Forensic Aspects of Consultation-

Liaison, Ethics, Informed Consent,

and Decision-Making Capacity
18th FVPA Post-Graduate Course
“Sharing Care: Psychiatry in the General Hospital Setting”
VMMC Dept. of Psychiatry
April 22, 2019
Basilio Valdes Hall, VMMC, Quezon City

Atty. Raúl Sy Grapilon, REB

“Forensic,” “consultation-liaison,” what?

Definitions
 Forensic

 Relating to or dealing with the application of scientific

knowledge to legal problems (Merriam-Webster, Inc.,
490)

 Belonging to courts of justice (Black, 648)

Consultation-Liaison Psychiatry

 Also known as psychosomatic medicine

 A subspecialty of psychiatry that focuses on the care

of patients with comorbid psychiatric and general
medical conditions (APA)
 Forensic Psychiatry

 That branch of medicine dealing with diseases and

disorders of the mind in relation to legal principles
and cases (Black, 649)
What are the common legal issues in consultation-liaison
psychiatry?

Forensic Aspects
 Issues

1. Competence to consent to, or refuse, treatment

 Informed consent
 Discharge against medical advice

2. Confidentiality and privilege in consultations

(Resnick, et al.)
 First issue

Competence to consent to, or

refuse, treatment
 Civil Personality

 Juridical capacity
 Fitness to be the subject of legal relations
 Inherent in every natural person
 Lost only through death

 Capacity to act
 Power to do acts with legal effect
 Acquired and may be lost (Art. 37, CCP)
 Capacity to Act

 Minority, insanity or imbecility, among others

 are mere restrictions on capacity to act, and
 do not exempt the incapacitated person from certain
obligations, as when the latter arise from his acts (Art.
38, CCP)
 Presumption

 Capacity to act must be supposed to attach to a

person who has not previously been declared
incapable and
 Such capacity is presumed to continue so long as the
contrary be not proved, that is, that at the moment of
his acting he was incapable, crazy, insane, or out of
his mind (The Standard Oil Company of New York v.
Arenas, et al.)
 Presumption

 There is a presumption that a person, once shown to

have been afflicted with insanity or lunacy of a
permanent character has remained so, and this
presumption prevails, even in the absence of a
special finding of the court, until the contrary is
shown (US v. Guendia)
 Presumption

 All persons, including service users, persons with

disabilities, and minors, shall be presumed to
possess legal capacity for the purposes of the Mental
Health Act or any other applicable law, irrespective of
the nature or effects of their mental condition or
disability (§8, MHA)
 Presumption

 An assumption of fact that the law requires to be

made from another fact or group of facts found or
otherwise established in the action
 An inference as to the existence of a fact not actually
known, arising from its usual connection with another
which is known, or a conjecture based on past
experience as to what course of human affairs
ordinarily take (Mabunga v. People)
 Presumption

 Has the effect of shifting the burden of proof to the

party who would be disadvantaged by a finding of the
presumed fact
 The presumption controls decision on the presumed
fact unless there is counterproof that the presumed
fact is not so (Mabunga v. People)
 Competence

 Refers to the degree of mental soundness necessary

to make decisions about a specific issue or to carry
out a specific act

 A legal, not a medical, state

 Only a court can make a determination of

incompetence (Resnick, et al.)
 Capacity Evaluation

 Capacity is defined as an individual’s ability to make an

informed decision

 Any licensed physician may make a determination of

capacity

 Forensic psychiatrists, however, are especially suited to

assess a person’s mental status and its potential for
interfering with specific areas of functioning (Resnick, et
al.)
 Capacity Evaluation

 Components
 Comprehension of relevant information
 Free or voluntary choice
 Reliability (Resnick, et al.)
 Proof

 General rule: The opinion of a witness is not admissible

(§48, Rule 130, ROC)
 Exceptions:
 Opinion of expert witness: the opinion of a witness on a
matter requiring special knowledge, skill, experience or
training which he is shown to possess, may be received in
evidence (§49, Rule 130, ROC)
 Opinion of ordinary witness: the opinion of a witness for
which proper basis is given, may be received in evidence
regarding the mental sanity of a person with whom he is
sufficiently acquainted (§50, Rule 130, ROC)
 Proof

 The testimony of the alleged incompetent himself has

peculiar cogency in the determination of whether he
should be placed under guardianship (Baluyut v.
Luciano, et al.)
 Incompetence

 Incompetence is defined by one’s functional deficits

(e.g., due to mental illness, mental retardation or
other mental condition), which are judged to be
sufficiently great that the person cannot meet the
demands of a specific decision-making situation
weighed in light of its potential consequences
(Resnick, et al.)
 Incompetence

 All alienists and those writers who have treated of this

branch of medical science distinguish numerous
degrees of insanity and imbecility, some of them, as
Casper, going so far into a wealth of classification and
details as to admit the existence of 60 to 80 distinct
states (The Standard Oil Company of New York v.
Arenas, et al.)
 Incompetence

 Hence, the confusion and the doubt in the minds of

the majority of the authors of treatises on the subject
in determining the limits of sane judgment and the
point of beginning of this incapacity (The Standard Oil
Company of New York v. Arenas, et al.)
 Incompetence

 there being some who consider as a sufficient cause

for such incapacity, not only insanity and imbecility,
but even those other chronic diseases or complaints
that momentarily perturb or cloud the intelligence, as
mere monomania, somnambulism, epilepsy,
drunkenness, suggestion, anger, and the diverse
passional states which more or less violently deprive
the human will of necessary liberty (The Standard Oil
Company of New York v. Arenas, et al.)
 Incompetence

 In the interpretative jurisprudence on this kind of

incapacity, to wit, lunacy or insanity, it is a rule of constant
application that is not enough that there be more or less
probability that a person was in a state of dementia at a
given time, if there is not direct proof that, at the date of
the performance of the act which it is endeavored to
invalidate for want of capacity on the part of the executor,
the latter was insane or demented, in other words, that he
could not, in the performance of that act, give his
conscious, free, voluntary, deliberate and intentional
consent (The Standard Oil Company of New York v. Arenas,
et al.)
 Incompetence

 Impairment or Temporary Loss of Decision-Making

Capacity refers to a medically-determined inability on
the part of a service user or any other person affected
by a mental health condition, to provide informed
consent (§4(g) MHA)
 Incompetence

 A service user has impairment or temporary loss of

decision-making capacity when the service user as
assessed by a mental health professional is unable to
do the following:
 Incompetence

1) Understand information concerning the nature of a

mental health condition

2) Understand the consequences of one’s decisions

and actions on one’s life or health, or the life or
health of others (§4(g), MHA)
 Incompetence

3) Understand information about the nature of the

treatment proposed, including methodology, direct
effect, and possible side effects; and

4) Effectively communicate consent to treatment or

hospitalization, or information regarding one’s own
condition (§4(g), MHA)
 Informed Consent

 In order for consent to medical treatment to be valid,

three things are required:
 The patient must have knowledge
 The patient must be competent
 The consent must be voluntary (Resnick, et al.)
 Informed Consent

 Informed Consent refers to:

 Consent voluntarily given by a service user to a plan for
treatment
 After a full disclosure communicated in plain language
by the attending mental health service provider, of the
 Nature,
 Consequences
 Benefits, and
 Risks of the proposed treatment, as well as
 Available alternatives (§4(h), MHA)
 Informed Consent
 Service users shall enjoy the right to give informed consent before
receiving treatment or care
 Including the right to withdraw such consent (§5(m), MHA)

 Service users must provide informed consent in writing prior to

the implementation of any plan or program of therapy or
treatment, including physical or chemical restraint (§8 MHA)

 Such consent shall be recorded in the service user’s clinical

record (§5(m), MHA)

 The Department of Health (DOH) shall develop guidelines to

obtaining and documenting informed consent (2nd ¶, §8, IRR)
 Exceptions

 Four (4) exceptions to informed consent

 Emergency
 Incompetence or lack of capacity to make decisions that
must be made without the benefit of the court
 Waiver
 Therapeutic privilege (Resnick, et al.)
 Exceptions

 Emergency
 Refers to the delivery of treatment without consent to a
patient who is unconscious or in imminent danger of
serious harm (Resnick, et al.)
 Psychiatric or Neurologic Emergency refers to a
condition presenting a serious and immediate threat to
the health and well-being of a service user or any other
person affected by a mental health condition, or to the
health and well-being of others, requiring immediate
medical intervention (§4(q), MHA)
 Exceptions

 Incompetence or lack of capacity

 Incompetent patients, by definition, cannot give
informed consent
 Consent should be obtained from a substitute decision-
maker or guardian (Resnick, et al.)
 Exceptions

 Waiver
 Refers to patient’s right to waive disclosure of
information
 Patients who waive their right to informed consent are
accepting the doctor’s decision to make unilateral
medical decisions
 e.g., a patient may tell the doctor: “Don’t tell me what’s
happening, just do what you think is best” (Resnick, et al.)
 Exceptions

 Therapeutic privilege
 Refers to a doctor’s decision to withhold information
from a patient because telling the patient would cause
psychological damage or render the patient ineffective
in decision-making
 Consultant psychiatrists may be asked to determine
whether the disclosure of information would result in
psychological damage to the patient or bring about an
irrational decision (Resnick, et al.)
 Right to Refuse Treatment

 A patient receives treatment only because he

consented to it

 A mentally competent patient is the master of his own

body, and has the right to accept or ignore his
doctor’s recommendation (Capule, citing Ruñez, Jr. v.
Jurado)
 Right to Refuse Treatment

 Doctors have no power to force patients into staying

under their care, save in certain instances, such as
when:
 The law makes treatment compulsory due to some
communicable disease
 Consent is withheld by a minor but non-treatment would
be detrimental
 The court of competent jurisdiction orders the treatment
(Ruñez, Jr. v. Jurado)
 Decision-Making

 The psychiatric consultant’s role or responsibility in

discharge against medical advice is to evaluate and
determine whether the patient:
 Has the capacity to refuse hospital treatment, or
 Meets involuntary commitment criteria (Resnick, et al.)
 Decision-Making

 If the patient lacks capacity to give informed consent

to medical treatment, the patient may need to be
referred for legal adjudication of competence
 When an incompetent patient refuses psychiatric
treatment, the court may become the vicarious
decision maker (Resnick, et al.)
 Decision-Making

 An individual who lacks capacity to make an informed

decision or give consent may:
 need to be referred for a competency hearing or
 need to have a guardian appointed (Resnick, et al.)
 Involuntary Commitment

 A hospital may legally detain a patient against his will:

1. When he is a detained or convicted prisoner, or
2. When the patient is suffering from a very contagious
disease where his release will be prejudicial to public
health, or
3. When the patient is mentally ill such that his release
will endanger public safety, or
4. In other exigent cases as may be provided by law
(Manila Doctors Hospital v. So Un Chua, et al.)
 Involuntary Commitment

 A petition for the commitment of a person to a

hospital or other place for the insane shall be filed by
the Director of Health in all cases where, in his
opinion, such commitment is:
 For the public welfare, or
 For the welfare of said person who, in his judgment
 Is insane and
 Such person or the one having charge of him is opposed to
his being taken to a hospital or other place for the insane
(§1, Rule 101, ROC)
 Involuntary Commitment

 When, in the opinion of the Director of Health, the

person ordered to be committed to a hospital or other
place for the insane is temporarily or permanently
cured, or may be released without danger, he may file
the proper petition with the Court of First Instance,
which ordered the commitment (§4, Rule 101, ROC)
 Procedure

 If the patient is found to have capacity to make

medical decisions, the patient’s preference for
treatment should be followed

 If the patient does not have the capacity to make

medical decisions, the advance directive will act as
the substitute decision-maker (Resnick, et al.), unless
doing so would pose an immediate risk of serious
harm to the patient or another person (§13(a), MHA)
 Advance Directive

 A service user may, through a signed, dated, and

notarized advance directive executed for the purpose:
 Set out his or her preference in relation to treatment(§9,
MHA)
 Appoint a legal representative to act on his or her behalf
(§4(i), MHA)
 An advance directive may be revoked by a new
advance directive or by a notarized revocation (§9,
MHA)
 Procedure

 In the event of incompetence and the absence of an

advance directive, the legal representative acts as the
substitute decision maker (Resnick, et al.)
 Legal Representative

 A service user may set designate a person of legal

age to act as his or her legal representative through a
notarized document executed for that purpose (§10,
MHA)
 Legal Representative

 If the service user fails to appoint a legal

representative, the following persons shall act as the
service user’s legal representative, in the order
provided below:
 Legal Representative

1) The spouse, if any, unless:

 Permanently separated from the service user by a
decree issued by a court of competent jurisdiction, or
 Such spouse has abandoned or been abandoned by
the service user for any period which has not yet
come to an end (§10(c)(1), MHA)
 Legal Representative

2) Non-minor children; (§10(c)(2), MHA)

3) Either parent by mutual consent if the service user
is a minor; (§10(c)(3), MHA)
 The father and mother shall jointly exercise parental
authority over the persons of their common children
 In case of disagreement, the father’s decision shall
prevail, unless there is a judicial order to the contrary
(Art. 211, FCP)
 Legal Representative

4) Chief, administrator, or medical director of a mental

health care facility; or (§10(c)(4), MHA)
 Mental health facility refers to any establishment, or
any unit of an establishment, which has, as its
primary function, the provision of mental health
services (§4(l), MHA)
5) A person appointed by the court (§10(c)(5), MHA)
 Court-appointed guardian?
 Guardian

• A guardian is an individual who has the legal authority and

the duty to care for another’s person or property
 The ward is the person for whom the guardian is
appointed
 The decision to appoint a guardian is made by a court
 The, ward, from that point on, may not enter into
contracts, manage funds, file lawsuits, or consent to
treatment (Resnick, et al.)
 Guardian

 A guardian appointed shall have the care and custody

of the person of his ward (§1, Rule 96, ROC)

 A person who has been declared incompetent for any

reason, or his guardian, relative, or friend, may
petition the court to have his present competency
judicially determined (§1, Rule 97, ROC)
 Guardian

 The word “incompetent” includes, inter alia:

 those who are of unsound mind, even though they have
lucid intervals and
 Persons not being of unsound mind, but by reason of
age, disease, weak mind, and other similar causes,
cannot, without outside aid, take care of themselves
and manage their property, becoming thereby an easy
prey for deceit and exploitation (§2, Rule 92, ROC)
 Flowchart

Service user with co-morbid medical and mental health conditions

Treatment compulsory Treatment not compulsory

Psychiatric or
Petition for Service user is incompetent due to an impairment or temporary
neurologic Service user is competent
commitment loss of decision-making capacity
emergency

Advance directive, unless

it would pose immediate
Consents to treatment Refuses treatment Advance directive, unless it would pose immediate risk of serious harm to patient or another
risk of serious harm to
patient or another

Review by internal review

Discharge against Spouse, non-minor children, or either parent if minor, Chief, administrator, or Attending mental health
board every fifteen (15)
medical advice refuses treatment medical director professional
days

Discharge against Petition for appointment Review by internal review

Petition for commitment
medical advice of guardian board
 No Liability

 A patient cannot attribute to a physician damages

resulting from his own failure to follow his advice,
even though he was ignorant of the consequences
which would result from his failure

 If a patient leaves the hospital contrary to

instructions, the physician is not liable for subsequent
events (Ruñez, Jr. v. Jurado)
 Criminal Liability
Failure to secure informed
consent
 Any person who fails to secure
informed consent of the
service user
 unless it is during psychiatric or
neurologic emergencies, or a
temporary loss of decision-
making capacity on his or her
part
Penalty
• Imprisonment of not less than six
(6) months, but not more than
two (2) years, and/or
• Fine of not less than Ten
thousand pesos (P10,000.00),
but not more than Two hundred
thousand pesos (P200,000.00)
(§44(a), MHA)
 Criminal Liability

Grave Coercions Penalty

 Any person who, without  The penalty of arresto mayor

authority of law, shall, by  One (1) month and one (1) day
means of violence, prevent to six (6) months; and a
another from doing something  Fine not exceeding 500 pesos
not prohibited by law, or
compel him to do something
against his will, whether it be
right or wrong (Art. 286, RPC)
 Criminal Liability

Arbitrary Detention Penalty

 Arbitrary detention  Arresto mayor in its maximum

period to prision correccional in
Any public officer or employee its minimum period, if the
who, without legal grounds, detention has not exceeded (3)
detains a person three days
 Prision correccional in its
medium and maximum periods,
if the detention has continued
more than three (3) but not more
than (15) fifteen days
 Criminal Liability

Arbitrary Detention Penalty

 Arbitrary detention  Prision mayor, if the detention

Any public officer or employee has continued more than
who, without legal grounds, fifteen (15) days but not more
detains a person (Art. 124, RPC) than six (6) months
 Reclusion temporal, if the
detention shall have exceeded
six (6) months
 Criminal Liability
Period/Duration Penalty
Not more than 3 days Four (4) months and
one (1) day to two (2)
years and four (4)
months
More than 3 days but Two (2) years, four (4)
not more than 15 days months and one (1) day
to six (6) years
Arbitrary detention
More than 15 days but Six (6) years and one
not more than 6 (1) day to twelve (12)
months years
More than 6 months Twelve (12) years and
one (1) day to twenty
(20) years
 Criminal Liability

 The following are considered legal grounds for the

detention of any person
 commission of a crime
 violent insanity or
 any other ailment requiring the compulsory confinement
of the patient in a hospital (2nd ¶, Art. 124, RPC)
 Criminal Liability
Illegal detention
 Any private individual who shall
kidnap or detain another, or in
any manner deprive him of his
liberty (Art. 267, RCP)
Penalty
 Reclusion perpetua to death
 If the detention shall have lasted
more than five (5) days
 If the person detained shall be a
minor, female or public officer
(Art. 267)
 Reclusion temporal if the
detention lasted less than five
(5) days (Art. 268, RPC)
 Criminal Liability

Period/Duration or Condition Penalty

Slight Illegal Detention Not more than 5 days Twelve (12) years and
one (1) day to twenty
(20) years
More than 5 days
Serious Illegal
Detention Person kidnapped is a Thirty (30) years
minor, female or a
public officer
 Civil Liability

 Any public officer or employee, or any private

individual, who directly or indirectly obstructs, defeats,
violates or in any manner impedes or impairs another
person’s freedom from arbitrary or illegal detention
shall be liable to the latter for damages (Art. 32, CCP)
 Every person who, contrary to law, willfully or
negligently causes damage to another, shall
indemnify the latter for the same (Art. 20, CCP)
 Administrative Liability

 Misconduct is defined as a transgression of some

established and definite rule of action, more particularly,
unlawful behavior or gross negligence by a public officer, a
forbidden act, a dereliction of duty, willful in character, and
implies wrongful intent and not mere error in judgment
 To constitute an administrative offense, misconduct should
relate to or be connected with the performance of the
official functions and duties of a public officer
 When the elements of corruption, clear intent to violate the
law or flagrant disregard of established rule are manifest,
the public officer shall be liable for grave misconduct
(Bondoc v. Mantala)
 Second issue

Confidentiality and Privilege in

Consultations
 Confidentiality and Privilege

Confidentiality Privilege

 Physician’s obligation to keep  Refers to the patient’s right to

information learned in a prevent a physician from
professional relationship providing testimony about
personal medical information
(Resnick, et al.)
 Confidentiality and Privilege

 The psychiatrist has a duty to honor the patient’s

privilege unless ordered to testify by a judge

 Information gained in confidence about a patient may

not be released without the authorization of the
patient (Resnick, et al.)
 Physician-Patient Privilege

 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 to such
patient in a professional capacity, which information was
necessary
 to enable him to act in such capacity, and
 which would blacken the reputation of the patient (§24(c), Rule 130,
ROC)
 Physician-Patient Privilege

 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 v. Chan)
 Physician-Patient Privilege

 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 (Chan v. Chan)
 Physician-Patient Privilege

 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 v. Chan)
 Physician-Patient Privilege

 Disclosing 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
 the equivalent of compelling the physician to testify on
privileged matters he gained while dealing with the
patient, without the latter’s prior consent (Chan v. Chan)
 Confidentiality and Privilege

 Confidentiality refers to ensuring that all relevant

information related to persons with psychiatric,
neurologic, and psychosocial health needs is kept
safe from access or use by, or disclosure to, persons
or entities who are not authorized to access, use, or
possess such information (§4(c), MHA)
 Confidentiality and Privilege

 Service users shall enjoy the right to confidentiality of

all information, communications, and records,
regarding the service user, any aspect of the service
user’s mental health, or any treatment or care
received by the service user, which information,
communications, and records, shall not be disclosed
to third parties without the written consent of the
service user concerned or the service user’s legal
representative…
 Exceptions

 except in the following circumstances:

1) Disclosure is required by law or pursuant to an order
issued by a court of competent jurisdiction
2) The service user has expressed consent to the disclosure
 A service user’s legal representative shall, inter alia,
receive medical information about the service user in
accordance with the Mental Health Act, act as substitute
decision maker, and be consulted with respect to any
treatment or therapy received by the service user
(§10(a)(1), (2), and (4), MHA)
 Exceptions

3) A life-threatening emergency exists and such

disclosure is necessary to prevent harm or injury to
the service user or to other persons
 Tarasoff v. Regents of the University of California
4) The service user is a minor and the attending mental
health professional reasonably believes that the
service user is a victim of child abuse
 Exceptions

5) Disclosure is required in connection with an

administrative, civil, or criminal case against a
mental health professional or worker for negligence
or a breach of professional ethics, to the extent
necessary to completely adjudicate, settle, or resolve
any issue or controversy involved therein (§5(l), MHA)
 Tarasoff

 When a therapist determines, or pursuant to the

standards of his profession should determine, that his
patient presents a serious danger of violence to
another, he incurs an obligation to use reasonable
care to protect the intended victim against such
danger
 Tarasoff

 The discharge of this duty may require the therapist to

take one or more of various steps, depending upon
the nature of the case. Thus it may call for him to
warn the intended victim or others likely to apprise
the victim of the danger, to notify the police, or to take
whatever other steps are reasonably necessary under
the circumstances
 Tarasoff

 The therapist’s obligations to his patient require that

he not disclose a confidence unless such disclosure is
necessary to avert danger to others, and even then
that he do so discreetly, and in a fashion that would
preserve the privacy of his patient to the fullest extent
compatible with the prevention of the threatened
danger
 Criminal Liability

 Any person who violates the confidentiality of

information, as defined under Section 4(c) of the
Mental Health Act shall be punished by
 imprisonment of not less than six (6) months, but not
more than two (2) years, or a
 fine of not less than Ten thousand pesos (P10,000.00),
but not more than Two hundred thousand pesos
(P200,000.00), or
 both, at the discretion of the court (§44(b), MHA)
 Conclusion

 The responsibilities of a consultation psychiatrist

include a general understanding of the legalities of
medical decision making
 Physicians evaluate a patient’s decision-making
capacity by clinical assessment
 Courts determine competence by a formal judicial
proceeding (Resnick, et al.)
 Authorities

 American Psychiatric Association, “Consultation-Liaison Psychiatry,” 2018, Online:

https://www.psychiatry.org/psychiatrists/practice/professional-interests/consultation-liaison-psychiatry
 Black, H. C., Black’s Law Dictionary, 6th Ed. [5th Rep.—1991]
 Capule, M.D., Atty. R. V., “When a Patient Fails to Heed Your Advice,” Legal Prescription, Philippine Journal of Internal
Medicine, Online: https://www.pcp.org.ph/files/PJIM%20Vol52%20No1/Legal_Prescription.pdf
 Merriam-Webster, Inc., Merriam-Webster’s Collegiate Dictionary, Eleventh Ed. (2012)
 Resnick, MD, P. J. and Sorrentino, MD, R., “Forensic Issues in Consultation-Liaison Psychiatry,” Psychiatric Times,
Issue 14, Vol. 23, December 1, 2005, Online: https://www.psychiatrictimes.com/forensic-issues-consultation-liaison-
psychiatry
 Rules of Court
 Act No. 3815, or “The Revised Penal Code”
 R.A. No. 386, or the “Civil Code of the Philippines”
 R.A. No. 3573, or the “Law on Reporting of Communicable Diseases”
 Executive Order No. 209 dated July 6, 1987, or the “Family Code of the Philippines”
 R.A. No. 11036, or the “Mental Health Act”
 Implementing Rules and Regulations (IRR) of Republic Act No. 11036, otherwise known as The Mental Health Act
 Cases

 The Standard Oil Company of New York v. Juan Condina Arenas, et al., G.R. No. L-5921, July 25,
1911
 The United States v. Evaristo Vaquilar, G.R. Nos. L-9471, March 13, 1914
 The United States v. Simeon Guendia, G.R. No. L-12462, December 29, 1917
 Marlene Dauden-Hernaez v. Hon. Walfrido de los Angeles… et al., G.R. No. L-27010, April 30 1969
 Vitaly Tarasoff, et al. v. The Regents of the University of California, et al., 17 Cal. 3d 425, July 1,
1976
 Encarnacion Lopez vda. de Baluyut v. Hon. Judge Leonor Ines Luciano… et al., G.R. No. L-42215,
July 13, 1976
 People of the Philippines v. Fernando Madarang y Magno, G.R. No. 132319, May 12, 2000
 Modesto “Moody” Mabunga v. People of the Philippines, G.R. No. 142039, May 27, 2004
 Samuel R. Ruñez, Jr. v. Marybeth V. Jurado, A.M. No. 2005-08-SC, December 9, 2005
 Manila Doctors Hospital v. So Un Chua, G.R. No. 150355, July 31, 2006
 Makati Stock Exchange, Inc., et al. v. Miguel V. Campos… G.R. No. 138814, April 16, 2009
 Josielene Lara Chan v. Johnny T. Chan, G.R. No. 179786, July 24, 2013
 Dr. Idol L. Bondoc v. Marilou R. Mantala, G.R. No. 203080, November 12, 2014