Medical D&m&y, Vol. 22, No. 3, pp. 265-266, 1997 Copyright D 1997 American Association of Medical Dosimetrist~

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A CODE OF ETHICS FOR THE MEDICAL DOSIMETRIST - THE AMERICAN ASSOCIATION OF MEDICAL DOSIMETRISTS EXPERIENCE

LINDA MARTIN, C.M.D.,’ BUD BAKER, C.M.D.,” DEBORAH FAIRALL, C.M.D.,’ KENN FLORELL, C.M.D.,‘! ALICE FOSTER, C.M.D.,’ KAREN GILBERT, C.M.D.,6 and

JOHN O’DONOGHUE, C.M.D.’ ‘Radiation Oncology Quality Assurance Center,Tampa, FL; ‘Nashua Regional Cancer Center, Nashua, NH; 3Allison

Cancer Center, Midland, TX; ‘Moore Regional Hospital, Pinehurst, NC; ‘Oncology Care Center, Belleville, IL; 6Lake Cancer Care Center. Eustis. FL; 7Therapy Service of Evansville, Evansville, IN

Abstract-The Committee on Protocol and Ethics of the American Association of Medical Dosimetrists (AAMD) has developed a Code of Ethics for a radiation oncology society of medical dosimetrists. The purpose of the code of ethics is fourfold: (1) Establish an ideal of professional conduct specific to the medical dosimetry profession; (2) Develop a statement of the moral values and commitment of the AAMD; (3) Recognize professional relationships and obligations; and (4) Define goals to which the medical dosimetrist should aspire. The Code of Ethics was-adopted a<AAMD policy in October 1995. 0 1997 American Association of Medical Dosimetrists.

Key Words: Ethics, Medical Dosimetry.

INTRODUCTION

Good ethics make good professional and business sense. But just what constitutes good ethics? What is the dif- ference between ethics and laws, and where does a code of ethics fit? How does a society develop a code of ethics unique to its profession while communicating an ideal of professional conduct? These and many other questions arise as an organization considers ethical issues and policy.

The American Association of Medical Dosimetrists (AAMD) is a society that represents medical dosimetry professionals. The AAMD’s interest in ethical issues prompted the Board of Directors to charge the Protocol & Ethics Committee with the development of a code of ethics. One year of research, discussion and debate by the committee culminated in the writing and revision necessary in developing such an important document. This paper describes the committee’s approach and ra- tionale in the development of the AAMD Code of Ethics.

BACKGROUND

Twenty years ago, the initial focus of those who formulated the concept of bioethics was upon the physi- cian-patient relationship.‘.” More recently ancillary med- ical societies and organizations have recognized the need to adopt a Code of Ethics.“54J,”

The language and intent of such ethical codes differ and are tied appropriately to the general mission state- ment and business of the organization. For example, an organization that administers an examination or license to its members would likely require a working code of

Reprint requests to: Linda Martin. C.M.D., Radiation Oncology Quality Assurance Center, 12902 Magnolia Drive, Tampa, FL 33612.

ethics that includes an enforcement po1icy.j Likewise, those organizations who represent a society of profes- sional colleagues may only wish to present a recom- mended guideline of ethical conduct.5 In either situation, expulsion from membership is the strongest penalty pres- ently imposed on a member who violates established ethical standards.4,7,8

CODE OF ETHICS

The Committee’s first step in the development of the code of ethics was to research ethical principles and study existing models. We limited our study to ethical models from medical organizations with an emphasis on societies within the radiation oncology community. Sec- ondly, specific points we intended the document to ad- dress were outlined.

The specific points to be addressed in the AAMD code of ethics included:

was

Establish an ideal of professional conduct specific to the medical dosimetry profession. Develop a statement of the moral values and com- mitment of the AAMD. Recognize professional relationships and obliga- tions to the patient, employer or client, and fellow medical dosimetrists. Define goals to which the medical dosimetrist should aspire. Create a document that encourages ethical decision- making.

A key component to the development of the code to tailor the statements specifically to the medical

dosimetry profession. A difficult question considered by the committee was whether to include a method of en-

266 Medical Dosimetry

forcement of the code of ethics. Concerns were raised over potential difficulties including:

1. The society’s liability status associated with en- forcement. These difficulties have been realized by the AMA in the form of civil charges.8

2. An enforcement policy would require clear descrip- tions of circumstances that would constitute a vio- lation of the Code of Ethics, and a process for outcome of such violations.

In lieu of these concerns, the committee chose to confine its descriptions directly to presenting the ideals of professional conduct. This decision is well suited to a membership society who does not administer an exami- nation or license, and follows precedent set by similar societies.5

CONCLUSION

The final document prepared by the Protocol & Ethics Committee and shown in Appendix A has now been adopted by the association. The AAMD Code of Ethics is an expression of the AAMD’s moral commit- ment to those who depend upon its members for service, and to each other. A heightened awareness of ethics must be supported by practicing mutual respect and consider- ation. The AAMD Code of Ethics expresses the moral values of our society. While, by itself, the AAMD cannot create or reform a person’s moral character, it may at least inform a conscience. The true test of a moral seriousness depends upon personal compliance of med- ical dosimetrists with ethical standards.

Acknowledgment-The authors wish ro thank James Busar for his legal counsel, the 1994-l 995 AAMD Board of Directors, and Sharon Ped- ersen for her secretarial support

REFERENCES

1. Council on Ethical and Judicial Affairs - Current Opinions with Annotations; American Medical Association: 1994.

2. Roberts, H.M. Robert’s Rules of Order - The Classic Manual of Parliamentary Procedure. 198-205; 1978.

3. Monague, J.F.; Thomasina, D.C. Medical Ethics - A Clinical Textbook and Reference for the Health Care Professions; MIT Press; 1983.

4. Standards of Ethics of the American Registry of Radiologic Tech- nologists. Adopted June 1993, revised January 1994.

5. Code of Ethics for the American Society for Therapeutic Radiol- ogy and Oncology (ASTRO). ASTRO Membership Directory, 1994-1995.

6. Guidelines for Ethical Practice for Medical Physicists. American

Volume 22, Number 3, 1997

Association of Physicists in Medicine; Membership Directory 1992.

7. Values in Conflict-Resolving Ethical Issues in Hospital Care. Re- port of the Special Committee on Biomedical Ethics American Hospital Association; Chicago, IL; 1985.

8. VanEys, J.; Bowen, J. The Common Bond - The University of Texas System Cancer Center. Springfield, IL; Charles Thomas Publishing; 1986.

APPENDIX A: AMERICAN ASSOCIATION OF MEDICAL DOSIMETRISTS CODE OF ETHICS

Preamble The purpose of the American Association of Medical Dosim-

etrists (AAMD) Code of Ethics is to establish an ideal of professional conduct to which members of the medical dosimetry profession should aspire. The Code of Ethics expresses the moral values of the AAMD. While, by itself, the AAMD cannot create or reform a moral character, it may at least inform a conscience. Such a code also signals the organization’s moral commitment to those who depend upon its mem- bers for services. In any profession, the test of moral seriousness depends upon personal compliance with ethical standards.

As Medical Dosimetrists, our primary objective is to use our training, experience, skills and talents for the benefit of society. To this end, we recognize our professional relationships with and obligations to the: (1) Patient

Although never directly responsible for prescribing medical pro- cedures, the health and welfare (even life) of many patients may directly depend upon the skill and dedication with which medical dosimetrists carry out their work. (2) Employer or Client

As professionals, medical dosimetrists have the obligation to act as faithful agents for their employers or clients and to devote their skills and talents to further the legitimate aims of their employers. In turn, they have the right to expect true professional consideration from their employers or clients. (3) Fellow Medical Dosimetrists

Medical Dosimetrists should contribute to the advancement of their profession and should avoid all practices which detract from the stature of Medical Dosimetry.

In furtherance of the principles stated in this Preamble, the AAMD has adopted this Code of Ethics.

Principles of ethics The following principles represent goals to which all medical

dosimetrists should aspire: (1) Medical Dosimetrists are obliged to uphold the honor and

dignity of their profession by exhibiting sound moral character and the highest degree of competence in their work.

(2) Medical Dosimetrists must be honest and forthright at all times in their dealings with employers, clients, and patients. Remuner- ation expected should be consistent with the type and quality of service provided.

(3) Patient privacy must be respected and confidentiality of patient information must be maintained.

(4) Medical Dosimetrists should strive continually to improve their knowledge and skills and participate in programs that lead to the improvement of the medical dosimetry profession and the health of the community.

(5) Collegiality, openness, and mutual respect shall characterize the relationships among medical dosimetrists.

(6) Medical Dosimetrists should conduct their affairs in a manner consistent with standards of excellence. Adopted by AAMD Board of Directors on October 16, 199.5 Adopted by AAMD Protocol & Ethics Committee on July 24, 2995