Focal role of tolerability and reasonableness in the radiological protection system

Schneider, Thierry; Lochard, J.; Vaillant, Ludovic

doi:10.1177/0146645316634565

Cited by 5 publications

(7 citation statements)

References 7 publications

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“…There have been a number of conceptual models that have attempted to help visualise how optimisation works in practice [20]. The proposed Quietude, Vigilance, Reaction (QVR) model, shown in figure 3, is the only model that truly attempts to integrate public attitude when facing an exposure situation [20,21].…”

Section: Relationshipsmentioning

confidence: 99%

The three R’s of reasonable in radiological protection: relationships, rationale, and resources

Wieder¹,

Schneider²,

Martínez³

2022

J. Radiol. Prot.

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Central to applying the principle of optimisation in the system of radiological protection is the evaluation of what level of radiation exposure should be considered “as low as reasonably achievable” (ALARA), after taking into account the prevailing circumstances. Determining what is “reasonable” is an abstract, although somewhat intuitive, concept with many potential interpretations depending on both the situation and those involved, whether individuals or organisations. There are common themes in the types of considerations that need to be addressed to determine “reasonableness” regardless of the exposure situation. However, despite the consistent and agreeable nature of these themes, there remains a gap in how to apply them in real situations. For example, without measurable goalposts (or a clear process for setting such goalposts) for determining what constitutes ALARA, we can find ourselves misinterpreting the optimisation process as keeping exposures “as low as possible.” We propose herein, by consolidating and building on existing ideas, an easily understandable and actionable “reasonableness” framework. This simple, yet broadly applicable tool is intended to help radiation protection experts in the systematic, deliberative, and collaborative reflection on all of the factors that make up “reasonable” before making a decision—whether it be a proposed medical treatment or clean-up of a contaminated site. Each process execution and decision itself will necessarily retain the complexity of the prevailing circumstance. The proposed “Rs” of Reasonable represent Relationships (stakeholders, empathy, and trust), Rationale (contextual, technical, and ethical), and Resources (technological, financial, and time).

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Section: Relationshipsmentioning

confidence: 99%

The three R’s of reasonable in radiological protection: relationships, rationale, and resources

Wieder¹,

Schneider²,

Martínez³

2022

J. Radiol. Prot.

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“…(62) The two key concepts of reasonableness and tolerability, which are central to the second and third principles, respectively, specify how the radiation risk is managed by combining and balancing the core ethical values (Schneider et al, 2016).…”

Section: Relationship Between the Core Ethical Values And The Fundamementioning

confidence: 99%

ICRP Publication 138: Ethical Foundations of the System of Radiological Protection

Cho¹,

Cantone²,

Kurihara-Saio³

et al. 2018

Ann ICRP

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Despite a longstanding recognition that radiological protection is not only a matter of science, but also ethics, ICRP publications have rarely addressed the ethical foundations of the system of radiological protection explicitly. The purpose of this publication is to describe how the Commission has relied on ethical values, either intentionally or indirectly, in developing the system of radiological protection with the objective of presenting a coherent view of how ethics is part of this system. In so doing, it helps to clarify the inherent value judgements made in achieving the aim of the radiological protection system as underlined by the Commission in Publication 103. Although primarily addressed to the radiological protection community, this publication is also intended to address authorities, operators, workers, medical professionals, patients, the public, and its representatives (e.g. NGOs) acting in the interest of the protection of people and the environment. This publication provides the key steps concerning the scientific, ethical, and practical evolutions of the system of radiological protection since the first ICRP publication in 1928. It then describes the four core ethical values underpinning the present system: beneficence/ non-maleficence, prudence, justice, and dignity. It also discusses how these core ethical values relate to the principles of radiological protection, namely justification, optimisation, and limitation. The publication finally addresses key procedural values that are required for the practical implementation of the system, focusing on accountability, transparency, and inclusiveness. The Commission sees this publication as a founding document to be elaborated further in different situations and circumstances.

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“…Concerns were expressed that elements of the System and its implementation have become overly conservative (Lorenz 2021, Magnússon et al 2021, Sasaki et al 2021. The work of ICRP Task Group 114 on reasonableness and tolerability is addressing an important part of this topic (Schneider et al 2021).…”

Section: Concepts Of the Systemmentioning

confidence: 99%

“…Task Group 114 has developed a preliminary approach relying on the three Rs: 'relationships' , 'rationale' and 'resources' . As next steps, Task Group 114 will further investigate the application of the concept of tolerability; refine the three Rs of reasonableness; and apply the concepts of tolerability and reasonableness for protection of the environment, medical exposures and potential exposures (Schneider et al 2021).…”

Section: Summary Of Icrp Task Group Presentationsmentioning

confidence: 99%

Summary of the 2021 ICRP workshop on the future of radiological protection

Ruehm

Clement²,

Cool³

et al. 2022

J. Radiol. Prot.

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The International Commission on Radiological Protection (ICRP) has embarked on a process to review and revise the current System of Radiological Protection (‘the System’). To stimulate discussion, ICRP published two open-access articles: one on aspects of the System that might require review, and another on research which might improve the scientific foundation of the System. Building on these articles, ICRP organised the Workshop on the Future of Radiological Protection as an opportunity to engage in the review and revision of the System. This digital workshop took place from 14 October to 3 November 2021 and included 20 live-streamed and 43 on-demand presentations. Approximately 1500 individuals from 100 countries participated. Based on the subjects covered by the presentations, this summary is organised into four broad areas: the scientific basis, concepts, and application of the System; and the role of ICRP. Some of the key topics that emerged included: classification of radiation-induced effects; adverse outcome pathway methodologies; better understanding of the dose–response relationship; holistic and reasonable approaches to optimisation of protection; radiological protection of the environment; the ethical basis of the System; clarity, consistency, and communication about the System; application of the System in medicine; and application of the principles of justification and optimisation of protection.

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Focal role of tolerability and reasonableness in the radiological protection system

Cited by 5 publications

References 7 publications

The three R’s of reasonable in radiological protection: relationships, rationale, and resources

The three R’s of reasonable in radiological protection: relationships, rationale, and resources

ICRP Publication 138: Ethical Foundations of the System of Radiological Protection

Summary of the 2021 ICRP workshop on the future of radiological protection

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