Morality, ethics, and radiologists' responsibilities.

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The goal of this discussion was to address the matter and methodology of ethics and critical thinking and to ask several questions about the relationship between ethics and radiology. Questions about the nature of the moral and how ethics inform decision making raise our awareness and may provide new understanding about moral thinking. Why is medicine a moral endeavor? Overridingness, universalizability, and other-regarding virtues were discussed. How do ethics inform medical decision making? Ethical theories, including parentalism, autonomy, and the engagement model, were discussed. What are radiologists' ethical responsibilities? Our ethical responsibilities as radiologists entail seven briefly described elements: assessing the appropriateness of the imaging examination, participating in the informed consent process, protecting patient interests, providing excellent image interpretation, communicating effectively with physicians and patients, seeking continued learning, and continuously improving quality. Of these responsibilities, competence, loyal concern for the patient's well-being, and respect for his or her person provide the basis for trust in the patient-physician relationship. If the central paradox in medicine is the tension between self-interest and altruism, then responsibility to the patient in this trust has the greatest force and overrides other obligations. Finally, our challenge is to critically examine our and each other's professional role and the extent to which we achieve excellence in our contribution to patient care; to break out of comfortable habits and reflect on new, alternative ways of knowing as caregivers; to think about what we are doing in medicine and the consequences for the human mind and spirit of our patients, our colleagues, and ourselves; and to provide a forum for this important dialogue in our practices, residency programs, and continuing education curricula.