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STATE REGULATION OF HOSPITAL OPERATION

Definition:

Licensure - granting a license to operate and


maintain a hospital according to an approved
minimum standard.

Accreditation - a process that a health care


institution, provider, or program undergoes to
demonstrate compliance with standards developed
by an official agency.

Certification - a process indicating that an individual


or institution has met predetermined standards;
Acknowledgment by a medical specialty board of
successful completion of requirements for recognition
as a specialist.

Cases:
MANILA DOCTORS HOSPITAL, petitioner, vs. SO UN CHUA
and VICKY TY, respondents.
G.R. No. 150355 | July 31, 2006 (1D)
Facts:

Respondent Chua, mother of Ty, was admitted to


petitioner hospital for hypertension and diabetes.
While Chua was confined, another daughter Judith
Chua was admitted for treatment of injuries
sustained after a vehicular accident. Ty shouldered
the hospital bills for the two.
After Judith was discharged, respondent Chua
remained confined. Ty was able to pay P435,800.00.
The hospital bills eventually totaled P1,075,592.95.
When Ty was unable to pay the bills, the hospital
allegedly pressured her, by cutting off the telephone
line in her room and removing the air-conditioning
unit, television set, and refrigerator, refusing to
render medical attendance and to change the
hospital gown and bed sheets, and barring the
private nurses or midwives from assisting the
patient, to settle the same through the signing of a
promissory note.
Ty issued postdated checks to pay the note. The
checks bounced. The petitioner alleged that that as
early as one week after respondent Chua had been
admitted to its hospital, Dr. Rody Sy, her attending
physician, had already given instructions for her to
be discharged, but respondents insisted that Chua
remain in confinement.
It also alleged that Ty voluntarily signed the
agreement that she will pay the bills and that no
undue pressure was exerted by them; and that the
cutting-off of the telephone line and removal of the
air-conditioning unit, television set, and refrigerator
cannot constitute unwarranted actuations, for the
same were resorted to as cost-cutting measures and
to minimize respondents' charges that were already
piling up, especially after respondent Ty refused to
settle
the
balance
notwithstanding
frequent
demands. Finally it alleged that this case was
instituted by Ty to provide leverage against the
hospital for filing criminal charges against the latter
for violation of BP 22.

Issue: Whether or not the hospital is liable for damages


Held: No
Conclusions are bereft of sound evidentiary
basis, self-serving and uncorroborated as they
are
Indeed the operation of private pay hospitals and
medical clinics is impressed with public interest and
imbued with a heavy social responsibility. But the
hospital is also a business, and, as a business,
it has a right to institute all measures of
efficiency commensurate to the ends for which

it is designed, especially to ensure its


economic viability and survival. And in the
legitimate pursuit of economic considerations, the
extent to which the public may be served and cured
is expanded, the pulse and life of the medical sector
quickens, and the regeneration of the people as a
whole becomes more visibly attainable.
In the institution of cost-cutting measures, the
hospital has a right to reduce the facilities and
services that are deemed to be non-essential,
such that their reduction or removal would not
be detrimental to the medical condition of the
patient.
o
For the moment, the question to be
considered is whether the subject facilities
are indeed non-essential the airconditioner, telephone, television, and
refrigerator the removal of which would
cause the adverse health effects and
emotional trauma the respondents so
claimed.
o
Corollary to this question is whether the
petitioner observed the diligence of a good
father of the family in the course of
ascertaining the possible repercussions of
the removal of the facilities prior to the
removal itself and for a reasonable time
thereafter, with a view to prevent damage.
The evidence in the record firmly establishes that the
staff of the petitioner took proactive steps to inform
the relatives of respondent Chua of the removal of
facilities prior thereto, and to carry out the necessary
precautionary measures to ensure that her health
and well-being would not be adversely affected: as
early as around two weeks after her admission
Authorities, including those of common law origin,
explicitly declare that a patient cannot be detained in
a hospital for non-payment of the hospital bill.
o
If the patient cannot pay the hospital or
physician's bill, the law provides a remedy
for them to pursue, that is, by filing the
necessary suit in court for the recovery of
such fee or bill.
o
If the patient is prevented from leaving the
hospital for his inability to pay the bill, any
person who can act on his behalf can apply
in court for the issuance of the writ of
habeas corpus.
The form of restraint must be total; movement must
be restrained in all directions. If restraint is partial,
e.g., in a particular direction with freedom to proceed
in another, the restraint on the person's liberty is not
total.
o
However, the hospital may legally detain a
patient against his will:

when he is a detained or convicted


prisoner, or

when the patient is suffering from a


very contagious disease where his
release will be prejudicial to public
health, or when the patient is
mentally ill such that his release
will endanger public safety,

or in other exigent cases as may be


provided by law.
o
Moreover, under the common law doctrines
on tort, it does not constitute a trespass to
the person to momentarily prevent him from
leaving the premises or any part thereof
because he refuses to comply with some
reasonable condition subject to which he
entered them. In all cases, the condition of
this kind of restraint must be reasonable in
the light of the circumstances.

Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel
Capules Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 2016 | Arellano University School of Law

At any rate, as stated above, the patient is


free to leave the premises, even in the
ostensible violation of these conditions,
after being momentarily interrupted by the
hospital staff for purposes of informing him
of those reasonable conditions, such as the
assessment of whether the patient is fit to
leave, insane, or suffering from a contagious
disease, etc., or simply for purposes of
making a demand to settle the bill.
o
If the patient chooses to abscond or
leave without the consent of the
hospital in violation of any of the
conditions deemed to be reasonable
under the circumstances, the hospital
may nonetheless register its protest
and may choose to pursue the legal
remedies available under law, provided
that the hospital may not physically detain
the patient, unless the case falls under the
exceptions abovestated.
Authorities are of the view that, ordinarily, a hospital,
especially if it is a private pay hospital, is entitled to
be compensated for its services, by either an express
or an implied contract, and if no express contract
exists, there is generally an implied agreement that
the patient will pay the reasonable value of the
services rendered; when a hospital treats a patient's
injuries, it has an enforceable claim for full payment
for its services, regardless of the patient's financial
status.
o

HOSPITAL MANAGEMENT SERVICES, INC. - MEDICAL


CENTER MANILA, Petitioner, vs. HOSPITAL MANAGEMENT
SERVICES, INC. - MEDICAL CENTER MANILA EMPLOYEES
ASSOCIATION-AFW
and
EDNA
R.
DE
CASTRO,
Respondents.
G.R. No. 176287 | January 31, 2011 (2D)
Facts:

One Rufina Causaren, an 81-year-old patient confined


at petitioner hospital fell from the right side of the
bed as she was trying to reach for the bedpan.
Because of what happened, the niece of patient
Causaren staying in the room was awakened and she
sought assistance from the nurse station. Instead of
personally seeing the patient, respondent De Castro
directed ward-clerk orientee Guillergan to check the
patient. The vital signs of the patient were normal.
Later, the physician on duty and the nursing staff on
duty for the next shift again attended to patient
Causaren.
A formal investigation was conducted regarding the
said incident. The Investigation Committee found
that the subject incident happened between 11:00
a.m. to 11:30 a.m. of March 23, 1999. The three
other nurses for the shift were not at the nurse
station.
The committee recommended that despite her more
than seven years of service, respondent De Castro
should be terminated from employment for her lapse
in responding to the incident and for trying to
manipulate and influence her staff to cover-up the
incident. A notice of termination was sent to the
respondent.
Respondent De Castro, with the assistance of
respondent association, filed a Complaint for illegal
dismissal against petitioners.
LA: In favor of respondent; NLRC: Reversed LA; CA:
Upheld LA

Petitioners
anchor
respondent
De
Castros
termination of employment on the ground of serious
misconduct for failure to personally attend to patient
Causaren who fell from the bed as she was trying to
reach for the bedpan.
Petitioners
anchor
respondent
De
Castros
termination of employment on the ground of serious
misconduct for failure to personally attend to patient
Causaren who fell from the bed as she was trying to
reach for the bedpan.
o
Despite our finding of culpability against
respondent De Castro; however, we do not
see any wrongful intent, deliberate refusal,
or bad faith on her part when, instead of
personally attending to patient Causaren,
she requested Nursing Assistant Tatad and
ward-clerk orientee Guillergan to see the
patient, as she was then attending to a
newly-admitted patient at Room 710.
o
Being her first offense, respondent De
Castro cannot be said to be grossly
negligent so as to justify her termination of
employment.
Moreover,
petitioners
allegation, that respondent De Castro
exerted undue pressure upon her co-nurses
to alter the actual time of the incident so as
to exculpate her from any liability, was not
clearly substantiated.
Negligence is defined as the failure to exercise the
standard of care that a reasonably prudent person
would have exercised in a similar situation.
o
The Court emphasizes that the nature of
the business of a hospital requires a
higher degree of caution and exacting
standard
of
diligence
in
patient
management and health care as what
is involved are lives of patients who
seek urgent medical assistance. An act
or omission that falls short of the
required degree of care and diligence
amounts to serious misconduct which
constitutes a sufficient ground for
dismissal.
However, in some cases, the Court had ruled that
sanctioning an erring employee with suspension
would suffice as the extreme penalty of dismissal
would be too harsh.
o
Considering that this was the first offense of
respondent De Castro in her nine (9) years
of employment with petitioner hospital as a
staff nurse without any previous derogatory
record and, further, as her lapse was not
characterized by any wrongful motive or
deceitful conduct.

Issue: Whether or not respondent De Castros dismissal is


illegal
Held: Yes
Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel
Capules Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 2016 | Arellano University School of Law

prompt states to exclude people without licenses from


practicing medicine.
FELIX MARQUEZ, petitioner, vs. THE BOARD OF MEDICAL
EXAMINERS and THE SECRETARY-TREASURER OF THE
BOARD OF MEDICAL EXAMINERS, respondent.
G.R. No. L-24119 | August 8, 1925 (EB)
Facts: Petitioner is a graduate of the Chicago Medical College,
having received the degree of M.D. from said institution on
June 8, of the year 1922. No question appears to have been
made by the respondents with respect to the petitioner's
qualifications of the physician's examinations in other
respects, but they have denied him admission to the
examinations on the grounds that the Chicago Medical
College, where the petitioner was graduated, has been
classified as a Class C medical college by the National Medical
State Board of the United States. For this reason the
respondents, in accordance with the regulations of the board
now in effect, have denied the requisite standing to said
institution and excluded petitioner.
Issue: Whether or not petitioner has a right to be admitted for
medical examinations
Held: No

STATE REGULATION OF PRACTICE OF MEDICINE


Dent v. West Virginia
129 U.S. 114 | January 14, 1889 (U.S. Supreme Court)
Facts: Frank Dent was a physician of the Eclectic sect, a group
which accepted and taught the conventional medical science
of the time. However, in the area of therapeutics, the Eclectics
carried on a rigorous campaign against excesses of drugging
and bleeding, which were still practices used by many
physicians at the time. In addition, all but one of their medical
schools were open to women.
Dent had been in practice for six years when he was
convicted under an 1882 West Virginia law which required
physicians to hold a degree from a reputable medical college,
pass an examination, or prove practice in West Virginia for the
previous ten years. In this case, the State Board of Health
refused to accept Dent's degree from the American Medical
Eclectic College of Cincinnati.
Held:
The Court's unanimous opinion which upheld the West Virginia
statute noted that each citizen had a right to follow any lawful
calling, subject to natural restraints such as age, sex, etc., as
well as state restrictions, as long as those state restrictions
were reasonable. In addition, the Court ruled that medicine,
because of the careful nature of its training, the large
knowledge of the human body required of doctors, and
nature of life-and-death circumstances with which
doctors dealt, reliance needed to be placed on the
assurance of a license. Certain circumstances might

In the argument for the petitioner it is admitted that under Act


No. 3111, and the regulations now in force, the petitioner is
disqualified to take the examinations; but it is pointed out that
at the time he began and even when he conducted his course
in the Chicago Medical School, said institution was still
recognized as a reputable medical institution; and the
question submitted is whether the petitioner's case should be
governed by the law and regulations in force at the time of his
enrollment in and graduation from the Chicago Medical
School, or by those in force at the time he filed his application
for admission, on or about September 26, 1924. It is
submitted for the petitioner that his case should be governed
by the law and regulations at the time of his graduation. To
hold otherwise, it is insisted, is to make the law retroactive in
effect and to do irreparable damage to the petitioner, who has
pursued his work in the institution referred to in good faith,
believing that said school had the status necessary to qualify
him from examination.
The position taken by the petitioner is, we think, untenable.
The question whether a medical institution is "a
reputable medical school," in the sense intended by
the law, is vested in the Board of Medical Examiners,
and although the action taken by them may
conceivably, in isolated cases, result in hardship,
nevertheless the interests of the public require that
the board should be free to exercise its judgment and
discretion without reference to the effect of the
determination of the question in particular instances.
There can in the nature of things be no vested right in
an existing law, which would preclude its change or
repeal. No one who has commenced preparation in a
particular institution has any inchoate right on account
of that fact. If the law were otherwise upon this point, it
would be impossible for the Board of Medical Examiners to
give effect to the knowledge which they from time to time
acquire as to the standing of medical schools; and an
intending physician, upon matriculating in a particular college,
takes upon himself the risk of changes that may be made in
the standing of the institution by the board.
PHILIPPINE MEDICAL ASSOCIATION, petitioner, vs. BOARD
OF MEDICAL EXAMINERS and JOSE MA. TORRES,
respondents.
G.R. No. L-25135 | September 21, 1968 (EB)
Facts: Torres graduated from the University of Barcelona,
Spain, with the degree of Licentiate in Medicine and Surgery.
He was granted special authority to practice medicine in

Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel
Capules Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 2016 | Arellano University School of Law

Lamitan, Basilan City, where he resides, pursuant to Section


771(e) of the Revised Administrative Code:
SEC. 771. Persons exempt from registration.
Registration shall not be required of the following
classes of persons: . . .
(e) In cases of epidemic or in municipalities where
there is no legally qualified practicing physician, or
when the circumstances require it, in the interest of
the public health, the Director of Health may issue
special authorizations, to all medical students who
have completed the first three years of their studies,
or to persons who have qualified in medicine, and to
graduate or registered nurses, who may request it.
On motion for reconsideration filed by respondent, the Board
issued a resolution, granting respondent a certificate to
practice medicine in the Philippines without the examination
required in Republic Act No. 2882. The resolution relied
therefor upon The Treaty on the Validity of Academic Degrees
and The Exercise of the Professions between the Republic of
the Philippines and the Spanish State.
Petitioner herein, Philippine Medical Association, addressed
the Chairman of the Board a communication requesting
reconsideration of said resolution, upon the ground that,
pursuant to said Medical Act of 1959, respondent has to take
and pass the examination therein prescribed, before he can
be allowed to practice medicine in the Philippines. Said
Chairman then replied, stating "that the final decision on the
matter will have to come from the President of the Philippines
upon whose authority said resolution has been finally
approved and implemented."
Issue: Whether or not he Board had violated Republic Act No.
2882 in granting respondent's certificate for the general
practice of medicine in the Philippines without the
examination prescribed in said Act
Held: Yes
The main issue herein hinges on the interpretation of Article I
of the Treaty aforementioned, reading as follows:
The nationals of both countries who shall have obtained
degrees or diplomas to practice the liberal professions in
either of the Contracting States, issued by competent national
authorities, shall be deemed competent to exercise said
professions in the territory of the Other, subject to the laws
and regulations of the latter. When the degree or diploma of
Bachelor, issued by competent national authorities allows its
holder without requiring further evidence of proficiency to
pursue normally higher courses of study, he shall also be
deemed qualified to continue his studies in the territory of
either Party in conformity with the applicable laws and
regulations of the State which recognizes the validity of the
title or diploma in question, and with the rules and regulations
of the particular educational institution in which he intends to
pursue his studies.
Inasmuch as the theory of respondent herein cannot be
accepted without placing graduates from our own educational
institutions at a disadvantage vis-a-vis Spanish graduates
from Spanish schools, colleges or universities. Indeed, the
latter could under respondent's pretense engage in the
practice of medicine in the Philippines without taking the
examination prescribed in Republic Act No. 2882, whereas the
former would have to take and pass said examination. Worse
still, since as we ruled in the Garcia case the benefits of
the aforementioned Treaty cannot be availed of in the
Philippines except by Spanish subjects, the result would be
should respondent's contention be sustained that
graduates from Spanish schools of medicine would be entitled
to practice medicine in the Philippines without examination, if
they were Spanish subjects, but not if they are Filipinos.

Surely said treaty was not made to discriminate against


Philippine schools, colleges or universities, much less against
nationals of the Philippines.
The Court held that said Treaty merely extended to
diplomas issued or degrees conferred by educational
institutions of Spain the same recognition and
treatment that we accord to similar diplomas or
degrees from local institutions of learning; that
holders of said Spanish diplomas or degrees must take
the examination prescribed by our laws for holders of
similar
diplomas
or
degrees
from
educational
institutions in the Philippines; that resolution No. 25,
series of 1965, of respondent Board is violative of Republic Act
No. 2882
TERESITA TABLARIN et. al, in their behalf and in behalf of
applicants for admission into the Medical Colleges during the
school year 1987-88 and future years who have not taken or
successfully hurdled tile National Medical Admission Test
(NMAT).
petitioners,
vs.
THE
HONORABLE
JUDGE
ANGELINA S. GUTIERREZ, Presiding Judge of Branch XXXVII
of the Regional Trial Court of the National Capital Judicial
Region with seat at Manila, THE HONORABLE SECRETARY
LOURDES QUISUMBING, in her capacity as Chairman of the
BOARD OF MEDICAL EDUCATION, and THE CENTER FOR
EDUCATIONAL MEASUREMENT (CEM), respondents.
G.R. No. 78164 | July 31, 1987 (EB)
Facts: The petitioners seek admission into colleges or schools
of medicine. However the petitioners either did not take or did
not successfully take the National Medical Admission Test
(NMAT). Republic Act 2382 as amended by R.A. 4224 and
5946, known as the Medical Act of 1959 created, among
others, the Board of Medical Education (BME) whose functions
include "to determine and prescribe requirements for
admission into a recognized college of medicine" (Sec. 5 (a).
Section 7 of the same Act requires from applicants to present
a certificate of eligibility for entrance (cea) to medical school
from the BME. MECS Order No. 52, s. 1985, issued by the then
Minister of Education, Culture and Sports, established a
uniform admission test called National Medical Admission Test
as additional requirement for issuance of a certificate of
eligibility.
Petitioners then filed with the RTC a petition for Declaratory
Judgment and Prohibition with a prayer Temporary Restraining
Order and Preliminary Injunction seeking to enjoin the Sec. of
educ, BME from enforcing Sec. 5(a) and (f) of R.A. 4224 and
MECS Order no. 2 and from requiring the taking and passing
of the NMAT as condition for securing (cea).
Issue: Whether or not Sec. 5(a) and (f) of R.A. 4224 and MECS
Order no. 2 violate the constitution as they prescribe an
unfair, unreasonable and inequitable requirement
Held: No
Perhaps the only issue that needs some consideration is
whether there is some reasonable relation between the
prescribing of passing the NMAT as a condition for admission
to medical school on the one hand, and the securing of the
health and safety of the general community, on the other
hand. This question is perhaps most usefully approached by
recalling that the regulation of the practice of medicine in all
its branches has long been recognized as a reasonable
method of protecting the health and safety of the public. That
the power to regulate and control the practice of
medicine includes the power to regulate admission to
the ranks of those authorized to practice medicine, is
also
well
recognized.
Thus,
legislation
and
administrative regulations requiring those who wish to
practice medicine first to take and pass medical board
examinations have long ago been recognized as valid
exercises of governmental power. Similarly, the

Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel
Capules Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 2016 | Arellano University School of Law

establishment
of
minimum
medical
educational
requirements-i.e.,
the
completion
of
prescribed
courses in a recognized medical school-for admission
to the medical profession, has also been sustained as a
legitimate exercise of the regulatory authority of the
state. What we have before us in the instant case is closely
related: the regulation of access to medical schools. MECS
Order No. 52, s. 1985, articulates the rationale of regulation of
this type: the improvement of the professional and technical
quality of the graduates of medical schools, by upgrading the
quality of those admitted to the student body of the medical
schools. That upgrading is sought by selectivity in the
process of admission, selectivity consisting, among
other things, of limiting admission to those who exhibit
in the required degree the aptitude for medical studies
and eventually for medical practice. The need to
maintain, and the difficulties of maintaining, high standards in
our professional schools in general, and medical schools in
particular, in the current state of our social and economic
development, are widely known.

proposed a gradual phase-out so as not to dislocate the


students and minimized financial losses

The Court believes that the government is entitled to


prescribe an admission test like the NMAT as a means
of achieving its stated objective of "upgrading the
selection of applicants into our medical schools" and of
"improving the quality of medical education in the
country."

Held: Given that the Secretary of Education, Culture and


Sports exercises the power to enjoin compliance with the
requirements laid down for medical schools and to mete out
sanctions where he finds that violations thereof have been
committed, it was a grave abuse of discretion for the
respondent judge to issue the questioned injunction and
thereby thwart official action, in the premises correctly taken,
allowing the College to operate without the requisite
government permit. A single ocular inspection, done after the
College had been pre-warned thereof, did not, in the
circumstances, warrant only the findings of more qualified
inspectors about the true state of the College, its faculty,
facilities, operations, etc. The, members of the evaluating
team came from the different sectors in the fields of
education and medicine, and their judgment in this particular
area is certainly better than that of the respondent Judge
whose sole and only visit to the school could hardly have
given him much more to go on than a brief look at the
physical plant and facilities and into the conduct of the
classes and other school activities. Respondent Judge gravely
abused his discretion in substituting his judgment for theirs. It
is well-settled doctrine that courts of justice should not
generally
interfere
with
purely
administrative
and
discretionary functions; that courts have no supervisory power
over the proceedings and actions of the administrative
departments of the government; involving the exercise of
judgment and findings of facts, because by reason of their
special knowledge and expertise over matters falling under
their jurisdiction, the latter are in a better position to pass
judgment on such matters and their findings of facts in that
regard are generally accorded respect, if not finality, by the
courts. There are, to be sure, exceptions to this general rule
but none of them obtains in this case.

THE BOARD OF MEDICAL EDUCATION and the HON.


LOURDES R. QUISUMBING, in her capacity as Secretary of
the Department of Education, Culture and Sports and
Chairman, Board of Medical Education, petitioners, vs. HON.
DANIEL P. ALFONSO, Presiding Judge of the Regional Trial
Court, Branch 74, Fourth Judicial Region, Antipolo, Rizal, and
the PHILIPPINE MUSLIM-CHRISTIAN COLLEGE OF MEDICINE
FOUNDATION, INC., respondents.
G.R. No. 88259 | August 10, 1989 (EB)
Facts: Petitioners BME, the government agency which
supervises and regulates the countrys medical colleges, Sec.
Quisimbing, chairman of the Department of Education, Culture
and Sports prayed for a writ of certiorari to nullify the order of
herein Respondent Judge Alfonso in Civil case No. 1385
restraining the enforcement of Pet. Order of closure of
Philippine Muslim-Christian College of Medicine Foundation
Inc(the college). -The college was founded on 1981 for the
purpose of producing physicians who will emancipate Muslim
citizens from age-old attitudes of health. -However, because
of the unstable peace and order situation in Mindanao, the
college was established in Antipolo, Rizal, given a temporary
permit to operate instead of the originally proposed location in
Zamboanga City. Antipolo was adopted as its permanent site
and the name was changed to Rizal College of Medicine. -In
1985, DECS & BME authorized the Commission on Medical
Education to conduct a study of all Medical Schools in the
Philippines. -The report showed that the college fell very much
short of the minimum standards set for medical schools.
Further, the team of inspectors cited the ff. Grounds among
others: (a)the College was not fulfilling its purpose due
inappropriate location (b)lack of university affiliation for
balance humanistic and scientific education (c) absence of
philosophy based hospitals for students training (d)more than
60% of the college faculty did not teach full time -The school
disputed these findings as biased and discriminatory and
requested BME to send another team of doctors for reevaluation. 2nd team confirmed the previous findings and
recommended the phase-out of the school. -There were third
and fourth evaluations but the college failed both and was
rendered inadequate in all aspects. -The DECS recommended
the college for closure but somehow the college succeeded to
have the Board form yet another team of inspectors but
although the findings show that there were major efforts to
improve the college, it is still rendered inadequate and
recommended for closure w/ provisions to disperse its
students
to
other
medical
schools.
-Mr.
Victor
Sumulong(chairman of BOT), upon learning the same

ALLOWED to operate until May 1989. -The college appealed


the decision to the OP, but the Executive Secretary found no
reason to disturb the contested decision
AFFIRMED! -The college filed civil case No. 1385 applying for
a writ of preliminary injunction to restrain its implementation
APPROVED! (by Judge Alfonso holding that there were no
evidence supporting the findings in the June 18, 1988 report,
and that contrary to the findings, the laboratory and library
areas were big enough and operations in the base hospital
was going smoothly.) -Thus, the present petition.
Issue: Whether or not Judge Alfonso acted with grave abuse of
discretion in substituting his judgment to for the
members/evaluators

Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel
Capules Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 2016 | Arellano University School of Law

DEPARTMENT OF EDUCATION, CULTURE AND SPORTS


(DECS) and DIRECTOR OF CENTER FOR EDUCATIONAL
MEASUREMENT, petitioners, vs. ROBERTO REY C. SAN
DIEGO and JUDGE TERESITA DIZON-CAPULONG, in her
capacity as Presiding Judge of the Regional Trial Court of
Valenzuela, Metro Manila, Branch 172, respondents.
G.R. No. 89572 | December 21, 1989 (EB)
Facts: The private respondent is a graduate of the University
of the East with a degree of Bachelor of Science in Zoology.
The petitioner claims that he took the NMAT three times and
flunked it as many times. 1 When he applied to take it again,
the petitioner rejected his application on the basis of the
MECS Order No. 12, Series of 1972 which provides that:
h) A student shall be allowed only three (3) chances to take
the NMAT. After three (3) successive failures, a student shall
not be allowed to take the NMAT for the fourth time.
In his original petition for mandamus, he first invoked his
constitutional rights to academic freedom and quality
education. By agreement of the parties, the private
respondent was allowed to take the NMAT. In an amended
petition filed with leave of court, he squarely challenged the
constitutionality of the said rule. The additional grounds raised
were due process and equal protection.
Issue: Whether a person who has thrice failed the National
Medical Admission Test (NMAT) is entitled to take it again
Held: No
In Tablarin v. Gutierrez, this Court upheld the constitutionality
of the NMAT as a measure intended to limit the admission to
medical schools only to those who have initially proved their
competence and preparation for a medical education.
The government is entitled to prescribe an admission
test like the NMAT as a means of achieving its stated
objective of "upgrading the selection of applicants
into [our] medical schools" and of "improv[ing] the
quality of medical education in the country." Given
the widespread use today of such admission tests in,
for instance, medical schools in the United States of
America (the Medical College Admission Test [MCAT]
and quite probably, in other countries with far more
developed educational resources than our own, and
taking into account the failure or inability of the
petitioners to even attempt to prove otherwise, we
are entitled to hold that the NMAT is reasonably
related to the securing of the ultimate end of
legislation and regulation in this area. That end, it is
useful to recall, is the protection of the public from
the potentially deadly effects of incompetence and
ignorance in those who would undertake to treat our
bodies and minds for disease or trauma.

Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel
Capules Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 2016 | Arellano University School of Law

The subject of the challenged regulation is certainly within the


ambit of the police power. It is the right and indeed the
responsibility of the State to insure that the medical
profession is not infiltrated by incompetents to whom patients
may unwarily entrust their lives and health.
The method employed by the challenged regulation is not
irrelevant to the purpose of the law nor is it arbitrary or
oppressive. The three-flunk rule is intended to insulate the
medical schools and ultimately the medical profession from
the intrusion of those not qualified to be doctors.
While every person is entitled to aspire to be a doctor, he
does not have a constitutional right to be a doctor. This is true
of any other calling in which the public interest is involved;
and the closer the link, the longer the bridge to one's
ambition. The State has the responsibility to harness its
human resources and to see to it that they are not dissipated
or, no less worse, not used at all. These resources must be
applied in a manner that will best promote the common good
while also giving the individual a sense of satisfaction.
The right to quality education invoked by the private
respondent is not absolute. The Constitution also provides
that "every citizen has the right to choose a profession or
course of study, subject to fair, reasonable and equitable
admission and academic requirements.
The contention that the challenged rule violates the equal
protection clause is not well-taken. A law does not have to
operate with equal force on all persons or things to be
conformable to Article III, Section 1 of the Constitution.
There can be no question that a substantial distinction exists
between medical students and other students who are not
subjected to the NMAT and the three-flunk rule. The medical
profession directly affects the very lives of the people, unlike
other careers which, for this reason, do not require more
vigilant regulation. The accountant, for example, while
belonging to an equally respectable profession, does not hold
the same delicate responsibility as that of the physician and
so need not be similarly treated.
There would be unequal protection if some applicants who
have passed the tests are admitted and others who have also
qualified are denied entrance. In other words, what the equal
protection requires is equality among equals.
PROFESSIONAL REGULATION COMMISSION (PRC) et al.
vs. ARLENE V. DE GUZMAN et al.
G.R. No. 144681 | June 21, 2004 (2D)
Facts: The respondents are all graduates of the Fatima College
of Medicine, Valenzuela City, Metro Manila. They passed the
Physician Licensure Examination conducted in February 1993
by the Board of Medicine (Board). Petitioner Professional
Regulation Commission (PRC) then released their names as
successful examinees in the medical licensure examination.
Shortly thereafter, the Board observed that the grades of the
seventy-nine successful examinees from Fatima College in the
two most difficult subjects in the medical licensure exam,
Biochemistry (Bio-Chem) and Obstetrics and Gynecology (OBGyne), were unusually and exceptionally high. Eleven Fatima
examinees scored 100% in Bio-Chem and ten got 100% in OBGyne, another eleven got 99% in Bio-Chem, and twenty-one
scored 99% in OB-Gyne.
For its part, the NBI found that the questionable passing rate
of Fatima examinees in the 1993 Physician Examination leads
to the conclusion that the Fatima examinees gained early
access to the test questions.
Issue: Whether or not respondents should be allowed to take
their oaths as physicians and be registered in the rolls of the
PRC, having fulfilled the requirements of Republic Act No.
2382

Held: No
Respondents counter that having passed the 1993 licensure
examinations for physicians, the petitioners have the
obligation to administer to them the oath as physicians and to
issue their certificates of registration as physicians pursuant
to Section 20 of Rep. Act No. 2382.
The intent or meaning of the statute should be ascertained
from the statute taken as a whole, not from an isolated part of
the provision. Accordingly, Section 20, of Rep. Act No. 2382,
as amended should be read in conjunction with the other
provisions of the Act. Thus, to determine whether the
petitioners had the ministerial obligation to administer the
Hippocratic Oath to respondents and register them as
physicians, recourse must be had to the entirety of the
Medical Act of 1959.
A careful reading of Section 20 of the Medical Act of 1959
discloses that the law uses the word "shall" with respect to
the issuance of certificates of registration. Thus, the
petitioners "shall sign and issue certificates of registration to
those who have satisfactorily complied with the requirements
of the Board." In statutory construction the term "shall" is a
word of command. It is given imperative meaning. Thus, when
an examinee satisfies the requirements for the grant of his
physicians license, the Board is obliged to administer to him
his oath and register him as a physician, pursuant to Section
20 and par. (1) of Section 2225 of the Medical Act of 1959.
However, the surrounding circumstances in this case call for
serious inquiry concerning the satisfactory compliance with
the Board requirements by the respondents. The unusually
high scores in the two most difficult subjects was
phenomenal, according to Fr. Nebres, the consultant of PRC on
the matter, and raised grave doubts about the integrity, if not
validity, of the tests. These doubts have to be appropriately
resolved.
The function of mandamus is not to establish a right but to
enforce one that has been established by law. If no legal right
has been violated, there can be no application of a legal
remedy, and the writ of mandamus is a legal remedy for a
legal right. There must be a well-defined, clear and certain
legal right to the thing demanded. It is long established rule
that a license to practice medicine is a privilege or franchise
granted by the government.
It is true that this Court has upheld the constitutional right of
every citizen to select a profession or course of study subject
to a fair, reasonable, and equitable admission and academic
requirements. But like all rights and freedoms guaranteed by
the Charter, their exercise may be so regulated pursuant to
the police power of the State to safeguard health, morals,
peace, education, order, safety, and general welfare of the
people. Thus, persons who desire to engage in the
learned professions requiring scientific or technical
knowledge may be required to take an examination as
a prerequisite to engaging in their chosen careers. This
regulation takes particular pertinence in the field of
medicine, to protect the public from the potentially
deadly effects of incompetence and ignorance among
those who would practice medicine. In a previous case, it
may be recalled, this Court has ordered the Board of Medical
Examiners to annul both its resolution and certificate
authorizing a Spanish subject, with the degree of Licentiate in
Medicine and Surgery from the University of Barcelona, Spain,
to practice medicine in the Philippines, without first passing
the examination required by the Philippine Medical Act. In
another case worth noting, we upheld the power of the State
to upgrade the selection of applicants into medical schools
through admission tests.
In the present case, the aforementioned guidelines are
provided for in Rep. Act No. 2382, as amended, which

Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel
Capules Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 2016 | Arellano University School of Law

prescribes the requirements for admission to the practice of


medicine, the qualifications of candidates for the board
examinations, the scope and conduct of the examinations, the
grounds for denying the issuance of a physicians license, or
revoking a license that has been issued. Verily, to be granted
the privilege to practice medicine, the applicant must show
that he possesses all the qualifications and none of the
disqualifications. Furthermore, it must appear that he has fully
complied with all the conditions and requirements imposed by
the law and the licensing authority. Should doubt taint or mar
the compliance as being less than satisfactory, then the
privilege will not issue. For said privilege is distinguishable
from a matter of right, which may be demanded if denied.
Thus, without a definite showing that the aforesaid
requirements and conditions have been satisfactorily met, the
courts may not grant the writ of mandamus to secure said
privilege without thwarting the legislative will.
BOARD OF MEDICINE, DR. RAUL FLORES (now DR. JOSE S.
RAMIREZ), in his capacity as Chairman of the Board,
PROFESSIONAL REGULATION COMMISSION, through its
Chairman, HERMOGENES POBRE (now DR. ALCESTIS M.
GUIANG), Petitioners, vs. YASUYUKI OTA, Respondent.
G.R. No. 166097 | July 14, 2008 (3D)
Facts: Yasuyuki Ota (respondent) is a Japanese national,
married to a Filipina, who has continuously resided in the
Philippines for more than 10 years. He graduated from Bicol
Christian College of Medicine on April 21, 1991 with a degree
of Doctor of Medicine. After successfully completing a oneyear post graduate internship training at the Jose Reyes
Memorial Medical Center, he filed an application to take the
medical board examinations in order to obtain a medical
license. He was required by the Professional Regulation
Commission (PRC) to submit an affidavit of undertaking,
stating among others that should he successfully pass the
same, he would not practice medicine until he submits proof
that reciprocity exists between Japan and the Philippines in
admitting foreigners into the practice of medicine.

or activity without prescribing definite rules and conditions for


the guidance of said officials in the exercise of their power.
R.A. No. 2382, which provides who may be candidates for the
medical board examinations, merely requires a foreign citizen
to submit competent and conclusive documentary evidence,
confirmed by the Department of Foreign Affairs (DFA),
showing that his countrys existing laws permit citizens of the
Philippines to practice medicine under the same rules and
regulations governing citizens thereof.
Nowhere in said statutes is it stated that the foreign applicant
must show that the conditions for the practice of medicine in
said country are practical and attainable by Filipinos. Neither
is it stated that it must first be proven that a Filipino has been
granted license and allowed to practice his profession in said
country before a foreign applicant may be given license to
practice in the Philippines.
While it is true that respondent failed to give details as to the
conditions stated in the Medical Practitioners Law of Japan -i.e., the provisions of the School Educations Laws, the criteria
of the Minister of Health and Welfare of Japan in determining
whether the academic and technical capability of foreign
medical graduates are the same as or better than that of
graduates of medical schools in Japan, and who can actually
qualify to take the preparatory test for the National Medical
Examination respondent, however, presented proof that
foreigners are actually practicing in Japan and that Filipinos
are not precluded from getting a license to practice there.

Respondent submitted a duly notarized English translation of


the Medical Practitioners Law of Japan duly authenticated by
the Consul General of the Philippine Embassy to Japan, Jesus I.
Yabes; thus, he was allowed to take the Medical Board
Examinations in August 1992, which he subsequently passed.
In spite of all these, the Board of Medicine (Board) of the PRC
denied respondent's request for a license to practice medicine
in the Philippines on the ground that the Board "believes that
no genuine reciprocity can be found in the law of Japan as
there is no Filipino or foreigner who can possibly practice
there."
Issue: Whether or not the Board erred in not issuing the
license of respondent to practice medicine in the Philippines
Held: Yes
There is no question that a license to practice medicine is a
privilege or franchise granted by the government. It is a right
that is earned through years of education and training, and
which requires that one must first secure a license from the
state through professional board examinations.
It must be stressed however that the power to regulate the
exercise of a profession or pursuit of an occupation cannot be
exercised by the State or its agents in an arbitrary, despotic,
or oppressive manner. A political body which regulates the
exercise of a particular privilege has the authority to both
forbid and grant such privilege in accordance with certain
conditions. As the legislature cannot validly bestow an
arbitrary power to grant or refuse a license on a public agency
or officer, courts will generally strike down license legislation
that vests in public officials discretion to grant or refuse a
license to carry on some ordinarily lawful business, profession,

SPECIAL LAWS APPLICABLE TO PHYSICIANS I


THE PEOPLE, Respondent, v. JOSEPHINE
Appellant.
Crim. No. 579. Fourth Dist. Jan. 10, 1947

CHAVEZ,

Facts: The defendant was charged with the murder of her


newborn baby. A jury found her guilty of manslaughter and
she has appealed from the judgment. An autopsy was
performed by a physician. He testified that the cord on the
baby was about eighteen inches long, untied and depleted of
blood; that the baby would live until it bled to death.
The appellant first contends that there is no substantial
evidence to support the verdict in that it does not sufficiently
appear from the evidence that this infant was born alive and
became a human being; that it appears from the testimony of
another doctor, called by the defense, that the doctor
performing the autopsy did not use certain tests which might
have been used and did not open the infant's head and heart
which this other doctor thought might disclose some

Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel
Capules Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 2016 | Arellano University School of Law

possibilities; and that it follows that the question of whether


this infant was born alive and became a human being rests
entirely on pure speculation.
Issue: Whether or not the child herein was born alive and
became a human being within the meaning of the homicide
statutes

Held: Yes
The evidence is sufficient to support a finding, beyond a
reasonable doubt, that a live child was actually born here, and
that it died because of the negligence of the appellant in
failing to use reasonable care in protecting its life, having the
duty to do so. This baby was completely removed from its
mother and even the placenta was removed. A factual
question was presented and the opinion of the autopsy
physician was evidence which could be considered by the jury.
His opinion was that the baby was born alive and that
it breathed and had heart action. He gave good
reasons for that opinion and while he admitted that
there could be a possible doubt his evidence justifies
the inference that there was no valid ground for a
reasonable doubt. While he admitted that he had not
used certain tests suggested by the other doctor he
stated that he knew of these tests but he did not
consider them necessary here. With respect to the test
most relied upon by the defense, it was stated by both
doctors that this test would show only what the autopsy
physician testified he had discovered by other means. The
doctor called by the defense had not seen the baby's body
and his testimony was based upon his general laboratory
experience. While it may be said that there was some conflict
between the testimony of these two doctors no more than a
conflict appears. The question was one of fact for the jury and,
in our opinion, the evidence is sufficient to support its
findings. If it could be said that there might be a possible
doubt with respect to this phase of the case, it cannot be said
that there was necessarily a reasonable doubt. The finding of
the jury is sufficiently supported, and the implied finding that
this was a human being rests on a factual basis and not upon
speculation.
SPECIAL LAWS APPLICABLE TO PHYSICIANS II
DR. FILOTEO A. ALANO, Petitioner, vs. ZENAIDA MAGUDLOGMAO, Respondent.
G.R. No. 175540 | April 7, 2014 (3D)
Facts:

As the extensive search for the relatives of Arnelito


yielded no positive result and time being of the
essence in the success of organ transplantation, Dr.
Ona requested Dr. Filoteo A. Alano, herein petitioner,
to authorize the removal of specific organs from the
body of Arnelito for transplantation purposes.
On March 3, 1988, Dr. Alano issued to Dr. Ona a
Memorandum, which reads as follows:
As shown by the medical records, the said patient
died on March 3, 1988 at 9:10 in the morning due to
craniocerebral injury. Please make certain that your
Department has exerted all reasonable efforts to
locate the relatives or next-of-kin of the said
deceased patient, such as appeal through the radios
and television, as well as through police and other
government agencies and that the NBI [MedicoLegal] Section has been notified and is aware of the
case.

If all the above has been complied with, in


accordance with the provisions of Republic Act No.
349 as amended and P.D. 856, permission and/or
authority is hereby given to the Department of
Surgery to retrieve and remove the kidneys,
pancreas, liver and heart of the said deceased
patient and to transplant the said organs to any
compatible patient who maybe in need of said
organs to live and survive.
Consequently, respondent filed with the trial court a
complaint for damages against several doctors,
including petitioner herein, alleging that they
conspired to remove the organs of Arnelito while the
latter was still alive and that they concealed his true
identity.
The court a quo rendered judgment finding only Dr.
Filoteo Alano liable for damages to plaintiff and
dismissing the complaint against the other
defendants for lack of legal basis.
CA affirmed the lower courts decision. Hence this
petition.

Issue: W/N respondent's sufferings were brought about by


petitioner's alleged negligence in granting authorization for
the removal or retrieval of the internal organs of respondent's
son who had been declared brain dead, making petitioner
liable for damages
Held: No
Petitioner maintains that when he gave authorization
for the removal of some of the internal organs to be
transplanted to other patients, he did so in
accordance with the letter of the law, Republic Act
(R.A.) No. 349, as amended by Presidential Decree
(P.D.) 856, i.e., giving his subordinates instructions to
exert all reasonable efforts to locate the relatives or
next of kin of respondent's son.
o
Thus, petitioner insists that he should not be
held responsible for any damage allegedly
suffered by respondent due to the death of
her son and the removal of her sons
internal organs for transplant purposes.
The appellate court affirmed the trial court's finding
that there was negligence on petitioner's part when
he failed to ensure that reasonable time had elapsed
to locate the relatives of the deceased before giving
the authorization to remove said deceased's internal
organs for transplant purposes.
The Memorandum dated March 3, 1988 issued by
petitioner, stated thus:

Respondent Zenaida Magud-Logmao is the mother of


deceased Arnelito Logmao. Petitioner Dr. Filoteo
Alano is the Executive Director of the National Kidney
Institute (NKI).
At the NKI, Arnelito, who was brought to the East
Avenue Medical Center (EAMC) in Quezon City by two
sidewalk vendors, who allegedly saw the former fall
from the overpass near the Farmers Market in
Cubao, Quezon City, was immediately attended to
and given the necessary medical treatment.
As he had no relatives around, Jennifer B. Misa,
Transplant Coordinator, was asked to locate his
family by enlisting police and media assistance.
The next day, Arnelito had been pronounced brain
dead by Dr. Abdias V. Aquino, a neurologist, and by
Dr. Antonio Rafael, a neurosurgeon and attending
physician
of
Arnelito,
and
that
a
repeat
electroencephalogram (EEG) was in progress to
confirm the diagnosis of brain death.
Upon learning that Arnelito was a suitable organ
donor and that some NKI patients awaiting organ
donation had blood and tissue types compatible with
A careful reading of the above shows that petitioner
Lugmoso, Dr. Ona inquired from Jennifer Misa
instructed his subordinates to "make certain" that
whether the relatives of Arnelito had been located so
"all reasonable efforts" are exerted to locate the
that the necessary consent for organ donation could
patient's next of kin, even enumerating ways in
be obtained.
Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel
9
Capules Syllabus
st
Rivad, Sherine L. | 1 Sem AY 2015 2016 | Arellano University School of Law

which to ensure that notices of the death of the


patient would reach said relatives. It also clearly
stated that permission or authorization to retrieve
and remove the internal organs of the deceased was
being given ONLY IF the provisions of the applicable
law had been complied with.
o
Such instructions reveal that petitioner
acted
prudently
by
directing
his
subordinates to exhaust all reasonable
means of locating the relatives of the
deceased. He could not have made his
directives any clearer. He even specifically
mentioned that permission is only being
granted IF the Department of Surgery has
complied with all the requirements of the
law.
o
Verily, petitioner could not have been
faulted for having full confidence in the
ability of the doctors in the Department of
Surgery to comprehend the instructions,
obeying all his directives, and acting only in
accordance with the requirements of the
law.
Furthermore, as found by the lower courts from the
records of the case, the doctors and personnel of NKI
disseminated notices of the death of respondent's
son to the media and sought the assistance of the
appropriate police authorities as early as March 2,
1988,
even
before
petitioner
issued
the
Memorandum.
o
Prior to performing the procedure for
retrieval of the deceased's internal organs,
the doctors concerned also the sought the
opinion and approval of the Medico-Legal
Officer of the NBI.
Thus, there can be no cavil that petitioner employed
reasonable means to disseminate notifications
intended to reach the relatives of the deceased. The
only question that remains pertains to the sufficiency
of time allowed for notices to reach the relatives of
the deceased.
o
If respondent failed to immediately receive
notice of her son's death because the
notices did not properly state the name or
identity of the deceased, fault cannot be
laid at petitioner's door. The trial and
appellate courts found that it was the EAMC,
who had the opportunity to ascertain the
name of the deceased, who recorded the
wrong information regarding the deceased's
identity to NKI. The NKI could not have
obtained the information about his name
from the patient, because as found by the
lower courts, the deceased was already
unconscious by the time he was brought to
the NKI.

NIEVES ESTARES BALDOS, substituted by FRANCISCO


BALDOS and MARTIN BALDOS, Petitioners, vs. COURT OF
APPEALS and REYNALDO PILLAZAR a.k.a. REYNALDO
ESTARES BALDOS, Respondents.
G.R. No. 170645 | July 9, 2010 (2D)
Facts: Reynaldo Pillazar, alias Reynaldo Baldos, was born on
30 October 1948. However, his birth was not registered in the
office of the local civil registrar until roughly 36 years later or
on 11 February 1985. His certificate of live birth indicated
Nieves Baldos as his mother and Bartolome Baldos as his
father. Nieves Baldos also appeared as the informant on the
certificate of live birth.
On 8 March 1995, Nieves Baldos filed in RTC for cancellation of
the late registration of Reynaldos birth. She claimed that
Reynaldo was not really her son.

Held: Yes
Presidential Decree No. 651, otherwise known as An Act
Requiring the Registration of Births and Deaths in the
Philippines which Occurred from 1 January 1974 and
Thereafter, provides:
Sec. 1. Registration of births. All babies born in hospitals,
maternity clinics, private homes, or elsewhere within the
period starting from January 1, 1974 up to the date when this
decree becomes effective, irrespective of the nationality,
race, culture, religion or belief of their parents, whether the
mother is a permanent resident or transient in the Philippines,
and whose births have not yet been registered must be
reported for registration in the office of the local civil registrar
of the place of birth by the physician, nurse, midwife, hilot, or
hospital or clinic administrator who attended the birth or in
default thereof, by either parent or a responsible member of
the family or a relative, or any person who has knowledge of
the birth of the individual child.
The report referred to above shall be accompanied with an
affidavit describing the circumstances surrounding the
delayed registration. (Emphasis supplied)
Sec. 2. Period of registration of births. The registration of the
birth of babies referred to in the preceding section must be
done within sixty (60) days from the date of effectivity of this
decree without fine or fee of any kind. Babies born after the
effectivity of this decree must be registered in the office of
the local civil registrar of the place of birth within thirty (30)
days after birth, by the attending physician, nurse, midwife,
hilot or hospitals or clinic administrator or, in default of the
same, by either parent or a responsible member of the family
or any person who has knowledge of the birth.
The parents or the responsible member of the family and the
attendant at birth or the hospital or clinic administrator
referred to above shall be jointly liable in case they fail to
register the new born child. If there was no attendant at birth,
or if the child was not born in a hospital or maternity clinic,
then the parents or the responsible member of the family
alone shall be primarily liable in case of failure to register the
new born child. (Emphasis supplied)
Presidential Decree No. 76612 amended P.D. No. 651
by extending the period of registration up to 31
December 1975. P.D. No. 651, as amended, provided
for special registration within a specified period to
address the problem of under-registration of births as
well as deaths. It allowed, without fine or fee of any kind,
the late registration of births and deaths occurring within the
period starting from 1 January 1974 up to the date when the
decree became effective.
Since Reynaldo was born on 30 October 1948, the late
registration of his birth is outside of the coverage of P.D. No.
651, as amended. The late registration of Reynaldos birth
falls under Act No. 3753, otherwise known as the Civil
Registry Law, which took effect on 27 February 1931. As a
general law, Act No. 3753 applies to the registration of
all births, not otherwise covered by P.D. No. 651, as
amended, occurring from 27 February 1931 onwards.
Considering that the late registration of Reynaldos birth took
place in 1985, National Census Statistics Office (NCSO)
Administrative Order No. 1, Series of 1983 governs the
implementation of Act No. 3753 in this case.
Under NCSO A.O. No. 1-83, the birth of a child shall be
registered in the office of the local civil registrar within
30 days from the time of birth. Any report of birth
made beyond the reglementary period is considered
delayed. The local civil registrar, upon receiving an
application for delayed registration of birth, is required
to publicly post for at least ten days a notice of the

Issue: Whether the late registration of Reynaldos birth is valid


Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel
Capules Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 2016 | Arellano University School of Law

10

pending application for delayed registration. If after


ten days no one opposes the registration and the local
civil registrar is convinced beyond doubt that the birth
should be registered, he should register the same.
Reynaldos certificate of live birth, as a duly registered public
document, is presumed to have gone through the process
prescribed by law for late registration of birth. It was only on 8
March 1995, after the lapse of ten long years from the
approval on 11 February 1985 of the application for delayed
registration of Reynaldos birth, that Nieves registered her
opposition. She should have done so within the ten-day period
prescribed by law. Records show that no less than Nieves
herself informed the local civil registrar of the birth of
Reynaldo. At the time of her application for delayed
registration of birth, Nieves claimed that Reynaldo was her
son. Between the facts stated in a duly registered public
document and the flip-flopping statements of Nieves, we are
more inclined to stand by the former.
Applications for delayed registration of birth go
through a rigorous process. The books making up the
civil register are considered public documents and are
prima facie evidence of the truth of the facts stated
there. As a public document, a registered certificate of
live birth enjoys the presumption of validity. It is not for
Reynaldo to prove the facts stated in his certificate of live
birth, but for petitioners who are assailing the certificate to
prove its alleged falsity. Petitioners miserably failed to do so.
Thus, the trial court and the Court of Appeals correctly denied
for lack of merit the petition to cancel the late registration of
Reynaldos birth.
ROMMEL JACINTO DANTES SILVERIO, petitioner,
REPUBLIC OF THE PHILIPPINES, respondent.
G.R. No. 174689 | October 22, 2007 (1D)

vs.

Facts: Petitioner Rommel Jacinto Dantes Silverio filed a


petition for the change of his first name and sex in his birth
certificate.
He further alleged that he is a male transsexual, that is,
"anatomically male but feels, thinks and acts as a female" and
that he had always identified himself with girls since
childhood. Feeling trapped in a mans body, he consulted
several doctors in the United States. He underwent
psychological examination, hormone treatment and breast
augmentation. His attempts to transform himself to a
"woman" culminated on January 27, 2001 when he underwent
sex reassignment surgery in Bangkok, Thailand. He was
thereafter examined by Dr. Marcelino Reysio-Cruz, Jr., a plastic
and reconstruction surgeon in the Philippines, who issued a
medical certificate attesting that he (petitioner) had in fact
undergone the procedure.
Issue: Whether or not a person successfully petition for a
change of name and sex appearing in the birth certificate to
reflect the result of a sex reassignment surgery
Held: No. A Persons First Name Cannot Be Changed On the
Ground of Sex Reassignment.
The State has an interest in the names borne by
individuals and entities for purposes of identification.
A change of name is a privilege, not a right. Petitions for
change of name are controlled by statutes. In this connection,
Article 376 of the Civil Code provides:
ART. 376. No person can change his name or
surname without judicial authority.
This Civil Code provision was amended by RA 9048 (Clerical
Error Law). In particular, Section 1 of RA 9048 provides:
SECTION 1. Authority to Correct Clerical or
Typographical Error and Change of First Name or

Nickname. No entry in a civil register shall be


changed or corrected without a judicial order, except
for clerical or typographical errors and change of first
name or nickname which can be corrected or
changed by the concerned city or municipal civil
registrar or consul general in accordance with the
provisions of this Act and its implementing rules and
regulations.
RA 9048 now governs the change of first name. It vests the
power and authority to entertain petitions for change of first
name to the city or municipal civil registrar or consul general
concerned. Under the law, therefore, jurisdiction over
applications for change of first name is now primarily lodged
with the aforementioned administrative officers. The intent
and effect of the law is to exclude the change of first name
from the coverage of Rules 103 (Change of Name) and 108
(Cancellation or Correction of Entries in the Civil Registry) of
the Rules of Court, until and unless an administrative petition
for change of name is first filed and subsequently denied. It
likewise lays down the corresponding venue, form and
procedure. In sum, the remedy and the proceedings
regulating change of first name are primarily administrative in
nature, not judicial.
Petitioners basis in praying for the change of his first name
was his sex reassignment. He intended to make his first name
compatible with the sex he thought he transformed himself
into through surgery. However, a change of name does not
alter ones legal capacity or civil status. RA 9048 does not
sanction a change of first name on the ground of sex
reassignment. Rather than avoiding confusion, changing
petitioners first name for his declared purpose may only
create grave complications in the civil registry and the public
interest.
Before a person can legally change his given name, he
must present proper or reasonable cause or any
compelling reason justifying such change. In addition,
he must show that he will be prejudiced by the use of
his true and official name. In this case, he failed to
show, or even allege, any prejudice that he might
suffer as a result of using his true and official name.
In sum, the petition in the trial court in so far as it prayed for
the change of petitioners first name was not within that
courts primary jurisdiction as the petition should have
been filed with the local civil registrar concerned,
assuming it could be legally done. It was an improper
remedy
because
the
proper
remedy
was
administrative, that is, that provided under RA 9048. It
was also filed in the wrong venue as the proper venue was in
the Office of the Civil Registrar of Manila where his birth
certificate is kept. More importantly, it had no merit since the
use of his true and official name does not prejudice him at all.
For all these reasons, the Court of Appeals correctly dismissed
petitioners petition in so far as the change of his first name
was concerned.
The changes sought by petitioner will have serious and wideranging legal and public policy consequences. First, even the
trial court itself found that the petition was but petitioners
first step towards his eventual marriage to his male fianc.
However, marriage, one of the most sacred social institutions,
is a special contract of permanent union between a man and a
woman. One of its essential requisites is the legal capacity of
the contracting parties who must be a male and a female. To
grant the changes sought by petitioner will substantially
reconfigure and greatly alter the laws on marriage and family
relations. It will allow the union of a man with another man
who has undergone sex reassignment (a male-to-female postoperative transsexual). Second, there are various laws which
apply particularly to women such as the provisions of the
Labor Code on employment of women, certain felonies under
the Revised Penal Code and the presumption of survivorship in
case of calamities under Rule 131 of the Rules of Court,

Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel
Capules Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 2016 | Arellano University School of Law

11

among others. These laws underscore the public policy in


relation to women which could be substantially affected if
petitioners petition were to be granted.
Petitioner REPUBLIC vs. JENNIFER B. CAGANDAHAN
G.R. No. 166676 | September 12, 2008 (2D)
Facts: Respondent Jennifer Cagandahan filed a Petition for
Correction of Entries in Birth Certificate. In her petition, she
alleged that she was born on January 13, 1981 and was
registered as a female in the Certificate of Live Birth but while
growing up, she developed secondary male characteristics
and was diagnosed to have Congenital Adrenal Hyperplasia
(CAH) which is a condition where persons thus afflicted
possess both male and female characteristics. She further
alleged that she was diagnosed to have clitoral hyperthropy in
her early years and at age six, underwent an ultrasound
where it was discovered that she has small ovaries. At age
thirteen, tests revealed that her ovarian structures had
minimized, she has stopped growing and she has no breast or
menstrual development. She then alleged that for all interests
and appearances as well as in mind and emotion, she has
become a male person. Thus, she prayed that her birth
certificate be corrected such that her gender be changed from
female to male and her first name be changed from Jennifer to
Jeff.
Issue: Whether or not respondents petition of correction of
entries in the birth certificate of respondent to change her sex
or gender, from female to male, on the ground of her medical
condition known as CAH, and her name from "Jennifer" to
"Jeff," under Rules 103 and 108 of the Rules of Court can be
properly granted
Held: Yes
Respondent undisputedly has CAH. This condition
causes the early or "inappropriate" appearance of male
characteristics. A person, like respondent, with this
condition produces too much androgen, a male
hormone. A newborn who has XX chromosomes coupled with
CAH usually has a (1) swollen clitoris with the urethral opening
at the base, an ambiguous genitalia often appearing more
male than female; (2) normal internal structures of the female
reproductive tract such as the ovaries, uterus and fallopian
tubes; as the child grows older, some features start to appear
male, such as deepening of the voice, facial hair, and failure
to menstruate at puberty. About 1 in 10,000 to 18,000
children are born with CAH.
CAH is one of many conditions that involve intersex
anatomy. During the twentieth century, medicine adopted
the term "intersexuality" to apply to human beings who
cannot be classified as either male or female. The term is now
of widespread use. According to Wikipedia, intersexuality "is
the state of a living thing of a gonochoristic species whose sex
chromosomes, genitalia, and/or secondary sex characteristics
are determined to be neither exclusively male nor female. An
organism with intersex may have biological characteristics of
both male and female sexes."
Intersex individuals are treated in different ways by different
cultures. In most societies, intersex individuals have been
expected to conform to either a male or female gender role.
Since the rise of modern medical science in Western societies,
some intersex people with ambiguous external genitalia have
had their genitalia surgically modified to resemble either male
or female genitals. More commonly, an intersex individual is
considered as suffering from a "disorder" which is almost
always recommended to be treated, whether by surgery
and/or by taking lifetime medication in order to mold the
individual as neatly as possible into the category of either
male or female.
In deciding this case, we consider the compassionate calls for
recognition of the various degrees of intersex as variations

which should not be subject to outright denial. "It has been


suggested that there is some middle ground between the
sexes, a no-mans land for those individuals who are neither
truly male nor truly female." The current state of Philippine
statutes apparently compels that a person be classified either
as a male or as a female, but this Court is not controlled by
mere appearances when nature itself fundamentally negates
such rigid classification.
In the instant case, if we determine respondent to be a
female, then there is no basis for a change in the birth
certificate entry for gender. But if we determine, based on
medical testimony and scientific development showing the
respondent to be other than female, then a change in the
subjects birth certificate entry is in order.
Biologically, nature endowed respondent with a mixed
(neither consistently and categorically female nor consistently
and categorically male) composition. Respondent has female
(XX) chromosomes. However, respondents body system
naturally produces high levels of male hormones (androgen).
As a result, respondent has ambiguous genitalia and the
phenotypic features of a male.
Ultimately, we are of the view that where the person is
biologically or naturally intersex the determining
factor in his gender classification would be what the
individual, like respondent, having reached the age of
majority, with good reason thinks of his/her sex.
Respondent here thinks of himself as a male and considering
that his body produces high levels of male hormones
(androgen) there is preponderant biological support for
considering him as being male. Sexual development in
cases of intersex persons makes the gender
classification at birth inconclusive. It is at maturity
that the gender of such persons, like respondent, is
fixed.
Respondent here has simply let nature take its course and has
not taken unnatural steps to arrest or interfere with what he
was born with. And accordingly, he has already ordered his life
to that of a male. Respondent could have undergone
treatment and taken steps, like taking lifelong medication, to
force his body into the categorical mold of a female but he did
not. He chose not to do so. Nature has instead taken its due
course in respondents development to reveal more fully his
male characteristics.
In the absence of a law on the matter, the Court will not
dictate on respondent concerning a matter so innately private
as ones sexuality and lifestyle preferences, much less on
whether or not to undergo medical treatment to reverse the
male tendency due to CAH. The Court will not consider
respondent as having erred in not choosing to undergo
treatment in order to become or remain as a female. Neither
will the Court force respondent to undergo treatment and to
take medication in order to fit the mold of a female, as society
commonly currently knows this gender of the human species.
Respondent is the one who has to live with his intersex
anatomy. To him belongs the human right to the
pursuit of happiness and of health. Thus, to him should
belong the primordial choice of what courses of action
to take along the path of his sexual development and
maturation. In the absence of evidence that
respondent is an "incompetent" and in the absence of
evidence to show that classifying respondent as a male
will harm other members of society who are equally
entitled to protection under the law, the Court affirms
as valid and justified the respondents position and his
personal judgment of being a male.
In so ruling we do no more than give respect to (1) the
diversity of nature; and (2) how an individual deals
with what nature has handed out. In other words, we
respect respondents congenital condition and his
mature decision to be a male. Life is already difficult

Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel
Capules Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 2016 | Arellano University School of Law

12

for the ordinary person. We cannot but respect how


respondent deals with his unordinary state and thus
help make his life easier, considering the unique
circumstances in this case.
As for respondents change of name under Rule 103, this
Court has held that a change of name is not a matter of right
but of judicial discretion, to be exercised in the light of the
reasons adduced and the consequences that will follow.[28]
The trial courts grant of respondents change of name from
Jennifer to Jeff implies a change of a feminine name to a

masculine name. Considering the consequence that


respondents change of name merely recognizes his preferred
gender, we find merit in respondents change of name. Such a
change will conform with the change of the entry in his birth
certificate from female to male.

Case Digest and Related Provisions on Legal Medicine based on Atty. Rodel
Capules Syllabus
Rivad, Sherine L. | 1st Sem AY 2015 2016 | Arellano University School of Law

13