Consider this scenario: A patient gives written consent to participate voluntarily in a research study. According to the protocol she receives a $50 gift certificate after a single blood draw. However, 3 days later she calls the researcher to say she’s changed her mind and does not want to be in the study anymore, and wants her blood back. If you were the researcher in this circumstance what would you do? As unreal as it sounds this is a real life case, and it’s just a sample of the types of issues we face as clinical laboratory specialists and researchers.
Ethical issues in laboratory medicine have been given limited attention, but they crop up in every day professional practice. With deep roots in history medical ethics now encompasses all aspects of patient care and research, though the basic principles as written by Hippocrates still remain.
Clinical laboratories have some unique ethical concerns, such as collecting specimens, retaining medical records, using leftover “remnant” specimens, making incidental findings, and biobanking specimens. At this morning’s symposium, “Ethical Issues in Laboratory Medicine,” Ann Gronowski, PhD, will discuss the guiding principles of bioethics and the ethical issues clinical laboratories face today.
Like other healthcare professionals, laboratorians must adhere to high ethical standards in order to provide the best possible patient care. The three core principles in biomedical ethics include: respect for persons/autonomy, beneficence and non-maleficence, and justice.
Applying these principles in the clinical laboratory involves using informed consent, assessing risks and benefits, providing fair and equitable treatment, and allocating resources. These principles apply to both medical research and clinical laboratory practice.
Sheldon Campbell, PhD, will discuss ethical issues pertaining to emerging infections. The three core bioethical principles conflict when samples from patients with emerging pathogens are sent to a laboratory, a very good example being the extensive Ebola outbreak of 2013-2016. During this outbreak, many questions needed to be addressed such as: What risks are acceptable for laboratory workers in order to help a sick patient and perhaps prevent an epidemic? and Who decides what risks to patients are acceptable in order to protect laboratory workers, or to protect other patients? Guidance from professional societies and public health authorities came piecemeal and was often contradictory, and consequently laboratories struggled to address these issues.
As laboratory professionals we need to actively develop both internal policies and external public health policies, and participate in the ongoing development of ethical approaches to new infectious risks. Both speakers will share their experiences from real-world cases to illustrate ethical challenges we face in everyday practice. Attendees will walk away armed with a solid foundation for understanding biomedical ethics and gain tools for teaching sound ethical practices to our staffs and trainees.