Professional Autonomy And Radiography - Research Paper Example

Professional Autonomy And Radiography Background: In the past 30 years, the demand for radiological services has expanded tremendously. The major increase in the demand can be solely given to the increased role of patient autonomy in healthcare. Patients today ask for x-rays, MRI, CT scans and positron emission tomography scans without any consultation from health professionals The major point emphasized on in this research will be the extent of influence upon radiological services due to enhanced interference of patient autonomy (Hofmann and Lysdahl). The literature review will talk about the factors that have led to increase in professional autonomy because to enhancement in patient’s autonomy. Furthermore, it will also highlight the issues concerning professional’s autonomy in radiology. Whether patient’s demand for exercising more and more radiology is a reasonable approach or is it subject to several side effects and abuse? If on one hand, it increases radiographers activity, providing them with the opportunity to expand their professional boundaries on the other hand it also gives rise to several ethical issues that occur because of giving freedom to patience to get the radiography done so often for instance morally unjustifiable actions such as exposure to radiation and sometimes results appearing from radiology give wrong perceptions of the patients putting them in psychological danger (Hogan). However, the adverse effects are not anything new to radiology since decades the relation of patient autonomy and professional autonomy regarding radiological services has been in debate by many concerned medical professionals. With time patients autonomy has become a quite a common trend in medical ethics. Today patients are given the option of making their own decisions regarding operations and other medical procedures however this has boosted patients confidence to the level where believe they don’t need doctor’s consent anymore. This is where professional autonomy has also taken birth and accelerated to a great extent in the last few years. It should be noted that professional and patient autonomy are two distinctive concepts in all the respective field of medical sciences (Keenan). Radiography in this aspect is the major field that is related with the concept of autonomy. Long gone are the days when radiography operations will be done only after a diagnostic case has been submitted by the clinical professionals. Today, due to massive support of patient autonomy no objections are raised on radiologists if they can perform radiography operations such as CT scans and x-rays without health professional’s consent but entirely upon patient’s desires. The radiographer despite knowing the ethical issues involved are still keen towards conducting the operation as it keeps them safe from hazardous lawsuits. In other words, the continuous demand of patient operations has introduced an unhealthy practice of autonomy in the field of radiography. Only health care professionals are supposed to practice autonomy with complete knowledge of medical history of patients (Hofmann and Lysdahl). Lack of autonomy amongst radiographers has been a constant concern amongst health professionals over the years as more and more cases of death due to unethical radiography operations are coming up front. Patients agree upon getting the operations done because they are not aware of the consequences and while the radiographers are aware they choose to not to tell because of the fear of losing business. Not only this, the increase in demand of radiologists has given rise to several autonomy professionals amongst radiologists who themselves lack knowledge this is why they do not bother to educate the patients leading to severe health disasters (Armstrong). The purpose of this research is to find out the level of unethical activities implemented by radiologists in order to meet the demand of the patient’s autonomy. And is the increased role of radiologists affecting the society negatively or positively? To attain these answers the researcher has conducted open-ended interviews with 22 radiologists to analyze whether they are aware of their ethical responsibilities while conducting radio-imagery operations. The analysis and the conclusion will be derived after deep analysis of the primary data collected. Problem Statement: The fact that patient autonomy is giving rise to unethical autonomy in radiology is proven by the fact that each year a large number of patients lose their life because of lack of professional autonomy amongst radiologists. The large number of radiologists has increased the competition to the level that now radiologists despite knowing the fact that excessive radiological operations if applied on the patient without health professional consent can cause un-repairable harm to their health choose to ignore and carry on with the procedure. The research aims on analyzing the level of ethical professional autonomy by radiographers through a survey questionnaire. Research Aim: The research aims to study the relation of radiography and professional autonomy. The research shall highlight the pointers from the previous researches which have been conducted so far. The pointers shall be justified with the implication of radiography laws and regulations. Evaluation of the pointers of debate regarding autonomy and radiography will help in understanding the previous and current trends of autonomy in the relation of radiography. It will also highlight whether allotting patients autonomy in the area of radiography can be trusted to improve health practices. This research will basically cover two schools of thoughts firstly, patient’s autonomy is directly related in increase of professional autonomy of radiologists and secondly, radiologists to beat competition are ignoring ethical principles concerning radiology. Research questions: The research is conducted keeping a clear view on the below mentioned research questions. The questions have been made with the aim of assisting the researcher in finding a practical solution to the underlined problems and main subject matter of the research. It should be noted that research questions are not limiting the context of the researcher rather they are providing the base for primary and secondary research. What are the effects of the increased patients’ autonomy on the autonomy of radiographers? Are radiographers giving due ethical considerations to their role and responsibilities? Is increased autonomy of radiographers contributing positively or negatively to the medical profession? Hypothesis: The research has been based on the following hypothesis. The hypothesis has been designed to provide two-fold roles to the researcher so he does not deviate from the main scope of the research and concentrates on the concrete problem so he can draw valid conclusions out of it. H0: Increased patients autonomy is directly related to the increase of professional autonomy of radiologists. The validation of this hypothesis concludes that it is the increase in demand of patients to get their x-rays and other radiological operation done without health professional’s consent that has become the core factor of large number of radiologists found today. It has also promoted many un- skilled individuals to enter the field of radiology and make good money. However, this along with other unethical acts adopted by radiographers has become the core reason that leads to harming human life. The invalidation of this hypothesis statement would mean that the reasons of increased number of radiologists is because of some other reasons such as promotion of advanced technology, easy availability of radiography license and increase in the diseases which require patients to go through extensive radiographic operations thus bringing a raise in their demand dramatically. In such a scenario, the unethical acts done by radiographers would be then entirely blamed upon their own negligence and of course the leniency of law & order. H1: Radiographers are not performing according to the ethical requirements of their profession. This hypothesis mainly concentrates on several unethical practices adopted by radiologists towards their patients. The validation of this hypothesis concludes that they have taken the large number of demand coming from patient autonomy to their advantage and despite knowing the fact that a particular radiological procedure may prove to be harmful to the patient’s health without doctor’s consent they continue on performing the act. This statement is supported by several cases and facts which prove the unethical acts of the radiographers and the after affects of these acts. If this statement fails to verify itself, then it will show that radiographers are complying according to the laws of autonomy of patients and they are not defying any ethical principles. Scope of the Research: It is imperative to realize that the study focuses solely upon impact of professional autonomy in radiology due to increased patient autonomy. In addition, the study also covers how the radiographers in order to cater to the demand of patients/ consumers ignore ethical requirements of their job. The study makes sure that the factors covered are factual and in context of showing the increase in radiographer’s professional activity because of increased demand. The study also covers the subject of radiologist’s ignorance of ethical requirements despite their increased activity and more customers. To do this, the study initially engages in the approach which will help the reader identify the core subject matter of the research and then with sheer intellectuality moves in to setting a comprehensive insight about the autonomy of radiologists, highlighting both its negative and positive effects. Literature Review: Autonomy of patients in the current era had sufficiently increased in demands for radiographic operations. The radiological imagery had come to people awareness in the changing global perspective of medical ethics. A great deal of researches and investigations had been conducted in order to analyze the increasing demand of radiological operations of imagery according to patient autonomy. But the question that is still needed to be answer is about the effects of patient autonomy regarding radiographic imagery operations on the radiologists and medical professionals. This literature review had been especially design to in comprehend all the investigations and researchers that had been conducted so far in the field of radiography. The researchers have claimed that there are numerous reasons which have given rise to the increasing demands of radiological operations. According to N. Magnavita, among different factors that have affected the choice of people to make use of radiological imagery processes is due to the nature of patients becoming more of consumers (Magnavita). Similar claims had been put forward by W. Osterlie, M. Solbjor, S. Hofvind, A R Saetnan, S. Forsmo and J-A Skolbekken explaining that the demand of the radiographic screening had now become very common in the society that women from every walk of life are now aware of the radiological processes. Consequently, an emerged level of medical ethics concerning autonomy of medical professionals had created many issues (Osterlie et al.). Southon Gray claimed that health services have now become easy to reach for every other individual in a society because now many individuals have setup their own radiological laboratories that are administrating a great deal of consumers (Gray). Similar conditions in the field of radiography had been investigated by Jill Yieldera in the year of 2009. The author has explained that the continuous need in the radiography imagery concerning patient autonomy have yielded results which have astonished medical professionals. The astonishing fact is that the radiographers have now come across a lot of competition. In order to bear the consequences of the tough competition among different radiographers, it has now become less imperative to understand whether patient autonomy should be served or not (Yeildera). The increasing demands of patients in the field of radiology have created issues such as claimed in the research by Sarah Lewis, Robert Heard, John Robinson, Karolyn White and Ann Poulos conducted in the year 2009. The authors had elaborated in the same context that the professional autonomy had now become less of concern as the demands of radiological processes had increase with respect to patient autonomy (Lewis et al.). The cases of increasing demands concerning patient autonomy have greatly made it complicated for the medical ethics to be fulfilled widely in general practices. Examples could be drawn from the investigation of Jill Yieldera which had been conducted in the year of 2009. The author had survey the fields of radiography in New Zealand, Australia and United Kingdom (Yieldera). The investigation by Jill Yeildera had provided us with the similar test results as done in the investigation by Sarah Lewis, Robert Heard, John Robinson, Karolyn White and Ann Poulos. Both the investigations claim that increased demands have become a threat for the professional autonomy and had increased the competition between different radiographers. According to research by Maryann Hardy, Jeffrey Legg, Tony Smith, Borgny Ween and Imelda Williams it could be understood well that due to the increased demands as concerned with the autonomy of patients, professional autonomy have becomes less priority (Hardy et al.). In the heated debate among two schools of thoughts that are claiming the need of autonomy of patients to be either useful or dangerous for medical ethics have discussed the consequences of radiography in particular. According to Santiago Sia, radiation protection is one of the most talked about ethical issues. The effects of radiations could be immensely dangerous thus it is the first and foremost duty of radiographers to make sure that they aware the patience about the dangerous effects (Sia). Unfortunately due to the increasing demand of radiographic imagery, radiographers have become less conscious about their duties. Such events have caused many ethical issues and law suits to be raised in front of the medical regulatory bodies (Sia). Radiographers had often been defending their practices of fulfilling patients demand by referring to the policies. Radiographers have claimed that it is the autonomy of patients that they want to radiographic processes such as CT scan, positron emission tomography scans etc. According to B. Hoffman and K.B. Lysdahl, it had been seen that the increasing autonomy of patients for radiographers is due to the fact that radiographers fulfil them (Hoffman and Lysdahl). Hogan Linda had also made similar claims that elaborate the concerns of ethical consideration are vastly being discussed and enhanced in the field of radiography. Radiographers thus need to understand their role with ethical issues that could rise with the fulfilment of autonomy of patients (Hogan). Furthermore, the newer technology being used widely in the field of radiography for imaging had installed new moral codes which are in debates. Such a claim had been backed up by the research conducted by Edward Gruppetta stating that the radiographers had long ago managed to change the trends as the autonomy of patients rose for the demand of radiographic processes. It had been also noted that the radiographers had been taken non-serious in the past as people were more inclined towards radiation free treatments (Grupetta). The continuous change in the trends of ongoing radiographic operations has thus now become very imperative. The trends have followed to the concepts of professionalism of radiographers. Milton J Guiberteau, Pamela A. Wilcox, and Sandra Bjork stated in their article Practice guidelines: the radiology perspective that the practices of radiography had now become considerably different as compared to the former practices in the field (Guiberteau, Wilcox and Bjork). Gigliola Bedetti, MDa, Carmine Pizzi, MDb, Gilberto Gavaruzzi, MDc, Federica Lugaresi, MDd, Alberto Cicognani, MDd, Eugenio Picano had proposed that the increasing need of the radiography makes sense to the medical professionals as radiography is the most important phenomenon in the medical world now. The drawbacks of such radiological processes could be dangerous. Patients are not yet concerned about the diseases that could take place due to overly use of radiographic processes. The responsibility of radiographers is to understand that there is a constant need of helping patients. Cancer is the major disease that could be a threat to patients who undergo radiographic processes. In return it becomes a most avid duty of radiographer to help patients understand the threat. But it seems that radiographers are more concerned with the fact that they can earn money and can continue radiography as a career without letting know patients about such threats (Giglioa). J.F. Malone also laid stress on the importance of the fulfilment of the role of radiographers in helping patients understand different threats that they could undergo. The author had also made a claim that medical ethics need to be refreshed as there had been some of the clauses which are still being practiced all around the world which are quite irrelevant in comparison with the modern times. The need of update in the medical ethics is due to the fact that more and more technological advancement had taken place. Along with extreme technological advancement in the current world, a number of ethical issues had also taken place (Malone). Bernice S. Elger, and Chevrolet Jean-Claude also highlighted the careless attitudes of such radiographers who had been more inclined towards providing radiological processes without any precautionary awareness given to the patient. The author had also claimed that it is due to the attitudes of such radiographers that now patients have the nature of consumer (Elger and Jean-Claude). Moreover, Howard P. Forman elaborated in his research that the behaviour of patients had also become ruthless. Using information the right way is also important in the current world order. But it seems with a great deal of access to information, people have almost become careless about the threats that could lead them to dangerous consequences regarding health (Forman). Bernard Gibaud talks about the significance of the field and profession of radiography and he has highlighted major advancements and the successful encounters that had taken place in the field of radiography and also mentions the importance of radiographers to take precautions. One important fact that had been highlighted by the author in the respective research is that radiographers are less fearful about the issue of lawsuit and ethical issues concerning radiography because patients themselves do not understand and get aware regarding the need of radiographic processes (Gibaud). Frank Earnest, Stephen J. Swensen, and Zink Frank also investigated the autonomy of patients and its impact on the autonomy of the radiographers. The claim had been associated with the ethical issues by the author. According to Frank Earnest, Stephen J. Swensen, and Zink Frank, it could be stated that there is very less consent available to address the threats and measures of precautions taken in the radiography so far. There is a constant need of understanding radiographic processes such as CT scan. Very less patients would understand that the process of CT scan could cause a troublesome situation of cancer. The need of radiographic scanning must be taken as per the requirement of professionals who undertake the process of diagnosis (Earnest). Isaac Bankman concluded in his research that also concluded that there is a major increase in the need of radiographic process as per the autonomy of the patients which had remarkably increased the career demand of radiography (Bankman). But the fact remains the same and concerned that there must be a careful understanding of ethical issues as mentioned above. Research Methodology Appropriate Study Design The establishment of an appropriate study design is crucial in order to ensure the success of a research. It not only serves to provide a road-map that the study can follow during the course of the research but also contributes in the development of a clear understanding of the purpose of the research. A research cannot be expected to come to conclusion with authentic research findings because the compatibility of the research design with the research findings tends to have a direct influence on the credibility of the research findings The study will be conducted as a qualitative combination of primary and secondary research. The primary study will be conducted through the interview approach. The interview will be based on an open-ended structure in order to allow the respondents to provide as much data as possible. In addition, the respondents will be given liberty to provide lengthy answers if they choose to. The collection of data during the interview process shall also be stimulated through interview techniques designed to extract relevant data from the respondents. The secondary research will be designed to incorporate peer reviewed publications pertaining to the study. The secondary research will play a key role in providing the study the ability to come to a concluding note with a set of recommendations. The secondary research will also serve as the exploratory element of the research. Books and peer reviewed journal articles on radiology shall be given special consideration for the purpose of the secondary research. In addition, the research articles identified earlier in the preliminary study shall assist in the development of the conceptual framework for the study. Study Population The interview approach shall be designed so that the data evaluation process began by collecting data through the interviews. Since the interviews shall be mainly designed to be open-ended, a significant volume of data can be expected. Once the data has been collected through the interview process the next stage will be to engage in a case by case analysis designed to establish the underlying themes in the collected data. The development of themes from the interview is a very important stage in the study process since it will allow the study to move from a somewhat unstructured approach towards a relatively structured approach. Sample Selection The sample selection shall be based on random sampling in order to ensure that the chances of bias inclusion can be minimized. However, it is imperative to note that sample selection will be limited by geographical and demographical factors. There are two reasons for this characteristic of the sample size. Firstly, the sample size will be limited by the region in which the research shall be conducted. Secondly, radiology requires extensive training and practice. As a result, professional radiologists tend to be beyond a certain age bracket. Selection Bias In order to address selection bias, a list of medical facilities was prepared that offered radiology services. A minimum of fifty (fifty) such medical facilities shall be included in the list. Once the list had been created, it will then be subjected to random sampling in an attempt to randomly shortlist entries. The radiologists in the shortlisted radiology-providing facilities will then be contacted for an interview. Since the interview is not extensively time consuming, the respondents shall be given the option of giving the interview over the phone if they are willing to contribute to the research but are unable to take out time to meet with the researcher. Potential Confounders In order to address potential cofounders, the research design was put together to limit data collection so that only the radiologists were taken as data sources. This proactive approach is being employed to that the research can be isolated from any confounding variables. Information Biases Bias is the most common of interview limitations and can frequently influence the findings of a study. In order to avoid letting any biases or prejudices influence the study findings, the interview process will be designed so that the respondents are asked to present validation and/or reason for an action or approach that they stand for. This precautionary approach will be incorporated in the interview structure in which some of the questions will be designed to invite the respondents to explore the rationale for their perceptions. This will ensure that the responses given by the respondents are those that are based on logical foundations. Data Analysis Data analysis for the primary and secondary data shall be carried out by initially collecting secondary data through literature analysis and then moving on to collect primary data through the interview approach. Once the data has been collected, it will then be brought into use to determine relationships and patterns in the data. Since the study is mainly qualitative, the determination of patterns in the primary data collected will be reliant on the inferences and conclusions drawn from the secondary data. As a result, this will also have an influence on the development of the credibility of the study. The direction of the data analysis shall be fundamentally determined by the research questions considered in the study. Research Sequence The study will initiate by developing a context to the research before moving on to lay down the aims, objectives and research questions. This will be followed by a literature analysis to carry out the secondary research which will then be supplemented with the explanation of the research methodology that the study will be following. The engagement of the literature analysis before the establishment of the final research design is necessary in order to facilitate the development of a clear understanding of the research variables. Once the research variables have been determined, the research design will be finalized and implemented. The study will then move on to present an analysis of the findings. This will constitute the identification of themes and patterns in the collected data. Once the patterns and themes have been identified, the study will then proceed to present concluding statements. The concluding statement will mainly constitute answers to the research questions and validations of the hypotheses considered earlier in the study. The study will come to a conclusion with a set of recommendations if found necessary. Project Methodology Feasibility The project is realistic because it combines primary and secondary data elements that rely entirely on elements that are present and in practice. No element of the research seeks to make unrealistic aims and the research process being employed is an advanced hybrid derivation of research methodologies that have been followed in studies pertaining to the same subject in the past. Ethical Considerations The project methodology is ethical because it shall be carried out with complete and unwavering adherence to copyright regulations and moral considerations. Every attempt required shall be made to ensure that no plagiarism makes its way into the project. It is imperative to highlight that the study does not violate and/or challenge any regulations and/or guidelines. The interview approach has been designed to facilitate the respondents with regard to information confidentiality. In addition, the study does not seek to take a radical approach the research objectives and third person sources of information are being used to collect data. ADMINISTRATIVE ISSUES BUDGET No funding is necessary. DATA STORAGE AND HANDLING Data handling will be carried out mainly through the recording of interviews upon the interviewee’s permission to do so. Data handling will be facilitated by maintaining journal entries and records of the research process. TIMELINE DEFINED The research process shall follow the following timeline.   October November   15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Introduction                                                                 Literature Review                                                                 Research Methodology                                                                 Findings & Analysis                                                                 Conclusions & Recommendations                                                                 Works Cited and Suggested Readings Adams, J., and T. Smith. "Qualitative methods in radiography research: a proposed framework." Radiography 9, no. 3 (2003): 193-199. Armstrong, J. D. "Morality, ethics, and radiologists' responsibilities." American Journal of Roentgenology 173 (1999): 279-284. Bankman, Isaac N. Handbook of medical imaging: processing and analysis. 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