ethics

ETHICS

ETHICS refers to two things:

Ethics refers to well based standards of right and wrong that prescribe what humans ought to do, usually in terms of rights, obligations, benefits to the society, fairness, or specific virtues

Example: standards that impose the reasonable obligations to refrain from rape, stealing, murder, assault, slander and fraud

Also includes virtues of honesty, compassion and loyalty

Standards relating to rights, such the right to life, right to freedom from injury, and the right to privacy

ETHICS

ETHICS refers to the study and development of one’s ethical standards

Feelings, laws and social norms can deviate from what is ethical

Ethics also means then, the continuous efforts of studying our own moral beliefs and our moral conduct

Ethics

Health care ethics

Professional ethics

Nursing ethics

Bioethics

Health Care Ethics

Deals with the conduct and moral issues that arise in the practice of health care professionals, nurses included

It is concerned with health care values, obligations, rights and needs

It strives to resolve ethical issues that often confront health care professionals

Health Care Ethics

ABORTION

EUTHANASIA

CONFIDENTIALITY

Professional Ethics

Is a branch of moral science concerned with the obligations that a member of the profession owes to the public

These norms of behavior called “code of ethics” helps member of the discipline to coordinate their actions or activities and to establish the public’s trust on the discipline

Nursing Ethics

In a limited sense, is known as nursing etiquette

In a general sense, it is concerned with moral principles governing the conduct of nurses in her relationship with patients, physicians, colleagues, the nursing profession and the public

BIO-ETHICS

It aims to identify, clarify, and resolve ethical problem areas in issues such as the end of life care (euthanasia, advance directives), genetics (human genome project, human cloning), AIDS, etc

MORALITY

Derived from the Greek word Moralis which means social consensus about moral conduct for human beings and society

It is a specific way of behavior of accomplishing ethical practices

It is the right or wrong, good or evil, proper or improper, cruel or benevolent acts

Is that quality of human acts where the acts could either be good or right, evil or wrong

ETHICS and MORALITY

RELATION

Both ethics and morality deal with human act or human conduct

Ethics studies about morality

Morality gives ethics a perspective of what to study about – that is the rectitude of whether an act is good or bad

Morality provides ethics with a quality that determines and distinguishes right conduct from wrong conduct

DISTINCTION

Ethics pertains to the knowledge of what to study about-that is goodness or evil of human act; Morality pertains to the application of this knowledge in the performance of human act

Ethics provides learning about morality of a human conduct; Morality provides ways in practicing what is learned

Ethics is the ‘word’; Morality is the ‘flesh”

Ethics indicates the ‘theory’; Morality indicates the ‘practice’

MORALS

standards of right & wrong

learned & internalized at early age

society & culture play important role

moral orientation generally based on religious beliefs

MORAL VALUES

preferences or dispositions reflective of right & wrong, should or should not, in human behavior

MORAL INTEGRITY

A focal virtue that relates to soundness, reliability, wholeness, an integration of character & fidelity in adherence to moral norms sustained over time

MORAL THOUGHT

individual’s cognitive examination of right & wrong, good & bad

MORAL DISTRESS

the reaction to a situation in which there are moral problems that seem to have clear solutions, yet one is unable to follow one’s moral beliefs because of external restraints; this may be evidenced in anger, frustration, dissatisfaction & poor performance in the work setting

“ MORALITY is what you believe is right and good while ETHICS is the critical reflection about morality and rational analysis about it.” Joseph Fletcher

ETHICAL DILEMMA

Defined as making a choice between two or more equally undesirable alternatives

Three Approaches toEthical Decision Making

1.Deontological

2. Teleological

3. Situational

DEONTOLOGICAL APPROACH

Comes from the Greek word deon which means duty

duty-focused normative approach centered on rules from which all action is derived.

“It is only through dutiful actions that people have moral worth. Even when individuals do not want to fulfill their duty, they are required to do so” (Immanuel Kant) german philosopher

TELELOGICAL APPROACH

Comes from the Greek word telos or “goal or end”

“The right thing to do is the good thing to do”

outcome- focused approach that places emphasis on results and protects the interest of the majority.

Also termed as the utilitarianism where the good resides in the promotion of happiness or the greatest net increase of pleasure over pain

If the act helps people, then it is a good one, and if it hurts people, then it a bad one (Joseph Fletcher)

SITUATIONAL APPROACH

no prescribed rules, norms, or majority-focused results that must be followed.

VIRTUE ETHICS APPROACH

known as aretaic ethics (arête ) that is focused primarily on the heart of the person performing the act.

Focuses on the traits and virtues of a good person such as courage, temperance, wisdom and justice

DIVINE COMMAND ETHICS

Based on the theory that there is a supreme or divine being that sets down

the rules to provide guidance to moral decisions.

Principles Of EthicalDecision Making (Ethical Principles used in Health Care)

1. Autonomy

2. Beneficence

3. Nonmaleficence

4. Paternalism

5. Utility

6. Justice

7. Truth telling (veracity)

8. Fidelity

9. Confidentiality

Autonomy

Comes from the Greek word Autos meaning self and Monos meaning governance.

It involves self- determination and freedom to choose and implement one’s decision, free from deceit, duress, constraint or coercion.

Respect for the Individual Autonomy

1. Respect for the individual autonomy, incorporates principle of freedom of choice, self-determination, and privacy.

2. The nurse has a duty to view and treat individual as autonomous, self-determining person with freedom to act.

DILEMMA!! occur when others' (the public) health may be affected, such as in the case of a patient's refusal to treat an infectious disease which might endanger the public. The patient may be forced into therapy or forced into isolation.

Autonomy

EVIDENCE OF AUTONOMY:

*INFORMED CONSENT. Relates to the process by which patients are informed of the possible outcomes, alternatives and risks of the treatments, and are required to give their consent freely.

Beneficence(Doing Good)

It promotes doing acts of kindness and mercy that directly benefit the patient.

considers a holistic approach considering the patient's beliefs, feelings and wishes

Example:

Giving antipyretic medications and TSB to febrile patients to lower the temperature; giving immunization to babies for protection against certain diseases; etc.

Patient’s Bill of Rights

Right to medical care and humane treatment

Right to informed consent

Right of privacy

Right to information

Right of privileged communication

Right to choose physician

Right to self-determination

Right to religious belief

Right to medical records

Right to leave

Right to refuse participation in Medical Research

Right to correspondence and received visitor

Right to express grievances

Right to be informed of his rights and obligations as a patient

NONMALEFICENCE

based on a person’s rigorous obligation to avoid injuring another individual

This principle obliges health care providers to “DO NO HARM”

This principle requires us that we do not intentionally create a needless harm or injury to the patient, either through negligent acts of commission or omission

Example:

Performing skin test before administering a highly allergenic medications

BENIFECENCE VERSUS NONMALEFICENCE

CASE :

Miranda is a 45 year old patient with terminal cancer (breast cancer stage 4). The cancer has metastasized to her bones, causing severe painful episodes. Doctors are arguing whether to give narcotic analgesia as it would cause dependence and can hasten death is given in amounts required to relive pain.

Paternalism

It means acting in a fatherly manner which involves engaging in behaviors associated with those of the traditional role of the father of a family (leadership, decision – making, discipline and protection)

Example:

Mrs. Gomez is 90 years old but still very lucid. She was advised by her doctors to have complete bed rest without bathroom privileges due to her problems with vertigo. Mrs. Gomez is very bored and she feels alright so she sits occasionally on the bed side chair. Upon seeing her sitting one time, the nurse reprimanded her and even threatened to tie her up in her bed if she continues to

violate such order.

Justice

Provides obligation to be fair to all

Social benefits and social burdens be distributed in accordance with the demands of justice

CASE : In a night shift at the ER, two patients were admitted. Both are needing blood transfusion, both are of rare blood type, AB+. The blood bank only has one available unit of blood. Who should receive the blood - The patient with hemophilia or the vehicular accident patient with hemorrhage?

Veracity

The truth, accuracy or precision of something

Refers to the principle of TRUTHFULNESS

In nursing, veracity is applied in the nurse’s responsibility to NEVER MISLEAD or DECEIVE a patient

This is observed when providing informed consent, health teachings and answering questions of patients about their health and treatment as TRUTHFULLY and HONESTLY as possible

The dilemma:

WHAT IF THE TRUTH WILL HASTEN A PERSON’S DEATH?

CASE : Mila and Roger have been married for 10 years. Both are healthy and active individuals but were unsuccessful in having a baby. Due to this, Mila suffered from clinical depression and attempted suicide twice. Roger knew that the source of Mila’s depression is their not having a baby. They sought consult in a fertility clinic where it was found out that the Mila already has an advanced uterine cancer and doctors wanted to do a hysterectomy. Should Mila be told the truth, despite the fact that it can cause a remission of her depression?

Fidelity

Refers to the obligation of a person to be faithful to agreements, responsibilities and commitments that he has made to himself and to others

• Related to the concept of faithfulness and the practice of keeping promises. It also relates to loyalty within the nurse-patient relationship.

• It is the main principle that supports the concept of accountability of nurses and other professionals

Confidentiality

Keeping privileged information private.

The ethical principle that requires nondisclosure of private or secret information with which one is entrusted. It is an expression of respect of persons and essential in a nurse-patient relationship.

CASE NO. 6. Jingle is a 16-year-old high school beauty queen. She comes to the clinic with complaints of heavy bleeding. Upon thorough examination and interview, she admitted to be pregnant attempting to do abortion by drinking Cytotec and placing the same drug in her vagina, as instructed by some friends. Doctors confirm incomplete abortion and scheduled her for D&C. Her parents need to be notified but Jingle refuses to give any information about her parents and wants the nurses and doctors to swear not to tell her parents about it.

CONFIDENTIALITY OF INFORMATIONmay only be revealed when:

The patient himself/herself permits such revelation as in the case of claim for hospitalization, insurance benefits, among others

The case is medico-legal such as attempted suicide, gunshot wounds which have to be reported to the local police or NBI or constabulary

The patient is ill of communicable disease and public safety may be jeopardized

Given to members of the health team if information is relevant to his care

Utility

The good of the many outweighs the wants/needs of the individual.

MORAL PRINCIPLES

1.The Golden Rule

2.The two fold Effect

a. That the action must be morally good

b. That the good effect must be willed and the bad effect merely allowed

c. That the good effect must not come from an evil action but from the action itself directly

d. That the good must be greater than the bad effect

3. The principle of totality

4. Epikia “Exception to the General Rule”

5. One who acts through an agent is himself responsible

6. No one is obliged to betray himself/herself

7. The end does not justify the means

8. Defects of nature may be corrected

9. If one is willing to cooperate in the act, no injustice is done to him/her

10. A little more or less does not change the substance of an act

11. The greatest good for the greatest number

12. No one is held to the impossible

13. The morality of cooperation

14. Principle relating to the origin and destruction of life

CODE OF GOOD GOVERNANCE

Promulgated by the PRC on July 23, 2003

States that the hallmark of all professionals is their willingness to accept a set of professional and ethical principles which they will follow in the conduct of their daily lives.

This code is adopted by the professional regulation commission and the 42 professional regulatory boards to cover an environment of good governance in which all Filipino professionals shall perform their duties.

This code which covers the common principles underlying the codes of the various professionals who face critical ethical questions in their work

GENERAL PRINCIPLE of Professional Conduct

Ethical awareness – refers to the ability to discern between right and wrong

Ethical competency – pertains to the ability to engage in sound moral reasoning and consider carefully the implications of alternative action

GENERAL PRINCIPLES

1. Service To Others

2. Integrity and Objectivity

3. Professional Competence

4. Solidarity and Teamwork

5. Social and Civic responsibility

6. Global Competitiveness

7. Equality of all professions

NURSING ETHICS

The study of historical and contemporary foundations of professional nursing action in order to understand the ‘good’ or the benefit that nursing provides for individuals and society

An analysis of potential or actual professional nursing actions (individual or disciplinary) for the ability of these to facilitate the ‘good’ proposed

The Code of Ethics For Registered Nurses

PNA Special Committee headed by Dean Emeritus Julita Sotejo has developed a Code of Ethics for Filipino Nurses in 1982 that was approved by the House of Delegates of the PNA

In 1984,the BON officially adopted the ICN’s Code of Ethics and added a fifth commitment which is ‘promotion of spiritual environment’ when it passed the Board Resolution No. 633

The Code of Ethics For Registered Nurses

In 1989, the PRC approved the Amended Code of Ethics and it was approved by the general assembly of the PNA during a convention held in 1990

In 2002, the Philippine Nursing Act of 2002 (RA 9173) was enacted and ordered the BON to promulgate a Code of Ethics for Registered Nurses in coordination and consultation with the accredited professional organization (Sec.9 Art.III of RA 9173)

Code of Ethics for Filipino Nurse

Section 9 (f) of RA 9173 provides that BON promulgate the Code of Ethics in coordination and consultation with the APO of nurses within one year from November 20, 2002, its date of effectivity

Thus, the BON promulgated BON Resolution No. 220 S 2004 or the Code of Ethics for Registered Nurses

Article IIRegistered Nurses and People

Values, customs and spiritual beliefs held by individuals shall be respected

Individual freedom to make rational and unconstrained decisions shall be respected

Personal information acquired in the process of giving nursing care shall be held in strict confidence

Article IIRegistered Nurses and People

Registered Nurses must:

Consider the individuality and totality of patients when they administer care

Respect the spiritual beliefs and practices of patients regarding diet and treatment

Uphold the rights of individuals

Take into consideration the culture and values of patients in providing nursing care. However, in the event of conflicts, their welfare and safety must take precedence

Registered Nurse and the People

Basic Nursing Services

Undertaking responsible nursing care of the patient

Supervision of patients and those contributing to the nursing care of patients

Execution of nursing procedures and techniques

Application and execution of legitimate orders of physicians concerning treatment and medication

Observation of symptoms of physical and mental conditions and needs of patient which require evaluation or application of principles based on the biological, physical and behavioral sciences

Responsibility to the Patient

Primary responsibility: to carry out physician’s orders concerning patient’s treatment

Promote learning for the patient

Assuming responsibility for the care of the patient with GENUINE concern for his welfare and safety

Maternal vs. Fetal Rights

Janet Rowen may be incarcerated because she is pregnant. Her doctor, Marion Smyth, thinks Janet drinks too much alcohol and has repeatedly advised her of the risks her drinking poses to the child she has chosen to have. Heavy alcohol use during pregnancy can result to “fetal alcohol syndrome”. Infants from this syndrome suffer from mental retardation and physical deformities and have increased chance of dying shortly after birth. Janet is unwilling to cut down on her drinking. Dr. Smyth is seeking a court order that would incarcerate Janet for the duration of her pregnancy, forcing her to follow Dr. Smyth’s medical advice


Almost half of the maternal-fetal specialists surveyed in a national recent study thought that pregnant women who refused medical advised and thereby endanger their future children should be detained in hospitals and forced to “follow doctors orders”

BUT DOES SOCIETY HAVE A RIGHT TO CONTROL THE BEHAVIOR OF PREGNANT WOMEN?


Maternal Rights

ARGUMENT 1: every person has a fundamental right to freedom of choice and control over his/her life

Forcing a pregnant woman to undergo medical treatment against her will or to behave in ways she does not freely choose violates this right

ARGUMENT 2: The threat to freedom posed by forced treatment of pregnant women

ARGUMENT 3: Justice requires that all persons be treated equally The right to refuse medical treatment


Fetal Rights:

ARGUMENT 1: The right to be protected from avoidable harm

ARGUMENT 2: The right to be born in a healthy state

Mother or fetus?

Where do our obligations lie?

Our answer will require a careful balancing of the values of freedom and self-determination, and the value we place on the right to be protected from harm

Assisted Suicide: a right or a wrong?

Matthew Donnely loved life. But Matthew Donnely wanted to die. For the past 30 years Matthew had conducted research on the use of x-rays. Now, skin cancer has riddled his tortured body. He had lost his nose, his left hand, 2 fingers on his right hand, and part of his jaw. He was left blind and was slowly deteriorating. The pain was unrelenting. Doctors estimated that he had a year to live. Lying in bed with teeth clenched from the excruciating pain, he pleaded to be put out of his misery. Matthew wanted to die now. His pleas went unanswered. Then one day, Matthew’s brother, Harold, unable to ignore Matthew’s repeated cry, removed a .30 caliber pistol from his dresser drawer, walked to the hospital, and shot and killed his brother. Harold was tried for MURDER.

Assisted Suicide: a right or a wrong?

Under the present law, suicide is not a crime, but assisting in suicide is.

Humane and Dignified Death Act (California) – that would allow physician to end life of a terminally ill patient upon the request of a patient, pursuant to properly executed legal documents

Article IIIRegistered Nurses and Practice

Human life is inviolable

Quality and excellence in the care of the patients are the goals of nursing practice

Accurate documentation of actions and outcomes of delivered care is the hallmark of nursing accountability



Know the definition and scope of nursing practice which are in the provisions of R.A. No. 9173, known as the “Philippine Nursing Act of 2002” and Board Res. No. 425, Series of 2003, the “Rules and Regulations Implementing the Philippine Nursing Act. Of 2002”, (the IRR)

Be aware of their duties and responsibilities in the practice of their profession as defined in the “Philippine Nursing Act of 2002” and the IRR

Acquire and develop the necessary competence in knowledge, skills and attitudes to effectively render appropriate nursing services through varied learning situations

If they are administrators, be responsible in providing favorable environment for the growth and developments of Registered nurses in their charge

Be cognizant that professional programs for specialty certification by the BON are accredited through the Nursing Specialty Certification Council (NSCC)



See to it that quality nursing care and practice meet the optimum standard of safe nursing practice

Insure that modification of practice shall consider the principles of safe nursing practice.

If in position of authority in a work environment, be normally and legally responsible for devising a system of minimizing occurrences of ineffective and unlawful nursing practice

Ensure that patients’ records shall be available only if they are to be issued to those who are professionally and directly involved in their care and when they are required by law


Registered nurses are the advocates of the patient: they should take appropriate steps to safeguard their rights and privileges.

Section 9 Guidelines to be observed:


Respect the “Patients Bill of Rights” in the delivery of nursing care

Provide the patients or their families with all pertinent information except those which may be deemed harmful to their well-being

Uphold the patients’ rights when conflict arises regarding management of their care


Registered Nurses are aware that their actions have professional, ethical, moral, and legal dimensions. They strive to perform their work in the best interest of all concerned



Perform their professional duties in conformity with existing laws, rules, regulations, measures and generally accepted principles of moral conduct and proper decorum

Not allow themselves to be used in advertisement that should demean the image of the profession (i.e. indecent exposure, violation of dress code, seductive behavior, etc)

Decline any gift, favor, or hospitality which might be interpreted as capitalizing on patients

Not to demand and receive any commission, fee or emolument for recommending or referring a patient to a physician, a co-nurse or another health care worker; not to pay any commission , fee or other compensations to the one referring or recommending a patient to them for nursing care. Avoid any abuse of the privilege access allowed o their property, residence or workplace

Article IVRegistered Nurses and Co-Workers

The registered nurse is in solidarity with other members of the healthcare team in working for the patient’s best interest

The registered nurse maintains collegial and collaborative working relationship with colleagues and other health care providers


Maintain their professional role/identity while working with other members of the health team

Conform with group activities as those of a health team should be based on acceptable, ethico-legal standards

Contribute to the professional growth and development of other members of the health team

Actively participate in professional organizations

Not act in any manner prejudicial to other professions

Honor and safeguard the reputation and dignity of the members of nursing and other professions; refrain from making unfair and unwarranted comments or criticisms on their competence, conduct and procedures; or not to do anything that will bring discredit to a colleague and to any member of the other professions

Respect the rights of their co-workers

Duty to Colleagues

Nurses should work together in harmony, each sharing with others whatever experience and practical knowledge they may have acquired

Responsibility to Physician

Should the physician make a mistake in the directions given, it is the duty of the nurse to call his attention to the error before carrying out his prescription. Otherwise, she may be held liable for the consequence thereof.

In emergencies, a nurse may recommend or give medical treatment without the physician’s order but in such case, he/she should report the action he/she has taken to a physician at the first opportunity

During epidemics or national emergencies, whenever services of duly registered physicians are not available, RN’s may be given limited and special authorization by the SOH to render medical services, but such authorization shall automatically cease when the epidemic or national

emergency is declared terminated by the SOH.


Be conscious of their obligations as citizens and as such, be involved in community concerns

Be equipped with knowledge of health resources within the community, take active roles in primary health care

Actively participate in programs, projects, and activities that respond to the problems of society

Lead their lives in conformity with the principles of right conduct and proper decorum

Project an image that will uplift the nursing profession at all times

Article VIRegistered Nurses and the Profession

Maintenance of loyalty to the nursing profession and preservation of its integrity are ideal

Compliance with the by-laws of the accredited professional organization (PNA), and other professional organizations of which the Registered Nurse is a member is a lofty duty

Commitment to continual learning and active participation in the development and growth of the profession are commendable obligations

Contributions to the improvement of the socio-economic conditions and general welfare of nurses through appropriate legislation in a practice and a visionary mission


Be members of the Accredited Professional Organization (PNA)

Strictly adhere to the nursing standards

Participate actively in the growth and development of the nursing profession

Strive to secure equitable socio-economic and work conditions in the nursing through appropriate legislation and other means

Assert for the implementation of labor and work standards

PERSONAL AND PROFESSIONAL DEVELOPMENT

UNIT V

CAREER MANAGEMENT

Guidelines in Choosing A Field of Nursing

1.Qualifications

What is your educational qualification?

Does it fit the job you are applying for?

Beginning positions in nursing do not usually require more than registration as well as BSN degree

2. Years of Experience and Training

What are your experiences and training?

Are these relevant to the position you are applying for?

ICU, OR, CCU and ER require nurses who have experience in these areas

Staff nurse do not require any experience and training although such may help in the evaluation of the applications

CAREER MANAGEMENT

3. Age and Physical Condition

Most employers prefer young nurses for beginning positions

An elderly nurse may not appreciate the idea of exerting much effort in doing home visits

Administrative positions will require nurses who are mature in judgment and decision-making and who possess the educational qualification required by the Philippine Nursing Law

CAREER MANAGEMENT

4. Emotional Stability and Goals in Life

How is your emotional self?

Can you be calm under stress?

Do you get along well with people?

Will you rather be alone or in a crowd?

What is your primary aim in going nursing: earn money or have the satisfaction of helping people?

Your own objectives and philosophy in life will determine to a great extent the kind of field you wish to get into

FACTORS IN SELECTING A FIELD OF NURSING

Kind of work to be performed

Availability of the work

Hours of work

Qualifications

Opportunities for advancement

Method of entering

Earning

Fringe benefits

Other benefits

DRAW A CAREER PLAN

S - pecific

M- easurable

A - ttainable

R - ealistic

T – imely/time bounded

NETWORKING

“ Its not what you know but who you know”

Network is a group of people connected to you through family, friendship, work, education and community

Networking refers to those activities that expand these connections

INFORMATIONAL INTERVIEWING

Job Interview is a screening process used by hiring managers to find the right person that would meet their company’s needs

Informational interview is a screening process used by job seekers to find the job that would meet their interests, skills, values and educational preparation

Identify the occupation you wish to learn about

Identify the people to interview

Prepare for the interview

Arrange the interview

Conducting the informational interview

Evaluating the informational interview

ADVERTISED VACANCIES

Both in print and electronically

Newspaper classified ads

Newsletters of professional organizations

Personnel department postings and phone lines

Internet job search/career center websites such as www.jobstreet.com or www.jobsdb.com

Job fairs in school campuses, malls, and government agencies as those conducted by DOLE

JOB FAIRS AND CAREER FAIRS

Types of job fairs:

Campus- Sponsored Job Fairs

Career Fairs

Commercial Job Fairs

Commercial Specialty Job Fairs

Community Job Fairs

Diversity job fairs

Job Fair Interviews

Screening interview

Mini- interview

Full interview

CONTACTING EMPLOYERS DIRECTLY

Phone Inquiry

Letter Inquiry

Applying for a job

Career Planning

APPLYING FOR A JOB

The essential things that you must prepare for when applying for a job:

Letters

Resume

Professional Portfolio

Interview

APPLICATION LETTER

There are 2 basic types of application letter

Letter of Inquiry/Prospecting Letter/Cold Call Job Application

This type of letter is sent by applicants who are looking for possible employment to a company/employer that has not yet advertised the position

Letter of Application/ Invited Letter

This type of letter is written in response to specific, advertised job opening.

Written to show your qualifications that fit the employer’s requirements for the position

APPLICATION LETTER

This letter should be organized as follows:

Identifying information: address, city, state and ZIP

Date

http://www.jobsdb.com/

http://www.jobstreet.com/

Employer’s name and address: include the name of the individual, his/her title, the organization name, the address, city, state and ZIP

Salutation: Dear Ms./Mr. _______. Be sure to address the letter to the appropriate individual. Find out the gender of the person and the proper spelling of his/her name.

Ms. Is probably the safest salutation for a woman

APPLICATION LETTER

Introductory Paragraph: clear statement of the purpose of the letter and answers the question whom you are and why you writing

Middle Paragraph: this is your chance to market your best qualities and indicate how you will serve the organization well

Final Paragraph: concludes the letter

Complimentary closing: common closing are Sincerely, Sincerely yours, or Best Regards

Your name typed: Be sure to sign your name in ink between the complimentary closing and your typed name. Leave 4 lines of space for your signature

Useful Pointers in Making a Letter of Application

Use clean, white, unlined paper

Use of ink or ball pen in writing

Use proper salutation

Observe proper margin and paragraphing

Write in a courteous manner

Enclose return postage

An application must contain the following:

Source and purpose

Qualifications

Reference

A request for personal interview

RESUME

Is the summary of the professional achievements, educational background, personal accomplishments, skills and qualities of a person

Should be concise yet complete enough so that it does not exceed 2 pages

Should be tailored to a specific job he/she is applying for

TYPES OF RESUME

Functional Resume:

Re arrange employment history into sections

Highlights areas of skill or competency and accomplishment such as managerial ability, technical ability, knowledge and interpersonal skills

Focuses on professional strengths and personal abilities of the applicant

Advisable for persons:

who changes job too often (job hopping)

new graduates,

persons who have gaps in their employment history,

persons who are changing job specialties, or

when current job does not match well with the job sought or

when person wishes to highlight certain skills or qualities

TYPES OF RESUME

Chronological Resume

Focuses on the work experience starting with the most current job and working backward

Ideal for those who have good, solid work histories and those who are seeking positions similar to the jobs they are leaving or they held before

PURPOSE OF RESUME

Purpose of Resume

Serve as a self inventory of your accomplishments

Market and advertise your self

Describe what you can do for the employer

Get you to the job interview

CONTENTS OF RESUME

Heading/Demographic Data

Mona San Martin

Mobile Phone: 09193618750

Telephone No: 451-52-58

Address: 777 Happiness Street, Quezon City

Email: [email protected]

Job Objectives: state the position of the job you are applying. Job objective needs to be:

Specific

Clear Job Objective:

Concise Seeking a position as a CLINICAL

INSTRUCTOR

CONTENTS OF RESUME

Education and Training: start with the most recent and work backwards

CONTENTS OF RESUME

Work History: can also be called Professional Experience or Related Experience

Create a list of work history starting with the most current job and work backwards

Important facts to record are employer name, city, job title, dates of employment, and a brief description of your overall responsibilities

Use action verbs such as created, implemented or increased/decreased to best describe accomplishments, activities performed or responsibilities held

CONTENTS OF RESUME

Certifications: List examinations passed or certifications obtained starting from the most recent

Include certificates related to the job being applied for

If you are to include board ratings include all board rating

mailto:[email protected]

attained in all examinations taken

CONTENTS OF RESUME

Professional Activities

Organizations

Honor/Awards/Recognition

Relevant Personal Activities

Skills and Abilities

Summary or Highlight of Qualifications

References

CURRICULUM VITAE or CV

A curriculum vitae on the other hand is longer (2 or more pages) as it contains a detailed lengthy and structured listing of education, publications, projects, awards, professional skills and work history.

Thus it can be 2 to 20 pages in length, sometimes longer if you have more extensive education and training

CURRICULUM VITAE (CV)

Colorado College’s Career Center lists important points to consider when preparing an effective Curriculum Vitae. It should be:

Clear – well organized and logical

Concise – relevant and necessary

Complete – includes everything you need

Consistent – don’t mix styles or fonts

Current – up to date

TYPES OF CV’s

STATIC CV’s – are general collections of your work, research, publications, and

presentations that you can give to any interested or potential employer

DYNAMIC CV’s – are created to specifically match the requirements for a particular position being applied for. This may mean eliminating less essential information or changing wording to highlight a match between your background and a prospective employer’s needs

ACCEPTING A JOB OFFER

Tangible Components

Salary

Salary Deductions

Legally Mandated Benefits

Private Institution Employed

Security of tenure

Normal work hours

Overtime pay

Leave benefits (SL, VL, Maternity Leaves)

Medical and Insurance benefits

Retirement Benefit

Allowances (Transportation, food)

Bonuses (Christmas bonus, etc)

Right to self- organization


Government Institution Employed – According to RA 7305 also known as “ The Magna Carta for Public Health Workers”, a nurse engaged in health and health related work employed by government owned and operated hospitals, sanitaria, health infirmaries, health centers, rural health units, barangay health stations, clinics and other health related establishments regardless of employment status


These are some of the benefits:

Married couples who are both public health workers shall be employed or assigned in the same municipality but not in the same office

Security of tenure for regular employees. If illegally dismissed from work, must be reinstated without loss of seniority rights and payment of back wages with 12% interest computed from the time the compensation was withheld to the time of reinstatement

Overtime pay – Normal work hours is 8 hours a day or 40 hours a week. OT pay shall be given for work in excess of 40 hours

Additional compensation for working during the worker’s scheduled rest day

Additional compensation for working during holiday

Night shift differential: additional 10% of his regular wage for each hour of work

Hazard allowance equivalent to 25% of the monthly basic salary receiving

salary grade of 19 and below and equivalent to 5% for those receiving salary grade of 20 and above

Subsistence allowance equivalent to 3 meals

Longevity pay equivalent to 5% of the monthly basic pay shall be paid to health workers for every 5 years of continuous, efficient, and meritorious services rendered as certified by the chief of office concerned

Laundry allowance

Remote Assignment Allowance

Housing

Free compulsory medical examination

Compensation for Injuries

Leave benefits

Highest basic salary upon requirement

Right to self organization

No discrimination against gender, civil status, health worker’s organization or union

No overloading or understanding to prevent health workers from overworking

Personal Interview

Personal Interview is a face to face conference between two people about something.

An interview between an applicant and a prospective employer gives both a chance to assess each other

Pointers in preparing for an Interview

Make an appointment either by mail or telephone

Be at the place at the appointed time

Know something about the institution where you will apply so that you can answer questions intelligently

Be at your best

Knock before you enter

Bring credentials such as your registration card, residence certificate, tax account number and the like

Ask questions about the job

Thank the interviewer for giving you some of his/her time

Give yourself time to think about the position

If the prospective employer does not answer, you may write a follow-up letter stating your interest in the position

Retaining A Position

Have an adequate knowledge and preparation for the job

Have a well developed personality

Develop good interpersonal relationship with your co workers by

Practicing the golden rule

Practicing self control

Remember: “No man is an island”

Having self confidence and being cheerful

Offering help when needed


Develop proficiency in communication, both in oral and in written forms

Be able to adjust to working conditions and to life patterns characteristic of particular occupations and communities

Keep abreast with advances in medicine, nursing and related sciences by reading professional literature and attending activities of professional organizations


Develop proficiency in communication, both in oral and in written forms

Be able to adjust to working conditions and to life patterns characteristic of particular occupations and communities

Keep abreast with advances in medicine, nursing and related sciences by reading professional literature and attending activities of professional organizations

CAUSES OF FAILURE

Incompetence

Poor interpersonal relationship

Personality defects such as imprudence

Inadequate knowledge in social conduct

Indifference to need for professional growth

Resigning from a JOB

REASONS:

Getting married, starting a family, or children requiring more time and attention

Relocation

Finding better employment in another agency, in other country or abroad

Changing specialties

Inability to adjust to working conditions

Dissatisfaction with the present job

To continue education on a full time basis

Resignation Letter

Submit a letter of resignation before leaving an agency

State the reason for leaving and express regret that you are resigning

Inform your employer at least 15-30 days before t effectivity of your resignation to give him enough time to get a reliever

Attach clearances for money, work and property responsibilities to free you from liabilities

Working Abroad

A nurse desiring to work abroad must prepare 2 travel documents which are the:

PASSPORT – issued by the DFA that proves the person’s citizenship

VISA – issued by the embassy of the foreign country where the nurse desires to go

It is a permit granted by a country to a foreigner that allows the person to enter and stay in tha country

Attaining and Maintaining Competence

The beginning practice of nurses after their initial registration would be entry level positions in any health care setting with which the graduates of BSN course (with its competency based and community oriented curriculum) were prepared to assume

The basic nursing education provides the following beginning competencies to enable a newly registered nurse to begin professional practice in a variety of health care settings

CORE COMPETENCIES expected of a graduate of the BSN Curriculum

A. Safe and Quality Nursing Care

Demonstrates knowledge on the health/illness status of individuals/groups

Provides sound decision making in the care of individuals/groups

Promotes safety and comfort of patients

Sets priorities in nursing care based on patient’s needs

Ensures continuity of care

Administers medications and other health therapeutics

Utilizes the nursing process as framework for nursing

Formulates a plan of care in collaboration with patients and other members of the health team

Implements planned nursing care to achieve identified outcomes

Responds to the urgency of the patient’s condition


B. Management of Resources and Environment

Organizes resources and workload to facilitate patient’s care

Utilizes resources to support patient care

Ensures functioning of resources

Checks proper functioning of equipment

Maintains a safe environment


C. Health Education

Assesses the learning needs of the patient and family

Develops health education plan based on assessed and anticipated needs

Develops learning materials for health education

Implements the health education plan

Evaluates the outcome of health education


D. Legal Responsibility

Adheres to practice in accordance with the nursing law and other relevant legislations including contracts, informed consent

Adheres to the organizational policies and procedures, local and national

Documents care rendered to patients

E. Ethico-moral responsibility

Respects the rights of individuals/groups

Accepts responsibility and accountability for own decisions and actions

Adheres to the national and international code of ethics for nurses


F. Personal and Professional Development

Identifies own learning needs

Pursues continuing education

Gets involved in professional organizations and civic activities

Projects a professional image of the nurse

Possesses positive attitude towards change and criticism

Performs functions according to professional standards


G. Quality Improvement

Gathers data for quality improvement

Participates in nursing audits and rounds

Identifies reports of variances

Recommends solutions to identified problems

Recommends improvement of systems and processes

H. Research

Gathers data using different methodologies

Recommends actions for implementation

Disseminates results of research findings

Applies research findings in nursing practice


I. Record Management

Maintains accurate and updated documentation of patient care

Records outcome of patient care

Observes legal imperatives in record keeping

J. Communication

Establishes rapport with patients

Listens attentively to client’s queries and request

Identifies verbal and non-verbal cues

Utilizes formal and informal channels

Responds to needs of individuals, families, groups, and communities

Uses appropriate information technology to facilitate communication


K. Collaboration and Teamwork

Establishes collaborative relationship with colleagues and other members of the health team

Collaborates plan of care with other members of the health team

The Philippine Nursing Law and Related Legislations

NCM 105- Nursing Jurisprudence

“ Ignorantia legis non excusat”

Ignorance of the law excuses no one (article 3 Civil Code)

• Functions of the LAW in Nursing

• Provides a framework in establishing what nursing actions in the care of patients are legal

• Delineates the nurse’s responsibilities from those of other health practitioners

• Helps to establish the boundaries of independent nursing action

• Assist in maintaining a standard of nursing practice by making nurses accountable under the law

• Nursing Jurisprudence

• Jurisprudence is the philosophy of law, or the science which treats the principles of positive law and legal relations

• NURSING JURISPRUDENCE – comprises all laws, rules, doctrines and principles, legal opinions and decisions of competent authority regarding governance and regulation of the practice of nursing

• Nursing Jurisprudence

• NURSING LEGISLATION – the act or process of making laws affecting the science, art and practice of nursing

• The Philippine Nursing Law

• HISTORY OF NURSING LEGISLATION

• Act No 2493

• Approved on February 5, 1915

• Amending the medical law, Act 310

• The law merely provided nursing registration but nothing about nursing examination , nursing education, nursing practice and health and human resource production, utilization and development


• Act 2808 (First True Nursing Law)

• Was approved on March 1, 1919

• Board of Examiners for nurses was created under the Department of the Interior with the physician as the chief executive officer

• 1920, the first Nursing Board Examination was conducted

• Republic Act No 465

• It was approved on June 1950

• It standardized the examination and registration fees charged by the Examining Boards

• Placing the BOE under the Office of the President


• Republic Act 877

• It took effect on June 19, 1953

• It was otherwise known as “The Philippine Nursing Law”

• It repealed all the provisions of the above mentioned laws that are inconsistent with its provisions on nursing education and practice

• It includes the provision for the organization of Board of

Examiners for nurses, nursing schools and colleges, examination and registration of nurses



• It was approved on June 18, 1966

• It amended RA 877

• Members of the BON increase from 3 to 5

• Members of the Board were to be appointed by the President with consent from the Commission on Appointments upon recommendation of the Civil Service Commission

• Board Members must be Master’s Degree Holder with an age limit of 65 years old



• It was approved on August 31, 1970

• It amended RA 877 and RA 4704

• It expressly authorized RN to administer intravenous and other injections as long as the administration is under the direction of and in the presence of a physician



• Introduced by Heherson Alvarez, it codified and revised all the laws regulating the practice of nursing

• It was approved on November 21, 1991

• It was entitled “The Philippine Nursing Act of 1991”

• It repealed, amended or modified existing laws that are inconsistent with it

• Redefinition in the scope of nursing practice

• Requiring a faculty member who is appointed by BON to resign from his/her teaching position

• Removed the age limit for members of the board, and required 10 years of continuous practice of the profession prior to appointment



• Made up of 9 articles and 41 sections

• Organization of the Board: Members of the Bon increases from 5 to 7 members

• Nursing Education: The provision “ applicants desiring to engage in nursing course must belong to the upper 40% of the graduating class of the general secondary course” is deleted (RA 7164)

• Nursing Practice: nurses are now recognized as an independent health practitioners with specific duties

• Basis of Philippine Nursing Jurisprudence

• RA 9173 (The Philippine Nursing Act of 2002)

• BON resolution #425 S 2003 (Implementing Rules and Regulations of the Philippine Nursing Act of 2002)

• RA 8981 (PRC Modernization Act of 2000)

• Code of Ethics for Registered Nurses (BON resolution # 220 S 2004)

• CHED memorandum orders (CMO # 30 S 2001, CMO #9 S 2002

• ARTICLE III – Organization of the Board of Nursing

• Sec 3. Creation and Composition of the Board

• The Professional Regulatory Board of Nursing which is created by Sec 3 of RA 9173 is composed of

• a CHAIRPERSON

• Six (6) members

• Under Sec 3 of RA 9173 there are 3 stages in the appointment of the Chairperson and/ or Members of the BON: Nomination, Recommendation, Appointment


• Sec 4. Qualifications of the Chairperson and Members of the Board

• At the time of his/her appointment, the Chairperson of the BON must be:

• A natural-born citizen

• A resident of the Philippines

• A member of good standing of the accredited professional organization of nurses

• A registered nurse

• A holder of a master’s degree in nursing conferred by a college or university duly recognized by the Government

• With at least 10 years of continuous practice of the profession prior to the appointment, the

last 5 years of which must have been in the Philippines

• Not a convict of any offense involving moral turpitude

• Citizenship – There are widely accepted principles in determining the citizenship of a person

• Jus soli – under which the place of the birth of person determines his/her citizenship

• Jus sanguinis – under which the citizenship of the parents determines the citizenship of the child

• There are 2 kinds of citizens in the Philippines:

• Naturalized Citizens – one who acquires citizenship by naturalization

• NATURALIZATION – is the process provided by law by which a person(alien) acquires citizenship after birth and becomes entitled to the privileges of citizenship

• Natural Born Citizens – are those described in Art IV Sec 2 of the 1987 Philippine Constitution

• Residence – refers to the permanent home, or the place of birth to which whenever absent for business or pleasure, one intends to return

• The term Accredited Professional Organization (APO) of nurses refers to the Philippine Nurses Association, Inc or any professional organization of nurses accredited by PRC

• A registered nurse – is one whose name appears in the Book of Registry

of Nurses as evidenced by duly issued Certificate of Registration as Nurse

• Conviction in a general sense, is the result of a criminal trial which ends in a judgment or sentence that the accused is guilty as charged

• Offense is a breach of the criminal laws; it is a violation of law for which penalty is prescribed

• Moral turpitude refers to the act of baseness, vileness or depravity in private and social duties which man owes to his fellow man, or to society in general, contrary to accepted and customary rule of right and duty in between man and man

• Examples of offenses that are considered as involving moral turpitude are MURDER, ABORTION, RAPE


• Qualifications of the Members of the BON

• A natural born citizen

• A resident of the Philippines

• A member of good standing of the accredited professional organization of nurse

• A registered nurse

• A holder of master’s degree in nursing, education or other allied medical profession conferred by a college or university duly recognized by the Government

• Have at least 10 years of continuous practice of the profession, the last 5 years of which must have been in the Philippines

• Not have been convicted of any offense involving moral turpitude


• Sec 5 – Requirements Upon Qualification as a Member of the BON

• A person who is appointed as Chairman or Member of the BON, upon qualification as such is required by law

• To immediately resign from any teaching position in any school or institution that offers BSN or review program for the Philippine Nursing Board Examinations

• To immediately resign from any office or employment 1) in the government or any subdivision, agency or instrumentality, including government-owned or government- controlled corporations or their subsidiaries 2) in the private sector

• Not to have any pecuniary interest in any school or institution that offers BSN or review classes for the Philippine Nursing Board Examinations

• Not to have any administrative supervision in any school or institution that offers BSN or review classes for the Philippine Nursing Board Examinations


• Sec 6 – Term of Office

• Term of Office – is the period during which an elected officer or appointee is entitled to hold office , perform its functions and enjoy its privileges and emoluments. It is a fixed and definite period of time which the law describes that an officer may hold office

• Tenure – is the period during which the incumbent actually holds office

• The term of office of the Chairperson and Members of the BON is 3 years


• Sec. 7 – Compensation of Board of Members

• The Chairperson and Members of a professional regulatory board shall receive monthly compensation equivalent to the following:

• Chairperson: Compensation equivalent to 2 steps higher than the Members of the Board

• Members: Compensation equivalent to, at least 2 salary grades lower than the salary grade of the Commissioners (of the PRC)

• Chairperson: Salary grade 30

• Members: Salary grade 28


• Sec 8. Administrative Supervision of the Board, Custodian of its Records, Secretariat and Support Services

• The Professional Regulations Commission (PRC) has

administrative supervision over the BON

• PRC is the legal custodian of all the records of the BON

• The records of the BON that are declared by law to be in custody of the PRC are the following:

• Applications for the nurse licensure examinations

• Examination papers

• Examination results

• Minutes of deliberation

• Records of administrative cases

• Records of investigations conducted by the Board


• Sec 8. Administrative Supervision of the Board, Custodian of its Records, Secretariat and Support Services

• The Professional Regulations Commission (PRC) has administrative supervision over the BON

• PRC is the legal custodian of all the records of the BON

• The records of the BON that are declared by law to be in custody of the PRC are the following:

• Applications for the nurse licensure examinations

• Examination papers

• Examination results

• Minutes of deliberation

• Records of administrative cases

• Records of investigations conducted by the Board


• Sec 9 – Power and Duties of the Board

• To supervise and regulate the practice of nursing profession in the Philippines

• To conduct licensure examination for nurses

• To issue, suspend or revoke COR for the practice of nursing

• To monitor and enforce quality standards of nursing practice in the Philippines and exercise the powers necessary to ensure the maintenance of efficient , ethical and technical, moral and professional standards in the practice of nursing taking into account the health needs of the nation

• To ensure quality nursing education by examining the prescribed facilities of universities or colleges of nursing or departments of nursing education and those seeking permission to open nursing courses to ensure that standards of nursing education are properly complied with and maintained at all times

• Sec 9 – Power and Duties of the Board

• To conduct hearings and investigations to resolve complaints against nurse practitioners for unethical and unprofessional conduct and violations of RA 9173 or its rules and regulations

• To promulgate a Code of Ethics in coordination and consultation with APO of nurses

• To recognize nursing specialty organizations in coordination with the APO

• To prescribe, adopt, issue and promulgate guidelines, regulations, measures and decisions as may be necessary for the improvement of the nursing practice, advancement of the profession and for the proper and full enforcement of RA 9173 subject to the review and approval by the Commission


• Sec 10 Annual Report

• The BON is required by Sec 10 of RA 9173 to submit an annual report

• The said annual report of the BON must be submitted to the President of the Republic of the Philippines

• The said annual report of the BON must be submitted to the President through the PRC

• The said annual report of the BON must be submitted at the close of the calendar year of the BON


• Sec 11 – Removal or Suspension of Board Members

• Continued neglect of duty or incompetence

• Commission or toleration of irregularities in the licensure examination

• Unprofessional, immoral or dishonorable conduct


• Neglect of duty is the omission or refusal, without sufficient excuse, to perform an act or duty, which it was the officers legal obligation to perform the failure to give due attention to the performance of duty

• Incompetency is defined as lack of adequate ability and fitness for the satisfactory performance of official duties by reasons of one’s vice or vicious habits, the lack of any physical, moral or intellectual quality which substantially incapacitates one to perform his duties


• Unprofessional conduct is defined as the conduct which by general opinion considered to be unprofessional because immoral, unethical or dishonorable. It refers to such conduct which violates ethical code or rules of profession, or to such conduct which is unbecoming a member of a profession

• Immoral conduct refers to the conduct which is willful, flagrant, or shameless, and which shows a moral indifference to the opinion of the good and respectable members of the community. It is not confined to sexual matters, but includes conduct inconsistent with rectitude, or indicative of corruption, indecency, depravity, dissoluteness

• ARTICLE IV – Examination and Registration

• Sec 12 – Licensure Examination

• Nurse Licensure Examination – is the written examination that is being given by the BON to an applicant for license to practice nursing in the Philippines, in such place and date designated by the PRC, and in accordance with PRC Modernization Act of 2000

• If only one examination is given in a year, it must be held on a weekday (Monday to Friday)

• When 2 or more examinations are given in a year, at least one examination must be held on a weekday


• Sec 13- Qualifications for Admission to the Licensure Examination

• He is a citizen of the Philippines

• He is of good moral character

• He is a holder of Bachelor’s Degree in Nursing from a college or university that complies with the standards of nursing education duly recognized by the proper government agency

• He has paid the fees prescribed by the PRC

• Documents to Accompany An Application for the NLE

• Transcript of Records with printed SO number, date of graduation, and seal of the School recognized by the government

• Original Birth Certificate issued by the local civil registrar (LCR) with registration number indicated or a copy of authenticated Birth Certificate by the NSO

• Marriage contract for married applicants

• 4 pieces of passport size colored picture with complete name on tag with white background

• Community tax certificate (current)

• Other documentary requirements as required by the law regulating the profession (case loads)


• Sec 14 – Scope of Examination

• Effective June 2006:

• TEST I – Nursing Practice (NP) I – Foundation of Professional Nursing Practice

• TEST II – Nursing Practice (NP) II – Community Health Nursing and Care of Mother and Child

• TEST III – NP III – Care of Clients with Physiological and Psychological Alterations (A)

• TEST IV – NP IV -Care of Clients with Physiological and Psychological Alterations (B)

• TEST V – NP V – Care of Clients Physiological and Psychological Alterations (C)

• Broad Areas of Nursing

• Fundamental Nursing

• Maternal and Child Nursing

• Community Health Nursing of Adolescent, Adults and Aged

• Mental Health and Psychiatric Nursing

• Other Discipline

• Physiology and Anatomy

• Pharmacology and Therapeutics

• Microbiology

• Nutrition and Diet Therapy


• Sec 15 – Ratings

• Passing Grade

• A general average of at least 75%

• A rating of not below 60% in any subject

• Rules when GA is below 75%

• An examinee who obtains a GA that is lower than 75% FAILS the licensure examination regardless of the ratings he obtain in the individual subject

• Rules when GA is 75% above

• An examinee who did not obtain a rating of below 60% in any subject, he PASSES the licensure examination.

• If he obtained a rating below 60% in any subject, he FAILS the licensure examination. However, he may take a REMOVAL examination

• However, in a REMOVAL EXAMINATION, the ratings in the subject being repeated must be at least 75%

• Removal examination shall be taken within 2 years after the last failed examination


• Sec 16 – Oath of Profession

• OATH – is any form of attestation by w/c a person signifies that he is bound in conscience to perform an act faithfully and truthfully.

• The oath may be recited in:

• English (Oath of Professionals)

• Filipino (Panunumpa ng Propesyonal)

• Florence Nightingale Pledge


• Sec 17. Issuance of Certification of Registration/ Professional Identification Card

• Under Sec 17 of RA 9173, a successful examinee shall be issued the following documents

• Certificate of Registration/ Professional License

• Professional Identification Card

• Contents of COR or Professional License

• Full name of the registrant

• Serial No of the Certificate

• Signature of the Chairperson of the PRC

• Signatures of the Members of the BON

• Official seal of the PRC

• Official seal of the Board of Nursing


• Sec 18. Fees for Examination and Registration

• Persons required to pay examination and registration fees set by the Commission

• All applicants for admission to the NLE

• All applicants for registration as professional nurse practitioner


• Sec 19. Automatic Registration of Nurses

• Automatically registered nurses under RA 9173:

• Nurses already in the Roster or Registry Book of Nurses

• Under Sec 40 of RA 9173, expressly repeals RA 7164, otherwise known as “The Philippine Nursing Act of 1991”

• Automatically or “ipso facto”

• The term “ipso facto” means by mere fact or by the mere effect of an act or fact

• Thus, by the mere fact of their names already appearing in the Roster or Book of Registry of Nurses when RA 9173 took effect this nurses also became RN under RA 9173

• There may be regarded as the automatically registered nurses under Sec 19 of RA 9173


• Sec. 20 Registration of Nurses by Reciprocity

• As a general rule, all applicants for license to practice in the Philippines are required by Sec 12 to pass the nurse licensure examination provided for in RA 9173

• However, those who are qualified for registration by reciprocity under Sec 20 of RA 9173 are exempted from this rule

• Thus, a nurse, who is registered under the law of any country other than the Philippines, may be issued without examination a certificate of registration or professional license, if the conditions mentioned in Sec 20 are met

• Registration by reciprocity under this Section is available only to nurses who are registered under the laws of a foreign state or country


• Sec 21. Practice Through Special/ Temporary Permit

• A special/ temporary permit to practice nursing is a permit that may be granted by the BON to a licensed nurse from a foreign state or country allowing him/her to engage in a special or temporary practice of nursing here in the Philippines without need of passing first the NLE

• Who may be issued Special/ Temporary Permit to Practice:

• He/ She is an internationally well known specialist or an outstanding expert in any branch or specialty in nursing (whose service may either be for a fee or for free)

• He/ She is on medical mission (whose services must be free in a particular hospital, center or clinic)

• He/ She is employed by a nursing school, as an exchange professor in a branch or specialty of nursing


• Sec 22. Non- registration and Non- Issuance of COR/ Professional License or Special/ Temporary Permit

• Grounds For Non- Registration and Non-Issuance of COR/PL or Special/Temporary Permit

• If he has been convicted by final judgment of a criminal offense involving moral turpitude

• If he is guilty of immoral or dishonorable conduct

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

• A person of UNSOUND MIND refers to one who from infirmity of mind is incapable of managing himself or his affairs. Includes insane persons


• Sec. 23 Revocation and Suspension of COR/PL and Cancellation of Special/Temporary Permit

• Suspension – means a “temporary stop, interruption or cessation”

• Revocation – means the withdrawal or recall of some power, authority or things granted; it is the total repeal or cancellation of something that exists

• Grounds for Suspension and Revocation, Cancellation of Special/ Temporary Permit

• Conviction by final judgment of any criminal offense involving moral turpitude

• Immoral or dishonorable conduct

• Unsoundness of mind as declared by court

• Unprofessional or unethical conduct

• Gross incompetence or serious ignorance

• Malpractice or negligence in the practice of nursing

• Use of fraud or deceit or false statements in obtaining certificate of registration or professional license

• Violation of any of the following

• RA 9173

• Implementing Rules and Regulations

• Code of Ethics for Nurses

• The policies of the BON and PRC

• Practicing his/her profession during his/her suspension

• Maximum Period of Suspension:

• Shall be for a period not to exceed 4 years

• May a revoked COR/PL be re-issued?

• Yes. Under sec 24 of RA 9173, the BON has the power to re-issue revoked COR


• Sec 24 Re-Issuance of Revoked Certificates and Replacement of Lost Certificates

• Conditions for Re – Issuance of Revoked Certificate of Registration / Professional License

• That there is a proper application with the BON for the re-issuance of the revoked COR/ PL

• That the application is made after the expiration of a maximum of 4 years from the date of revocation of the certificate

• That the cause of revocation has disappeared or has been cured or corrected

• That the re-issuance is sought for reasons of equity and justice

• That the required fees have been paid

• Replacement of Lost Destroyed or Mutilated COR/ PL

• Lost

• Destroyed

• Mutilated

• ARTICLE V- Nursing Education

• Sec 25 Nursing Education Program

• requires nursing education program to provide sound general and professional foundation for the practice of nursing

• That learning experiences must adhere strictly to specific requirements embodied in the prescribed curriculum as promulgated by the CHED policies and standards of nursing education


• Sec 26. Requirement for Inactive Nurses Returning to Practice

• An inactive nurse is a nurse who has not actively practicing the nursing profession for 5 consecutive years

• Required to undergo training program

• Training program for inactive nurses returning to practice:

• 1 month didactic training

• 3 months of practicum


• Sec 27. Qualification of the Faculty

• Qualifications of Faculty- Members in a College of Nursing

• A registered nurse in the Philippines

• With at least 1 year of clinical experience in a field of specialization

• A member of good standing in the APO of nurses

• A holder of master’s degree in nursing,

education, or other allied medical and health sciences conferred by a college or university duly recognized by the Government


• Qualifications of the Dean of a College of Nursing

• A registered nurse in the Philippines

• With at least 1 year of clinical practice in a field of specialization

• A member of good standing in the APO of nurses

• A holder of master’s degree in nursing conferred by a college or university duly recognized by the government

• With at least 5 years of experience in nursing

• ARTICLE VI – Nursing Practice

• Sec 28. Scope of Nursing

1. singly or in collaboration with another, initiates and performs nursing services to individuals,families and communities

2. provide nursing care from delivery up to old age

3. as independent practitioner, primarily responsible for the promotion of health and prevention of illness

4. collaborates with other members of health team

• DUTIES OF NURSES:

1. Provide nursing care

2. Establish linkages with community resources

3. Provide health education

4. Teach, guide and supervise students in nursing programs

5. Undertake research and training, professional continuing education

6. Observe Code of Ethics

• Fields of Nursing

• Hospital/ Institutional Nursing – involves nursing practice in hospitals and similar institutions

• Community Health Nursing – involves nursing practice in the community health center or other public health agency

• Military nursing – involves nursing practice in military bases or camps of the AFP

• Occupational Health/industrial nursing – involves nursing practice in the place of employment


• Clinic/Office Nursing – involves nursing practice in medical clinics or in the office of the physician

• Private duty nursing – involves full time professional service to one patient in the hospital or in the home

• Nursing education – involves teaching in a school of nursing or other educational institutions for nurses


• School Health Nursing – nursing practice in schools, assisting the school physician in his duties

• Independent nursing practice

• ARTICLE VI- Nursing Practice

• Sec 29. Qualifications of Nursing Service Administrators

• A nursing service administrator is a person occupying a supervisory or managerial position that requires knowledge of nursing

• Qualification of Nursing Service Administrator:

• Registered nurse in the Philippines

• With at least 2 years of experience in general nursing service administrations

• With BSN degree

• With at least 9 units in management and administration courses at graduate level

• A member of good standing of the APO of nurses

• ARTICLE VI- Nursing Practice

• Qualifications of a Chief Nurse or Director of Nursing Service:

• Registered nurse in the Philippines

• With at least 2 years of experience in general nursing service administrations

• With BSN degree

• With at least 9 units in management and administration courses at graduate level

• A member of good standing of the APO of nurses

• With at least 5 years of experience in a supervisory or managerial position in nursing

• With a master’s degree major in nursing

• ARTICLE VII – Health Human Resource Production Utilization and Development

• Sec 30. Studies for Manpower Needs, Production, Utilization and Development

• The BON has the duty under Sec 30 of RA 9173 to initiate, undertake and conduct studies on health human production, utilization and development

• Sec 31. Comprehensive Nursing Specialty Program

• The BON is mandated by this Section to formulate and develop a comprehensive nursing specialty program that would upgrade the level of skill and competence of specialty nurse clinicians in the country

• Critical care

• Oncology

• Renal

• Such areas as may be determined by the Board


• Sec 32. Salary

• Nurses working in public health institutions have the right to receive not less than the minimum base pay provided in Sec 32 of RA 9173 ; must not be lower than Salary Grade 15 prescribed under RA 6758, otherwise known as “ The Compensation and Classification Act of 1989”

• Sec 33. Funding for the Comprehensive Nursing Specialty Program

• PCSO

• PAGCOR shall equally share the cost of the training mentioned in Sec 33

• The annual fund shall be released to the DOH and the DOH shall set the criteria for the availment of this program


• Who may avail of this PCSO- PAGCOR- Funded Program:

• Member of the nursing staff of a government hospital participating in the comprehensive nursing specialty program

• 10 % of the nursing staff of the participating government hospitals

• Sec 34. Incentives and Benefits

• Forms of Incentives and Benefits

• Free hospital care for nurses and their dependents

• Scholarship grants

• Other non- cash benefits

• ARTICLE VIII – Penal and Miscellaneous Provisions

• Sec 35. Prohibitions in the Practice of Nursing

• This section is what we know the penal clause of RA 9173; this part enumerates certain acts that are declared CRIMINAL, id est, prohibited and punishable

• Penalties:

• Fine (minimum 50,000 –maximum 100, 000)

• Imprisonment (minimum 1 year – maximum 6 years)

• Both (Fine and Imprisonment)


Any person practicing nursing

1. without a COR/PL, special/ temporary permit

2. uses an invalid certificate;

3. uses a suspended or revoked Certificate or expired or cancelled permit

4. gives false evidence to the Board

5. falsely poses or advertises or conveys the impression that he is a registered nurse

6. who appends BSN, RN without authority

7. who as a registered nurse, assists illegal practice of a non-qualified person


Penalties:

• a fine of not less than P50000. Nor more than P100,000. Or imprisonment of not less than 1 year nor more than six years, or both, upon the discretion of the court

• ARTICLE IX – Final Provisions

• Sec 36. Enforcement of this Act

• Sec 37.Appropriations

• Sec 38. Rules and Regulations

• Sec 39. Separability Clause

• Sec 40. Repealing Clause

• Sec 41. Effectivity of the Act

Legal Aspects of Nursing

Other Laws That Affect Nursing

Laws, Resolutions, Proclamations and Executive Orders Affecting the Practice of Nursing in The Philippines

NCM 105 – Legal Aspect of Nursing

Executive Orders

Executive Orders are orders issued by the Chief Executive in order to implement a constitutional mandate or statutory provision

EO 51 –The Milk Code; it aims to provide safe and adequate nutrition for infants by protection and promotion of breastmilk and by ensuring the proper use of breastmilk substitutes

The labels of milk products covered by this code shall have written important notice such as “This product is not intended to replace breastmilk” or “ Breastfeeding is best for your baby”

Executive Orders

EO 174 – The national drug policy on availability, affordability of safe, effective and good quality drugs for all

EO 209 – The Family Code of the Philippines

Letter of Instruction (LOI)

LOI is an order issued by the President to serve as guide to his previous decree or order

LOI 47- directs all schools of midwifery and nursing, social work, medicine and allied medical profession to include family planning in their curricula

LOI 949 – which created the Primary Health Care System

LOI 1000 – which directs government agencies to give preference to members of accredited professional organizations when hiring employees

Presidential Decree (PD)

PD are orders coming from the President of the Philippines who exercised legislative powers during state of martial law

PD 48 – 4 children with paid maternity leave privileges

PD 69 – 4 children for tax exemption

PD 442 – which is the Labor Code of the Philippines

PD 491 – Nutrition Program

PD 603 – The Child and Youth Welfare Code of the Philippines. It protects the right, and promotes the welfare of the children


PD 626 – which provide for an Employee Compensation and Insurance Fund, providing more benefits to persons covered by SSS and GSIS for injury, illness and disabilities

PD 651 – Birth and Death Registration law

PD 925 – which provided penalty for improper garbage disposal and other forms of uncleanliness

PD 856 – Code on Sanitation

PD 965 –required marriage license applicants to receive instruction on Family Planning and Responsible Parenthood prior to the issuance of marriage license


PD 996 – which provided for compulsory basic immunization for children and infants below eight years of age

PD 1519 – revised medicare benefits; which provided for medical benefits of government employees regardless of status of appointment

PD 1636 – which requires compulsory membership to SSS or GSIS retirement fund

PROCLAMATIONS

These are official declaration by the Chief Executive of Office of the President on certain programs, projects or situations

Proclamation # 6 – declaring that UN’s goal of Universal Child Immunization , involved NGO’s in the immunization program

Proclamation # 499 – which declares December 1 as the National AIDS Awareness Day

Proclamation # 539 – Last week of October as Nurse’s Week

Republic Acts (RA)

These are acts or laws passed by the Congress of the Philippines

RA 1080 – which declared that professionals who passed the board and bar exams are civil service eligible (Civil Service Eligibility)

RA 1082 – which is “The Rural Health Act”, creating RHU all over the country with the goal of promoting the health and well being of the rural population

RA 1612 – which provides that a privilege tax shall be paid before any business or occupation can be lawfully begun or pursued

To be paid before January 31 of each year

Professionals working in gov’t agencies are exempted from this

Republic Acts (RA)

RA 1636 – Compulsory membership to SSS of the self employed individual

RA 2382 – which is the “ Philippine Medical Act” regulating the practice of medicine in the Philippines

RA 3573 – the law on the reporting of communicable diseases to the nearest health station and that any person may be inoculated, administered or injected with prophylactic injections

RA 4226 – which is the Hospital Licensure Act, requiring all hospitals to be licensed before they can operate

Republic Acts (RA)

RA 5181 – this act prescribes permanent residence and reciprocity qualifications for any examination or registration for the practice of any profession in the Philippines

RA 5901 – working hours and compensation of hospital and clinical personnel

RA 6111 – which is the Philippine Medical Care Act of 1969 (MEDICARE) providing for hospitalization benefits for employees who are members of the GSIS and SSS

Republic Acts (RA)

RA 6675 – which is the “ Generic Acts of 1988”

RA 6713 – which is the “Code of Conduct and Ethical Standards for Public Officials and Employees”

RA 7170 – the law that governs organ donation

RA 7305 – which is the Magna Carta of Public Health Workers

RA 7600 – which is the Rooming-in and Breastfeeding Act of 1992

RA 7610 – which is “ The Special Protection of Children Against Child Abuse, Exploitation and Discrimination Act”

Republic Acts (RA)

RA 7875 – which is the National Health Insurance Act of 1995.

It is an act instituting a national health insurance program for all Filipinos and establishing the PHIC for the purpose

RA 7877 – which is “ The Anti-Sexual Harassment Act of 1995”

It is an act declaring sexual harassment unlawful in the ff environment: 1. employment 2. education 3. training

RA 8749 – The Philippine Clean Air Act of 1999

RA 8981 – The PRC Modernization Act of 2000

RA 9211 – No smoking act

Nurses contracts and wills

NCM 105 – Nursing Jurisprudence

CONTRACT

Is a meeting of minds between 2 or more persons whereby one binds himself, with respect to the others, to give something or to render some service

CONTRACT

Is the basis of a relationship between a nurse and an employer

For example: a nurse and a hospital, or a nurse and a physician

It is also a basis of the relationship that a nurse has with patient

Doctrines Applied in Contracts

DO UT DES – “I give that you may give” – applied to giving money or goods under a promise of repayment in money or goods, and to loans of money, and contracts of sale

FACIO UT FACIAS – “I perform so that you are to perform” – signifies an agreement to do work for another if the other will do work for him; or to do any positive acts on both sides

Doctrines Applied in Contract

FACIO UT DES – “ I do that you may give” – a valid and enforceable contract results from an implied consent where one party renders service to another and the latter accepts such service without proof that the same is given gratuitously

DO UT FACIAS – “ I pay in order that you perform” – When one agrees with the employee to give wage based on performance

Essential Requisites of Contract

Consent of the contracting party

Object certain which is the subject matter of the contract

Cause of the obligation which is established

Expressed Contract VS Implied Contract

Expressed – when 2 parties discuss and agree orally or in writing to its terms

Example: the nurse will work at a hospital for a stated length of time under stated conditions

Implied – one in which there has been no discussion between the parties, but the law considers that a law contracts exists

Example : when an unconscious patient receives an IV infusion from a nurse, the law considers that an agreement is implied; that the patient must pay for the infusion and for the nurse’s service

WILLS

Is an act whereby a person is permitted, with formalities prescribed by law , to control to a certain degree the disposition of his estate, to take effect after his death (Art. 783 Civil Code)

KINDS OF WILL

Notarial will – a will that is subscribed or signed by the testator himself of by some other person in the presence of the testator and by his express direction and attested and subscribed by 3 or more credible witnesses in the presence of the testator and of one another

KINDS OF WILL

Holographic will – a will which is entirely written, dated and signed by the testator himself and is not subject to any specific form and need not be witnessed

Nuncupative will – oral will

Terms Commonly used in Wills

BEQUEST is a gift by will of personal property

EXECUTOR is one to whom another man commits by his last will the execution of that will and testament

TESTATOR is one who has made a testament or will

DECEDENT applied to the person whose property is transmitted through succession, whether or not he left a will

Persons who may make a will

Male or female who at least 18 years of age

Persons of sound mind at the time of the execution of the will

A married woman. Even without the husband’s consent or authority of the court

Who may witness to wills

Any person:

Of sound mind

18 years of age and above

Not blind, deaf or dumb

Able to read and write

NURSES AND TORTS

NCM 105 – Nursing Jursiprudence

TORTS

Are CIVIL (not criminal) wrongs that are done to clients

When a criminal act has occurred, the court seeks to punish the person responsible

TORTS

TORTS: A legal wrong, committed against a person or property

TYPES:

1. Unintentional- do not require intent but do require the element of harm.

Ex. Negligence and malpractice

PROFESSIONAL NEGLIGENCE

“NEGLIGENCE” refers to the commission or omission of an act, pursuant to a duty, that a reasonably prudent person in the same or similar circumstance would or would not to, and acting or the non-acting of which is the proximate cause of injury to another person to his property.

SPECIFIC EXAMPLES OF NEGLIGENCE

1. Failure to report observations to attending Physicians

2. Failure to exercise the degree of diligence which the circumstances of the particular case demands

3. Mistaken Identity

4. Wrong medicine, wrong concentration, wrong route, wrong dose

5. Defects in the equipment such as stretchers and wheelchairs may lead to falls thus injuring the patients

5. Errors due to family assistance

6. Administration of medicine without a doctor’s prescription

MALPRACTICE

Implies the idea of improper or unskillful care of a patient by a nurse. It also denotes stepping beyond one’s authority with serious consequences

EXAMPLES OF MALPRACTICE:

Misdiagnosis of an illness, failure to diagnose or relay diagnosis

Birth Injuries

Surgical Complications

Prescription errors

Failure to provide treatment

Anesthesia related complications

Failure to follow advance directive

Failure of hospital or pharmacy to dispense the right medicine, dosage

INCOMPETENCE

Is the lack of ability, legal qualifications or fitness to discharge the required duty

Although a nurse is registered, if in the performance of her duty she manifests incompetency, there is ground for revocation or suspension of her certificate of registration

2. Intentional- the act was done on purpose or with intent; no harm, injury or damage is needed to be liable.

A. ASSAULT AND BATTERY

ASSAULT- an attempt or threat to touch another person unjustifiably; mental or physical threat

Ex.- forcing a pt. to take his medication or treatment

BATTERY- physical harm through willful touching of person or clothing without consent.

Ex. – giving of injection without pt’s consent

B. FALSE IMPRISONMENT

- Unjustifiable detention of a person without a legal warrant

- occurs when the person is not allowed to leave a health care facility when there is no legal justification to detain the client.

- occurs when restraining devices are used without an appropriate clinical need.

USE OF RESTRAINTS

Restraints should be used with caution and discretion. All patients should have the right to independence and freedom of movement. Restraints require a physician’s order. If a patient or his legal guardian refuses to be restrained, this should be documented in the patient’s medical record.

C. INVASION OF PRIVACY

Right to privacy is the right to be left alone

Right to be free from unwarranted publicity

Exposure to public view

Divulge information from patient’s chart to improper sources or unauthorized person

PRIVILEGED COMMUNICATION: Statements uttered in good faith; not permitted to be divulged in court of justice

5. DEFAMATION

Character assassination

There must be a third person who hears or read the comment before it can be considered defamation

TYPES:

Slander-oral defamation

Libel-written words

CRIMINAL LAW AND THE NURSE

Nursing Jurisprudence

CRIMINAL LAW

CRIMINAL LAW is the branch of law which defines crimes, treats of their nature and provides for their punishment

Crime

Is an act or an omission that is punishable by law

FELONIES AND OFFENSES

FELONIES are those crimes punished by the Revised Penal Code of the Philippines

OFFENSES are those crimes punished by a special penal law

EXAMPLES

INFANTICIDE which is the killing of a child less than 3 days of age is a crime punishable by ARTICLE 255 of the Revised Penal Code, this crime is therefore a FELONY

Practicing nursing in the Philippines without a COR/PL and Professional Identification Card is a crime punishable by Section 35 (a) (1) of RA 9173, which is a special penal law. This crime is therefore an OFFENSE

FELONIES

Are crimes punishable by Revised Penal Code of the Philippines. It has three essential elements

There must be an act or an omission

The act or omission must be punishable by the Revised Penal Code

The rule is: “There is no crime when there is no law punishing the act” (nullum crimen, nulla poena sine lege)

The act is performed or the omission is incurred by means of either malice or fault

FELONIES

Malice it refers to criminal intent or the deliberate intent to do an injury to another, his property or his right

Fault refers to imprudence or negligence

Imprudence indicates a deficiency of action and usually involves lack of skill

Negligence indicates deficiency of perception and usually involves lack of foresight

2 kinds of felonies according to manner of commissionIntentional Felonies are those committed by means of malice or criminal intent

Culpable Felonies are those committed by means of fault

3 kinds of felonies according to the stages of acts of execution

Attempted Felony – when the offender commences the commission of the felony directly by over acts, and does not perform all the acts of execution which should produce the felony by reason of some cause or accident other than his spontaneous desistance


Frustrated Felony – is when the offender performs all the acts of execution which would produce the felony as a consequence but which, nevertheless, do not produce it by reason of causes independent of the will of the perpetrator


Consummated Felony – is consummated when all the elements necessary for its execution and accomplishment are present

CASE ILLUSTRATION

With the intent to kill a 4 year old boy under her care, the nanny prepared a bowl of cereals and laced it with poison sufficient, if substantial amount is taken to kill the boy

If, after she had fed the boy with the said cereals, the boy dies of the said poison, the crime is CONSUMMATED (and that is MURDER)

If, despite having fed the boy with all the contents of the said bowl, the boy does not die because of timely medical attention, the crime is FRUSTRATED

CASE ILLUSTRATION

If the boy did not die because after she fed him spoonful of the said cereals, he started to retch such that she was not able to anymore (although the nanny still wanted ) to feed him more of the poisoned cereals, the crime is ATTEMPTED

FELONIES According to GRAVITY

Grave Felonies are those which the law punishes with capital punishment or with any of the afflictive penalties

Capital Punishment is DEATH PENALTY

Afflictive Penalties includes:

RECLUSION PERPETUA – an imprisonment from 20 years and 1 day to 40 years

RECLUSION TEMPORAL – imprisonment from 12 years and 1 day to 20 years

PRISION MAYOR – imprisonment from 6 months and 1 day to 6 years


Less Grave Felonies – are those which the law punishes with any of the correctional penalties

Correctional Penalties include:

Prision Correcional which is an imprisonment from 6 months and 1 day to 6 years

Destierro (which is restriction of FREEDOM) from 6 months and 1 day to 6 years

Arresto Mayor which is an imprisonment from 1 month and 1 day to 6 months


Less Felonies – are those which are punished by law with arresto menor or with a fine not exceeding 200 pesos, or both such imprisonment and fine

ARRESTO MENOR – Is a light penalty which is consists of an imprisonment or deprivation of freedom from one day to 30 days

CONSPIRACY

Exists when two or more persons come an agreement concerning the commission of a felony and decide to do it

Persons who are Criminally liable for Felonies

For GRAVE FELONIES and LESS GRAVE FELONIES, the following are criminally liable:

Principal

Accomplices

Accessory

However, for LIGHT FELONIES only the principals and the accomplice are criminally liable, the accessories are not

PRINCIPALS

PRINCIPALS in criminal law are of 3 kinds:

PRINCIPALS BY DIRECT PARTICIPATION are those who take a direct part in the execution of the felony

PRINCIPALS BY INDUCTION are those who directly force or induce others to commit the felony

PRINCIPALS BY INDESPENSABLE COOPERATION are those who cooperate in the commission of the felony by another act without which it would not have been accomplished

ACCOMPLICES

Are those persons who are not principals but who cooperate in the execution of the felony by previous or simultaneous acts

ACCESSORIES

Are those who, having knowledge of the commission of the felony, and without having participated therein (either as principals or accomplices), take part AFTER the felony was committed

CASE ILLUSTRATION

Anna is 4 months pregnant and her boyfriend Bonny decided that she must have abortion. Bonny sought help of Chris who brought Bonny (and Anna) to Doddy, an abortionist. After Bonny paid the price he demanded, with the help of his assistant, Edong, performed the abortion on Anna (although without Anna’s consent). After the fetus was expelled, Fred, a helper of Doddy buried it to prevent the discovery of the crime

ANALYSIS

The felony committed here is INTENTIONAL ABORTION punishable under ARTICLE 256 of the Revised Penal Code and the following may be held liable:

Bonny as a PRINCIPAL by INDUCTION

Chris as an ACCOMPLICE

Doddy as a PRINCIPAL by direct participation

Edong as PRINCIPAL by INDESPENSABLE COOPERATION

Fred, as an ACCESSORY

Circumstances affecting Criminal Liability

J-E-M-A-A

Justifying Circumstances

Are those circumstances which make the act of a person to be legal and not criminal, so that he is deemed not to have violated the law and is free from both criminal and civil liability

When there is a justifying circumstance, no crime exists; consequently, no criminal and civil liability are incurred

Justifying Circumstances

The following are justifying circumstances:

SELF DEFENSE

Unlawful aggression

Reasonable necessity of the means employed to prevent or repel such aggression

Lack of sufficient provocation on the part of the person defending himself

Defense of Relatives

Defense of Strangers

Advance of Greater Evil or Injury

Fulfillment of duty, or lawful exercise of right or office

Obedience to a lawful order

Exempting Circumstances

Are those circumstances which make the act of a person to be lacking in any of the condition that would make it intentional or culpable

When there is an exempting circumstance, the actor (perpetrator of the act) is exempt from criminal liability

Exempting Circumstances

Imbecility or insanity

Being 9 years or less of age

Being over 9 and under 15 years of age

Accident

Irresistible force

Uncontrollable fear

Insuperable cause

Mitigating Circumstances

Are those circumstances which, if present in the commission of the felony, do not entirely free the actor from criminal liability but serve only to reduce the penalty

Mitigating Circumstances

Incomplete Justifying or Exempting Circumstance

Being under 18 or over 70 years of age

No intention to commit so grave a wrong

Provocation or threat

Vindication of a grave offense

Passion or obfuscation

Surrender or Confession of guilt

Physical defect

Illness of the offender

Similar and analogous circumstances

Impulse of jealousy

Extreme poverty and necessity

Aggravating Circumstances

Are those circumstances which, if present in the commission of the felony, serve to increase the penalty (without exceeding the maximum penalty provided by law for the felony)


Taking advantage of Public position

Contempt or insult to public authorities

Disregard of rank, age or sex

Dwelling of the offended party

Abuse of confidence

Obvious ungratefulness

Palace of the chief executive

In the presence of the chief executive


Where public authorities are engaged in the discharge of their duties

Place dedicated to religious worship

Nighttime

Uninhabited place

On the occasion of calamity or misfortune

With the aid of armed men

Habituality

Price , reward or promise

Inundation, fire, poison, explosion , etc


Evident premeditation

Craft, fraud or disguise

Superior strength

Means to weaken defense

Treachery

Unlawful entry

Alternative Circumstances

Are those circumstances which must be considered either as aggravating or mitigating depending upon the nature and effects of the felony and the other conditions attending its commission

Alternative Circumstances

Relationship

Intoxication

Degree of instruction and education

ethics

Documents

public ethics ethics

wrong ethics

moral conduct ethics

ethical bioethics ethics

code of ethics

flesh ethics

morality morality

human conduct ethics