Case Digest and Notes

7/23/2019 Case Digest and Notes

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STATE REGULATION OF HOSPITAL OPERATION

Defnition: Licensure - granting a license to operate and

maintain a hospital according to an approvedminimum standard.

Accreditation - a process that a health careinstitution, provider, or program undergoes todemonstrate compliance with standards developedby an ocial agency.

Certifcation - a process indicating that an individualor institution has met predetermined standardsAc!nowledgment by a medical specialty board o"success"ul completion o" re#uirements "or recognitionas a specialist.

Cases:

MANILA DOCTORS HOSPITAL, petitioner, vs. SO UN CHUAand VICKY TY, respondents.G.R. No. 150355 | July 31, 2006 (1D)

$acts: %espondent Chua, mother o" &y, was admitted to

petitioner hospital "or hypertension and diabetes. 'hile Chua was confned, another daughter (udith

Chua was admitted "or treatment o" in)uriessustained a"ter a vehicular accident. &y shouldered

the hospital bills "or the two. A"ter (udith was discharged, respondent Chua

remained confned. &y was able to pay *+,//.//.&he hospital bills eventually totaled *0,/1,23.2.'hen &y was unable to pay the bills, the hospitalallegedly pressured her, by cutting o4 the telephoneline in her room and removing the air-conditioningunit, television set, and re"rigerator, re"using torender medical attendance and to change thehospital gown and bed sheets, and barring theprivate nurses or midwives "rom assisting thepatient, to settle the same through the signing o" apromissory note.

&y issued postdated chec!s to pay the note. &hechec!s bounced. &he petitioner alleged that that asearly as one wee! a"ter respondent Chua had been

admitted to its hospital, Dr. %ody 5y, her attendingphysician, had already given instructions "or her tobe discharged, but respondents insisted that Chuaremain in confnement.

6t also alleged that &y voluntarily signed theagreement that she will pay the bills and that noundue pressure was e7erted by them and that thecutting-o4 o" the telephone line and removal o" theair-conditioning unit, television set, and re"rigeratorcannot constitute unwarranted actuations, "or thesame were resorted to as cost-cutting measures andto minimi8e respondents9 charges that were alreadypiling up, especially a"ter respondent &y re"used tosettle the balance notwithstanding "re#uentdemands. $inally it alleged that this case wasinstituted by &y to provide leverage against the

hospital "or fling criminal charges against the latter"or violation o" * 33.

6ssue: 'hether or not the hospital is liable "or damages

;eld:


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o At any rate, as stated above, the patient is"ree to leave the premises, even in theostensible violation o" these conditions,a"ter being momentarily interrupted by thehospital sta4 "or purposes o" in"orming himo" those reasonable conditions, such as theassessment o" whether the patient is ft toleave, insane, or su4ering "rom a contagiousdisease, etc., or simply "or purposes o"ma!ing a demand to settle the bill.

o I" #) +a#in# c)ooss #o a!scond orla$ .i#)ou# #) consn# o" #)

)os+i#al in $iola#ion o" an% o" #)condi#ions d,d #o ! rasona!lundr #) circu,s#ancs& #) )os+i#al,a% non#)lss r(is#r i#s +ro#s#and ,a% c)oos #o +ursu #) l(alr,dis available under law, providedthat the hospital may not physically detainthe patient, unless the case "alls under thee7ceptions abovestated.

Authorities are o" the view that, ordinarily, a hospital,especially i" it is a private pay hospital, is entitled tobe compensated "or its services, by either an e7pressor an implied contract, and i" no e7press contracte7ists, there is generally an implied agreement thatthe patient will pay the reasonable value o" theservices rendered when a hospital treats a patient9s

in)uries, it has an en"orceable claim "or "ull payment"or its services, regardless o" the patient9s fnancialstatus.

HOSPITAL MANAGEMENT SERVICES& INC/ ' MEDICALCENTER MANILA, *etitioner, vs. HOSPITAL MANAGEMENTSERVICES& INC/ ' MEDICAL CENTER MANILA EMPLOYEESASSOCIATION'AF8 and EDNA R/ DE CASTRO&%espondents.G.R. No. 176287 | January 31, 2011 (2D)

$acts: ?ne %ufna Causaren, an 0-year-old patient confned

at petitioner hospital "ell "rom the right side o" thebed as she was trying to reach "or the bedpan.

ecause o" what happened, the niece o" patient

Causaren staying in the room was awa!ened and shesought assistance "rom the nurse station. 6nstead o"personally seeing the patient, respondent De Castrodirected ward-cler! orientee @uillergan to chec! thepatient. &he vital signs o" the patient were normal.Later, the physician on duty and the nursing sta4 onduty "or the ne7t shi"t again attended to patientCausaren.

A "ormal investigation was conducted regarding thesaid incident. &he 6nvestigation Committee "oundthat the sub)ect incident happened between 00://a.m. to 00:/ a.m. o" >arch 3, 0222. &he threeother nurses "or the shi"t were not at the nursestation.

&he committee recommended that despite her morethan seven years o" service, respondent De Castroshould be terminated "rom employment "or her lapsein responding to the incident and "or trying tomanipulate and inuence her sta4 to cover-up theincident. A notice o" termination was sent to therespondent.

%espondent De Castro, with the assistance o"respondent association, fled a Complaint "or illegaldismissal against petitioners.

LA: 6n "avor o" respondent


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STATE REGULATION OF PRACTICE OF MEDICINE

Dn# $/ 8s# Vir(inia129 U.S. 114 | January 14, 1889 (U.S. Supr! "our#)

$acts: $ran! Dent was a physician o" the Gclectic sect, a groupwhich accepted and taught the conventional medical scienceo" the time. ;owever, in the area o" therapeutics, the Gclecticscarried on a rigorous campaign against e7cesses o" druggingand bleeding, which were still practices used by manyphysicians at the time. 6n addition, all but one o" their medicalschools were open to women.

Dent had been in practice "or si7 years when he wasconvicted under an 03 'est Hirginia law which re#uiredphysicians to hold a degree "rom a reputable medical college,pass an e7amination, or prove practice in 'est Hirginia "or theprevious ten years. 6n this case, the 5tate oard o" ;ealth

re"used to accept Dent9s degree "rom the American >edicalGclectic College o" Cincinnati.

;eld:

&he Court9s unanimous opinion which upheld the 'est Hirginiastatute noted that each citi8en had a right to "ollow any law"ulcalling, sub)ect to natural restraints such as age, se7, etc., aswell as state restrictions, as long as those state restrictionswere reasonable. 6n addition, the Court ruled #)a# ,dicin&!caus o" #) car"ul na#ur o" i#s #rainin(& #) lar(;no.ld( o" #) )u,an !od% r9uird o" doc#ors& andna#ur o" li"'and'da#) circu,s#ancs .i#) .)ic)doc#ors dal#& rlianc ndd #o ! +lacd on #)assuranc o" a licns/ Certain circumstances might

prompt states to e7clude people without licenses "rompracticing medicine.

FELI< MAR=UE>, petitioner, vs. THE *OARD OF MEDICALE.D. "rom said institution on

(une , o" the year 0233. edical 5chool, said institution was stilrecogni8ed as a reputable medical institution and the#uestion submitted is +#r # p#-#-onr /a oul 'orn y # la+ an r'ula#-on -n or/ a# # #-! o -nroll!n# -n an 'raua#-on ro! # "-/a'o -/aS/ool, or y #o -n or/ a# # #-! l - appl-/a#-onor a!--on, on or aou# Sp#!r 26, 1924. 6t issubmitted "or the petitioner that his case should be governedby the law and regulations at the time o" his graduation. &ohold otherwise, it is insisted, is to ma!e the law retroactive ine4ect and to do irreparable damage to the petitioner, who haspursued his wor! in the institution re"erred to in good "aith,believing that said school had the status necessary to #uali"yhim "rom e7amination.

&he position ta!en by the petitioner is, we thin!, untenableT) 9us#ion .)#)r a ,dical ins#i#u#ion is ?ar+u#a!l ,dical sc)ool&? in #) sns in#ndd !%#) la.& is $s#d in #) *oard o" Mdical E:a,inrsand al#)ou() #) ac#ion #a;n !% #), ,a%conci$a!l%& in isola#d cass& rsul# in )ards)i+n$r#)lss #) in#rs#s o" #) +u!lic r9uir #)a##) !oard s)ould ! "r #o :rcis i#s @ud(,n# anddiscr#ion .i#)ou# r"rnc #o #) c# o" #)d#r,ina#ion o" #) 9us#ion in +ar#icular ins#ancsT)r can in #) na#ur o" #)in(s ! no $s#d ri()# inan :is#in( la.& .)ic) .ould +rclud i#s c)an( orr+al/ No on .)o )as co,,ncd +r+ara#ion in a+ar#icular ins#i#u#ion )as an% inc)oa# ri()# on accoun#o" #)a# "ac#/ 6" the law were otherwise upon this point, it

would be impossible "or the oard o" >edical G7aminers togive e4ect to the !nowledge which they "rom time to timeac#uire as to the standing o" medical schools and anintending physician, upon matriculating in a particular collegeta!es upon himsel" the ris! o" changes that may be made inthe standing o" the institution by the board.

PHILIPPINE MEDICAL ASSOCIATION, petitioner, vs. *OARDOF MEDICAL E


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Lamitan, asilan City, where he resides, pursuant to 5ection110EeF o" the %evised Administrative Code:

S". 771. ron !p# ro! r'-#ra#-on. R'-#ra#-on all no# ru-r o # ollo+-n'/la o pron: . . .

() ;n /a o p-!-/ or -n !un-/-pal-#- +r#r - no l'ally ual- pra/#-/-n' py-/-an, or+n # /-r/u!#an/ ru-r -#, -n # -n#r# o# pul-/ al#, # D-r/#or o edical Association, addressedthe Chairman o" the oard a communication re#uestingreconsideration o" said resolution, upon the ground that,pursuant to said >edical Act o" 022, respondent has to ta!e

and pass the e7amination therein prescribed, be"ore he canbe allowed to practice medicine in the *hilippines. 5aidChairman then replied, stating Ithat the fnal decision on thematter will have to come "rom the *resident o" the *hilippinesupon whose authority said resolution has been fnallyapproved and implemented.I

6ssue: 'hether or not he oard had violated %epublic Act na#-onal o o# /oun#r- +o all a o#a-n'r or -plo!a #o pra/#-/ # l-ral pro-on -n-#r o # "on#ra/#-n' S#a#, -u y /o!p#n# na#-onalau#or-#-, all ! /o!p#n# #o r/- a-

pro-on -n # #rr-#ory o # ?#r, u@/# #o # la+an r'ula#-on o # la##r. An # 'r or -plo!a o*a/lor, -u y /o!p#n# na#-onal au#or-#- allo+ -#olr +-#ou# ru-r-n' ur#r -n/ o pro/-n/y #o

puru nor!ally -'r /our o #uy, all alo ! ual- #o /on#-nu - #u- -n # #rr-#ory o-#r ar#y -n /onor!-#y +-# # appl-/al la+ anr'ula#-on o # S#a# +-/ r/o'n-= # al--#y o ##-#l or -plo!a -n u#-on, an +-# # rul an r'ula#-ono # par#-/ular u/a#-onal -n#-#u#-on -n +-/ -n#n #o

puru - #u-.

6nasmuch as the theory o" respondent herein cannot beaccepted without placing graduates "rom our own educationalinstitutions at a disadvantage vis-a-vis 5panish graduates"rom 5panish schools, colleges or universities. 6ndeed, thelatter could J under respondent9s pretense J engage in thepractice o" medicine in the *hilippines without ta!ing thee7amination prescribed in %epublic Act , *residing (udge o" ranch H6o" the %egional &rial Court o" the anila, &;G ;?


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s#a!lis),n# o" ,ini,u, ,dical duca#ionalr9uir,n#s'i//& #) co,+l#ion o" +rscri!dcourss in a rco(nid ,dical sc)ool'"or ad,ission#o #) ,dical +ro"ssion& )as also !n sus#aind as al(i#i,a# :rcis o" #) r(ula#or% au#)ori#% o" #)s#a#/'hat we have be"ore us in the instant case is closelyrelated: the regulation o" access to medical schools. >GC5?rder -C;%65&6A< C?LLG@G ?$ >GD6C6ay 022. -&he college appealedthe decision to the ?*, but the G7ecutive 5ecretary "ound noreason to disturb the contested decision

A$$6%>GDR -&he college fled civil case


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DEPARTMENT OF EDUCATION& CULTURE AND SPORTSDECS and DIRECTOR OF CENTER FOR EDUCATIONALMEASUREMENT, petitioners, vs. RO*ERTO REY C/ SANDIEGO and BUDGE TERESITA DI>ON'CAPULONG, in hecapacity as *residing (udge o" the %egional &rial Court oHalen8uela, >etro >anila, ranch 013, respondents.G.R. No. 89572 | D/!r 21, 1989 (*)

$acts: &he private respondent is a graduate o" the Bniversityo" the Gast with a degree o" achelor o" 5cience in Noology.

&he petitioner claims that he too! the A& three times andun!ed it as many times. 0 'hen he applied to ta!e it againthe petitioner re)ected his application on the basis o" the>GC5 ?rder


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&he sub)ect o" the challenged regulation is certainly within theambit o" the police power. 6t is the right and indeed theresponsibility o" the 5tate to insure that the medicalpro"ession is not infltrated by incompetents to whom patientsmay unwarily entrust their lives and health.

&he method employed by the challenged regulation is notirrelevant to the purpose o" the law nor is it arbitrary oroppressive. &he three-un! rule is intended to insulate themedical schools and ultimately the medical pro"ession "romthe intrusion o" those not #ualifed to be doctors.

'hile every person is entitled to aspire to be a doctor, hedoes not have a constitutional right to be a doctor. &his is trueo" any other calling in which the public interest is involvedand the closer the lin!, the longer the bridge to one9sambition. &he 5tate has the responsibility to harness itshuman resources and to see to it that they are not dissipatedor, no less worse, not used at all. &hese resources must beapplied in a manner that will best promote the common goodwhile also giving the individual a sense o" satis"action.

&he right to #uality education invo!ed by the privaterespondent is not absolute. &he Constitution also providesthat Ievery citi8en has the right to choose a pro"ession orcourse o" study, sub)ect to "air, reasonable and e#uitableadmission and academic re#uirements.

&he contention that the challenged rule violates the e#ualprotection clause is not well-ta!en. A law does not have tooperate with e#ual "orce on all persons or things to becon"ormable to Article 666, 5ection 0 o" the Constitution.

&here can be no #uestion that a substantial distinction e7istsbetween medical students and other students who are notsub)ected to the A& and the three-un! rule. &he medicalpro"ession directly a4ects the very lives o" the people, unli!eother careers which, "or this reason, do not re#uire morevigilant regulation. &he accountant, "or e7ample, whilebelonging to an e#ually respectable pro"ession, does not holdthe same delicate responsibility as that o" the physician andso need not be similarly treated.

&here would be une#ual protection i" some applicants whohave passed the tests are admitted and others who have also#ualifed are denied entrance. 6n other words, what the e#ualprotection re#uires is e#uality among e#uals.

PROFESSIONAL REGULATION COMMISSION PRC et al.vs. ARLENE V/ DE GU>MANet al.G.R. No. 144681 | Jun 21, 2004 (2D)

$acts: &he respondents are all graduates o" the $atima Collegeo" >edicine, Halen8uela City, >etro >anila. &hey passed the*hysician Licensure G7amination conducted in $ebruary 022by the oard o" >edicine EoardF. *etitioner *ro"essional%egulation Commission E*%CF then released their names assuccess"ul e7aminees in the medical licensure e7amination.5hortly therea"ter, the oard observed that the grades o" theseventy-nine success"ul e7aminees "rom $atima College in thetwo most dicult sub)ects in the medical licensure e7am,

iochemistry Eio-ChemF and ?bstetrics and @ynecology E?-@yneF, were unusually and e7ceptionally high. Gleven $atimae7aminees scored 0//P in io-Chem and ten got 0//P in ?-@yne, another eleven got 22P in io-Chem, and twenty-onescored 22P in ?-@yne.

$or its part, the


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prescribes the re#uirements "or admission to the practice o"medicine, the #ualifcations o" candidates "or the boarde7aminations, the scope and conduct o" the e7aminations, thegrounds "or denying the issuance o" a physicians license, orrevo!ing a license that has been issued. Herily, to be grantedthe privilege to practice medicine, the applicant must showthat he possesses all the #ualifcations and none o" thedis#ualifcations. $urthermore, it must appear that he has "ullycomplied with all the conditions and re#uirements imposed bythe law and the licensing authority. 5hould doubt taint or marthe compliance as being less than satis"actory, then theprivilege will not issue. $or said privilege is distinguishable

"rom a matter o" right, which may be demanded i" denied.&hus, without a defnite showing that the a"oresaidre#uirements and conditions have been satis"actorily met, thecourts may not grant the writ o" mandamus to secure saidprivilege without thwarting the legislative will.

*OARD OF MEDICINE& DR/ RAUL FLORESEnow D%. (?5G 5.%A>6%GNF, in his capacity as Chairman o" the oard,*%?$G556?>6556??@G.@B6Aedical *ractitioners Law o" (apan duly authenticated bythe Consul @eneral o" the *hilippine Gmbassy to (apan, (esus 6.

abes thus, he was allowed to ta!e the >edical oardG7aminations in August 0223, which he subse#uently passed.

6n spite o" all these, the oard o" >edicine EoardF o" the *%Cdenied respondent9s re#uest "or a license to practice medicinein the *hilippines on the ground that the oard Ibelieves thatno genuine reciprocity can be "ound in the law o" (apan asthere is no $ilipino or "oreigner who can possibly practicethere.I

6ssue: 'hether or not the oard erred in not issuing thelicense o" respondent to practice medicine in the *hilippines

;eld: es

&here is no #uestion that a license to practice medicine is aprivilege or "ranchise granted by the government. 6t is a rightthat is earned through years o" education and training, and

which re#uires that one must frst secure a license "rom thestate through pro"essional board e7aminations.

6t must be stressed however that the power to regulate thee7ercise o" a pro"ession or pursuit o" an occupation cannot bee7ercised by the 5tate or its agents in an arbitrary, despotic,or oppressive manner. A political body which regulates thee7ercise o" a particular privilege has the authority to both"orbid and grant such privilege in accordance with certainconditions. As the legislature cannot validly bestow anarbitrary power to grant or re"use a license on a public agencyor ocer, courts will generally stri!e down license legislationthat vests in public ocials discretion to grant or re"use alicense to carry on some ordinarily law"ul business, pro"ession,

or activity without prescribing defnite rules and conditions "othe guidance o" said ocials in the e7ercise o" their power.

%.A. edical *ractitioners Law o" (apan --i.e., the provisions o" the 5chool Gducations Laws, the criteriao" the >inister o" ;ealth and 'el"are o" (apan in determiningwhether the academic and technical capability o" "oreignmedical graduates are the same as or better than that o"graduates o" medical schools in (apan, and who can actually#uali"y to ta!e the preparatory test "or the edicaG7amination = respondent, however, presented proo" tha

"oreigners are actually practicing in (apan and that $ilipinosare not precluded "rom getting a license to practice there.

SPECIAL LA8S APPLICA*LE TO PHYSICIANS I

THE PEOPLE, %espondent, v. BOSEPHINE CHAVE>Appellant."r-!. No. 579. Cour# D-#. Jan. 10, 1947

$acts: &he de"endant was charged with the murder o" henewborn baby. A )ury "ound her guilty o" manslaughter andshe has appealed "rom the )udgment. An autopsy wasper"ormed by a physician. ;e testifed that the cord on thebaby was about eighteen inches long, untied and depleted o"blood that the baby would live until it bled to death.

&he appellant frst contends that there is no substantiaevidence to support the verdict in that it does not sucientlyappear "rom the evidence that this in"ant was born alive andbecame a human being that it appears "rom the testimony oanother doctor, called by the de"ense, that the doctoper"orming the autopsy did not use certain tests which mighthave been used and did not open the in"ant9s head and heartwhich this other doctor thought might disclose some

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possibilities and that it "ollows that the #uestion o" whetherthis in"ant was born alive and became a human being restsentirely on pure speculation.

6ssue: 'hether or not the child herein was born alive andbecame a human being within the meaning o" the homicidestatutes

;eld: es

&he evidence is sucient to support a fnding, beyond areasonable doubt, that a live child was actually born here, and

that it died because o" the negligence o" the appellant in"ailing to use reasonable care in protecting its li"e, having theduty to do so. &his baby was completely removed "rom itsmother and even the placenta was removed. A "actual#uestion was presented and the opinion o" the autopsyphysician was evidence which could be considered by the )ury.His o+inion .as #)a# #) !a!% .as !orn ali$ and #)a#i# !ra#)d and )ad )ar# ac#ion/ H (a$ (oodrasons "or #)a# o+inion and .)il ) ad,i##d #)a##)r could ! a +ossi!l dou!# )is $idnc @us#is#) in"rnc #)a# #)r .as no $alid (round "or arasona!l dou!#/ 8)il ) ad,i##d #)a# ) )ad no#usd cr#ain #s#s su((s#d !% #) o#)r doc#or )s#a#d #)a# ) ;n. o" #)s #s#s !u# ) did no#considr #), ncssar% )r/'ith respect to the testmost relied upon by the de"ense, it was stated by both

doctors that this test would show only what the autopsyphysician testifed he had discovered by other means. &hedoctor called by the de"ense had not seen the baby9s bodyand his testimony was based upon his general laboratorye7perience. 'hile it may be said that there was some conictbetween the testimony o" these two doctors no more than aconict appears. &he #uestion was one o" "act "or the )ury and,in our opinion, the evidence is sucient to support itsfndings. 6" it could be said that there might be a possibledoubt with respect to this phase o" the case, it cannot be saidthat there was necessarily a reasonable doubt. &he fnding o"the )ury is suciently supported, and the implied fnding thatthis was a human being rests on a "actual basis and not uponspeculation.

SPECIAL LA8S APPLICA*LE TO PHYSICIANS II

DR/ FILOTEO A/ ALANO, *etitioner, vs. >ENAIDA MAGUD'LOGMAO, %espondent.G.R. No. 175540 | &pr-l 7, 2014 (3D)

$acts: %espondent Nenaida >agud-Logmao is the mother o"

deceased Arnelito Logmao. *etitioner Dr. $iloteoAlano is the G7ecutive Director o" the isa,

&ransplant Coordinator, was as!ed to locate his"amily by enlisting police and media assistance.

&he ne7t day, Arnelito had been pronounced braindead by Dr. Abdias H. A#uino, a neurologist, and byDr. Antonio %a"ael, a neurosurgeon and attendingphysician o" Arnelito, and that a repeatelectroencephalogram EGG@F was in progress toconfrm the diagnosis o" brain death.

Bpon learning that Arnelito was a suitable organdonor and that some isawhether the relatives o" Arnelito had been located sothat the necessary consent "or organ donation couldbe obtained.

As the e7tensive search "or the relatives o" Arnelitoyielded no positive result and time being o" theessence in the success o" organ transplantation, Dr?na re#uested Dr. $iloteo A. Alano, herein petitionerto authori8e the removal o" specifc organs "rom thebody o" Arnelito "or transplantation purposes.

?n >arch , 02, Dr. Alano issued to Dr. ?na a>emorandum, which reads as "ollows:

& o+n y # !-/al r/or, # a- pa#-n#- on ar/ 3, 1988 a# 9:10 -n # !orn-n' u #o/ran-o/rral -n@ury. la !aB /r#a-n #a# your

Dpar#!n# a r# all raonal or# #olo/a# # rla#- or n#%o%B-n o # a-/a pa#-n#, u/ a appal #rou' # ra-oan #l--on, a +ll a #rou' pol-/ an o#r'orn!n# a'n/- an #a# # N*; E-/o%$'alF S/#-on a n no#- an - a+ar o #/a.

; all # ao a n /o!pl- +-#, -na//oran/ +-# # pro--on o Rpul-/ &/# No349 a a!n an .D. 856, pr!--on anorau#or-#y - ry '-n #o # Dpar#!n# oSur'ry #o r#r- an r!o # B-ny

pan/ra, l-r an ar# o # a- /apa#-n# an #o #ranplan# # a- or'an #o any/o!pa#-l pa#-n# +o !ay -n n o a-

or'an #o l- an ur-. Conse#uently, respondent fled with the trial court a

complaint "or damages against several doctorsincluding petitioner herein, alleging that theyconspired to remove the organs o" Arnelito while thelatter was still alive and that they concealed his trueidentity.

&he court a #uo rendered )udgment fnding only Dr$iloteo Alano liable "or damages to plainti4 anddismissing the complaint against the othede"endants "or lac! o" legal basis.

CA armed the lower courts decision. ;ence thispetition.

6ssue: 'Q< respondent9s su4erings were brought about bypetitioner9s alleged negligence in granting authori8ation "o

the removal or retrieval o" the internal organs o" respondent9sson who had been declared brain dead, ma!ing petitioneliable "or damages

;eld: arch , 02 issued bypetitioner, stated thus:

A care"ul reading o" the above shows that petitionerinstructed his subordinates to Ima!e certainI thaIall reasonable e4ortsI are e7erted to locate thepatient9s ne7t o" !in, even enumerating ways in

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which to ensure that notices o" the death o" thepatient would reach said relatives. 6t also clearlystated that permission or authori8ation to retrieveand remove the internal organs o" the deceased wasbeing given ?arch 3,

02, even be"ore petitioner issued the>emorandum.

o *rior to per"orming the procedure "orretrieval o" the deceased9s internal organs,the doctors concerned also the sought theopinion and approval o" the >edico-Legal?cer o" the C,who had the opportunity to ascertain thename o" the deceased, who recorded thewrong in"ormation regarding the deceased9sidentity to


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+ndin( a++lica#ion "or dla%d r(is#ra#ion/ I" a"#r#n da%s no on o++oss #) r(is#ra#ion and #) localci$il r(is#rar is con$incd !%ond dou!# #)a# #) !ir#)s)ould ! r(is#rd& ) s)ould r(is#r #) sa,/

%eynaldos certifcate o" live birth, as a duly registered publicdocument, is presumed to have gone through the processprescribed by law "or late registration o" birth. 6t was only on >arch 022, a"ter the lapse o" ten long years "rom theapproval on 00 $ebruary 02 o" the application "or delayedregistration o" %eynaldos birth, that ;?N 1. &u#or-#y #o "orr/# "lr-/al or>ypo'rap-/al rror an "an' o C-r# Na! or

N-/Bna!. I No n#ry -n a /--l r'-#r all /an' or /orr/# +-#ou# a @u-/-al orr, /p#or /lr-/al or #ypo'rap-/al rror an /an' o r#na! or n-/Bna! +-/ /an /orr/# or/an' y # /on/rn /-#y or !un-/-pal /--r'-#rar or /onul 'nral -n a//oran/ +-# #

pro--on o #- &/# an -# -!pl!n#-n' rul anr'ula#-on.

%A 2/+ now governs the change o" frst name. 6t vests thepower and authority to entertain petitions "or change o" frstname to the city or municipal civil registrar or consul genera

concerned. Bnder the law, there"ore, )urisdiction oveapplications "or change o" frst name is now primarily lodgedwith the a"orementioned administrative ocers. &he intenand e4ect o" the law is to e7clude the change o" frst name"rom the coverage o" %ules 0/ EChange o"


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among others. &hese laws underscore the public policy inrelation to women which could be substantially a4ected i"petitioners petition were to be granted.

P#i#ionr REPU*LICvs/ BENNIFER */ CAGANDAHANG.R. No. 166676 | Sp#!r 12, 2008 (2D)

$acts: %espondent (enni"er Cagandahan fled a *etition "orCorrection o" Gntries in irth Certifcate. 6n her petition, shealleged that she was born on (anuary 0, 020 and wasregistered as a "emale in the Certifcate o" Live irth but whilegrowing up, she developed secondary male characteristics

and was diagnosed to have Congenital Adrenal ;yperplasiaECA;F which is a condition where persons thus aYictedpossess both male and "emale characteristics. 5he "urtheralleged that she was diagnosed to have clitoral hyperthropy inher early years and at age si7, underwent an ultrasoundwhere it was discovered that she has small ovaries. At agethirteen, tests revealed that her ovarian structures hadminimi8ed, she has stopped growing and she has no breast ormenstrual development. 5he then alleged that "or all interestsand appearances as well as in mind and emotion, she hasbecome a male person. &hus, she prayed that her birthcertifcate be corrected such that her gender be changed "rom"emale to male and her frst name be changed "rom (enni"er to

(e4.

6ssue: 'hether or not respondents petition o" correction o"

entries in the birth certifcate o" respondent to change her se7or gender, "rom "emale to male, on the ground o" her medicalcondition !nown as CA;, and her name "rom I(enni"erI toI(e4,I under %ules 0/ and 0/ o" the %ules o" Court can beproperly granted

;eld: es

Rs+ondn# undis+u#dl% )as CAH/ T)is condi#ioncauss #) arl% or ?ina++ro+ria#? a++aranc o" ,alc)arac#ris#ics/ A +rson& li; rs+ondn#& .i#) #)iscondi#ion +roducs #oo ,uc) andro(n& a ,al)or,on/A newborn who has chromosomes coupled withCA; usually has a E0F swollen clitoris with the urethral openingat the base, an ambiguous genitalia o"ten appearing moremale than "emale E3F normal internal structures o" the "emalereproductive tract such as the ovaries, uterus and "allopiantubes as the child grows older, some "eatures start to appearmale, such as deepening o" the voice, "acial hair, and "ailureto menstruate at puberty. About 0 in 0/,/// to 0,///children are born with CA;.

CAH is on o" ,an% condi#ions #)a# in$ol$ in#rs:ana#o,%/ During the twentieth century, medicine adoptedthe term Iinterse7ualityI to apply to human beings whocannot be classifed as either male or "emale. &he term is nowo" widespread use. According to 'i!ipedia, interse7uality Iisthe state o" a living thing o" a gonochoristic species whose se7chromosomes, genitalia, andQor secondary se7 characteristicsare determined to be neither e7clusively male nor "emale. Anorganism with interse7 may have biological characteristics o"both male and "emale se7es.I

6nterse7 individuals are treated in di4erent ways by di4erentcultures. 6n most societies, interse7 individuals have beene7pected to con"orm to either a male or "emale gender role.5ince the rise o" modern medical science in 'estern societies,some interse7 people with ambiguous e7ternal genitalia havehad their genitalia surgically modifed to resemble either maleor "emale genitals. >ore commonly, an interse7 individual isconsidered as su4ering "rom a IdisorderI which is almostalways recommended to be treated, whether by surgeryandQor by ta!ing li"etime medication in order to mold theindividual as neatly as possible into the category o" eithermale or "emale.

6n deciding this case, we consider the compassionate calls "orrecognition o" the various degrees o" interse7 as variations

which should not be sub)ect to outright denial. I6t has beensuggested that there is some middle ground between these7es, a Zno-mans land "or those individuals who are neithetruly Zmale nor truly Z"emale.I &he current state o" *hilippinestatutes apparently compels that a person be classifed eitheas a male or as a "emale, but this Court is not controlled bymere appearances when nature itsel" "undamentally negatessuch rigid classifcation.

6n the instant case, i" we determine respondent to be a"emale, then there is no basis "or a change in the birthcertifcate entry "or gender. ut i" we determine, based on

medical testimony and scientifc development showing therespondent to be other than "emale, then a change in thesub)ects birth certifcate entry is in order.

iologically, nature endowed respondent with a mi7edEneither consistently and categorically "emale nor consistentlyand categorically maleF composition. %espondent has "emaleEF chromosomes. ;owever, respondents body systemnaturally produces high levels o" male hormones EandrogenFAs a result, respondent has ambiguous genitalia and thephenotypic "eatures o" a male.

Bltimately, we are o" the view that .)r #) +rson is!iolo(icall% or na#urall% in#rs: #) d#r,inin("ac#or in )is (ndr classica#ion .ould ! .)a# #)indi$idual& li; rs+ondn#& )a$in( rac)d #) a( o"

,a@ori#%& .i#) (ood rason #)in;s o" )is)r s:%espondent here thin!s o" himsel" as a male and consideringthat his body produces high levels o" male hormonesEandrogenF there is preponderant biological support "oconsidering him as being male. S:ual d$lo+,n# incass o" in#rs: +rsons ,a;s #) (ndclassica#ion a# !ir#) inconclusi$/ I# is a# ,a#uri#%#)a# #) (ndr o" suc) +rsons& li; rs+ondn#& is:d/

%espondent here has simply let nature ta!e its course and hasnot ta!en unnatural steps to arrest or inter"ere with what hewas born with. And accordingly, he has already ordered his li"eto that o" a male. %espondent could have undergonetreatment and ta!en steps, li!e ta!ing li"elong medication, to"orce his body into the categorical mold o" a "emale but he didnot. ;e chose not to do so.


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"or #) ordinar% +rson/ 8 canno# !u# rs+c# )o.rs+ondn# dals .i#) )is unordinar% s#a# and #)us)l+ ,a; )is li" asir& considrin( #) uni9ucircu,s#ancs in #)is cas/

As "or respondents change o" name under %ule 0/, thisCourt has held that a change o" name is not a matter o" rightbut o" )udicial discretion, to be e7ercised in the light o" thereasons adduced and the conse#uences that will "ollow.S3T

&he trial courts grant o" respondents change o" name "rom(enni"er to (e4 implies a change o" a "eminine name to a

masculine name. Considering the conse#uence tharespondents change o" name merely recogni8es his pre"erredgender, we fnd merit in respondents change o" name. 5uch achange will con"orm with the change o" the entry in his birthcertifcate "rom "emale to male.

Cas Di(s# and Rla#d Pro$isions on L(al Mdicin !asd on A##%/ Rodl 0

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