Responsibility, rules and norms. More than in any other sector, nuclear activities are strictly regulated by safety rules and norms, internationally recognized and adopted at national level, having as main target the protection of the operators, as well as of the public. Each nuclear operator is aware of them, but much less aware is the public. Responsible implementation of these rules and norms should be accompanied by the communication of safety culture aspects linked to ionizing radiation utilization. Good practice is considered: - when good practice is itself formalized in clear regulations, to become the norm of practice to which each source responsibly aspires. This is the approach reflected by the establishment of the Basic Safety Standards8, for example when “in the medical area, important technological and scientific developments have led to a notable increase in the exposure of patients.” In this context, “clinical responsibility means responsibility of a practitioner for individual medical exposures, in particular, justification; rganizedd; clinical evaluation of the outcome; cooperation with other specialists and staff, as appropriate, regarding practical aspects of medical radiological procedures; obtaining information, if appropriate, on previous examinations; providing existing medical radiological information and/or records to other practitioners and/or the referrer, as required; and giving information on the risk of ionizing radiation to patients and other individuals involved, as appropriate”. COUNCIL DIRECTIVE 2013/59/EURATOM As an example of implementing clinical responsibility in this domain, German medical imaging centers require that the images be returned to the center. They are not kept by the patient. In Germany there is a centralized databasing and control of how many images are being produced, by whom, of whom and for whom. Bad practice is: - when clinical responsibility is not upheld, and practitioners fail to effectively optimize medical IR exposure. There can be many reasons for such failure, related to: • ignorance (patients may not know that each exposure brings new risk, that they should dialogue with their doctor about their prior exposure and the need for a new procedure, and that they should benefit from shielding during certain procedures; medical technicians may not be sufficiently trained) A contrast between countries is seen in regard to the propensity to report imaging or therapeutic history to one’s doctor. In Poland, not all consider it 8 xxxx:/...
