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Ethical and legal aspects of
medical laboratory
Presented to:
Dr. Zaid Al-Hamdan
Presented by:
Ruba Abd Al-Jawad
Bara’ah Azaizeh
• A branch of philosophy that seeks to
determine how human actions may be
judged right or wrong.
– Code of moral principles.
– Set standards of “good” and “bad”.
• Ethical behavior
– What is accepted as good and right in the
context of the governing moral code.
• Law, values, and ethical behavior:
– Legal behavior is not necessarily ethical
– Personal values help determine individual
ethical behavior.
Ethics and law
• Law often represents an ethical
minimum ( Law is not the same as
• Law reflects society’s codified ethics.
• Ethics often represents a standard that
exceeds the legal minimum.
Main ethical approaches
• Normative: involves supplying and
justifying moral systems.
– Focuses on “what should be”.
• Descriptive: involves describing,
characterizing and studying morality.
– Focuses on “what is”.
Factors influencing ethical behavior
– The person
• Family influences, religious values, personal standards,
and personal needs.
– The organization
• Supervisory behavior, group norms and behavior, and
policy statements and written rules.
– The environment
• Government laws and regulations, societal norms and
values, and competitive climate in an industry.
Cultural issues in ethical behavior:
– Cultural relativism
• Ethical behavior is always determined by
cultural context.
– Cultural universalism
• Behavior that is unacceptable in one’s home
environment should not be acceptable
anywhere else.
Ethical philosophy
• There are three different ethical philosophies
that individuals follow under different
situations in an organizational set-up.
• These are- utilitarianism, individual rights,
and justice.
Ethical philosophy
• The individual rights philosophy
deals with safe guarding the rights of
individuals, such as the right to be
informed, right to free consent, and the
right to privacy.
• Utilitarianism recommends that a
course of action that achieves the
greatest good for the greatest number
of people is ethical.
Ethical philosophy
• Justice requires that the rules of the
organization be enforced fairly and
• Utilitarianism is the most commonly
followed ethical philosophy
Ethical decision ideology
• Ethical decision ideologies can be
classified based on two dimensions: one
• Idealism – the belief that behaving
ethically ensures positive results; and
the other is
• Relativism – the belief that moral
values depend on circumstances.
Ethical decision ideology
• Based on these two dimensions, there
are four classifications of ethical
decision ideologies
• Absolutist,
• Exceptionist
• Situationist, and
• Subjectivist.
Ethical decision ideologies Matrix
Ethical decision ideologies Matrix
• An Absolutist believes in strictly
following the universally accepted
ethical principles.
• An Exceptionist refers to universally
accepted ethical principles for broad
guidance rather than for strict
Ethical decision ideologies Matrix
• A Situationist takes a decision on a
case to case basis by studying and
comprehending the situation at hand.
• A Subjectivist prepare to abide by
their respective individual ethical
principles rather than adhering to
universally accepted ethical principles.
Codes of ethics ( Employee role):
• Formal statement of an organization’s
values and ethical principles regarding
how to behave in situations susceptible
to the creation of ethical problems.
Code of Ethics (IFBLS)
International Federation of
Biomedical Laboratory Science
• Maintain strict confidentiality of patient
information and test results within the
limits of the law.
• Safeguard the dignity and privacy of
• Be accountable for the quality and
integrity of clinical laboratory services.
Cods of ethics
• Treat patients and colleagues with
respect, care and thoughtfulness.
• Perform duties in an accurate, precise,
timely and responsible manner.
• Prudently use laboratory resources.
Three models of management ethics
• Immoral management: a style devoid of
ethical principles and active opposition
to what is ethical.
• Moral management: conforms to high
standards of ethical behavior.
• Amoral management: causal or careless
about ethical factors.
Ethical role models:
– Top managers serve as ethical role models.
– All managers can influence the ethical behavior of
people who work for and with them.
– Excessive pressure can foster unethical behavior.
Manager role
• Assure implementation of results
• Reward employees who perform and
deliver on values.
– Reward systems should be integrated with
the performance measurements systems.
• Provide ethical training.
– Structured programs that help participants
to understand ethical aspects of decision
Manager role
• Dealing with poor performance by
disciplinary action or discharge.
– Traditional discipline systems don’t make the job
any easier.
– A good manager replaces traditional punitive
employee discipline measures such as warnings,
probations and unpaid suspensions with the
requirement that people take personal
responsibility for their performance and behavior
and commit to doing the job right.
Manager role
– Creates dramatic reductions in disciplinary
incidents, while producing major improvements in
recognition and commitment.
– For those employees who never become involved
in any type of disciplinary issue provides specific
procedures to help managers recognize and
reinforce the performance of their good, solid
• Track employees attendance and job
Manager role
• View and approve staff leave records.
– The employer has the right where the
employee is sick or injured for three or
more calendar days to require the
employee to provide proof, such as a
medical certificate, of the injury or illness.
Manager role
• Develops standards of performance so
that the employee knows how he or she
will be judged when rated in job
performance (job appraisal).
– Provide the employees with written job
– Annual merit raises are often linked to job
Manager role
– Gives the employees feedback throughout
the year on how they are doing so that
they have an opportunity to correct poor
Manager role
• Organize personnel records that should
and contain all the information required
by regulatory bodies:
• Name
• Colleges attended
• Specialized laboratory training
• Laboratory certification
• Job description signed by employee
• Record of job training at present job
• Record of continuing education
• Record of medical test
Employee role
• Report anything that interferes with day to
day activity.
• Violation of policy.
• Unusual event resulting in harm.
• Equipment malfunction.
• Employees are required to inform the
employer at the earliest opportunity of the
intention to take sick leave – preferably
before they are due to start work, but
otherwise as early as possible.
Accrediting agencies
• All laboratories must be accredited (licensed) under
(CLIA) Clinical Laboratory Improvement Act.
– which means that every laboratory must register
with (CMS) Centers for Medicare and Medicaid
Services for every test it performs and must meet
certain minimum quality standards.
• Laboratories are monitored by inspections which
include a review of a laboratory’s procedures, quality
control program, documentation, and patient
Common areas of government
regulations and laws:
• Occupational safety and health.
• Fair labor practices.
• Environmental protection.
Laboratory regulations
• The Environmental Protection Agency
– Regulates the disposal of toxic chemicals
and biohazardous waste.
• Occupational Safety and Health
Administration (OSHA)
– Regulates employee safety in the
Lab regulations
• The office of the inspector General
– Monitor laboratories for fraud and abuse in
the billing Medicare.
• The Health Information Portability and
Accountability Act (HIPAA)
– legislates the need to maintain security and
privacy of information found in patient
Lab regulations
– This means having secure phone and faxes
for transmission of laboratory data and
limiting access to patent data to only those
individuals needing to know the results.
Health Sciences Authority
• Providing legal and regulatory advice
and support.
• Ensure regulatory compliance with
related legislations and regulations.
• Assist in formulating policies,
procedures to ensure compliance with
applicable laws and regulations.
• paid the minimum wage as well as any
overtime, the right to a safe workplace,
the right to take leave to care for your
or a family member's illness, birth, or
adoption, and the right to privacy in
personal matters.
Jordanian labor law of 1996
• Jordanian Labor law number (8) was
issued in 1996 to regulate the
relationship between the Employer and
the Employee, which means that any
contract or any term in any contract
between both parties that contradicts
the labor law is considered invalid.
• Hours of work:
• The average number of working hours for
men and women is 8 hours a day. Breaks are
not part of working time. If the employee
accepts to work more than the working hours
specified in the law, then he will be entitled
for overtime.
• Article 4 forbids the employment of women in
night work, with exception in certain fields:
hospitals, clinics, medical institutions……
• Dismissal:
• Article 28 states that workers can be
discharged without notice, if they assault or
beat or humiliate any worker or other person.
• Article 29 states that if a worker is assaulted
by the employer or his representative, the
worker may quit work without notice, and still
retain his legal rights.
• Leave:
• Article 67 states that when the number of workers in
an establishment is equal to, or exceeds ten, women
workers in such an establishment have the right to
take one year of leave without pay in order to look
after their children. However, if the employee works
in another establishment during this leave, the
employer can dismiss her. Article 68 states that an
employee (man or woman) may take a non-paid
leave that does not exceed two years, in order to
accompany his or her spouse who works abroad.
• Article 70 states that the maternity leave is 10 weeks
with full pay. Women, who go on maternity leave,
cannot return to work until six weeks after the
• Article 71 states that upon their return from a
maternity leave, mothers are entitled to a daily
nursing break of one hour, for one year after giving
• Article 72 states that:
• The owner of an establishment which employs 20 or
more married women with at least 10 children under
4 years old, should provide a nursery and hire a
qualified governess to take care of the children.
• An employer must not dismiss a pregnant employee
from the sixth month of pregnancy or during
maternity leave.
• Paid leave:
• Every worker is entitled to annual leave with full pay
for a period of fourteen days for every year of
employment. This leave is extended to twenty one
days where the worker has been in the employment
of the same employer for five consecutive years.
Official and religious holidays and weekly rest days
shall not be counted as part of a worker's annual
leave unless they fall in its course.
• If a worker's employment is terminated for any
reason before he uses up his annual leave, he shall
be entitled to receive his remuneration for all
remaining leave days. Any agreement by which a
worker relinquishes his right to annual leave in full or
in part shall be null and void.
• Termination of the Contract:
• Labor law verifies the cases that gives the employer
the right to terminate the employment contract
without paying any compensation due to termination.
Other than these cases verified in the labor law, the
termination will be considered unlawful.
The termination of the employment contract for any
reason – with or without cause - does not have an
effect on the other rights enjoyed by the employee
such as annual leave, unpaid salaries, overtime, or
any other benefits.
• The foreigner workers:
• According to labor law, it is not allowed to
employ any foreigner workers without prior
consent from the Ministry of Labor. The work
permit should not exceed one year and can
be renewed for extra years.
Any employer who uses any foreign employee
without obtaining a work permit will be liable
for a fine between 100 – 150 Jordanian Dinar
for each month until the employer meets the
legal requirements.