MRO Confidentiality & Ethics 4 — Questions and Answers
Question 1: An MRO discovers that a laboratory is routinely cutting corners on quality control. The MRO's ethical obligation is to:
- Continue accepting specimens from the lab while monitoring results closely
- Report concerns to the DOT-certified laboratory program and consider suspending use of that lab (Correct answer)
- Notify only the employer so they can choose a different lab
- Ignore the issue unless an employee challenges a result
Correct answer: Report concerns to the DOT-certified laboratory program and consider suspending use of that lab
MROs have an ethical duty to use only laboratories that meet HHS certification standards and must report systemic quality failures to appropriate authorities.
Question 2: When an MRO is also employed as the company's occupational health physician, which ethical principle is most at risk?
- Beneficence
- Confidentiality and impartiality (Correct answer)
- Justice
- Autonomy
Correct answer: Confidentiality and impartiality
Serving dual roles creates conflicts that can compromise the MRO's confidentiality obligations and impartiality in making verification decisions.
Question 3: Under DOT regulations, an MRO is required to retain records of verified positive, adulterated, and substituted results for a minimum of:
- One year
- Two years
- Five years (Correct answer)
- Seven years
Correct answer: Five years
DOT Part 40 requires MROs to retain records of non-negative results (positives, adulterations, substitutions) for a minimum of five years.
Question 4: An employee on federal safety-sensitive duty discloses to the MRO during a verification call that he is taking a prescribed narcotic that impairs his ability to safely perform his job. The MRO should:
- Take no action because the prescription is legal
- Advise the employee to self-report to the employer and, if he refuses, contact the DER to discuss immediate safety concerns (Correct answer)
- Report the information directly to the employee's prescribing physician
- File a complaint with the state pharmacy board
Correct answer: Advise the employee to self-report to the employer and, if he refuses, contact the DER to discuss immediate safety concerns
When an employee discloses an immediate safety risk, the MRO should encourage self-reporting and, if the employee refuses, may contact the DER to address the imminent safety concern.
Question 5: A prospective employer contacts an MRO asking for the drug testing history of a job applicant who was previously tested under a DOT program. Without the applicant's consent, the MRO must:
- Provide the complete history because DOT records are employer property
- Decline to release any information; consent or a legal mandate is required (Correct answer)
- Release only negative results to protect the applicant's interests
- Forward the inquiry to the original employer for authorization
Correct answer: Decline to release any information; consent or a legal mandate is required
Drug testing history cannot be released to third parties, including prospective employers, without the individual's written consent or a legal mandate.
Question 6: Which of the following is an ethically appropriate reason for an MRO to recuse himself from reviewing a specific donor's specimen?
- The MRO does not like the employer's industry
- The donor is the MRO's immediate family member (Correct answer)
- The donor previously filed a complaint about the testing program
- The donor works night shifts and the MRO prefers daytime calls
Correct answer: The donor is the MRO's immediate family member
A personal relationship with the donor—such as being a family member—creates a clear conflict of interest requiring the MRO to recuse himself.
Question 7: An MRO receives a written request from the employee's attorney for all records related to a drug test. Before releasing any records, the MRO should:
- Immediately comply because an attorney's request carries legal authority
- Verify that the request is accompanied by the employee's written authorization or a valid legal order (Correct answer)
- Forward the request to the employer's legal department for handling
- Require the attorney to appear in person with photo identification
Correct answer: Verify that the request is accompanied by the employee's written authorization or a valid legal order
An attorney's letter alone is not sufficient; the MRO requires either a signed employee authorization or a court order before releasing test records.
MRO Confidentiality & Ethics 4
An MRO discovers that a laboratory is routinely cutting corners on quality control.
The MRO's ethical obligation is to: