Article Text
Abstract
The referral is the key source of information that enables radiologists and radiographers to provide quality services. However, the frequency of suboptimal referrals is widely reported. This research reviews the literature to illuminate the challenges suboptimal referrals present to the delivery of care in radiology departments. The concept of suboptimal referral includes information, that is; missing, insufficient, inconsistent, misleading, hard to interpret or wrong. The research uses the four ethical principles of non-maleficence, beneficence, Autonomy and Justice as an analytic framework.
Suboptimal referrals can cause harm by hindering safe contrast-media administration, proper radiation protection by justification of procedures, and compassionate patient care. Suboptimal referrals also hinder promoting patient benefits from the correct choice of imaging modality and protocol, an optimal performed examination, and an accurate radiology report. Additionally, patient autonomy is compromised from the lack of information needed to facilitate benefit–risk communication. Finally, suboptimal referrals challenge justice based on lack of reasonable patient prioritising and the unfairness caused by unnecessary examinations.
These findings illuminate how suboptimal referrals can inhibit good health and well-being for patients in relation to safety, missed opportunities, patient anxiety and dissatisfaction. The ethical challenges identified calls for solutions. Referral-decision support tools and artificial intelligence may improve referral quality, when implemented. Strategies addressing efforts of radiology professionals are inevitable, including gatekeeping, shared decision-making and inter-professional communication; thereby raising awareness of the importance of good referral quality and promoting commitment to ethical professional conduct.
- radiology
- ethics
- quality of health care
- health personnel
Data availability statement
Data sharing not applicable as no datasets generated and/or analysed for this study. The manuscript submitted was based on reviewed literature from scientific published journals all of which are available and accessible to the public.
Statistics from Altmetric.com
Read the full text or download the PDF:
Other content recommended for you
- Principlist approach to multiple heart valve replacements for patients with intravenous drug use-induced endocarditis
- The ethical dilemma of emergency department patients with low-risk chest pain
- An emergency department intervention to protect an overlooked group of children at risk of significant harm
- The bioethical principles and Confucius’ moral philosophy
- Challenge studies of human volunteers: ethical issues
- Work conditions, mental workload and patient care quality: a multisource study in the emergency department
- Health incentive research and social justice: does the risk of long term harms to systematically disadvantaged groups bear consideration?
- How well informed are patients when leaving the emergency department? comparing information provided and information retained
- Informed consent in neurosurgery—translating ethical theory into action
- What does it mean for a clinical AI to be just: conflicts between local fairness and being fit-for-purpose?