CONSTITUTIONAL LAW II TOPICS: POLICE POWER, DUE PROCESS AND EQUAL PROTECTION

TERESITA TABLARIN -vsTHE HONORABLE

JUDGE ANGELINA S. GUTIERREZ

No. L-78164

FACTS:
Republic Act 2382, as amended, also known as the: Medical Act of 1952 has the objective to provide for and shall govern (a) the standardization and regulation of medical education; (b) the examination for registration of physicians; and (c) the supervision, control and regulation of the practice of medicine in the Philippines." The statute created a Boar of Medical Education (BME). Among its functions are: " (a) To determine and prescribe requirements for admission into a recognized college of medicine; x x x (f) To accept applications for certification for admission to a medical school and keep a register of those issued said certificate; and to collect from said applicants the amount of twenty-five pesos each which shall accrue to the operating fund of the Board of Medical Education; (h) to promulgate and prescribe and enforce the necessary rules and regulations for the proper implementation of the foregoing functions." Under the statute, one of the admission requirements is a certificate of eligibility for entrance to a medical school from the BME. Subsequently, the then Minister of Education, Culture and Sports issued MECS Order No. 52 establishing a uniform admission test called the National Medical Admission Test (NMAT) as an additional requirement for the issuance of earlier stated certificate of eligibility. It ordered also that the cutoff score for the successful applicants, based on the scores on the NMAT, shall be determined every year by the Board of Medical Education after consultation with the Association of Philippine Medical Colleges which the petitioner assailed as a violation to the equal protection clause. Petitioner also contended that the MECS Order No. 52, s. 1985 is unfair, unreasonable and inequitable requirement which results in a denial of due process.

ISSUES:
Is there a violation of due process? Whether or not the assailed order is a valid exercise of police power. Is the assailed order violated the equal protection clause of the Constitution?

HELD:
The petitioners also urge that the NMAT prescribed in MECS Order No. 52, s. 1985, is an "unfair, unreasonable and inequitable requirement," which results in a denial of due process. Again, petitioners have failed to specify just what factors or features of the NMAT render it "unfair" and "unreasonable" or "inequitable." They appear to suggest that passing the NMAT is an unnecessary requirement when added on top of the admission requirements set out in Section 7 of the Medical Act of 1959, and other admission requirements established by internal regulations of the various medical schools, public or private. Petitioners arguments thus appear to relate to utility and wisdom or desirability of the NMAT requirement. But constitutionality is essentially a question of power or authority: this Court has neither commission or competence to pass upon questions of the desirability or wisdom or utility of legislation or administrative regulation. Those questions must be addressed to the political departments of the government not to the courts. There is another reason why the petitioners' arguments must fail: the legislative and administrative provisions impugned by them constitute, to the mind of the Court, a valid exercise of the police power of the state. The police power, it is commonplace learning, is the pervasive and non-waivable power and authority of the sovereign to secure and promote all the important interests and needs in a word, the public order of the general community. An important component of that public order is the health and physical safety and well being of the population, the securing of which no one can deny is a legitimate objective of governmental effort and regulation. Perhaps the only issue that needs some consideration is whether there is some reasonable relation between the prescribing of passing the NMAT as a condition for admission to medical school on the one hand, and the securing of the health and safety of the general community, on the other hand. This question is perhaps most usefully approached by recalling that the regulation of the practice of medicine in all its branches has long been recognized as a reasonable method of protecting the health and safety of the public. 8 That the power to regulate and control the practice of medicine includes the power to regulate admission to the ranks of those authorized to JLLEDDA, LLB1 54

CONSTITUTIONAL LAW II TOPICS: POLICE POWER, DUE PROCESS AND EQUAL PROTECTION practice medicine, is also well recognized. Thus, legislation and administrative regulations requiring those who wish to practice medicine first to take and pass medical board examinations have long ago been recognized as valid exercises of governmental power. Similarly, the establishment of minimum medical educational requirements i.e., the completion of prescribed courses in a recognized medical school for admission to the medical profession, has also been sustained as a legitimate exercise of the regulatory authority of the state. What we have before us in the instant case is closely related; the regulation of access to medical schools. MECS Order No. 52, s. 1985, as noted earlier, articulates the rationale of regulation of this type: the improvement of the professional and technical quality of the graduates of medical schools, by upgrading the quality of those admitted to the student body of the medical schools. That upgrading is sought by selectivity in the process of admission, selectivity consisting, among other things, of limiting admission to those who exhibit in the required degree the aptitude for medical studies and eventually for medical practice. The need to maintain, and the difficulties of maintaining, high standards in our professional schools in general, and medical schools in particular, in the current stage of our social and economic development, are widely known. The Supreme Court believes that the government is entitled to prescribe an admission test like the NMAT as a means for achieving its stated objective of "upgrading the selection of applicants into [our] medical schools" and of "improving the quality of medical education in the country." Given the widespread use today of such admission tests in, for instance, medical schools in the United States of America (the Medical College Admission Test [MCAT] and quite probably in other countries with far more developed educational resources than our own, and taking into account the failure or inability of the petitioners to even attempt to prove otherwise, we are entitled to hold that the NMAT is reasonably related to the securing of the ultimate end of legislation and regulation in this area. That end, it is useful to recall, is the protection of the public from the potentially deadly effects of incompetence and ignorance in those who would undertake to treat our bodies and minds for disease or trauma. Petitioners have contended, finally, that MECS Order No. 52, s. 1985, is in conflict with the equal protection clause of the Constitution. More specifically, petitioners assert that portion of the MECS Order which provides that. - "the cutoff score for the successful applicants, based on the scores on the NMAT, shall be determined every year by the Board of Medical Education after consultation with the Association of Philippine Medical Colleges." - infringes the requirements of equal protection. They assert, in other words, that students seeking admission during a given school year. e.g., 1987-1988, when subjected to a different cutoff score than that established for an, e.g., earlier school year, are discriminated against and that this renders the MECS Order "arbitrary and capricious." The force of this argument is more apparent than real. Different cutoff scores for different school years may be dictated by differing conditions obtaining during those years. Thus, the appropriate cutoff score for a given year may be a function of such factors as the number of students who have reached the cutoff score established the preceding year; the number of places available in medical schools during the current year; the average score attained during the current year; the level of difficulty of the test given during the current year, and so forth. To establish a permanent and immutable cutoff score regardless of changes in circumstances from year to year, may well result in an unreasonable rigidity. The above language in MECS Order No. 52, far from being arbitrary or capricious, leaves the Board of Medical Education with the measure of flexibility needed to meet circumstances as they change.

JLLEDDA, LLB1

55

CONSTITUTIONAL LAW II TOPICS: POLICE POWER, DUE PROCESS AND EQUAL PROTECTION

RODOLFO S. BELTRAN -vsTHE

SECRETARY OF HEALTH
November 25, 2005

G.R. No. 133640

FACTS:
Blood banking and blood transfusion services in the Philippines have been arranged in four categories: blood center run by the Philippine National Red Cross; government-run blood services; private hospital blood banks; and commercial blood services. It was reported that the blood units collected in 1992, 64.4% were supplied by commercial blood banks, 14.5% by the PNRC, 13.7% by the government-hospital based blood banks, and 7.4% by the private hospital based blood banks. Clearly, commercial blood banks are higher in rate in terms of blood banking and blood transfusion services. It was further found out that commercialized bloods are likely susceptible of infections and transmissible diseases like AIDS, Hepatitis B, Malaria, Syphilis than those voluntary or donated bloods. In so far as these findings are concerned, the Congress enacted RA 7719 or the National Blood Services Act of 1994. This act seeks to provide an adequate supply of safe blood by promoting voluntary blood donation and by regulating blood banks in the country. The Implementing Rules and Regulations of the said law was promulgated by herein respondent Secretary of Health (AO No.9 s. of 1995). Section 7 of RA 7719 ("Section 7.Phase-out of Commercial Blood Banks All commercial blood banks shall be phased-out over a period of two (2) years after the effectivity of this Act, extendable to a maximum period of two (2) years by the Secretary") and Section 23 of AO No. 9 (Section 23. Process of Phasing Out. The Department shall effect the phasing-out of all commercial blood banks over a period of two years, extendible for a maximum period of two years after the effectivity of R.A. 7719. The decision to extend shall be based on the result of a careful study and review of the blood supply and demand and public safety.), are put into question because according to the petitioner, they unconstitutional.

ISSUES:
Whether or not RA 7719 is passed in the exercise of states police power and was it a valid exercise of such power? Whether the act amounts to deprivation of property without due process of law and a violation to equal protection clause of the Constitution.

HELD:
Police power of the state is validly exercised if (a) the interest of the public generally, as distinguished from those of a particular class, requires the interference of the State; and, (b) the means employed are reasonably necessary to the attainment of the objective sought to be accomplished and not unduly oppressive upon individuals. In the earlier discussion, the Court has mentioned of the avowed policy of the law for the protection of public health by ensuring an adequate supply of safe blood in the country through voluntary blood donation. Attaining this objective requires the interference of the State given the disturbing condition of the Philippine blood banking system. In serving the interest of the public, and to give meaning to the purpose of the law, the Legislature deemed it necessary to phase out commercial blood banks. This action may seriously affect the owners and operators, as well as the employees, of commercial blood banks but their interests must give way to serve a higher end for the interest of the public. What may be regarded as a denial of the equal protection of the laws is a question not always easily determined. No rule that will cover every case can be formulated. Class legislation, discriminating against some and favoring others is prohibited but classification on a reasonable basis and not made arbitrarily or capriciously is permitted. The classification, however, to be reasonable: (a) must be based on substantial distinctions which make real differences; (b) must be germane to the purpose of the law; (c) must not be limited to existing conditions only; and, (d) must apply equally to each member of the class. Republic Act No. 7719 or The National Blood Services Act of 1994, was enacted for the promotion of public health and welfare. In the aforementioned study conducted by the New Tropical Medicine Foundation, it was revealed that the Philippine blood banking system is disturbingly primitive and unsafe, and with its current condition, the spread of infectious diseases such as malaria, AIDS, Hepatitis B and syphilis chiefly from blood transfusion is unavoidable. The situation becomes more distressing as the study showed that almost 70% of the blood supply in the country is sourced from paid blood donors who are three times riskier than voluntary blood donors because they are unlikely to disclose their medical or social history during the blood screening. JLLEDDA, LLB1 56

CONSTITUTIONAL LAW II TOPICS: POLICE POWER, DUE PROCESS AND EQUAL PROTECTION The above study led to the passage of Republic Act No. 7719, to instill public consciousness of the importance and benefits of voluntary blood donation, safe blood supply and proper blood collection from healthy donors. To do this, the Legislature decided to order the phase out of commercial blood banks to improve the Philippine blood banking system, to regulate the supply and proper collection of safe blood, and so as not to derail the implementation of the voluntary blood donation program of the government. In lieu of commercial blood banks, non-profit blood banks or blood centers, in strict adherence to professional and scientific standards to be established by the DOH, shall be set in place. Based on the foregoing, the Legislature never intended for the law to create a situation in which unjustifiable discrimination and inequality shall be allowed. To effectuate its policy, a classification was made between nonprofit blood banks/centers and commercial blood banks. The Supreme Court deems the classification to be valid and reasonable for the following reasons: One, it was based on substantial distinctions. The former operates for purely humanitarian reasons and as a medical service while the latter is motivated by profit. Also, while the former wholly encourages voluntary blood donation, the latter treats blood as a sale of commodity. Two, the classification, and the consequent phase out of commercial blood banks is germane to the purpose of the law, that is, to provide the nation with an adequate supply of safe blood by promoting voluntary blood donation and treating blood transfusion as a humanitarian or medical service rather than a commodity. This necessarily involves the phase out of commercial blood banks based on the fact that they operate as a business enterprise, and they source their blood supply from paid blood donors who are considered unsafe compared to voluntary blood donors as shown by the USAID-sponsored study on the Philippine blood banking system. Three, the Legislature intended for the general application of the law. Its enactment was not solely to address the peculiar circumstances of the situation nor was it intended to apply only to the existing conditions. Lastly, exception. the law applies equally to all commercial blood banks without

JLLEDDA, LLB1

57