RE: A question of ethics

["William G. Nabor" <wgnabor@uci.edu>]

In Message Fri, 21 Jun 96 17:05:30 -0500,
  Devane Clarke <DCLARKE@smtpgate.tnrcc.state.tx.us> writes:

<SNIP>
>Last week I went the hospital for a CAT
>scan. <snip> On the way out of the examining room, I asked the
>technician to tell me how much radiation
>dose I had received from the procedure.
>He said that he didn't know. <SNIP>
I, too, recently had an X-ray procedure (several pictures for a kidney
stone).  I, too, asked the technician how much dose I received and got
the same reply, "I don't know."  The difference was that my technician was
able to go to her files and pull out a prepared single-sheet blurb that
explained the procedure and gave an estimate of the dose, which was valid,
of course, only if the technician observed the exact same procedure for
which the blurb discussed (same KvP, exposure time, etc).  This was better
than nothing, but the technician didn't (or couldn't) explain any
differences, if any, and I was denied a consultation with a physician and
was in too much pain to press the issue (quite frankly, at that point if
they had said I had to receive 500 REM before the next dose of codine, there
would have been no argument, and I'm not certain that I would have balked at
5000 - dead might have been preferable).
     Three points:
         1) A prepared statement is better than nothing.
         2) My OPINION is that a technician that cannot calculate a dose and
explain it to a patient is the equivlent of a mechanic who doesn't know how
much oil he put in your crankcase.  I think it unprofessional.  It should be
a mandatory part of their certification requirements.  It is allowed to
exist because only health physicists ask such questions.  It's a matter of
patient training.
         3) Calculating a dose to the degree of precision and accuracy
adequate for patient information is not rocket science.  A simple program on
a programmable calculator (such as an HP32S - $50) could do it.  Medical
physics could update the calculator's fudge factors each time they survey
the machine.  But this will not come about until (and unless) patients start
demanding it.
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William G. Nabor
University of California, Irvine
EH&S Office
Irvine, CA,  92717-2725
WGNABOR@UCI.EDU
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