Midwife Licensure Exam Bioethics & Professional Conduct — Philippine Nursing Law & Legal AccountabilityCheat Sheet

Term

Republic Act No. 9173

Example

All questions on nurse licensure, scope of practice, and BON authority trace back to RA 9173.

Definition

The Philippine Nursing Act of 2002; the governing statute for nursing regulation and practice, repealing RA 7164 (1991 Act).

Term

Professional Regulation Commission (PRC)

Example

The PRC administers the NLE and renews your professional ID card.

Definition

Government agency that administers licensure exams, issues licenses, maintains registries, and enforces professional regulations for all regulated professions including nursing.

Term

Board of Nursing (BON)

Example

The BON sets passing requirements (75% general average, no below 60% in any subject) and promulgates the Code of Ethics.

Definition

Professional regulatory board under the PRC, composed of appointed members; conducts the NLE, issues/suspends/revokes certificates of registration, and monitors nursing practice standards.

Term

Declared Policy of RA 9173

Example

This policy governs all regulatory decisions and interpretations of the law.

Definition

To maintain high standards of nursing practice, uphold profession dignity, and ensure quality nursing care through humane working conditions, professional growth, and adequate compensation.

Term

Scope of Nursing Practice

Example

A nurse assesses a patient using the nursing process, educates on medications, and collaborates with the physician team—all within scope.

Definition

The professional functions and activities a registered nurse may legally perform; defined in RA 9173 as actions done for compensation in any healthcare setting.

Term

The Nursing Process

Example

Assessing a patient's vital signs and pain level, diagnosing Acute Pain related to postoperative incision, planning pain relief interventions, implementing them, and evaluating effectiveness.

Definition

A systematic, cyclical method of nursing care comprising five steps: assessment, nursing diagnosis, planning, implementation, and evaluation.

Term

Sound Nursing Judgment

Example

A nurse questions a dose that seems excessive and contacts the physician before administering—this is sound judgment protecting patient safety.

Definition

The nurse's professional discretion and critical thinking applied when carrying out a physician's order; the nurse is accountable even if following a legal order.

Term

Collaborative Practice

Example

The nurse participates in a morning rounds with the physician, contributes nursing assessment findings, and co-implements a treatment plan.

Definition

Working as part of an interdisciplinary health team (physician, pharmacist, therapist, etc.) to deliver integrated, quality care.

Term

Expanded Functions

Example

A nurse with advanced training may perform wound care procedures or administer certain medications under standing orders in a primary health care setting.

Definition

Advanced nursing activities (e.g., certain procedures, prescribing in some contexts) that nurses may perform under delegation, protocol, or when licensed for specialization.

Term

Legal Accountability

Example

A medication error may result in BON disciplinary action (administrative), a lawsuit by the patient (civil), and criminal charges if the error caused death.

Definition

Answerability for one's professional actions; a nurse may face administrative, civil, and/or criminal liability for conduct.

Term

Administrative Liability

Example

A nurse is reported for falsifying patient records; the BON conducts a hearing and may suspend the license for six months.

Definition

Disciplinary action by the BON/PRC that may suspend or revoke the nurse's license for unprofessional conduct, negligence, incompetence, conviction of a crime involving moral turpitude, or practicing while impaired.

Term

Civil Liability

Example

A patient sues the nurse for damages after a medication error causes harm; the nurse and/or employer may be ordered to pay damages.

Definition

A private lawsuit brought by an injured patient to obtain monetary compensation for harm caused, typically arising from negligence or intentional tort.

Term

Criminal Liability

Example

A nurse administers an incompatible blood type and the patient dies; criminal charges for reckless imprudence resulting in death may be filed.

Definition

Prosecution by the State when a nurse's act constitutes a crime; examples include reckless imprudence resulting in injury or death, or illegal practice of nursing.

Formula

Negligence = Duty + Breach + Causation + Damages (all 4 required)

Meaning

Duty (nurse–patient relationship exists); Breach (failure to meet standard of care); Causation (breach directly caused harm); Damages (actual injury to patient).

Watch Out

Students often forget that causation MUST be direct (proximate); a breach that did not cause the harm is not actionable negligence.

When To Use

Whenever analyzing liability or reading an exam case; absence of ANY element defeats negligence.

Term

Negligence

Example

A nurse fails to monitor blood pressure after medication administration and misses signs of hypertensive crisis; the patient strokes. Negligence: duty (monitoring required), breach (did not monitor), causation (breach led to missed symptoms), damages (stroke).

Definition

Failure to do what a reasonably prudent nurse would do, or doing what a prudent nurse would not, under similar circumstances, resulting in harm.

Term

Malpractice

Example

A nurse administers the wrong dose of insulin to a diabetic patient, causing hypoglycemia. This is malpractice because it violates the standard of pharmaceutical care expected of a nurse.

Definition

Professional negligence by a licensed professional in the performance of professional duties; judged against the professional standard of care.

Term

Standard of Care

Example

The standard for medication administration includes checking the '5 rights' (right patient, drug, dose, route, time), verifying allergies, and monitoring for adverse effects.

Definition

The level of skill, knowledge, and attention expected of a reasonably prudent nurse in the same or similar circumstances; the benchmark against which conduct is judged.

Term

Res Ipsa Loquitur

Example

A surgical instrument is found inside a patient after surgery. Negligence is presumed without need to prove the specific breach; the item should never be there.

Definition

Latin: 'the thing speaks for itself'; negligence is inferred because the injury ordinarily would not occur without negligence.

Term

Respondeat Superior

Example

A nurse employed by a hospital commits negligence while on duty. The hospital may be sued and held liable; the nurse's liability is not erased.

Definition

Latin: 'let the master answer'; the employer may be vicariously liable for the negligent acts of employees performed within the scope of employment.

Term

Proximate Causation

Example

A nurse delays reporting a patient's fever by 2 hours. If the delay directly worsened the patient's condition and caused additional harm, causation is established.

Definition

The direct causal link between the breach and the harm; the breach must be the 'but-for' cause (without it, the harm would not have occurred).

Term

Doctrine of Force Majeure

Example

A flood destroys a health facility and patient records are lost. The nurse is not liable for negligence caused by the flood.

Definition

No liability for unforeseeable events beyond human control (acts of God, natural disasters, etc.).

Term

Doctrine of Last Clear Chance

Example

A nurse is administering an IV but pauses when the patient reports pain. The nurse has the last clear chance to verify the site is patent; if the IV extravasates, the nurse bears responsibility for not checking.

Definition

The party who had the final opportunity to avert harm but failed may bear liability, even if others were also negligent.

Term

Assault

Example

A nurse, angry at a patient, raises a fist and says, 'I'll hit you!' The patient fears imminent harm. This is assault even if the nurse does not touch the patient.

Definition

An intentional act that creates in another a reasonable apprehension of harmful or offensive contact (threat without actual contact).

Term

Battery

Example

A nurse performs a procedure (e.g., inserting a catheter) on a patient without consent. The touching, even if medically beneficial, is battery because it was unauthorized.

Definition

Intentional, unauthorized, and harmful or offensive contact with another person's body.

Term

False Imprisonment

Example

A nurse uses restraints on an alert, oriented patient without a physician's order or the patient's consent (not a psychiatric hold). This is false imprisonment.

Definition

Unjustified restraint or confinement of a person's movement; restraining a patient without legal authority or justification.

Term

Defamation

Example

A nurse tells others that a colleague 'steals drugs from patients,' when this is false. If spoken, it is slander; if written, libel. The colleague may sue for defamation.

Definition

False statement that harms a person's reputation; libel if in writing, slander if spoken.

Term

Invasion of Privacy / Breach of Confidentiality

Example

A nurse discusses a patient's HIV status with coworkers in the break room where others can overhear. This breaches confidentiality and violates RA 10173 (Data Privacy Act).

Definition

Unauthorized disclosure of private, personal, or confidential information (including health data) about another person.

Term

Patient Rights

Example

A patient has the right to know their diagnosis and treatment plan in understandable terms, the right to refuse treatment, and the right to privacy of medical records.

Definition

Recognized entitlements of patients under Philippine law and professional standards, including dignity, information, consent, privacy, and access to care.

Term

Informed Consent

Example

Before surgery, a patient reads and signs a consent form after the surgeon explains the procedure, possible complications, recovery time, and alternative treatments.

Definition

Voluntary, competent agreement to treatment after being provided with complete, understandable information about the procedure, risks, benefits, and alternatives.

Term

Right to Refuse Treatment

Example

A Jehovah's Witness patient may refuse a blood transfusion even if medically necessary; the healthcare team must respect this decision (with documentation).

Definition

A competent patient's legal right to decline any treatment, even if refusal may result in harm or death.

Term

Confidentiality & Privacy

Example

A nurse may share the patient's medication list with the pharmacist (need-to-know for care) but may not share the patient's diagnosis with a family member without the patient's consent.

Definition

Patient information (including health data) must be kept private and disclosed only on a need-to-know basis for care, with valid consent, or by law.

Term

Anti-Hospital Deposit Law (RA 8344, as amended by RA 10932)

Example

A patient arrives at the ER with acute chest pain. The facility must provide emergency care immediately; requiring payment before stabilizing the patient violates the law.

Definition

Law prohibiting hospitals and healthcare facilities from demanding a deposit before administering emergency or serious-case treatment.

Term

Code of Ethics for Registered Nurses

Example

The Code requires nurses to respect the dignity and rights of every person, maintain competence, keep confidentiality, and promote the health and welfare of the public.

Definition

The professional ethical standard promulgated by the BON in coordination with the PNA via BON Board Resolution No. 220, series of 2004; it articulates the nurse's ethical obligations.

Term

Ethical Duties to Patients/People Served

Example

A nurse prioritizes patient safety by questioning a questionable physician order, advocates for pain relief, and respects the patient's wishes for end-of-life care.

Definition

The nurse respects the dignity and rights of every person, provides safe and competent care, protects the vulnerable, and advocates for patient welfare.

Term

Ethical Duties to Practice

Example

A nurse keeps CPD current, accurately documents care, reports errors promptly, and does not claim credentials or experience not held.

Definition

The nurse maintains competence, is honest and truthful, upholds professional standards, and avoids fraud or deception.

Term

Ethical Duties to Co-workers

Example

A nurse does not make derogatory comments about colleagues, cooperates in team care, and reports a colleague administering medications while impaired.

Definition

The nurse treats colleagues with respect, promotes teamwork, does not discriminate, and reports unsafe or unethical conduct.

Term

Ethical Duties to Society & Environment

Example

A nurse participates in health education in the community, practices infection control to prevent disease spread, and advocates for equitable access to care for all.

Definition

The nurse promotes public health and welfare, protects the environment, and advocates for just and equitable healthcare.

Term

Ethical Duties to the Profession

Example

A nurse participates in research, mentors nursing students, presents at conferences, and advocates for nursing recognition and fair working conditions.

Definition

The nurse advances professional knowledge and practice, upholds the dignity of the profession, and mentors newer nurses.

Term

Republic Act No. 10173 (Data Privacy Act of 2012)

Example

A patient's medical records, lab results, medication list, and psychiatric history are designated as 'sensitive personal information' and are protected under RA 10173.

Definition

Philippine law protecting personal and sensitive personal information, including health data, from unauthorized processing, disclosure, and misuse.

Term

Sensitive Personal Information (SPI)

Example

A patient's HIV status, history of substance abuse, or diabetes diagnosis is SPI; unauthorized disclosure is a violation of RA 10173.

Definition

Personal information concerning health, genetic data, religion, ethnicity, or other inherently private categories; requires heightened protection.

Term

Lawful Basis for Processing

Example

A nurse may access a patient's full medical record during hospitalization (necessity for care); sharing the record with a patient's family requires the patient's consent.

Definition

Valid authorization to collect, use, or share personal/health information; typically consent or the necessity of providing medical care.

Term

National Privacy Commission (NPC)

Example

A patient files a complaint with the NPC because a nurse disclosed the patient's health information without consent. The NPC investigates and may impose fines on the nurse and facility.

Definition

Independent government agency that enforces RA 10173, investigates violations, and imposes administrative penalties.

Term

Clinical Record / Medical Record

Example

A nurse's charting of vital signs, medications administered, patient response, and patient teaching becomes evidence in a negligence lawsuit.

Definition

The documented account of a patient's care, including assessments, interventions, and responses; it is a legal document that can be presented in court.

Term

The Nursing Maxim: 'If It Was Not Documented, It Was Not Done'

Example

A nurse provides extensive patient education about medication but fails to document it in the chart. In a lawsuit, the nurse cannot prove the education was given; the patient claims ignorance of side effects. Documentation failure is a liability.

Definition

The principle that care not recorded in the patient's chart is legally presumed not to have been provided, even if it was.

Term

Accurate & Timely Documentation

Example

A nurse documents vital signs immediately after measuring them, noting 'BP 150/90 at 10:00 AM, patient reports headache' (factual, objective, timely).

Definition

Recording of care must be factual, objective, legible, timely (at or near the time of care), and include the date, time, and nurse's signature/initials.

Term

Incident Report

Example

A patient falls from a bed. The nurse completes an incident report describing the fall, contributing factors, and injuries. This report is filed separately, not in the patient's chart.

Definition

A record of an unexpected adverse event, near-miss, or incident; it is an internal quality/safety tool and generally NOT part of the patient's medical record.

Term

Unprofessional or Unethical Conduct

Example

A nurse discloses a patient's HIV status to coworkers, demeans a patient, or accepts bribes in exchange for special treatment.

Definition

Actions or behavior that violate the Code of Ethics or professional standards; includes breach of confidentiality, fraud, abuse, and conduct unbecoming a nurse.

Term

Incompetence

Example

A nurse administers insulin via an IV line (wrong route) or fails to recognize signs of septic shock in a deteriorating patient.

Definition

Lack of knowledge, skill, or judgment required to perform nursing functions safely; may include expired CPD or failure to maintain current knowledge.

Term

Negligence / Malpractice

Example

A nurse fails to monitor a patient post-procedure and misses signs of hemorrhage; the patient deteriorates.

Definition

Failure to meet the standard of care, resulting in harm; the four-element test applies.

Term

Conviction of a Crime Involving Moral Turpitude

Example

A nurse is convicted of theft, fraud, sexual abuse, or drug trafficking. Conviction is grounds for revocation.

Definition

Conviction (by final judgment) of a felony or crime that reflects dishonesty, depravity, or perversion of morals; grounds for automatic or mandatory BON sanction.

Term

Practicing While Impaired

Example

A nurse arrives at work visibly intoxicated or administers medication after consuming alcohol.

Definition

Providing nursing care while under the influence of alcohol, drugs, or medication that impairs judgment or motor control.

Term

Fraud or Falsification

Example

A nurse falsifies CEU certificates to meet CPD requirements or misrepresents work experience on the licensure application.

Definition

Falsifying credentials, experience, records, examination answers, or other documentation to obtain licensure or maintain registration.

Term

Abuse of a Patient (Physical, Emotional, Sexual, Financial)

Example

A nurse strikes a patient, ignores a patient's call light out of anger, makes sexual advances, or misappropriates a patient's funds.

Definition

Intentional causing of harm, injury, or exploitation of a patient under the nurse's care.

Term

Duty of Care

Example

The moment a patient is assigned to a nurse, a duty of care begins; the nurse is legally responsible for the patient's safe care.

Definition

The legal and ethical obligation of a nurse to act in the patient's best interest and to prevent foreseeable harm; it arises when a nurse–patient relationship is established.

Term

Standard of Care

Example

The standard for post-operative monitoring includes checking vital signs at defined intervals, assessing for bleeding, infection, and pain, and reporting changes promptly.

Definition

The conduct and skill level expected of a reasonably competent, prudent nurse under the circumstances; it is the benchmark for negligence.

Term

Reasonable Nurse Test

Example

A medication error is evaluated by asking: 'Would a reasonably prudent nurse have checked the '5 rights' before administering this medication?' If yes, failure to do so is breach.

Definition

A legal standard asking: 'What would a reasonably prudent nurse with similar training and experience do in the same situation?' This is how standard of care is determined.

Term

Vicarious Liability (Respondeat Superior)

Example

A nurse employed by a hospital commits negligence. Both the nurse and the hospital may be sued and held liable; the hospital cannot escape responsibility.

Definition

The employer's liability for the negligent acts of an employee performed in the scope of employment; the employee's liability is not erased.

Term

Foreseeability

Example

A nurse knows that a patient is on anticoagulants and at risk of bleeding; leaving the patient unmonitored and failing to assess for bleeding is negligent because bleeding is foreseeable.

Definition

The legal test of whether harm was reasonably foreseeable from the nurse's conduct; required to establish duty and causation.

Values

• Failure to meet standard of care; unintentional harm
• Professional negligence; negligence by licensed professional in professional capacity
• Deliberate, unauthorized harmful or offensive act

Property

Definition

Values

• No; unintentional breach
• No; unintentional breach in professional context
• Yes; intentional or reckless disregard

Property

Intent Required

Values

• Duty, breach, causation, damages (all 4)
• Duty, breach, causation, damages + professional standard
• Intentional act + harm/offense (varies by tort type)

Property

Elements Required

Values

• Medication error, patient fall, missed diagnosis
• Administering wrong dose of insulin, post-op bleeding not monitored
• Battery (procedure without consent), assault (threat), false imprisonment

Property

Examples

Values

• Civil (sue for damages); possibly criminal if severe
• Civil (sue for damages); possibly administrative (BON); possibly criminal
• Civil (sue for damages); possibly criminal; administrative (BON)

Property

Type of Liability

Values

• Absence of any element defeats claim; force majeure; last clear chance
• Same as negligence + professional standard exceptions (judgment in emergencies)
• Consent, justification (self-defense), legal authority

Property

Defense Available

Values

• Board of Nursing / PRC
• Regular courts (civil case, private plaintiff)
• Regular courts (criminal case, State prosecution)

Property

Forum

Values

• BON (on complaint or sua sponte)
• Patient or patient's family (private lawsuit)
• State / Public Prosecutor

Property

Initiator

Values

• Preponderance of evidence (more likely than not)
• Preponderance of evidence (more likely than not)
• Beyond a reasonable doubt (highest standard)

Property

Burden of Proof

Values

• Suspension (temporary) or revocation (permanent) of license
• Monetary damages (compensation to patient)
• Imprisonment, fines, restitution; criminal record

Property

Remedy / Penalty

Values

• Unprofessional conduct, negligence, incompetence, moral turpitude, impairment, fraud, abuse
• Negligence (malpractice), intentional tort
• Crime under RPC or special law (e.g., reckless imprudence, illegal practice)

Property

Grounds

Values

• Yes; often triggered together
• Yes; often triggered with administrative or criminal
• Yes; often triggered with administrative or civil

Property

Can One Act Trigger Multiple?

Values

• Direct impact; license may be suspended/revoked
• No direct impact (but may affect licensure if severe)
• May trigger BON investigation and sanction

Property

Impact on Nursing License

Values

• Yes; to Court of Appeals and Supreme Court
• Yes; through normal civil appeal process
• Yes; through normal criminal appeal process

Property

Appeal Available

Values

• Professional ethical obligation of nurses to keep patient information confidential
• Broad legal protection of all personal and sensitive personal information (health data is SPI)

Property

Scope

Values

• Nurses and healthcare professionals
• All organizations and individuals processing personal/health data

Property

Applies To

Values

• Board of Nursing (administrative sanction: suspension/revocation)
• National Privacy Commission (administrative fine up to PHP 5M; criminal penalties)

Property

Enforcer

Values

• BON discipline (suspension, revocation); loss of license
• NPC fines, corrective orders, criminal charges (up to 3 years imprisonment)

Property

Violation Consequences

Values

• Nurse must not disclose patient info without consent or legitimate need
• Organization must have lawful basis (consent or necessity) to process health data and implement safeguards

Property

Key Requirement

Values

• Need-to-know for patient care; mandatory reporting (abuse, disease); law requires it
• Necessity for providing care; lawful basis; patient-approved purposes

Property

Basis for Disclosure Without Consent

Values

• Temporary; for a defined period (months to years)
• Permanent; the nurse loses all rights to practice

Property

Duration

Values

• Less serious violations: minor unprofessional conduct, competence issues addressable by retraining or monitoring
• Serious violations: moral turpitude, patient abuse, repeated violations, practicing while impaired

Property

Grounds

Values

• Automatic at end of suspension period (if conditions like CPD/retraining are met)
• Not automatic; nurse may petition for reinstatement after waiting period, but no guarantee

Property

Reinstatement

Values

• No; nurse cannot practice during suspension
• No; nurse can never practice without reinstatement (which is discretionary)

Property

Right to Practice During Penalty

Values

• Nurse falsifies CPD certificates; BON suspends license for 2 years. After 2 years and proof of legitimate CPD, license is reinstated.
• Nurse is convicted of theft or sexually abuses a patient; BON revokes license permanently; nurse must petition for reinstatement after 5+ years if at all possible.

Property

Example

Values

• Voluntary agreement after full disclosure of procedure, risks, benefits, and alternatives in understandable language
• Before surgery: patient receives written and verbal explanation, asks questions, signs consent form
• MUST be obtained for all non-emergency invasive procedures, research, and treatment

Property

Informed Consent

Values

• Consent inferred from patient's conduct or emergency circumstances when explicit consent cannot be obtained
• Unconscious patient in ER; implied consent to emergency procedures to save life
• Valid in true emergencies; patient is unconscious or unable to communicate

Property

Implied Consent

Values

• Explicit agreement (verbal or written) given directly by the patient
• Patient verbally or in writing agrees to medication administration, dressing change, or therapy
• Clear and directly obtained from the patient

Property

Express Consent

Values

• Competent patient's right to decline treatment, even if refusal causes harm or death
• Jehovah's Witness refuses blood transfusion; competent adult refuses dialysis
• MUST be respected; nurse documents refusal and informs physician; no battery if refusal is honored

Property

Refusal