Just like all other healthcare professionals, dentists have responsibilities to their patients, employers, associations and, most important, to their own personal integrity. It is so serious that the dentist be prepared to make sound decisions and actions based on ethical concerns for each patient. Dentists, also face a number of ethical issues related to the treatment of their patients. Some issues are clearly medical, involving the treatment of the patient. Other issues are related to the management of a dentist’s practice, such as employment, corporate sponsorship and advertising.
Dentists know that healthy teeth are not always attractive. A patient may have perfectly healthy teeth that, through discoloration or a lack of alignment, do not have an appealing look or the patient does not like to smile much. For example, when a patient visits our dentist for a checkup or a routine cleaning, should the dentist remark on these problems and suggest corrective procedures? On one hand, this may make the patient feel insecure about the look of their teeth, possibly allowing the dentist to look as though he is taking advantage of the patient financially on this insecurity in the form of an expensive cosmetic procedure.
Then again, a patient may be unaware that their problem can be fixed; to not inform the patient of this find might be considered negligent. This raises tough ethical questions for dentists. Most dental offices have corporate sponsorship which means the dental offices prefer to use a certain product like Colgate or Crest and buy these products from a certain company. Often, after cleaning a patient’s teeth or performing a routine procedure, dentists will offer the patient free dental hygiene products, such as tooth brushes, packs of floss and tubes of toothpaste.
According to (Hasegawa 2001, p. 118) “dentists often receive many of these free products from medical supply companies seeking to advertise their products. While most patients are happy to receive these gifts, the practice raises a number of ethical issues. For example, if a dentist offers a sample to a patient, is it his responsibility to make sure the gift is of a high quality? Does passing along the free sample constitute an endorsement of the product? And, by accepting free gifts from the company, is the dentist’s impartiality undermined?
”So many ethical issues may come up when treating patients with highly infectious diseases. For example, fearing infection, a dentist may wonder if he can ethically refuse to treat the patient. Or, if he does choose to treat the patient, can he ethically evaluate the patient and add on additional charges for the expenses of taking increased precautions against the infection? If the dentist is referring the patient to another dentist, the dentist may wonder if it is ethical to inform the new dentist so that he or she may take proper precautions.
According to (Hasegawa 2001, p. 118), “a dentist cannot decline to treat a person with HIV based on a supposed risk of HIV transmission or because the dentist simply does not feel comfortable treating a person with HIV. ” That would be ethically wrong and the dentist could get sued for negligence. I know it is illegal for the dentist to deny an HIV-positive person the full and equal enjoyment of dental services or to deny an HIV-positive person the opportunity to benefit from dental services in the same manner as other patients.
The dentist cannot provide different or separate services to patients who are HIV-positive or fail to provide services to patients in the most integrated setting. The dentist may not deny equal services to a person who is known to have a relationship or association to a person with HIV, such as a spouse, partner, child, or friend. A dentist cannot limit the scheduled times for treating HIV-positive patients, such as insisting that an HIV-positive patient come in at the end of the day.
According to (Hasegawa 2001, p. 118), “even if a dentist does not have a patient’s actual HIV test result, there is still a legal obligation to protect confidential HIV-related patient information under the HIPPA Rule. ” When it comes to patient abandonment a dentist may dismiss a patient or terminate the dentist-patient relationship for a reasonable cause. There are requirements by the SBDE Rule 108. 5 regarding Patient Abandonment that must be followed.
According to (Humphris, G. 2003, p.701), “the dentist must take steps to protect the dental health of the patient by completing any dental procedures that may be in progress prior to terminating the dentist-patient relationship. The dentist must also remain available for emergency services for at least thirty (30) days after notice of termination is served upon the patient. ” As healthcare professionals, dentists assume openly and take on responsibilities founded on the principle of non-maleficence – first do no harm.
Some of the many characteristics of being an ethical dental professional are presented in the American College of Dentists Core Values. Autonomy: Patients have the right to determine what should be done with their own bodies. Because patients are moral entities they are capable of autonomous decision-making. The dentist must also weigh benefits and harms and inform the patient of contemporary standards of oral health care. Beneficence, often cited as a fundamental principle of ethics, is the obligation to benefit others or to seek their good.
While balancing harms and benefits, the dentist seeks to minimize harms and maximize benefits for the patient. The dentist refrains from harming the patient by referring to those with specialized expertise when the dentist’s own skills are insufficient. Compassion: Compassion requires caring and the ability to identify with the patient’s overall well-being. Relieving pain and suffering is a common attribute of dental practice. Acts of kindness and a sympathetic ear for the patient are all qualities of a caring, compassionate dentist.
Competence: The competent dentist is able to diagnose and treat the patient’s oral health needs and to refer when it is in the patient’s best interest. Maintaining competence requires continual self-assessment about the outcome of patient care and involves a commitment to lifelong learning. Service to the patient is the primary obligation of the dentist as a professional person. Service to patients includes the delivery of quality, competent, and timely care within the bounds of the clinical circumstances presented by the patient.
In serving the public, a dentist may use reasonable choice in accepting patients into the dental practice. However, in keeping with the core value of justice, according to (Hasegawa 2001, p. 118), “it is unethical for a dentist to refuse to accept a patient into the practice, deny dental service to a patient, or otherwise discriminate against a patient because of the patient’s gender, sexual, racial, religious, or ethnic characteristics. ” According to (Humphris, G. 2003, p.701), “fully informed consent is vital to the ethical practice of dentistry and reflects the patient’s right of self-decision.
Except as excused by state law, a dentist has the obligation to obtain the fully informed consent of the patient or the patients legal guardian prior to treatment, or the use of any identifiable artifacts (such as photographs, X-rays, study models, etc. ) for any purpose other than treatment. Informed consent is also required when using a human subject for research. ”
According to (Wakefield, R.DDS 2005, p. 102), “dentists are obligated to safeguard the confidentiality of patient records under the HIPPA. Dentists shall maintain all patient records in a manner consistent to protect the welfare of the patient. Upon request of a patient or another dental practitioner, dentists shall provide any information in accordance with applicable law that will be beneficial for the future treatment of that patient. ” A dentist has the obligation to comply with all state and federal laws and regulations.
According to (Humphris, G. 2003, p. 701), “it is unethical for a dentist to violate any law of the state he is practicing in relating to the practice of dentistry or to engage in activity for which the dentist may be reprimanded, disciplined, or sentenced by final action of any court or other authority of competent jurisdiction, when such action reflects unfavorably on dentists or the dental profession. It is also unethical for a dentist to engage in unprofessional conduct as it is defined by the Dental Practice Act.
”Just like all other healthcare professionals, dentists have responsibilities to their patients, employers, associations and, most importantly, to their own personal integrity. It is so serious that the dentist be prepared to make sound decisions and actions based on ethical concerns for each patient. Few things can strike anxiety in the heart of a person like an upcoming visit to the dentist. However, in the last four decades the field has come a long way and today’s dentist office visit should be painless and with no side effects.
It is important for the dentist to be professional at all times and to provide the best quality healthcare and communication to each patient without discrimination regarding infectious disease, race, religion, gender, and ethical characteristics. A dentist must always ask ethical questions of himself concerning such issues as pricing, treatment, doctor-patient relations and staff assignments for specific tasks, always keeping in mind the principle of professionalism and ethics.
Reference Wakefield, R. DDS (2005), Transferring Records of the Demanding Patient (January 2005), Vol. 122, Is. (1); pgs. 101-103retrieved from www. dentalethics. org/ethicaldilemmas. shtml July 20, 2011 Hasegawa, T. Jr. , DDS (2001), Sensitive (Ethical) Issues for the Dentist (October 2001), Vol. 8 4, Is. 11; pg. 118 retrieved from www. dentalethics. com July 18, 2011 Humphris, G. (2003), Dental ethics at chairside professional principles and practical applications London: Jun 28, 2003. Vol. 194, Is. 12; p. 701 retrieved from