CODE OF ETHICS

OF THE
PHILIPPINE MEDICAL ASSOCIATION
 7 ARTICLES
ARTICLE I GENERAL PRINCIPLES
ARTICLE II DUTIES OF THE PHYSICAN TO THEIR
PATIENTS
ARTICLE III DUTIES OF PHYSICIANS TO THE
COMMUNITY
ARTICLE IV DUTIES OF PHYSICIANS TO THEIR
COLLEAGUES AND TO THE
PROFESSION
ARTICLE V DUTIES OF PHYSICIANS TO ALLIED
PROFESSIONALS
ARTICLE VI RELATIONSHIP OF PHYSICIANS WITH THE
HEALTH PRODUCT INDUSTRY
ARTICLE VII AMMENDMENTS
 PMA CODE OF ETHICS
IMPLEMENTING RULES AND GUIDELINES

Enacted to guide physicians, the PRC and the Commission on

Ethics
Pursuant to the Medical Act of 1959, the Code of Ethics by the
PMA shall be complied with by all physicians, whether such
physicians are members of the Association or not
Violations of the Code shall constitute unethical practice and
unprofessional conduct and shall be grounds for reprimand,
suspension or expulsion from the Association for cases filed
with the Commission on Ethics of the Association and shall be
grounds for reprimand, suspension or revocation of license for
cases filed before the PRC subject to the rules of procedures
and policies of said bodies
 ARTICLE I General Provisions

Section 1 Service to mankind

Section 2 Friend to mankind
Section 3 Fulfill civic duties
Section 4 Work in harmony and respect
Section 5 Cooperate and safeguard interest
and reputation of paramedical,
other health professionals
Section 6 Upright, diligent, sober
Section 7 Priority of patient health over
physician benefits
 RTICLE I
GENERAL PRINCIPLES
Section 1. The primary objective of the practice of
medicine is service to mankind irrespective of race, age,
disease, disability, gender, sexual orientation, social
standing, creed or political affiliation. In medical practice,
reward or financial gain should be a subordinate
consideration.
Section 2. On entering the profession, a physician
assumes the obligation of maintaining the honorable
tradition that confers the well deserved title of a friend of
mankind. The physician should cherish a proper pride in
the calling and conduct himself/herself in accordance with
this Code and in the generally accepted principles of the
International Code of Medical Ethics.
Section 3. Physicians should fulfill the civic duties of a
good citizen, must conform to the laws and cooperate
with the proper authorities in the application of medical
knowledge for the promotion of the common welfare.

Section 4. Physicians should work together in

harmony and mutual respect.

Section 5. Physicians should cooperate with and

safeguard the interest, reputation and dignity of
paramedical and other health professionals.
Section 6. Physicians should be upright,
diligent, sober, modest and well versed in both
the science and the art of the profession.
Section 7. The promotion and advancement
of the health of the patients should be
prioritized over the benefits of the physicians
and the health products industries.
 ARTICLE II Duties of
Physicians to their Patients
Section 1 Dedicated, competent,
professional
Section 2 Free to choose patients
Section 3 Emergency provision of treatment
(Provided there is NO risk to safety)
Section 4 Seek specialist assistance
Section 5 Good faith and honesty of
opinions
Section 6 Sacredness and confidentiality of
patient information
Section 7 Reasonable fees
 ARTICLE II
DUTIES OF PHYSICIANS TO THEIR PATIENTS

Section 1. A physician should be dedicated to provide

competent medical care with full professional skill in
accordance with the current standards of care,
compassion, independence and respect for human dignity.

Section 2. A physician should be free to choose patients.

Section 3. In an emergency, provided there is no risk to
his or her safety, a physician should administer at least first
aid treatment and then refer the patient to the primary
physician and/or to a more competent health provider and
appropriate facility if necessary.
Section 4. In serious/difficult cases, or when the
circumstances of the patient or the family so
demand or justify, the attending physician should
seek the assistance of the appropriate specialist.
Section 5. A physician should exercise good faith and honesty in
expressing opinion/s as to the diagnosis, prognosis, and treatment of
a case under his/her care. A physician shall respect the right of the
patient to refuse medical treatment. Timely notice of the worsening of
the disease should be given to the patient and/or family. A physician
shall not conceal nor exaggerate the patients condition except when
it is to the latters best interest. A physician shall obtain from the
patient a voluntary informed consent. In case of unconsciousness or
in a state of mental deficiency the informed consent may be given by
a spouse or immediate relatives and in the absence of both, by the
party authorized by an advanced directive of the patient. Informed
consent in the case of minor should be given by the parents or
guardian, members of the immediate family that are of legal age.
Section 6. The physician should hold as sacred and
highly confidential whatever may be discovered or
learned pertinent to the patient even after death, except
when required in the promotion of justice, safety and
public health.

Section 7. Professional fees should be commensurate

to the services rendered with due consideration to the
patients financial status, nature of the case, time
consumed and the professional standing and skill of the
physician in the community.
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

In the determination of professional fees, the

principle of transparency and the right of patients
to disclosure shall obtain so that the physician
even before the start of treatment shall discuss
with his or her patient the possible expenses
including professional fees to be paid by the
patient. In determining the professional fee to be
charged to the patient the following in their
chronological relevance, shall apply:
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

a. Nature of the case. The physician, in

determining his or her professional fee, shall
be guided by the following [a] The
complexity of the case; [b] The existence of
co-morbid situations; [c] The emergency
nature of the case; [d] The risk to the
physician, either social or environmental
(place of war, etc.) or medical (HIV, SARS,
etc);
b. Time consumed: The physician, in
determining his or her professional fee,
must consider how much time he has given
PERSONAL attention by being physically
present in attending to his or her patient;
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

c. Professional Standing and Skill of the Physician. In

the determination of the professional fee of a
physician, his or her specialty and/or experience in
practice is relevant;

d. Financial status of the patient. In a hospital setting,

the patient shall be charged according to the
classification done by the hospitals social service
department or its equivalent. In no case shall a full
charity patient be charged with a professional fee. In
case of partially paying patient who can not pay in full,
the patient shall be given the option to pay according
to a schedule of payment agreed by the patient and
the attending physician.
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

In an outpatient setting, the physician shall make his or her

objective and honest assessment as to the financial
capability of the patient. The physician may be guided by
asking the patients means of livelihood, kind of abode, size
of the family, and such other information that may help him
or her to evaluate the financial capability of his or her
patient.
In the consideration of professional fee, the physician must
conform to the norm or standard prescribed by the society,
association or organization of which the physician is
member. For non-specialty practice, the norm or standard
fee shall be that prevailing in the locality. In both cases, any
professional fee charged or collected twice or more than the
norm or standard shall be considered exorbitant.
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

No advance payment for medical services shall

be demanded by the physician, although a
physician may accept such upon a voluntary
payment made by a patient.

Professional fees shall be charged and collected

only for actual medical service rendered as
defined by the Medical Act of 1959 as amended.
 ARTICLE III Duties of
Physicians to the Community
Section 1 Cooperate with authorities
Section 2 Expert witness
Section 3 Encouraged to expose and report
unlicensed medical practitioners,
charlatans, quacks
Section 4 No agent in patient solicitation and
recruitment
Section 5 Media involvement, no
commercial endorsements
 ARTICLE III
DUTIES OF PHYSICIANS TO THE COMMUNITY

Section 1. A physician should cooperate with the duly constituted

health authorities in the education and enforcement of laws and
regulations for the promotion of health. Furthermore, in times of
epidemic and public calamity, except when his or her personal safety
is at stake, the physician must attend to the victims, alert the public
and duly constituted health authorities on the dangers of
communicable diseases and enforce measures for prevention and
cure in accordance with existing laws, rules and regulations.

Section 2. A physician shall assist the government in the

administration of justice in accordance with law. He/she maybe
accorded a fair and just remuneration when called upon as an expert
witness.
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

As an expert witness in the administration of

justice, the fair and just remuneration may
consists of reimbursement of the physicians
expenses in going to and from the court hearing.
The reimbursement may consist of gasoline
expenses, board and lodging, food expenses, bus
and/or air fare, and other costs in connection with
his or her being an expert witness. In addition to
the preceding, the physician may ask for
reasonable appearance fees in the amount
prevailing in the locality where the physician has
testified as an expert witness.
Section 3. A physician is encouraged to
expose and report to the proper authorities
unlicensed medical practitioners, charlatans
and quacks in as much as their nefarious
practices may cause injury to health and life. A
physician should never condone nor connive
with such fake health providers.
 DOH CAUTIONS PUBLIC ON IRIDOLOGY
(PRESS RELEASE/4 AUGUST 2008)

Advised the public against iridology because it is neither a diagnostic

tool nor a therapeutic modality in alternative medicine.

There is no scientific validation for the use of iridology and it does not
have a strong evidence of having value either for diagnosis and
treatment of disease. Health Secretary Francisco T. Duque

After examination, patients are encouraged to buy alleged herbal

remedies peddled by iridologists to prevent a problem from starting or
reduce an existing problem.

Iridology cannot replace effective diagnostic tools.

- actual illness being given information based on intuition
- serious illness may be missed, delaying effective treatment
Section 4. A physician shall not employ agents in the solicitation
and recruitment of patients. For the promotion of medical practice, a
physician may use professional cards, classified advertising,
publications, internet, directories and signboards. Signboards shall
not exceed one by two (1x2) meters in size. Except in internet web
sites, only the name of the physician, field of specialty, office hours
or office or residential addresses may appear. The act of the
physician in publishing his or her personal superiority, special
certificates or diplomas, post graduate training, specific methods of
treatment, operative techniques or former connections with hospitals
or clinics is not allowed. However, these matters may be placed by a
physician within the confines of his clinic or residence. For internet
web sites, recognizing the right of a patient to know the capabilities
and qualifications of his doctor, special certificates or diplomas, post
graduate training and former connections with hospitals or clinics
may be posted.
Section 5. A physician involved in multi media must be
well informed of the matter under discussion. Only the
name of the physician and membership to a society or
institution may be mentioned or posted. A physician should
only make a general opinion and shall refrain from making
a specific diagnosis, therapy or projection to individual
cases in his appearances in the broadcast media. An
article written by a physician must be evidence-based and
disclose connections with pharmaceutical or health product
companies. A physician shall not commercially endorse
any medical or health product.
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

A medical or health product is defined as any

product used by health professionals to fulfill their
mission of preventing, screening, diagnosing,
treating and monitoring of patients and it
encompasses products available to the general
public for health purposes. Health products are
classified into four categories, namely:
1.chemical products;
2.physical products;
3.blood components and transplants;
4.hospitals and medical clinics; and
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

Chemical products include medicinal and

related products. Medicinal products are
substances likely to have pharmacological and
toxicological effects on the human body and
can either be preventive, diagnostic and
therapeutic and pleading to the modification of
physiologic function. These include both
prescription as well as non-prescription
medicines, traditional and herbal medicines and
preparations, dietary supplements, plasma
derived medicinal products, vaccines and
biological products in any form.
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

For herbal medicines or preparations, these

include products that contain an active ingredient
or a incipient of an aerial or an underground
plant, part of plant or other plant material such as
juices, gums, poppy oils and other substances of
its nature.

Chemical products also include those derived

from mollusks, insects, reptiles, amphibians,
mammals, whether in their true state or finished
preparation.
 HERBAL MEDICINE
COMMUNITY-BASED PROGRAM

Lagundi Bayabas
Yerba Buena Akapulko
Sambong Ulasimang Bato
Tsaang Gubat Bawang
Niyug-niyugan Ampalaya
*Philippine Institute of Traditional and Alternative Health Care (PITAHC)
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

Dietary supplements include vitamins, minerals,

organ tissues and metabolites.

Other related products are primarily food or

cosmetics that have secondary therapeutic use
exemplified by lozenges, fluoride toothpaste,
beauty creams, astringents, lotions, vaginal
douche, soaps and sprays, facial and body wash.

Blood components include human products like

blood, cells and tissue products such as labile
blood components.
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

Physical products include medical devices

which encompass all non-medicinal products
that are used for the diagnosis, prevention,
treatment or alleviation of disease or injury.
These include contraptions, wound dressings
and electronic products that emit radiation.
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

Hospitals are defined as facilities devoted

primarily to the diagnosis, treatment, and care of
individuals suffering from illness, disease, injury
or deformity or in need of obstetrical or other
medical or nursing care. They shall also be
construed as an institution, building or place
where there are facilities and personnel for the
continued and prolonged care of patients.
Clinics are places where patients can avail of
consultation or treatment on an outpatient basis.
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

A physician shall not commercially endorse any

medical or health product that are classified as
chemical, physical or blood components and
transplants. A physician shall not commercially
endorse a specific or named hospital or clinic nor
shall he or she commercially endorse the
performance of a medical procedure or service in
a specific or named hospital or clinic.
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

Commercial endorsement shall include the

advertising or promotion of medical and health
products as above defined, whether a physician
is paid or not. It includes statements or
declarations promoting or advertising medical or
health products and the use of the names or the
pictures of physicians in the advertisements or
promotions. Favorable written or verbal reviews
or statements of support for a medical or health
product are included as commercial
endorsements and are prohibited.
 Implementing Rules and Regulations
RA No. 9502 Universally Accessible Cheaper
and Quality Medicines Act of 2008
(July 4, 2008)

Chapter VII
Cost Containment Measures

Rule 40. Prohibited Promotions by Medical and Para-or Allied

Medical Practitioners

No medical practitioner or health worker shall promote,

advertise or endorse any drugs and medicines in quad media,
in print or visual display.
 Chapter I
General Provisions

Rule 7. Definition of Terms.

(i) Drugs and medicines refer to any chemical compound

or biological substance, other than food, intended for use
in the alleviation of symptoms and the treatment,
prevention or diagnoses of diseases in humans or
animals, including but not limited to:

(1) Articles recognized in the current official United

States Pharmacopoeia-National Formulary
(USP-NF)Philippine Pharmacopoeia, official
PNDF;
(2) Articles intended for use in the diagnosis, cure,
mitigation, treatment or prevention of disease in
humans or animals;
Rule 7. Definition of Terms.

(3) Articles other than food intended to affect the

structure or any function of the human
body
or animals;
(4) Articles intended for use as a component of
articles specified in clauses (1), (2) or (3) not
including devices or their components, parts or
accessories;
(5) Herbal and or traditional drugs which are articles
of plant or animal origin used in folk medicine
that are:

(i) Recognized in the Philippine Drug

Formulary Vol. I (Essential Drugs List);
(ii) Intended for use in the treatment, cure or
mitigation of disease symptoms, injury or
body defects in humans;
Rule 7. Definition of Terms.

(iii) Other than food, intended to affect the

structure or any function of the human
body;
(iv) In finished or ready-to-use dosage form;
and
(v) Intended for use as a component of any
of the articles specified in clauses (i),
(ii), (iii), and (iv).

(6) In cases of conflicts, the BFAD drug classification

will prevail.
 ARTICLE IV Duties of Physicians to their
Colleagues and to the Profession
Section 1 Waive fees to colleague, spouse, children and financially dependent parents
Section 2 Specialist consultation
Section 3 Referral protocol
Section 4 Temporary suspension of service
Section 5 Unnecessary comments
Section 6 Referral to PMA/Specialty Society of irreconcilable cases
Section 7 Adequate qualification of medical journal editorial board
Section 8 No commissions for patient referral
Section 9 Encouraged to report corrupt or dishonest conduct
Section 10 CMEs for improved and optimized patient care
Section 11 Funds for association/society
Section 12 Subsidies for CMEs
Section 13 Acceptance of honoria as resource person
Section 14 Scholarships for physicians
Section 15 Use of generics in scientific for a
Section 16 Commercial exhibits
 ARTICLE IV
DUTIES OF PHYSICIANS TO THEIR COLLEAGUES AND
TO THE PROFESSION

Section 1. A physician shall waive his professional fees to a

colleague, his or her spouse, children and parents who are
financially dependent on him.
Section 2. When necessary, the attending physician should always
seek consultation from an available appropriate specialist.
Section 3. The primary and consultant physicians should always
observe the proper protocol of the referral system. The consultant
may make another referral but should seek permission from the
primary physician. In making a referral, a physician should forward a
clinical abstract and specify the purpose as to whether the case is for
opinion/evaluation, for co-management, or for transfer of service.
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

As a colleague in the medical profession, a

physician shall not collect any professional fee
from the following:

Colleague;
Colleagues legitimate spouse(s)
Colleagues legitimate children who are minors, or not
minor but mentally or incapacitated and dependent upon
the colleague for support;
Colleagues parents;
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

Provided, however, that the colleague-patient shall

reimburse at cost the work-up done (X-ray, Laboratory,
etc.) on the colleague-patient, Provided further that the
attending physician may receive from his or her colleague-
patient such reasonable gift/s from the colleague-patient
as a show of gesture of goodwill in return for the
generosity of the attending-colleague-physician.
This shall not apply however to plastic or cosmetic
procedures unless the cosmetic service is for
reconstructive procedure for conditions resulting from
diseases or accidents.

In case of package deals, professional fees included in

said package shall be waived.
Section 4. With the consent of the patient, in cases where a
physician has to suspend service during temporary absences, the
substitute physician shall treat the patient with the same dedication
and quality of care extended to his/her own patient. The patient
should be returned to the care of the primary physician as soon as
possible.

Section 5. Whenever a physician makes a social or business call

on a patient under the care of another, making comments
pertaining to the case is unethical unless if an emergency arises.

Section 6. Whenever there is an irreconcilable difference of opinion

in the management of a case, the matter should be referred to the
Philippine Medical Association or the specialty society concerned.
Section 7. Members of the editorial board of
medical journals should possess adequate
qualifications. Written articles and scientific
presentations in scientific conferences should
include full disclosure of any pharmaceutical
support and should be independent of any
commercial influence.
Section 8. A physician shall not receive any commission
for referring patients to a colleague, third person or
institution. However, nominal gifts during occasions may
be received by a physician.
Section 9. A physician is encouraged to report to the
Philippine Medical Association or the Board of Medicine
personal knowledge of any corrupt or dishonest conduct of
the members of the profession.
PMA CODE OF ETHICS: IMPLEMENTING RULES AND GUIDELINES

A physician shall not receive nor give any

commission for referring patients or receiving
referrals to and from a colleague, third person
or institution. Fee splitting is a form of
commission. However, nominal gifts during
occasions may be received by a physician.
Section 10. Continuing medical education conferences and
professional meetings must contribute to improve and optimize
patients care or address the educational needs of the targeted
medical audience. They must be organized by a medical society
on its own or in cooperation with sponsoring entities.

Section 11. Funds from commercial sources may be accepted for

the benefit of the association or society.

Section 12. Physicians may accept reasonable subsidies from

health and other industries to support their participation in CME
events.
Section 13. The faculty/speaker/consultant of conferences or
meetings is allowed to accept from health industries honoraria and
reimbursement for reasonable transportation, lodging and meal
expenses.
Section 14. Scholarships for physicians and medical students are
permissible as long as the selection of scholars are made by the
organizers or academic institutions concerned.

Section 15. Generic names shall be used during the course of CME
activities. However, after the lectures, the sponsoring entity may
promote or indicate their branded products.
Section 16. When commercial exhibits are part of the overall
program, arrangements for these should not influence the planning
nor interfere with the CME activities. Only relevant information of the
product should be included in the exhibit area.
 ARTICLE V Duties of Physicians to
Allied Professionals
Section 1 Never pay or receive commissions
to or from any allied health worker

Pare, yung
Commission
ko ha?!
 ARTICLE VI Relationship of Physicians
with the Health Products Industry

Section 1 No material gain from samples

Section 2 Informed consent by patients in post
marketing studies and the like
Section 3 Acceptance of reasonable gifts
Section 4 Request for donations
Section 5 Participation to research activities
Section 6 Conformity of research trials
 ARTICLE VI
RELATIONSHIP OF PHYSICIANS WITH THE
HEALTH PRODUCTS INDUSTRY

Section 1. The physician shall not derive any form of material gain
from product samples.
Section 2. Physicians may participate in post-marketing or similar
activities where they are asked to try new products on patients
provided that the patients are properly informed and have given their
informed consent. Physicians are encouraged to report or share the
result of such activities to the duly constituted authorities.
Section 3. Only gifts of reasonable value that primarily entail benefit to
patient care or related to physicians work may be accepted by a
physician from a health product company.
Section 4. Physicians may request donations for a
charitable purpose for as long as it does not redound to
his or her personal benefit.
Section 5. Research activities shall be ethically
defensible, socially responsible, and scientifically valid.
Any remuneration should be reasonable and should not
constitute an enticement.

Section 6. Research trials conducted by physicians for

an industry should be done in accordance with the
national or institutional guidelines for the protection of
human subjects.
 ARTICLE VII Amendments

Section 1 The Board of Governors of the Association,

upon recommendation of the Commission on Ethics may
amend or repeal this code by a 2/3 vote of the members
of the Board. Amendments shall be subsequently ratified
by the General Assembly following the approval by the
Board.
 Patients Responsibilities

1. Know your Rights

2. Provide Adequate, Accurate and Complete
Information
3. Participate in all decisions about Treatment
4. Compliance to Treatment
5. Report Unexpected Health Changes
6. Understand the Purpose and Cost of Treatment
7. Accept the consequences of Own Informed Consent
8. Settle Financial Obligations
9. Respect the Rights of Health Care Providers
10. Obligation to Self Care
11. Report Infractions and Exhaust Grievance
Mechanism