|Thank you for the opportunity to comment on this consultative document. These are the comments of the United Kingdom Ministry of Defence.
Page 23 Levels of Justification. It is believed that ICRP need to make clear in this section that every exposure should take into account factors such as pregnancy (possibly cross reference to section 17.1 pregnancy and medical radiation), age and availability of alternative imaging modalities.
Page 38 line 20 Education and Training. ICRP calls for radiological protection training for physicians and other health professionals, who order, conduct, or assist in medical procedures. This is somewhat vague and ICRP are asked to expand on what is meant by radiological protection training.
Page 38 line 20 There are separate roles and responsibilities for the clinician and the radiologist which should be reflected in this document. The responsibility for the care of the patient and hence the choice of the procedure to be undertaken should be that of the person requesting the examination e.g. the physician (clinician). However, he/she should seek the opinion of the expert as to the most effective imagining examination. This will be the specialist health professional, normally the radiologist, who should have adequate training and expertise in all medical imaging modalities. The specialist health professional has a responsibility to confirm that the imaging sought is appropriate for the purpose and suggest alternatives if a better outcome will result for the patient. This may be in terms of improved diagnostic power in relation to dose delivered (justification and optimization), to offer the best interpretation of images obtained and to discuss with the clinician when uncertainties arise. Clearly there is a need for close co-operation between all those involved.