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ICRP: Free the Annals!

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Submitted by Jerome Benoit, oncovet france
   Commenting as an individual
Document Ethical Foundations of the System of Radiological Protection
 
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As a veterinarian, specialised on radio-oncology and being directly involved in the set-up and follow-up of radioprotection rules and procedures at my institution in France, but also in other countries where I worked and where I still work as a consult, it has always amazed me to realise how much every "rule" we follow is only focused at the users (veterinarians, technicians) and that our companion animals, or experimental animals (research models) get no consideration from our local authorities when it comes to their exposure to radiation.

As a matter of fact, animals are gaining more and more rights in our western countries and are now "finally" considered as sensitive living beings. Our good practice, as veterinarians, is dictated by our national colleges, ethical and deontological rules, but when it comes to radiation exposure, only our professionalism and personnal common sense come into place. For experimental animals, rules and guidelines are extensively written about what can be done or not, but I do not think there is anything stated about radiation exposure.

Yet, some "standard" procedures and malpractice can be directly related to unnecessary exposure of our animals. For some of these procedures, we as radiation workers, are indirectly potentially exposed as well. For instance, in the case of repeated imaging procedures (follow-up staging in oncology cases for insance), or radiotherapy procedures, it would not be unreasonnable to better identify how much we expose our animals to radiation (how to best optimize image quality vs. dose ; perform regional scans vs. full body scans). In the case of radiotherapy units, there is no obligation for us, veterinarians, to perform any quality assurance of the dose rate and output of our machines. Beside the dose and protocols we are using, it only comes to our own will to perform these tests. It takes time to do them, it costs money to have medical physicists best calibrate these complex piece of equipements and there is no obligation to be certified in the field to own a radiotherapy unit (such as a linear accelerator) and perform radiotherapy treatments on our animals. This lack of frame, awarness certainly leads to some treatment "mistakes" and fraudulous malpractice in some cases (underdosing of some tumours, overdosing and unacceptable side effects or complications).

Finally, the radiation safety authorities in some countries, give recommandations which are not teh best for our patients. In France where I work, veterinary institutions are under the umbrella of the Industrial RP (ASN-Industrie). Some of the RP I have for the use of my linear accelerator are unique to the industry and does not apply to the medical side because it has some possible consequence on the patient being treated in the room. For example, some special locks on the door, required under the Industrial rules (not the medical ones), are an obstacle if one urgently need to interrupt the treatment and come in the room to assist our patients anesthesia.

Thus, it comes to an era when the radiation exposure of companion and experiment animals is needed, and this should be part of the ethical foundation.

Best regards to all.

Jérôme Benoit
DVM
Diplomate of the American College of Veterinary Radiology / Radiation Oncology
Diplomate of the European College of Veterinary Diagnostic Imaging / Add. Radiation Oncology