Ethics in Radiological Protection for Medical Diagnosis and Treatment

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115

Required education and training in ethics is essential for medical radiological protection workers

Education and training in underlying ethics is essential for medical radiological workers

Not limited to the radiological protection workers.

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137

Professionals working in radiological protection in medicine are expected to adhere to their organisation’s Codes of Ethics

Professionals working in medicine are expected to adhere to their profession’s(?) Codes of Ethics

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259

adopted by the ICRP

adopted by the Commission

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277

and race and x-ray registry of the population

Meaning is unclear.

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352

into local and national radiotherapy protocols

into the radiotherapy protocols

Questionable if there are national protocols.

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362

this has sometimes reduced unnecessary imaging

What does ‘this’ indicate?

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406, 415

ICRP

Commission

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420

Table 2.1.

The levels of justification in the medical context differ from those explained in Publication 105(para. 60). See para. 204 in this draft document.

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422

Table 2.1. General description of Optimisation.

… makes exposures, and the probability and magnitude of potential exposures, as low as

… makes exposures, and the risk of potential exposures, as low as

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422

In the medical context

Sometimes the best patient protection may involve high occupational doses for staff (ICRP, 2018b).

(delete) Not a key point.

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422

Limitation

… to ensure that the radiation risk is acceptable

Application of dose limits

… to avoid unacceptable risk.

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439

Table 2.3.

Contents of the 3^rd column giving examples in Publication 138 are not relevant to ethics in medicine. Better to delete them.

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453

addressing all possible exposure situations

addressing all exposure situations

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513

In the history of ICRP,

Historically,

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912, 915

Comforters and carers

In Commission’s recommendations, ‘carers and comforters’ should mean those helping or comforting patients whose informed exposure being regarded as a medical exposure. To avoid confusion, we may use ‘caregivers’ here.

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955

to their organisation’s Codes of Ethics

to their profession’s Codes of Ethics

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965

May add the IRPA Code of ethics.

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1038

specific clinical approaches to the practical implementation of ethical values have been developed

approaches to the practical implementation of ethical values in specific clinical practices have been developed

The term ‘clinical approaches’ may misleading.

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1041,

1046

clinical approaches

approaches

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1075

The Imaging Wisely and Imaging Gently

The Image Wisely and Image Gently

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1268

Subsection 3.3.5

Different terms are used without explanations: ‘radiological protection culture’, ‘radiation safety culture’, ‘radiological safety culture’.  

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1296

to radiological protection workers

to radiological protection in medicine

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1380

Para 152

Better to make the key message focused safety culture in the context of ethics in radiological procedures in medicine.

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1455

47 years of lifespan

47 years of working-age span

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1465

optimisation of patient imaging

optimisation of patient protection

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1468

International Radiation Safety Standards

International Basic Safety Standards

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1478

The second reason is that 1479 a given tissue reaction is not solely determined by a given level of dose but varies according to 1480 the individual radiosensitivity.

Different sensitivity among individuals does not nullify concept of ‘deterministic’.

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1721

the right NOT to know

Is this a right or a freedom?

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1822

are almost entirely based

are largely based

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1836

a matter for national professional bodies, health and regulatory authorities

a matter for professional bodies, national health and regulatory authorities

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1888

the principle of “doing more good than harm” justification amounts to considering only the ethical values of beneficence/non-maleficence at the expense of others

This conclusive statement is questionable. Both ‘good’ and ‘harm’ are multidimensional and inclusive attributes, and may be related to other ethical values like justice or inequity, not just beneficence and maleficence although this has not been explicitly presented in the interpretation.

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1912

This training includes staff protection for the justification and optimisation of medical exposures which may require high staff exposures for patient optimisation See Chapter VII on Medical Exposures, art. 55 to art. 64. Art.19 Justification of practices)

This training includes staff protection.

Training for staff protection is weakly related to justification and optimization of medical exposure. The listed articles of EU BSS may not be relevant.

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1920

optimisation may require personalised care in pregnant patients who may have difficulties with normal positioning in lifesaving, urgent interventional procedures or in young children who have difficulty with motion, sometimes requiring sedation/anaesthesia.

These tailored care for pregnant patients or children may be just necessary and good practice rather than a part of optimisation.

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2001

Cases in sections 6 and 7.

Those scenario cases are almost reproduction of the work of J. Malone et al.(2019). May need a paragraph or footnote explicitly expressing thanks for the permission, in addition to the citation.

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2893

the possibility of risk

the associated risk

Risk encompasses possibility.

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2908,

2932

the greatest possible benefit at the lowest possible risk

the greatest benefit at the lowest risk

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2945

principles of radiation radiological protection

principles of radiological protection

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2949

However, there will be times where an ethical dilemma requires a formal, explicit response from a professional and graduates should be prepared to process these situations clearly and systematically while presenting their ethical reasons for their decisions to others.

Strike out(duplication of the next para.)

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2952

graduates should be

professionals should be

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2956

Students and graduates

Professionals ?

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3097

the current ICRP document

the current document

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3825

religion, etc., protected by the Universal Declaration of Human Rights.

religion, etc.