RAMILO, SHEENA PATRICIA M.

NCENH07
ACTIVITY 1
1. Using the ethical principle of justice, determine whether health care in the
Philippines should be a right or a privilege. Are the uninsured and the
insured “unequal” that should be treated according to their differences? Does
the type of health insurance that one has also create a system of unequals? If so,
is the unequal s being treated according to their differences? Explain your
answer not less than 500 words and support it with some evidences like journals.

The most basic concept of justice, one that has been generally accepted since
Aristotle first described it more than 2000 years ago, is the theory that “equals should be
treated equally and unequal’s equally” This concept is often articulated in its
contemporary form as follows that individuals should be handles the same, unless they
vary in ways that are important to the situation they are involved in. For example, if both
John and Esther do the same job, and there are no major disperancies between them or
the job they are doing, then the same wages should be paid in the name of justice. And
if John is paid more than Esther because he is a male or because he is white, then
because race and sex are not important to normal job circumstances, we have injustice
a form of discrimination regarding to work. In relation to our health care system, I can
say that it is a “privileged” because poor people can’t go to a better health care facility
when they are hospitalized and because they cannot afford it while rich people is
privilege because they can choose what health care service they should be in when
they get hospitalized. In the name of justice, it is not fair. According to the journal that I
have read that equity, fairness, justice is the basic concept of health care system here in
the Philippines but in reality it is not. An example which the money of the Phil health has
been corrupted by the irresponsible official that is why million of Filipino people whether
it is rich or poor are all suffering because of that corruption.
In addition, all Filipino people in our country whether rich and poor have the RIGHT to
have a health insurance, have the RIGHT to be treated well in the hospital institutions
but not all have the privilege to be given by a better service like staying in a private
room instead of wards. But in justice it states that in all medical decisions there should
be an element of equity; fairness and decisions that burden and profit, as well as
equitable allocation of limited resources and new therapies, and for medical
practitioners to follow the laws and regulations applicable when making decisions.
However there are several variations that we regard as justifiable criteria for handling
individuals differently. For instance, we think it’s fair and just when a father gives more
attention and care to his children in his private affairs than giving attention to other
children; we think it is fair or just when the government gives advantages to the poor
that it doesn’t provide more wealthy citizens. We consider these criteria-need,
contribution and effort as justifying unequal care, so they are numerous.
While I am typing this essay I realized that if we want to have a better service or have a
good life especially in our health care facility, we need to pursue our dreams to strive it
so that we can reach our goal in life. So that when hardship in life comes, there is
something we can sow because our destiny lies in our hands.
 Activity 2
Case Analysis
A.) Think of celebrated cases where defendants have been tried in both civil and
criminal court. What were the verdicts in both cases? If the verdicts were not the
same, analyze why this happened. Do you agree that taking away an individual’s
personal liberty by incarceration should require a higher burden of proof than
assessing for monetary damages?
Also complete a literature search to see if you can find cases where a
nurse faced both civil and administrative charges. Were you able to find cases
where the nurse was found guilty in a civil court but did not lose his or her
license here in the Philippines? Did you find the opposite? (In 700 words)

The article that I have read is about the case of Carlos Borromeo the petitioner,
and FAMILY CARE HOSPITAL, INC. AND Ramon S. Inso, M.D., which are the
respondents from this case.
Since enduring a routine appendectomy, Carlos Borromeo lost his wife Lillian
when she died. The hospital and the attending surgeon tell that because of unusual, life-
threatening disorder that prevented her blood from clotting normally, Lillian bled to
death. However, Carlos claims that the hospital and the surgeon were actually
incompetent in his late wife’s treatment. The verdict here were not the same because on
the first trial in civil service, Dr. Inso was found guilty because of the testimony of Dr.
Reyes (the one who do the autopsy for Lillian) concluded that bleeding from petechial
blood vessels was the cause of Lilian 's death: internal bleeding. In addition, he
concluded that the internal bleeding was caused by an opening of 0.5 x 0.5 cm at the
repair site. He felt that if the site was fixed with double suturing instead of the single
continuous suture repair that he noticed, the bleeding may have been stopped. The
complainant lodged a lawsuit for damages against Family Care and Dr. Inso for medical
negligence, based on the autopsy.
However the verdict tell that Mr. Inso the attending surgeon of Mrs. Lillian
Borromeo was found not guilty in the court appeal because Dr. Hernandez testified that
the suspected false suture could not be attributed to Lilian 's death. He argued that it
was difficult to reconcile the presence of blood in the lungs, stomach, and the entire
length of the intestines with the hypothesis of Dr. Reyes that the hemorrhage originated
from a single-sutured appendix.
The respondents raised the case to the CA and docketed the appeal as CA-G.R.
No. CV 89096.
The CA overturned the RTC’s decision on January 22, 2010 and dismissed the lawsuit.
Dr. Hernandez and Dr. Ramos 'testimonies about Dr. Reyes' results were given greater
weight by the CA since the latter was not a specialist in anatomy, appendectomy, or
surgery. Dr. Avila’s view was disregarded because the underlying assumption of his
testimony was that the doctor who performed the autopsy was a pathologist of
comparable or greater competence than Dr. Ramos or Dr. Hernandez.
The CA denied that the doctrine of res ipsa loquitur was valid because there was
no factor of causation between the instrumentality under Dr. Inso's control and
management and the injury that caused Lillian’s death; the respondents adequately
established that DIC was the cause of Lillian’s death. And I agree that taking away
someone liberty by putting the person to jail with a strong proof of evidence is better
than assessing for monetary damages, money is just their we can earn it but a dead
person will never be alive again.

In addition, I read a case about the negligence of a nurse here in the Philippines but did
not lose her license. Here is the story, the third Caesarean section (C-section) of Regina
Capanzana (Regina), a 40-year-old nurse and clinical teacher pregnant with her third
child, was scheduled for 2 January 1998. However, on 26 December 1997, a week ago,
she went into premature labour and was admitted to the petitioner's hospital for a C-
section emergency. Dr. Miriam Ramos and Dr. Milagros Joyce Santos, the same
attending physicians in her previous childbirths, first underwent a preoperative physical
examination. After she reacted negatively to questions about tuberculosis, rheumatic
fever, and cardiac diseases, she was considered fit for anesthesia. She gave birth to a
baby boy the same day. She was released from the recovery room when her condition
stabilized and transferred to a normal hospital room. After transferring the patient, she
suffered from pulmonary edema. The witnessed testified that she called the nurse 3x
but didn’t response that is why the condition of Regina becomes worsened. The CA
upheld the RTC's above ruling that whatever the cause of the deprivation of oxygen
was, its timely and successful management would have prevented the chain of events
leading to the condition of Regina.
In this case, the court of appeal affirms the conclusions of the courts below that
the nurses' reckless delay was the next cause of the brain injury sustained by Regina.
The nurse found guilty but she did not lose her license because of assessing monetary
damages.
 ACTIVITY 3

COMPONENTS OF PROFESSIONAL NEGLIGENCE

ELEMENTS OF LIABILITY EXPLANATION EXAMPLE IN GIVING

MEDICATIONS
1. Duty to use due care The treatment that should The nurse should give the
(defined by the standard of be provided under the medications on time, on the
care) conditions (what would right patient and the
have been done by a fairly medications must be
cautious nurse) complete.
2. Failure to meet the Not providing the treatment It’s the opposite on
standard of care (breach of that under the example number 1; the
duty) circumstances should be nurse fails to give the
given medication on time,
accurately and completely.
3. Forseeability of harm The nurse must have fair The drug manual states
access to information as to that the patient could be
whether there is a potential affected by the wrong dose
for injury. or route.
4. A direct relationship Patients are injured when Wrong dosage causes
between failure to meet the proper treatment is not convulsions in patients
standard of care  ( breach ) given.
and injury can be proved

5. Injury Actual harm results to Seizures and other serious

patient. complications may occur.