FIFTEENTH CONGRESS OF THE 
REPUBLIC OF THE PHILIPPINES 
First Regular Session 
) 
) 
) 
SENATE 
S. B. NO. 146 
'. ',1.0 
.( 
flECEIV"t) r.r··, .,~. 
Introduced'by Senator Pia Cayetano 
EXPLANATORY NOTE 
Section 15 Article II of the Constitution provides that "(t)he State shall protect and 
promote the right to health of the people and instill health consciousness." In addition, 
Section 11 of Article 12 states that "(t)he State shall adopt an integrated and 
comprehensive approach to health and development which shall endeavor to make 
essential goods, health and other social services available to the people at affordable 
costs." 
To give substance and spirit to the above constitutional precepts, the bill seeks to 
provide a "Magna Carta of Patients Rights and Obligations". Under this proposal, the 
duties and responsibilities of the government vis-a-vis the people's concomitant rights 
and obligations are stressed in order to give them decent, humane and quality health 
care. 
The proposed measure provides for individual and societal rights, as well as 
obligations of patients, health care practitioners and health care institutions. 
The bill also proposes a grievance mechanism wherein any complaint arising 
from violations of any of the rights of patients shall first be submitted for mediation. 
Premises considered, immediate passage of this bill is earnestly sought. 
t. A(JI 
SEN'J;OR PIUS. CAYETANO 


FIFTEENTH CONGRESS OF THE REPUBLIC 
) 
OF THE PHILIPPINES 
) 
First Regular Session 
) 
SENATE 
S.B. NO. 
1'16 
INTRODUCED BY SENATOR PIA S. CAYETANO 
AN ACT 
PROCLAIMING THE RIGHTS AND OBLIGATIONS OF PATIENTS, PROVIDING A 
GRIEVANCE MECHANISM THEREOF AND FOR OTHER PURPOSES 
Be enacted by the Senate and House of Representatives of the Philippines in 
Congress assembled: 
SECTION 1. Short Title. - This Act shall be known as the "Magna Carta of 
Patient's Rights and Obligations of 2010." 
SEC. 2. Declaration of Policy. - It is hereby declared the policy of the State 
to promote the right to health of the people and instill health consciousness among 
them. It shall likewise protect and enhance the right of all people to human dignity 
thereby establishing the Magna Carta of Patient's Rights and Obligations in order to 
ensure a decent, humane and quality Health Care for all patients and Health Care 
Providers. 
SEC. 3. Definition of Terms. - As used in this Act, the following terms shall 
be defined as follows: 
a. Emergency Patient - one who is in immediate threat of dying or losing life 
or limb; 
b. Health Care - measures taken by a Health Care Provider or in a Health 
Care Institution in order to determine a patient's state of health or to 
restore or maintain it; 
c. Health Care Institution - a site devoted primarily to the maintenance and 
operation of facilities for the prevention, diagnosis, treatment and care of 
individuals suffering from illness, disease, injury or deformity if in need of 
medical and nursing care; 


d. Health Care Provider -
any physician, dentist, nurse, pharmacist or 
paramedic and other supporting health personnel, including, but not 
limited to, dental and medical technicians and technologists, nursing 
aides, therapists, nutritionists trained in Health Care and/or duly 
registered and licensed to practice in the Philippines as well as traditional 
and alternative Health Care practitioner; and 
e. Patient - a person who avails of the health and medical care services. 
SEC. 4. Individual Rights of Patients. - The following individual rights of 
Patients shall be respected by all those involved in the delivery of Health Care 
services: 
a. Right to Good Quality Health Care and Humane Treatment - Every 
person has a right to a continuity of good quality Health Care without 
discrimination and within the limits of the resources, manpower and 
competence available for health and medical care. In the course of such 
care, his human dignity, convictions, integrity, individual needs and 
culture shall be respected. 
If a Patient cannot immediately be given treatment that is medically 
necessary, he shall be informed of the reason for the delay and be 
treated in accordance with his best interests, Provided, that the treatment 
applied shall be in accordance with generally accepted medical principles. 
Emergency Patients shall be extended immediate medical care 
and treatment without requiring, as a prerequisite thereof, any pecuniary 
consideration. 
b. Right to Dignity - The Patient's dignity, culture and value shall be 
respected at all times in medical care and teaching. Likewise, terminally ill 
patients shall be entitled to humane terminal care to make dying as 
dignified and comfortable as possible. 
c. Right to be Informed of His Rights and Obligations as a Patient -
Every person has the right to be informed of his rights and obligations as 
2 


a Patient. In line with this, the Department of Health, in coordination with 
Health Care Providers, professional and civic groups, the media, health 
insurance corporations, people's organizations and local government 
organizations, shall launch and sustain a nationwide information and 
education campaign to make known to the people their rights as Patients, 
as provided in this Act. It shall also be the duty of Health Care Institutions 
to inform Patients of their rights as well as of the institution's rules and 
regulations that apply to the conduct of the Patient while in the care of 
such institution. These rights and rules and regulations shall be posted in 
a bulletin board conspicuously placed in a Health Care Institution. 
d. Right to Choose His Physician I Health Institution - The Patient is free 
to choose the services of a physician or health institution of his choice 
except when he chooses to be confined in a charity ward. In this case, 
the attending physician shall be the consultant under whose service the 
patient was admitted as appearing in the Doctor's Order Sheet of the 
Medical Record. The Patient shall have the right to seek a second opinion 
and subsequent opinions, if necessary, from another physician or health 
institution, and to change his physician or health institution. 
e. Right to Informed Consent -
The Patient has a right to self-
determination and to make free decisions regarding himself/herself. 
However, the attending physician shall inform the Patient of the 
consequences of his/her decisions. 
A Patient who is mentally competent and is of legal age, or in his 
incapacity or age of minority, his legal representative, has a right to a 
clear explanation, in layman's terms, of all proposed or contemplated 
procedures, whether diagnostic or therapeutic, including the identity and 
professional circumstances of the person or persons who will perform the 
said procedure or procedures. The explanation shall include the amount 
of information necessary and indispensable for him to intelligently give his 
3 


consent, including, but not limited to, the benefits, risk, side effects and 
the probability of success or failure, as a possible consequence of said 
proposed procedure or procedures, including the implications of 
withholding consent. Ion the explanation, the comprehensive ability of the 
patient shall also be considered, taking into account his level of 
education, the dialect or language that he speaks and understands, and if 
possible, with the use of anatomic sketch or any materials or visual aids 
that may aid the Patient, or his legal representative, in fully understanding 
the proposed procedure or procedures. 
The right to informed consent shall likewise consider the 
voluntariness in which the Patient or his/her legal representative has 
given his/her consent, seeing to it that the Patient or his legal 
representative was allowed to ask questions, or that he/she is given the 
chance to consult his/her kin, or to seek another expert opinion. If the 
Patient is unconscious or is unable to express his/her will, informed 
consent must be obtained whenever possible from a legal representative, 
Provided however, That when medical intervention is urgently needed, 
the consent of the patient may be presumed, Provided further, That a 
physician should always try to save the life of a Patient who is 
unconscious due to suicide attempt. 
In the case of a Patient who is legally incompetent or is a minor, 
the consent of a legal representative is required, Provided however, That 
the Patient must be involved in the decision making process to the fullest 
extent allowed by his mental capacity. If the legally incompetent Patient 
can make rational decisions, his/her decisions must be respected, and 
he/she has the right to 'forbid disclosure of such information to his/her 
legal representative. 
If the patient's legal representative forbids treatment, but, in the 
opinion of the physician, it is contrary to the patient's best interest, the 
4 


physician may challenge this decision in court, Provided however, That in 
emergency cases, the physician shall act in the patient's best interest, 
Provided further, That in emergency cases where there is no one who 
can give consent on the patient's behalf, the physician can perform any 
emergency diagnostic or treatment procedure in the best interest of the 
patient. 
f. 
Right to Refuse Diagnostic and Medical Treatment - The Patient has 
the right to refuse diagnostic and medical treatment procedures, provided 
that the following conditions are satisfied; 
i. The Patient is of legal age and is mentally competent; 
ii. The Patient is informed of the medical consequences of his/her 
refusal; 
iii. The Patient releases those involved in his care from any 
obligation relative to the consequences of his/her decision; and 
iv. The Patient's' refusal will not jeopardize public health and 
safety. 
g. Right to Refuse Participation in Medical Research - The Patient has 
the right to be advised of plans to involve him/her in medical research that 
may affect the care or treatment of his/her condition. Any proposed 
research shall be performed only upon the written informed consent of the 
Patient. 
h. Right to Religious Belief and Assistance - The Patient has the right to 
receive spiritual and moral comfort, including the help of a priest or 
minister of his/her chosen religion. He/she also has the right to refuse 
medical treatment or procedures which may be contrary to his religious 
beliefs, subject to the limitations described in paragraph 6 of this Section. 
i. 
Right To Privacy and Confidentiality - The patient has the right to 
privacy and protection from unwarranted publicity. The right to privacy 
shall include the patient's right not to be subjected to exposure, private or 
5 


public, either by photography, publications, video-taping, discussion, or by 
any other means that would otherwise tend to reveal his person and 
identity and the circumstances under which he was, he is, or he will be, 
under medical or surgical care or treatment. 
The Patient and his/her legal representative has the right to be 
informed by the physician or his/her legal representative of the patient's 
continuing Health Care requirements following discharge, including 
instructions about home medications, diet, physical activity and other 
pertinent information. 
All identifiable information about a patient's health status, medical 
condition, diagnosis, prognosis and treatment, and all other information of 
a personal kind, must be kept confidential even after death, Provided, 
That descendants may have a right of access to information that will 
inform them of their health risks. 
All identifiable Patient data must also be protected. The protection 
of the data must be appropriate as to the manner of its storage. Human 
substance from which identifiable data can be derived must be likewise 
protected. 
Confidential information can be disclosed in the following cases: 
i. 
When the patient's medical or physical condition is in 
controversy in a court litigation and the court, in its discretion, 
orders the patient to submit to physical or mental examination 
of a physician; 
ii. 
When public health or safety so demands; 
iii. When the Patient, or in 
his incapacity, his/her legal 
representative, expressly gives the consent; 
iv. When the patient's medical or surgical condition is discussed 
in a medical or scientific forum for expert discussion for 
his/her benefit or for the advancement of science and 
6 


medicine, Provided however, That the identity of the Patient 
should not be revealed; and 
v. When it is otherwise required by law. 
j. 
Right to Disclosure of, and Access to, Information - In the course of 
the patient's treatment and hospital care, the Patient or his/her legal 
guardian has the right to be informed of the result of the evaluation of the 
nature and extent of his/her disease. Any other additional or further 
contemplated medical treatment on surgical procedure or procedures, 
shall be disclosed and may only be performed with the written consent of 
the patient. 
The disclosure of information may be withheld if giving the 
information to the Patient will cause mental suffering or further impair his 
health, Provided, That such disclosure may be withheld or deferred to 
some future opportune time upon due consultation with the patient's 
immediate family, Provided further, That such information must be given 
in a way that is appropriate to the local culture and in a manner the 
Patient can understand. 
The Patient has the right to choose who he/she desires should be 
informed on his behalf, Provided however, That the Patient also has the 
right not to be informed on his explicit request, unless it is required for the 
protection of another person's life. 
The Patient has the right to be given, and examine, an itemized bill 
for hospital and medical services rendered. He is entitled to a thorough 
explanation of such bill. 
k. Right to Correspondence and to Receive Visitors - The Patient has 
the right to communicate with his/her relatives and other persons and to 
receive visitors subject to reasonable limits prescribed by the rules and 
regulations of the Health Care Institution. 
7 


I. 
Right to Medical Records -
The Health Care Institution and the 
physician shall ensure and safeguard the integrity and authenticity of the 
medical records. 
The Patient, upon his/her request, is entitled to a medical 
certificate and clinical abstract. He/she has the right to view, and obtain 
an explanation of, the contents of his/her medical records from the 
attending physician, except for psychiatric notes and other incriminating 
information obtained about a third party. 
The Patient may also obtain from the Health Care Institution a 
reproduction, at his/her expense, of his/her medical records, except for 
the psychiatric notes and incriminating evidence referred to above, 
Provided, That any relevant document that the Patient may require for 
insurance claims shall be made available to him within a reasonable 
period of time. 
m. Right to Health Education - Every person has the right to health 
education that will assist him in making informed choices about personal 
health and about available health services. The education shall include 
information about healthy lifestyles and about methods of prevention and 
early detection of illnesses. The personal responsibility of everybody for 
his own health should be stressed. 
n. Right to Leave Against Medical Advise - The Patient has the right to 
leave a hospital or any other Health Care Institution regardless of his 
physical condition, Provided, That: 
i. 
He/she is informed of the medical consequences of his/her 
decision; 
ii. He/she releases those involved in his/her care from any 
obligation relative to the consequences of his/her decision; 
and 
iii. His/her decision will not prejudice public health and safety. 
8 


o. Right to Express Grievances. - Every Patient has the right to express 
valid complaints and grievances about the care and services received 
and to know the disposition of such complaints, in accordance with 
Sections 7-8 of this Act. 
SEC. 5. Societal Rights of Patients. - In addition to the individual rights of 
Patients, the Patient has likewise the following societal rights: 
a. Right to Health - The Patient has the right to access quality Health Care 
and physicians who are free to render clinical and ethical judgment 
without interference or ~xtemal pressure. He has likewise the right to 
regain/and or acquire the highest attainable standard of health in a non-
discriminatory, gender sensitive and equal manner which health 
authorities and Health Care Providers must progressively contribute to 
realize. 
b. Right to Access to Quality Public Health Care - The Patient has the 
right to a comprehensive and integrated Health Care delivery system with 
the necessary manpower and facility resources. He shall also have the 
right to a functioning public health and Health Care facilities, needed 
programs, such as public health insurance, goods and services in 
sufficient quantity. He shall likewise be provided with health facilities and 
services with adequate provision for essential drugs, regular screening 
programs, appropriate treatment of prevalent diseases, illnesses, injuries 
and disabilities. Towards this end, the government shall approximate the 
international standard allocation for the health sector as set by the World 
Health Organization. 
c. Right to a Healthy and Safe Workplace - The Patient has the right to a 
healthy natural workplace environment with adequate supply of safe and 
potable water and basic sanitation, industrial hygiene, prevention and 
reduction of exposure to harmful substances, preventive measures for 
occupational 
accidents and 
diseases, 
and 
an 
environment that 
9 


discourages abuse of alcohol, tobacco and drug use, and the use of other 
harmful substances, 
d. Right to Medical Information and Education Programs - The Patient 
has the right to medical information and education programs on 
immunization; prevention, treatment and control of diseases; behavior-
related concerns; and disaster relief and emergency situations during 
epidemics and similar health hazards. The State shall endeavor to 
provide these information through lectures, symposia, tri-media, posters 
and the like. 
e. Right to Participate in Policy Decisions - The Patient has the right to 
participate in policy decisions relating to patient's right to health at the 
community and national levels. 
f. 
Right to Access to Health Facilities - The Patient has the right to be 
admitted to primary, secondary, tertiary and other specialty hospitals 
when appropriate and necessary. 
g. Right to an Equitable and Economical Use of Resources -
The 
Patient has the right to an equitable and economical use of resources 
such that health institutions, projects and programs of the State are 
equitably established and implemented in various regions of the country. 
h. Right to Continuing Health Care - The Patient has the right to avail of, 
or secure access to, programs that will ensure continuity of care in the 
form of hospice care, rehabilitation, chemotherapy, radiotherapy and 
other similar modalities. 
i. 
Right to Be Provided Quality Health Care In Times of Insolvency -
The Patient has the right, at all times, to access quality medical care in 
spite of insolvency. The State must provide for a system of payment to 
Health Care Institutions and Providers for all the valid and necessary 
medical expenses of the poor and marginalized citizens. 
10 


SEC. 6. The Obligations of Patients. - The Patient shall fulfill the following 
obligations and responsibilities regarding his/her medical care and/or personal 
behavior: 
a. Know Rights - The Patient shall ensure that he knows and understands 
what his/her rights as a Patient are and shall exercise those rights 
responsibly and reasonably. 
b. Provide Adequate, Accurate and Complete Information - The Patient 
shall provide, to the best of his/her knowledge, adequate, accurate and 
complete information about all matters pertaining to his/her health, 
including medications and past or present medical problems, ailments, 
medical history, consultation with other physicians, results of diagnostic 
work-up and treatment, to his/her Health Care Provider. 
c. Report Unexpected Health Changes -
The Patient shall report 
unexpected changes to his/her condition or symptoms, including pain, to 
his/her Health Care Provider. 
d. Understand the Purpose and Cost of Treatment - The Patient shall 
ensure that he/she understands the purpose and cost of any proposed 
treatment or procedure before deciding to accept it. He/she shall notify 
his/her Health Care Provider if he/she does not understand any 
information about the proposed care or treatment. The Patient shall insist 
upon explanations until adequately informed and shall endeavor to make 
all the necessary consultations before reaching a decision. 
e. Accept the Consequences of Own Informed Consent - The Patient 
shall accept all the consequences of his/her own informed consent. If 
he/she refuses treatment or does not follow the instructions or advice of 
the Health Care Provider, he/she must accept the consequences of such 
decision and relieve the Health Care Provider of any liability as a result of 
the exercise of his/her right to self-determination. 
11 


f. 
Settle Financial Obligations. -
The Patient shall ensure that the 
financial obligations as a result of his/her Health Care are fulfilled as 
promptly as possible. Otherwise, he/she shall make the appropriate 
arrangements to settle unpaid hospital bills and/or professional fees in 
accordance with Republic Act No. 9439. The patient must seek support 
from the State in order to establish a system of payment to Health Care 
Institutions and Providers. 
g. Respect the Rights. of Health 
Care Providers, 
Health Care 
Institutions and Other Patients - The Patient is obligated to give due 
respect to the rights and well-being of Health Care Providers, Health Care 
Institutions and other Patients. He shall act in a considerate and/or 
cooperative manner and shall give respect to the rights and properties of 
others. He shall follow the policies, rules and regulations, and procedures 
of Health Care Institutions. 
h. Obligation to Self - The Patient shall refrain from indulging in unhealthy 
food consumption; addiction forming substance foods such as tobacco, 
alcohol and drugs; lifestyles that have an adverse impact on health, such 
as sexual promiscuity and reckless activities; and contamination of the 
environment. The Patient is obligated to maintain a state of wellness. 
i. 
Provide Adequate Health Information and Actively Participate in 
His/Her Treatment. - The Patient shall ensure that he/she has adequate 
health information that will allow him/her to actively participate in the 
formulation of his/her diagnostic and treatment plans. When he/she signs 
an informed consent, it is assumed that he has the necessary information. 
j. 
Respect the Right to Privacy of Health Care Providers and 
Institutions. - The Patient has the obligation to submit grievances to the 
proper authorities or venue and not resort to unwarranted publicity in the 
media. He/she shall not disclose to the public any alleged complaint 
12 


against Health Care Providers and/or Institutions if it has not been fully 
decided by a court or administrative tribunal of prosper jurisdiction. 
k. Exercise Fidelity on Privileged Communication - A patient-physician 
relationship is a fiduciary one where mutual trust, respect and confidence 
are expected. 
All communications are privileged and the patient is 
obliged not to breach this privileged communication especially if it 
involves a third party. 
\. 
Respect a Physician's Refusal to Treat Him - While the Patient has 
the right to choose his/her physician, he/she is also obligated to respect 
the physician's decision to choose whom he/she will treat. 
m. Respect the Physician's Decision on Medical Reasons based on 
His/Her Religious Beliefs -
The Patient is obliged to respect the 
physician's religious beliefs. If the Patient is a minor or is legally 
incapacitated, his/her parents or legal representatives are obliged to 
likewise respect the physician's decision on matters relating to medical 
reasons despite their religious beliefs. 
n. Ensure Integrity and Authenticity of Medical Records - The Patient is 
obliged to ensure the integrity and authenticity of his/her medical records. 
Any manner of alteration of his/her records is a criminal offense subject to 
the provisions of the Revised Penal Code. 
o. Participate in the Training of Competent Future Physicians - The 
Patient is obligated to participate in the training of future physicians 
provided that necessary information is provided to him/her and the 
appropriate ethical considerations are observed. 
p. Report Infractions and Exhaust Grievance Mechanism. - The Patient 
shall immediately inform his/her Health Care Provider of any perceived or 
alleged infraction of his/her rights as set forth in this Act through proper 
channels in order to promote mutual trust, respect and confidence 
between the Provider and the and Patient. The Patient shall exhaust the 
13 


grievance mechanism mediation provided in Sections 7-8 of this Act 
before filing any administrative or legal action. 
SEC. 7. 
Grievance Mechanism. -
Any written complaint arising from 
violation of any of the rights of patients shall first be submitted for mediation. There 
shall be two (2) forms of mediation: 
the hospital-based mediation and the 
barangay-based mediation. 
The hospital-based mediation committee shall be composed of a physician 
who shall be appointed by the hospital and shall act as chairperson and two other 
(2) physicians recommended by the Philippine Medical Association local component 
society and acceptable to both parties as members. The chairperson and the 
members of the committee must be in good standing of the PMA and its local 
component society. 
The barangay-based mediation committee shall be composed of the local 
health officer as chairperson, one from the religious or duly accredited people's 
organization, and one from the PMA local component society who is a member in 
good standing. 
The mediation procedure shall not be adversarial in nature. The Patient and 
the Health Care Provider shall be given the opportunity to discuss the complaint and 
efforts shall be made for its amicable settlement. No monetary compensation nor 
legal counsels shall be involved at this stage. 
The aggrieved party shall be given thirty (30) days from occurrence of the 
incident to file his/her written complaint for mediation. Upon receipt of the written 
complaint, the concerned mediation committee shall have ninety (90) days to 
resolve the complaint. 
A successful mediation shall bar the filing of any judicial or administrative 
actions. 
SEC. 8. Second-Tier Mediation. - When mediation fails or no agreement 
is reached after the lapse of the ninety (90) day period, the mediation committee 
14 


shall refer the complaint to the' PMA through its local component society for 
appropriate administrative action. 
The PMA local component society shall serve as the second tier mediation. It 
shall be composed of the president of the local society as the presiding officer and 
one representative from each of the following: component medical society, specialty 
society corresponding to the case, the People's Health Watch or other civic 
organizations, and a representative from the local religious organization. The PMA 
component society shall render its decision within sixty (60) days from receipt of the 
complaint. 
In the event that the second tier medication fails, the case shall be 
automatically referred to the PMA Commission on Ethics which shall likewise render 
its decision within sixty (60) days from receipt of the complaint. 
Resort to mediation and referral to the PMA Commission on Ethics shall be a 
condition precedent to the filing of a legal action in court. 
All parties to the complaint shall be bound by the rules on confidentiality on 
all levels of the mediation. 
All minutes of the mediation proceedings shall not be disclosed to any party 
unless authorized by the court of law. Any discussion held or admissions made 
therein shall not be used for or against any party in subsequent or other 
proceedings. 
In the event there is compensation, it shall be limited to actual monetary loss 
due to treatment related to physical injuries. It shall not cover for "pain and 
suffering" or other explicit non-monetary loss. An award shall bar the patient from 
filing any other legal actions. 
SEC. 9. Prescriptive Period. - The time during which the case is submitted 
for mediation shall toll the running of the prescriptive period for the filing of a civil or 
criminal case under the Revised Penal Code or any administrative case under 
existing laws. 
15 


SEC.10. Inclusion In School Curriculum, Licensure Examinations and 
Training. -
The provisions of this Act shall be considered in the medical and 
medical-related school curriculum and licensure examinations, including trainings 
and seminars of traditional and alternative Health Care Providers or practitioners. 
SEC. 11. Rules and Regulations. - The Secretary of Health, in consultation 
with the Philippine Medical Association, the Philippine Hospital Association, the 
Philippine Institute of Traditional and Alternative Health Care and other concerned 
private agencies, non-governmental organization and people's organizations shall 
promulgate such rules and regulations as may be necessary for its implementation 
within One Hundred Eighty (180) days from the effectivity of this Act. 
SEC. 12. Repealing Clause. -
All Acts, Executive Orders, Rules and 
Regulations, or parts thereof that are inconsistent with the provisions of this Act are 
hereby repealed or modified accordingly. 
SEC. 13. Effectivity. - This Act shall take effect fifteen (15) days after the 
date of its publication in at least two (2) major newspapers of general circulation. 
Approved, 
16