Re: X-Ray Dosimetry for Children

[Philip Hypes <phypes@lanl.gov>]

True, depending on your views on hormesis, there aren't any immediate
benefits to the children involved.  However, that does not automatically
mean that the proposal is unreasonable or unethical.  The risk from
extremity doses, even in children, is probably going to be hugely outweighed
by the risk involved in driving to and from the hospital.  I say this from
experience;  I've driven in Boston!  Is it also unethical for a parent to take
a child along "for the drive" while running errands?  Is that unethical?

It is also possible that the results of this research may benefit one of
the children involved later in life, assuming the research is worthwhile.
These children will someday have children themselves, who may also
benefit from the research.  Assuming parental consent is obtained (an
issue that wasn't and probably needn't have been addressed in the
original posting) and the risks are determined to be sufficiently low in
the opinion of the relevant committees, I would have no problem allowing
my children to be involved in such research.  When the procedures
involved do not directly benefit the "patient" (I'll use this term in
preference
to "test subject"), the protocol obviously must meet an even higher
standard than a protocol involving, say, terminal patients for whom no
treatment exists.  But that does not mean all such research is unethical.

Actually, if the protocol involves other tests to characterize the health
of the patient, that may constitute net benefit for patients who might
otherwise not receive such testing.

The point of all this is that the issue is not as simple as Mr. Owen implies.
Any protocol that can survive LNT-based risk analysis and the litany of
committees involved in setting up a research protocol might just be alright,
assuming those committees are doing their jobs.

At 03:12 PM 4/21/99 -0500, you wrote:
>In consulting with a medical physicist on staff, it would be beneficial
for you to contact Keith Strauss at Children's Hospital in Boston, MA for
relevant information.  He will have a lot of data pertaining to children,
published and unpublished.
>
>Nonetheless, though not knowing the whole picture, it is unthinkable that
any physician would subject children to a lot of x-ray procedures without
any benefit without parental consent and FDA approval.  This project should
be discussed with your radiation safety committee, where the FDA protocol
and organ doses would be discussed.  Maybe I'm stating the obvious and this
is your next step.  However, I'm really having difficulty envisioning
anyone proposing deliberate irradiation of children without medical benefit
for any purpose.  As a health physics professional, I am concerned about
this as an acceptable practice. 
>
>>>> "Richard, Mack L" <mrichar@iupui.edu> 04/20/99 08:56AM >>>
>Dear Radsafers:
>
>A researcher here wants to perform a number of x-rays of children (ages
>4-18) in support of a research study (i.e., the patient receives no
>benefit)....(snip)
___________________________________________________________
Philip Hypes
Los Alamos National Laboratory
Safegaurds Science and Technology Group (NIS 5)
(505) 667-1556  phypes@lanl.gov

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