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NURSING

JURISPRUDENCE
BY: MAE GERALDINE E. DACER
LAW
 Etymology : lex
 A set of rules established by a governing
power to guide actions, regulate conduct
of the people and impose sanctions for
violation or non-compliance thereof.
 Obligatory upon the people because it
commands the people to do right and
prohibits them to do wrong.
Branches of Law
 Divine Law : promulgated by our
Creator.
 Human Law
* General / Public Law : includes
international law and religious law
* Individual or private law : consists of
civil law, mercantile and procedural law.
Jurisprudence
 Etymology : juris (oral legal tradition
and to functional applications of Law, to
and in particular sets of facts ans
circumstances); prudentia (one who
behaves prudently or wisely because he
has knowledge of the possible
consequences of a particular action).
Jurisprudence (cont)
 Denotes or pertains to the judicial
precedent or the course or established
decisions of the Supreme Court.
NURSING
JURISPRUDENCE-
 department of law which comprise
all legal rules and principles
affecting the practice of nursing.
NURSING LEGISLATION
 the making of laws, or the body of
laws already affecting the practice
of nursing.
LEGAL RIGHT
 a claim which can
be enforced by
legal means
against a person
whose duty is to
respect it.
COURT MECHANISM:
LAWSUIT- proceeding in court for a
purpose.

Purpose:
1. to enforce a right
2. to redress a wrong
Q:If you think that a person has
done something seriously wrong to
you, the correct action to do get
redress for the injury received is to:

A. systematically plan on how to have


a vindication for the damage done
B. file a lawsuit against the person
for damage
C. hire someone to take revenge for
you
Parties to cases:
 Civil case- Complainant/ defendant
 Criminal case- Plaintiff/ accused
Q: The person who institutes
legal proceeding is called:
A. Plaintiff
B. respondent
C. defendant
D. Accused
Q:A hospital filed a case of damages
against nurse for breach of contract.
Who is the nurse in the case?

A. complainant
B. accused
C. defendant
D. plaintiff
STATUTE OF LIMITATIONS
- the length of time following the
event during which the plaintiff
may file a suit.
 Example: negligence- filed within

2-3 years from occurrence.


DUE PROCESS
 is a fair and
orderly process
which aims to
protect and
enforce a
person’s right.
FUNDAMENTAL REQUIREMENTS OF DUE
PROCESS:

 1. Right to
be informed
2. Right to remain silent
3. Right to a competent
counsel
4. No use of violence, threat,
torture
 PRE-TRIAL- eliminate matters not
in dispute, agree on issues or
settle procedural matters.

 TRIAL- facts are presented and


determined; law applied at the
end.
 SUMMONS- is a writ commanding
an authorized person to notify a
party to appear in court to answer
a complaint made against him.
 WARRANT- presented by an
arresting officer
 SUBPOENA- is an order that
requires a person to attend at a
specific time and place to testify as
a witness.
 SUBPOENA DUCES TECUM- is a
subpoena that requires a witness
to bring documents/ papers in his
possession.
A process whereby the BON only compel the
personal attendance of a witness to bring with
him to the court books, papers and the like to
elucidate the matters in issue:

a. Warrant
b. Subpoena
c. Subpoena duces tecum
d. Summons
WITNESS- person giving
necessary details
Nurses as witness:

 Could not divulge PRIVILEGED


COMMUNICATION in a civil case
- means that the nurse is incompetent to testify on
the communications made to him by the
patients, all the device given and all the
information gathered by observation during the
seal of secrecy.

Exceptions:1. criminal case


2. with the patient’s consent
3. patient sued doctor for damages
Q:For privileged communication in the
doctor, the nurse and the patient, the seal
of secrecy:

a. forever remains until removed by


patient
b. may be broken upon death of the
patient
c. may be disclosed when the patient is
insane
d. all of the above
Testimonies of Facts- factual information
no opinion unless an expert witness

PERJURY- is the willful telling of a lie


under oath.
HEARSAY EVIDENCE- rumors, not
admissible in evidence

DYING DECLARATION or ANTE


MORTEM STATEMENTS- considered
hearsay unless the dying person is a
victim of a crime.
APPEALS
-review of the case by appellate court and

when decided by it, the final judgment


results and matter is ended.

EXECUTION OF JUDGMENT
- Failure to comply means contempt of court
FELONIES
- acts or omissions punishable by law.
- An offense more serious than a misdemeanor, often

punishable by death or imprisonment for more than


one year.
Elements:
1. Deceit-( dolo) - the action or practice of deceiving

someone by concealing or misrepresenting the truth.


2. 2. Fault-(culpa) - due to imprudence, negligence

or lack of foresight/ skill


Difference in criminal offenses
 FELONY  MISDEMEANOR
 Penalty is a term  Penalty is a prison
of more than one term of one year
year in prison or less
 Murder, robbery,  Simple assault,
rape, possession minor theft,
with intent to possession
distribute
Q: A crime can be committed
with the element of culpa if:
 A. the person committed the crime
because of ignorance of the law
 B. the person knows the action is a
crime and he chooses to do it
 C. the person committed the crime
because he lacked the competency to
act correctly
Stages of felonies
1. Consummated all elements executed,
with successful result

2. Frustrated all elements executed


but no successful result

3. Attempted not all elements


executed, no
successful result
Degree of Felonies
degree penalty fine
grave Capital above P6k
punishment or
>6yrs & 1 day
Less grave 1 month and 1 not > P 6 K
day to 6 years but not
<P200

Light felony 1 day to 30 fine not >


days P 200
Q: If the penalty is the death
penalty, what is the degree of the
felony?

A. grave
B. less grave
C. light felony
Q: If the fine is exactly P200.,
what is the degree?

 A. grave
 B. less grave
 C. light felony
CLASSIFICATION OF PERSONS
CRIMINALLY LIABLE:

1. PRINCIPAL

a. By direct
participation-
doer of the act
b. By inducement-directly force or
induce others

c. By cooperation- indispensable
2. ACCOMPLICE
-a person who cooperates
“ accessory before the fact”- absent
at the time crime is committed.
3. ACCESSORY
“ accessory after the fact”
a. Profits
b. Conceals/ destroys evidence
c. Assists in the escape of the principal
Situation: Danaya is two-months
pregnant. Her parents do not know
this. Danaya informed her friend
Alena about the problem. Alena
referred Danaya to Pirena , an
abortionist. Danaya had an
abortion.
If those involved will be charged
legally, who is considered as the
principal?
a. Danaya b.Alena
c. Pirena d. None of them
Who is considered as an
accomplice?
a. Danaya b.Alena
c. Pirena d. None of them
If during the investigation, the
pieces of evidence were not found
because Gurna the maid of Pirena
burned it. Gurna is consider as:
a. accomplice b. accessory
c. principal d. co-principal
A nurse is liable as an accomplice in
an abortion if she:
a. Assist in the escape of the offender
b. Refers the pregnant mother to the
abortionist
c. Conceals the evidence of the crime
d. None of these
Circumstances
affecting
criminal
liability
J-E-M-A-A
JUSTIFYING
 SELF-DEFENSE
 Unlawful aggression

 Reasonable necessity

 Lack of sufficient provocation

 Fulfillment of Duty
 Obedience to an order from superior
 Order must be lawful

 Superior acting within the scope of

practice
EXEMPTING
I nsane/imbecile
 Performance of a lawful act causes
injury by mere accident
 Under 9 y/o
 Under compulsion of uncontrollable
force
 Under impulse of uncontrollable fear
 Failure to perform an act required by
law when prevented by some lawful
cause
MITIGATING
 Under 18y/o or over 70 y/o
 No intention to commit so grave a
wrong
 Sufficient provocation/threat preceding
the act
 Immediate vindication of a grave
offense
 Voluntary surrender
 Deaf & dumb/ with physical defect
 Suffer from such illness that diminishes
willpower
AGGRAVATING
 Treachery/taking advantage of
superior strength or position
 Price, reward, promise
 Use of fire, poison, explosion
 Calamities
 Craft, fraud or disguise
employed
 Evident Premeditation
 Cruelty
ALTERNATIVE
 May increase/ decrease criminal
liability depending on the nature
and effects of the crime
Relationship
Intoxication
Degree of instruction/ education
DRILLS
1. Under compulsion of
uncontrollable force
2. There is sufficient provocation
3. Act is committed with abuse of
confidence
4. Fulfillment of a duty
5. Offender is over 70 years old
6. Voluntary surrender
7. Disguise be employed
8. Defense of a stranger
9. Acts under the impulse of an
uncontrollable fear
10. Offender is insane
Q: Premeditating to commit a
crime is considered as:

 A. justifying
 B. mitigating
 C. aggravating
 D. exempting
Q: When the defendant kills
someone accidentally:

 A. justifying
 B. exempting
 C. aggravating
 D. mitigating
CRIMES CONCERNING
THE NURSE
 -the victim or
offender is the
 1. father
 2. mother
 3. brothers/sisters
 4. ascendants
 5. descendants
 6. spouse
The killing of another human
being
-The killing of another human being with
any of the aggravating circumstances
provided by law.
treachery
- the killing of an
infant less than
three days
or 72 hours.
ACTS OF LASCIVIOUSNESS
MALICIOUS MISCHIEF
PHYSICAL INJURIES
1. Serious Physical
Injuries

2. Less Serious
Physical Injuries

3. Slight Physical
Injuries
ANTI- RAPE LAW (RA 8353)
I.
 A. MARITAL RAPE
 B. STATUTORY
RAPE
II. Anyone who inserts his penis into
the oral orifice of another by force
is liable under this law.
III. Anyone who
inserts anything
into the anal
orifice or genitalia
of another is
liable under this
law.
ROBBERY
- Anyone who gets
the personal
property of
another with the
use of
force,violence or
intimidation.
THEFT
-anyone who gets
the personal
property of
another without
the latter’s
permission.
ASSAULT
- imminent threat
of harmful/
offensive body
contact
BATTERY
- intentional,
unconsented
touching of
another person.
ILLEGAL DETENTION/ FALSE
IMPRISONMENT
-Deprive another
of his freedom of
movement or space.
Patient restraint
SIMULATION OF BIRTH
 1. Pretend that
a woman gave
birth
2. Substitution or
exchanging of
babies in the
nursery
 3. intentionally
putting wrong
information in
the birth
registration
form
DEFAMATION
1. Slander- oral
2. Libel- written
Q: The nurse writes the following note in
the client’s chart “ The physician is
incompetent because he ordered the
wrong drug dosage”.This statement
may lead to a charge of:
a. Assault
b. slander
c. libel
d. Invasion of privacy
INVASION OF PRIVACY
THE RIGHT TO BE LEFT ALONE, FREE
FROM UNWARRANTED PUBLICITY,
RIGHT TO LIVE ONE’S LIFE
* Nurses liable if they divulge any
information from patient’s chart
to improper or unauthorized
persons.
MISDEMEANOR
 An act less than a felony.
Q: A person uses the license of
another person to practice nursing.
Liable for What?

 A. negligence
 B. malpractice
 C. misdemeanor
 D. invasion of privacy
DRILLS
1. A student nurse is overheard
talking in the cafeteria about a
client and his suicidal tendencies.
2. A nurse asks a client why he chose
Dr. Smith for her physician when
this doctor is always rude to the
staff.
3. A client is told he must pay the
remainder of his medical bill before he
can leave the facility.
4. A nurse told the client that she will
inject her with sedatives if he does not
cooperate.
5. A nurse forcibly opened the mouth of a
pedia patient and gave his medication.
6. A nurse takes the wallet of the
patient while the latter is sleeping.
7. A nurse takes the wallet of the
patient with the use of violence
and intimidation.
8. A nurse gives a potent injection
of morphine to a patient causing
his death.
9. A nurse poisons his client to end
his life.
10. A patient died because of wrong
medication given.
GUIDELINES TO PREVENT
CRIMINAL LIABILITY:

1. Be very familiar with the


Philippine Nursing law
2. Be familiar with the laws affecting
nursing practice
3. Know agency rules, regulations,
policies
4. Upgrade skills and competence
Q:To upgrade your skills, you
must:
 A. enrol in the graduate school
 B. be a member of the PNA
 C. attend seminars and trainings
 D. renew license
5. Develop good IPR with co-workers
6. Consult superior as needed
7. Verify vague/ erroneous orders
8. Always keep doctor updated regarding
patient
9. Ensure accurate recording and
reporting
10. Get informed consent
11. Do not delegate responsibilities to
others
LEGAL CONSIDERATIONS IN
CHARTING:
1. Don’t tamper with
medical records-
(ARD)adding,
rewriting and
destroying original
record
2. Observe agency’s
standards on
documentation
 complete, concise,
specific, use
standard
abbreviation
TELEPHONE ORDERS
TIPS FOR AVOIDING LEGAL
PITFALLS:
1. Patient Falls
 do proper assessment

 appropriate assistance

 use protective measures

 document all nursing

interventions
2. Medication
errors
 observe 7 R’s of drug
administration
 Check dr’s order
 Understand the
medication you will
administer
 Consult drug
handbook/ pharmacy
 Not exempt from
liability for following
dr’s order
 A co-nurse confided that she has given
a medication to the wrong patient.
What will you do?
a. advise her to report the incident to the head
nurse
b. advise her to keep quiet about what
happened
c. accompany her to the head nurse to report
the incident
d. report her immediately to the head nurse
3. Equipment
injuries
 refuse to use a device
not know how to operate
 report adverse events
to superiors
 monitor patient regularly
 bring questionable
orders to the attention
of the doctor or superior
Failure to communicate
 promptly report  proper
changes in the documentation
patient’s of all
symptoms and assessments
signs of distress and telephone
to the Dr conversations
with the Dr
NURSES AND CONTRACTS

 CONTRACT- agreement between at


least two parties which create an
obligation recognized by law.
Elements of a valid contract:

1. given freely/ voluntarily- no coercion/


pressure
2. competent parties- 18 yrs old, sound
mind
3. lawful object- within the bounds of law
4. valid consideration- has monetary
value
Essential requisites:

1. Consent
2. Object certain
3. Cause of the obligation
Types of Contract:
1. Implied- terms are inferred from
actions of contracting parties.
2. Expressed- verbal/ written, terms
are specified/ given at the time the
contract is made.
3. Void or inexistent- inexistent from the
very beginning therefore may not be
enforced. Ex: contrary to law.
4. Illegal - expressly prohibited by law like
obtained through fraud, undue influence
or duress.
5. Voidable/annullable- one of the parties
is incapable of giving consent
5. Formal- agreement among parties
and is required to be in writing by
special laws. Ex: marriage, Deed of
sale
6. Informal- concluded as a result of
a written document where the law
does not require the same to be in
writing.
Q: A person entered the clinic of a doctor
for treatment.What type of contract?

 A. formal
 B. implied
 C. informal
 D. expressed
Q: A nurse and a pregnant woman agreed
that the nurse will do home delivery for a
fee. What type of contract?

 A. informal
 B. implied
 C. expressed
 D. formal
 BREACH OF CONTRACT- failure
without legal excuse to
perform any promise which
forms the contract.
The following constitute breach
of contract for nursing service:
1. Prevention of performance
2. Failure of performance because of
inconvenience or difficulty
3. Abandonment of duty
4. Substitution of performance
Legal excuses in refusing or
failure to perform a contract:
1. Discovery of material
misrepresentation
2. Where performance will be illegal
3. Impossible by reason of illness
4. Impossible by death of patient or
nurse
5. Made for other reasons
6. Contract is insufficient
Will
 an act whereby a
person is
permitted with
formalities of law
to control to
certain degree the
disposition of a
state to take
effect after his
death.
 DECEDENT- person whose property is
transmitted through succession.
 TESTATOR- a decedent who left a will
 HEIR- a person called to succession
TYPES OF SUCCESSION:
1. Testate- a person dies leaving a
will.
2. Intestate- a person dies without
leaving a will.
:
 TWO KINDS
1. Notarial will- acknowledged before
a notary public, with attestation clause
2. Holographic will- entirely written,
dated and signed in the handwriting of
the testator
Who makes wills:

1. those not expressly prohibited by


law
2. 18 yrs old
3. sound mind
Who could be witnesses:
1. sound mind
2. 18 and above
3. not blind, deaf or dumb
4. able to read and write
 Bakekang, 59 years old, is suffering
from a debilitating disease but of
sound mind. She has asked you to help
her make a will. How should you
respond to the situation?
a. let her dictate and write for her
b. call her intended beneficiaries as witnesses
c. assist patient to consult a legal officer
d. refuse request since it is not your duty
NURSE’S OBLIGATION IN THE
EXECUTION OF A WILL:

1. Note the
soundness of
client’s mind and
to ensure that
there is freedom
from fraud/
undue influence.
2. Note that the will is signed by the
testator.
3. Note that the witnesses shall be
present at the time and sign in the
presence of testator.
GIFTS MORTIS CAUSA
 disposing of gifts
by a person in
anticipation of
death/ belief in
approaching
death.
Limitations:
1. limited to personal properties
2. acceptance by the recipient
3. gifts are revocable and subject to
the claims of creditors without
proof of intent of defrauding them
 BOARD QUESTIONS:
1. The nurse out of pity unhooked the
patient from a respirator. The patient
died after 15 minutes. This type of
felony is:
a. consummated
b. frustrated
c. attempted
2. Circumstances which are said to
be in accordance with the law are
said to be:
a. Justifying
b. Exempting
c. Mitigating
d. Aggravating
3. All of the following are exempting
circumstances except:
a. Imbecile
b. 8 year old
c. performance of a lawful act
d. offender is deaf and dumb
4. When a politician takes advantage of
his power in the performance of
unlawful actions, this is considered
as:
a. justifying circumstance
b. exempting circumstance
c. mitigating circumstance
d. aggravating circumstance
5. When one alters a record to conceal
possible evidence of negligence,
she can be charged as:
a. accomplice
b. accessory
c. principal
d. co-principal
 BOARD QUESTIONS:
1. A client in a long term care facility refuses to
take his oral medications. The nurse threatens
the client and tells him that, if the medication
isn’t taken, restraints will be applied. The
nurse’s statement constitutes which legal tort?
a. assault
b. battery
c. negligence
d. right to refuse treatment
2. The nurse is at risk for lawsuit. Which of the
following actions will shield her from
possible lawsuits?
1. knowledge and implementation of standards
of care
2. documentation of actions accurately and
concisely
3. document outcome of care
4. following all doctor’s order
a. 1,2,4 b. 2 & 3 c. 1,2,3 d. 2,3,4
3. One of the midwives in the health
center injected Cotrimoxazole to a 5
year old patient without the consent of
the parents. Which of the following
can the midwife be possibly accused
of?
a. malpractice
b. battery
c. negligence
d. assault
4. If that nurse divulges the information
that she is caring for the child of a
patient with sexually transmitted
disease, she can be liable for:
a. libel
b. slander
c. tort
d. invasion of privacy
5. Two janitors were having a heated argument
as to who shall dispose the waste of a
patient with typhoid fever. The first one
called the other “lazybone” and “pain in the
neck” within the hearing of the rest of the
nurses.The case is:
a. libel
b. invasion of privacy
c. slander
d. negligence
6. Should the accusation be written
in the newsletter of the hospital,
such liability is a:
a. assault
b. libel
c. slander
d. battery
7. The nurse observed that in the hospital where she
worked, it is a practice to accept medical orders by
telephone. In this aspect, she should remember the
following:
a. T.O should be countersigned by the attending physician
at the first opportunity to make it legal order
b. T.O are risky and should not be accepted
c. The nurse could write on the the doctor’s order sheet
the exact date, time and full name of the dr giving
the order
d. The nurse can sign for the doctor on the order sheet
 a. 1,4 b. 1,2 c. 3 only d. 1, 3
8. The nurse noticed that restraining patients is a
common practice. Which of the following
should she remember?
a. Restraints are necessary so that the nurse
could do more work for patients
b. Use of restraints is an effective intervention
c. Restraints require a physician’s order
d. Refusal to be restrained is a ground for
terminating the nurse-patient relationship
 9. Patient records are very important in court
litigations. Which of the following safeguards
should be adopted by the nurse?
 A. follow standard charting
 b. photocopy pt’s chart before submitting to
the medical records Office
 c. maintain a logbook of potential legal case
 all of the above

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