Absence of any elements would not make it a valid contract.

It would also means

that there is no physician-patient relationship. No malpractice case may be brought
up against you if there is no physician-patient relationship.
Consent mutual agreement between the parties (physician and patient)
They agree upon the contract and content (medical services rendered and fees of
the physician)
Law on contracts parties can agree on anything under the sun and nobody can
complain because that is the agreement. What is prohibited are the ones that are
illegal/impossible/contrary to law (one party is promising to catch a falling star,
revive a dead patient, get the sun)
The physician can contractually agree to perform intentional abortion because it is a
crime (contrary to the constitution). If the patient is not satisfied with abortion
because of complications, she cannot go to court because it is illegal in the first
place. Both of them will go to prison.
Let us suppose that the physician is treating the patient for free. Does it mean there
is no physician-patient relationship? Because there is no fee? If it is looked upon
that way, it would mean that the doctor can do anything to the patient (experiment
on the patient etc.)
NO. The rationale is that mere benevolence, love, liberality, passion for mankind is
sufficient cause. Rendering services for free does not mean that he/she can do
anything to the patient.
Donations are kind of contracts.
Consideration not monetary; love, beneficence, and compassion can be
considered as cause.
Free services - Mitigating circumstance but not enough as a sufficient excuse
CONSENT
There is usually no expressed consent or a written contract stating that he/she is
saying that he/she is allowing Dr. ___ to diagnose or treat him/her. Nobody says,
You are my patient or you are my doctor.
Consent may be implied. The mere fact that the patient entered the clinic, and the
doctor started the check-up/normal procedure and the patient allowed them to be
done then there is already an implied physician patient relationship.
An applicant to a big company goes to the company doctor and undergoes acts
constituting to a practice of medicine and was found to have a tuberculosis. Doctor
reported TB to the company. There is no breach of contract/duty because there is no
actual physician-patient relationship. The duty of the doctor is to the insurance
company/big company. The duty to keep secrets sacred is not violated.

Performing autopsies no physician-patient relationship because the patient is

already dead but the doctor also has a duty to perform the autopsy well (not to be
negligent).
Death ends physician-patient relationship. If the patient dies, the doctor still has the
duty to keep secrets found while attending to the patient who died.
There should be a mutual agreement that there would be no patient-physician
relationship. The patient can withdraw anytime; however, the physician cannot
withdraw from the patient immediately. He/she must ensure that the patient has
another physician who can attend to him/her, and the replacement should have an
endorsement.
Consent sound mind and legal of age
If the patient is 18 years old, and insisted that he/she wants a procedure done and
the parents disagree, the doctor is not legally bound to follow the parents as the 18
year-old person is already legal.
PEDIATRIC 18 and 364 days
Expectation that the patient is completely honest with the doctor with whatever
information that he or she divulges to the doctor. If there is an omission of a
material risk with regards to a procedure, (enough that would change the mind of
the patient) then there is enough for the patient to sue the doctor.
PHYSICIAN & TORTS
Lets say you are being sued for malpractice and you can be sued for malpractice
(left operating sponge in the abdomen after X-lap). You can be sued civil, criminal
and administrative case.
Suit based on torts civil case
Committed an act of medical negligence, medical malpractice can be sued in 3
ways
The moment that you have a patient-physician relationship, you have a
Duty to be reasonably competent, diligent, served utmost good faith and exercise
best judgement.
Breach of medical duties, injure body and health.
Quasi-delict
Usually if you want to collect damages.
It is arguable if they can use breach of contract. No set of guidelines if the medical
malpractice can be taken as a breach of contract but in the past 20 years, medical
malpractice is brought as quasi-delict and not breach of contract.
Direct liability
- Prove fault or negligence, act of omission which caused damage to the
patient

4 elements of medical negligence (that must be proved by the relatives/actually

even in the criminal case)
Book of Dr. Pedro-Solis
Physician reasonably competent
Average physician you dont take the least and the worst; just consider the
ordinarily good ones (dont consider the bad apples) Terrible doctors are not
standards.
Yardstick in a physician SAME LINE OF PRACTICE
- NOT: Competence of nephrologist vs cardiologist in a kidney disease
Utmost or extra-ordinary care THEY ARE DIFFERENT.
Extra-ordinary care if something goes wrong, the doctor is immediately held liable
Ordinary and reasonable care interchangeable
Extra-ordinary care common carrier (taxi and airline) up to the carrier to prove
that it is not negligent