Introduction to Dental Ethics

Introduction to Dental Ethics

• Nievin Ahmad Mahran is an Assistant Professor of Biochemistry at Sinai University.
• The university's vision is to be an academically accredited faculty in dentistry, a pioneer in research and community-based work at a national and regional level.
• The mission is centered around the graduation of dentists who meet and exceed national academic standards and can compete in the local and regional market.
• These dentists are expected to perform innovative research, maintaining ethical and professional values, and offering exceptional community services.

What is Ethics?

• Ethics is the systematic study of human decision-making, specifically addressing what constitutes right or wrong actions.
• Morals provide standards to differentiate right from wrong actions.
• There are no absolute standards of right/wrong, laws, or punishments associated with ethical decisions.

Key Aspects of Dental Ethics

• Dental ethics is a critical component of professional practice.
• Dental practice requires significant competence and training for dentists. This competency isn't static; constant learning and development are crucial.
• Patients entrust dentists with their bodies and sensitive information, highlighting the ethical imperative of compassion, competence, and respect for autonomy.
• The core values of dentistry include compassion (understanding their concerns), competence (high degree of skill), and autonomy (patient's right to determine their treatment).

Decision-Making Approaches

• Non-Rational Approaches:
  • Obedience: Making ethical decisions based on following instructions from authority figures.
  • Imitation: Basing decisions on the actions of role models.
  • Feeling or Desire: Subjective decision-making based on personal feelings and desires.
  • Intuition: Acting based on immediate perceptions of the right course of action.
  • Habit: Repetitive decision-making based on previous experience, possibly ignoring best practices.
• Rational Approaches:
  • Deontology: Focuses on the rules and principles governing ethical decision-making, such as treating everyone equally.
  • Consequentialism: Evaluates potential outcomes to determine the best course of action.
  • Principlism: Combines deontological and consequentialist elements, using ethical principles in decision-making, while considering consequences.
  • Virtue Ethics: Emphasizes the character and virtues (like compassion and honesty) of the decision-maker.

Problem Solving Framework (ACD)

• Assess: Evaluate the situation considering fairness, quality, legality, principles, likely outcomes, and alternatives.
• Communicate: Engage in open discussion with all stakeholders and consider professional guidelines and consultation.
• Decide: Determine the best course of action, considering the timing, ability to execute it, aligning patient interests, and mirroring what would be desired for oneself.
• Assess (again): Reflect on the decision and readiness to approach similar situations in the future with potentially alternate actions.

Case Study: Lalia Hassan

• Lalia is a patient with a history of negative experiences with dentists.
• She presents with pain in her upper right quadrant.
• A thorough examination, including radiographs, trans-illumination, percussion, and probing, is conducted.
• A previous dentist recommended extracting teeth 6 and 7 due to cracks, which Lalia refused.
• Lalia insists on having two molars extracted.
• Possible solutions include: Extracting the molars, performing root canals on the molars, preparing them for crowns, or referring the patient to a neurologist.

Ethical Principles in the Case Study

• Deontological: Prioritizing the patient's autonomy is key; do no harm.
• Consequentialist: Evaluating potential outcomes and harms of each action is necessary.
• Principlism: Combining the principles of patient autonomy and well-being with best possible outcomes. Avoid harming the patient.