UAE Dental Practice Ethics PDF

ADA Codes of ethics UAE code of ethics in dental practice Lecture 12 1.The Principles of Ethics The ADA Code has three main components: 1.The Principles of Ethics, are the aspirational goals of the profession. They provide guidance and offer justification for the...

ADA Codes of ethics UAE code of ethics in dental practice Lecture 12 1.The Principles of Ethics The ADA Code has three main components: 1.The Principles of Ethics, are the aspirational goals of the profession. They provide guidance and offer justification for the Code of Professional Conduct and the Advisory Opinions – There are five fundamental principles that form the foundation of the ADA Code: Patient autonomy, Nonmaleficence, Beneficence, Justice and Veracity. -Principles can overlap each other as well as compete with each other for priority. More than one principle can justify a given element of the Code of Professional Conduct. Principles may at times need to be balanced against each other. The Code of Professional Conduct 2. The Code of Professional Conduct is an expression of specific types of conduct that are either required or prohibited. All elements of the Code of Professional Conduct result from resolutions that are adopted by the ADA’s House of Delegates. The Code of Professional Conduct is binding on members of the ADA, and violations may result in disciplinary action. 3.The Advisory Opinions 3.The Advisory Opinions are interpretations that apply the Code of Professional Conduct to specific fact situations. - They are adopted by the ADA’s Council on Ethics, Bylaws and Judicial Affairs to provide guidance to the membership on how the Council might interpret the Code of Professional Conduct in a disciplinary proceeding. - The ADA Code is the result of an ongoing dialogue between the dental profession and society, and as such, is subject to continuous review. - Although ethics and the law are closely related, they are not the same. 1 –Patient Autonomy The dentist has a duty to respect the patient’s rights to self-determination and confidentiality. - This principle expresses the concept that professionals have a duty to treat the patient according to the patient’s desires, within the bounds of accepted treatment, and to protect the patient’s confidentiality.  1.A. PATIENT INVOLVEMENT. - The dentist should inform the patient of the proposed treatment, and any reasonable alternatives, in a manner that allows the patient to become involved in treatment decisions. 1.B. PATIENT RECORDS. - Dentists are obliged to safeguard the confidentiality of patient records. Dentists shall maintain patient records in a manner consistent with the protection of the welfare of the patient. Advisory opinions SUPPLYING COPIES OF RECORDS. - A dentist has the ethical obligation on request of either the patient or the patient’s new dentist to provide in accordance with applicable law, either free or for minimal cost, dental records or copies or summaries of them, including dental X-rays or copies of them, as will be beneficial for the future treatment of that patient. CONFIDENTIALITY OF PATIENT RECORDS. - The dominant theme is the protection of the confidentiality of a patient’s records. Dentists should obtain the patient’s written permission before forwarding health records which contain information of a sensitive nature, such as HIV seropositivity. Section 2 – Non Maleficence The dentist has a duty to refrain from harming the patient. - This principle expresses the concept that professionals have a duty to protect the patient from harm. - Under this principle, the dentist’s primary obligations include keeping knowledge and skills current, knowing one’s own limitations and when to refer to a specialist or other professional, and knowing when and under what circumstances delegation of patient care to auxiliaries is appropriate. Code of professional conduct EDUCATION. - The privilege of dentists to be given professional status depends primarily in the knowledge, skill and experience with which they serve their patients and society. All dentists, therefore, have the obligation of keeping their knowledge and skill current. CONSULTATION AND REFERRAL. - Dentists shall be obliged to seek consultation, if possible, whenever the welfare of patients will be safeguarded or advanced by utilizing those who have special skills, knowledge, and experience. When patients visit or are referred to specialists or consulting dentists for consultation: 1. The specialists or consulting dentists upon completion of their care shall return the patient, unless the patient reveals a different preference. 2. The specialists shall be obliged when there is no referring dentist and upon a completion of their treatment to inform patients when there is a need for further dental care Advisory opinions SECOND OPINIONS. - A dentist who has a patient referred for a “second opinion” regarding a diagnosis or treatment plan recommended by the patient’s treating dentist should render the requested second opinion. USE OF AUXILIARY PERSONNEL. - Dentists shall be obliged to protect the health of their patients by only assigning to qualified auxiliaries those duties which can be legally delegated. Dentists shall be further obliged to prescribe and supervise the patient care provided by all auxiliary personnel working under their direction. PERSONAL IMPAIRMENT. - It is unethical for a dentist to practice while abusing controlled substances, alcohol or other chemical agents which impair the ability to practice. All dentists have an ethical obligation to urge chemically impaired colleagues to seek treatment. Advisory opinions ABILITY TO PRACTICE. - A dentist who have any disease or becomes impaired in any way that might endanger patients or dental staff shall, with consultation and advice from a qualified physician, limit the activities of practice to those areas that do not endanger patients or dental staff. POSTEXPOSURE, BLOODBORNE PATHOGENS. The dentist’s ethical obligation in the event of an exposure incident extends to providing information concerning the dentist’s own blood- borne pathogen status to the evaluating health care practitioner, if the dentist is the source individual, and to submit to testing that will assist in the evaluation of the patient Advisory opinions PATIENT ABANDONMENT. - Once a dentist has undertaken a course of treatment, the dentist should not discontinue that treatment without giving the patient adequate notice and the opportunity to obtain the services of another dentist. Care should be taken that the patient’s oral health is not jeopardized in the process. PERSONAL RELATIONSHIPS WITH PATIENTS. - Dentists should avoid interpersonal relationships that could impair their professional judgment or risk the possibility of misusing the confidence placed in them by a patient. Section 3 – Beneficence The dentist has a duty to promote the patient’s welfare. - This principle expresses the concept that professionals have a duty to act for the benefit of others. - Under this principle, the dentist’s primary obligation is service to the patient and the public at-large. - The most important aspect of this obligation is the competent and timely delivery of dental care within the bounds of clinical circumstances presented by the patient, with due consideration being given to the needs, desires and values of the patient. Code of professional conduct COMMUNITY SERVICE. - Since dentists have an obligation to use their skills, knowledge and experience for the improvement of the dental health of the public and are encouraged to be leaders in their community, dentists in such service shall conduct themselves in such a manner as to maintain or elevate the esteem of the profession. GOVERNMENT OF A PROFESSION. - Every profession owes society the responsibility to regulate itself. Such regulation is achieved largely through the influence of the professional societies. All dentists, therefore, have the dual obligation of Code of professional conduct RESEARCH AND DEVELOPMENT. - Dentists have the obligation of making the results and benefits of their investigative efforts available to all when they are useful in safeguarding or promoting the health of the public. PATENTS AND COPYRIGHTS. - Patents and copyrights may be secured by dentists provided that such patents and copyrights shall not be used to restrict research or practice. ABUSE AND NEGLECT. - Dentists shall be obliged to become familiar with the signs of abuse and neglect and to report suspected cases to the proper authorities, consistent with country laws. PROFESSIONAL DEMEANOR IN THE WORKPLACE. - Dentists have the obligation to provide a workplace environment that supports respectful and collaborative relationships for all those involved in oral health care. Advisory opinions REPORTING ABUSE AND NEGLECT. - The public and the profession are best served by dentists who are familiar with identifying the signs of abuse and neglect and knowledgeable about the appropriate intervention resources for all populations. Dentists, therefore, are ethically obliged to identify and report suspected cases of abuse and neglect to the same extent as they are legally obliged to do so in the jurisdiction where they practice. Advisory opinions DISRUPTIVE BEHAVIOR IN THE WORKPLACE. – Dentists are the leaders of the oral healthcare team. As such, their behavior in the workplace is instrumental in establishing and maintaining a practice environment that supports the mutual respect, good communication, and high levels of collaboration among team members required to optimize the quality of patient care provided. 4. Principle of Justice The dentist has a duty to treat people fairly. - This principle expresses the concept that professionals have a duty to be fair in their dealings with patients, colleagues and society. - Under this principle, the dentist’s primary obligations include dealing with people justly and delivering dental care without prejudice. Codes of professional conduct PATIENT SELECTION. - Dentists shall not refuse to accept patients into their practice or deny dental service to patients because of the patient’s race, faith, color, gender, or national origin. EMERGENCY SERVICE. - Dentists shall be obliged to make reasonable arrangements for the emergency care of their patients of record.  EXPERT TESTIMONY. - Dentists may provide expert testimony when that testimony is essential to a just and fair disposition of a judicial or administrative action. Advisory opinions PATIENTS WITH BLOODBORNE PATHOGENS. - A dentist has the general obligation to provide care to those in need. A decision not to provide treatment to an individual because the individual is infected with Human Immunodeficiency Virus, Hepatitis B Virus, Hepatitis C Virus or another blood-borne pathogen, based solely on that fact, is unethical. - Decisions regarding the type of dental treatment provided or referrals made or suggested should be made on the same basis as they are made with other patients. - As is the case with all patients, the individual dentist should determine if he or she has the need of another’s skills, knowledge, equipment or experience. The dentist should also determine, after consultation with the patient’s physician, if appropriate, if the patient’s health status would be significantly compromised by the provision of dental treatment  Thus, a dentist who pays for advertising or marketing services by sharing a specified portion of the professional fees collected from prospective or actual patients with the vendor providing the advertising or marketing services is engaged in fee splitting. 5.VERACITY The dentist has a duty to communicate truthfully. - This principle expresses the concept that professionals have a duty to be honest and trustworthy in their dealings with people. Under this principle, the dentist’s primary obligations include respecting the position of trust inherent in the dentist-patient relationship, communicating truthfully and without deception, and maintaining intellectual integrity. CODES OF PROFESSIONAL CONDUCT REPRESENTATION OF CARE. - Dentists shall not represent the care being rendered to their patients in a false or misleading manner. REPRESENTATION OF FEES. - Dentists shall not represent the fees being charged for providing care in a false or misleading manner. DISCLOSURE OF CONFLICT OF INTEREST. - A dentist who presents educational or scientific information in an article, seminar or other program shall disclose to the readers or participants any financial or other special interest the dentist may have with a company whose products are promoted or endorsed in the presentation. DEVICES AND THERAPEUTIC METHODS. - Except for formal investigative studies, dentists shall be obliged to prescribe, dispense, or promote only those devices, drugs and other agents whose complete formulae are available to the dental profession.  PROFESSIONAL ANNOUNCEMENT. - In order to properly serve the public, dentists should represent themselves in a manner that contributes to the esteem of the profession. Dentists should not misrepresent their training and competence in any way that would be false or misleading in any material respect. ADVERTISING. - Although any dentist may advertise, no dentist shall advertise to patients in any form of communication in a manner that is false or misleading in any material respect. NAME OF PRACTICE. - Since the name under which a dentist conducts his or her practice may be a factor in the selection process of the patient, the use of a trade name or an assumed name that is false or misleading in any material respect is unethical.  ANNOUNCEMENT OF SPECIALIZATION AND LIMITATION OF PRACTICE. - A dentist may ethically announce as a specialist to the public in any of the dental specialties recognized by the American Dental Association/MOH, provided the dentist meets the educational requirements required for recognition. Dentists who choose to announce specialization should use “specialist in” and shall devote a sufficient portion of their practice to the announced specialty to maintain expertise in that specialty. GENERAL PRACTITIONER ANNOUNCEMENT OF SERVICES. - General dentists are permitted to announce the availability of services so long as they avoid any communications that express or imply specialization. General dentists shall also state that the services are being provided by general dentists. ADVISORY OPINIONS UNEARNED, NONHEALTH DEGREES. - A dentist may use the title Doctor or Dentist, D.D.S., D.M.D. or any additional earned in an announcement to the public. The announcement of an unearned academic degree may be misleading because of the likelihood that it will indicate to the public the attainment of specialty. Generally, unearned or non-health degrees and fellowships that designate association, rather than attainment, should be limited to scientific papers and curriculum vitae. UAE code of ethics in dental practice Dr. Asok Mathew Communicable diseases and clinical practice If you suspect to or have any communicable disease that could be passed on to patients, or if your judgment or performance could be affected by a condition or its treatment, you must consult a suitably qualified professional. You must follow their advice about any changes to your practice or treatment they consider necessary. You must not rely on your own assessment of the risk to patients. You must inform the HR if you have any concerns regarding the health, conduct or competence of other licensed professionals you work with that may negatively impact the safety and welfare of patients and/or the public. Please refer to the fitness to practice policy issued by REGULATOR for more information You must deal impartially and safely with risks of infection to your patient and to yourself. You must make sure that all staff and trainees, if any, you manage have appropriate supervision to carry out the activities safely RESEARCH When participating in clinical research, you must put the care and safety of your patient first and ensure that the trial is approved by DHA /MOH / DOH research ethical committee. In addition, informed consent must be obtained from participants. Patient’s privacy and confidentiality of information Keep your patient’s records confidential, and use the information obtained in the course of your professional practice only for the purposes for which it was given, or where it is otherwise lawful. Ensure that there is no disclosure of any patient information without consent, except where it is required or permitted by law or if it is required to protect your patient or others from harm. Not in any way exploit or abuse the relationship with your patient and the trust your patient has placed in you. Take reasonable steps to make sure that there is no unauthorized access, use or accidental disclosure of your patient’s information. Respect your patient’s refusal for therapy, whether in part or in whole. During consultation of patients During patient consultation you should: Adequately assess the patient’s conditions, taking account of their history (including the symptoms and psychological, spiritual, social and cultural factors), their views and values; and examine the patient. Promptly provide or arrange suitable advice, investigations or treatment. Prescribe drugs or treatment, including repeat prescriptions, only when you have adequate knowledge of the patient’s health and are satisfied that the drugs or treatment will help with the patient’s ailment. Provide effective treatments based on the best available evidence. Be satisfied that they have informed consent before carrying out any examination or investigation, provide treatment or involve patients or volunteers in teaching or research.  Take all possible steps to alleviate pain and distress whether or not a cure may be possible. Consult colleagues where appropriate. Inform patients about their right to see another doctor and ensure that they have enough information to exercise that right. 3.3.2.9 Conduct clinical examination of patients from opposite gender in the presence of a chaperone. Check that the care or treatment provided for each patient is compatible with any other treatments the patient is receiving, including (where possible) self-prescribed over-the-counter medications. Respect your patient’s choice and obtain informed consent You must ensure that your patient understands the need for treatment or services to be provided, the risks involved and expected outcomes from the treatment provided prior to proceeding, except in an emergency situation. If your patient is unable to give consent, informed consent should be obtained from family members as appropriate in accordance with UAE law Code If your patient or family refuses treatment or therapy that you believe is necessary for their well-being or else would put them at significant risk or harm, you must take reasonable efforts to persuade them to be treated. You must respect your patient’s wish for a second opinion, and/or decision to consult with other health professionals. You must make reasonable records of the information provided to your patient, your patient’s consent or decision on treatment provided. Communicate … communicate Take reasonable steps to ensure effective communication with your patient, their family, fellow professional colleagues, and other healthcare professionals, to enhance outcomes for your patient. Be truthful, respectful and courteous in all your professional communications, with your patient, his caregivers, or other professionals. Listen to patients, take account of their views, and respond honestly to their questions. Ensure that patients are involved, within the limits of their capacities, in understanding the nature of their problems, the range of possible solutions, as well as the likely benefits, risks, and costs, and should assist them in making informed choices. Ensure that your communication with your patient and/or his family is done in a manner that does not impair confidence in other professionals involved in his care. You must not disrespect any professional or criticize their opinion in any situation. Strive to communicate clearly and effectively with your fellow professional colleagues, and other professionals Truthful Advertising You must ensure that any advertising you publish or support, or any information provided about you or your services is truthful, factual and accurate. You must not persuade your patient to acquire more services than are required. You must not mislead the public and your patients with regard to your professional qualification, experience and expertise. Your advice and recommendations on products or services to your patient must not be influenced by financial or other forms of rewards. If you have a financial interest in an organization or service to which you intend to refer patients for any treatment or investigation, you must always disclose this interest to your patient before making a referral. Skills development , competencies You must only practice within the scope of your own competence, or the fields in which you have the appropriate education, training and experience and hold a valid license from REGULATOR. You must consult or refer as appropriate, for further advice or treatment, if you discover in the course of treating your patient that your patient requires interventions that are beyond your own scope of practice or experience. If you are returning to practice after a gap in service, you may be required to practice under supervision or according to the Approved Practice Setting and Back to Practice regulation set by the Human Resources. Ethics in Research If you are conducting or participating in a research, you should abide with the following: Strive to attain the highest possible standards in all aspects of conservation. All actions should be governed by an informed respect for cultural property. Research aims should contribute to the good of society. Research must be based on sound theory. Research participants must voluntarily consent to research participation. Research must avoid unnecessary physical and mental suffering. The degree of risk taken with research participants cannot exceed anticipated benefits of results. Proper environment and protection for participants is necessary. Ethics in Research Experiments can be conducted only by scientifically qualified persons. Human subjects must be allowed to discontinue their participation at any time. Must be prepared to terminate the experiment if there is cause to believe that continuation will be harmful or result in injury or death. The results of research should be presented to the academic community and wider public in a responsible manner The results of research should be used and communicated through appropriate and timely activities. Should keep in confidence all information obtained about research participants References Ministerial Resolution No. (1448) of 2017 (mohap.gov.ae ) Code of Ethics and Professional Conduct - final.latest.pdf (dha.gov.ae)  Thank you.