Comparative analysis of ISO 15189:2022 with earlier versions with reference to ethics
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Sudip K. Datta
, Nilda Fink
Abstract
Objectives
The International Organisation for Standardisation (ISO) 15189 standard provides the requirements for quality and competence in medical laboratories. It aims to ensure that laboratories deliver accurate and reliable results for patient care. The first version of the same was published in 2003, followed by editions in 2007, 2012 and 2022. The objective of this article is to analyze the ethical commitments and requirements assumed to achieve reliable results in laboratory medicine incorporated in the ISO standard.
Methods
We compare the concepts and changes related to ethics introduced over time in the ISO 15189 versions. We also present, a comparative study about the evolution of ethical concepts in the clinical laboratory and how these changes have been reflected in ISO 15189 standards through 2003 to 2022.
Results
After a thorough comparative analysis, we observe that the ISO 15189:2022 version has strengthened the requirements for several key concepts of Ethics such as impartiality and confidentiality, and addressed the issues of laboratory users with regards to autonomy, beneficence and justice although these terminologies are not explicitly mentioned. However, several other key words and concepts have not been addressed with adequate emphasis.
Conclusions
We recommend that several key concepts related to ethics may need to be included in the future revisions, especially those related to new and upcoming technologies being used in laboratory diagnostics and research.
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Research ethics: Not applicable.
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Informed consent: Not applicable.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Use of Large Language Models, AI and Machine Learning Tools: None declared.
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Conflict of interest: The authors state no conflict of interest.
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Research funding: None declared.
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Data availability: Not applicable.
References
1. International Organization for Standardization. ISO 15189:2003. Medical laboratories – requirements for quality and competence. Geneva: ISO; 2003.Suche in Google Scholar
2. International Organization for Standardization. ISO 15189:2007. Medical laboratories – requirements for quality and competence. Geneva: ISO; 2007.Suche in Google Scholar
3. International Organization for Standardization. ISO 15189:2012. Medical laboratories – requirements for quality and competence. Geneva: ISO; 2012.Suche in Google Scholar
4. International Organization for Standardization. ISO 15189:2022. Medical laboratories – requirements for quality and competence. Geneva: ISO; 2022.Suche in Google Scholar
5. Linko, S, Boursier, G, Bernabeu-Andreu, FA, Dzneladze, N, Vanstapel, F, Brguljan, PM, et al.. EN ISO 15189 revision: EFLM Committee Accreditation and ISO/CEN standards (C: A/ISO) analysis and general remarks on the changes. Clin Chem Lab Med 2025;63:1084–98. https://doi.org/10.1515/cclm-2024-1451.Suche in Google Scholar PubMed
6. Committee on Conformity Assessment (CASCO). Common elements in ISO/CASCO standards. CASCO QS-CAS-PROC/33. 2020.Suche in Google Scholar
7. International Organization for Standardization. ISO 15189:2003. Medical laboratories – requirements for quality and competence. Annex C: ethics in laboratory medicine. Geneva: ISO; 2003.Suche in Google Scholar
8. International Organization for Standardization. ISO 15189:2007. Medical laboratories – requirements for quality and competence. Annex C: ethics in laboratory medicine. Geneva: ISO; 2007.Suche in Google Scholar
9. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The belmont report: ethical principles and guidelines for the protection of human subjects of research. Washington: U.S. Department of Health, Education and Welfare. DHEW (Publication Number. (OS) 78-0014); 1979.Suche in Google Scholar
10. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Ferney-Voltaire, France: World Medical Association; 2024. Adopted by the 18 WMA General Assembly, Helsinki, Finland, June 1964 and amended by the: 29 WMA General Assembly, Tokyo, Japan, October 1975 35 WMA General Assembly, Venice, Italy, October 1983 41 WMA General Assembly, Hong Kong, September 1989 48 WMA General Assembly, Somerset West, Republic of South Africa, October 1996 52 WMA General Assembly, Edinburgh, Scotland, October 2000 53 WMA General Assembly, Washington DC, USA, October 2002 (Note of Clari6cation added) 55 WMA General Assembly, Tokyo, Japan, October 2004 (Note of Clari6cation added) 59 WMA General Assembly, Seoul, Republic of Korea, October 2008 64 WMA General Assembly, Fortaleza, Brazil, October 2013 and by the 75 WMA General Assembly, Helsinki, Finland, October 2024. Published on 3rd April 2025.Suche in Google Scholar
11. IFCC Taskforce on Ethics. International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Code of Ethics (reviewed and approved by IFCC Executive Board). IFCC; August 2021. Available from: https://ifcc.org/ifcc-news/archive/2021/2021-08-20-tf-e-code-of-ethics/.Suche in Google Scholar
12. Verona, J, Yilmaz, G, Zaninotto, M, Munsaka, S, Serdarevic, N, Datta, SK, et al.. Ethical checklists for clinical research projects and laboratory medicine: two tools to evaluate compliance with bioethical principles in different settings. Clin Chem Lab Med 2024;63:60–70. https://doi.org/10.1515/cclm-2024-0604.Suche in Google Scholar PubMed
13. WHO. Global Health Ethics. Key issues. Geneva: World Health Organization; 2015.Suche in Google Scholar
14. Plebani, M. Ethics in laboratory medicine: lessons from the COVID-19 pandemic. Biochim Clin 2022;46:74–7.Suche in Google Scholar
15. Pennestrì, F, Banfi, G. Artificial intelligence in laboratory medicine: fundamental ethical issues and normative key-points. Clin Chem Lab Med 2022;60:1867–74. https://doi.org/10.1515/cclm-2022-0096.Suche in Google Scholar PubMed
16. Carobene, A, Padoan, A, Cabitza, F, Banfi, G, Plebani, M. Rising adoption of artificial intelligence in scientific publishing: evaluating the role, risks, and ethical implications in paper drafting and review process. Clin Chem Lab Med 2023;62:835–43. https://doi.org/10.1515/cclm-2023-1136.Suche in Google Scholar PubMed
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