SM Professional Ethics & Standards 2 — Questions and Answers
Question 1: A microbiologist discovers a colleague has been falsifying antibiotic susceptibility results to favor a hospital's preferred vendor. What is the MOST appropriate first action?
- Ignore it to avoid workplace conflict
- Report the concern through the institution's compliance or ethics reporting channel (Correct answer)
- Confront the colleague publicly in the laboratory
- Alter the records back to accurate results without documentation
Correct answer: Report the concern through the institution's compliance or ethics reporting channel
Falsifying patient-relevant results is a serious ethical violation that must be reported through institutional compliance channels to protect patient safety.
Question 2: Which principle underpins the requirement for microbiologists to maintain competency through continuing education?
- Beneficence toward patients by ensuring accurate and current laboratory services (Correct answer)
- Compliance with union contracts
- Increasing billable service hours
- Meeting minimum staffing ratios
Correct answer: Beneficence toward patients by ensuring accurate and current laboratory services
Continuing competency is grounded in beneficence—the duty to act in the best interest of patients by providing accurate, evidence-based laboratory results.
Question 3: A laboratory receives a proficiency testing (PT) specimen and a technologist wants to consult with another laboratory about the result before submitting. This practice is:
- Acceptable if the other lab uses the same method
- Required by CLIA for complex specimens
- Prohibited and constitutes a PT integrity violation (Correct answer)
- Allowed as a form of peer review
Correct answer: Prohibited and constitutes a PT integrity violation
CLIA regulations prohibit inter-laboratory communication about PT specimens before submission, as it undermines the validity of proficiency testing.
Question 4: Under HIPAA, which of the following represents a permissible disclosure of a patient's positive culture result without explicit patient authorization?
- Disclosure to the patient's employer upon request
- Reporting to the state public health department as required by law (Correct answer)
- Sharing with the patient's insurance company for underwriting purposes
- Posting de-identified results on a public research database without IRB approval
Correct answer: Reporting to the state public health department as required by law
Mandatory public health reporting to state or local health departments is a legally recognized exception to HIPAA's general prohibition on unauthorized disclosure.
Question 5: A microbiologist holds a patent on a novel diagnostic method and is asked to evaluate a competing method for publication. What is the ethical obligation?
- Decline to review and disclose the conflict of interest to the journal (Correct answer)
- Accept the review and recommend rejection without examination
- Accept the review and not disclose the patent
- Request payment before completing the review
Correct answer: Decline to review and disclose the conflict of interest to the journal
A financial stake in a competing product constitutes a conflict of interest that must be disclosed; the reviewer should typically recuse themselves.
Question 6: Which document serves as the primary ethical framework guiding clinical laboratory scientists in the United States?
- The Nuremberg Code
- ASCLS Code of Ethics (Correct answer)
- Declaration of Helsinki
- Belmont Report
Correct answer: ASCLS Code of Ethics
The American Society for Clinical Laboratory Science (ASCLS) Code of Ethics is the primary professional ethical framework for clinical laboratory scientists in the U.S.
Question 7: A laboratory director is pressured by administration to reduce turnaround time by skipping repeat testing on discordant blood culture results. The director should:
- Comply because administration has authority over laboratory operations
- Document the concern and refuse, citing patient safety and standard of care obligations (Correct answer)
- Ask staff to informally skip repeats but not document the policy change
- Reduce repeats only for patients with private insurance
Correct answer: Document the concern and refuse, citing patient safety and standard of care obligations
Laboratory directors are professionally and legally responsible for maintaining testing standards; compromising patient safety for administrative convenience violates ethical and regulatory obligations.
SM Professional Ethics & Standards 2
A microbiologist discovers a colleague has been falsifying antibiotic susceptibility results to favor a hospital's preferred vendor.
What is the MOST appropriate first action?