Communicating the harmful effects of radiation exposure from medical imaging: malpractice considerations.

Concerns about possible harmful effects of exposure to radiation arising from diagnostic radiologic procedures have existed in both the scientific and lay communities for many decades. There is, however, no question that the degree of concern over the past years has escalated to the "anxiety" if not the "fear" level. Potential exposure to radiation is not a new issue, but it is certainly a "hot" issue. Americans were exposed to more than six times as much ionizing radiation from diagnostic medical procedures in 2006 than they were in early 1980s. To what extent this increased exposure elevates the risk of genetic mutations and/or development of cancer is not known with any degree of certainty. The available data are subject to varying interpretations, often debatable and thus controversial. What should be communicated to the public? The medical and scientific communities must encourage public attention and discussion regarding radiologic imaging and associated radiation exposure. They must talk to the public sensibly about the uncertainty regarding the hazards of radiation exposure. Exposure to imaging involving radiation and the hazards related to such exposure has myriad medical/legal ramifications. There has never been a successful medical malpractice lawsuit that alleged development of cancer or genetic defects resulting from diagnostic x-ray examinations. However, there have been and continue to be lawsuits filed alleging soft tissue injury resulting from overexposure to diagnostic radiologic equipment and cancer caused by overexposure to radiation oncology equipment. It is quite likely that lawsuits alleging development of cancer arising from diagnostic imaging using standard levels of ionizing radiation will be forthcoming. How the courts will deal with these remains to be determined.