Dental Ethics Lecture 1 & 2 PDF

G Mail : [email protected] Dr: Nievin Ahmad Mahran Assistant professor of Biochemistry sinaiuniversity.ne Faculty of dentistry t 2025-2020 ‫رؤيه ورساله كليه طب االسنان –جامعه سيناء –فرع القنطره‬ ‫ رؤية الكلية‬  ‫أن نكون...

G Mail : [email protected] Dr: Nievin Ahmad Mahran Assistant professor of Biochemistry sinaiuniversity.ne Faculty of dentistry t 2025-2020 ‫رؤيه ورساله كليه طب االسنان –جامعه سيناء –فرع القنطره‬ ‫ رؤية الكلية‬  ‫أن نكون كلية معتمدة أكاديميا ورائدة في‬ ‫مجال طب األسنان علميا وبحثيا ومجتمعيا‬ ‫على المستوى المحلى واالقليمى‬ Vision   To be an academically accredited faculty and pioneer in the field of dentistry, scientifically as well as research, and community wise at the national and regional levels. 2  ‫رسالة الكلية‬ ‫ء أسنان وفقا للمعايير‬ ‫معة سيناء بتخريج أطبا‬ ‫فسة في سوق العمل‬ ‫كلية طب األسنان – جا‬ ‫جعية قادرين على المنا‬ ‫تلتزم‬ ‫ي إطار القيم األخالقية‬ ‫ألكاديمية القومية المر‬ ‫بحوث علمية مبتكرة ف‬ ‫ا‬ ‫دمات مجتمعية متميزة‬ ‫حلى واالقليمى واجراء‬ ‫والمهنية وتقديم خ‬. ‫الم‬ The faculty of den Mission tistry – Sinai Univ graduating dentis ersity is committe ts in accordance w d to academic referen ith the national ce standards who national and regio can compete in t nal local market, he scientific research perform innovativ within the frame o e professional value f the ethical and s, and provide exc ellent communal services. 3 Dental Ethics” Professional Ethics Lecture -1&2 01/22/2025 4  What is Ethics? Ethics is the study and analysis of human decision-making. Ethics are “Morals” that provide standards to determine whether actions are right or wrong No absolute right and wrong No laws No punishment  What is Ethics? Voluntary controls within a profession Methods of self-polishing/ self improvement You raise your own bar Medical Practice? Research?? – Medical Practice Subject welfare – Research Advancement of science Subject welfare Header 01/22/2025 7  What are we going to discuss today? The core values of Case dentistry Studies Decision Making  What is Dental Ethics? Every day dentists are faced with situations that call for ethical judgment Ethics helps dentists deal with these questions Header 01/22/2025 9  Being a dentist is SPECIAL “ People come to you for relief from pain and restoration of oral health They allow you to see, touch and treat their bodies They disclose information about themselves that they would not want others to know They do this because they trust their dentists to act in their best interests.  What are the core values of dentistry? Compassion Competence Autonomy Header 01/22/2025 11 1- Compassion Understanding and concern for another person’s distress Patients respond better to treatment if they feel that the dentist appreciates their concerns 2- Competence A very high degree of competence is both expected and required of dentists Dentists undergo long training to ensure competence But, the rapid advance of dental knowledge, makes it is a constant challenge for them to maintain their competence. 3- Autonomy (self-determination) Recently, patient autonomy is gaining widespread acceptance. The patients have the right to determine what happens to their own bodies “Dentists must get consent before starting treatment or clinical examination for a patient”.  DECISION MAKING 1- Non-rational approaches 2- ▪ Rational approaches  Decision making Non- rational approaches  1- Obedience  A common way of making ethical decisions Especially by children and some strict organizations  Morality is following the instructions of those in authority, whether or not you agree with Header 01/22/2025 16 Decision making Non- rational approaches  2- Imitation  Like obedience, you substitute your judgment about right and wrong to that of another person, a role model Morality is following the example of the role model One of the common ways of learning dental ethics by observing and imitating senior dentists. Header 01/22/2025 17 Decision making Non-rational approaches  3- Feeling or Desire  is a subjective approach to moral decision-making  What is right is what feels right What is wrong is what feels wrong  Feelings can vary greatly from one individual to another, and even within the same individual over time. Header 01/22/2025 18 Decision making Non-rational approaches  4- Intuition  Is an immediate perception of the right way to act in a situation.  The decision comes from the mind not the heart However, it is not systematic but the moral decision comes through a flash of insight.  Like feeling and desire, it varies greatly from one individual to another, and even within the same individual over time. Header 01/22/2025 19 Decision making Non-rational approaches  5- Habit  There is no need to repeat a systematic decision-making process each time the same moral issue arises.  Bad habits? good habits?  Situations that appear similar may require different decisions.  Habit is useful but one cannot place all his confidence in it Header 01/22/2025 20 Decision making Rational approaches  Ethics recognizes the usefulness of non- rational approaches to  decision-making  However, it is primarily concerned with rational approaches. Header 01/22/2025 21 Decision making Rational approaches 1- Deontology  Search for the foundation rules of making moral decisions.  e.g. “Treat all people as equals.” However, there is disagreement about how to apply the rules  e.g. does the equality of all human beings entitles them to basic oral health care? Header 01/22/2025 22 Decision making Rational approaches  2- Consequentialism  Bases ethical decision-making on an analysis of the likely consequences of different actions. “  The right action is the one that produces the best outcomes”  Do evil that good may come from  What counts as a good outcome in healthcare decision making; cost-effectiveness? or quality of life?  Supporters of consequentialism generally do not have much use for principles; ‘the end justifies the means’ Header 01/22/2025 23 Decision making Rational approaches  3- Principlism  Use ethical principles as the basis for making moral decisions.  Take into account both rules and consequences Recently, principlism is the most influential ethical approach  The four important principles for ethical decision making in health care are;  1-respect for autonomy,  2-beneficence,  3-non-beneficence  4- justice Header 01/22/2025 24 Decision making Rational approaches  4- Virtue  A virtue is a type of moral excellence  Ethics focuses less on decision making and more on the character of decision makers  Virtues that are especially important for dentists are compassion, honesty and dedication.  Dentists who possess these virtues are more likely to make good decisions However, even virtuous individuals often are unsure how to act in particular situations Header 01/22/2025 25 Decision making Rational approaches  None of the rational/non-rational approaches has been able to win universal assent Because each approach has both strengths and weaknesses.  However, principlism takes into account both rules and consequences, it may be the most helpful for making clinical ethical decisions at the chairside.  Virtue ethics is especially important for ensuring that the behavior of the decision maker is admirable. Header 01/22/2025 26  Decision Making NON-RATIONAL RATIONAL APPROACHES APPROACHES 1. Obedience 1. Deontology 2. Imitation 2. Consequentialism 3. Feeling or Desire 3. Principlism 4. Intuition 4. Virtue 5. Habit Header 01/22/2025 27 What do I do when faced with a problem ???  ACD  Assess  Communicate  Decide Header 01/22/2025 28 What do I do when faced with a problem ??? ACD  ASSESS  Is it fair?  Is it quality?  Is it legal?  Does it follow the Principles?  What are the likely Consequences?  What are the alternative solutions? Header 01/22/2025 29 What do I do when faced with a problem ??? ACD  COMMUNICATE  Have you listened?  Have you consulted dental association codes of ethics?  Have you consulted respected colleagues? Have you informed and discuss your proposed solution with the people your decision will affect ?  Have you explained outcomes?  Have you presented alternatives? Header 01/22/2025 30 What do I do when faced with a problem ??? ACD  DECIDE  Is now the best time?  Is it within your ability?  Is it in the best interests of the patient?  Is it what you would want for yourself? Make your decision Header 01/22/2025 31 What do I do when faced with a problem ??? ACD  ASSESS  Evaluate your decision  and be prepared to act differently in the future Header 01/22/2025 32 CASE STUDY  Lalia Hassan(L.D) is a healthy 45 years old patient She comes to your office for regular dental care She had bad experiences from dentists as a child Lalia complains from pain in the upper right quadrant You performed careful assessment using radiographs,  trans - illumination, percussion and probing. Header 01/22/2025 33 CASE STUDY  She had a small filling in the UR 7, you removed it, checked for cracks and refilled it. In your summer holiday, lalia went to another dentist He told her that she has to extract the UR6 and 7 because they have cracks. lalia refuses treatment by the other dentist, returns back to you and insists that you extract her 2 molars Header 01/22/2025 34 What would you do?????  1. Extract the 2 molars  2. Do RCT for the 2 molars  3. Prepare the 2 molars for crowns  4. Refer Lalia for a neurologist  5. Insist that she needs no treatment Header 01/22/2025 35 Deontology principles involved:  - The needs of the patients are the  over- riding concern  – Do no harm  – Respect patient's autonomy Header 01/22/2025 36 Consequentialism  – Do nothing  : patient remains in pain + extract somewhere else  – If you extract her 2 teeth,  you are harming her Header 01/22/2025 37  Principlism  – Attempt to relief pain  without harming the patient  – Diagnose; CBCT/ TMD/ Sinus Header 01/22/2025 38  LIEF IS ABOUT LEARNING ; WHEN YOU STOP LEARNING, YOU DIE (TOM CLANCY) Header 01/22/2025 39 Header 01/22/2025 40