Draft report: Ethics in Radiological Protection for Medical Diagnosis and Treatment

Abstract

Publication 138 defines the ethical foundations of the system of radiological protection, based on core values (beneficence/non-maleficence, dignity, justice and prudence) and procedural values (accountability, transparency and inclusiveness). The purpose of this report is to propose a practical application of values for the medical radiological protection professions. Because medicine has a long history and strong culture of ethics, this report starts by identifying the shared values and defines a common language between biomedical ethics and radiological protection. The core values are very similar, with the autonomy of biomedical ethics which can be seen as a corollary of dignity, and the precautionary principle which can be understood as the implementation of prudence. In recent years, medical education and training has emphasised the values of solidarity, honesty, and above all empathy. All these values are defined and interpreted in the specific context of the use of ionising radiation in medicine. For those more familiar with radiological protection, the ethical implications of their actions are described. Conversely, for those who already have a good background in ethics, this report highlights the specificities of ionising radiation that also deserve consideration In order to emphasise the coherence between the values involved in biomedical ethics and those involved in radiological protection, this report proposes to combine them: dignity/ autonomy; beneficence/ non-maleficence; prudence/ precaution; justice/ solidarity; transparency/ accountability/ honesty; inclusiveness/ empathy. This allows a structured review of practical situations from an ethical perspective. For the sake of both example and education, the report proposes twenty-one realistic scenarios (11 in imaging procedures and 10 in radiation therapies), which are all presented and analysed in a one-page format. Sensitising questions are provided to stimulate reflection and discussion. The ultimate goal is to be able to use ethical values in clinical imaging and therapy situations. Required education and training in ethics is essential for medical radiological protection workers throughout their career span. An example of a framework of knowledge, skills, and competencies is proposed. In order to assist the reader in a theoretically complex subject, key messages are distributed throughout the text, as fixed points that can easily be understood. Although primarily aimed at medical radiological protection professionals, this report is also intended for authorities, patients, and the public.

An online workshop will be held as part this consultation, on Friday 2 June 2023, 14:00-17:00 Central European Time. Details will be announced soon. We look forward to active participation, and note that comments should be submitted using the link below even if brought up during the workshop.

ICRP routinely solicits comments on most draft documents prior to publication, with the exception of those that are basically compilations of computed values such as specific absorbed fraction values or dose conversion factors.


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Draft Document