Ethical Considerations in Pathology and Lab Medicine: RMIT Report

This report delves into the ethical considerations within pathology and lab medicine, emphasizing the importance of duty of care and addressing various ethical dilemmas. It explores the three phases of the examination process – pre-analytic, analytic, and post-analytic – highlighting ethical issues at each stage, including specimen collection, analysis, and result interpretation. The report focuses on problematic areas such as HIV testing, genetic testing, prenatal examinations, and autopsies, discussing challenges related to confidentiality, autonomy, and justice. It examines the roles and responsibilities of healthcare professionals, patients, and other stakeholders, emphasizing the need for informed consent, counseling, and clear guidelines to navigate complex ethical situations. The report also touches upon the ethical implications of genetic testing, including the potential for stigmatization, and the importance of protecting patient privacy. References to relevant literature are provided to support the analysis and provide further context.

Running Head: PATHOLOGY AND LAB MEDICINE 1
DUTY OF CARE AND ETHICAL CONSIDERATIONS
STUDENT:
INSTITUTION:
DATE:

PATHOLOGY AND LAB MEDICINE: 2
Laboratory examination of patients is encountered by a number of value problems. Earlier
on, the function of laboratory testing was focused on identification of diseases. Today, lab
testing has raised ethical conflicts. First, conflicts may be caused by diverging views on the
benefits and risks of examination and the rights and obligations of all the parties involved
including professionals, patients, relatives, health caregivers, and the society. The other
occasion is the dilemma in values about inner convictions of life. Patients and the deceased are
bounded by ethical issues of values.
Examination of patients is an in-time process where several different professionals participate.
The examination process is divided into three phases namely the pre-analytic, the analytic and
the post-analytic phases to effectively describe the problematic value situations. The storage of
results is also an ethical issue (5).
The following sub-steps raise ethical issues.
The pre-analytic phase The analytic phase The post-analytic phase
- Organizing
examination.
- Making the patient
aware.
- Ordering an
examination and
preparation of a
patient.
- Collection of the
specimen.
- Preparation of the
sample.
- Storage of sample.
- Analyzing results.
- Verification of results.
- Reporting results.
- Interpretation.
- Making the patient or
family or both the
meaning of the
results.
- Applying results to
patient care.
Ethical situations in laboratory testing mostly concern invasive examinations. The most
recorded areas of value issue in the pathology lab were HIV, genetic testing, prenatal and
autopsy examinations. Autopsies and genetic testing are the most problematic types of
examinations. The problems of genetic examination point to confidentiality, autonomy
protection, and justice. Confidentiality problem stems from mistakes in predictive values and
diagnostic errors while the autonomy rises from counseling. A situation of ethics which is
connected to justice entails legal justification of genomic screening. Ethical problems
concerning autopsies relate to autonomy in terms of decision-making and informed consent (4).
The organizers and performers of genetic tests have the role of informing the risks and benefits
of the test to the individual client, the society, and future generations. Genome projects have

PATHOLOGY AND LAB MEDICINE: 3
aroused ethical challenges, especially in commercial health insurance. Prognosis and calculation
of risks pose more problems when dealing with patients who are symptom-free. HIV tests
conducted on healthcare professionals and groups of people like prisoners are highly exposed
to loss of autonomy and privacy. An ethical problem looms in justifying HIV testing on
employees and costs of arranging the program to curb the spread of tuberculosis (2). Prenatal
HIV tests are controversial at the legal, ethical, clinical, scientific, theological, economic, cultural
and social points of view.
The parties involved have opinions which must be considered. Parties in the autopsy are the
coroner, the relatives, the deceased, researchers, legal authorities, medical students and
clinicians (3). The ethical factors to be considered in autopsy are the cost of autopsy, need for
autopsy, legal requirements, benefit to research, people with brain death, integrity of the
deceased, the wishes of the relatives, value of respecting the dead, cultural views, religious
views, application of the ethical principles, beneficence and organ transfer. Patients who have
recently died have den used to train doctors about emergency skills and this practice is being
criticized by ethical, legal and religious organizations. Clear guidelines should state whether
medical practitioners should practice minimally invasive trials on recently dead bodies (1).
Genetic testing requires a consent which is completely informed about the risks and
benefits. A counselor should be prepared psychologically to handle any emotional distress
which may be a consequence of the testing. An example of a patient with Alzheimer’s genetic
disease requires counseling to overcome the fear of stigmatization and prejudice. In case of
third party’s consent, the patient should be approved as such.
An example of ethical situations that RMIT lab experience is the possession of tissues of sick
and even dead people got from public hospitals. The information of the respective dead and
sick people is always blocked so that employees and students do not recognize the identity.
In summing up, there is no face-to-face contact for laboratory physicians and the patients.
Technicians are required to act in complete interests of the sick person. Knowledge about the
patient is not completely available and this will be overcome by collaboration between the
patient, the physician and the clinician. Definitive decisions about events which are life-altering
are acceptable at the act of faith of the patient.

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References
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for Postpartum Mood and Anxiety Disorders in Pediatric Primary Care. Current Problems
in Pediatric and Adolescent Health Care. 2017 Sep 12.
2. Amirian P, Lang T, van Loggerenberg F, Thomas A, Peeling R. Big Data Analytics for
Extracting Disease Surveillance Information: An Untapped Opportunity. In Big Data in
Healthcare 2017 (pp. 59-83). Springer, Cham.
3. Colby LA, Quenee LE, Zitzow LA. Considerations for infectious disease research studies
using animals. Comparative Medicine. 2017 Jun 1;67(3):222-31.
4. Siedner MJ, Bwana MB, Moosa MY, Paul M, Pillay S, McCluskey S, Aturinda I, Ard K,
Muyindike W, Moodley P, Brijkumar J. The REVAMP trial to evaluate HIV resistance
testing in sub-Saharan Africa: a case study in clinical trial design in resource-limited
settings to optimize effectiveness and cost-effectiveness estimates. HIV Clinical Trials.
2017 Jul 11:1-7.
5. Habibi H, Nekavand M, Akrami SM. Prevention of laboratory errors in the genetic study
and related ethical issues: a case report. Iranian Journal of Medical Ethics and History of
Medicine. 2017 Jan 15;9(5):63-70.
6. Hussain S, Moiz B, Aqeel S, Zaidi N. Issues in reproductive health in females having
inherited bleeding disorders in Pakistan. Haemophilia. 2017 Jul 1;23(4).