Personnel and patient doses: are there ethical consequences to the use of X-rays?

Interventional cardiology has witnessed a period of great technological change. The introduction of new dedicated cardiology X-ray equipment, as well as advances in catheter and stent design, has revolutionised clinical practice in cardiology. As a consequence, the number, range and complexity of procedures have increased. This has meant that patients can be treated as outpatients without requiring hospitalisation for surgery. The public are aware of these benefits and demand greater access. However, these changes have had an impact on patient and staff doses and these are reviewed. Simple approaches to dose reduction for patients and staff are illustrated. There are a number of ethical issues concerning both patients and staff. For patients, these are related to informed consent. For staff, the ethical issues are associated with dose control. These issues will be discussed.