Re: A question of ethics

[Alex Zapantis <a.zapantis@qut.edu.au>]

At 02:39 PM 24/6/96 -0500, you wrote:

>1) How can physicians "fully explain" the risks of diagnostic radiation 
>procedures when the HPs, who deal with radiobiology all the time, can't 
>even agree about what the risks are, if any? 

OK, lets not get pedantic about the numbers used in quoting risk to
patients. Patients SHOULD be advised of the risks involved. The basis for
the guestimation of those risks should be the LNT model because it is still
the basis of our "science". When (or if) it is discredited completely and
dropped by the ICRP THEN we can use other models. The patient has a hard
enough time understanding the jargon we are often guilty of propogating. We
definitely should NOT subject them to a crash course in the LNT debate.


>2) A large majority of patients do not question the need for 
>their diagnostic exposure to radiation.  Going through a long 
>explanation of LNT, hormesis, BEIR V, etc. with most of these patients 
>will do more harm than good.

AGREED. That is precisely why we should ALL use the LNT model at this time.
Of course it would be acceptable to advise the patient that the risk we
quote is conservative, ie probably lareger than reality.


>3) The few patients that do question their radiation exposure certainly 
>deserve an answer.  But as #1 suggests, many times the answer is inexact 
>and that is particularly frustrating to those who want a "yes" or "no" 
>answer.  Dose is relatively easy to come up with.  What the numbers mean 
>is another matter.

When patients want a yes or no answer, it is our role to communicate to them
that it is not that simple. Use analogies. I particularly like the "crossing
the road" analogy. The more times you cross, the more chance of being hit by
a car. It places the risk in terms to which they can relate.

 
  Alex Zapantis                                         
  Radiation Safety Officer                                     
  Queensland University of Technology 
  Acting Manager       
  Health & Safety Section                             
  Victoria Park Road                 Ph     : 61 7 3864 3566
  Kelvin Grove Qld 4059             fax     : 61 7 3864 3993
  AUSTRALIA                           Email  : a.zapantis@qut.edu.au    

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    "From the moment I could talk I was ordered to listen."

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