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Physician-Patient Privilege Communication Rule


Sec. 24. Disqualification by reason of privileged communication. — The following persons cannot testify as to matters learned in confidence in the following cases:
x x x
(c) A person authorized to practice medicine, surgery or obstetrics cannot in a civil case, without the consent of the patient, be examined as to any advice or treatment given by him or any information which he may have acquired in attending such patient in a professional capacity, which information was necessary to enable him to act in capacity, and which would blacken the reputation of the patient; (Rule 130, Rules of Court)


What does the physician-patient privileged communication rule mean? 

The physician-patient privileged communication rule essentially means that a physician who gets information while professionally attending a patient cannot in a civil case be examined without the patient’s consent as to any facts which would blacken the latter’s reputation. (Chan vs. Chan, G.R. No. 179786, July 24, 2013)


What is the rationale for the rule?

● This rule is intended to encourage the patient to open up to the physician, relate to him the history of his ailment, and give him access to his body, enabling the physician to make a correct diagnosis of that ailment and provide the appropriate cure. Any fear that a physician could be compelled in the future to come to court and narrate all that had transpired between him and the patient might prompt the latter to clam up, thus putting his own health at  great risk. (Chan vs. Chan)

●This rule on the physician-patient privilege is intended to facilitate and make safe full and confidential disclosure by the patient to the physician of all facts, circumstances and symptoms, untrammeled by apprehension of their subsequent and enforced disclosure and publication on the witness stand, to the end that the physician may form a correct opinion, and be enabled safely and efficaciously to treat his patient. It rests in public policy and is for the general interest of the community. (Lim vs. CA)


What requisites must concur in order that the privilege may be successfully claimed?

In order that the privilege may be successfully claimed, the following requisites must concur:

1.  the privilege is claimed in a civil case;

2. the person against whom the privilege is claimed is one duly authorized to practice medicine, surgery or obstetrics;

3. such person acquired the information while he was attending to the patient in his professional capacity;

4.  the information was necessary to enable him to act in that capacity; and

5. the information was confidential, and, if disclosed, would blacken the reputation of the patient. (Lim vs. CA, G.R. No. 91114. September 25, 1992)


Is the physician-patient privilege rule violated by permitting a physician to give expert opinion testimony in response to a strictly hypothetical question in a lawsuit involving the physical mental condition of a patient whom he has attended professionally?

The statutory physician-patient privilege, though duly claimed, is not violated by permitting a physician to give expert opinion testimony in response to a strictly hypothetical question in a lawsuit involving the physical mental condition of a patient whom he has attended professionally, where his opinion is based strictly upon the hypothetical facts stated, excluding and disregarding any personal professional knowledge he may have concerning such patient. But in order to avoid the bar of the physician-patient privilege where it is asserted in such a case, the physician must base his opinion solely upon the facts hypothesized in the question, excluding from consideration his personal knowledge of the patient acquired through the physician and patient relationship. If he cannot or does not exclude from consideration his personal professional knowledge of the patient’s condition he should not be permitted to testify as to his expert opinion. (Lim vs. CA)


May the privilege be waived?

Since the object of the privilege is to protect the patient, it may be waived if no timely objection is made to the physician’s testimony. (Lim vs. CA)


Cases:

Lim vs CA
G.R. No. 91114. September 25, 1992

Facts: Juan filed a petition for annulment of his marriage with Nelly on the ground that the latter has been allegedly suffering from a mental illness called schizophrenia "before, during and after the marriage and until the present." During trial, Juan's counsel announced that he would present as his next witness Dr. Lydia Acampado, a Doctor of Medicine who specializes in Psychiatry. Said counsel forthwith orally applied for the issuance of a subpoena ad testificandum. Nelly's counsel opposed the motion on the ground that the testimony sought to be elicited from the witness is privileged since the latter had examined the Nelly in a professional capacity and had diagnosed her to be suffering from schizophrenia. Juan's counsel contended, however, that Dr. Acampado would be presented as an expert witness and would not testify on any information acquired while attending to Nelly in a professional capacity. The trial court denied the motion and allowed the witness to testify. Dr. Acampado thus took the witness stand, was qualified as an expert witness and was asked hypothetical questions related to her field of expertise. She neither revealed the illness she examined and treated Nelly for nor disclosed the results of her examination and the medicines she had prescribed.

Issue: Was the information given by the physician in her testimony in open court a privileged communication?

Held: No. The physician may be considered to be acting in his professional capacity when he attends to the patient for curative, preventive, or palliative treatment. Thus, only disclosures which would have been made to the physician to enable him "safely and efficaciously to treat his patient" are covered by the privilege. It is to be emphasized that "it is the tenor only of the communication that is privileged. The mere fact of making a communication, as well as the date of a consultation and the number of consultations, are therefore not privileged from disclosure, so long as the subject communicated is not stated." One who claims this privilege must prove the presence of these aforementioned requisites.

Petitioner failed to discharge that burden. In the first place, Dr. Acampado was presented and qualified as an expert witness. She did not disclose anything obtained in the course of her examination, interview and treatment of the petitioner; moreover, the facts and conditions alleged in the hypothetical problem did not refer to and had no bearing on whatever information or findings the doctor obtained while attending to the patient. There is, as well, no showing that Dr. Acampado’s answers to the questions propounded to her relating to the hypothetical problem were influenced by the information obtained from the petitioner. Otherwise stated, her expert opinion excluded whatever information or knowledge she had about the petitioner which was acquired by reason of the physician-patient relationship existing between them. As an expert witness, her testimony before the trial court cannot then be excluded.


Krohn vs. CA
G.R. No. 108854 June 14, 1994

Facts: Edgar filed a petition for the annulment of his marriage with Ma. Paz before the trial court.  In his petition, he cited the Confidential Psychiatric Evaluation Report which Ma. Paz merely denied in her Answer as "either unfounded or irrelevant."

At the hearing, Edgar took the witness stand and tried to testify on the contents of the Confidential Psychiatric Evaluation Report. This was objected to on the ground that it violated the rule on privileged communication between physician and patient. Edgar contends that the prohibition applies only to a physician and is not applicable to the case at bar where the person sought to be barred from testifying on the privileged communication is the husband and not the physician of the petitioner.

Held: In the instant case, the person against whom the privilege is claimed is not one duly authorized to practice medicine, surgery or obstetrics. He is simply the patient's husband who wishes to testify on a document executed by medical practitioners. Plainly and clearly, this does not fall within the claimed prohibition. Neither can his testimony be considered a circumvention of the prohibition because his testimony cannot have the force and effect of the testimony of the physician who examined the patient and executed the report.

Counsel for petitioner indulged heavily in objecting to the testimony of private respondent on the ground that it was privileged. He invoked the rule on privileged communications but never questioned the testimony as hearsay. It was a fatal mistake. For, in failing to object to the testimony on the ground that it was hearsay, counsel waived his right to make such objection and, consequently, the evidence offered may be admitted.


Chan vs. Chan
G.R. No. 179786, July 24, 2013

Facts: Josielenefiled a petition for the declaration of nullity of her marriage to respondent Johnny. During the pre-trial conference, Josielene pre-marked the Philhealth Claim Form 1 that Johnny attached to his answer as proof that he was forcibly confined at the rehabilitation unit of a hospital. The form carried a physician’s handwritten note that Johnny suffered from “methamphetamine and alcohol abuse.” Following up on this point, Josielene filed with the RTC a request for the issuance of a subpoena duces tecum addressed to Medical City, covering Johnny’s medical records when he was there confined. Johnny opposed the motion, arguing that the medical records were covered by physician-patient privilege.

Held: The case presents a procedural issue, given that the time to object to the admission of evidence, such as the hospital records, would be at the time they are offered. The offer could be made part of the physician’s testimony or as independent evidence that he had made entries in those records that concern the patient’s health problems.

Since the offer of evidence is made at the trial, Josielene’s request for subpoena duces tecum is premature. She will have to wait for trial to begin before making a request for the issuance of a subpoena duces tecum covering Johnny’s hospital records. It is when those records are produced for examination at the trial, that Johnny may opt to object, not just to their admission in evidence, but more so to their disclosure.

It is of course possible to treat Josielene’s motion for the issuance of a subpoena duces tecum covering the hospital records as a motion for production of documents, a discovery procedure available to a litigant prior to trial. Section 1, Rule 27 of the Rules of Civil Procedure provides: x x x

But the above right to compel the production of documents has a limitation: the documents to be disclosed are “not privileged.”

Josielene of course claims that the hospital records subject of this case are not privileged since it is the “testimonial” evidence of the physician that may be regarded as privileged. Section 24(c) of Rule 130 states that the physician “cannot in a civil case, without the consent of the patient, be examined” regarding their professional conversation. The privilege, says Josielene, does not cover the hospital records, but only the examination of the physician at the trial.

 To allow, however, the disclosure during discovery procedure of the hospital records—the results of tests that the physician ordered, the diagnosis of the patient’s illness, and the advice or treatment he gave him— would be to allow access to evidence that is inadmissible without the patient’s consent. Physician memorializes all these information in the patient’s records. Disclosing them would be the equivalent of compelling the physician to testify on privileged matters he gained while dealing with the patient, without the latter’s prior consent.

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