MEDICAL JURISPRUDENCE: PHYSICIAN-PATIENT RELATIONSHIP

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Sergio P. Paguio, MD., LL.B., FPSP, FPSO

To examine patient and inform him of the state of health.

To examine the patient, diagnose the condition, inform him of it

PHYSICIAN-PATIENT RELATIONSHIP
and recommend the appropriate remedy, without giving any treatment.

Relationship of Doctor and patient is CONTRACTUAL.

To examine the patient, diagnose his condition and give him

Contract- is the meeting of minds between two persons whereby

emergency treatment only.
one binds himself with respect to the other, to give something or to
render some service.
Nature of Relationship:

It is CONSENSUAL it is based on mutual consent of both the

physician and then patient.

It is FIDUCIARY the contractual relation is based on mutual trust

and confidence in one another.
Requisites of a Contractual Relationship:

There must be consent of the contracting parties:

Manifested by the meeting of the offer and the

acceptance upon the thing and the cause which are to constitute a
contract.
- must be voluntary

There must be cause or consideration:

This is the factor that instigated the physician to render

medical service.

There must be an object which is the subject matter of the

contract.

Object or subject matter is medical service.

Forms of Physician-Patient Relationship:

EXPRESSED CONTRACT:

When the nature and extent of the medical service to

be rendered by the physician and the renumeration to be given by
the patient is explicitly stated orally or in writing.

IMPLIED CONTRACT:

agreement inferred by LAW as matter of reason and

justice for their acts or conduct, the circumstances surrounding
their transaction, or even a necessary assumption that a contract
existed between them by a tacit understanding.

the existence of a contract can be inferred from the

acts of the contracting parties.
Instances when there is no physician-patient relationship by decisions of
Courts:

Pre-employment physical examination

Physical exam for the purpose of eligibility for insurance.

When physician is appointed by the trial court to examined the

accused and to report whether he was insane or not.

Relation between a pathologist performing an autopsy.

Casual question asked of physician in an unordinary case such as

social gathering or party.
Psychological Patterns of Physician-Patient Relations:

ACTIVITY-PASSIVITY RELATION:

No interaction between doctor and patient.

Patient is unable to contribute to the activity.

Seen in an emergency situation ( unconscious patient )

GUIDANCE COOPERATION RELATION:

Patient is conscious.

He is ready and willing to cooperate.

Physician is in a position of trust.

MUTUAL PARTICIPATION RELATION:

Patient thinks he is equal to the doctor.

Physician feels that the patient is uncooperative.

Patient feels that Physician is unsympathetic and lacks

understanding.
Specific type of Medical Service which the patient may solicit from his
physician:

To perform specific tests or examination.

Transcribed by: KC

To examine the patient, diagnose his conditions and treat him as

to only one or more, but not all conditions affecting him without followup care.

To examine the patient, diagnose his condition and treat him as to

only one or more but not all conditions affecting him and with follow-up
care.

To examine the patient, diagnose his condition and treat him fully,
giving him full follow-up care.
Duties and obligations imposed on the physician to the physician-patient
relationship:

He should possess the knowledge and skill of which an average

physician is expected.

He should use such knowledge and skill with ordinary care and
diligence.

He is obliged to exercise the best judgment.

He has the duty to observe utmost good faith.

Terms which are not included in Physician-Patient relationship

It does not imply any promise or guaranty by the physician that

the treatment will be successful.

It does not imply any promise or guaranty that the treatment will
benefit the patient.

It does not imply or guaranty that the treatment will produce

certain result.

It does not promise that the physician will not commit errors in an
honest way.
Duties and Obligations Imposed on the Patient in the course of the
Physician-Patient Relationship

The patient must give an honest medical history of the illness.

Even if the patient has to submit to painful management he will

cooperate and follow the instructions, orders and suggestions of the
physicians.

He must inform the physician of that occurred in the course of the

treatment so that the latter may know effect of treatment he is giving.

If he is given the necessary instructions, he must state whether he

understands the contemplated course of action and the things expected
of him

The patient must exercise the prudence to be expected of an

ordinary patient under the same circumstances. In other words, he
cannot act as if he was stranger to his own problem.
Commencement of the Physician-Patient Relationship

Very important to know is the determination of the establishment

of physician-patient relationship
Termination of Physician-Patient Relationship

Recovery of patient from the condition for which he was receiving

treatment or when the physician considers that his further services will
no longer be beneficial to the patient.

Withdrawal of the physician

Discharge of the physician by the patient.

Death of the patient.

Death or incapacity of physician.

Fulfillment of the obligations stipulated in the contract.

In case of emergency, when the attending physician or physician

of choice of the patient is already available, or whenever there is
cessation of condition of emergency.

Expiration of period, if the contract of medical service is for a

specific period.

Mutual agreement between the physician and patient that the

physician-patient relationship is terminated.

Reference:

Dr. Paguios Power Point

KCs notes

END OF TRANS

Transcribed by: KC