Dental Ethics Overview

Dental Ethics

• Professional Conduct & Duty of Care are influenced by society's expectations and legal frameworks.
• Changing Social Environment includes a more informed and aware patient population with consumer protection rights.
• Continuing Education is crucial for maintaining standards, and clinical audits, peer reviews, and ombudsman reports contribute to professional accountability.
• Ethics Definition:
  • Right vs. Wrong
  • Principles: based on cultural, religious, legal, human rights, and experiences
  • Judgment: ethics assist in decision-making
• Principles of Ethics
  • Nonmaleficence (do no harm): foundation of healthcare ethics
  • Beneficence (do good): healthcare professionals must act with the intention to benefit patients
  • Autonomy: patient self-determination & control over decisions
  • Justice: fair and equitable treatment
• Ethical Dilemmas: arise when ethical principles clash.

Nonmaleficence

• The Hippocratic Oath emphasizes avoiding harm to patients.
• Trust is central to the doctor-patient relationship, built on the promise of non-harm.
• Evolving Definition: extends beyond avoiding harm to include preventing and removing harm, as well as promoting good.

Beneficence

• Healthcare Actions: professionals must act in the best interests of the patient, aiming to improve health and well-being.

Autonomy

• Patient Empowerment: patients have the right to make decisions about their own healthcare.
• Informed Consent: patients need to understand the risks and benefits of a procedure before agreeing to it.

Respect for Autonomy

• Patients' Rights: include honesty, privacy, confidential information protection, informed consent, and support in decision-making.

Justice

• Equality & Fairness: treating individuals with similar needs equally, regardless of background.
• Resource Distribution: challenges in healthcare systems where choices have to be made regarding balanced benefits and burdens.

Informed Consent

• Patient Authorization: patients need to voluntarily agree to any dental procedure after receiving relevant information.
• Understanding & Decision-Making: Two-step process: providing information and allowing the patient to understand it and make an informed choice.

Confidentiality

• Trust & Privacy: critical for sharing personal information.
• Patient Autonomy: disclosing personal information is the patient’s choice.
• Professional Duty: the patient’s confidential information must be protected.

Breach of Confidentiality

• Exceptions: disclosure of information is sometimes necessary for notifiable diseases, abuse, crime prevention, and public safety.
• Patient Consent: essential for sharing patient information with other healthcare professionals.
• Professional Conflict: the duty to protect confidential information may conflict with the duty to prevent harm.

HIV Issues

• Patient Duty to Disclose: patients are not usually mandated to disclose their HIV status.
• Dentist's Duty to Treat: ethical and legal obligation to provide care to all patients, including those with HIV, with appropriate precautions.
• Dentist's Duty to Disclose: dentists are not legally obligated to disclose their HIV status.
• Testing for HIV: recommended only when essential to management of the patient, taking into account the potential harm to the patient.
• Refusal to Treat: While no legal obligation to treat all patients, ethical practice promotes compassion and avoiding refusal based on HIV status.
• Differences in Treatment: patients should not be treated differently based on their HIV status.
• OHCW Status: no professional obligation to disclose HIV status to patients.
• HIV Management: dentists have the responsibility to provide care to HIV-positive patients but not to disclose confidential information.