MLS 201

MEDICAL LABORATORY ETHICS, CODE

OF CONDUCTS
BY
DR EMENUGA VERA

ETHICS OF MEDICAL LABORATORY PRACTICES

DEFINITION

Ethics means principles or standards of human conduct,

sometimes called morals philosophy.
Ethics, as a branch of philosophy, is considered a normative science,
because it is concerned with norms of human conduct, as
distinguished from the formal sciences, such as mathematics and
logic, and the empirical sciences, such as chemistry and physics.
Philosophers have attempted to determine goodness in conduct
according to two chief principles, and have considered certain types of
conduct either good in themselves or good because they conform to a
particular ethical standard.

KEY ETHICAL VALUES

The long-standing principles of non-maleficence (do no harm) and
beneficence (do good) require that physicians be aware of the extent
to which medical acts of omission or commission carry risks of harm as
well as potential benefits for their patients. it is required of physicians
to appropriately inform patients of potential harms and benefits of
proposed treatment and then to act according to patient’s informed
wishes regarding healthcare. For the laboratory scientist, this
requirement is upheld by ascertaining that informed consent has been
given by patients for investigations to be performed (after pretest
counseling, there should also be a post test counseling). The
laboratory scientist should ensure that investigation results are applied
in the patient’s best interest. Careful recording of laboratory results,
with avoidance of falsification and fabrication of data is crucial. The
overall goal for laboratory scientist is to maintain professional integrity.
This involves developing an ethics lens to aid in daily dealings with
oneself, patients, colleagues and society.

THE ETHICS OF MEDICAL LABORATORY PROFESSION ARE:-

1. The laboratory scientist should treat all patients fairly and without
discrimination.
2. The laboratory scientist should collect adequate information for
the proper identification of the patient, which enables the
requested examinations and other laboratory procedures to be
 carried out, but should not collect unnecessary personal
information.
3. The patient should be aware of the purpose for which the
information is collected. All procedures carried out on a patient
require the informed consent of the patient. Forcing someone to
undergo medical testing of any kind is an invasion of privacy and
a violation of human rights.
4. Safety of staff and other patients are legitimate concerns when
communicable diseases are possible.
5. For most laboratory procedures, consent can be inferred when
the patient presents him or herself at a laboratory with a request
form and willingly submits to the usual collecting procedures, for
example, venipuncture. Patient in a hospital bed should normally
be given the opportunity to refuse.
6. Special procedures, including the more invasive procedures, will
require a more detailed explanation and, in some cases, written
consent.
7. The laboratory shall not perform HIV test unless the individual has
been given pre-test counselling and Informed consent of the
patient will be taken before the blood is collected. Then a post-
test counselling should be done too. The result of HIV test shall
be kept strictly confidential.
8. In emergency situations, consent might not be possible and under
these circumstances, it is acceptable to carry out necessary
procedures provided they are in patient's best interest.
9. The laboratory scientist should endeavour to see that results with
serious implications are not communicated directly to the patient
without the opportunity for adequate counselling.
10. Adequate privacy during reception and sampling should be
maintained.
11. If the primary sample arrives at the laboratory in a condition
that is unsuitable for the requested examination, it should
normally be discarded and referring physician notified.
12. The laboratory shall use examination procedures, including
those for collection of specimens, which meet the needs of the
users of laboratory services and are appropriate for the
examinations. Preferred procedures are those that have been
published and established in peer-reviewed texts or journals or in
international, national or regional guidelines. If in-house
procedures are used, they shall be appropriately validated for
intended use and fully documented.
13. Any fabrication of result is completely unacceptable.
14. The results of laboratory examinations are confidential
unless disclosure is authorized. The results will normally be
reported to the requesting physician and may be reported to other
parties with the patient's consent or as required by law. The
 results of laboratory examination that have been separated from
all patient identification (un-linked, anonymous) may be used for
such purposes as epidemiology, demography or other statistical
analyses.
15. Should ensure that, as far as possible, the examinations are
correctly interpreted and applied in the patient's best interest.
16. All records should be legible and stored such that they are
readily retrievable. Records should be stored on any appropriate
medium subject to national, regional or local legal requirements.
Facilities shall provide a suitable environment to prevent damage,
deterioration, loss or unauthorized access.
17. Medical laboratories should not enter into financial
arrangements with referring practitioners where those
arrangements act as an inducement for the referral of patients.
18. Rooms used for primary sample collection should be
completely independent and kept clean always.

All health workers should consider ethical and professional principles

in each and every interaction with patients and service recipients. This
will help create a safe environment for patients, respect privacy and
human dignity, create a positive image of ethical values in a clinical
setting in addition to improving service quality. It is universally
accepted to consider ethical standards in any clinical environments,
including hospitals, clinics, research centers, health centers, and also
laboratories.

ETHICAL VIRTUES FOR MEDICAL LABORATORY PRACTICE

The virtuous laboratory scientist is one who is habitually disposed to
act in the patient’s good. Laboratory ethics provides the Scientist with
a useful guide to act when faced with ethical issues.
The virtues mentioned below are some of the ethical virtues a scientist
should have.
Ethical virtues:Box 1 Five focal virtues in healthcare
 Compassion (active regard for another’s welfare)
 Discernment (ability to make fitting judgements and reach
decisions without being unduly influenced by external factors)
 Trustworthiness (acts that merit confidence in one’s character
and conduct)
 Integrity (being faithful to one’s moral values and standing up in
their defence)
 Conscientiousness (motivation to do what is right because it is
right and exerting an appropriate level of effort to do so) .
The general principle of healthcare ethics is that the patient's welfare is
paramount.
ETHICAL OBLIGATIONS

Medical laboratory scientists demonstrate an application of their ethical

obligations through their professional and personal conduct.
NB:-Patient safety and protection is paramount at all times.

Obligations to Patients:
Medical laboratory scientists put their patient(s)’ interest(s) above their
personal interest(s). MLSs carry out their professional duties
competently and with integrity. They respect their patients’ individual
needs and overall welfare at all times, including the patients’ right to
freedom of choice in health care provider, free and enlightened
consent, and an expectation of confidentiality of all patient information,
in accordance with existing legislation.

Obligations to the Public:

Medical laboratory scientists are dedicated to serving the public’s
health care needs through respectful, accessible, and cooperative
interactions with the public and patients, other healthcare providers,
and students. MLSs facilitate awareness and understanding of the
medical laboratory technology profession.

Obligations to the Profession:

Medical laboratory scientists contribute to the profession’s
development through collaboration, mentorship, self-development, and
support of its institutions. MLSs strive for excellence in their
professional practice, and professional and personal conduct through
life-long learning. Medical laboratory scientists recognize, disclose, and
resolve conflicts of interest to safeguard patient care.
Obligations to the Regulatory Body:
Medical laboratory scientists understand, respect and comply with
provincial Acts and regulations, and the Code of Ethics, Standards of
Practice, bylaws and practice guidelines approved by their regulatory
body. Medical laboratory scientists cooperate and maintain
harmonious relations with, and promptly reply to all correspondence
from the regulatory body at all times.

Obligations to Oneself:
Medical laboratory scientists are accountable and responsible for their
professional and personal conduct. MLSs practice within their scope of
professional competence and recognize their professional and
personal limitations. Medical laboratory scientists maintain and
improve their knowledge, skills, judgement and behaviours to ensure
the best possible patient care.

ETHICAL PRINCIPLES

Medical laboratory scientist demonstrate the following ethical principles

through the medical laboratory services delivered, either alone or in
collaboration with a multidisciplinary team, and any services rendered
under the MLSs’ direction and supervision.

Confidentiality / Privacy / Conflict of Interest

Medical laboratory scientist shall:

 Respect and protect patient confidentiality and privacy by

understanding and complying with applicable privacy legislation and
 policies regarding the collection, use, and disclosure of confidential
information.
 Recognize, disclose, and act appropriately to resolve conflicts of
interest that arise in the course of professional activities. They will
maintain the integrity of personal health information, maintain
transparency, and deliver unbiased patient-centered care. MLSs
never use confidential information to the detriment of a patient or to
benefit themselves or another person.

Diversity / Respect / Dignity / Consent

Medical laboratory scientist shall:

 Value, respect and protect the rights, welfare, and dignity of all
patients by providing patient care and service with respect for
human rights, regardless of, but not limited to race, ethnicity,
religion, language, sexual orientation, age and socio-economic
status, mental or physical abilities at all times.
 Obtain free and informed consent from patients before undertaking
any action, in accordance with relevant legislation and policies,
recognizing that consent can be withdrawn at any time.
 Maintain appropriate professional boundaries with patients,
colleagues, and other healthcare providers while delivering patient-
centered care.

Safety
Medical laboratory scientist shall:

 Practice according to established protocols, safety guidelines,

relevant current provincial and federal legislation, institutional
policies and procedures, and environmental considerations. They do
so to protect patients, colleagues, healthcare providers, society, the
 environment, and themselves from any potential harm while acting
in the best interest of the patient.
 Promote a culture of safety with colleagues, and other healthcare
team members.

Accountability / Responsibility
Medical laboratory scientist shall:

 Exercise independent judgment, accept responsibility for their

actions and the foreseeable consequences of their actions, and
recognize their accountability for the service they provide.
 Practice within the scope of their professional competence,
recognize the competence of others and seek their assistance as
required.
 Take appropriate action in responding to situations which may
jeopardize patient care or harm the profession, including reporting
impaired, incompetent, and/or unethical colleagues in accordance
with their legal requirements.

Professionalism / Behaviours / Attitudes / Professional

Development
Medical laboratory scientist shall:

 Strive for excellence in their professional practice, and in their

professional and personal conduct to uphold the integrity of the
profession and the public trust.
 Communicate effectively with patients, the public, colleagues and
other healthcare providers, contributing to a healthy and positive
work environment
 Maintain and enhance professional practice and augment their
knowledge, skills, judgement, and behaviour through self-reflection
and self-directed professional development and by demonstrating
continued competence
 Demonstrate collegiality, mentorship, and sharing of new and
emerging professional knowledge.

Collaboration
Medical laboratory scientist shall:

 Display integrity and respect in all interactions and collaboration with

healthcare providers and others involved in patient care.
 Contribute to ongoing improvement in healthcare provision through
an application of a process-orientation and focus on quality.
 Promote learning by facilitating the sharing of knowledge, skills and
judgment processes with colleagues, students, other healthcare
professionals, and the public.

STAGES IN ETHICAL PRACTICES IN THE LABORATORY EXAMINATION

PROCESS
These ethical practices should be applied in the various stages of
laboratory procedure by dividing the examination process into the pre-
analytic, analytic and post-analytic phases.
The pre-analytic phase includes:
 deciding to organize the examination;
 informing the patient and gaining consent;
  ordering the examination and preparing the patient, and
 collecting the specimen.
The analytic phase consists of:
 preparing the sample;
 storing the sample;
 analyzing the results, and
 verifying the results.
The post-analytic phase includes:
 reporting the results;
 interpreting the results;
 informing the patient or relatives of the meaning of the results,
 applying the results to patient care