The Ethiopian Public Health Institute Ministry of Health-Ethiopia

Chapter 10

PROFESSIONAL ETHICS AND

GOOD LABORATORY PRACTICES

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
2
Health Institute
 Content Outline

• Types and Principles of ethics

• Right and Obligation of Medical Laboratory

Professionals

• Ethics and Law

• Good Laboratory Practices

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
3
Health Institute
 Learning Objectives

• List types and explain principles of ethics

• Describe the Right and Obligation of Medical

Laboratory Professionals

• Differentiate between Ethics and Law

• Conduct Good laboratory practices(GLP)

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
4
Health Institute
 Scenario
• A SMALL TRUTH MAKES LIFE 100%
IF

ABCDEFGHIJKLMNOPQRSTUVWXYZ

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
5
Health Institute
 Scenario……….. Cont’d

Luck: L+U+C+K
• 12+21+3+11 = 47%

Love: L+O+V+E
12+15+22+5 = 54%

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
6
Health Institute
 Scenario……….. Cont’d
Money: M+O+N+E+Y
• 13+15+14+5+25 = 72%

Behavior: B+E+H+A+V+I+O+R
2+5+8+1+22+9+15+18 = 80%

Leadership: L+E+A+D+E+R+S+H+I+P
12+5+1+4+5+18+19+9+16 = 89%
The Ethiopian Public Health Institute Ministry of Health-Ethiopia
The Ethiopian Public Ministry of Health-Ethiopia
7
Health Institute
 Scenario……….. Cont’d
• Then what makes 100% ?
Is it Knowledge? ... NO ! ! !
K+N+O+W+L+E+D+G+E
11+14+15+23+12+5+4+7+5 = 96%

Hard Work ? ... NO ! ! !

H+A+R+D+W+O+R+K
8+1+18+4+23+15+18+11 = 98%

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
8
Health Institute
 Scenario……….. Cont’d
• Every problem has a solution, only if we
perhaps change our attitude.
• To go to the top,
• to that 100% ,
• what we really need to go further... a bit
more...

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
9
Health Institute
 Scenario……….. Cont’d

• ATTITUDE
A+T+T+I+T+U+D+E 1+20+20+9+20+21+4+5 =
100%

It is OUR ATTITUDE towards Life and

Work that makes OUR Life 100% ! ! !

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
10
Health Institute
 What Is Ethics?
Derived from the Greek word ethos, meaning custom or
character
Is a major branch of philosophy which study values and
customs of a person or group
Is concerned with what is right or wrong, good or bad, fair or
unfair

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
11
Health Institute
 Systems governing human behavior

Ethics IS not… Ethics IS…

 Moral Principles.
 The same as feelings.  What is good and bad.
 What is right and wrong.
 Religion.
 Based on value system.
 Following the law.  Ethical norms are not
universal – depends on
 Following culturally the sub culture of the
society.
accepted norms.
 Science.
The Ethiopian Public Health Institute Ministry of Health-Ethiopia
The Ethiopian Public Ministry of Health-Ethiopia
12
Health Institute
 Systemic Governing…………Cont’d
Ethics refers to standards of behavior that tell us how
human beings ought to act in the many situations in which
they find themselves:
• As friends,
• Parents,
• Children,
• Citizens,
• Businesspeople,
• Teachers,
• Professionals, and so on.

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
13
Health Institute
 Why is Ethics Important?
Ethics influence and contribute to:
• Employee commitment.
• Customer loyalty and confidence.
• Customer satisfaction.
• The ability to build relationships with stakeholders.
• Cost control.
• Performance, revenue, and profits.
• Reputation and image: - “One of an organization’s most
prized assets is its reputation.”

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
14
Health Institute
 Type of Ethics

Activity 10.1. Think/Pair/share

Instruction: First think about the following
question and then discuss in pair with a
participant sitting next to you and share your
idea.
Question: What is ethics?
Time: 3 minutes

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
15
Health Institute
 Type of Ethics…..Cont’d
1. Applied Ethics:
Is a discipline of philosophy that attempts to apply ethical theory
to real-life situations.
Example:-
• Business ethics
• Medical ethics (e.g. Bioethics)
• Medical Laboratory ethics
• Journalism ethics
• Engineering ethics
• Legal ethics

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
16
Health Institute
 Type of Ethics…..Cont’d
2. 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.

• Adherence to professional standards is expressed through

taking a professional oath and accepting professional code of
ethics

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
17
Health Institute
 Type of Ethics…..Cont’d
3. Organizational Ethics:
Organizational ethics is the application of morality related
choices as influenced and guided by values, standards, rules,
principles, and strategies associated with organizational
activities.

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
18
Health Institute
 Type of Ethics…..Cont’d
4. Work Ethics:
• A standard of conduct and values for job performance.
• The importance of developing a strong work ethic and how
the work ethic you develop will impact your future as an
employee.
Top ten work ethics;
• Attendance • Productivity
• Character • Organizational skill
• Team work • Communication
• Appearance • Cooperation
• Attitude • Respect

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
19
Health Institute
 Elements of a strong work ethics

• Integrity
• Emphasis on Quality of Work
• Professionalism
• Discipline
• Sense of Responsibility
• Sense of Teamwork

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
20
Health Institute
 Who is Responsible for Ethical Conduct?

EVERYONE!

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
21
Health Institute
 Principles of Ethics
Ethical principles are the fundamentals of ethical analysis
because they are the viewpoints that guide a decision.
There are four fundamental principles of health care ethics.
• Autonomy
• Beneficence
• Non-maleficence
• Justice

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
22
Health Institute
 Principles of Ethics…Cont’d
The major principles of medical laboratory ethics are:

• Autonomy: means independence and ability to be self directed

in health care. Autonomy is the basis for the client’s right to self
determination.

• Beneficence: acting in the best interests of patients (doing or

promoting good). This principle is the basis for all health care
providers
The Ethiopian Public Health Institute Ministry of Health-Ethiopia
The Ethiopian Public Ministry of Health-Ethiopia
23
Health Institute
 Principles of Ethics…Cont’d

• Non-maleficence: means to avoid doing harm. Health

professionals should not inflict harm on patients.

• Justice: fair, equitable and appropriate treatment. Treat all

patients equally – no unfair discrimination.

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
24
Health Institute
 Core values of Ethics
Trustworthiness
Respect
Responsibility
Fairness
Caring
Citizenship

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
25
Health Institute
 Confidentiality
• Confidentiality in healthcare ethics underlines the importance
of respecting the privacy of information revealed by a patient
to his or her health care provider, as well the limitation of
healthcare providers to disclose information to a third party.

• The healthcare provider must obtain permission from the

patient to make such a disclosure.

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
26
Health Institute
 Confidentiality…Cont’d
The high value that is placed on confidentiality has three
sources:
• Autonomy: personal information should be confidential, and be
revealed after getting a consent from the person

• Respect for others: human beings deserve respect; one

important way of showing respect is by preserving their privacy.

• Trust: confidentiality promotes trust between patients and

health workers.

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
27
Health Institute
 Informed Consent
• Informed consent is legal document whereby a patient signs
written information with a complete information about the
purpose, benefits, risks and other alternatives before he/she
receives the care intended.
• It is a body of shared decision making process, not just an
agreement.
• For consent to be valid, it must be voluntary and informed,
and the person consenting must have the capacity to make
the decision.

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
28
Health Institute
 Informed Consent …Cont’d
• Voluntary: the decision to either consent or not to consent
must be made by the person him or herself, and must not be
influenced by pressure.

• Informed: the person must be given all of the information in

terms of what the treatment involves

• Capacity: the person must be capable of giving consent,

which means they understand the information given to them,
and they can
The Ethiopian Public Health Institute
use it to make an informed decision.
Ministry of Health-Ethiopia
The Ethiopian Public Ministry of Health-Ethiopia
29
Health Institute
 Right and Obligations of medical laboratory professionals

Activity 10.2. Self-reflection

Instruction: Read the following question and
answer it.

Question: What are the Rights and Obligations of

medical laboratory professionals?

Time: 3 minutes

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
30
Health Institute
 Right and Obligations ……Cont’d

• The Code of Ethics describes the expected ethical

obligations and principles that patients, the profession and
the public believe will guide the professional and personal
conduct of all medical laboratory professionals.

• These principles can be thought of more as exhibited

behaviors than the knowledge and skills listed in a
Standards of Practice document.

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
31
Health Institute
 Right and Obligations ……Cont’d

Honesty
• In performing lab testing
• In reporting lab results
Dependability
• Taking your position seriously
• Being at work when you assigned to be
Kindness and firmness
• Use compassion with patients and co-workers
• Remain firm in your duties and in doing what is right and
best for your patient
The Ethiopian Public Health Institute Ministry of Health-Ethiopia
The Ethiopian Public Ministry of Health-Ethiopia
32
Health Institute
 Right and Obligations …Cont’d

Humanity and Justice

•Be fair in running all patients’ laboratory tests
•Put yourself in the patient’s position before you argue or say
something you will regret
•Put yourself in your co-worker’s position before you argue or say
something you will regret

Maintaining good reports

•Use good handwriting when signing out patient results
• Take your time to record all patient information in all log books
•Be honest in all your reporting

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
33
Health Institute
 Right and Obligations …Cont’d

Adaptability

• Be willing to change work hours to help a co-worker

• Be willing to stay at work a little longer if patient work is not

completed

• Be willing to make changes in testing procedures and other

areas as needed

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
34
Health Institute
 Right and Obligations …Cont’d
Co-operation
• If you expect others to co-operate with you, you need to co-
operate with them
• Team work will finish lab work quicker than an individual

Ethical behaviors

• In all that you do, base your actions and decisions on ethical
behavior

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
35
Health Institute
 Rights of Medical laboratory Professionals
• Safe working environment
• Appropriate wage, allowance
• Legal protection
• Security
• Insurance for occupational hazard
• Access to medication

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
36
Health Institute
 Rights of Medical laboratory…cont’d

• Professional risk allowance

• Standard work load

• Proper leave (education, maternity, paternity , sick )

• Right to exercise the profession scientifically , ethically and

legally

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
37
Health Institute
 Rights of Medical laboratory…cont’d

• The right to participate in health facility management

and policy making
• Safety to new technology
• The right to receive Vaccination
• Be rewarded for innovative ideas

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
38
Health Institute
 Professional Malpractice
Malpractice
• An act of omission by health care provider that deviates
from accepted standards of practice in medical community
which causes harm to the patient.

Malpractice: Area of concern

Fraud
• The deliberate falsification of analytical or quality
assurance results, where failed method requirements are
made to appear acceptable during reporting.
• The intentional recording or reporting of incorrect
information
The Ethiopian Public Health Institute Ministry of Health-Ethiopia
The Ethiopian Public Ministry of Health-Ethiopia
39
Health Institute
 Malpractice: Area of concern…Cont‘d

• Fraud is purposeful and intentional

• Fraud is not a mistake.
• Fraud is an intentional misrepresentation of lab data to hide
known or potential problems.
• Fraud makes data look better than it really is, with the intent
to deceive/mislead.

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
40
Health Institute
 Malpractice: Area of concern…Cont‘d
• Data manipulation
• Failure to follow Policy, SOPs/reference methods
• Falsifying existing data
• Incomplete record keeping
• Reporting data for samples not analysed
• Failure to respect customers
• Partiality/Injustice
• Unsafe practice
• Failure to adhere professional ethics
The Ethiopian Public Health Institute Ministry of Health-Ethiopia
The Ethiopian Public Ministry of Health-Ethiopia
41
Health Institute
 What Are the Penalties for malpractice

Some Possible Legal Actions

 Suspension

 Civil Prosecution
 Criminal Prosecution

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
42
Health Institute
 Prevention of malpractice
Create effective policies:
• Zero Tolerance – fraud is grounds for immediate dismissal
• Be Proactive: Develop a Code of Conduct and
Provide Ethical declaration/ Agreement
Training /orientation
Provide job description
Create effective communication system
Write SOPs (manual integration
The Ethiopian Public Health Institute Ministry of Health-Ethiopia
The Ethiopian Public Ministry of Health-Ethiopia
43
Health Institute
 Ethics and law
Activity 10.3. Think/Pair/share
Instruction: First think about the following
question and then discuss in pair with a participant
sitting next to you and share your idea.
Question: Describe about the difference between
ethics and law?

Time: 3 minutes

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
44
Health Institute
 Ethics and law….Cont’d
What is the Relation between Ethics and Law?
• Law – the authority is external
• Ethics – the authority is internal

Ethics is considered as a standard of behavior and a

concept of right and wrong beyond.

Law is defined as a rule of conduct or action prescribed or

formally recognized as binding or enforced by a controlling
authority.
The Ethiopian Public Health Institute Ministry of Health-Ethiopia
The Ethiopian Public Ministry of Health-Ethiopia
45
Health Institute
 Good Laboratory Practices (GLPs)

Activity 10.4. Self-reflection

Instruction: Read the following question and
answer it.

Question: What are GLPs?

Time: 3 minutes

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
46
Health Institute
 Good Laboratory Practices…..Cont’d
• 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 meticulous planning,
perfect execution and thorough checking of results by the
whole team involved.
The Ethiopian Public Health Institute Ministry of Health-Ethiopia
The Ethiopian Public Ministry of Health-Ethiopia
47
Health Institute
 Good Laboratory Practices…..Cont’d
• Good Laboratory Practice (GLP) embodies a set of principles that
provides a framework within which laboratory studies are planned,
performed, monitored, recorded, reported and archived.

• In the clinical and research arena, the phrase good laboratory

practice or GLP generally refers to a system of management
controls for laboratories and research organizations to ensure the
consistency and reliability of results

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
48
Health Institute
 Good Laboratory Practices…..Cont’d
• Data management (recording, reporting and archiving)
• Using 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
• External quality assessment
• Internal audit (identify problems and weak points in the system
and suggest remedial measures
The Ethiopian Public Health Institute Ministry of Health-Ethiopia
The Ethiopian Public Ministry of Health-Ethiopia
49
Health Institute
 Summary
• Ethics is a moral guide that governs the professional and personal
conduct of all regulated members of an institution and communicates to
the public.

• General principle –Ethics are applied for the best interest of the patient.

• Medical Laboratory Technologists and Scientists understand and comply

with applicable privacy legislation and policies regarding the collection,
use, & disclosure of confidential information.

• Medical Laboratory professionals maintains a culture of safety

The Ethiopian Public Health Institute Ministry of Health-Ethiopia

The Ethiopian Public Ministry of Health-Ethiopia
50
Health Institute
 The Ethiopian Public Health Institute Ministry of Health-Ethiopia
The Ethiopian Public Ministry of Health-Ethiopia
51
Health Institute
 u !!
Yo
n k
h a
T
The Ethiopian Public Health Institute Ministry of Health-Ethiopia
The Ethiopian Public Ministry of Health-Ethiopia
52
Health Institute