Professionalism and Ethics
Professionalism and Ethics tests judgment under pressure: scope of practice, consent, confidentiality, error disclosure, and regulatory reporting. Items usually describe a conflict between what is convenient and what is correct, and the best answer protects the patient and the record.
Scope and delegation
- Practice within your certification and state scope. A therapist does not alter a prescription, modify an approved plan, or perform a physicist calibration.
- Accept only tasks you are competent and authorized to perform, and confirm supervision requirements (direct versus general) are met for the procedure.
Consent, privacy, and records
- Informed consent is the physician discussion and signature; your role is to confirm it exists, answer logistical questions, and witness where policy permits.
- PHI includes images, schedules, and hallway conversation. No identifiers on social media, and no photographing a treatment screen with a personal phone.
- Documentation is contemporaneous and factual. Never back-date or alter an entry to conceal a delay or an error.
Errors and reporting
- Stop, protect the patient, notify the radiation oncologist and medical physicist, and document the facts.
- A medical event under 10 CFR 35.3045 requires telephone notification to the NRC no later than 24 hours after discovery and a written report within 15 days. The RSO typically files, but your escalation starts the clock.
- Disclosure to the patient follows institutional and physician guidance; honesty is an ethical duty, not an admission of liability.
Worked example
At the console you realize the record-and-verify system loaded the previous plan revision, and one field has already been delivered. You stop delivery, keep the patient positioned, and call the physicist and physician. The delivered dose is recalculated; if the deviation crosses the reporting threshold, the RSO is notified the same day so the 24-hour clock is met. You write a factual note with times and delivered MU, and you do not edit the earlier record or discuss the case in the staff room.
Traps
- Deciding a small deviation is not worth mentioning.
- Discussing a patient diagnosis with a colleague not involved in that patient care.
- Signing a chart check for a plan you did not actually verify.
- Assuming someone else reported an incident, or that a verbal report satisfies the written-report requirement.