Individually, physicians who offer diagnostic imaging services that have not been scientifically validated and for which a patient has not been referred by another physician have an ethical obligation to:
- Perform a requested diagnostic imaging test only when, in the physician’s judgment, the possible benefits of the service outweigh its risks.
- Recognizing that in agreeing to perform diagnostic imaging on request, the physician:
- establishes a patient-physician relationship, with all the ethical and professional obligations such relationship entails;
- assumes responsibility for relevant clinical evaluation, including pre- and post-test counseling about the test, its results, and indicated follow-up. Physicians may choose to refer the patient for post-test counseling to an appropriate physician who accepts the patient.
- Obtain the patient’s informed consent. In addition to the usual elements of informed consent, the physician should disclose:
- that the diagnostic imaging test has not been validated scientifically;
- the inaccuracies inherent in the proposed test;
- the possibility of inconclusive results;
- the likelihood of false positive and false negative results;
- circumstances that may require further assessments and additional cost.
- Ensure that the patient’s interests are primary and place patient welfare above physician interests when the physician has a financial interest in the imaging facility.
- Ensure that any advertisements for the services are truthful and not misleading or deceptive, in keeping with ethics guidance and applicable law.
Collectively, physicians should:
- Advocate for the conduct of appropriate trials aimed at determining the predictive power of diagnostic imaging tests and their sensitivity and specificity for target populations.
- Develop suitable guidelines for specific diagnostic imaging tests when adequate scientific data become available.