Radiologist–Patient Communication in the Digital Era: Ethical and Legal Reflections

To the Editor, With the widespread implementation of digital hospital information systems, patients now have direct access to their radiology reports and increasingly direct diagnostic questions to radiologists. This transformation has introduced a new and somewhat ambiguous domain of medical communication, in which traditional professional boundaries are becoming less clearly defined. The primary responsibility of the radiologist is to interpret and report imaging findings. However, these findings attain their full clinical meaning only when integrated with the patient’s medical history, laboratory data, and physical examination results (1,2). Because radiologists do not directly examine patients, image-based interpretations alone cannot ensure clinical completeness. Consequently, providing diagnostic or therapeutic explanations directly to patients may lead to misunderstanding, inappropriate reassurance or concern, and potential medicolegal consequences. According to current Turkish medical regulations, physicians are not permitted to provide diagnostic or therapeutic advice outside their area of specialization (3). Despite this, radiologists are increasingly confronted with patient expectations such as, “You wrote my report, so you should explain it to me.” This situation raises several important questions: Does a radiologist’s direct response to a patient constitute an obligation of disclosure, or does it represent a breach of professional boundaries? Could such explanations, even when well-intentioned, disrupt coordination between the referring clinician and the radiologist? In the absence of explicit legal or professional guidance, uncertainty persists in everyday clinical practice (4). In our view, radiologist–patient communication should be informative yet deliberately limited in scope and framed in a manner that directs the patient back to the referring clinician. Statements such as, “These imaging findings should be interpreted together with your clinical information by your treating physician,” represent an ethically sound and legally prudent approach (1,5). This strategy safeguards patient safety while preserving professional responsibility and interdisciplinary collaboration. In conclusion, the development of clear, consensus-based guidelines by professional societies and health authorities regarding the radiologist’s role in direct patient communication would help reduce ambiguity and variability in clinical practice. This issue deserves renewed discussion within the broader context of patient rights, professional autonomy, and team-based medical care (2,5). Sincerely