# Presentation: 164520

## Module 16:  Professional Ethics

## Learning Objectives

- By the end of the module, you will be able to:
- Describe ethical issues related to HIV rapid testing
- Explain the importance of professional ethics
- Apply ethical conduct to HIV rapid testing
- Take appropriate actions to maintain client confidentiality

## Content Outline

- What is ethics?
- Why is ethics important?
- Who is responsible for ethics?
- How is ethics applied to HIV rapid testing?
- Maintaining confidentiality
- Code of conduct

## Scenario I

- A pregnant woman comes for HIV testing.  Your test site has just run out of the 2nd test in the algorithm.  You tell her that she will have to come back in 2 days.  She becomes very emotional and explains that she has traveled a long distance after finally deciding to get tested and won't be back in the area for a long time.
- Feeling sorry for her, you proceed to perform test one, and report a resulting positive test to the client.

## Scenario II

- At the HIV rapid testing site, you discover that you just run out of the buffer for Test 1 of the algorithm. Rather than denying testing to clients, you decide to go ahead and perform Test 1 using the buffer from kits of Test 2.

## Scenario III

- Today is Monday. You discover that there are enough test devices to last through the entire week, but they will expire on Wednesday.
- Since resources are tight and you don’t want to waste any test kits (it is only a couple of days past expiration anyway), you decide to use the test devices until the end of the week.

## What Could Be the Consequences of...

- A false positive HIV result?
- A false negative result?

## What Is Ethics?

- “A set of principles of right conduct”

**Notes:**
Definition from Churchill’s Medical Directory

## Why is Ethics Important?

- “Decisions about diagnosis, prognosis and treatment are frequently based on results and interpretations of laboratory tests. Irreversible harm may be caused by erroneous tests.”

- International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)

**Notes:**
In other words if we do not apply a code of ethics the patient will suffer

## Scenario IV

- Rick, the tester, is excited about getting home at the end of his work day, because a relative he hasn’t seen in quite some time is scheduled to arrive. Right before he is ready to leave, he gets distracted by a phone call and forgets to lock up the lab register in the cabinet.

## Maintaining Confidentiality

- It is important to:
- Keep all client/patient information private
- Secure all records / logbooks
- Restrict access to testing areas

- People often violate ethics not because they mean to, but because they are careless. As a matter of fact, they sometimes act with good intentions.

**Warning**

## Role-Play

- Watch the role-play and discuss:
- What happened?
- What were the ethical issues involved?
- What were the implications?
- What would you do if you were in this situation?

## Who is Responsible for Ethics?	

- EVERYONE!
- Medical Laboratory Technician
- Nurse Counselor
- Clerk
- Secretary
- General Hand
- Driver

## How Do We Apply Ethics To HIV Rapid Testing?

- Work done
- Behavior of the staff
- Behavior of management

## Code of Ethics (IFBLS)

- Maintain _strict confidentiality_ of patient information and test results
- Safeguard the _dignity and privacy_ of patients
- _Be accountable_ for the quality and integrity of clinical laboratory services

**Excerpts from International Federation of Biomedical Laboratory Science (IFBLS)**

## Code of Ethics (ASCP)

- Treat patients and colleagues with respect, care and thoughtfulness
- Perform duties in an accurate, precise, timely and responsible manner
- Safeguard patient information as confidential, within the limits of the law
- Prudently use laboratory resources

**Excerpts from American Society for Clinical Pathology  (ASCP)**

**Notes:**
A Code of Ethics is an expression of basic values  - the principles and standards by which you should conduct yourself

A number of laboratory professional organizations have code of ethics, with common principles of conduct.  The next 2 slides highlight principles from IFBLS and ASCP 

STATE each bulleted point.  ASK participants to feedback what the meaning is to ensure understanding.

Be accountable... - by that we mean that you have must take responsibility for everything you do.... be able to answer for your conduct conduct and moral obligations to choose to do right over wrong. 

## Summary

- In your own words, what is ethics?
- Why is it important?
- Give examples of actions you can take to maintain client confidentiality.
- Give an example of a code of ethics to which you are willing to personally commit.

## Key Messages

- Ethical issues are important. We must constantly remind ourselves of the code of conducts and ensure we do the right thing.
- Ethical issues are often hard to deal with because they create dilemmas.
- People often violate ethics not because they mean to, but because they are careless. As a matter of fact, they sometimes act with good intentions.