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ACB-CLIN-CHEM-GEN  November 2014

ACB-CLIN-CHEM-GEN November 2014

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Subject:

Re: extent of patient consent required for pathology tests

From:

Webster Craig <[log in to unmask]>

Reply-To:

Webster Craig <[log in to unmask]>

Date:

Tue, 11 Nov 2014 15:09:30 +0000

Content-Type:

text/plain

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From personal experience of viewing a copy of my medical records as asked for by my life insurer, I’m starting to have a concern that maybe all tests should be consented for. The level of “intrusiveness” is if anything increasing in this area and I don’t think the nuances of reference ranges / interpretation of results in the correct context is accurately documented in the patient record.



If my experience is anything to go by (n =1 I know), Ive had one set of records “contaminated” by another persons laboratory results and correspondence, which luckily for me was a diabetic so there was a discrepancy between what I had said and what my medical record had said.



On the second occasion, the standard of documentation was poor, for example a letter from an eye clinic stated I had high pressures in my eyes when I squeezed them but otherwise my risk for glaucoma was low. Ive no idea where the idea of eyeball squeezing comes from!



Some of these issues could be removed by having a secure system which has error checking / quality control of messages record entries.





Best Wishes

Craig







On 11 November 2014 at 12:50:57, Myers Martin (LTHTR) ([log in to unmask]<mailto:[log in to unmask]>) wrote:

Summary and conclusion:



There were differences in responses, from:



“we do not get specific consent for “a” or “b” genotyping. However for referral to other labs we get consent because the samples go to research labs that store the DNA for future testing”

to

“All our patients for genetic testing are consented, we would never assume consent, we also need to consent for the DNA storage.  Please see the BSGM Guidance for your information”.  http://www.rcpath.org/Resources/RCPath/Migrated%20Resources/Documents/C/consent_and_confidentiality_2011.pdf



It would be concluded that for biochemical testing there is implied consent from the patient which would include cascade testing (within reason) if it helps the original clinical enquiry.  For tests such as PSA and CA125 we assume that the requesting physician has counselled the patient and the Biochemistry lab does not insist on documentary evidence of this.  However it would be concluded that ANY genetic test requires specific patient consent wherever it is analysed.



I am passing this up the professional chain for comment



Martin



From: Myers Martin (LTHTR)

Sent: 10 November 2014 13:55

To: [log in to unmask]

Subject: extent of patient consent required for pathology tests



Following on from the LFT debate…..Is there a consensus that ALL genetic testing requires specific patient consent, e.g. prothrombin gene, porphyria, Gilbert’s etc etc. and how should that consent be worded?





Martin

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