Ethical aspects in the use of radiation in medicine: public consultation of the report from ICRP Task Group 109

ICRP Publication 138 defines the ethical foundations of the System of radiological protection, based on four core values (beneficence/non-maleficence, dignity, justice and prudence) and three procedural values (accountability, transparency and inclusiveness). The mission of Task Group 109 mission was to propose a practical application in the medical field. As this field was already infused with a strong culture of biomedical ethics, the first action was to identify the values and define a common language. The core values are very similar, with the autonomy of biomedical ethics, which can be seen as a corollary of dignity, and the precautionary principle, which can be understood as the implementation of prudence. In recent years, medicine has been experiencing an emphasis on the values of solidarity, honesty, and empathy. We therefore proposed a grouping of these values in order to allow a structured review of practical situations from an ethical perspective. For the sake of concreteness, the report proposes 21 realistic scenarios (11 in imaging and 10 in therapy), which are all presented and analysed in a one-page format. Sensitising questions are provided to stimulate reflection. We hope that this report will allow all professionals in the medical and radiological protection fields to discuss situations and dilemma on a common ground. To achieve this, we also propose a strategy for the implementation of education and training, based on the Bloom taxonomy. In order to assist the reader in a theoretically complex subject, key messages are distributed throughout the text, as fixed points that can easily be understood. The report will soon be made available for public consultation and we look forward to any suggestions for improvement.