Sir, Madam,
On behalf of SFPM, we thank the authors for this great working and also for the webinar that has permitted extensive explanations.
The report submitted for review is very interesting and comprehensive, and fills a gap given the specific nature of radiation protection in the medical field, both in terms of diagnosis and therapy.
It is clearly indicated that the field of medical research is covered by another report that will be updated.
The structuring into fundamental ethical values and procedural values defines the architecture of the document. The link between the values of biomedical ethics and those specific to radiation protection ethics is obtained by combination (dignity/autonomy; beneficence/non-maleficence; prudence/precaution, justice/solidarity, transparency/accountability/honesty, inclusiveness/empathy). It would be interesting to highlight the importance of not drifting from empathy to pathos in order to maintain informed, non-subjective discernment.
We feel that this step is perfectly suited to making it easier for readers who are more interested in radiation protection than in ethics to understand the key points.
However, it seems to us that the work of Ricœur, and in particular "Réflexion faite" (1995), could be cited in view of its importance in procedural ethics: it provides a critical reflection that makes it possible to value them but also to better understand their limitations.
Chapter 3 places this report in the context of state and professional requirements, which seems to us to highlight the importance of such a document at both personal and professional levels.
Chapter 4 provides the missing information, whether in terms of radiation protection theory or ethics; we feel that this is essential in order to create a strong link between ethics and radiation protection.
The practical part begins in Chapter 5, with a method of analysis that is well described in the various tables presented. The examples are varied and give the reader a better grasp of concepts that may be abstract. A number of diagnostic and therapeutic examples are given, reflecting some of the practices we encounter on a daily basis. They are fairly Anglo-Saxon in their approach, but understandable to non-UK readers. We understand the international vocation of such a report. However, societal values should not interfere with treatment. Universalist values seem to us to be of paramount importance
The last chapter concerns teaching and the examples in the previous chapters provide a basis that can be used to pass on the ethical values specific to medical radiation protection.
In our view, this work is comprehensive, particularly relevant and fills a gap. It is clear and well written, the examples are relevant and, within the 21 examples, everyone will be able to find an example related to their own practice to reinforce their theoretical knowledge. Its overall approach focuses on the relationship between carer and patient, but it would be interesting to extend this to the relationship between carers and the hierarchy.
The French Medical Physicist Society has initiated the process of drafting a code of ethics, and this document will undoubtedly lend legitimacy to this work in progress.
For the Société Française de Physique Médicale, the Ethics working group.
Catherine Dejean, Matthieu Moreau, Christophe Aventin, Juliette Angles, Bénédicte Perrin, Noëlle Pierrat, Pierre-Yves Pagan, Aurélien Vasseur, Christine Boutry