EDITOR'S NOTE: Corrects attribution to "YouTube" instead of "the YouTube." To readers who pointed this out, our sincerest gratitude.

MANILA, Philippines—From a legal standpoint, a civil case may be made against those responsible for the posting on the Internet of a video of a controversial rectal surgery in a state-run hospital, Justice Secretary Raul Gonzalez said Thursday.

Gonzalez said the Vicente Sotto Memorial Medical Center (VSMMC) in Cebu City, where the surgery was conducted on an anesthetized male patient, should also be held accountable because people other than members of the medical team were allowed inside the operating room to watch.

"There's clearly a case for damages. And the hospital would seem to be liable because why were people allowed to watch in the operating room?" Gonzalez told reporters.

Doc still training

An investigation by the Department of Health has found that Dr. Phillips Leo Arias could be liable for misconduct, being the head surgeon and, in effect, the captain of the ship who should be in full control of the operation.

But in Cebu, Arias' lawyer Merlo Bagano said this doctrine would apply only in the exercise of the medical skill involving the treatment of the patient.

Bagano, who is also Arias' brother-in-law, said it was the VSMMC management that should be investigated for failing to implement the hospital policies against the entry of non-surgical personnel in the operating room and the taking of video footage of surgical procedures.

Besides, Bagano said, Arias was still under training at the hospital. He said a supervisor was present during the operation, which meant, he added, that Arias was not the highest ranking official at that time.

"This is why it is our position that Dr. Arias is innocent; there was no misconduct on his part," the lawyer said.

Human relations violation

The video uploaded on YouTube showed more than 10 people in the operating room laughing and cheering as Arias was extracting a perfume canister from the 39-year-old patient's rectum.

Arias was later seen spraying the observers with the contents of the canister.

Pointing out that the video of the surgery was seen in various parts of the world, Justice Secretary Gonzalez said the civil case for damages could be based on the violation of human relations.

He cited Article 19 of the Civil Code, which states that "every person must, in the exercise of his rights and in the performance of his duties, act with justice, give everyone his due, and observe honesty and good faith."

He also cited Article 26, which states that certain acts, including the vexation or humiliation of another person based on his/her religious beliefs, lowly station in life, physical defect or other personal condition, could produce a cause of action for damages.

The Board of Medicine and the Professional Regulation Commission may also take action against those involved in the incident, he said.

Asked about the nature of the hospital's purported liability, Gonzalez said administrative sanctions could be slapped on the VSMMC.

"It's just like the liability of a hotel – for example, if you stay in a hotel and your valuables were lost," he said.

Libel, mutilation

Gonzalez said it was also possible for the patient to pursue a criminal case for libel, if the latter was so inclined.

However, he said, the person who put the perfume canister in the patient's rectum was the one "more liable" and could possibly be charged with mutilation, if the person could be found.

Asked to comment on the statement on Wednesday of Msgr. Achilles Dakay that the real issue in the case was the commission of a homosexual act, Gonzalez said: "The end does not justify the means."

He also pointed out that Dakay, the spokesperson of the Archdiocese of Cebu, was commenting on the case from the point of view of the Roman Catholic Church.

Dakay had said the main issue in the scandal was "the wrong act of a guy with another man."

Investigators have obtained the affidavit of the patient, Deputy Ombudsman for the Visayas Pelagio Apostol said Thursday.

The patient had earlier complained that his privacy was violated when the video of his surgery was uploaded on YouTube without his knowledge.

Laughing, but...

Bagano said that while it was true that at the start of the operation, Arias ordered that only the medical team involved in the surgery should be in the operating room, "the hospital has the responsibility to control the crowd during the conduct of the operation."

The lawyer also admitted that Arias was laughing after the operation and that he sprayed those present with the contents of the perfume canister. But he said these acts were done as an "expression of relief" that a "serious and delicate" operation was a success.

Bagano said he and the defense team had been able to identify the person who took the video and uploaded it on YouTube as a male intern from a nursing school in Cebu City.

He said that according to the information they had received, the nursing intern was not able to graduate because of his action.

Bagano said the intern was not part of the medical team and had just come from another operating table at the VSMM OR Complex when he decided to join the group watching the surgery and to take his own video using the camera on his cellular phone.

According to Bagano, the taking of the video and the cheering of the onlookers were no longer part of the medical treatment of the patient.