Review of Rad Protection and Ethics

The system of radiological protection was developed through the recommendations of

International Commission of Radiological Protection

What are the 3 fundamental principles radiological protection is based on?

• Justification

• Optimization

• Application of Dose Limits

Justification

benefit and harm includes impact to overall health and well-being and includes social, cultural, economic and environmental impacts and balancing w other risks; benefits must be greater than harm

Optimization

only for justified exposure situations, doses as low as reasonably achievable (though doses can be increased or decreased depending on the situation), key - reasonableness, 3 Rs; active and iterative process

3 Rs

• Relationships

• Rationale

• Resources

Relationships

engage stakeholders, demonstrate empathy, and build trust

Rationale

strong, honest, and well-communicated technical, contextual, and ethical justification

Resources

responsible use of technology and techniques, finances, and time

Application of Dose Limits

not applicable to medical exposure, recommendations at international level, regulations at national level, intended to limit risk of stochastic effects, prevent occurrence of deterministic effects, and avoid significant inequities in dose distribution

Exposure categories

• occupational

• medical

• public

Occupational exposure

exposure received as a direct consequence of one’s job

Medical exposure

patients, carers/comforters, research and volunteers

Public exposure

exposure that is not occupational, medical, or from natural background

Exposure situations

• planned

• existing

• emergency

Planned exposure

planned introduction and operation of sources

Existing exposure

already exist when a decision on control must be made

Emergency exposure

unexpected situations requiring urgent attention

Practice

activity that increases radiation exposure/risks

Intervention

activity that reduces radiation exposures or risks

Carer

individual who may be knowingly exposed to radiation as a voluntary helper providing support or care for a patient (not part of their job, which would otherwise be occupational exposure)

Are animals generally legally recognized as patients?

no

If exposure of an owner/handler is deemed justified, dose constraints should be

used to guide optimization of protection in a proportionate, practical way

Level 1 Human medicine

proper use of radiation in medicine is accepted as doing more good than harm to society

Level 1 veterinary practice

proper use of radiation in veterinary medicine is accepted as doing more good than harm to society

Level 2 human medicine

improve the diagnosis or treatment or if it will provide necessary info about exposed individuals

Level 2 veterinary practice

improve diagnosis or treatment of a defined group of animal patients or if it will provide necessary info about exposed animals

Level 3 human medicine

judged in advance to do more good than harm to the individual patient

Level 3 veterinary practice

judged in advance to do more good than harm in the management of the individual animal patient

What 2 levels is optimization applied at?

• design, appropriate selection, and construction of equipment and installations

• the day-to-day methods of working

What are the 3 foundational ethical theories?

• consequentialism

• deontology

• virtue ethics

Consequentialism

emphasis on consequences of actions (ex: utilitarian ethics)

Utilitarian ethics

greatest good for greatest number of people

Deontology

emphasis on the nature of the act and the intent (ex: Kantian ethics)

Kantian ethics

responsibility to treat others with respect as they have inherent value

Virtue ethics

emphasis on being responsible human being (ex: ethics of aspiration)

Ethics of aspiration

striving for excellence of character in life

Universal Declaration on Human Rights (UN 1948)

all human beings are born free and equal in dignity and rights. they are endowed w reason and conscience and should act towards one another in a spirit of brotherhood

Core ethical values

• beneficence/non-maleficence

• prudence

• justice

• dignity

Beneficence/non-maleficence

doing good, avoiding harm

Prudence

practical wisdom

Justice

fairness

Dignity

treat people with respect/involve stakeholders

Procedural ethical values

• accountability

• transparency

• inclusiveness

Accountability

responsibility of answering for one’s actions

Transparency

timely and complete openness/honesty

Inclusiveness

involving all relevant parties in the decision making processes related to radiation protection

Four principles in Principles of Biomedical Ethics

• respect for autonomy

• non-maleficence

• beneficence

• justice

Virtues in Veterinary Practice

• Beneficence/non-maleficence - animal welfare

• Justice - solidarity

• Prudence - sustainable development

• Dignity - reverence for life

• Accountability - stewardship

• Transparency - respect for autonomy

• Inclusiveness - empathy

Justification level 1

general use

Justification level 2

specific procedure and objective

Justification level 3

particular procedure for the patient

What 3 things comprise the system of radiological protection?

• science

• experience

• values