A Radiologic Technologist’s Guide to Patients’ Rights, HIPAA, and Ethical Consent

Adopted from Dr. Angela Thomas' lecture on Patients' Rights from the 21 Day Registry Review Challenge

In the world of radiologic technology, our job doesn’t begin and end with producing diagnostic images. We’re in a uniquely trusted position—one that demands ethical clarity, compassion, and accountability. Whether assisting in a routine chest X-ray or preparing a patient for a complex fluoroscopic study, our duty to uphold patients' rights remains constant.

This comprehensive guide dives deep into three core areas every radiologic technologist must understand:

1. Consent (informed, oral, implied)

2. Confidentiality and HIPAA compliance

3. The AHA's Patient Care Partnership (Patient Bill of Rights)

Whether you’re a student preparing for the ARRT registry or a seasoned RT seeking to sharpen your professional standards, understanding these principles is essential not just for compliance—but for care.

I. Consent: The Cornerstone of Patient Autonomy

Consent isn’t a checkbox. It’s an ethical and legal necessity. Every patient has the right to understand and agree—or refuse—any procedure before it's performed.

A. Informed Consent

Informed consent is required before any invasive or experimental procedure. It must:

• Be written in language the patient understands

• Include an explanation of the procedure, risks, benefits, and alternatives

• Be signed by the patient (or legal representative) and a witness

If the patient is sedated, non-English speaking, or cognitively impaired, the technologist must involve a trained medical interpreter or ensure a legally authorized representative is present.

"If you cannot answer a patient’s question about the procedure, you must get the correct answer before proceeding—an improper response may invalidate consent." — Dr. Angela Thomas

B. Oral and Implied Consent

Oral consent is verbal approval for routine, low-risk procedures like a chest X-ray. It’s usually sufficient, but should still be acknowledged in documentation.

Implied consent arises from behavior, like a patient lifting their gown for an abdominal ultrasound. However, it should never replace informed consent in sensitive or high-risk situations.

C. Revoking Consent

Even after signing a consent form, patients maintain the right to withdraw their agreement at any time. Technologists must respect this decision, document it, and inform the referring physician.

II. Confidentiality and HIPAA: Safeguarding Private Health Information

Confidentiality is the ethical obligation to protect a patient's personal and medical information. Legally, this is governed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

A. HIPAA Basics for Radiologic Technologists

HIPAA requires that health providers:

• Obtain written patient consent before disclosing any personal health information (PHI)

• Limit access to PHI to trained individuals only

• Allow patients to review and request corrections to their records

Key HIPAA compliance practices include:

• Avoid calling out full names in public areas

• Keep printed schedules with names out of sight

• Encrypt digital files and password-protect systems

• Never discuss patient cases outside professional settings—even with friends or family

B. Violations and Consequences

Sharing diagnostic images on social media, commenting about a patient's condition to a non-healthcare provider, or leaving a computer screen with PHI unattended could all result in HIPAA violations—with consequences ranging from institutional reprimands to federal fines.

C. Practical Application

Let’s say a transport aide casually asks, “Did Mr. Gray’s scan look bad?” While it might feel harmless to respond, doing so would breach confidentiality—even if the aide is part of the care team. In this situation, redirect the conversation or suggest they speak to the attending physician.

III. AHA’s Patient Care Partnership: Rights Every Patient Should Know

Previously known as the Patient’s Bill of Rights, the AHA Patient Care Partnership outlines what patients can expect during their care. Radiologic technologists must understand these rights, especially when participating in direct patient care.

A. Right to Privacy and Dignity

Patients have a right to bodily privacy and modesty:

• Provide appropriate draping

• Always knock and announce before entering

• Offer a same-sex chaperone for intimate exams

• Avoid exposing sensitive areas unnecessarily

B. Right to Know: Access to Information

Patients are entitled to:

• Know the identity and credentials of those involved in their care

• Understand the nature and purpose of any exam or procedure

• Receive access to their medical images and reports (as permitted by facility policy)

C. Right to Participate in Decisions

Patients are partners in their care. They can:

• Accept or refuse procedures

• Ask questions about their care

• Provide or revoke consent

Technologists must refer diagnostic or treatment questions to physicians. We do not interpret images or give diagnostic impressions.

D. Right to Advanced Directives

Patients may have legal documents expressing end-of-life wishes, such as:

• Living Will – specifies what kind of medical care they want (or don’t want)

• Durable Power of Attorney for Healthcare – appoints someone to make decisions on their behalf

• DNR/DNI Orders – indicate that no resuscitation or intubation should be performed

These directives must be respected by all healthcare professionals, including RTs.

E. Right to Say “No”: Refusal of Treatment

Patients can decline imaging at any point—even mid-procedure. If this happens:

• Stop immediately

• Document the refusal

• Inform the attending physician

• Remain respectful and non-confrontational

IV. Research Participation: Special Consent Required

If a patient is asked to participate in research, they must receive a separate, specific informed consent document that outlines:

• Study purpose and procedures

• Risks and benefits

• Voluntary nature of participation

Patients can withdraw from the study at any time without impacting their standard of care.

Final Thoughts: Why This Matters

Radiologic technologists are more than image producers—we are healthcare professionals with a moral and legal duty to advocate for our patients. Whether explaining a procedure, safeguarding medical information, or respecting a DNR order, the ethical responsibility is ours to uphold.

“The patient is the reason for the exam, not the interruption to it.”

Knowing patients' rights is only the beginning. Living them out—every shift, every scan, every conversation—is what defines true professionalism in radiologic science.

Want to learn more from Dr. Thomas? Sign up to the 21 Day Registry Review Challenge.