ICRP TG 114, application of tolerability and reasonableness in the medical field.

Medical exposure for patients is part of the planned exposure situations. Unique aspects of radiological protection distinguish medical exposure for patients from public or occupational exposures. The ultimate goal of the process of medical uses of radiation is the delivery of quality healthcare to the patients, i.e. maximising the benefits for patients' care while taking under control radiation risks. The application of radiation protection principles is a key driver for the quality of medical procedures using radiation. In order to better understand the concepts of tolerability and reasonableness in relation to the principles of justification and optimisation in medicine, it is interesting to investigate the generic dimensions of quality in healthcare. Tolerability and reasonableness assume the presence of a radiation safety culture, including policies, processes, quality assurance, and training. Radiation safety culture needs to encompass all stakeholders who could affect the exposure of a patient, including the patient her/himself. The development of a radiation safety culture requires an organisation that takes into account radiation protection and safety, good medical practice, and human factors.