ETHICS IN LABORATORY MEDICINE NEED OF THE HOUR

Dr.T.V.Rao MD
Dr.T.V.Rao MD In the developing countries limited or no attention is paid for the issues related to
Laboratory medicine, however we just take HIPPOCRATIC OATH as practicing Doctors, and Ethical
issues have been given limited attention, no attention at all by professionals in laboratory medicine.
Doctors order the tests/ investigations casually to fish for diagnosis and many corporate Hospitals
promote the laboratories as tools to make more money in spite of no need for testing the patients,
as guinea pigs. Never forget all our lives are linked to the laboratory investigations as the
competency and professional accountability decreasing on clinicians efficiency and unhealthy
competition in the profession. The ICMR has prevented many experiments on little animals and
today we do many laboratory tests with purpose and many times without purpose on humans a
matter of right of the treating Doctors. Professional ethics is the moral bond that links a profession,
the people it serves, and society. Understanding the complexities of individual and common good is
essential for full professional participation in major issues in health care. More open discussion
about ethics is necessary in our professional literature however NABL accreditation is bringing in
more accountability in testing, I wish NABL should assess the outcome of many investigations the
hospital and give credit to the purposeful laboratories instead of following the facts on blind
documentation Many analytics prove the cost of the diagnostic tests are mutifold than the
treatment itself. Today many are moving to alternative Medicines in view of unbearable costs of
unnecessary and modern investigative advances.
WRONG RESULTS MAY COST PATIENTS LIVES BUT EVEN MANY HEALTHY LIVES
For example: false positive results are as deadly as false negative results It is unfortunate the
laboratory services are left to most ill qualified people the reasons are many non-availability of
qualified people with expertise. If you access sincerely most unscientific information is generated in
diagnostic Microbiology laboratories in making inappropriate isolation pathogenic bacteria and
leading to unnecessary use of Antibiotics and increasing drug resistance, however many of these
matters are related unethical practices in laboratory medicine.
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. 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.
Special procedures, including the more invasive procedures, will require a more detailed explanation
and, in some cases, written consent. This is desirable when there is likelihood of complications
following the procedure. Laboratories performing human immunodeficiency virus (HIV) testing shall
follow National AIDS Control Organization (NACO) guidelines, which include pre-test and post-test
counselling. Unfortunately which is never practiced in our country. The result of HIV test shall be
kept strictly confidential.
All laboratories should document the standard operative procedures The laboratory shall establish
and implement procedures for identification, collection, indexing, access, storage, maintenance and
safe disposal of quality and technical records. All records should be legible and stored such that they
are readily retrievable. Records may 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. The laboratory shall decide the retention time of
records as per the national, regional or local regulations. As per National Accreditation Board for
Testing and Calibration Laboratories (NABL) guidelines, the minimum period for retention of test
reports issued shall be five years for histopathology and cytopathology and one year for other
disciplines
I wish we should have more accountability and can practice on little matters to upgrade the moral
accountability of the laboratories

Bring in Accountability
Medical Laboratory Technologists and Scientists are accountable for their actions
Records & documents
We are ultimately responsible to God I say it is just our consciousness, then to patient, authorities,
and society for safe and lawful practice, and the sustainable use of resources.
Confidentiality and conflict of interest
Medical Laboratory Technologists and Scientists understand and comply with applicable privacy
legislation and policies regarding the collection, use, & disclosure of confidential information.
We recognize & reveal conflicts of interest, and resolve them in a manner which maintains the
integrity of personal health information & protects the best interest of patient care.
Safety of the Patients is a serious issue concerned with all of us
Medical Laboratory Scientists and Technologists should maintains a culture of safety
AN UNETHICAL DOCTOR HARMS FEW BUT UNETHICAL LABORATORY KILLS THE HOSPITALS
Ref 1 Ethics and laboratory medicine. McQueen MJ1. Clin Chem. 1990 Aug; 36(8 Pt 1):1404-7.
2 Ethics in laboratory medicine DR Arora1, B Arora2 GUEST EDITORIAL Year : 2007 | Volume : 25 |
Issue : 3 | Page : 179-180
Dr.T.V.Rao MD Professor of Microbiology Freelance writer