Ethical, Moral and Legal Considerations in
Phlebotomy
Morality VS. Ethics
WHAT IS MORALITY?
 Greek word: “Mos” = Customs
 Latin Word: “Moralitas” = Beliefs
 Morality is a system of beliefs
about what is right and wrong thing to do.
 Its relies on an authority such a Divine
Being, or it can be politically or personally
driven.
“The ideas we believe about being right and
wrong”
WHAT IS ETHICS?
 Is a branch of philosophy
dealing with values
relating to
human, with respect to the rightness
and wrongness of certain actions and to t
he
goodness and
badness of the motives and
ends of such actions.
 It’s a system of moral principles that is
based on values and reasoning.
“The laws, rules, principles and codes that
governs doing right and wrong”
MEDICAL ETHICS
 The code of behavior considered to be
correct for members of the medical profession
 Examines the questions of rights and
wrongs in the practice of medical
profession.
 Medical ethics involves examining a
specific problem, usually a clinical case,
and using values, facts, and logic to
decide what the best course of action
should be.
 Ethical decisions
should respect the
values and
attitudes of
patients.
PILLARS OF MEDICAL ETHICS
 AUTONOMY
 BENEFICENCE
 CONFIDENTIALITY
 D O NOT DO HARM/ NON-
MALEFICENCE
 EQUITY OR JUSTICE
Code of Ethics of the Profession
1. Accept the responsibilities of being a
professional
2. Uphold the law at all times
3. Equality to all
4. Camaraderie among the profession
5. Respect to the employer
6. Work integrity
7. Sharing of expertise
8. Contribute to the advancement of the
profession
9. Respect for others
10. Stick to the law of confidentiality
11. Uphold the dignity of the profession
12. Promote life and protect human dignity
Ethical Standards in Phlebotomy
1. Proper identification of the patient.
2. Collection of appropriate sample using
appropriate technique.
3. Appropriate identification of the sample so
that the right tests are performed.
4. Appropriate handling, transporting and
processing of the specimen.
5. Safety of the patient, the phlebotomist and
the institution.
LEGAL ISSUES IN PHLEBOTOMY
Laws Governing Patient Rights
1. Article III, Section 1 of the 1987
Constitution
“No person shall be deprived of life, liberty, or
property without due process of law, nor shall any
person be denied the equal protection of the
laws.”
2. Universal Healthcare Bill
“All Filipinos will automatically be enrolled into the
National Health Insurance Program”
3. Magna Carta of Patient’s Rights and
Obligations Act of 2017
“It is hereby declared that the policy of the state to
promote right to health of the people and instill
health consciousness among them and it shall
likewise protect and enhance right of all people
to human dignity”
4. Data Privacy Act of 2012
CHAPTER 5, SEC 20
“The personal information controller must
implement reasonable and appropriate
organizational, physical and technical measures
intended for the protection of personal
information against any accidental or unlawful
destruction, alteration and disclosure, as well
as against any other unlawful processing.”
PATIENT RIGHTS
1. Right to good quality health care, humane
treatment and dignity
2. Right to be informed of his rights and
obligations as a patient.
3. Right to choose healthcare provider and
facility
4. Right to informed consent
5. Right to refuse diagnostic and medical
treatment
6. Right to refuse participation in Medical
research
7. 9. Right to Privacy and Confidentiality
8. 10. Right to Leave
9. 11. Right to correspondence and to
visitors
10. 12. Right to express grievances
11. 13. Right to Information and records
12. 14. Right to safety and healthy safe
workplace
13. 15. Right to an Equitable and Economical
use of resources
RIGHT TO INFORMED CONSENT
 Informed consent should be clear,
truthful and contains substantial
explanation, in a manner and language
understandable to the patient.
 It should comprise all proposed
procedures whether diagnostic,
preventive, curative, rehabilitative or
therapeutic.
 It also includes the name and the
credentials of the person who will
perform the procedure.
 All information such as possibilities of any
risk of mortality or serious side effects,
problems related to recuperation, and
probability of success and reasonable
risks involved.
 Consent doesn’t go out of date
GUIDELINES OF THE INFORMED CONSENT
1. Informed consent shall be obtained from a
patient concerned if he is of legal age and
of sound mind.
2. In cases when the patient is, mentally
incapable and minor, a third party is
required:
a. Spouse
b. Son or daughter of legal age
c. Either parent
d. Brother or sister of legal age
e. Guardian
f. Court (in cases of litigation)
3. Cases that does not require patient
consent:
a. Emergency cases
b. When the health population is dependent
on the adoption of a mass health program
to control epidemic
c. When the law submits everyone to
undergo a procedure
 d. When disclosure of material information to
the patient will jeopardize success of
treatment
e. When the patient waives his right in
writing
Patient Privacy & Confidentiality
 Privacy of the patient must be assured
always at all stages of the laboratory
procedures.
 The right of privacy shall include right not
to be subjected to exposure, private or
public, either by photography,
publications, videotaping, discussion
or by any means that reveals sensitive
information about the patient.
 All identifiable information about patients
health status, laboratory results,
diagnosis, prognosis and treatment
must be kept confidential even after
death.
When can confidentiality be breached?
 The patient who is in sound mind and of
legal age is only allowed to obtain those
information personally.
 Disclosure of the patient information can
be without his consent is allowed in
following situations:
a. When the patient’s medical or physical
condition is in controversy in a court
litigation
b. When public safety so demands
c. When the patients medical condition is
discussed in scientific forum for the benefit
and advancement of science and
medicine; provided that his/her identity
should not be revealed
d. When it is otherwise required by law
e. When the patient or in his capacity, his/her
legal representative or the patient wives his right.
 Who are allowed to be patient’s legal
representatives?
1. Spouse
2. Son or daughter of legal age
3. Either parent
4. Brother or sister of legal age
5. Guardian (close family kin/relative)
6. Presiding Judge (in cases of litigation)
MALPRACTICE & NEGLIGENCE
• NEGLIGENCE
 When the healthcare worker who is on
duty of care, has failed in that duty and as
a consequence injury or death arisen.
 Violation of duty to exercise reasonable
skill and care performing tasks
• MALPRACTICE
 Improper or unskillful care of a patient by
an healthcare worker, or any
unreasonable lack of skill or professional
misconduct
Cases Resulting from Negligence and
Malpractice in Phlebotomy
1. Patient misidentification
2. Hematomas
3. Infection to the puncture site
4. Patient injury from fall
5. Fainting
6. Nerve damage
7. Emotional distress
8. Professional misconduct
How to minimize law suit?
1. Perform the proper standards according to the
laboratory protocol.
2. Perform the collection procedures according to
national standards.
3. Obtain informed consent in a proper manner.
4. Do not violate patients privacy and
confidentiality.
5. Maintain blood collection area with appropriate
supplies, especially for safety concerns.
6. Exhibit good listening and critical thinking skills.
7. Report and document the incident immediately.
8. Act professionally at all times.