Ethical Problems in Clinical Pathology

ABSTRACT The much discussed ethical problems of clinicians, who have direct care of patients, are mainly within their responsibilities to the 'index'patient with whom they are immediately concerned. When pathologists are practising clinical pathology they are responsible for performing and interpreting tests on specimens from patients at the request of clinicians, and advising on these tests. Their ethical problems, as they do not have direct care of patients, mainly lie between their obligations to the requesting clinician, to the index patient under investigation in the laboratory, and also to other patients, and to their staff. These problems are largely ignored in the literature both of medical ethics and of pathology. The ethical principles of: (1) respect for autonomy; (2) non-maleficence; (3) beneficence; and (4) justice are discussed with particular reference to the work of clinical pathologists: possible applications of virtue ethics are also considered. Ethical problems that arise in the course of a pathologist's receiving, investigating, and reporting and advising on, a patient's specimen are examined on the basis of the above principles: an attempt is made to offer guidance on the problems.