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During World War I, the demand for x-ray technicians in military hospitals was so great that a shortage of technical workers became acute at home. The value of the well-trained technician was emphasized, and the radiologist was no longer satisfied with someone who knew only how to throw the switch and develop films. Margaret Hoing, The First Lady of Radiologic Technology A History of the American Society of X-Ray Technicians, 1952
The field of radiologic technology began on November 8, 1895, when Wilhelm Conrad Röntgen, a German physicist, was working in his laboratory at the University of Wurzburg. Röntgen had been experimenting with cathode rays and was exploring their properties outside glass tubes. He had covered the glass tube to prevent any visible light from escaping. During this work, Röntgen observed that a screen that had been painted with barium platinocyanide was emitting light (fluorescing). This effect had to be caused by invisible rays being emitted from the tube. During the next several weeks, Röntgen investigated these invisible rays. During his investigation, he saw the very first radiographic image, his own skeleton. Röntgen became the first radiographer when he produced a series of photographs of radiographic images, most notably the image of his wife's hand . He termed these invisible rays x-rays because x is the symbol for an unknown variable
Radiologic technology is the technical science that deals with the use of x-rays or radioactive substances for diagnostic or therapeutic purposes in medicine. Radiologic technologist is a general term applied to persons qualified to use x-rays (radiography) or radioactive substances (nuclear medicine) to produce images of the internal parts of the body for interpretation by a physician known as a radiologist. Radiologic technology also involves the use of x-rays or radioactive substances in the treatment of disease (radiation therapy).
A radiologic technologist specializing in the use of x-rays to create images of the body is known as a radiographer . Radiographers perform a wide variety of diagnostic x-ray procedures, including examinations of the skeletal system, the chest, and the abdomen.
To become a registered radiographer, an accredited radiography program must be completed. Programs are most commonly sponsored by hospitals, community colleges, and universities. Approximately 600 radiography programs are available in the United States. On successful completion of an accredited program, individuals are awarded a certificate, an associate degree, or a baccalaureate degree and are eligible to take the national examination in radiography offered by the American Registry of Radiologic Technologists (ARRT). A registered radiographer uses the initials RT(R) after his or her name. This abbreviation means registered technologist (radiography).
Accreditation is a voluntary peer-review process. Although accreditation is voluntary, few programs choose not to undergo the accreditation process. Nearly all schools value their accreditation status highly and work hard to maintain standards that meet all the accreditation recommendations
The Criteria for a Profession Radiologic technology has evolved from an undereducated workforce of x-ray technicians in the early 1900s to the continued advances as a profession in the 21st century. This progression took place over a number of years with the efforts and dedication of the persons who worked in this field. The term profession implies a body of work that requires extensive training and the mastery of study by its members who have specialized skills, has a professional organization and ethical code of conduct, and serves a specific social need.
Radiography is considered to be the fifth oldest allied health profession because the first Essentials document was established in 1944, after occupational therapy, medical technology, physical therapy, and medical records administration. Not until 1969 was the Joint Review Committee on Education in Radiologic Technology (JRCERT) established. The JRCERT board is currently nominated by the American College of Radiology, the American Society of Radiologic Technologists, the Association of Educators in Radiological Sciences, and the American Healthcare Radiology Administrators. The JRCERT accredits approximately 600 radiography programs (more than any other allied health profession), as well as approximately 80 radiation therapy technology programs (web site: http://wwwjrcert.org).
Professionalcertification is a process through which an agency grants recognition to an individual on demonstration, usually by examination, of specialized professional skills. It is a voluntary process and is the responsibility of the person, not of the person's school or employer. Each certification organization sets requirements for the recognition of professionals through registration, certification, or other recognition of skills by examination.
Actually, a registry is simply a listing of individuals holding a particular certification. The term registry is commonly applied to the agency that carries out the certification function and maintains the registry list
The American Registry of Radiologic Technologists (ARRT) was founded in 1922 by the Radiological Society of North America (RSNA), with the support of the American Roentgen Ray Society (ARRS) and the cooperation of the Canadian Association of Radiologists and the American Society of X-Ray Technicians (now known as the American Society of Radiologic Technologists [ASRT] The purposes of the ARRT include encouraging the study and elevating the standards of radiologic technology, examining and certifying eligible candidates, and periodically publishing a listing of registrants. This mission is accomplished through voluntary certification by examination. Once an individual has passed the appropriate examination, he or she is listed in the registry and granted the right to use an appropriate professional title. These designations are registered technologist (RT), with a specialty designation for radiographer (R),
The ASRT was founded in 1920. As the most prominent national professional voice for radiologic technologists, the ASRT represents individual practitioners, educators, managers and administrators, and students in radiography, radiation therapy, and nuclear medicine, as well as the many specialties within each modality. The ASRT has approximately 115,000 members (nearly one half of the registered technologists in the United States). The goals of the ASRT are to advance the professions of radiologic technology and imaging specialties, to maintain high standards of education, to enhance the quality of patient care, and to further the welfare and socioeconomics of radiologic technologists. The ASRT publishes a peer-reviewed, refereed journal (Radiologic Technology), conducts regional and national conferences, and produces educational programs of all types
The criteria for a group of practitioners: A vital human service is provided to the society by the profession. Professions possess a special body of knowledge that is continuously enlarged through research. Practitioners are expected to be accountable and responsible. The education of professionals takes place in institutions for higher education. Practitioners have an independent function and control their own practice. Professionals are committed to their work and are motivated by doing well. A code of ethics guides professional decisions and conduct. A professional organization oversees and supports standards of practice
The radiographer will interact on a daily basis with his peers in diagnostic imaging and with other members of the health care team : • Physician • Nurse • Physical and occupational therapist • Pharmacist • Lab Technologist • Social worker
Imaging and radiation science professionals face a variety of ethical challenges within medical imaging services. Because of their differing diagnostic applications, individual modalities present specific ethical dilemmas. Imaging professionals should consider these dilemmas to be challenges and opportunities for growth. When faced with such challenges, imaging professionals and radiation science practitioners must apply professional standards and exercise personal integrity to respond correctly to the situation. A firm grounding in ethics may help imaging professionals, radiation therapy specialists, and other health care professionals respond positively to the dilemmas they encounter in the workplace
Ethics is the system or code of conduct and morals advocated by a particular individual or group.
The child's parents are afraid their son will outlive them if he has the surgery. A vascular imaging technologist who assisted with the cardiac catheterization is horrified when she finds out the young child will not be operated on because of low IQ and quality-of-life decisions made for the child by others. She wonders whose good the parents and physician are considering and in what way they arrived at such a decision.
To resolve ethical dilemmas, one may apply this established set of principles to decision making: • Autonomy • Beneficience • Confidentiality • Fidelity • Justice • Nonmaleficence • Paternalism • Sanctity of life • Veracity • Respect for property
Autonomy: Refers to the right of all persons to make rational decisions free from external pressures.
Fidelity: Refers to the duty to fulfill one's commitments and applies to keeping promises both stated and implied
Justice: Refers to all persons being treated equally or receiving equal benefits according to need.
Nonmaleficence: Refers to the duty to abstain from inflicting harm and also the duty to prevent harm.
Paternalism: Refers to the attitude that sometimes prompts health care workers to make decisions regarding a person's care without consulting the person affected
Sanctity of life: Refers to the belief that life is the highest good and nobody has the right to judge that another person's quality of life is so poor that his or her life is not of value and should be terminated.
Veracity: Refers to honesty in all aspects of one's professional life. One must be honest with patients, co-workers, and oneself
Respect for property: Refers to keeping the patients' belongings safe and taking care not to intentionally damage or waste equipment or supplies with which one works
Double Effect: Refers to the fact that some actions may produce both a good and a bad effect
Conflicts among beneficence, nonmaleficence, and autonomy (the state of independent self-government) may arise during consideration of principles of justice. The general belief in the right to health care brings beneficence and nonmaleficence into conflict with autonomy and justice. Although most people believe that the good of health care should be available to all, health care resources are limited and hard decisions must be made about their allocation. Limited resources reduce the overall quality of care and may lead to less avoidance of evil. When quality of health care is reduced, the patient's autonomy suffers from loss of freedom of choices. When choices are limited, the obligations of the patient and health care giver may conflict with resources and justice for the patient
A female patient is scheduled for a lumbar spine imaging series. The imaging professional in charge of the examination is interrupted and called to the emergency room to care for victims of a massive accident. Another imaging professional arrives to take over the examination before the initial exposure is taken. When asked if everything is ready, the first technologist says yes and hurries to the emergency room. The second imaging technologist surveys the patient, who is covered with a sheet, introduces himself, and performs the lumbar spine series. The processed images reveal that the woman is in her first trimester of pregnancy. Obviously, an injustice has been done, and a lawsuit may possibly result
Was the injustice active, that is, did the first or second imaging professional deliberately not shield the patient and ask about possible pregnancy? Or was the injustice an unintentional error of omission resulting from the confusion caused by the first technologist's leaving to attend to accident victims in the emergency room?
We don't receive wisdom; we must discover it for ourselves after a journey that no one can take for us or spare us. MARCEL PROUST
Professionalism is an awareness of the conduct, aims, and qualities defining a given profession, familiarity with professional codes of ethics, and understanding of ethical schools of thought, patient-professional interaction models, and patient rights
Ethics may be divided into three broad schools of thought: 1.Consequentialism 2.Deontology 3.Virtue ethics
Consequentialism, deontology, and virtue ethics are ways of establishing a value hierarchy in ethical decisions. Each school of thought offers different guidelines for ethical problem solving. No one school is better than the others; imaging professionals must choose the one that best serves individual, professional, and institutional goals
Consequentialism, or teleology, bases decisions on the consequences or outcomes of a given act. It evaluates the good of an activity by assessing whether immediate harm is balanced with future benefit. For example, a patient undergoing radiation therapy for cancer may experience some discomfort now, but the palliation or cure of the cancer is the desired beneficial consequence of the therapy. Consequentialism advocates providing the greatest good for the greatest number
Deontology bases decision making on individual motives and morals rather than consequences. It is therefore the opposite of teleology. Deontology examines the significance of actions themselves. For example, members of certain religious groups refuse blood transfusions because they believe the act is morally wrong. Although they may be concerned about the consequences of this refusal, they are making the choice based on their religious beliefs regarding blood transfusions. Personal rules of right and wrong derived from individual actions, duties, relationships of all kinds, and society are used for reasoning and problem solving in the deontologic school of thought.
Virtue ethics is a relatively new school of thought. It focuses on the use of practical wisdom and moral character for emotional and intellectual problem solving. Virtue ethics incorporates elements of teleology and deontology to provide a more holistic approach to solving ethical dilemmas. Careful analysis and consideration of consequences, rules established by society, and short-term effects play significant roles in decision making in virtue ethics.
Law: the principles and regulations established in a community by some authority and applicable to its people, whether in the form of legislation or of custom and policies recognized and enforced by judicial decision.
Practice Standards The Professional Performance Standards define the activities of the practitioner in the areas of education, interpersonal relationships, personal and professional self-assessment, and ethical behavior. The Clinical Performance Standards define the activities of the practitioner in the care of patients and the delivery of diagnostic or therapeutic procedures and treatment. The section incorporates patient assessment and management with procedural analysis, performance, and evaluation. The Quality Performance Standards define the activities of the practitioner in the technical areas of performance including equipment and material assessment, safety standards, and total quality management
Statutory laws are derived from legislative enactments. Common law usually results from judicial decisions
