The Department of Medical Imaging and Radiation Sciences faculty place a strong emphasis in promoting professionalism, ethics, integrity, collaboration, diversity and human flourishing. As a faculty member and administrator, Barbara M. Curcio, David Ross Boyd Professor Emeritus, served to develop and uphold these principles for the Department and students. The following narrative written by Professor Emeritus Curcio expresses these ideals which will be upheld by current procedures and policies found in this Handbook.
By Barbara M. Curcio, M.Ed., RT(R)
David Ross Boyd Professor Emeritus of Medical Imaging and Radiation Sciences
Barbara Curcio
No portion of this narrative may be copied, published or otherwise reproduced
without the express permission of the Department of Medical Imaging and Radiation Sciences.
Professional Ethics
In the true sense of the word, ‘ethics’ is not merely a set of rules for behavior, but a branch of philosophy that deals with the search for ideal behavior. At the onset the student is urged to remember that for professional personnel, ethical behavior is a dynamic process of developing judgment, sensitivity and motivation for the kind of behavior that is needed, as well as learning the rules. “Professional Ethics” as discussed in this section stresses specific guidelines that will help the student in his/her efforts to achieve the behavior necessary in the health care setting.
In the health care fields, which involve direct patient contact, professional ethics are based upon two major considerations of patient care. These may be expressed as follows:
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Consider the welfare of the patient first, subjugating all things to the end.
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Put yourself in the patient’s place and treat the patient as you would wish to be treated.
The codes of ethics in the medical imaging and radiation science disciplines represent the public codes upon which we base the rules and regulations governing our daily behavior as professionals who are in contact with patients, peers, supervisors, other professional practitioners and the health care community at large. These codes, which are studied in the AHS Medical Ethics course, contain central themes that are found in the codes of all of our respective professions.
Educational programs of the department are designed to prepare students to function in the delivery of health care services to patients in the clinical setting. This means that the student will be obliged to accept special responsibilities and conduct himself/herself in a manner appropriate to such a setting. This section is designed to assist and support this goal.
While it is important to anticipate all situations arising in the clinical setting and in the interaction of students with the professional community, some basic guidelines having universal application are discussed below.
Lines of Authority
Respect lines of authority, recognizing that faithful execution of the physician’s orders for the patient is a cornerstone of good patient care and proper medical ethics. In the clinic affiliates, students should observe the appropriate line of authority with respect to clinical assignments and activities.
The chief or supervising technologist and technologist instructor are the immediate authority in the clinical setting. With respect to your academic training, these individuals work with and under the general guidance of your program director, the faculty and chairperson of the department in providing and supervising your clinical experience.
Diagnostic Interpretation and Treatment Decisions Are Made by Physicians
Diagnostic interpretation of imaging and/or the decision with respect to therapeutic radiation dosage and treatment parameters is always made by the physician. A student should make no diagnoses or interpretive diagnostic judgments to anyone under any circumstances unless his/her opinion is solicited by the physician. To do so is a serious breach of medical ethics and also potentially compromising from a medical-legal aspect.
Confidentiality
From an ethical and medical-legal aspect, all information of a personal nature that comes to your attention regarding the patient must be kept confidential. This includes details of his/her illness, treatment, progress, diagnostic studies and personal life. Do not discuss these matters with anyone but duly authorized persons of the health care team participating in the patient’s care and only when necessary to perform your responsibilities. Failure to observe this basic principle of medical ethics is both professionally unacceptable as well as potentially compromising from a medical-legal aspect.
Radiation Protection and Safety
Make it your personal responsibility to practice all appropriate radiation protection procedures for yourself, for other members of the health care team and for the patient. This includes utilizing personal radiation dosimeters; observing rules such as closing doors during radiographic examinations; specific procedures of collimation; and utilization of equipment safety devices; protective shielding and clothing; safety precautions with respect to radioactive materials; portable radiography; measures for protection of nonmedical assisting personnel and all other specific radiation protection measures indicated for procedures in the various specialties.
In addition to radiation protection procedures, observation of all appropriate general safety, fire regulations and institutional regulations in effect for medical asepsis should be considered part of your personal responsibility in delivering safe, competent patient care. Make it your responsibility to know, understand and practice the principle of ALARA and other required regulations.
Student Initiative
As a student you are not to attempt on your own initiative, a procedure for which you have not received permission. Since all students in departmental programs work either with direct, by the side supervision, or (when experience warrants) by indirect, but on-site supervision, there is never a time when the student cannot obtain prior permission to proceed with a specific procedure.
Respecting Authority
Proper professional conduct calls for you to follow the orders of your immediate supervisors in the clinic affiliates in patient care situations. Do not hesitate to request clarification of any written or verbal order with respect to patient care. Questions, conflicts, and concerns which you may have with respect to what is required of you in the clinical setting are never debatable at the time a patient-related activity is in progress. This situation could potentially compromise proper patient care and create an undesirable discussion in the presence of a patient. Should you have concerns about clinical requirements in affiliates, such matters should be brought to the attention of the faculty clinical coordinator, the program director, or the chairperson, in an orderly and professional manner as soon as possible after the immediate patient care requirements have been met.
Dependability / Accountability
Proper medical care depends upon all members of the health care team knowing their responsibilities and being in the right place at the right time. You will be expected to be prompt and give advance notice if it is unavoidable that you be late or absent from either class or clinical responsibilities. You will need to demonstrate a sense of responsibility and dependability with respect to the use of time, equipment and materials at your disposal in the classroom, laboratories and clinic affiliates.
Accepting Critique / Limitations
Since you will be in a learning capacity for some time, there is no need to feel hesitant about asking questions, seeking clarification or advice and assistance at any time it is necessary, on any aspect of your training. Also, constructive critical analysis of your work and progress is an essential part of the educational process. You will have the opportunity to comment freely and respond to the periodic evaluation reports made by faculty and clinic instructors/preceptors. Try to take necessary constructive criticism in stride and benefit from it.
Medical Records
From an ethical and medical-legal standpoint, proper medical record notation and record-keeping is a fundamental responsibility and obligation of the health care professional. In each of the programs of this department, some form of record notation and record-keeping is necessary. The student will learn the correct procedures for his/her profession. Proper form, legibility, accuracy, correct terminology, avoidance of jargon and irrelevancy are applicable in all medical record keeping.
Patient Respect
Never underestimate the power and great value of a pleasant attitude and smile. They have incalculable value in patient care and in maintaining a good working relationship with peers and supervisors. Maintaining both also goes a long way in dispelling discouragement over feelings of ineptness and failure.
Do not make visible or implied judgments of the patient’s reactions, personal characteristics, appearance, socioeconomic status, race or national origin. Health professions are no place for personal judgments of others or for personal prejudice.
Gaining the confidence of the patient, allaying fears, anticipating and responding to his/her reactions, are not only significant in terms of proper professional and ethical procedures, but also are highly significant in fostering the patient’s cooperation which is often essential for obtaining a satisfactory examination. Patients frequently exhibit reactions of fear, depression, worry, anger and despair. These reactions must be accepted as manifestations of the patient’s illness to be dealt with as empathetically, courteously and competently as the situation allows. They are not to be labeled right or wrong.
Physical deformity, unsightly wounds, unpleasant odors and the like are conditions over which the patient has little or no control. Thus, the patient’s physical appearance must be accepted with no visible display of distaste or displeasure. This will be, perhaps, the most difficult quality to develop as it requires a high degree of self-discipline to look beyond physical deformity and repugnant conditions to the suffering human being who is your patient. Perhaps it will help to remember that such patients are generally deeply embarrassed with respect to their personal appearance and suffer greatly as a result of being the source of distaste and repugnance to others.
Communicating with Patients
At all times, provide your patients with the basic conditions due to them as human beings as well as patients. Attention to important details such as addressing the patient by name and introducing yourself and any other person participating in the procedure is your duty as a person as well as a health care professional. With the possible exception of small children, patients are not called by their first names or familiar endearments. Use the title Mr., Mrs., Ms., etc. and the patient’s name unless they ask you specifically to do otherwise.
The patient should always be treated courteously and in a manner consistent with his or her age. Further, it is the patient’s right to have the procedure explained and to know what is expected of him/her. Providing maximum privacy, comfort and safety for the patient and his/her personal belongings, and a clean and orderly environment are all important considerations that should never be overlooked.
Patients frequently need to talk and it is entirely appropriate for you to be an empathetic and encouraging listener. However, you should avoid becoming involved in discussion of the relative merits or failures of various physicians, hospitals, nurses, clinics or other health care professionals. It is unacceptable professional behavior to engage in gossip about other institutions or medical personnel.
You should not allow the patient to put you on the spot with respect to the details of his/her radiologic diagnosis or treatment being received. In such instances, admit honestly that you are not the doctor and cannot assume that role in diagnosis or treatment.
Never put off a patient who has a desire to know what is his/her right to know. If the information sought is within your power and authority to relate, then do so. If it is not, then assist the patient in learning whom to contact and how to get the information and assistance he/she may need. The limits and extent of your authority in these matters may vary from situation to situation and from discipline to discipline, but the basic requirement for all of us is to be prepared to deal with the patient’s questions with honesty, tact and humanity. In this you share a common challenge with every other person in your field including your faculty, who have had many years of experience in such matters. If you need help, ask them.
Personal Appearance
Be aware that your own personal appearance is as important in good patient care as are your words and actions. The uniform dress codes of each discipline are designed to assure appropriate clothing for the work involved as well as to project the necessary clean and professional image that is valuable in building patient confidence.
Honesty and Integrity
Nothing characterizes you more completely than the role of trust you assume when you professionally care for other human beings. In the personal therapeutic relationship that exists between care-giver and client, practitioner and patient, there is no room for small, medium or large dishonesties of mind, spirit or substance. From being honest with oneself with respect to one’s talents and limitations – to the most exquisite honesty and care in making treatment records or reporting events related to patient care – the onus is on us to be worthy of the trust placed in us as caregivers and to exemplify the quality of character such a profession demands. Nothing characterizes us more, or serves us better in our professional lives, as the quality of our honesty and integrity. It is as important as the quality of our skills and the depth of our caring.
