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MEDICAL IONISING RADIATION COMMITTEEDo you know your legal responsibilities when you request x-rays?In October 2002, the Statutory Instrument 'SI 478 European Communities (Medical Ionising Radiation Protection) Regulations (2002)' on the health protection of individuals against the danger of ionising radiation in relation to medical exposures was passed into law. This transposed earlier European directives on the medical use of ionising radiation into Irish law. The SI 478 (2002) embodies principles of good clinical practice in relation to the use of radiology for patient care. The radiologist is referred to as 'the practitioner' under this law and those who refer patients for radiological procedures are called 'prescribers'. Only doctors or dentists may be 'prescribers' under the law and the request must be in writing. Irish law recognises requests by electronic means as equivalent to writing in this respect. It is the duty of the radiologist to determine that the procedure is justified but the prescriber is required to give his or her reasons for requesting the procedure. The prescriber is also required to obtain and inform the radiologist of prior medical records and diagnostic information relevant to the request. How thoroughly do you fill in such information for each and every request for an X-ray? The law imposes certain restrictions on the use of ionising radiation. Exposures on medico-legal grounds, where there is no direct health benefit for the person undergoing the exposure, may only be performed with a specific written direction from the courts. There are restrictions also on the use of ionising radiation for occupational health surveillance. The law has also required the Medical Council to establish strict directives guiding the use of ionising radiation procedures for medical research. The prescriber must establish whether a woman of childbearing age is pregnant and record this information on the request for a radiological procedure. If she is, or may be, pregnant, the relative risks of doing the procedure versus the risk of not doing the procedure have to be carefully evaluated. For radioisotope studies, it is also important to establish if a woman is breastfeeding and to take precautions to protect the infant from the radiation risks. These regulations do not change what has always been good practice in terms of requesting radiological examinations. But it is now the 'law of the land' that these principles are adhered to. The next time you are tempted to omit 'Clinical Details' or you are tempted not to fill in the 'LMP box' on your X-ray or CT request form, remember you may be breaking the law! Further information on the work of the Medical Ionising Radiation Committee can be obtained on our website at www.medicalcouncil.ie, where the following documents can be downloaded: 'Dose Constraints for 'Helpers' (Comforters and Carers)' (adopted September 2004) 'Diagnostic Reference Levels: Position Paper' (adopted September 2004) 'Criteria for Clinical Audit' (adopted October 2004) 'Protocols for Standard Radiological Practice - Good Practice Guidelines as defined by SI (478) 2002' (adopted November 2004) 'Policy Document on the Use of Medical Ionising Radiation' (adopted February 2005) 'Radiation Protection 99: Guidance on Medical Exposures in Medical and Biomedical Research' (adopted April 2005) 'Radiation Protection 100: Guidance for protection of unborn children and infants irradiated due to parental medical exposures' (adopted April 2006)
Stephanie Ryan FFR RCSI, |
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