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News and Articles
The AIUM Releases New Statement
Regarding Keepsake Imaging
(2005-08-10)
LAUREL, MD - The American Institute of Ultrasound in Medicine (AIUM),
an organization that advocates the safe and responsible use of
diagnostic ultrasound, has strengthened and detailed its stance on
ultrasound that is done for nonmedical purposes.
To develop a revised statement, a Keepsake Ultrasound Task Force was
created to consider the various aspects of the use of ultrasound for
entertainment. The AIUM wanted to ensure that all positions were
addressed, so the task force encouraged input from all ultrasound
professions. An e-mail was sent to AIUM members asking them to provide
comments on specific keepsake issues they had, and members were able to
provide their comments via the AIUM’s website.
“The Task Force on Keepsake Ultrasound met by conference call
several times and had a vigorous e-mail correspondence,” said
Joshua A. Copel, MD, chair of the committee. “The new
statement is comprehensive and robust and is the result of outstanding
contributions by all members of the committee and AIUM members who
submitted comments.”
The new position statement is as follows:
The AIUM advocates the responsible use of diagnostic ultrasound for all
fetal imaging. The AIUM understands the growing pressures from patients
for the performance of ultrasound examinations for bonding and
reassurance purposes largely driven by the improving image quality of
3D sonography and by more widely available information about these
advances. Although there is only preliminary scientific evidence that
3D sonography has a positive impact on parental—fetal
bonding, the AIUM recognizes that many parents may pursue scanning for
this purpose.
Such “keepsake imaging” currently occurs in a
variety of settings, including the following:
1. Images or video clips given to parents during the course of a
medically indicated ultrasound examination;
2. Freestanding commercial fetal imaging sites, usually without any
physician review of acquired images and with no regulation of the
training of the individuals obtaining the images; these images are
sometimes called “entertainment videos”; and,
3. As added cost visits to a medical facility (office or hospital)
outside the coverage of contractual arrangements between the provider
and the patient’s insurance carrier.
The AIUM recommends that licensed medical professionals (either
physicians or registered or registry-eligible sonographers) who have
received specialized training in fetal imaging perform all fetal
ultrasound scans. These individuals have been trained to recognize
medically important conditions, such as congenital anomalies, artifacts
associated with ultrasound scanning that may mimic pathology, and
techniques to avoid ultrasound exposure beyond what is considered safe
for the fetus. Any other use of “limited medical
ultrasound” may constitute practice of medicine without a
license. The AIUM reemphasizes that all imaging requires proper
documentation and a final report for the patient medical record signed
by a physician.
Although the general use of ultrasound for
medical diagnosis is considered safe, ultrasound energy has the
potential to produce biological effects. Ultrasound bioeffects may
result from scanning for a prolonged period, inappropriate use of color
or pulsed Doppler ultrasound without a medical indication, or excessive
thermal or mechanical index settings. The AIUM encourages patients to
make sure that practitioners using ultrasound have received specific
training in fetal imaging to ensure the best possible results.
The AIUM also believes that added cost arrangements other than those of
providing patients images or copies of their medical records at cost
may violate the principles of medical ethics of the American Medical
Association (E-8.0621 and E-8.0632) and the American College of
Obstetricians and Gynecologists.3 The AIUM therefore reaffirms the
Prudent Use Statement4 and recommends that only scenario 1 above is
consistent with the ethical principles of our professional
organizations.
The market for keepsake images is driven in part by past medical
approaches that have used medicolegal concerns as a reason not to
provide images to patients. Sharing images with patients is unlikely to
have a detrimental medicolegal impact. Although these concerns need
further analysis and evaluation, we encourage sharing images with
patients as appropriate when indicated obstetric ultrasound
examinations are performed.5
References:
1. American Medical Association. E-8.062: Sale of Non-Health-Related
Goods From Physician’s Offices. Chicago, IL: American Medical
Association; 1998.
2. American Medical Association. E-8.063: Sale of Health-Related
Products From Physician’s Offices. Chicago, IL: American
Medical Association; 1999.
3. American College of Obstetricians and Gynecologists. Commercial
Enterprises in Medical Practice. In: Ethics in Obstetrics and
Gynecology. Washington, DC: American College of Obstetricians and
Gynecologists; 2004
4. American Institute of Ultrasound in Medicine. Prudent Use. Laurel,
MD: American Institute of Ultrasound in Medicine; 1999.
5. American Institute of Ultrasound in Medicine. Providing Images to
Patients. Laurel, MD: American Institute of Ultrasound in Medicine;
1998.
For more information about the inappropriate use of ultrasound for
entertainment purposes, visit the AIUM website at www.aium.org under
“Patient Info,” and then click on
“Entertainment Ultrasound.”
The American Institute of Ultrasound in Medicine is a multidisciplinary
association dedicated to advancing the safe and effective use of
ultrasound in medicine through professional and public education,
research, development of guidelines, and accreditation.
# # #
Contact: Adam Freestone
afreestone@aium.org
301-498-4100
American Institute of Ultrasound in Medicine
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