The Supreme Court ruled that hospital records are protected by the physician-patient privilege and cannot be subpoenaed in a case for declaration of nullity of marriage without the patient’s consent. This means that private medical information shared between a patient and their doctor remains confidential and cannot be used against the patient in court unless they explicitly waive this right. The ruling emphasizes the importance of maintaining patient confidentiality to encourage open communication with healthcare providers and ensure proper medical care.

The Battle for Medical Records: Marriage Nullity vs. Patient Confidentiality

This case revolves around the attempt by Josielene Lara Chan to obtain the medical records of her husband, Johnny T. Chan, to support her petition for the declaration of nullity of their marriage. Josielene argued that Johnny’s alleged mental deficiency due to substance abuse justified the annulment. To bolster her claim, she sought a subpoena duces tecum, compelling Medical City to produce Johnny’s medical records from his confinement there. Johnny resisted, asserting that these records were protected by the physician-patient privilege. The central legal question is whether the need to prove marital issues outweighs the right to patient confidentiality in this specific context.

The Supreme Court grounded its decision on Section 24(c), Rule 130 of the Rules of Evidence, which explicitly protects privileged communication:

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 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 that capacity, and which would blacken the reputation of the patient.

This rule, the Court emphasized, serves a vital purpose: fostering open and honest communication between patients and their physicians. The Court explained that if patients fear that their medical information could be disclosed in court, they might be hesitant to share crucial details about their health, hindering accurate diagnosis and treatment. Therefore, protecting this privacy is paramount to ensuring effective healthcare.

The Court pointed out a procedural issue: Josielene’s request for a subpoena was premature. The proper time to object to the admission of evidence, including hospital records, is when they are formally offered in court. Section 36, Rule 132 of the Rules of Evidence dictates that objections must be raised immediately after the offer of evidence. Thus, Josielene needed to wait until the trial began and the records were presented before requesting a subpoena. This allowed Johnny the opportunity to object to both the admission and disclosure of the records.

The Court then considered Josielene’s request as a motion for production of documents, a discovery procedure outlined in Section 1, Rule 27 of the Rules of Civil Procedure:

SEC. 1. Motion for production or inspection; order.— Upon motion of any party showing good cause therefor, the court in which an action is pending may (a) order any party to produce and permit the inspection and copying or photographing, by or on behalf of the moving party, of any designated documents, papers, books, accounts, letters, photographs, objects or tangible things, not privileged, which constitute or contain evidence material to any matter involved in the action and which are in his possession, custody or control; or (b) order any party to permit entry upon designated land or other property in his possession or control for the purpose of inspecting, measuring, surveying, or photographing the property or any designated relevant object or operation thereon. The order shall specify the time, place and manner of making the inspection and taking copies and photographs, and may prescribe such terms and conditions as are just.

However, this rule also contains a crucial limitation: it applies only to documents that are “not privileged.” The Court reasoned that allowing the disclosure of hospital records during discovery would essentially bypass the protection afforded by the physician-patient privilege. Disclosing test results, diagnoses, and treatment plans would be tantamount to compelling the physician to testify on privileged matters without the patient’s consent. This would defeat the purpose of the privilege and discourage open communication between doctors and patients.

Josielene argued that Johnny had waived his right to privacy by attaching a Philhealth claim form to his answer, indicating his confinement. She cited Section 17, Rule 132 of the Rules of Evidence, which states:

SEC. 17. When part of transaction, writing or record given in evidence, the remainder admissible.— When part of an act, declaration, conversation, writing or record is given in evidence by one party, the whole of the same subject may be inquired into by the other, and when a detached act, declaration, conversation, writing or record is given in evidence, any other act, declaration, conversation, writing or record necessary to its understanding may also be given in evidence.

The Court rejected this argument, emphasizing that the trial had not yet begun, and Johnny had not formally presented the Philhealth claim form as evidence. Filing an answer does not equate to adducing evidence, making any request for disclosure premature. Until Johnny actively used the claim form as evidence, the privilege remained intact.

Justice Leonen, in his concurring opinion, suggested an alternative route for Josielene: Rule 28 of the Rules of Civil Procedure, which governs physical or mental examinations. This rule allows the court, under specific conditions and with good cause shown, to order a party to undergo a medical examination. This approach could provide a means for Josielene to obtain medical evidence relevant to her case, while also safeguarding Johnny’s right to privacy.

Justice Leonen also stated the importance of Rule 28 and how this balances the needs of the claimant and the right to privacy.

Discovery procedures provide a balance between the need of the plaintiff or claimant to fully and fairly establish her case and the policy to protect to a certain extent – communications made between a patient and his doctor. Hence, the physician-patient privilege does not cover information discovered under Rule 28. This procedure is availed with the intention of making the results public during trial. Along with other modes of discovery, this would prevent the trial from being carried on in the dark.

This case reaffirms the importance of the physician-patient privilege in Philippine law. It highlights the court’s commitment to protecting patient confidentiality and ensuring that individuals feel safe disclosing sensitive medical information to their doctors. While the need to present evidence in legal proceedings is important, it cannot override the fundamental right to privacy in medical matters.

FAQs

What was the key issue in this case?	The central issue was whether a wife could subpoena her husband’s medical records in a marriage annulment case, or if those records were protected by the physician-patient privilege.
What is the physician-patient privilege?	The physician-patient privilege protects confidential communications between a doctor and patient from being disclosed in court without the patient’s consent. This encourages patients to be open with their doctors to receive proper medical care.
Why did the Court deny the subpoena?	The Court denied the subpoena because the medical records were deemed privileged and the husband had not waived his right to confidentiality. Allowing the subpoena would violate the physician-patient privilege.
Did the husband’s answer to the petition waive his privilege?	No, the Court ruled that including a Philhealth claim form in his answer did not constitute a waiver of the privilege. The trial had not yet begun and he had not formally presented it as evidence.
What is a subpoena duces tecum?	A subpoena duces tecum is a court order requiring a person to produce certain documents or things in their possession for use as evidence in a legal proceeding.
What is a motion for production of documents?	A motion for production of documents is a discovery procedure that allows a party to request the opposing party to produce relevant documents for inspection and copying.
What is Rule 28 of the Rules of Civil Procedure?	Rule 28 pertains to the physical or mental examination of persons. This may be ordered by the court, in its discretion, upon motion and showing of good cause by the requesting party, in cases when the mental and/or physical condition of a party is in controversy.
Can a patient ever waive the physician-patient privilege?	Yes, a patient can waive the physician-patient privilege, typically by consenting to the release of their medical records or by testifying about their medical condition in court.

This ruling reinforces the sanctity of patient privacy in the Philippines, providing clear guidance on when medical records can be accessed in legal proceedings. It strikes a balance between the need for evidence and the fundamental right to confidentiality, ensuring that individuals feel safe seeking medical care without fear of their private information being exposed.

For inquiries regarding the application of this ruling to specific circumstances, please contact ASG Law through contact or via email at frontdesk@asglawpartners.com.

Disclaimer: This analysis is provided for informational purposes only and does not constitute legal advice. For specific legal guidance tailored to your situation, please consult with a qualified attorney.
Source: JOSIELENE LARA CHAN v. JOHNNY T. CHAN, G.R. No. 179786, July 24, 2013