Republic of the Philippines

UNIVERSITY OF EASTERN PHILIPPINES

University Town, Northern Samar
Web: [Link] Email: uepnsofficial@[Link]
COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

THE PATIENT BILL OF

RIGHTS
and
Advance Directives /
Living Will

Prepared By:
Raj Arielle T. Flores
Joyce Ann C. Garote
OVERVIEW
• Importance of patient rights in healthcare.
• Empowering patients through knowledge of their rights.
• Introduction to advance directives and living wills

LEGISLATIVE BACKGROUND
• Senate Bill No. 812: Magna Carta of Patient's Rights and Obligations
• Introduced by Senator Ramon Bong Revilla Jr.
• Aims to declare patient rights and establish a grievance mechanism for violations.
• Reference: Senate Bill No. 812

Patient Bill of Rights

• is a document outlining the rights and responsibilities of patients receiving
healthcare. It provides a framework for understanding what patients can expect
during their treatment, including access to information, privacy, and fair treatment.

THE RIGHTS OF PATIENT

1. Right to Appropriate Medical Care and Humane Treatment.
2. Right to Informed Consent.
3. Right to Privacy and Confidentiality.
4. Right to Information.
5. Right to Choose Health Care Provider and Facility.
6. Right to Self-Determination.
7. Right to Religious Belief.
8. Right to Medical Records.
9. Right to Leave.
10. Right to Refuse Participation in Medical Research.
11. Right to Correspondence and To Receive Visitors.
12. Right to Express Grievances.
13. Right to be informed of his Rights and Obligations as a Patient.
1. Right to Appropriate Medical Care and Humane Treatment.
• Every person has a right to health and medical care corresponding to his state of
health, without any discrimination and within the limits of the resources, manpower
and competence available for health and medical care at the relevant time.
• The patient has the right to appropriate health and medical care of good quality. In
the course of such care, his human dignity, convictions, integrity, individual needs
and culture shall be respected.

2. Right to Informed Consent.

• Patients have the right to clear, truthful, and understandable information about any
proposed medical procedure (diagnostic, preventive, curative, rehabilitative, or
therapeutic).
The healthcare provider must disclose:
• Their Name and Credentials.
• Risks (including mortality and side effects)
• Recovery issues and success probabilities.
No procedure shall be done without written informed consent, except in the following
cases:
a. Emergency – when delay risks life or serious harm
b. Public Health – during epidemics or mass health programs
c. Legal Requirement – procedures mandated by law
d. Incompetent Patient/Minor – consent from legal guardian or authorized third
party
e. Therapeutic Privilege – when full disclosure could harm treatment outcome
f. Waiver – patient waives the right in writing
Consent may be given by:
1. Spouse
2. Son/Daughter (Legal Age)
3. Parent
4. Sibling (Legal age)
5. Legal Guardian
 If consent is refused and the procedure is life-saving, courts may authorize
treatment upon petition.

3. Right to Privacy and Confidentiality.

• Patients have the right to privacy throughout their treatment.
• Unwarranted public exposure is not allowed, except:
➢ By court order for examination;
➢ When public health and safety require it;
➢ If the patient waives the right.
• Patient information and records must remain confidential. Disclosure is only
allowed:
With patient consent;
➢ For public health and safety;
➢ By court order;
➢ For continued treatment or research (with de-identification).
• Patients may choose which family members to inform. If underage or
incapacitated, information goes to parents, guardians, or next of kin.

4. Right to Information.
• Patients or their legal guardians have the right to be fully informed about:
a) The diagnosis and extent of illness
b) Proposed treatments, procedures, medicines (with generic names), and
possible complications
c) Changes in the care plan and their role in it
d) Expected payments from PhilHealth / other payors and out-of-pocket
charges
e) The health professionals involved and the frequency of services

• Patients have the right to:

a) Examine and receive an itemized bill with full explanation
b) Receive discharge instructions (e.g., medications, diet, physical activity)
 c) Get a written summary of illness and treatment after confinement
d) Access and view medical records in the presence of the physician or
hospital representative
e) Request copies of medical records at their own expense
f) Obtain a medical certificate for previous confinement, free of charge
g) Refuse information if they explicitly choose not to be informed

5. Right to Choose Health Care Provider and Facility.

• The patient is free to choose the health care provider to serve him as well as the
facility except when he is under the care of a service facility or when public health
and safety so demands or when the patient expressly or impliedly waives this right.
• The patient has the right to discuss his condition with a consultant specialist, at the
patient’s request and expense. He also has the right to seek for a second opinion
and subsequent opinions, if appropriate, from another health care
provider/practitioner.

6. Right to Self-Determination.
• Patients have the right to choose or refuse any recommended diagnostic or
treatment procedure. A legally competent person may create a written directive for
terminal care during the final phase of a terminal illness, provided that:
a) they understand the medical consequences,
b) they release healthcare providers from liability, and
c) their decision does not endanger public health or safety.

7. Right to Religious Belief.

• The patient has the right to refuse medical
treatment or procedures which may be contrary to his religious beliefs, subject to the
imitations described in the preceding subsection: Provided, That such a right shall not be
imposed by parents upon their children who have not reached the legal age in a life
threatening situation as determined by the attending physician or the medical director of
the facility.
8. Right to Medical Records.
• Patients can access and view their medical records, except for psychiatric notes
and third-party information.
• A summary of medical history and condition must be provided with the physician's
explanation.
• Patients may request a copy of their records upon discharge, at their own expense,
even if bills are unpaid.
• Records must be kept confidential, intact, and authentic by the healthcare
institution.
• Medical certificates and documents for insurance claims must be issued upon
request within a reasonable time.

9. Right to Leave.
• Patients have the right to leave a hospital or health care facility at any time,
regardless of their condition, if:
a) They are informed of the medical consequences;
b) They release care providers from liability;
c) Their decision does not harm public health or safety.

• Patients cannot be detained solely for unpaid bills, but may leave once
arrangements for payment are made. Unpaid bills may be treated as income loss
by the hospital.

10. Right to Refuse Participation in Medical Research.

Patients have the right to be informed and to refuse participation in any medical
research or human experimentation. Participation requires written informed
consent. Research must follow ethical standards under an approved review board
(per the Declaration of Helsinki). The Department of Health ensures ongoing
training for healthcare providers to support medical advancement.

11. Right to Correspondence and To Receive Visitors.

 The patient has the right to communicate with relatives and other persons and to
receive visitors subject to reasonable limits prescribed by the rules and regulations
of the health care institution.

12. Right to Express Grievances.

The patient has the right to express complaints and grievances about the care and
services received without fear of discrimination or reprisal and to know about the
disposition of such complaints. The Secretary of Health, in consultation with health
care providers, consumer groups and other concerned agencies shall establish a
grievance system wherein patients may seek redress of their grievances. Such a
system shall afford all parties concerned with the opportunity to settle amicably all
grievances.

13. Right to be informed of his Rights and Obligations as a Patient.

• Every patient has the right to be informed of their rights and responsibilities. The
Department of Health, with partners, shall lead a nationwide campaign to educate
the public. Health care institutions must:
a) Display patient rights and obligations on a visible bulletin board.
b) Inform patients of these rights and the facility’s rules and regulations.
ADVANCE DIRECTIVES AND LIVING WILLS
Definition
• Legal documents that outline a person's preferences for medical treatment in
situations where they are unable to communicate.
Components
• Living Will: Specifies desired medical treatments.
• Durable Power of Attorney for Healthcare: Appoints someone to make
decisions on the patient's behalf.
Importance:
• Ensures patient autonomy and guides healthcare providers and family members

The Constitution, Article 2, Section 15 provides:

"The State shall protect and promote the right to health of the people and instill health
consciousness among them."
According to the National Health Institute of the University of the Philippines, six often
Filipinos who succumb to sickness die without ever seeing a doctor. Hence, it is time for
Filipinos to discuss and learn about future health care decisions for themselves and their
family, and possibly start thinking about options that can help them with these choices,
like advance directives. Advance directives are decisions that can be written down prior
to medical treatment, so the family can carry out a person's wishes for health care if this
person is unable to communicate them. Thus, this bill directs the Secretary of Health,
directly or through grants, contracts, or interagency agreements, to develop a national
campaign to inform the public of the importance of advance care planning and of an
individual's right to direct and participate in his or her healthcare decisions. The
comprehensive public education campaign shall raise awareness of the importance of
planning for care near the end of life.

Case scenario on Advance Directives:

• Mr. Dela Cruz, diagnosed with a terminal illness, prepares an advance directive
stating he does not wish to be resuscitated. When he later suffers cardiac arrest,
the medical team honors his directive, providing comfort care instead.
Summary:
• Understanding and respecting patient rights are fundamental to ethical healthcare.
• Advance directives and living wills empower patients to make informed decisions
about their care.