RA 8344 & emergency & hospital

You can find many stories and reports on the Internet that hospitals and doctors ask for an advanced payment or
deposit before helping a patient. There are also stories of patients dying on the sidewalk in front of a hospital
because of this behavior. Here comes RA 8344 to help.
For westerners and others coming from more developed countries this scenario is unthinkable. Hospitals and
especially doctors and nurses have taken the Hippocratic Oath to do whatever they can to help people in medical
need.
For decades, and still today, many Philippine hospitals are private institutions; and act more as a business than a
hospital. The more money they make the better. There is nothing wrong with making money, but the moment
money comes before a patient, that is not good.
Let us all hope you will never need this information, but it is good to know that there is a clear law about this
issue.
RA 8344
Not so many people are aware of the Republic Act 8344 (RA 8344), in which is stated that it is not allowed for
hospitals and their staff or a physician to ask for advance payment or a deposit in life threatening or severe
situations. Read the whole text of the RA 8344.
Only a few months ago a hospital in Mindanao get in trouble with this RA 8344. Read the story in the Gold Star
Daily, a leading newspaper in Mindanao Hospital in hot water over deposit policy from August 18, 2014.
So in short: All hospital staff in Emergency departments, physicians and nurses, but also finance staff should
know about RA 8344 and its rules. (When you are a member of PhilHealth it is much easier. PhilHealth is a Health
care insurer owned by the Philippine government and is funded to help people who do not have sufficient funds
for better health care. But always carry the membership card with you, you never know )
emergency RA 8344In other words:
No deposit required
In emergency or serious cases, it is unlawful for any proprietor, president, director, manager or any other officer,
and/or medical practitioner or employee of a hospital or medical clinic:
To request, solicit, demand or accept any deposit or any other form of advance payment as a prerequisite for
confinement or medical treatment of a patient in such hospital or medical clinic, or to refuse to administer
medical treatment and support as dictated by good practice of medicine to prevent death or permanent
disability.
When patient transfer is allowed
However, by reason of inadequacy of the medical capabilities of the hospital or medical clinic, the attending
physician may transfer the patient to a facility where the appropriate care can be given, after the patient or his
next of kin consents to said transfer and after the receiving hospital or medical clinic agrees to the transfer. And
when such patient is unconscious, incapable of giving consent and/or unaccompanied, the physician can transfer
the patient even without his consent, provided that such transfer shall be done only after necessary emergency
treatment and support have been administered to stabilize the patient and after it has been established that
such transfer entails less risks than the patients continued confinement.
And no hospital or clinic, after being informed of the medical indications for such transfer, shall refuse to receive
the patient nor demand from the patient or his next of kin any deposit or advance payment.
After the hospital or medical clinic mentioned above shall have administered medical treatment and support, it
may cause the transfer of the patient to an appropriate hospital consistent with the needs of the patient,
preferably to a government hospital, especially in the case of poor or indigent.
The transferring and receiving hospital, shall be as much as practicable, be within a 10 kilometer radius of each
other. The transfer shall always be properly documented.
Hospitals may require a deposit or advanced payment when the patient is no longer under the state of
emergency and he/she refuses to be transferred.
Additional requirements
A copy of the law and the implementing rules and regulations should be displayed prominently at hospital
emergency rooms, hospital admission, counters and medical clinic premises.

Hospital and clinic managers should instruct their personnel to provide prompt and immediate medical attention
to emergency and serious cases without any prior requirements for payment or deposit.
Hospital and clinic managers should establish billing and collection procedure for treatment or confinement of
emergency and serious cases which shall not commence until the essential appropriate treatment of such cases
has been completed.
Consequences
The official, medical practitioner or employee of the hospital or medical clinic shall be punished by imprisonment
from 6 months and 1 day up to 2 years and 4 months, or a fine between P20,000.00 and P100,000.00 or both, at
the courts discretion.
If the violation was committed pursuant to an established policy of the hospital or clinic or upon instruction of its
management, the director or officer of such hospital or clinic responsible shall be punished by imprisonment of 4
to 6 years, or a fine between P100,000.00 and P500,000.00 or both, at the courts discretion.
At the instance of the Bureau of Licensing and Regulation, administrative proceedings may also be pursued
against erring clinics or hospitals that could lead to either suspension or revocation of appropriate licenses.
Hospitals may be founded for profit but their core business at all times require them to give priority to the health
and well being of their customers ahead of monetary gain. It is about time, they follow this law and that people
should be fully aware of it.

HOSPITAL CODE OF ETHICS

From Philippine Hospital Association
http://www.pha.ph/code_of_ethics.php
Introduction
To promote public welfare primarily and secondly, to guide governing bodies, hospital administrators,
professional and non-professional staff members and others who constitute the hospital family, ethical and
administrative principles are herewith established for the Philippine Hospital System. By the sincere and
voluntary commitment to those principles, the hospital is better able to perform the functions in a manner that
will deserve and receive the patronage and support of the community it serves. It is not always possible to
clearly distinguish between ethical principles which apply basically to conduct, and administrative principles
which refer to the means by which ethical principles may be carried out. Both are important to the proper and
acceptable operation of the hospital. For the purpose of this concern, Ethics is defines as standards of conduct
normally established as a moral guide for human behavior and principles are universally applicable beliefs
that may be developed to guide the conduct of both individuals and institution.
I. Ethical and Administrative Principles for Hospitals
Objectives of the Hospital:
1. The Primary objective of the hospital are the following:
1.2 To provide the best possible facilities for the care of the sick and injured at all times;
1.3 To constantly upgrade and improve methods for the care, the cure, amelioration and prevention of disease;
and
1.4 To promote the practice of medicine by Physicians within the institution consistent with the acceptable
quality of patient care.
These objectives require an efficient organization, a competent administrator, a qualified medical staff, other
well-trained personnel and adequate physical facilities with all of which services are made available at all times
consistent with community needs.
2. The hospital should have the following secondary objectives:
2.1 To encourage research and teaching and to assist in the advancement of scientific knowledge.
2.2 To set an example of ethical practice, cooperate with other hospitals and take an active part in the promotion
of health;

2.3 To provide kind and considerate care for all patients and must always provide needed emergency treatment.
The hospital has a moral responsibility to make every effort to ensure full and complete recovery of its patients
because of which the hospitals interest and activities require an extension beyond its walls.
1.1.1 To cooperate with recognized hospital associations and agencies and to develop cooperative action with
other hospitals within the country.
II. Hospital Ethics
1. Hospital must recognize that the care of the sick is their first responsibility and a sacred trust, striving, at all
times, to provide the best possible care and treatment to all in need of hospitalization.

2. Hospitals, recognizing their unique role in safeguarding the nations health, should seek through
compassionate and scientific care and health education, to extend life, alleviate suffering, and improve the
general health of the communities they serve.
3. Hospitals should remain and promote harmonious relationships within the organization, to insure the proper
environment for effective, efficient and equitable care and treatment of patients.
4. Hospitals should seek to inspire the confidence of the entire community and should appreciate and respect the
social and religious practices and customs of patients.
5. Hospitals, to the extent possible and within their limitations, should conduct educational projects, stimulate
research, and encourage preventive health practices in the community.
6. Hospitals should cooperate with other hospitals, health and welfare agencies, government and nongovernment, and other recognized organizations engaged in activities related to the health of the country.
7. Hospitals, in reporting their work to the public, should give a factual and objective interpretation of
accomplishments and objectives without putting down directly or indirectly by implication, the work of other
hospitals or related organizations.
8. Hospital, cognizant of their social responsibilities, should actively support and encourage every effective
means which will ease the financial burdens of illness.
9. Hospital should be fair, honest and impartial in all their business relationships and utilize legal and legitimate
means in promoting their public relations.
10. Hospitals should be progressive in policies, personnel policies, and effort to maintain up-to-date equipment,
methods and standards of performance.
Formulated through the collaboration of the Philippine Hospital Association (PHA) & the Philippine College of
Hospital Administrators (PCHA).
INTERNATIONAL CODE OF MEDICAL ETHICS
DUTIES OF DOCTORS IN GENERAL
A DOCTOR MUST always maintain the highest standard of professional conduct.
A DOCTOR MUST NOT allow himself to be influenced merely by motives of profit.
THE FOLLOWING PRACTICES are deemed unethical: a) Any self advertisement except such as expressly
authorized by the national code of medical ethics. b) Taking part in any plan of medical care in which the doctor
does not have professional independence. c) To receive any money in connection with services rendered to a
patient other than the acceptance of a proper professional fee, or to pay any money in the same circumstances
without the knowledge of the patient.
UNDER NO CIRCUMSTANCESis a doctor permitted to do anything that would weaken the physical or mental
resistance of a human being, except from strictly therapeutic or prophylactic indications imposed in the interest
of the patient.
A DOCTOR IS ADVISED to use great caution in publishing discoveries. The same applies to methods of treatment
whose value is not recognized by the profession.
WHEN A DOCTOR IS CALLED UPON to give evidence or a certificate he should only state that which he can verify.
DUTIES OF DOCTORS TO THE SICK

A DOCTOR MUST always bear in mind the importance of preserving human life from the time of conception until
death.
A DOCTOR OWES to his patient complete loyalty and all the resources of his science. Whenever an examination
or treatment is beyond his capacity he should summon another doctor who has the necessary ability.
A DOCTOR OWES to his patient absolutely secrecy on all which has been confided to him or which he knows
because of the confidence entrusted to him.
A DOCTOR MUST GIVE the necessary treatment in emergency, unless he is assured that it can and will be given
by others.
Duties of Doctors to each other
A DOCTOR OUGHT to behave to his colleagues as he would have them behave to him.
A DOCTOR MUST NOT entice patients from his colleagues.
A DOCTOR MUST OBSERVE the principles of The Declaration of Geneva approved by The World Medical
Association. Declaration of Geneva Adopted by the General Assembly of the World Medical Association at
Geneva, Switzerland, September, 1948

AT THE TIME OF BEING ADMITTED AS MEMBER OF THE MEDICAL PROFESSION:

I SOLEMNLY PLEDGE myself to consecrate my life to the service of humanity.
I WILL GIVE to my teachers the respect and gratitude which is their due;
I WILL PRACTICE my profession with conscience and dignity;
THE HEALTH OF MY PATIENT will be first consideration;
I WILL RESPECT the secrets which are confided in me;
I WILL MAINTAIN by all the means in my power, the honor and the noble traditions of the medical profession;
I WILL NOT PERMIT considerations of religion, nationality, race, party, politics or social standing to intervenes
between my duty and my patient.
I WILL MAINTAIN the utmost respect for human life, from the time of conception; even the threat, I will not use
my medical knowledge contrary to the laws of humanity.
I MAKE THESE PROMISES solemnly, freely and upon my honor.

HEALTHCARE EXECUTIVES SOCIETY OF THE PHILIPPINES CODE OF ETHICS

I. RESPONSIBILITY TO THE PROFESSION OF HEALTHCARE MANAGEMENT
The member shall:
Conduct professional activities with honesty, integrity, respect, fairness and good faith in a manner that will
reflect well upon the profession;
Comply with all laws and regulations pertaining to healthcare management in which the healthcare executive
governs or conducts professional activities;
Maintain competence and proficiency in healthcare management by implementing quality assessment guidelines
and continuing professional education to improve knowledge in healthcare management;
Avoid undue exploitation of professional relationships for personal gain;
Disclose financial and other related conflicts of interest;
Use this Code to further the interests of the profession and not for personal reasons;
Respect professional competencies;
Enhance the dignity and image of the healthcare management profession through public information programs
thru education; and

Refrain from participating in any activity that may question the credibility and dignity of the healthcare
management profession.
II. RESPONSIBILITY TO PATIENTS OR OTHERS SERVED
The member shall, within the scope of his or her authority:
Implement and ensure the existence of a process to assess the quality of care or service rendered;
Avoid practice of discrimination and institute the necessary safeguards to prevent discriminatory practices;
To ensure that a process exist that will advise patients or others of their rights, opportunities, responsibilities and
risks regarding available healthcare services;
To ensure that there is a process that will govern the resolution of conflicts that may arise when values and
cultural diversities of patients and their families differ from those of employees and physicians;
Implement zero tolerance for any abuse of power that compromises the different stakeholders of the organization
such as patients, physicians, associates;
To provide a system that ensures and process the autonomy and self-determination of patients or others served;
and
To ensure that the confidentiality and privacy of patients or others served are protected.
III. RESPONSIBILITY TO THE ORGANIZATION
The member shall, within the scope of his or her authority:
Provide quality healthcare services consistent with available resources and work to ensure the existence of a
resource allocation process that considers ethical implications;
Implement collaborative programs in ways that improve community healthcare services;
Lead the organization in the use of acceptable and ethical standards of management and sound business
practices;
Respect the cultural diversity and practices of patients or others served, consistent with the organizations
philosophy;
Be truthful in all forms of professional and organizational communication, and avoid disseminating false and
misleading information
Create an organizational environment in which both clinical and management mistakes are minimized and, when
they do occur, are discussed, disclosed and addressed immediately; and
Establish an ethics compliance monitoring team.
IV. RESPONSIBILITY TO EMPLOYEES
Members have ethical and professional obligations to the employees they govern:
Establish an environment that promotes ethical conduct by employees;
Create a work environment that provides an avenue to discuss and address ethical concerns and provides
mechanisms for resolving such concerns;
Providing a work environment that discourages harassment and coercion of any kind to perform illegal or
unethical acts; and discrimination on the basis of cultural differences, ethnicity, religion, gender, sexual
orientation, age, or disability;
Providing a work environment that promotes empowerment and the proper use of employees knowledge and
skills;
Providing a work environment where employees can make a difference; and
Create grievance, inquiry and appeals mechanisms.
V. RESPONSIBILITY TO COMMUNITY AND SOCIETY
The member shall:
Identify and meet the healthcare needs of the community it serve;

Support access to quality healthcare services;

Knowledgeable on healthcare policy issues, and promote advocacy programs that will improve health status and
promote quality healthcare; and
Implement short- and long-term assessments to management decisions affecting both community and society.