This month’s Radiological Protection Study Group was held on July 4, with the theme “Focus on Ethics in Radiological Protection for Medical Diagnosis and Treatment“. The presentation was led by Dr. Kimberly Applegate, Chair of Committee 3 (Medicine) of the International Commission on Radiological Protection.

The presentation was based on the work of ICRP Task Group 109, which clarifies and identifies the ethical values when using radiation in medicine. It builds on Publication 138 of 2018, which identifies the core values of the radiation protection system: beneficence/non-maleficence, prudence, justice, and dignity.

Both publications recognize procedural ethical values in order to implement necessary policies and practices:

• Accountability: decision-makers must answer for their actions to all those who are likely to be affected;
• Transparency: openness about decisions and activities that affect society, the economy, and the environment, and a willingness to communicate accurately and honestly. In the medical field, it is implemented, for example, through training for workers and informed consent of patients;
• Inclusion: involvement of all relevant parties in decision-making processes related to radiation protection and medical facilities.

TG109 further develops procedural values of solidarity, empathy, honesty, precaution, and autonomy as described below and pairs them in multiple clinical scenarios.

Evaluating these ethical values provides a practical context, allowing professionals, patients, and families to consider the relevance of ethical perspectives to different cultures and situations. Ethical values are essential and must be taught from the undergraduate level and throughout ones career.  These values are applicable for example in situations when there is a lack of scientific evidence about the use of radiation technologies in patient care, disagreement between patient/family and the care team, and disagreement within the care team about the appropriate care.

TG109 has proposed a teaching method using realistic but simplified clinical scenarios where the case can be either in compliance or noncompliance with a paired ethical value. There is no correct answer but rather a balance of values is sought in order to arrive at a solution.

The complete presentation will soon be available on the YouTube channel of the São Paulo Society of Radiology.