PROFESSIONAL ETHICS

MeLS 2083
 Course Title:
Professional Ethics

Course Number: MeLS 2083

Prerequisite: None
Instructor: Derso Wale
 Course Objectives
• At the end of the course students will be able to:
• Define terms such as Ethics, Profession (professional,
professionalism), Behavior, Moral,
• Legal practice, Common law, Civil law, Court, Precedent,
Medical Laboratory Science
• Recognize how the law operates in relation to clinical
laboratory practice
• regard to legal process, principles and penalties
• Apply ethical concepts to clinical laboratory practice in all
interactions with clients

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 Course Objectives, cont’d
• Maintain the highest standard of care and
professional ethics by identifying the rights and
obligations of medical laboratory professionals
• Support the interests and needs of clients and their
families to exercise their rights to make informed
decisions regarding their care
• Recognize and maintain code of ethics for medical
laboratory professionals
• Exercise good laboratory practice

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 Course Outline:
1.0. Introduction
1.1. Definition of terms
1.2. Classification of ethics
1.3. Principles of ethics
2.0. Interpersonal relationships
3.0. Good Laboratory Practices (GLPs)
4.0 Principles of confidentiality and privacy responsibility
5.0 Responsibility and accountability to the profession

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 Course Outline, cont’d
6.0. Rights and obligations of medical laboratory
professionals
7.0 Patient’s bill of rights
8.0 Introduction to compassionate care
9.0 Concepts of respectful and dignified care
10.0 Compassionate leadership

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 1.0. Introduction
Outline
1.1. Definition of terms
1.2. Classification of ethics
1.3. Principles of ethics

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 Objectives
At the end of this session students will be able to:
• Define ethics, Profession (professional, professionalism),
Behavior, Moral, Legal practice, Common law, Civil law,
Court, Precedent,
• Discuss Classification of ethics

• Discuss principles of ethics

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 Why study ethics?
• When students enter the professional world, you will be
expected to follow an explicit or implicit ethical code.
• To responsibly confront moral issues raised by medical
laboratory activities
• How to deal with ethical dilemmas in their professional
lives?
• To achieve moral autonomy
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 1.1. Definitions
1.1.1. Definition of ethics
– derived from the Greek word ethos, meaning “custom” or
“character”
– Is concerned with what is right or wrong, good or bad

– Ethics analyzes and evaluates human actions and

provides justifying reasons for our approval or rejection
of such actions.

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 Definitions continued
1. 1.2. Definition of profession:
– Occupation, practice, or vocation requiring mastery of
a complex set of knowledge and skills through formal
education and/or practical experience.
• All professions are occupations, but not all
occupations are professions

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• Criteria to distinguish a profession from other
occupations.
– Knowledge

– Professional Code of Conduct or Ethics

– Professional Organization

– Legal Recognition of the Profession by the Government & Public

– Freedom of Practice

– Entry into the Profession is Strictly Controlled

– A Profession Provides In-service and Professional Growth for

Practitioner
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Period of Internship of Apprenticeship
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 Definitions cont’d
-Professional:
• a person who possesses the qualities required by a certain
profession

-Professionalism:
• The actions of the members of a profession based on the
accepted code of conduct

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 Definitions cont’d
– Professional ethics

• Professional ethics are principles and standards that govern

how members of a profession or workers.

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 Definitions cont’d
Code of Conduct:
•A professional code of ethics is guidelines that clearly
identifies professional obligations and responsibilities with
reference to the rights of clients.

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 Definitions cont’d
1.1.3. Definition of Behavior:- The way somebody behaves

1.1.4. Definition of Moral

– derived from the Latin word, ‘mores’ or ‘moralis’ meaning
"manner, character, proper behavior“
– defined as the customs of a community accepted as the standard or
principles of good behavior.
– In its descriptive use, morals are arbitrarily and subjectively created
by society, philosophy, religion, and/or individual conscience

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 Definitions: Ethics vs Moral
• Very close relationship between ethics and morality to the
extent that sometimes people confuse ethics for morality and
use the two terms interchangeably.
• The basic difference is that morality is concerned with the
right and wrong of human actions;
• whereas ethics provides the basic principles for justifying and
determining the rightness or wrongness of the human actions.

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 Ethics vs Moral
• Where an action is said to be right or wrong in
morality, ethics steps in, using its ethical principles
(ethical theories) to prove or justify the wrongness or
goodness of that action.
• Ethics is the philosophical thinking or systematic study
about morality, moral problems and moral judgments.

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 Definitions cont’d
1.1.5. Definition of Legal practice:

- legislation having legal enforcement

1.1.6. Definition of Common law

– evolved law i.e., the body of law developed as a result of custom
and judicial decisions, as distinct from the law laid down by
legislative assemblies.

1.1.7. Definition of Civil law:

– law of citizen's right
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 Definitions cont’d
1.1.8. Definition of Court:
– meeting where legal judgments are made

1.1.9. Definition of Precedent:

– "rule of law established for the first time by a court for a particular
type of case and there after referred to in deciding similar cases"
– an action or decision that can be used subsequently as an example
for a similar decision or to justify a similar action
–  

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 1.2 Classification of Ethics
Ethics is divided into three primary areas:
 Meta – ethics:
• investigates where our ethical principles come from, and what they mean.

 Normative ethics:
• takes on a more practical task, involve arriving at moral standards that
regulate right and wrong conduct. 

 Applied/Professional ethics:
• the study of the use of ethical values

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 Applied Ethics
• Is a discipline of philosophy that attempts to apply ethical
theory to real-life situations
• There are several sub-branches of professional/applied ethics:
• Business ethics

• Medical ethics (e.g. Bioethics)

• Medical Laboratory ethics

• Journalism ethics

• Engineering ethics

• Legal ethics
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 Applied Ethics cont’d

• One of the major areas where ethicists practice is in

the field of health care. These include:
– Medical ethics

– Nursing ethics

– Pharmacy ethics

– Medical Laboratory ethics

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 Professional Ethics
• is the moral principle, which should guide members of
the profession in their dealings with each other and with
their patients, the patrons (clients), the state etc.
• is a collective and disciplined concern of the group

• attitude of the professional should be unselfish concern

for the welfare of others

Note: Professional ethics is therefore, an inherent

characteristic of professional behavior
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 Professional Ethics, cont’d
• Adherence to professional standards is expressed through taking
a professional oath and accepting professional code of ethics
• The oath is usually brief, general and intended to obligate and
inspire the professional to abide by applicable laws, codified
ethics and the dictates of conscience and religious principles
• The code of ethics, compared with an oath is normally more
detailed and more explicit.

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 Professional morality vs Ethics

• Professional Morality– what we do in our

occupational lives
• Professional Ethics – the study of what we do in our
professional lives

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 1.3. Principles of Ethics
• The most commonly accepted principles of medical ethics
include:

1. Autonomy: an individual who is master of himself/herself and

can act, make free choices and take decisions without the
constraint of another
 Infants, young children, mentally handicapped or incapacitated people, or
comatose patient do not have the capacity to participate in decision making
about their healthcare. If the client becomes unable to make decisions for
himself/herself, a “surrogate decision maker” would act on client’s behalf.

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 Principles of Ethics cont’d
2. Beneficence: acting in the best interests of patients
(doing or promoting good). This principle is the basis
for all health care providers

3. Non-maleficence: means to avoid doing harm.

Health professionals should not inflict harm on patients.

4. Justice: fair, equitable and appropriate treatment.

Treat all patients equally – no unfair discrimination.

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 Principles of Ethics cont’d

5. Veracity: means telling the truth, which is essential

to the integrity of the client-provider relationship.

6. Fidelity: means being faithful to one’s commitments

and promises

7. Confidentiality: Confidential is a secrete or private

matter not to be divulged to others.

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 2.0
Interpersonal Relationships

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 2.0. Interpersonal Relationships
outline
2.1. Interpersonal relationship with patients
2.2. Interpersonal relationship with one’s family
2.3. Interpersonal relationship with visitors
2.4. Interpersonal relationship with colleagues and other health professionals
2.5. Medical laboratory patient- relationships

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 Objectives
Upon completion of this chapter the student will be able to:
• Define terms such as interpersonal, patient, client, surrogate,
informed consent and disclosure
• Describe interpersonal relationship with patients, with one’s
family, with visitors, with colleagues and other health
professionals
• Explain the importance of medical laboratory patient-
relationships.
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 2.1. Interpersonal r/ships with patients
• Medical Laboratory professionals are accountable for the
quality and integrity of the laboratory services they provide
• The medical laboratory technologist should:

– always regard concern for the best interests or well-being

of your patients as your primary professional duty.
– honor the trust of your patients

– be mindful that a medical laboratory science practitioner

is in a position of power over a patient and avoid abusing
your position.
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 Interpersonal r/ships with patients, cont’d
• The medical laboratory technologist should:

– respect patients’ privacy and dignity

– treat patients politely and with consideration

– apply the principle of informed consent as an on-going process

– recognize the rights of patients to expect that you will not pass
on any personal and confidential information you acquire in
the course of your professional duties, unless they agree to
disclosure or the law demands

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 Interpersonal relationships with
patients, cont’d
• The medical laboratory technologist should:

– Ask patients’ permission before sharing information

with their spouses, partners or relatives.
– always seek to give priority to the laboratory
diagnostic service to patients solely on the basis of
clinical need.

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2.2. Interpersonal r/ships with family
• Group activity

1. Have you ever accompanied a friend or family member to a

hospital?

2. Did healthcare professionals at the hospital smile and offer to help

you? – were you treated with respect?

3. Please give examples of behaviors that were positive and also those
examples that were negative

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 2.3. Interpersonal relationship with
visitors
The medical laboratory technologist should:
• Explain to family and visitors that your first duty is to honor the trust
and confidentiality of your patients
• Be polite and respectful of family and visitors and offer to answer
questions for directions; questions about the patient’s condition
should be directed to the patient (or clinician with patient approval)
• Respect family and visitor dignity 

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 2.4. Interpersonal relationship with
colleagues and other health professionals
The medical laboratory technologist should:
• Not make a patient doubt a colleagues’ knowledge or skills by
making comments about them that cannot be fully justified
• Actively strive to establish cooperative and respectful
working relationships with other health care professionals
with the primary objective of ensuring a high standard of
care for the patients they serve.

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The medical laboratory technologist should:
• Not discriminate against colleagues, including professionals
applying for posts
– Because of race, culture, ethnicity, social status, lifestyle,
perceived economic worth, age, gender, disability, communicable
disease status, sexual orientation, religious or spiritual beliefs, or

any condition of vulnerability.

• Refrain from speaking ill of colleagues or other health care

professionals
• Share
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 2.5. Medical laboratory patient-
relationships
• is the corner stone of medical practice

• Remember the health of your patient should be your

first consideration
• The following topics pose problems to medical
laboratory professionals in their daily practice
– Communication and consent

– Confidentiality
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 Communication and consent
• The patient has the right to self- determination, to make free
decisions regarding himself/herself.
• The medical laboratory professional will inform the patient of the
consequences of his/her decisions.
• A mentally competent adult patient has the right to give or withhold
consent to any diagnostic procedure or therapy.
• The patient has the right to the information necessary to make
his/her decisions.

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 Communication and consent
• The patient should understand clearly the purpose of any test or
treatment, what the result would imply, and what would be the
implication of withholding consent.
• Competent patients have the right to refuse treatment, even when
the refusal will result in disability or death.
• As an ethical concern if a patient is not mentally capable to make
a decision, a surrogate decision maker needs to be part of the
discussion.
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 Communication and Consent
• The surrogate decision maker is a person designated by the
patient to make medical decisions in the event the patient is
unable to.

Informed Consent:
• Definition: A patient’s willing acceptance of a medical
intervention after adequate disclosure from the health
professional of the nature of the intervention, risks, benefits and
alternative treatment options
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 Informed Consent
• What constitutes informed consent?

– Disclosure: information to allow reasonable person to make a

decision
– Understanding: comprehension of the information given

– Voluntary: no coercion or incentive to accept or deny a treatment

– Agreement: verbal or written (preferred) to discussed

intervention

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 Confidentiality

• The medical laboratory professional’s duty to keep

patient information confidential has been a
cornerstone of medical laboratory ethics.
• Medical laboratory professionals shall preserve
absolute confidentiality on all he knows about his
patient even after the patient has died.

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 Confidentiality
• Patient confidentiality must be upheld

• Breaching patient confidentiality may be merited only:

– When ordered by court of law – a court case

– Where statutory/legal requirement – public health laws

– Where required in health professional’s defense –

malpractice suit
– Where necessary for appropriate patient care-speaking to
another provider in the medical care system
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 Chapter 3
Good Laboratory Practices (GLPs)
 Objectives

Upon completion of this chapter the student will be able

to:
•Define Good Laboratory Practice

•Describe what constitutes good laboratory practice

•Discuss situations in which good laboratory practice is

not exhibited

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 Good Laboratory Practices (GLPs)
• Laboratory services are an integral part of disease diagnosis,
treatment, monitoring response to treatment, disease surveillance
programs and clinical research.
• Laboratory test results, therefore, should be reliable, accurate and
reproducible.
• Generation of such 'quality' results involves a step wise process of
careful planning, perfect execution and detailed checking of
results by the whole team involved.
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 Good Laboratory Practices
• Good Laboratory Practice (GLP) include a set of principles
that provides a framework within which laboratory studies
are planned, performed, monitored, recorded, reported and
archived.

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 GLP includes
– Infrastructure

• Infrastructure of laboratories should be planned

according to the services provided by the laboratory.
– Equipment

– Reagents and materials

– Specimen collection

– Requisition form

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– Reporting test results

– Specimen rejection record

– Data management (recording, reporting and archiving)

– Standard operating procedure (SOP)

– Safety in laboratories (to protect both staff and the environment)

– Ethical considerations

– Quality assurance: the total process whereby the quality of laboratory

reports can be guaranteed.
– IQC and External quality assessment

– Internal audit (identify problems and weak points in the system and
suggest remedial measures
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 chapter 4
Principles of confidentiality and
privacy

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 4.0. Principles of confidentiality and privacy

4.1. Ethical dilemma in decision making

4.1.1. Moral theories

4.1.2. Ethics and Law

4.1.3. Ethics and Medical Laboratory Science

4.1.4. Professional ethics and the law

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 Objectives
Upon completion of this chapter the student will be able to:
•Define terms such as ethical dilemma, moral and legal

•Discuss moral theories

•Differentiate ethics from law

•Describe ethical situations involving the laboratory

•Describe health law involving the laboratory

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 Ethical Dilemma
• A situations in which two or more moral obligations,
duties, rights, or ideals come into conflict
– there is no clear right or wrong answer or
– there may be more than one correct solution
• To resolve we must identify the factors, gather facts,
rank moral considerations, consider alternative
courses of actions, and arrive at a judgment.

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 How to resolve Dilemmas?
• Some dilemmas are resolved because they are not moral
dilemmas.
• Some MORAL dilemmas can be resolved through a
creative third alternative that satisfies both moral
outcomes.
• Or, possible to sequentially act on each one.

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 Ethical Dilemma Group Activity*:
• The hijacked plane with 200 people is approaching a building
with 50,000 people
• Vote! Will you shoot down the plane?

• A true moral dilemma

• Which position has the greatest weight in the circumstances?

Note: further discussion after the theories

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 Ethical / Moral Theories

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 4.1.1 Moral Theory

Is a broad perspective which:

• helps us decide which element of a moral problem is most
important (e.g. consequences, rights, goods, virtues, etc.)
• helps us resolve conflicts between rules and between values.

• help people make the best moral decisions

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 Ethical theory
1. Deontological

2. Teleological and

3. Virtue ethics
• The first two are considered deontic or action-based
theories of morality because they focus entirely upon the
actions which a person performs.
• The third doesn't judge actions as right or wrong but rather
the character of the person doing the actions.
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 1. Deontology theory
• Deontology is a duty-based moral theory.

• It states that society needs rules in order to function, and that a

person can only be called moral to the extent that he abides by
those rules.
• uses rules rather than consequences to justify an action or
policy.
• The best-known deontological theory is that of Immanuel Kant

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 Kantianism
• Decide if an act is right or wrong without looking at
consequences.
• Rules should comply with the categorical imperative.
• Duties:
• “Always tell the truth”

• “Always avoid taking an innocent life”

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 2. Teleological theory
• Is when actions are judged morally right based upon their
consequences.
• Thus, in order to make correct moral choices, we have to
have some understanding of what will result from our
choices.
• One sub class of teleological moral theory is
Consequentialism
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 Consequentialism
• Right and wrong is determined by the overall goodness
(utility) of the consequences of action. 
• An act is right only if it tends to result in the greatest net
good
• All acts are potentially permissible; depends on
consequences
• Difficult to determine which consequences, what
probability, what weight?
• May
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 Utilitarianism:
• One forms of Consequentialist theories

• A theory that holds that the best way to make a moral

decision is to look at the potential consequences of each
available choice, and then pick the option that either does
most to increase happiness or does least to increase
suffering.
• Summed up as a philosophy of "The greatest good for the
greatest number."
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 3. Virtue Theories
• Virtue ethics states that only good people can make good
moral decisions.
• Therefore, the best way to be moral is to constantly seek to
improve oneself.
• Virtue ethicists list a number of qualities that they believe
are universal, and are appreciated in all cultures.

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 4.1.2 Ethics and Law
Description of Ethics and Law:
• Medical ethics and the law are not the same, but often
help define each other
• Breach of ethical obligation may not necessarily
mean breach of law
• Breach of ethical obligation may be used to prove
medical malpractice
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 Cont…

• Even the most detailed of laws cannot govern every

aspect of our laboratory experience
• Simply stated, ethics represents what we should do,
not what we must do.
• It represents an expression of conscience rather than
the obligatory fulfillment of governmental fiat.

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 Ethics vs Law
• Law – the authority is external

• Ethics – the authority is internal

• Much of law, but not all, is based in morality

• Sometimes law is unethical

• Much of what is ethical is unaddressed by legal rules

• There is a moral duty to obey the law (with some caveats)

• Professional ethics covers more issues than the law

• One can be unethical without behaving illegally

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 Ethics vs Law
• Be very careful not to assume that there is a legal rule for
every situation.
• Often the gaps between legal rules require one to switch to
an ethical analysis.

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 4.1.3 Ethics and Medical Laboratory
Science
• Health professional’s ethics emanated and expressed
through:
– Law

– Institutional policies

– Policy of professional organization

– Professional standards of care

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 Chapter 5

Responsibility and accountability to

the profession
 outline

5.1. introduction

5.1. Responsibility and accountability to the

profession

5.2. Professional Responsibility

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 5.1. introduction
The medical laboratory technologist should:
• uphold and maintain the dignity and respect of medical
laboratory profession
• contribute to the advancement of the profession by
• improving the body of knowledge,

• adopting scientific advances that benefit the patient

• maintaining high standards of practice and education, and

75
 Cont…..
• Strive to maintain a reputation of honesty, integrity and
reliability.
• Promote the image and status of your profession by
maintaining high standards in your professional practice and
through active support of your professional bodies.
• Take responsibility for your professional acts

• Not misuse your professional skills or knowledge for personal

gain
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 5.2. Responsibility/ethical duty of
Medical Laboratory Professionals
• A moral duty to obey the law

• Professional ethics covers more issues than the law

• Behaving unethically without behaving illegally

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 5.3. Professional responsibility
- is the area of practice that encompasses the duties/ethics
of medical laboratory professionals to:
Act in a professional manner

Obey the law

Avoid conflicts of interest

Put the needs of patients ahead of their own interests.

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 Cont…
Have a responsibility to never disclose confidential
patient or co-worker information
Are under a strict duty of confidentiality to keep
information received in the course of their work
secret.
Have the ethical responsibility to make the best
decision in every situation

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 References for Chapters 1-5
• Ethiopian Medical Laboratory Association (Ethiopia Medical
Laboratory Association) Code of Ethics for Medical Laboratory
Technologists Practicing in Ethiopia, 2008
• Medical Ethics Manual, World Medical Association, 2005
• James M. Gripando. Nursing Perspectives and Issues; Delmar
publishers INC 3rd edition
• International Federation of Biomedical Laboratory Science
(IFBLS) code of ethics IFBLS general assembly of delegates,
1992

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 Any question????

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