Warner Elizabeth A, Walker Robert M, Friedmann Peter D
Department of Internal Medicine, Division of General Internal Medicine, University of South Florida, Tampa, Florida 33612, USA.
Am J Med. 2003 Jul;115(1):54-8. doi: 10.1016/s0002-9343(03)00236-5.
Laboratory testing for drugs of abuse is often conducted in medical settings, with little consideration of the technical limitations and the potential for legal and social harm to the patient. We consider several technical problems associated with such testing, including the lack of chain-of-custody procedures, the possibility of false-positive results with screening immunoassays, and the infrequency of confirmatory testing. Important ethical issues arise because of the sensitive nature of drug test results, the ramifications of false-positive results, the limitations of confidentiality protection, and the practice of testing without the patient's knowledge. Taken together, these technical and ethical concerns suggest that drug testing policies in medical settings should specify which conditions require explicit informed consent, as well as create procedures for protecting this sensitive information.
对滥用药物进行实验室检测通常是在医疗环境中进行的，很少考虑到技术限制以及对患者可能造成的法律和社会伤害。我们考虑了与这种检测相关的几个技术问题，包括缺乏保管链程序、筛查免疫测定出现假阳性结果的可能性以及确证检测的频率较低。由于药物检测结果的敏感性质、假阳性结果的后果、保密保护的局限性以及在患者不知情的情况下进行检测的做法，引发了重要的伦理问题。综合来看，这些技术和伦理问题表明，医疗环境中的药物检测政策应明确规定哪些情况需要明确的知情同意，同时制定保护这些敏感信息的程序。
