Radiation Protection Dosimetry Advance Access originally published online on February 21, 2009
Radiation Protection Dosimetry 2009 135(2):90-94; doi:10.1093/rpd/ncp012
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Ethical concerns arising from screening procedures such as mammography and self-referral
Quality Assurance Reference Centre, Kingfisher Way, Wallsend, Tyne and Wear, Newcastle NE28 9ND, UK
* Corresponding author: keith.faulkner{at}nhs.net
Shortly after the discovery of X-rays, their harmful effects became apparent. While the harmful effects of ionising radiation were recognised at an early stage, it took some time before a systematic approach to radiation protection evolved. This began with the development of simple rules to reduce the risk of stochastic effects (such as cancer induction) and the occurrence of deterministic injuries (e.g. cataract formation). These rules have evolved into the basic principles of radiation protection, one of which is the concept of justification, which in its simplest form may be taken as doing more benefit than harm. The concept of justification has particular ethical concerns when applied to population screening procedures. These problems are described in this paper with a particular emphasis on the cases of screening and self-referral procedures.