Diane Valentin, MS, MT(ASCP)MB

Twice a year I am “forced” to look at the ASCLS Code of Ethics.1 Not because my boss is making me do this but because I am doing it for the sake of my students. In our freshman MLS orientation class, I introduce them to this document as a way to inform them of their ethical duties as a medical laboratory scientist, as well as to inspire passion about the field.

During this introduction I ask open-ended questions such as, “What does it mean to make an ethical decision?” One student answered, “Ethics is doing what is right.” Then we had a conversation about what “right” is and then explored the concept of rightness, stating that one person’s feeling of rightness may be different from another’s. After this exchange, I explained we can’t rely on our own personal ethics to guide us, rather we need to look at what ASCLS and other medical laboratory professional organizations put forth as guidance. So, let’s go through and highlight some pieces of the ASCLS Code of Ethics together.

“[W]e can’t rely on our own personal ethics to guide us, rather we need to look at what ASCLS and other medical laboratory professional organizations put forth as guidance.”

Preamble

The Code of Ethics of the American Society for Clinical Laboratory Science sets forth the principles and standards by which Medical Laboratory Professionals and students admitted to professional education programs practice their profession.

As I read this preamble, I am happy and impressed to see students entering into their clinical rotations are obliged to abide by the Code of Ethics, just as their laboratory instructors and future peers are also obliged.

Duty to the Patient
The first paragraph of this section states that medical laboratory professionals provide “High quality laboratory services [that] are safe, effective, efficient, timely, equitable, and patient-centered … without regard to disease state, ethnicity, race, religion, or sexual orientation.” Does the second half of this statement sound familiar? It should, because part of it is written in the Title VI of the Civil Rights Act of 1964 under the U.S. Department of Justice, Civil Rights Division.2 This is telling us that all patients have a civil right to have their sample treated as equally as the next patient.

The next paragraph lists three important concepts of the self-regulation of each medical laboratory professional. We must practice our “highest level of individual competence … exercise sound judgment in all aspects of laboratory services … safeguard patients from others’ incompetent or illegal practice.” These three lines inform the medical laboratory professional how to proceed with our careers by continuing to educate ourselves about and be competent in the tests we perform; to understand when to follow through with a rejection protocol or when to say “no” to unnecessary testing and the like; and to have the courage to speak out when your coworkers, in and out of the lab, are incompetent or breaking the law.

Duty to Colleagues and the Profession
This section should be the fight song of the medical laboratory profession. It is inspiring us to be true to the field, true to ourselves, and true to the work put forth. We are being requested to advance the profession by “improving and disseminating the body of knowledge”; to take pride in and protect the profession by “maintaining high standards of practice and education”; and to work in solidarity with our peers to ensure a living wage. In these statements, we are being asked to gain and maintain licensure and certification to ensure the integrity of our unique knowledge and skill sets and prohibit the less qualified from performing specimen collection and laboratory testing critical to patient health.

The last sentence in this section is something we may struggle with: “establish cooperative, honest, and respectful working relationships within the clinical laboratory and with all members of the healthcare team.” In my time as an MLS I’ve seen and, honestly but sadly, participated in in-fighting with fellow laboratorians and have felt contempt for our healthcare partners. We all have experienced these feelings and may be exhausted from time to time, which makes us behave in these ways. But medical laboratory professionals need to lift each other up and be understanding of each department’s or interdepartmental coworkers’ unique demands of their duties. We also need to be the utmost professional when interacting with our healthcare partners, to demonstrate we are knowledgeable and are necessary to their patient’s care and deserve to have a “place at the table.”

Duty to Society
Medical laboratory professionals serve a community of people—sick and healthy, young and old. We may serve our neighbors, religious leaders, teachers, lawyers, and friends. We are all really good at what we do in the laboratory and have pride in that fact. We are very comfortable at the microscope, with a pipette in hand, and changing out reagent tubing. But we also need to be comfortable with being uncomfortable.

We need to step out of our comfort zones to assist on ASCLS committees, communicate with local and federal government, and address the needs of the general community. This does not mean you need to chair a committee on changing the U.S.Senate’s mind on a proposed healthcare ruling. But it could mean gaining a mentor to learn how to navigate your ASCLS membership. It could mean writing to your local U.S. senator, state governor, or city mayor about a healthcare issue. Having your PBT, MLT, or MLS designation behind your name will tell them you are educated in the profession and pushes your agenda that much further. It could also mean speaking about proper specimen collection to a group of LPNs at a nursing home or teaching about Sickle Cell disease to a group of middle or high schoolers.

Before I started teaching, I reached out to my daughter’s middle school science teacher about introducing the fifth through eighth graders to medical laboratory science and donning proper PPE for the assigned task. The teacher approved my activities and I spent four hours talking to four grade levels about what I do. They ate it up! About a week after this I received some great thank you cards, one which was signed, “Your Student, Jimmy.” This experience was very rewarding for both “teacher” and student alike.

Find your passion about your medical laboratory profession and spread the word. You can inform someone about the importance of laboratory medicine, serve as a volunteer either in membership or as a citizen, and, better yet, inspire someone to become a medical laboratory professional.

So let us, as medical laboratory professionals, review the Pledge to the Profession.1

As a Medical Laboratory Professional, I pledge to uphold my duty to Patients, the Profession and Society by:

  • Placing patients’ welfare above my own needs and desires.
  • Ensuring that each patient receives care that is safe, effective, efficient, timely, equitable and patient-centered.
  • Maintaining the dignity and respect for my profession.
  • Promoting the advancement of my profession.
  • Ensuring collegial relationships within the clinical laboratory and with other patient care providers.
  • Improving access to laboratory services.
  • Promoting equitable distribution of healthcare resources.
  • Complying with laws and regulations and protecting patients from others’ incompetent or illegal practice.
  • Changing conditions where necessary to advance the best interests of patients.

In summary, as medical laboratory professionals, we should all feel a sense of responsibility for the well-being of every patient. As our careers melt away from months into years, years into decades, we see thousands of patient samples, perform thousands of tests. It is easy to forget the passion we once had as a fledgling medical laboratory professional. Take a page from my book and “force” yourself to revisit the ASCLS Code of Ethics on a regular basis to help keep that passion alive.

References

  1. ASCLS, Code of Ethics, accessed 1/30/2020
  2. U.S. Department of Justice, U.S. Department of Justice, Civil Rights Division, Federal Coordination and Compliance Section, accessed 1/30/2020

Diane Valentin is the interim program director of the Medical Laboratory Science Program and instructor in the Biological Sciences Department at University of Sciences in Philadelphia, Pennsylvania.