►Research is defined as the creation of
new knowledge and/or the use of
existing knowledge in a new and creative
way so as to generate new concepts,
methodologies and understandings.
►This could include synthesis and analysis
of previous research to the extent that it
leads to new and creative outcomes.
►Research is a process of systematic
inquiry that entails collection of data;
documentation of critical information;
and analysis and interpretation of
that data/information, in accordance
with suitable methodologies set by
specific professional fields and
academic disciplines.
►Research is a careful and
detailed study into a specific
problem, concern, or issue using
the scientific method.
►Research is a systematic inquiry
to describe, explain, predict, and
control the observed
phenomenon.
►Research is the process of solving
problems and finding facts in an
organized way.
►Research is done by applying what is
known (if anything), and building on it.
Additional knowledge can be discovered
by proving existing theories, and by
trying to better explain observations.
►Research is a systematic inquiry to
describe, explain, predict, and
control the observed phenomenon.
Research involves inductive and
deductive methods.
THREE GENERAL
TYPES OF RESEARCH
1. DESCRIPTIVE RESEARCH
2. EXPLANATORY OR CORRELATION
RESEARCH
3. INTERVENTION OR EXPERIMENTAL
RESEARCH
DESCRIPTIVE RESEARCH
► IT FINDS ANSWER TO THE QUESTIONS
WHO, WHAT, WHEN, WHERE, AND
HOW.
►IT DESCRIBES A SITUATION OR A
GIVEN STATE OF AFFAIRS IN TERMS OF
SPECIFIED ASPECTS OR FACTORS.
EXPLANATORY OR CORRELATION OR
ASSOCIATION RESEARCH
►IT ATTEMPTS TO EXPLAIN THE
POSSIBLE FACTORS RELATED TO
A PROBLEM WHICH HAVE BEEN
OBSERVED IN A DESCRIPTIVE
STUDY.
►THIS TYPE OF STUDY ANSWERS
THE QUESTIONS WHY AND HOW.
EXPLANATORY OR CORRELATION
OR ASSOCIATION RESEARCH
►IT INVESTIGATES RELATIONSHIPS
BETWEEN FACTORS OR
VARIABLES.
►IT USES A THEORY OR
HYPOTHESIS TO ACCOUNT FOR
OR EXPLAIN THE FORCES THAT
ARE ASSUMED TO HAVE CAUSED
THE PROBLEM.
EXAMPLE OF ASSOCIATION OR
CORRELATION RESEARCH
► KNOWLEDGE AND PRACTICES OF
RADIOLOGIC TECHNOLOGISTS DURING
THE PANDEMIC IN SELECTED PRIVATE
HOSPITALS IN ILOILO CITY
INTERVENTION OR
EXPERIMENTAL RESEARCH
►IT EVALUATES THE EFFECT OR
OUTCOME OF A PARTICULAR
INTERVENTION OR TREATMENT.
►IT STUDIES THE CAUSE AND
EFFECT RELATIONSHIP BETWEEN
CERTAIN FACTORS ON A CERTAIN
PHENOMENON UNDER
CONTROLLED CONDITIONS.
INTERVENTION OR
EXPERIMENTAL RESEARCH
►IT RANDOMLY ASSIGNS THE
SUBJECTS OF THE STUDY TO THE
EXPERIMENTAL AND CONTROL
GROUPS;
►BOTH GROUPS ARE EXPOSED TO
SIMILAR CONDITIONS EXCEPT
FOR THE INTERVENTION OR
TREATMENT.
EXPERIMENTAL RESEARCH METHOD
►IT IS USED TO DETERMINE THE
EFFECTIVENESS OF A TREATMENT
OR AN INTERVENTION
►OR THE CAUSE AND EFFECT
RELATIONSHIP OF CERTAIN
PHENOMENON UNDER
CONTROLLED CONDITIONS.
SURVEY RESEARCH METHOD
►IT OBTAINS DATA TO DETERMINE
SPECIFIC CHARACTERISTICS OF A
GROUP.
►IT IS APPLIED TO OBTAIN THE
GENERAL PICTURE OF THE
CHARACTERISTICS OF A STUDY
POPULATION AT A PARTICULAR
TIME.
HISTORICAL RESEARCH METHOD
►IT IS USED TO DETERMINE THE
GROWTH AND DEVELOPMENT OF A
GROUP, OR ORGANIZATION.
►DATA ARE OBTAINED FROM
SECONDARY SOURCES SUCH AS
RECORDS, DOCUMENTS, OR OTHER
WRITTEN MATERIALS.
CONTENT ANALYSIS
►IT IS USED TO ASCERTAIN THE
QUALITY OF MESSAGE OR
INFORMATION FOUND IN A
DOCUMENT OR IN MASS MEDIA.
CONTENT ANALYSIS
►IT IS USED TO DETERMINE THE
LEVEL OF READABILITY OF
CERTAIN TEXTBOOKS.
►IT IS ALSO USED TO CHECK FOR
THE AUTHENTICITY OF
DOCUMENTS.
►A research problem may be defined
as an area of concern, a gap in the
existing knowledge, or a deviation in
the norm or standard that points to
the need for further understanding
and investigation. ... Writing
a statement of the problem should
help you clearly identify the purpose
of the research project you will
propose.
►A good research problem should
have the following characteristics:
►It should address a gap in
knowledge.
►It should be significant enough to
contribute to the existing body of
research
►It should lead to further research.
►A good research problem should have
the following characteristics:
►The problem should render itself to
investigation through collection of data
►It should be of interest to the
researcher and suit his/her skills, time,
and resources
►The approach towards solving the
problem should be ethical.
►Key points:
►A statement of the problem is used in
research work as a claim that outlines
the problem addressed by a study.
►A good research problem should address
an existing gap in knowledge in the field
and lead to further research.
►To write a persuasive problem statement,
you need to describe (a) the ideal, (b),
the reality, and (c) the consequences.
►What is the format for writing a
statement of the problem?
►A persuasive statement of problem is
usually written in three parts:
►Part A (The ideal): Describes a
desired goal or ideal situation;
explains how things should be.
► What is the format for writing a statement
of the problem?
► Part B (The reality): Describes a condition
that prevents the goal, state, or value in
Part A from being achieved or realized at
this time; explains how the current situation
falls short of the goal or ideal.
► Part C (The consequences): Identifies the
way you propose to improve the current
situation and move it closer to the goal or
ideal.
INFORMED CONSENT
⮚It is the written assent of a
patient to receive a proposed
treatment;
⮚Adequate information is essential
for the patient to give truly
informed consent.
INFORMED CONSENT
⮚It is required for invasive
procedures and;
⮚those for which disclosure of
associated risks would help the
patient determine whether or not
to proceed with the procedure or
treatment.
INFORMED CONSENT
⮚Case law concerning informed
consent was established in the
1957 case of Salgo v Leland
Stanford Jr. University Board of
Trustees and…
INFORMED CONSENT
⮚The 1972 case of Canterbury v
Spense;
⮚Generally physicians are required
to give patients enough
information to enable them to
make informed decisions.
(Truman v Thomas, 1980)
INFORMED CONSENT
⮚This information includes risks,
benefits, alternative treatment
options, and expected outcomes
if they choose not to undergo the
proposed diagnostic testing or
treatment.
⮚(Truman v Thomas, 1980)
Autonomy
“ One human person, precisely as
a human person, dares not to have
the authority and should not have
power over another human
person.”
Autonomy
“In a medical sense, a patient will
not be treated without informed
consent of his or her lawful
surrogates, except in narrowly
defined emergencies.”
ELEMENTS IN INFORMED CONSENT
The consent must be given voluntarily by a
mentally competent adult. The patient
should not be coerced into giving consent.
Patients must understand exactly to what
they are consenting. If a patient speaks
foreign language or is deaf, an interpreter
must explain the procedure requiring
consent.
ELEMENTS IN INFORMED CONSENT
The request for consent should include a
description of the risks and benefits of the
procedure, alternative treatment options, and
expected outcomes if treatment is not
commenced.
The consent should be written, signed by the
patient or representative, witnessed, and dated.
ELEMENTS IN INFORMED CONSENT
Consent to treat a minor patient is usually given
by a parent or guardian, but if the minor patient is
at least 7 years old, he or she should be included
in the decision-making process.
CRUCIAL ELEMENTS IN PATIENT AUTONOMY
AND INFORMED CONSENT
MAINTENANCE OF PATIENT’S RIGHTS
PROVISION OF EDUCATION TO FACILITATE CONSENT
PROMOTION OF HUMAN DIGNITY
DETERMINATION OF INCOMPETENCE
ADVOCACY OF SURROGATES
CRUCIAL ELEMENTS IN PATIENT AUTONOMY
AND INFORMED CONSENT
ELIMINATION OF ATTITUDES OF PATERNALISM
CLARIFICATION OF UNCLEAR COMMUNICATION INVOLVING
THERAPEUTIC PRIVILEGE
STRATEGIES FOR DEALING WITH EMERGENCY SITUATIONS
USE OF COMPATIBLE PARAMETERS FOR CONSENT IN
SPECIFIC HEALTH CARE FACILITIES
EDUCATION REGARDING THE ETHICAL THEORIES
INVOLVED IN PATIENT AUTONOMY AND INFORMED
CONSENT
RULES FOR EXPLAINING PROCEDURES
PATIENT PREFERENCE RULE
PROFESSIONAL CUSTOM RULE
PRUDENT PERSON RULE
SUBJECTIVE SUBSTANTIAL DISCLOSURE RULE
COMBINATION OF RULES
COMPETENCE
►It is the ability to make choices and
consider their consequences.
►It is a necessary element in informed
consent.
►In the condition of short-term
incompetence, the patient may
require a surrogate or
postponement…
RESPECT FOR AUTONOMY
(Jonsen, Siegler, & Winslade, 2002)
1. Is the patient mentally capable and
legally competent?
Is there any evidence of incapacity
that would affect the imaging
procedure?
2. If competent, has the imaging
patient expressed any preferences
for the imaging procedure?
RESPECT FOR AUTONOMY
(Jonsen, Siegler, & Winslade, 2002)
3. Does the imaging patient
understand the benefits and the risks,
and has he or she given consent?
4. If the patient is in need of a
surrogate, is the surrogate using the
appropriate standards for decision
making?
RESPECT FOR AUTONOMY
(Jonsen, Siegler, & Winslade, 2002)
5. Has the imaging patient expressed
prior preferences (e.g. advance
directives)?
6. If the imaging patient is unable or
unwilling to cooperate with the
imaging procedure, is there a specific
reason?
RESPECT FOR AUTONOMY
(Jonsen, Siegler, & Winslade, 2002)
7. After a consideration of the first six
points, is the patient’s rights to choose
being respected to the extent possible
both ethically and legally?
On Emergency Situations
⮚According to the laws of many
states, three conditions must be
present for the omission of
informed consent to be justified:
Emergency Situations
1. The patient is incapable of giving
consent, and no lawful surrogate
is available.
2. Danger to life or risk of a serious
impairment to health is apparent.
3. Immediate treatment is necessary
to avert these dangers.
Advance Directives
It is a predetermined (usually
written) choice made to inform
others of the ways in which the
patient wishes to be treated while
incompetent.
IMAGING SCENARIO
A 90-year old patient with terminal cancer who is mentally ill, hard of
hearing, and visually impaired is scheduled for a double contrast barium
enema. Even a healthy 20-year old patient may have difficulty with this
procedure,
IMAGING SCENARIO
…which is embarrassing and often uncomfortable. The imaging
professional wonders why this terminal ill, feeble, geriatric patient should
be forced to endure the procedure. The professional is not sure that the
patient truly understands what it entails.
IMAGING SCENARIO
The patient may have been influenced by a physician concerned
with doing everything possible to avoid legal repercussions, and
informed consent may have been given by a family member who
wants to hang on to this elderly relative no matter what…
IMAGING SCENARIO
If the patient had made himself
clearer concerning his wishes
before the illness became
invasive, all the involved parties
would not be struggling with the
implications and consequences
of the procedure.
IMAGING SCENARIO
Answer
Among the ethical theories that
might be applied when issues of
patient autonomy are
considered, virtue ethics,
involving practical wisdom and
reason, may be the most
adaptable
(Towsley-Cook & Young, 2007).
TORT
⮚A civil wrong for which the law
provides for remedy.
(Canterbury v Spencer, 1972).
TORT LAW
⮚A tort action is filed to recover
damages for personal injury or
property damage occurring from
negligent conduct or intentional
misconduct.
Schloendorff v Society of N.Y.
Hospitals (1914)
“Every human being of adult years
and sound mind has a right to
determine what shall be done with
his own body; and a surgeon who
performs an operation without his
consent commits an assault for
which he is liable in damages.”
INTENTIONAL TORTS
Are wrongs resulting from acts done with the intention of causing
harm to another;
Includes assault, battery, and false imprisonment.
ASSAULT
It is a deliberate act wherein one
person threatens to harm another
person without consent and the
victim perceives that the other has
the ability to carry out the threat.
BATTERY
It is touching to which the victim has not
consented, even if the touching may
benefit the patient.
It occurs if the x-ray examination is actually
performed on the competent, unwilling
patient.
LEGAL CRITERIA FOR THE USE OF RESTRAINT
► Touching or restraint to which the patient has not consented is needed
to protect the patient, health care team members, or the property of
others.
► The restraint used is the least intrusive method possible.
LEGAL CRITERIA FOR THE USE OF RESTRAINT
► Regular reassessment of the need to restrain occurs.
► The restraint is discontinued as soon as practicable.
FALSE IMPRISONMENT
According to 1914 case Schloendorff v Society of N.Y. Hospitals, It is the
unlawful confinement of a person within a fixed area.
MEDICAL IMMOBILIZATION
► It is considered a regular part of medical diagnostic or therapeutic
procedures based on standard practice.
► The use of which to reduce radiation exposure and obtain optimal
images or treatment is not considered restraint.
Note:
When restraints are necessary, the imaging professional
must be able to justify the restraint using specific criteria.
UNINTENTIONAL TORTS
► These are wrongs resulting from actions that were not intended to do
harm.
► Examples are
► Negligence,
► Lack of informed consent, and
► Breach of patient confidentiality.
MEDICAL MALPRACTICE
► It is unintentional tort most commonly encountered in medical imaging,
► A broad term that in most jurisdictions encompasses negligence,
► Failure to obtain informed consent, and breach of patient
confidentiality.
THE ROLE OF RT IN
INFORMED CONSENT
► RTs have the duty to ensure that procedures are explained and
► Consent is obtained before beginning the procedure.
CONSENT FORMS
These are useful tools to help inform patients about procedures
and document consent.
CONSENT FORMS generally includes
► The name of the procedure;
► A brief explanation of the procedure, including risks and benefits;
► Spaces for the patient’s name and the
name of the person performing the procedure and obtaining
consent and
► At least one witness.
A person may cause evil to others not only by his actions, but by his
inaction, and in either case he is justly accountable to them for the injury.
JOHN STUART MILL