Introduction to Dental Ethics

Study Notes

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.

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.

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).

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.

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.

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.

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.

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