Dear PAO,
I am an attending physician in a small hospital in our locality. Yesterday, an unconscious man was brought by the emergency ambulance. Unfortunately, our small hospital cannot accommodate him due to lack of facilities. However, because he is unconscious and does not have any relative with him, I could not get consent to transfer him to another hospital who could better give him the needed medical treatment. Is it legal to still transfer him without obtaining consent? Please help me be clarified. Thank you.
Dr. Nicolo

Dear Dr. Nicolo,
The government continues to establish laws and regulations to achieve its mandate to provide adequate health care for Filipinos. As a result, a law was created regarding the regulation of hospitals, whether private or public, refusing to provide the necessary medical treatment and support in cases of emergencies or serious conditions.

Under Section 1 of Republic Act (RA) 10932, it is prohibited for any hospital or clinic to refuse to provide initial medical services based on the lack of a deposit. Nonetheless, the law still allows an attending physician to refuse a patient due to a lack of facilities, subject to compliance with certain conditions. Accordingly:
“x x x Provided, That by reason of inadequacy of the medical capabilities of the hospital or medical clinic, the attending physician may transfer the patient to a facility where the appropriate care can be given, after the patient or his next of kin consents to said transfer and after the receiving hospital or medical clinic agrees to the transfer: Provided, however, That when the patient is unconscious, incapable of giving consent and/or unaccompanied, the physician can transfer the patient even without his consent: Provided, further, That such transfer shall be done only after necessary emergency treatment and support have been administered to stabilize the patient and after it has been established that such transfer entails less risks than the patient’s continued confinement: x x x”

Generally, consent of the patient or his next of kin is necessary before a patient may be transferred for medical care due to lack of facilities. However, the law allows attending physicians to transfer unconscious and or unaccompanied patients without consent, provided that they have already been given appropriate emergency care to stabilize their condition and it there is lesser risk in transferring them to another facility. Additionally, it is necessary that the receiving hospital or clinic agrees to the transfer.
To answer your question, as the attending physician, you may transfer the unconscious and unaccompanied patient without his consent after providing the needed emergency care and making sure that the receiving hospital or clinic has agreed to accept your patient. Failure to follow the requirement of the law exposes you to possible imprisonment or fine. Under Section 4 of the said law:

“Section 4. Section 4 of the same Act, as amended, is hereby further amended to read as follows:
“Sec. 4. Any official, medical practitioner or employee of the hospital or medical clinic who violates the provisions of this Act shall, upon conviction by final judgment, be punished by imprisonment of not less than six (6) months and one (1) day but not more than two (2) years and four (4) months, or a fine of not less than One hundred thousand pesos (₱100,000.00), but not more than Three hundred thousand pesos (₱300,000.00) or both, at the discretion of the court: Provided, however, That if such violation was committed pursuant to an established policy of the hospital or clinic or upon instruction of its management, the director or officer of such hospital or clinic responsible for the formulation and implementation of such policy shall, upon conviction by final judgment, suffer imprisonment of four (4) to six (6) years, or a fine of not less than Five hundred thousand pesos (₱500,000.00), but not more than One million pesos (₱1,000,000.00) or both, at the discretion of the court, without prejudice to damages that may be awarded to the patient-complainant: Provided, further, That upon three (3) repeated violations committed pursuant to an established policy of the hospital or clinic or upon the instruction of its management, the health facility’s license to operate shall be revoked by the DOH. The president, chairman, board of directors, or trustees, and other officers of the health facility shall be solidarily liable for damages that may be awarded by the court to the patient-complainant.”

We hope that we are able to answer your queries. This advice is based solely on the facts you have narrated and our appreciation of the same. Our opinion may vary when other facts are changed or elaborated.

We appreciate your trust and support.

Editor’s note: Dear PAO is a daily column of the Public Attorney’s Office. Questions for Chief Acosta may be sent to [email protected]