Example A of quiz type 1: Ethical issues in Medical Science

This is a quiz question that was developed by Diana Quinn and used within a Medical Science course to particularly develop graduate quality 5, awareness of social and ethical issues associated with the profession.

Points of interest

· No correct or incorrect answer options

· Language of learning incorporated in feedback to support person development of understandings

· Use of web addresses to send learners to appropriate information to develop understandings

Please select your preferred option in response to this scenario.

You are working in a pathology laboratory within a regional centre. You are working the late shift and are essentially alone in the laboratory. The telephone rings and it is an old friend of yours, Jill. Jill is quite distressed, and asks you if you could give out her pregnancy test result, which is yet to be done. You end the call and do the test. You had heard that Jill had recently broken up with her partner Mark, and wondered if this is why she was so distressed. The test result is positive, but the negative control result shows some background reaction. You are about to retest the sample when the phone rings. It is Jill again and she is almost hysterical, begging you to tell her what the result is. What do you do?

a) Validate the result again, and now that you are confident of the result, contact Jill.
b) Try to work out if Jill and Mark are still together before you tell the results
c) Say to Jill that as a professional you can not say anything, but you organize to meet socially after work.
d) Do not tell Jill the result and ask her not to call back

No answer marked as correct

Feedback to option a

It is good practice to validate any results that you are sceptical of. Negative controls that give background reactions indicate that the patient’s plasma may be reacting non-specifically with the test reagents, and thus could be a source of false positive results. This assay will need to be repeated to ensure the control performs appropriately. However, regardless of whether you are confident of the result or not, it is not appropriate for you to contact Jill to let her know the results as it violates the code of ethics of the medical scientist profession. You are not aware of the issues surrounding the test and therefore you can not contextualise the result for the patient. This is the job of the physician, not you. You are best advised to not tell Jill anything and ask her not to call back.
If you would like to know more about the code of ethics of medical science and how it will impact on your practice as a medical scientist, you can visit the website of the International Federation of Biomedical Laboratory Science http://www.ifbls.org/code_of_ethics.htm

Feedback to option b

I can understand why you might want to help Jill, who is obviously distressed, however in this case, the code of ethics of the medical scientist profession indicates that this is inappropriate. It really is irrelevant if Jill and Mark are together or not, as Mark may not be the father of the baby. You are not aware of the issues surrounding the test and therefore you can not contextualise the result for the patient. This is the job of the physician, not you. You are best advised to not tell Jill anything and ask her not to call back. If you would like to know more about the code of ethics of medical science and how it will impact on your practice as a medical scientist, you can visit the website of the International Federation of Biomedical Laboratory Science http://www.ifbls.org/code_of_ethics.htm
Another point that needs to be made is about the validity of a test result that has a positive reaction in the negative control. This indicates that the test that was used to determine Jill's result may be flawed and would need to be validated. 

Feedback to option c

I can understand why you might want to help Jill, who is obviously distressed, however in this case, the code of ethics of the medical scientist profession indicates that this is inappropriate. You were probably aware of this because you knew not to talk with her over the telephone about the results, but what you may not appreciate is that the code does not cease to operate when you leave the laboratory! You are a professional all day every day, and bound by this code.  If you would like to know more about the code of ethics of medical science and how it will impact on your practice as a medical scientist, you can visit the website of the International Federation of Biomedical Laboratory Science http://www.ifbls.org/code_of_ethics.htm
There are also some concerns that the test may be flawed (graininess in the negative control) and would need to be validated.

Feedback to option d

Of all the options this is the most appropriate -do not tell Jill the result and ask her not to call back. Although it is a normal reaction to want to help distressed friends you are not in a position to support her as this would violate the code of ethics of the medical scientist profession.  Have you visited the website of the International Federation of Biomedical Laboratory Science http://www.ifbls.org/code_of_ethics.htm to see the code? It has a brief description of the difference between morals and codes, a point that people often confuse.
In addition there are also some concerns that the test may be flawed (graininess in the negative control) and would need to be validated.