MT6313 MEDICAL TECHNOLOGY LAWS AND PROFESSIONAL BIOETHICS

UNIT 11: THE CONCEPT OF HEALTH

References: PPT; Assoc. Prof. Hapan’s Discussion

DEFINITION OF HEALTH PSYCHOSOCIAL CONCEPT

• State of complete physical, mental, and social well-being • Regard health as both a biological and social
and not merely the absence of disease and infirmity (WHO) phenomenon
• Health is something that is not dynamic and static • Takes into consideration the following factors: Social,
it can be quantified, measured, and appraised Psychological, Cultural, Economic, and Political
• Understanding of the concept of health is very important
because it is the basis in health care EMOTIONAL HEALTH Feeling
SOCIAL HEALTH Relating
SDG 3: GOOD HEALTH AND WELL-BEING MENTAL HEALTH Thinking
SPIRITUAL HEALTH Being

HOLISTIC CONCEPT
• Synthesis of all the other concepts
• Recognizes the strength of: Social, Economic, Political, and
Environmental
• Focus is on the well-being of a person as a whole
• Emphasis is on the promotion and preservation of health

• Healthcare
• Relaxation
• Environment
• There are 17 SUSTAINABLE DEVELOPMENT GOALS • Body care
• Good health and well-being: number three (3) among • Fitness
the 17 goals intended to transform our world • Nutrition
• Mindset
• Supporting health and well-being is one of the 17 global
• Relationship
goals that make up the 2030 sustainable development • Stress Management
goals. Ensuring healthy lives and promoting wellbeing at all • Sport
ages is essential to sustainable development
• Recognizing the interdependence of health and DEFINITIONS OF ILLNESS, SICKNESS & DISEASE
development: ILLNESS
o The Sustainable Development Goals provide an • Subjective state of a person who feels not to be well
ambitious and comprehensive plan of action to • A broad term that connotes the poor state of mind, body,
promote and achieve health and development and, to a certain extent, spirit
outcomes • Denotes a general feeling of being sick or unwell
• SDG 3 aspires to ensure health and well-being for all • Ambiguous symptoms
o including a bold commitment to end the epidemics of • Illness refers to the presence of a specific disease
AIDS, tuberculosis, malaria and other communicable o also to the individual’s perceptions and behavior in
diseases by 2030 response to the disease
• It also aims to achieve universal health coverage, and o as well as the impact of that disease on the
provide access to safe and effective medicines and psychosocial environment
vaccines for all
SICKNESS
CONCEPTS OF HEALTH • Condition of being ill
BIOMEDICAL CONCEPT • Sickness is related to a different phenomenon which the
• Merely the absence of disease social role a person with illness or sickness takes or is given
o If the person is not sick, he is considered healthy in society, in different arenas of life
• This concept views the body merely as a machine • Sickness refers to a state of social dysfunction
o Human body = machine • affected by social and cultural conceptions which affect
o Disease is considered to being analogous to the how a patient reacts
breakdown of this machine
DISEASE
• has undermined the fact that environment, social, and
PAST CURRENT
cultural determinants play an important role in health
o Minimized the role of the environment, social, and Earlier viewed as a Now viewed as a channel to better
cultural determinants of health suffering, a curse, or understand the human body’s
• Found to be inadequate due to developments in Medical punishment for sins capabilities, interactions, and
and Social Sciences development limitations

ECOLOGICAL CONCEPT
• Ecologists viewed health as a dynamic equilibrium
between the human body and the environment
o There is a relationship between the human body and
the environment
• Disease: maladjustment between the human body and
the environment
o Any maladjustment or disruption in this equilibrium will
result to a disease
• Oxford definition:
o Derangement of the body or some part or organ
o Disruption of the functions of the body or some
parts/organs of the body
• Webster definition:
o A condition in which body health is impaired
o A departure from the state of health
o An alteration of the human body interrupting the vital
functions

GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
• Characterized by an underlying pathology VIDEO TRANSCRIPT:
o that is biologically defined based on a practitioner’s SOCIAL DETERMINANTS OF HEALTH
perspectives or a doctor’s perspectives • A very important concept to understand, because on the
• The term disease literally means “without ease” health of individuals and populations
(uneasiness), when something is wrong with bodily function • Health is quite variable, not just between individuals but
also across different population groups, and even within
MEDICINE HAS STUDIED DISEASE IN TERMS OF: countries
• Disturbance of bodily homeostasis o e.g. In 2015, the life expectancy of a child born in
• Morphological changes of internal organs Sierra Leone was 50 years, whereas in Australia it was
• Morphological changes in tissues and cells 83 years – a difference of 33 years
• Irritation of organs and their actions, reactions o e.g. In Australia, the life expectancy of Indigenous
(physiological) people is about 10 years lower than that of non-
• Invasion of the body by an external contagion indigenous people
• Genetic alteration • Health is influenced by social status
o People with higher income, a higher level of
education, and a better occupation have better
health and a greater life expectancy
• Health status can change as well
o Studies of migrants have shown that the type of
diseases, health behaviors, and risk factors are
different in migrants compared to those in their
country of origin
• A person’s health is influence by a range of factors called
DETERMINANTS OF HEALTH, these include:
o Who they are
o Individual factors: age, sex, and genetic makeup
o What they do: health behaviors such as smoking,
physical activity, alcohol use, and diet
• Health is also largely influenced by SOCIAL DETERMINANTS
ILLNESS SICKNESS DISEASE OF HEALTH:
individual community doctor o conditions in which people are born, grow, live, work,
“I feel ill” “You look sick” “You have a and age: social and community networks,
disease” socioeconomic, cultural, and environmental
ILLNESS & SICKNESS Family: “Yes, you are sick” conditions that people live in, health systems
ILLNESS & DISEASE Patient: “Yes doctor, I am sick” o ultimately shaped by the distribution of money, power,
SICKNESS & DISEASE Family: “Yes doctor, they are sick” and resources at an international, national, and local
All agree level
o have a marked influence on health inequities
THREE PERSPECTIVES: DISEASE, SICKNESS, & ILLNESS § which is the unfair and avoidable health
differences between different groups of people
within countries or between countries
• There are many social determinants of health across many
levels and with complex interactions between them
o Influence and interact with each other to affect
health and well-being
• WHO- COMMISSION FOR SOCIAL DETERMINANTS OF HEALTH
o Framework developed by the WHO
o According to this framework, there are two broad
types of health determinants that influence health and
can lead to health inequities
DISEASE SICKNESS ILLNESS § These are (1) structural determinants and (2)
underlying social & cultural a person’s intermediary determinants
pathology; conceptions of this subjective o STRUCTURAL DETERMINANTS
conditions: cultural experience of § Refer to the socioeconomic and political context
beliefs and their symptoms. in which a person is born into and lives in
reactions such as
® Governance
fear or rejections;
® how society organizes itself to make and
biologically these affect how what the
implement economic, social, and public
defined: the the patient reacts patient brings
policies
practitioner’s to the doctor
® social and cultural values that communities
perspective
place on health
the illness seen in also covers what is
§ can determine and lead to the unequal
terms of a theory considered a
distribution of material and monetary resources
of disorder disorder suitable for
which shapes a person’s socioeconomic position
medical treatment
® described a person’s place in society
® can affect their exposure vulnerability and
outcomes to conditions that have an impact
on their health

GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
 ® determined by education, occupation,
income, gender, race or ethnicity, and social
class
® in turn affects the intermediary determinants
o INTERMEDIARY DETERMINANTS
§ These include material circumstances
® quality of housing
® financial means to buy healthy food,
clothing, or other requirements for healthy
living
® work environment
§ also includes psychosocial factors
® stressful living
® relationships
® social support
§ behavioral and biological factors
§ influence health and health inequities
o Health systems have an impact on the type and
quality of health care available to people
§ It also determines how easy it is for people to
access health services and receive the
healthcare they need
o Social cohesion & Social capital
§ Factors that bridge the structural and
intermediary determinants
§ Describe the willingness of people living in a
community to make sacrifices and to cooperate
with each other for a wider benefit
o Links between these different factors are not always
linear but are complex and can go in both directions
§ e.g. poor income and education can impact
health, and also poor health can limit
opportunities for people to participate in the
workforce or receive education
§ e.g. If population is affected by a lot of disease, it
can have a broader impact on the
socioeconomic and political context
o Addressing the social determinants of health involves:
§ Identifying the structural and intermediate
determinants
§ Taking appropriate actions to improve them
§ Actions across all sectors of society and at all
levels (local, national, and international)
® The actions will depend on the existing socio-
economic and political context, resources,
and commitment for action.

GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
 MT6313 MEDICAL TECHNOLOGY LAWS AND PROFESSIONAL BIOETHICS
UNIT 12: THE CALLING OF THE HEALTHCARE PROVIDER
References: PPT; Assoc. Prof. Hapan’s Discussion
HEALTHCARE PROFESSION
• A special calling
• Service characterized by a trusting and caring relationship
between the professional and the patient
• There is always a trusted caring service that exist between
the healthcare provider who offers help and a dependent
patient who needs and receives the help that is offered
• Medical Technology is a healthcare profession
HEALTHCARE PROVIDER
• Healthcare providers may be working in hospitals, in clinics,
in pharmacies, in retirement homes, in clinical laboratories,
and other health care facilities
• Deal with individuals who are not in the best state of health,
o therefore, should possess certain qualities to be able
to provide personalized and professionalized service
to the patients
• There are qualities needed for a healthcare provider to be
more effective in establishing a trusting and caring
relationship with patients
QUALITIES OF A HEALTHCARE PROVIDER
1. EFFECTIVE COMMUNICATION SKILLS
• Patients would like their condition and medical condition
explained to them in simple language which they can
easily understand, this involves
o Effective speaking and listening
o Following directions without problem
o Can talk easily to patients and families and
understand their needs
§ Being able to find the right words to say
§ Being able to talk to patients and patients’
relatives
§ Being able to understand their needs
2. EMOTIONAL STABILITY
• The healthcare provider must be emotionally stable as
shown by his ability to:
o handle stressful and traumatic situations, such as,
patient suffering and death
o able to work without allowing stress to cause him
personal harm and affect his job performance
3. SELF-RESPECT
• Proper regard to the dignity of one’s character or
profession
• Appreciation of one’s obligation to care for the sick
4. FLEXIBILITY
• willingness to work long periods, overtime, night shifts, and
even on holidays
• willingness to accept other responsibilities
o colleagues’ responsibilities or to pitch in for a co-
worker who is unable to report to work
5. GOOD ATTENTION TO DETAILS
• attentive to details and understands every step
• careful not to make any error
o should be able to follow and administer instructions
carefully to avoid errors
o should be very careful not to commit errors when one
is caring for the sick, as errors will have adverse effects
on the patient’s condition
GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
6. GOOD INTERPERSONAL SKILLS
• ability to work well with different people
• works well in a variety of situation (deliver services in a
variety of challenging situation), involves:
o showing concerns for others
o displaying a sincere interest to serve and to help others
o demonstrating sensitivity to other’s feelings,
particularly, that of patient’s and patient’s relatives
7. PHYSICAL STAMINA
• strong physical endurance
• able to endure long hours of work
• able to perform taxing duties
• endure the physical demands of providing health services
and answer to varying patient needs and demands
• healthcare being a demanding career would require
healthcare providers who are physically fit
8. PROBLEM-SOLVING SKILLS
• think quickly, solve problem creatively
• address problems even before they arise
• besides caring for patients, they deal with other challenges
and problems such as:
o service delivery
o management
o maintenance
o allocation problems
9. ABILITY TO RESPOND QUICKLY
• always prepared to respond to sudden incidences
• can respond quickly to emergencies
o critical to healthcare as this would definitely save lives
and prevent unnecessary suffering
10. RESPECT FOR OTHERS
• Respect is an essential component of any organization and
any profession
• A healthcare provider should be able to:
o respect people
o respect rules
o heedful of confidentiality requirements
§ mindful of patient’s rights to autonomy, privacy,
and confidentiality
o considerate of other cultures and traditions
o respects wishes and decisions of patients
• respect for others definitely creates a healthy and caring
environment in which patients feel their value as patients
11. EMPATHY
• the act of correctly acknowledging the emotional state of
another person without actually experiencing it
o ability to identify with another person’s feelings
o ability to understand a patient’s experience, validate
patient’s fear, anxiety, and pain
• provides an effective and powerful means to establish
patient connection that results to patient’s trust and
improve health care outcomes
12. COMPASSION
• sensitivity - sensitive enough to understand patient’s
feelings or patient’s suffering
• willingness to assist other people
• promote patient’s well-being
• help improve patients’ health outcomes
• help enhance patients’ well-being ROLES OF HEALTHCARE PROFESSIONALS
• improve the quality of patients’ relationship with those • play a central and critical role in improving access and
providing health care quality health care for the population, providing health
services to those who are in need of health care
VIRTUES OF A HEALTHCARE PROVIDER • provide essential services that promote health, prevent
• Virtue came from the ancient Greek word arête/Arete: diseases and deliver health care services to individuals,
which means moral excellence families and communities based on the primary health
o trait that refers to something which is morally good care approach
and is therefore valued as a foundation of principle • healthcare providers often function exclusively in a
and good moral being supportive role as long as patients are able to advocate
o disposition to act according to moral principles, rules, for their own wishes
and ideals • Healthcare professional provides treatment and advice
o essence of one’s character, considering that the based on formal training and experience
manner by which healthcare is delivered greatly The field includes those who work as:
depends on what virtues the healthcare provider Physicians Dentist Psychiatrist
values Surgeons Midwives Pharmacist
• to transcend one’s profession the healthcare provider must Nurses Psychologists Medical technologists or
be virtuous Medical Laboratory Scientist
Including those who perform services in
o without virtues, the delivery of health care is just a
other allied health professions
business contract
o with virtues, it becomes a covenant of trust RIGHTS OF HEALTHCARE PROFESSIONALS
1) Basic individual rights, including the civil, constitutional,
1. FIDELITY
and statutory rights as a person
• keeping the promise and remaining faithful to being a 2) Right to considerate and respectful behavior from the
patient advocate patients and to be free from harassment, abuse, attack,
• provide competent care and professional service and verbal and mental abuse
• avoid conflicts of interest • Right to considerate and respectful behavior from
their superiors
2. HUMILITY
3) Right to protect ourselves from physical attack
• recognizing one’s capabilities and limitations 4) Right to register a complaint about a patient, and to pursue
• respecting patient’s autonomy that complaint through the hospital system or in a court of
• willingness to accept suggestions from colleagues law without risk to our employment
• putting aside one’s ego and recognizing the value of the 5) Right NOT to be required to put patients’ life, their physical
person to whom care is given health, or the health of their families at risk
6) Right to reasonable access to the tools needed to perform
3. COMPASSION
the duties of their position
• willingness to sacrifice for others 7) Right to sufficient personal time during the work shift to
• genuine concern for the sufferings of others keep hydrated and nourished as needed

4. JUSTICE WHAT ARE PATIENTS

• constant will to give what is due to others with fairness and
rightfulness
o distribute equally and equitably scarce resources
o uphold moral and applicable laws and legislations
when making decisions
• offering needed treatments/interventions
• fairness & rightfulness
5. COURAGE
• doing what is right without undue fear
• being true to one’s calling without fear
• willingness to fight for patient’s right
• Courage becomes a virtue when we choose to do good
and to do what is right especially when doing it is most
difficult without undue fear
• it is moral strength in the face of danger and demands our
respect when it incurs risk without selfish motivation
• among healthcare providers, courage may mean having
the personal strength and vision to innovate and achieve
goals that are consistent with one’s values
6. PRAYERFULNESS
• inclination to seek God
• prays for encouragement, strength, and consolation
• Patiens (Latin): means one who suffers
• persons receiving medical care/treatment
• persons under health care
• Out-patient: one who is hospitalized for less than 24 hours
• In-patient: one who is confined overnight or for an
indeterminate time in the hospital
PATIENTS’ RIGHTS
• Does not only protect the patient but the healthcare
provider and the hospital as well
• Offer guidance and protection to patients by providing
them with the necessary information about the
responsibilities that they can expect from healthcare
institutions and healthcare providers
UNDER THE PRINCIPLE OF AUTONOMY
1) Right to self-determination
• The patient has the moral right to determine what is
good for himself
UNDER THE MEDICAL CONTEXT
1) Right to informed consent
• right to knowledge of, and information about, and
consent to a particular form of treatment
• Information should include the risk and advantages of
any medical treatment that concerns the patient
• Right to receive all necessary information concerning
diagnosis and treatment

GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
2) Right to informed decision
• patient is entitled to all information that will lead to his
understanding of his condition and enable him to
have genuine deliberation resulting to sound decision
• right to know all the necessary information regarding
procedures & treatment before these are carried out
• patient must be informed and must understand the
whole process
3) Right to informed choice
• right to know all the alternative courses of treatment
and the possible consequences
• goes together with the right to informed consent and
informed decision
o since once the patient is well informed and
consent is given, patient then makes a decision
that becomes the patient’s moral choice
4) Right to refusal of treatment
• right to refuse treatment and be informed of its
consequences
• only up to the extent provided by law
• may be due to a patient’s religious conviction
PATIENTS’ BILL OF RIGHTS
(AMERICAN HEALTH ASSOCIATION)
1) These rights can be exercised on the patient’s behalf by a
designated surrogate or proxy decision maker if the
patient lacks decision-making capacity, is legally
incompetent, or is a minor.
1) Has the right to CONSIDERATE AND RESPECTFUL CARE
2) The patient has the right to and is encouraged to OBTAIN
from physicians and other direct caregivers relevant,
CURRENT, AND UNDERSTANDABLE INFORMATION
concerning diagnosis, treatment, and prognosis.
3) The patient is entitled to the OPPORTUNITY TO DISCUSS AND
REQUEST INFORMATION RELATED TO:
• the specific procedures and/or treatments
• the risks involved
• the possible length of recuperation
• the medically reasonable alternatives and their
accompanying risks and benefits
à Except in emergencies when the patient lacks decision-
making capacity and the need for treatment is urgent
4) Patients have the right to KNOW THE IDENTITY OF
PHYSICIANS, NURSES, AND OTHERS INVOLVED in their care
• as well as when those involved are students, residents,
or other trainees.
5) The patient also has the right to KNOW THE IMMEDIATE AND
LONG-TERM FINANCIAL IMPLICATIONS OF TREATMENT
choices, insofar as they are known.
6) The patient has the right to MAKE DECISIONS ABOUT THE
PLAN OF CARE
• prior to and during the course of treatment
• and to refuse a recommended treatment or plan of
care to the extent permitted by law and hospital
policy and to be informed of the medical
consequences of this action.
• In case of such refusal:
o the patient is entitled to other appropriate care
and services that the hospital provides or transfer
to another hospital.
o The hospital should notify patients of any policy
that might affect patient choice within the
institution.
GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
7) The patient has the right TO HAVE AN ADVANCE DIRECTIVE
• such as a living will, health care proxy, or durable
power of attorney for health care
• concerning treatment or designating a surrogate
decision maker
• with the expectation that the hospital will honor the
intent of that directive to the extent permitted by law
and hospital policy.
• Health care institutions must advise patients of their
rights under state law and hospital policy to make
informed medical choices, ask if the patient has an
advance directive, and include that information in
patient records.
• The patient has the right to timely information about
hospital policy that may limit its ability to implement
fully a legally valid advance directive.
8) Patient has the right to every CONSIDERATION OF PRIVACY
• Case discussion, consultation, examination, and
treatment should be conducted so as to protect each
patient’s privacy.
9) The patient has the right TO EXPECT THAT ALL
COMMUNICATIONS AND RECORDS pertaining to his/her
care will be TREATED AS CONFIDENTIAL by the hospital
• EXCEPT in cases such as suspected abuse and public
health hazards when reporting is permitted or required
by law.
• The patient has the right to expect that the hospital will
emphasize the confidentiality of this information when
it releases it to any other parties entitled to review
information in these records.
10) The patient has the right to REVIEW THE RECORDS
PERTAINING TO HIS/HER MEDICAL CARE
• and to have the information explained or interpreted
as necessary, except when restricted by law.
11) The patient has the right to expect that, within its capacity
and policies, a HOSPITAL WILL MAKE REASONABLE
RESPONSE TO THE REQUEST OF A PATIENT for appropriate
and medically indicated care and services.
• The hospital must provide evaluation, service, and/or
referral as indicated by the urgency of the case.
• When medically appropriate and legally permissible,
or when a patient has so requested, a patient may be
transferred to another facility.
o The institution to which the patient is to be
transferred must first have accepted the patient
for transfer.
o The patient must also have the benefit of
complete information and explanation
concerning the need for, risks, benefits, and
alternatives to such a transfer.
12) The patient has the right to ASK AND BE INFORMED OF THE
EXISTENCE OF BUSINESS RELATIONSHIPS
• among the hospital, educational institutions, other
health care providers, or payers that may influence
the patient’s treatment and care.
13) The patient has the right to CONSENT TO OR DECLINE TO
PARTICIPATE IN PROPOSED RESEARCH STUDIES or human
experimentation
• affecting care and treatment or requiring direct
patient involvement
• to have those studies fully explained prior to consent.
• A patient who declines to participate in research or
experimentation is entitled to the most effective care
that the hospital can otherwise provide.
14) The patient has the right to EXPECT REASONABLE
CONTINUITY OF CARE when appropriate
• and to be informed by physicians and other
caregivers of available and realistic patient care
options when hospital care is no longer appropriate.
15) The patient has the right to be INFORMED OF HOSPITAL
POLICIES AND PRACTICES that relate to patient care,
treatment, and responsibilities.
• The patient has the right to be informed of available
resources for resolving disputes, grievances, and
conflicts, such as ethics committees, patient
representatives, or other mechanisms available in the
institution.
• The patient has the right to be informed of the
hospital’s charges for services and available payment
methods.
PERSONALIZING THE HEALTHCARE PROFESSION
• With new discoveries and innovations and the availability
of information and communications technology,
personalized healthcare has become a possibility.
• Advocates of personalized healthcare are getting away
with the standardized one-size-fits-all approach in treating
patients.
1) Health care workers should treat their patients as unique
individuals
2) Personalization improves the patient’s experience and
increases patient engagement
3) Patients’ ownership of their health and outcomes is
increasingly essential
4) Healthcare professionals need to personalize care and
motivate patients to become active participants in their
health journeys

PATIENTS’ BILL OF RIGHTS (PHILIPPINES) • Patients may not respond to certain drugs the same way
1) Right to appropriate medical care and humane treatment o Personalized healthcare can assist healthcare
2) Right to informed consent professionals to provide personalized therapy, which
3) Right to privacy and confidentiality can improve the quality of care and at the same time
4) Right to correct information be cost effective
5) Right to choose the health care provider and facility • Patients become a crucial part of their health journey,
6) Right to self-determination o when health professionals finds ways to share
7) Right to religious belief information with their patients, and patients in return
8) Right to medical records share information an experiences with healthcare
9) Right to leave professionals.
10) Right to refuse participation in medical research o Patients become more trusting and gain more
11) Right to correspondence and to receive visitors confidence in their health care plan or treatment plan
12) Right to express grievances personalizing the health profession, may include:
13) Right to be informed of his rights and obligations as a
patient 1) Getting patients involved in their own care
2) Personalized health recommendations
PATIENTS’ RESPONSIBILITIES 3) Personalized online therapy
• Patients not only have rights, but they also have 4) Personalized delivery of health, services and results
responsibilities.
• This is due to the collaborative nature of healthcare.
o Which requires that patients and/or their families
participate in their care
• The success of any healthcare depends in part on active
and responsible patient participation in the healthcare and
treatment process and on the patients fulfilling the
following responsibilities

1) Knowing their own rights

2) Providing information about past illnesses, hospitalizations,
medications, and other health related matters
3) Requesting additional information or clarification about
their health status or treatment when they do not fully
understand the current information or instructions
4) Making sure that the health care institution has a copy of
their written advance directive if they have one
5) Informing their physicians and other caregivers if they
anticipate problems in following prescribed treatment
6) Being aware that the hospital has to be reasonably
efficient and equitable in providing care to other patients
and the community
7) Being considerate of and making reasonable
accommodations to the needs of the hospital, other
patients, medical staff, and hospital employees

ADDITIONAL:
• know rights
• provide accurate and complete information
• report unexpected health changes
• understand purpose and cost of treatment
• accept consequences of own informed consent
• settle final obligations
• relate well to others
• exhaust grievance mechanisms

GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
 MT6313 MEDICAL TECHNOLOGY LAWS AND PROFESSIONAL BIOETHICS
UNIT 13: INTRODUCTION TO BIOETHICS
References: Book, PPT; Assoc. Prof. Hapan’s Discussion
ETHICS
• Came from the word “ethos”
• Also-called “Moral Philosophy”
o It is the discipline that is concerned with what is morally
good or bad and morally right or wrong
o Branch of philosophy that involves systematizing,
defending, and recommending concepts of right and
wrong conduct.
• It deals with questions at all levels.
o Its subject consist of the fundamental issues of
practical decision making
o its major concerns include the nature of ultimate value
and the standards by which human actions can be
judge, right or wrong.
• Moral principles that govern a person's behavior or the
conduct of an activity.
• Set of rules that society have to agree about living with
other people
INTRODUCTION TO BIOETHICS
• As members of the health care profession, ethical
responsibility becomes a part of the profession and the
professional. The principles and practice of bioethics and
professional ethics are therefore expected from health
care professionals.
• Bioethics embraces a diversity of ethical concerns when it
comes to the delivery of health care services.
• It plays an important role in making decisions when
confronted with health issues that may involve both the
patient and the healthcare provider.
WHAT IS BIOETHICS
• comes from the word:
o bio which means life
o ethics which means a way of acting
• BRANCH OF ETHICS: ETHICS OF LIFE
o deals with the natural laws of life and the ways of how
one should live life
o It is in a sense, practical because of its application to
everyday living or life
• LIFE OF SCIENCE: BIOLOGY
o It is also a science because it is based on a
systematized knowledge that tells a person what
ought to be done and what should not be done
• PHILOSOPHY
o A Philosophical study of ethical issues brought about
by advances in science and technology
o It helps people understand moral issues pertaining to
life by putting considerations into their proper
perspectives
• PROFESSIONAL ETHICS IN ALLIED HEALTH
o Often known as medical ethics or clinical ethics
o Moreover, bioethics is commonly understood to refer
to the ethical implications and applications of health-
related life sciences.
o important aspect of the healthcare profession and
healthcare professionals
o these implications of Bioethics can run the entire
length of the bench-to-bedside "translational
pipeline.”
• Application of the basic principles of ethics to the new
possibilities opened by modern biology and biotechnology
• Interdisciplinary study of problems brought about by
biological and medical progress
GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
• has applications ranging from birth to the end of life and
exerts its impact on all facets/aspects of human life,
society, and its value system
• It also deals with Bioethical dilemmas
o Dilemmas can arise for the basic scientist who wants
to develop synthetic embryos to better study
embryonic and fetal development but is not sure just
how real the embryos can be without running into
moral limits on their later destruction.
SCOPE OF BIOETHICS
1) Studies of human actions of allied health professionals with
regard to human life
2) Studies of human actions of allied health professionals
toward their patients
HISTORY OF BIOETHICS
• Preceded by MEDICAL ETHICS
o However, after WWII, it became clear that medical
ethics was no longer sufficient to meet contemporary
challenges
o As early as 1960, Bioethics has drawn a lot of public
attention, particularly, as a separate field of discourse.
o As a consequence of enormous medical and
healthcare development which brought optimism in
fighting against diseases and prolonging human life,
some serious ethical issues and ethical dilemmas were
recognized and this gradually involved academic
concerns.
o As scholars began to write articles regarding these
ethical issues, problems, and dilemmas, the new field
of study came to be known as BIOETHICS.
• It is an interdisciplinary field that has emerged rapidly
during the second half of the 20th century.
• Primary focus: The concept of bioethics is commonly
understood as a generic term for THREE (3) MAIN
SUBDISCIPLINES:
1. Medical ethics
2. Animal ethics
3. Environmental ethics
• Where significant overlap of many issues, ethical
approaches, concepts, and moral considerations are
observed.
• Doctors use their knowledge and power to
o Benefit the sick
o Do no harm
o Preserve life
o Keep in strictest confidence any patient information
WHY DO WE STUDY BIOETHICS?
1) Address perennial ethical problems, issues, dilemmas
confronting health care workers and their patients
2) Address legal problems in health care with ethical
concerns
3) Address the challenges of modern technology
4) Enhance professional development and ethical values of
health care professionals
PRINCIPLES OF BIOETHICS
• Medical Technologist/ Medical Laboratory Scientists as
healthcare professionals are confronted by both minor and
major ethical issues and ethical choices which may be
guided by the 4 BIOETHICAL PRINCIPLES:
• Principles can overlap and compete with each other for
priority
 AUTONOMY MAY BE USEFUL IN THE FOLLOWING:
• Refers to freedom of choice 1) Identify and clarify ethical questions
• This principle implies that the patient should be able to act 2) Find ethically acceptable course/s of action
intentionally, with understanding 3) Encourage honest and respectable communication
o absence of any controlling factors or influences that among all patients
would interfere against a free and voluntary act. 4) Recommend clinically and ethically acceptable solution/s
• Basis of informed consent in any transaction between the for the case in question
healthcare provider and the patient • What may be a clinical solution?
• Considering patient’s desires within the bounds of • What may not be an ethical solution?
accepted treatment 5) Improve institutional responses to ethical dilemma
• Involving patients in making decisions
• Considering patients’ needs, desires, and abilities GENETICS
• Safeguarding patients’ privacy • Emerging technologies and knowledge on genetics
engender numerous value conflicts.
NON-MALEFICENCE • Bioethics in the age of genomics is challenged by the
• Means do no harm increased collection and use of personal, medical,
• Fundamental commitment on the part of healthcare biological information such as that required by genomics
providers in general, and medical technologists in • Raises issues of privacy and security
particular o There is already a lot of information available, and this
o As medical technologists, the need to protect patients poses a lot of ethical as well as moral issues
from harm is of utmost importance. • Challenge on autonomy
• Protecting patient from harm o Challenges the adequacy of traditional conceptions
• No intentional harm or injury be done on the patient either of autonomy, particularly, informed consent
through acts of omission or commission
o One should not impose a careless or unreasonable CLINICAL NEUROETHICS
risk of harm upon another. • A field at the intersection of neuroethics and clinical ethics,
o The laws of society as well as our moral convictions two dynamic and exciting disciplines.
provide a proper standard to at least minimize if not • Clinical neuroethics addresses topics such as:
avoid the risk of harm to others. Consciousness Deep brain Enhancement
• Knowing one’s own limitations stimulation in clinical
• Knowing when delegation of patients’ care to trainees is Pain Death setting
appropriate
PRECISION MEDICINE
BENEFICENCE
• Means to do good
• As healthcare providers, medical technologists have a
duty to be of help or benefit to the patient
• At the core of healthcare and this implies that a patient
can enter into a relationship with one who is licensed as a
competent medical technologist or any healthcare
provider for that matter.
• The performance of laboratory procedures and analysis
which aid the physician in the diagnosis and treatment of
diseases and maintenance of good health is applied to
individual patients and for the good of society in general • sometimes called Personalized Medicine
• Service to the patient and the public at large • an approach for protecting the health and treating
• Duty to promote patient’s welfare diseases that takes into account a person’s genes, a
• Competent and timely delivery of health care person’s behaviors, as well as the environment and other
• To always act in the best interest of the patient factors affecting the person’s health
• intervention and the treatment are tailored to the patient.
JUSTICE • often ethically ambiguous
• Refers to fairness (goods in society are fairly distributed) • One goal of precision medicine is identify biomarkers that
• There are a variety of factors used as criteria for justice: predict effectiveness in individuals
o to give each person an equal share
o to team person according to need REPRODUCTIVE ETHICS
• Addresses topics that commonly provoke social and legal
o to each person according to effort
controversy.
o to each person according to contribution
• Intimately connect to concerns over Reproductive Justice
o to each person according to merit
o to each person according to free-market exchanges. FIELD LOOKS AT ISSUES RELATED TO:
• Delivering health care without prejudice nor discrimination Assisted Assisting fertility
• Shall not deny service to patients due to race, color, creed, Reproduction Surrogacy
gender, or nationality Genetic Manipulation of offspring
• Attend to patients according to need Restricting Fertility Sterilization
• To always act in the best interest of the patient Contraception
Abortion Terminating a pregnancy
SPECIFIC AREAS IN BIOETHICS
CLINICAL ETHICS • Minors and access
• As a practical discipline, clinical ethics aims to identify, • Concerns that are more general over maternal and fetal
analyze, and resolve ethical issues and conflicts arising best interests
when there is a disagreement between and among
patients, families, surrogates, and other stakeholders.

GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
 HEALTH POLICY SURROGACY
• This refers to government efforts to manage healthcare for • Assisted reproduction
the public good. o Refers to the process of assisting the reproduction of
• A sound health policy should be able to: parents who are not capable of reproducing or
o Assure access to needed healthcare for all sustaining the development of a child inside the
o Incentive curative research womb
o Protect health quality • Gestational surrogates
o Control healthcare costs o In most cases, surrogacy is carried out by gestational
women or gestational surrogates
SHARED DECISION-MAKING o who are willing to carry and deliver a child for another
• Effective clinical encounters depend on good
person or another couple.
communication
• With the goal of arriving at the best possible decision for the ISSUES
individual patient 1) Exploitation of poor women who are desperate for money
• process whereby a healthcare decision is presented, 2) Complication of women’s bodies as commodities
discussed, deliberated, and negotiated between the 3) The moral and ethical consequences of transforming a
provider and the patient. normal biological function of a woman’s body into a
• a physician taps their knowledge about the available commercial transaction
evidence and combines it with their experienced clinical
judgment to provide balanced information regarding WHOLE GENOME SCREENING
treatment choices. • It involves access to the complete genome of a newborn
o That information then is communicated to the patient • Which allows for early detection or determination of a
o allowing patients to clarify and determine their newborn’s predisposition to certain diseases
healthcare options in light of their own values and QUESTIONS
preferences.
• When Whole-Genome Screening became feasible in the
• evolved from the recognition of a patient’s right to
clinical setting, it has raised new and different questions
autonomy and reflects ethical medical practice.
such as:
• Recognizing that there are two experts in the room, shared
1) Should it be used as a part of the mandated newborn
decision-making is the pinnacle of patient-centered care
screening?
SOCIAL DETERMINANTS OF HEALTH 2) How should we deal with the massive amounts of
• In the clinical encounter, patients bring complex social information and uncertainties associated with its
circumstances that are a consequence of their physical interpretation?
and social environment and access to resources. ISSUES
• Limitations on those resources determine a patient’s ability
1) Data and information release
to prevent illness, maintain health, and recover when illness
2) Identifiability
occurs.
3) Adequacy of consent
• Social justice draws our attention to disparities in health
4) Stereotyping or stigmatization
and asks not only that we recognize such disparities — but
it also requires us to actively work toward solutions both for HUMAN CLONING
the individual and the population as a whole. • Creating a new population of genetically similar and
• Learning about and respecting a patient's socially identical organisms
circumscribed access to resources can enhance the • Reproduction of human cells or tissues
patient-doctor relationship. • May not necessarily refer to the natural conception or
• Even with the expanding emphasis on genetics and delivery of identical individuals
precision medicine, it remains the case that "it’s zip code
ISSUES
not genetic code”
o where a person lives as well as their related social 1) Individuals as sources of organs
experiences have a profound impact on their health. 2) Human life becoming a commodity
3) Safety and efficacy of procedures
BIOETHICAL ISSUES 4) Use for destructive embryonic stem cell research
ABORTION 5) Effects on child/parent relationships
• premature ending of a pregnancy which may occur:
o spontaneously (miscarriage) STEM CELL RESEARCH AND THERAPY
• Involves the use of embryos as sources of undifferentiated
o through surgery, medication, or force.
cells for research
• Issue of intense moral and personal concern
• Use of stem cells to treat diseases
Sexuality Autonomy Politics
• Since it involves the destruction of human embryos for stem
Science Religion
cells, and the embryo is considered as human life,
o therefore the extraction of stem cells to be used for
• The central ethical question in abortion is the moral status
research or for therapy is considered unethical.
of the embryo or the fetus
o The fetus is a human being with full moral status and ISSUES
rights from the time of conception 1) Medical risks
o To the belief that the fetus has no rights even if it is 2) Protection of the reproductive interests of women
human in the biological sense 3) Confidentiality of donor information
o One of the most polarizing issues, some are on one 4) Embryonic Stem Cell Research poses a moral dilemma,
side or the other, but very few are undecided • forces us to choose between two moral principles:
o duty to prevent and alleviate pain or suffering,
o duty to respect and value human life (preserving
the life of the embryo)

GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
 • In case of Stem Cell Research and Therapy, it is
impossible to respect both.
o in order to get stem cells, the embryo has to be
destroyed, which means destroying human life.

EUGENICS
• Improving the human society or race
o Works on the possibility of creating a superior human
society or a superior human race
o by selectively promoting the reproduction of
populations with positive or desirable traits.
o While controlling and prohibiting the reproduction of
populations with negative or undesirable traits.
• Aims to reduce human suffering by “breeding out” disease,
disabilities and so-called undesirable characteristics from
the human population

ISSUES
1) Horrible abuses committed in the name of eugenics
through coercive policies
2) How new genetic knowledge is used
3) Confidentiality of donor information
4) Social inequality
5) Subjectivity of perfection
• What is perfect to one, may not be perfect for another
• Matter of taste, culture, and personal experiences

EUTHANASIA
• Comes from the words:
o Eu: meaning Good or Easy
o Thanatos: meaning Death
• Literally means Good death or Easy death
• Ending the life of an individual to cease pain or suffering
• Assisted suicide or mercy-killing

ISSUES
1) Sanctity of life
2) Autonomy and human rights
3) Doctor-patient relationship
• To commit euthanasia is to fail to see the intrinsic worth or
the dignity of the human person.
o The dignity of the sick should not be erased by
suffering or pain.
• Mercy should be extended without inducing death

CRYONICS
• Reversion of death
• Freezing to reanimate or bring the individual back to life
o Temperature: −196 °C or −320.8 °F
ISSUES
1) Autonomy and rights of a person
• Can a person who is already pronounced dead still
maintain their rights?
2) Right and dignity of the healthcare team
• If a healthcare team believes that cryopreservation is
immoral or unethical, and does not agree with it,
should they be involved in caring for a cryo-preserved
person?
3) Non-maleficence
• By preserving their loved ones, a family may be less be
able to move on with their own lives and accept the
death of the relative
• This could cause much suffering

There is actually an ethical obligation to completely consider

the positive and negative consequences of cryonics

GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
 MT6313 MEDICAL TECHNOLOGY LAWS AND PROFESSIONAL BIOETHICS
UNIT 14: PROFESSIONAL ETHICS AND PROFESSIONAL CONDUCT
References: Book, PPT, Assoc. Prof. Hapan’s Discussion

PROFESSIONAL ETHICS PROFESSIONAL CONDUCT

• includes all standards of behavior in one’s personal life, one’s occupation, & the workplace • Involves:
• encompasses values and guiding principles established by professional organizations to help o Ethics
guide professionals in performing their job functions based on sound moral and ethical o Morals
principles o Standards of behavior
• Principles that govern a person’s behavior in the workplace or work environment • being a professional, it is
• Often codified as a set of rules on how professionals should act towards other people in the necessary for the person to
place of work maintain his/her ethical
• branch of moral science concerned with the obligations which a member of a profession behavior and to show
owes to the public, to his profession, and to his clients. good professional conduct
• Every aspect of professional practice is governed by a set of ethical standards.
• Professional Codes of Conduct is based on PROFESSIONAL ETHICAL PRINCIPLES such as:
honesty trustworthiness loyalty respect for others
adherence to the law doing good avoiding harm to others accountability
• The expectations that the profession and the society have of its members are also based on
the professional ethical principles

OCCUPATION PROFESSION MAIN OBJECTIVES OF PROFESSIONAL CODE OF ETHICS

Delivers important Works in a morally permissible way
services to work to support a moral ideal
Makes a Follow special standards for
commitment to carrying on their occupational work
serve the public
PROFESSIONAL CODE OF ETHICS
• To profess is to:
o make a public declaration
o make a commitment
o to serve for a good end
• cover personal and corporate standards of behavior
expected from and by a professional
• prescribes how professionals are to pursue their common
ideals and to protect each professional from certain
pressures.
• It provides professionals a clear set of obligations based on:
o Tradition
o Society’s expectations
o Contracts
o Laws
o Rules of ordinary morality
• informs the professionals about their obligations to their
employers, clients, customers, other professionals, the
profession itself, and the society in general
• differ from every profession and for each profession
• defined by a certain sort of judgement and reason not
merely by the knowledge that it presupposes
• Medical technologists do not only know how to perform
laboratory procedures and analyses but perform their work
based on good reason and judgement
• Describes the expected ethical obligations and principles
that patients, the profession, and the public believe
• Guides the professional and personal conduct of all
medical technologists
o who must adhere not only to the guidelines, but also
to the underlying spirit and precepts
• As professionals, our professional decisions affect not only
ourselves but the people around us: our patients,
colleagues and other stakeholders
• It should be a part of our day to day decisions.
• Medical Technologists are not only expected to have
ethical commitment but they are also expected to
exercise ethical awareness and demonstrate ethical
competency
Ethics provide the underpinning for correct
behavior and acceptable conduct. It establishes
rules, principles, and values
1) To define professional privileges, behaviors and
responsibilities towards the members of the community in
general
2) To promote professional quality, professional conduct and
a moral method of procedures
3) To defend private professions from undue interference by
the government or by other agencies
4) To preserve the dignity of the profession and the
confidence of the public
5) To defend clients from unscrupulous individuals
6) To fix certain standards of the compensations for services or
work
THE CODE OF ETHICS OF MEDICAL TECHNOLOGISTS
• always recited during the oath taking ceremony when you
pass the board examination for Medical Technologists.
As I enter the practice of medical technology, I shall:
1) Accept the responsibilities inherent to being a
professional.
2) Uphold the law and shall not participate in illegal work.
3) Act in a spirit of fairness to all and in a spirit of
brotherhood toward other members of the profession.
4) Accept employment from more than one employer
only when there is no conflict of interest.
5) Perform my task with full confidence, absolute
reliability, and accuracy.
6) Share my knowledge and expertise with my
colleagues.
7) Contribute to the advancement of the professional
organization and other allied health organizations.
8) Restrict my praises, criticisms, views, and opinions within
constructive limits.
9) Treat any information I acquired in the course of my
work as strictly confidential.
10) Uphold the dignity and respect of my profession and
conduct myself a reputation of reliability, honesty, and
integrity.
11) Be dedicated to the use of clinical laboratory science
to promote life and benefit mankind.
12) Report any violations of the above principles of the
professional conduct to authorized agency and to the
ethics committee of the organization.
To these principles, I hereby subscribe and pledge to
conduct myself at all times in a manner befitting the dignity
of my profession. So, help me God.

GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
 PROFESSIONAL CODES OF CONDUCT
• official documents that clearly define how a professional or
a company employee should behave in the workplace on
a daily basis.
• provide the action to the code of ethics
• serve to apply the codes of ethics to particular and
relevant situations
• list of guidelines or conditions
PROVIDE THE FOLLOWING BENEFITS:
1) Build confidence in the profession’s trustworthiness
2) Provide greater transparency and certainty about how
clients’ affairs will be handled
3) Provide a supporting framework to the members of the
profession, for resisting pressure to act inappropriately, &
for making acceptable decisions in what may be “grey
areas”
4) Provide a common understanding of acceptable practice
which builds collegiality and allows for fairer disciplinary
procedures within the procedure
5) Others dealing with the profession, as the profession will be
seen as more reliable and easier to deal with
GENERAL PRINCIPLE OF PROFESSIONAL CONDUCT
• from the PH Professional Regulation Commission (PRC)
PROFESSIONALS ARE REQUIRED TO HAVE:
1) An ethical commitment
2) A personal resolve to act ethically
3) Ethical awareness
• Ability to know what is right or wrong
4) Ethical competency
• Ability to engage in sound moral reasoning & consider
carefully the implications of alternative actions
SPECIFIC PRINCIPLES OF PROFESSIONAL CONDUCT
• lifted from the Philippine Professional Regulation
Commission (PRC)
1. SERVICE TO OTHERS
• Professionals are committed to a life of service to others
• They protect life, property, and public welfare
• To serve others, the shall be prepared for heroic sacrifice
and genuine selflessness in carrying out their professional
duties even at the expense of personal gain
2. INTEGRITY AND OBJECTIVITY
• To maintain and broaden public confidence
• Professionals shall perform their responsibilities with the
highest sense of integrity and imbued with nationalism and
spiritual values
• In the performance of any professional service,
professionals shall, at all times, maintain objectivity, be free
from any conflict of interest and refrain from engaging in
any activity that would compromise their abilities to carry
out their duties ethically.
• They shall avoid making any representation that would
likely cause a reasonable person to misunderstand or to be
deceived
3. PROFESSIONAL COMPETENCE
• A certain level of competence is necessary (knowledge,
technical skills, attitudes, and experience)
• Professionals shall, therefore, undertake only those
professional services that they can reasonably deliver with
professional competence
• It is their express obligation to keep up with new knowledge
and techniques in their field
o continually improve their skills
o upgrade their level of competence and take part in a
lifelong continuing education program
GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
4. SOLIDARITY AND TEAMWORK
• Each profession shall nurture and support one organization
for all its members
• Through a deep spirit of solidarity, professionals should put
the broader interest of the profession above one’s personal
ambition and preference
• Through teamwork within a cohesive professional
organization, each member shall effectively observe
ethical practices
o and pursue continuing professional development as
well as deepen one’s social and civic responsibility
5. SOCIAL AND CIVIC RESPONSIBILITY
• Professionals shall always carry out their professional duties
with due consideration of the broader interest of the public
• Serve their clients/employers and the publics with
professional concern and in a manner consistent with their
responsibilities to society.
• As responsible Filipino citizens, they shall actively contribute
to the attainment of the country’s national objectives
6. GLOBAL COMPETITIVENESS
• Professionals shall remain open to challenges of a more
dynamic interconnected world
• Shall rise up to global standards and maintain levels of
professional practices fully aligned with global best
practices
7. EQUALITY OF ALL PROFESSIONS
• Professionals shall treat their colleagues with respect and
shall strive to be fair in their dealings with one another
• No one group is superior or above others
• All professionals perform an equally important, yet distinct,
service to society
• In the eyes of the PRC, all professions are equal and,
therefore, every one shall treat one other professionals with
respect and fairness
EXAMPLE: DIFFERENCE BETWEEN PROFESSIONAL
CODE OF ETHICS & PROFESSIONAL CODE OF CONDUCT
Code of Ethics Code of Conduct
may state that • may provide a list of guidelines or
all professionals conditions in implementing
shall observe confidentiality
confidentiality • E.g. Prohibition in posting laboratory test
results on social media; video
conferencing of laboratory procedures,
processes and operations
EXECUTIVE ORDER NO. 220, S. 2003
Directing the Adoption of the Code of Good
Governance for the Professions in the Philippines
• Signed on: June 23, 2003
President GLORIA MACAPAGAL-ARROYO
Executive Secretary ALBERTO G. ROMULO
• WHEREAS, pursuant to Section 14, Article XII of the
Constitution, “the sustained development of a reservoir of
national talents consisting of Filipino scientist
xxx professionals xxx high-level technical manpower
xxx shall be promoted by the State.“
• WHEREAS, good governance is one pillar of a strong republic;
• WHEREAS, by virtue of the provisions of Section 5 and 7(a)
of Republic Act No. 8981, otherwise known as the PRC
Modernization Act of 2000, the Professional Regulation
Commission (PRC), hereinafter called the Commission, is
empowered to adopt policies, such as professional
standards and principles designed to enhance and
maintain high professional, technical, and ethical
standards in the practice of the professions;
• WHEREAS, the adoption of the Code of Good Governance
will promote and establish ethical awareness and
competency among Filipino professionals to make them
accountable to their public liability and fully fulfill their
professional obligation to their clients; and
• WHEREAS, the Code will empower professionals not only to
upgrade or improve their technical and ethical proficiency
but also to keep them abreast with modern trends and
technology in their respective professions, thereby assuring
the highly qualitative and globally-competitive
professional services, and secure the safety and protection
of the public.
such a way that it would promote the development of
the professional life of the laboratory staff, highlighting
human values and responsibilities, as well as honesty in
the workplace
• This will surely initiate and encourage a change of
paradigm with the aim of increasing knowledge,
keeping in mind ethical principles in the performance
of daily laboratory procedures

SECTION 1
• The Code of Good Governance for the Professions in the
Philippines shall be adopted by all registered professionals.

SECTION 2
• The Governance Advisory Council and the Professional
Regulation Commission (PRC) are hereby directed to
undertake measures including networking with
government agencies and civil society
o to effectively implement and enforce the Code
through the Professional Regulatory Boards (PRBs)
under the Commission’s supervision and control.

SECTION 3 POST-ANALYTICAL • Reporting and interpretation of

• The PRC shall, after consultation with and upon PHASE results
recommendation of the various Boards: • Residual specimen
• issue the necessary guidelines and procedures for the • Data access
enforcement of the Code. • Patient interaction
• Specimen collection
SECTION 4 • Sample receiving
• Repealing Clause • Sample transport
• Any executive issuance, orders or provisions thereof ANALYTICAL PHASE • Right to decline specimen
inconsistent with the provisions of this Executive Order are examined
deemed modified or repealed • Best possible analytical result to
patient
SECTION 5 • No discrimination in
• Effectivity: this Executive Order shall take effect examination of patients sample
immediately. on the basis of gender, age, or
race
ETHICAL ISSUES IN THE LABORATORY • Sample processing
• Necessary to incorporate principles and guidelines of • Quality control
bioethics and professional ethics in laboratory medicine PRE-ANALYTICAL • Informed consent
• Uphold the reputation and dignity of the profession PHASE • All tests benefit to the patient
• Ethics training program • Access to all tests at reasonable
cost
ETHICS IN LABORATORY MEDICINE: AN OVERVIEW OF • Reporting of test results
CONSIDERATIONS FOR ETHICAL ISSUES • Keeping and maintaining
• Authors: Neerja Aggarwal, Pawan Kumar Kare and Sudip records
Kumar Datta
• Submitted: July 9, 2020 DURING THE PRE-ANALYTICAL PHASE
• Reviewed: January 20th 2021 • Requests for laboratory tests
• Published: February 4th 2021 o Clinicians requesting laboratory tests come under the
• DOI: 10.5772/intechopen.96122 most important ethical obligation of requesting only
the needed or the required laboratory tests
CONCLUSION o Laboratory personnel are also required to act every
1) Necessary to incorporate principles and guidelines of time to confirm whether the tests are being performed
bioethics and professional ethics in laboratory medicine • No financial interest involved
• Any laboratory involving human participants should o It is commonly assumed that clinicians are requesting
follow international standards and practices of ethics laboratory test so as to benefit the patient without any
2) Uphold the reputation and dignity of the profession financial interest involved
• Laboratories shall not engage in practice restricted by • Proper identification of the patient with respect to the test/s
law and should uphold the reputation and the dignity requested
of their profession o There is a collective responsibility of many people
3) Ethics training program including clinicians, nurses, healthcare providers, and
• It is required to develop an ethics policy and to add even the laboratory staff collecting the samples
to the laboratory’s Quality Assurance Manual o Their role includes identification of the patient with
• Development and implementation of an Ethics respect to the test being requested
Training Program for laboratory staff should be done in

GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
• Proper collection, labelling, handling of samples,
performance of tests
o Proper collection, proper labelling, proper handling of
the samples until the tests are performed
THREEE BASIC PRINCIPLES FOR ALL PHASES
1) Respect for Persons
2) Beneficence
3) Justice
PRINCIPLES PRE-ANALYTICAL PHASE
• Consent must be understood by the
patient
o Informed consent may lead to an
ethical problem if the patient is
incompetent owing to age, mental
status, or critical illness
• The patient’s right to refuse to get the test
done should be respected
o In special cases, healthcare
professionals should be obliged to
RESPECT FOR
consult the Institutional Guidelines
PERSONS
regarding this
• Any information regarding patient
demographics, their visit to the testing
laboratory, the test that were done, and
the requirement for their test should be
provided only to authorized personnel
o At every step of sample handling,
from sample collection to data entry,
strict confidentiality must be
maintained
• All tests performed must benefit the
patient
o Any adverse event, during or after
sample collection, must be
managed by trained workers with
the help of standard operating
procedures
• Collection of samples should be done as
per universally recommended
precautions to protect the health care
worker and the patients also
• The additional samples should not be
BENEFICENCE
drawn from the patient without first
informing and getting permission from
the patient and from the Institutional
Ethics Committee
o Any sample drawn from the patient
without the patient consent is
unethical
• The specimen should be well labeled
with minimum unique identifiers
• Transport of samples should also be done
properly in order to protect the integrity
of the specimen
• Justice provides access to several
laboratory tests at a reasonable cost
• The laboratory should evaluate the need
to introduce new tests and the
opportunities to discontinue other tests
JUSTICE when better tests are already available
in the market
• No preference should be given to some
patients in order to facilitate or
accelerate the collection procedures at
the expense or cost of other patients
GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)
DURING THE ANALYTICAL PHASE
• Confidentiality, quality, competency
o Confidentiality: sometimes almost a byproduct of
laboratory automation which makes use of:
automated code readers, automated analysis, as well
as auto verifications
§ The names of persons are normally given at a
unique sequential number for processing
§ However, maintaining confidentiality is more
challenging during the analytical phase
especially in small laboratories as compared to
larger ones, because smaller laboratories tend to
do manual testing
• Maintain ethical standards
o It is most important to maintain ethical standards by
each laboratory in conducting patient testing
PRINCIPLES ANALYTICAL PHASE
• Associated with the collection and
processing of samples, since persons
have the right to refuse to have their
samples processed or examined
RESPECT FOR
o In such case, confidentiality should
PERSONS
be appreciated and preserved
• Special care must be taken to preserve
confidentiality especially in point-of-
care testing
• The aim of the laboratory is to make the
best possible results available to patients
o This is accomplished through good
laboratory practices and high
professional standards
• Good laboratory practice should involve
quality assurance program including:
o Quality control analysis
o Proficiency testing
o Accreditation of the laboratory
• In this regard, a wrong result is worse than
no results
o No result is actually better than a
BENEFICENCE wrong result. This is a critical guiding
principle.
• Good laboratory practice refuses to
evaluate or account a result in the
presence of:
o Poor sample integrity
o Improper or poor labeling
o Any other insufficiency that may
compromise the test results
• All laboratories should maintain proper
authorization and only qualify properly
skilled and properly trained personnel
• Authorized to execute point-of-care
testing or perform laboratory tests
• There should be no discrimination in the
examination of patient samples on the
basis of:
o Gender, age, or race because
otherwise it would be an injustice
o All samples should be treated likewise
• It is recognized that laboratories must
JUSTICE develop appropriate provisions for STAT
or priority testing
• should also state which tests are to be
included and their expected turn-
around times
• It is anticipated that all specimens are
being analyzed correctly in a timely
routine
 DURING THE POST-ANALYTICAL PHASE o When we delay the release of the
• Reporting and interpretation of test results results or the access of the patient to
• Storage of residual samples their own laboratory results, this may
o All laboratories should have a procedure for the be in cases of non-payment for
storage of specimens, as well as archiving of the example, there may be harm
results, either in electronic or hardcopy formats caused on the patient and this may
o Documents that can be archived include: request not be ethically acceptable
forms, raw analytical, as well as quality control data o Hence, delaying in reporting should
results and reports be avoided
o Guidelines on the retention or distraction of these • Although reporting of test results must be
records, along with remaining sample retention and its consistent for all patients, speedy
disposal, should be kept in place reporting may be possibly demanded
• Access to laboratory data for certain results
o Policy manual should also mention the strategies o Including those that are at critical or
regarding the identification of authorized personnel, considered to be significant race
such as doctors and laboratory staff that can be results
allowed to access medical records • Instructions for quick reporting must
o The patient should have the right to give consent for apply in respective of the source of
his or her data to be accessed by others, such as sample as well as the patient’s financial
JUSTICE
family members or relatives if required capability
• Maintain ethical standards • Remaining patient samples should not
be used further without the patient’s
PRINCIPLES POST-ANALYTICAL PHASE
knowledge or consent
• Involves patients reasonably expecting
o There is much discussion and the
that their specimens will not be used
literature on who owns the patient
beyond the testing or procedure
specimens
prescribed by the physician
• Whether patients should share in profits if
• In many areas, the patient and the
financial gains are derived from residual
referring clinician are the only authentic
samples
recipients of laboratory data
• In other areas, the patient's family is also APPLICATION: REAL-LIFE CASE
considered to be genuine recipients of a A patient gives written consent to participate voluntarily in a
patient's laboratory test results research study. According to the protocol she receives a $50
• Laboratories should develop a strategy gift certificate after a single blood draw. However, 3 days later
for results dissemination she calls the researcher to say she’s changed her mind and
RESPECT FOR
o reliable communication methods does not want to be in the study anymore, and wants her blood
PERSONS
must be used back. If you were the researcher in this circumstance what
o security should be observed and would you do?
maintained when conveying the
results regardless of the channel of
communication being used
• The Local Ethics Committee of the
institution should also have provisions on
any further testing concerning residual
specimens
o If residual specimens have to be
used for any other purpose, patient
consent must be obtained
• Reporting should be in proper time with
correct and have all necessary
information
o so that the clinician gets the true
interpretation and patients benefit
out of the test laboratory results
• A complete report usually covers:
o name of the test executed
o a suitable reference interval
o units of measurement if needed
BENEFICENCE o a remark that the result is within or
outside the reference interval
• As per laboratory conditions, turn-
around time should be at a minimum for
any test,
o but it should not compromise the
validity or reliability of the test result
• Timely access to test results is very
essential for the welfare of the patients,
especially during emergency conditions

GUEVARRA. LANSANGAN. LUMIO. MAGNO. MAÑO. NABAZA. PADULLO| 2GMT (A.Y. 2020-2021)