
5. Nurses and the profession
6. Responsibility of the nurse to the patient
7. Responsibility of the nurse to the physician
8. Responsibility of the nurse to her colleagues
9. Responsibility of the nurse towards themselves

RESPONSIBILITIES OF THE NURSE TO THE PATIENTS

1. Give him/her the kind of care his/her condition needs
regardless of his/her race, creed, color, nationality or status.
2. The patients care shall be based on needs, the physicians
orders, and the ailment.
3. 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.

RESPONSIBILITIES OF THE NURSE TO THE PATIENTS

5. Know the patients Bill of Rights.
6. Be patient advocate. Treat patient in a manner that will
show concern whether the patient is rich or poor.
7. Nurses should not leave a patient or any agency without
proper permission or resignation or without relief
8. Nurses should commit themselves to the welfare of those
entrusted to their care
MORAL/SPIRITUAL
RESPONSIBILITIES of
NURSES: # 1 to 13.

PATIENTS 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.

PATIENTS BILL OF RIGHTS

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.

PATIENTS BILL OF RIGHTS

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 in so far as his care is
concerned.
9. The patient has the right to be advised
if the hospital proposes to engage in or
perform human experimentation
affecting his care or treatment.

PATIENTS BILL OF RIGHTS

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.

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 environment 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.

NURSES BILL OF RIGHTS

4. Nurses have the right to freely and openly advocate for
themselves and their patients, without fear of retribution.
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.

Basic Standards of Clinical Nursing Practice as Taking

Orders thru Phone
Attending Physician should be the one responsible for
making important and urgent orders through phone call.
The order must be read twice
by nurse to ensure clarity
The nurse who received the
order must inform the head
nurse immediately
The nurse must see to it that the attending physician who
made the order must sign the order within 24 hours.

Golden Rules for Administering Medicines Safely

Right Patient
Right Drugs
Right Time
Right Dose
Right Route of Administration
*

Helpful Tips About Nursing

Ethics and Jurispridence

Five (5) common legal

issues in nursing: What
every nurse should know?.

1. Signatures are Golden

2. Document, Document,
Document

3. Report it or Tort it

4. Right to Privacy

5. Youre Dosing What?

LEGAL ASPECT
(Accountability in the
practice of profession)

 Another major ethical and

legal issues that is common
to the nursing profession is

NEGLIGENCE.
Here are some examples

Tort a civil wrong & can be done

intentional or unintentional.
Incompetence lack of ability, legal
qualifications or fitness to
discharged the required duty.

Negligence - refers to the commission or omission of an act,

pursuant to a duty, that a reasonably prudent person 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.

Elements of Professional Negligence:

Failure to meet the standard of due care.
The foreseeability of harm resulting from
failure to meet the standard.
The fact that the breach of this standard
resulted in an injury.

Malpractice - the idea of improper or

unskillful care of a patient by a nurse;
*denotes stepping beyond ones authority
with serious consequences.

Have you been in any of this situation?

Unsafe Patient to Nurse Ratio
Youve been assigned to an area where you would
handle 20 patients at the same time.
Big Question: Who will you prioritize? What
method will you use in determining who will
receive the first intervention youll give.

 The nurse has an ethical duty to keep her

patients safe. An ethical dilemma happens
when a nurse finds herself in a situation
where she has too many patients and cannot
provide adequate care for all of them on her
own.

 Inappropriate Medication Orders

The Doctor has ordered a medication for your
patient that you are unsure of.
Big Questions: What will you do? Will you
aggressively go and research information about
the medication? Do you have the courage to
challenge the physician as an advocate of your
patient? Or youll just let go

 Giving wrong medication dosages or

medication for the wrong illness is unsafe for
patients and may lead to death .. Nurses can
find themselves in an ethical dilemma when
they have to challenge a medication order
written by a physician.

 Inappropriate Tasks
You have been assigned to a new area where you
dont gave any experience at all. Your charge nurse
has instructed to do an intervention you have read
but doesnt have any experience doing the actual
thing
Big Questions: Will you do it? Or Not?

 Nurses float from department to department

in the course of their career. When a nurse
finds herself in an unfamiliar department and
is asked to provide care she is inadequately
trained for, she may have to refuse to provide
care to avoid making the patient unsafe or
request assistance from the charge nurse or
the headnurse

 Life Threatening Patient Decisions

Your patient have refuse any treatment to be
given to her. Very timely that she experience an
attack and needs intervention to save her life
while knowing her decision,

WILL YOU DO?

WHAT

 Patients sometimes make decisions that are

unsafe, such as refusing treatment, taking
medication or life saving procedures. The
nurse finds herself in an ethical dilemma
because not giving the needed treatment goes
against the Principle of Beneficence and giving
it ignores patient Autonomy.

/
Nurses adhere to certain ethical principles when
caring for patients. These principles include
beneficence which is doing NO harm to the patient,
maleficence which is doing harm to a patient for
positive outcome, based on need and patient
autonomy which is respecting the patients right to
make health decisions. Conflict with these
principles results in an ethical dilemma.

 Burns resulting from hot water bags, heat lamps,

sitz bath,
Objects left inside the patients body & sponges,
loose dentures lodged in the patient trachea,
falls of the elderly & to patients who are not
fully recovered from anesthesia...Liability for
negligence therefore shall be imposed upon the
nurse who has failed to behave as a reasonable,
prudent nurse.

 Failure to report observations to attending physician

Mistaken Identity
Wrong medicine, wrong concentration, wrong route,
wrong dose
Administration of medicine without a doctors order
Defects on the equipment such as stretchers &
wheelchairs may lead to fall thus injuring the patient.
Failure to exercise diligently that is required in a given
situations..attended pt delivery w/o prenatal check
up,,,placental delivery>> bleeding>>uterine
atony>death

Elements of Professional Negligence:

Failure to meet the standard of due care.
The foreseeability of harm resulting from
failure to meet the standard.
The fact that the breach of this standard
resulted in an injury.

Malpractice - the idea of improper or

unskillful care of a patient by a nurse;
*denotes stepping beyond ones authority
with serious consequences. It is the term
for negligence or carelessness of
professional personnel.

LEGAL DOCTRINES TO DESCRIBE PROFESSIONAL

NEGLIGENCE
Doctrine of Res Ipsa Loquitur the thing speaks
for itself
This means that injury could
not have happened if someone
was not negligent that no further
proof is required.

LEGAL DOCTRINES TO DESCRIBE PROFESSIONAL

NEGLIGENCE
Examples:
1. A sciatic nerve was injured after an administration
of an injection. The patient complain of severe pain
& eventually got paralyzed.
2. The presence of sponges in the patients abdomen
after an operation
3. Fracture of newly delivered baby born by breech
presentation.

Doctrine of Respondeat Superior - let the master answer

for the acts of the subordinate.
Under this doctrine, the liability is expanded to include
the master as well as the employee and not a shift of
liability from the subordinate to the master. Therefore,
when a person, through his negligence, injures
another, he remains fully responsible.

Doctrine of Respondeat Superior - let the

master answer for the acts of the
subordinate.
Examples:
1. The hospital will be held liable, if an effort to cut
down on expenses decides to hire under board
nurses in place of professionals, and these persons
prove to be incompetent.
2. The surgeon will be held responsible in case a
laparotomy pack is left in a patients abdomen.

Doctrine of Force Majeure means an irresistible force,

one that is unforeseen or inevitable.
Under the Civil Code of the Philippines, no person shall be
responsible for those events which cannot be foreseen.

RECOGNIZE LIMITATIONS

PARTRICIA BENNERSTAGES
(5 stages)

Law
the sum total of rules & regulation s by which
society is governed or can be defined as a rule of
conduct pronounced by controlling authority &
which may be enforced
Jurisprudence
philosophy or science of law upon which a
particular legal system is built.
Nursing Jurisprudence
a science of law which pertains to nursing
practice.

A. According to Source of Authority

1. Divine Law 2. Human Law -

B. Groups of Human Law

1.2. International 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

B. Groups of Human Law

1.3. Political Law - Threats the science of politics
(Government) Regulates the relation
between the state and individual.
1.3.1. Constitutional Law - law that relates to a set
of rules governing an organization or the supreme
laws & rights of the country.
1.3.2. Administrative Law - the body of rules and
regulations
and orders and decisions created by
administrative
agencies of government.

B. Groups of Human Law

1.4. Private Law - law that relates the private
matters which do not 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)
*arh*

Definition Of Terms

Plaintiff or Accuser
Defendant or Respondent
Witness
Accomplice
Tort/Crime
Summons
Subpoena
Justice
Felony

Crime an act committed or omitted in violation of

the law.

Criminal offenses are composed of two

elements:
1. Criminal act
2. Evil/criminal intent

Criminal offenses are composed of two

elements:
1. Criminal act deal with acts or offenses
against public welfare
This may vary from minor offenses,
misdemeanors, and felonies
2. Evil/criminal intent is the state of mind of a
person at the time the criminal act is
committed that is, he/she knows that an act
is not lawful and still decided to do it.

Felony is committed with deceit and fault. A

crime of a serious nature usually punishable
for a period of longer than one year or by
death.
Deceit (Dolo) exist when the act is
performed with deliberate intent.
Fault (Culpa) when the wrongful acts result
from imprudence, negligence, or lack of skill
or foresight.

Stages of Felony according to the degree of

the acts of execution:
1. Consummated Felony when all the
elements necessary for its execution and
accomplishment is present.
2. Frustrated Felony when the offenders
performs all the acts which will produce the
felony but, do not produce it by reason of
causes independent the will of the
perpetrator.
3. Attempted Felony - when the offender
commences the commission of the acts, and

Stages of Felony 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 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.

Justice
Refers to the right to demand to be treated
justly, fairly and equally.
Fair treatment to all regardless of gender,
race, religion and others.

CIRCUMSTANCES AFFECTING CRIMINAL LIABILITY

Justifying Circumstances
A person may not incur criminal liability under the following circumstances:
1. When he acts in defense of his person or rights provided.
2. there is unlawful aggression on the part of the offended party
3. there is reasonable necessity for the means employed by the person
defending himself to prevent such aggression;
4. there is lack of sufficient provocation on the part of the person
depending himself
5. When he acts in defense of the person or the rights of his spouse,
ascendants, descendants, or legitimate or natural or adopted
brothers/sisters or relatives.
6. When he acts in defense of the person or rights of a stranger provided in
the first circumstance and that the person defending is not induced by
revenge, resentment or other evil motives.
7. When any person who, in order to avoid an evil or injury, does an act
damage to another and there is no other way to prevent it.
8. When he acts in the fulfillment of a duty or in lawful exercise of a right
or office

CIRCUMSTANCES AFFECTING CRIMINAL LIABILITY

Exempting Circumstances
The following persons under the circumstances stated are expressly
exempted by law from criminal liability for the crime they may have
committed:
1.
2.
3.
4.
5.
6.
7.

An imbecile or insane person, unless the latter has acted during a

lucid interval.
A person under nine years of age
A person over nine years of age and under fifteen unless he acted
with discernment
A person causing an injury which is merely an accident without fault
or intention of causing it.
Any person who acts under the compulsion of an irresistible force
Any person who acts under the impulse of an uncontrollable fear of
an equal or greater injury
Any person who fails to perform an act required by law, when
prevented by some lawful or insuperable cause.

CIRCUMSTANCES AFFECTING CRIMINAL LIABILITY

Mitigating Circumstances
Are those which do not constitute justification
or excuse of the offense in question, by which
in fairness and mercy, may be considered as
reducing the degree of moral culpability.

The following are some circumstances considered by

law as mitigating:

1. When the offender has no intention to

commit grave act.
2. When the offender is under eighteen years of
age or over seventy years of age.
3. When sufficient provocation or threat on
the part of the offended party immediately
precedes the act.

The following are some circumstances considered by

law as mitigating:

4. When the person acts upon impulse so powerful

as naturally to have produced the crime.
5. When the offender voluntarily surrenders self to
a person in authority, or voluntarily confess his
guilt before the court prior to the presentation of
the evidence for the prosecution.
6. When the defender is deaf and dumb, blind o
suffering from some physical defect which thus
restrict his means of action, defense or
communication with his fellow beings.

CIRCUMSTANCES AFFECTING CRIMINAL LIABILITY

Aggravating Circumstances
Are those attending the commission of a
crime and which increase the criminal
liability of the offender or make his guilt
more severe.

Circumstances considered by law aggravating

include the following:
1. When the offender takes advantage of his public position;
2. When the crime is committed in contempt of or with insult to
public authorities;
3. When the act is committed with insult or in disregard the
offended party on account of his rank, age, or sex.
4. When the act is committed with abuse or confidence or obvious
ungratefulness;
5. When the crime is committed in a place of worship;
6. When the crime is committed on the occasion of shipwreck,
earthquake, epidemic, or other calamity or misfortune.

Circumstances considered by law aggravating

include the following:
7. When the crime is committed in consideration of a price, reward,
or promise.
8. When the act is committed with evident premeditation or after an
unlawful entry;
9. When craft, fraud, or disguise is employed8

Alternative Circumstances
Are those which may be taken into
consideration as aggravating or mitigating
according to the nature and effects of the
crime and other conditions attending its
commission..
.

RECOGNIZE LIMITATIONS

PARTRICIA BENNERSTAGES
(5 stages)

LAWS & ORGANIZATION

PROTECTING NURSES

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.

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 examiners 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:

Issue and revoke certificates of registration for
practitioners of the nursing profession.
Study the conditions affecting the practice of
the nursing profession in all parts of the
Philippines.
Exercise the power conferred by the law to
maintain efficient, ethical and technical
standards in nursing profession.
Promulgate regulations governing the nurse
examination and standards to be attained.

 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

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 Examination

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 within 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.

THE PHILIPPINE NURSING LAW (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

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.

LAWS & ORGANIZATION PROTECTING NURSES

A. Philippine Nursing Act of 2002 (RA 9173)

B. Philippine Constitution 1987
C. Philippine Nurses Association
D. Magna Carta for Health Workers (RA 7305)
E. Code of Ethics for Nurses

Magna Carta for Health Workers (RA 7305)

The state shall instill health consciousness among our
people to effectively carry out the health programs and projects
of the government essential for the growth and health of the
nation.
AIMS:
1. To promote and improve the social and economic well being
of the health workers, their living and working conditions and
terms of employment
2. To develop their skills and capabilities in order that they will be
more responsive and better equipped to deliver health projects.
3. To encourage those with proper qualifications and excellent
abilities to join and remain in government service.

REFERENCES:
Lydia M. Venzon, RN, MAN, PhD, FPCHA and Ronald M. Venzon
Professional Nursing in the Philippines
11th Edition, C&E Publishing Corp., 2010
Rustico T. De Belen and Donna Vivian De Belen
Nursing Law, Jurisprudence & Professional Ethics 1st Edition, C&E Publishing
Corp., 2007
DOH Nursing Service Manual, 2005
Kozier, Erb, Berman and Snyder
Fundamentals of Nursing: Concepts, Process and Practice
8th Edition, C&E Publishing Corp
Commission on Higher Education CHED Memorandum Order (CMO)
no. 14,S. 2009

Thank You