FIFTEENTH CONGRESS OF THE REPUBLIC 
) 
OF THE PHILIPPINES 
) 
Second Regular Session 
) 
SENATE 
s.No.3156 
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11AR 19 r 2 :49 
Introduced by Senator Miriam Defensor Santiago 
EXPLANATORY NOTE 
The Constitution provides: 
Article 2, Section 15, The State shall protect and promote the right to 
health of the people and instill health consciousness among them. 
Article 13, Section 11. The State shall adopt an integrated and 
comprehensive approach to health development which shall endeavor to make 
essential goods, health and other social services available to all the people at 
affordable cost. There shall be priority for the needs of the underprivileged, sick, 
elderly, disabled, women, and children. The State shall endeavor to provide free 
medical care to paupers. 
In medicine, end-of-life care refers to medical care not only of patients in the final hours 
or days of their lives, but more broadly, medical care of all those with a terminal illness or 
terminal condition that has become advanced, progressive, and incurable. 
End-of-life care requires a range of tough decisions, such as questions of palliative care; 
patients' right to treatment and quality health care; and the ethics and efficacy of extraordinary or 
hazardous medical interventions, and even of continued routine medical interventions. 
Ultimately, end-of-life treatments are subject to considerations of patient autonomy. It is up to 
patients and their fanlilies to determine when to pursue aggressive treatment or withdraw life 
support. 
This bill provides for comprehensive information and cowlseling on end-oOife care 
options to patients and their families, to alleviate the physical, emotional, social, and spiritual 
discomfOiis of an individual who is experiencing the last phases of life due to the existence of a 
terminal disease, and provide supportive care to the primary caregiver and the family of the 
patient. 
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! , 


FIFTEENTH CONGRESS OF THE REPUBLIC 
OF THE PIIILIPPINES 
Second Regular Session 
) 
) 
) 
SEN1TE 
S. No. 3 56 
Introduced by Senator Miriam Defensor Santiago 
I 
~Acr 
'12 
MI~ 19 P;,' :49 
Vi: e 
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PROVIDING FOR END-OF-LIFE CARE TO PATIENTS AND THEIR FAMILY MEMBERS 
Be it enacted by the Senate and the House of Representatives of the Philippines in 
Congress assembled: 
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SECTION I. Short Title. - This Act shall be known as the "End-of-Life Care Act of 
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2012." 
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SECTION 2. Declaration of Policy. - It is the policy of the State to protect and promote 
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the right to health and quality health care of the people. It is also the policy ofthe State to adopt 
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an integrated and comprehensive approach to health development which shall endeavour to make 
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essential goods, health, and other services available to all at affordable cost. 
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SECTION 3. Definition of Terms. - For purposes of this Act, the following definitions 
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shall apply: 
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(A) 
"Actively dying" means the phase ofterminal illness when death is imminent. 
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(B) 
"Disease-targeted treatment" means treatment directed at the underlying disease 
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or condition that is intended to alter its natural history or progression, irrespective of whether or 
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not a cure is a possibility. 
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(C) 
"Health care provider" means an attending physician and surgeon. It also means a 
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nurse practitioner or physician assistant practicing in accordance with standardized procedures or 
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protocols developed and approved by the supervising physician and surgeon and the nurse 
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practitioner or physician assistant. 
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(D) 
"Health facility" means any facility, place, or building that is organized, 
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maintained, and operated for the diagnosis, care, prevention, and treatment of human illness, 
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physical or mental, including convalescence and rehabilitation and including care during and 
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after pregnancy, or for anyone or more of these purposes, for one or more persons, to which the 
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persons are admitted for a 24-hour stay or longer. 
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(E) 
"Hospice" means a specialized form of interdisciplinary health care that is 
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designed to provide palliative care, alleviate the physical, emotional, social, and spiritual 
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discomforts of an individual who is experiencing the last phases of life due to the existence of a 
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terminal disease, and provide supportive care to the primary caregiver and the family of the 
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hospice patient. 
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(F) 
"Palliative care" means medical treatment, interdisciplinary care, or consultation 
provided to a patient or family members, or both, that has as its primary purpose the prevention 
of, or relief from, suffering and the enhancement of the quality of life, rather than treatment 
aimed at investigation and intervention for the purpose of cure or prolongation of life. In some 
cases, disease-targeted treatment may be used in palliative care. 
(G) 
"Refusal or withdrawal oflife-sustaining treatment" means foregoing treatment or 
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medical procedures that replace or SUppOit an essential bodily function, including, but not limited 
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to, cardiopulmonary resuscitation, mechanical ventilation, artificial nutrition and hydration, 
dialysis, and any other treatment or discontinuing any or all of those treatments after they have 
been used for a reasonable time. 
SECTION 4. Information and Counseling on Legal End-of Life Care Options. - When a 
health care provider makes a diagnosis that a patient has a terminal illness, the health care 
provider shall, upon the patient's request, provide the patient with comprehensive information 
and counseling regarding legal end-of-life care options pursuant to this section. When a 
terminally ill patient is in a health facility, the health care provider, or medical director of the 
health facility if the patient's health care provider is not available, may refer the patient to a 
hospice provider or private or public agencies and community-based organizations that 
specialize in end-of-life care case management and consultation to receive comprehensive 
infonnation and counseling regarding legal end-of-life care options. 
(A) 
If the patient indicates a desire to receive the information and counseling, the 
comprehensive information shaH include, but not be limited to, the following: 
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(1) 
Hospice care at home or in a health care setting. 
(2) 
A prognosis with and without the continuation of disease-targeted treatment. 
(3) 
The patient's right to refusal of or withdrawal from life-sustaining treatment. 
(4) 
The patient's right to continue to pursue disease-targeted treatment, with or 
without concurrent palliative care. 
(5) 
The patient's right to comprehensive pain and symptom management at the end of 
life, including, but not limited to, adequate pain medication, treatment of nausea, 
palliative chemotherapy, relief of shortness of breath and fatigue, and other 
clinical treatments useful when a patient is actively dying. 
(6) 
The patient's right to give individual health care instruction, such as an advance 
health care directive, and the patient's right to appoint a legally recognized health 
care decisionmaker. 
(B) 
The information described in subdivision (A) may, but is not required to, be in 
writing. Health care providers may utilize information from organizations specializing in end-of-
life care that provide information on factsheets and Internet Web sites to convey the information 
described in subdivision (A). 
(C) 
Counseling may include, but is not limited to, discussions about the outcomes for 
the patient and his or her family, based on the interest ofthe patient. Information and counseling, 
as described in subdivision (A), may occur over a series of meetings with the health care 
provider or others who may be providing the information and counseling based on the patient's 
needs. 
(D) 
The information and counseling sessions may include a discussion of treatment 
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options in a manner that the patient and his or her family can easily understand. If the patient 
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requests information on the costs of treatment options, including the availability of insurance and 
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eligibility of the patient for coverage, the patient shall be referred to the appropriate entity for 
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that information. 
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SECTION 5. If a health care provider does not wish to comply with his or her patient's 
request for information on end-of-life options, the health care provider shall do both of the 
following: 
(A) 
Refer or transfer a patient to another health care provider that shall provide the 
requested information. 
(B) 
Provide the patient with information on procedures to transfer to another health 
care provider that shall provide the requested information. 
SECTION 6. Separability Clause. - If any provision, or part hereof is held invalid or 
unconstitutional, the remainder of the law or the provision not otherwise affected shall remain 
valid and subsisting. 
SECTION 7. Repealing Clause. - Any law, presidential decree or issuance, executive 
order, letter of instruction, administrative order, rule or regulation contrary to or inconsistent 
with, the provisions of this Act is hereby repealed, modified, or amended accordingly. 
SECTION 8. Effectivity Clause. - This Act shall take effect fifteen (15) days after its 
publication in at least two (2) newspapers of general circulation. 
Approved, 
/jab031912 
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