A Matter of Principle

Imagine this:  You are driving alone at night on a business trip in a very remote area when you come across a motor vehicle on its roof. One other vehicle is lighting up the scene with its high beam after sending out a plea for help.

Stopping to assist you observe under torch light, a female obviously deceased in the driver’s seat. Amongst all the debris are children’s toys and baby wipes.

Your thoughts then race from the female to images of an injured baby and children, that may possibly lie somewhere around the vehicle after being jettisoned.

A seasoned travel of this road you know that emergency services will take sometime to attend your location. Not waiting until they arrive, you and your fellow good Samaritans commence searching; stopping only when Police arrive and you are sure there are no other victims.

Public domain image - The Good Samaritan of Gallipoli

Courtesy of the Australian War Memorial

Anzac Day tradition continues 25 April

You then give your version of what has transpired, in what may well be one of your worst nightmares, to the investigating Police.

Now into the early morning you are allowed to leave. This sad event will stay long in your memory but you’re heartened that you stopped to help someone in need; as you would have expected them to do for you, if the shoe was on the other foot.

What takes place next will surprise you and make you recoil with utter disgust.

Having contacted your employer to give full account for why you have been delayed, their response is:

“How’s any of that your problem?”

As a matter of principle you quit on your return.

§ § §

1. Under all the circumstances would you have quit your job?
2. What do you think of the employer’s response?
3. Has anything like this ever happened to you?

As for me, I'm quite certain I would have done the same thing and quit my job.

To be continued...

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How dangerous are CT scans?

In 2009 I attended a hospital emergency department in-service lecture given by a senior radiologist who spoke on the use of computed axial tomography scanners (CAT or CT Scan) as a diagnostic tool and their dangers, especially for children, due to the high levels of radiation.

So much so that signed informed consents should be obtained from patients and parents to show and document that they were made fully aware of the dangers of a CT scan. At the same time it should be explained what other options are available, especially if they will provide the same results as the CT scan. In my experience signed informed consents are not required for CT scans.

What is a CT Scan? "The computed tomography (CT) scan is a medical imaging procedure that uses x-rays and digital computer technology to create detailed two or three-dimensional images. Unlike other forms of medical imaging, the CT scan can image every type of body structure at once including bone, blood vessels and soft tissue." – Source Better Health Channel

CT scanner - public domain Image - Wikimedia Commons - Author NithinRao

At the end of the lecture it was suggested that if ever we needed a CT scan to insist on Magnetic resonance imaging (MRI) as it does not use ionizing radiation. Yes, CT scans are beneficial but at what cost?

Being more than fully aware of the popular use of CT scans in hospital emergency department’s for urgent head and body investigations and the radiation risks, about 100 times the dose of chest x-ray, I was not aware of their fatal malignancy statistics.

In March 2010 my attention was again drawn to the risks of CT scans when I read two articles on the net, CT scan use risk to children by The Australian and Cancer linked to CAT scan on the ABC’s, The World Today.

Being a Doubting Thomas when it comes to the media I looked further into this and located a PDF document created by Australian Radiologists, John De Campo and Margaret De Campo and published in the Medial Journal of Australia in 2010.

With some hesitation I contacted Dr John De Campo by email and to my great pleasure he kindly gave me permission to publish both a quote and the statistics from his document that highlight the need for informed consents and the risks of fatal malignancy associated with CT Scans that very few of the public knew about until recently, including me:

"If informed consent is regularly sought before administration of general anaesthesia and intravenous contrast agents, then it is equally appropriate and consistent to seek informed consent before CT scans in children and young adults. Anything less may not be medicolegally sustainable."

Fatality Risks
Procedure	< one year	Age 10	Age 20
CT body scan	1/500	1/1250	1/1600
General Anaesthetic	Low	1/56,000	1/56,000
Administration of intravenous contrast agents	1/170,000	1/170,000	1/170,000
Source – Australian Radiologists Drs John & Margaret De Campo: Is informed consent necessary for computed tomography in children and young adults? – as published in the The Medical Journal of Australia Volume 192 Number 7 - 5 April 2010 Page 423 – Permission granted to publish.

The risk of fatal malignancy to children and young adults being higher due to the fact their cells are dividing more rapidly than older persons and due to their tender years have more time for a malignant growth to develop.

§ § §

1. Where you aware of the risk associated with CT scans?
2. Have you developed a malignancy as a result of a CT scan?
3. Do you have a different opinion to the ones mentioned here?
4. What have been your experiences with CT scans?
5. Having had a CT scan, did your doctor inform you of the risks?
6. Having had a CT scan, did you sign a consent form beforehand?

To be continued...

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