Overusing laboratory tests: why is it unethical?

In the July issue of Journal of Laboratory and Precision Medicine, Dr. Montagnana and Lippi (1) discussed whether or not the drawbacks of overusing laboratory tests outweigh the advantages. According to our perspective, from a bioethical standpoint, the answer should be yes, obviously, and we provide the following explanations.

It is universally acknowledged, at least in the Western world, that four core principles should govern ethics in medicine, i.e., respect for the patients’ autonomy, beneficence, no maleficence, and justice (also called equity) (2).

Dr. Montagnana and Lippi have actually provided a good reason, at least implicitly, about the first three principles, but we would like to briefly examine the issue from the perspective of the fourth principle, i.e., justice.

It is indeed against justice to waste resources that could be more useful when allocated elsewhere. Lab tests often have substantial costs. Millions of people on earth not only will never have access to lab testing, but also are denied access to basic needs such as access to potable water. Moreover, overusing lab tests can be synonymous of destroying the environment, thus contributing to global warming on earth, and to mass extinction of animal and vegetal species (3). There is indeed a great need for humanity in general, and labs in particular, to change their paradigms.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Journal of Laboratory and Precision Medicine. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jlpm.2017.07.09). The author has no conflicts of interest to declare.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

1. Montagnana M, Lippi G. Overusing laboratory tests: more advantages or drawbacks? J Lab Precis Med 2017;2:41. [Crossref]
2. Beauchamp T, Childress J. Principles of Biomedical Ethics. New York: Oxford University Press, 1979.
3. How humans are driving the sixth mass extinction. The Guardian, 20 Oct 2015. Available online: https://www.theguardian.com/environment/radical-conservation/2015/oct/20/the-four-horsemen-of-the-sixth-mass-extinction