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Best Practice when providing interpretative comments for laboratory medicine published

24/09/2014 16:06:48

Following consultation with the membership, and having been through ACB Council twice for comment, the ‘Best Practice when providing interpretative comments on laboratory medicine reports’ document has now been ratified and is available on the Best Practice Guidelines page.

One of the areas of greatest discussion was around reflective (or ‘add on’) testing and as part of the consultation we took advice from both the Medical Protection Society and the Medical Defence Union. In their response, they highlighted how current General Medical Council guidance might influence the answer to the question, pointing us towards the GMC Guidance on Consent found at http://www.gmc-uk.org/guidance/ethical_guidance/consent_guidance_scope_of_decisions.asp

An addendum to Paragraph 37 of this document states:

* Note for pathologists and radiologists: there may be times when uncertainty about a diagnosis can only be resolved by investigations which were not specifically ordered as part of the original request for testing. If these investigations appear to fall outside the scope of the original consent given by the patient, or there are particular sensitivities around the condition for which the pathologist or radiologist wishes to test, they must contact the treating doctor and establish whether further discussion with, and consent from, the patient is necessary before proceeding

Also, an earlier paragraph which states:

32. You must tell patients if an investigation or treatment might result in a serious adverse outcome, (9) even if the likelihood is very small.

The number (9) in this paragraph refers to the following footnote defining a ‘serious adverse outcome’ as being:

An adverse outcome resulting in death, permanent or long-term physical disability or disfigurement, medium or long-term pain, or admission to hospital; or other outcomes with a long-term or permanent effect on a patient's employment, social or personal life.

With regard to relevant HCPC guidance, neither the ‘Standards of Conduct, Performance and Ethics’ or the ‘Standards of Proficiency for Clinical Scientists’ documents made any statement that was nearly as specific to the topic as that of the GMC.

The section on Reflective Testing in our own document has changed little from the first draft circulated but at least we now know it reflects views consistent with both ourselves and the GMC.

Prof Eric Kilpatrick - ACB President

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