Chapter 3 & 4: Dental Standard of Care & Duty to Treat PDF

CHAPTER 3: THE STANDARD OF CARE  WHO DETERMINES HOW A DENTIST SHOULD BEHAVE? The Bolam case What if a patient wants treatment that is against the standard of care? Change of the standard over time  A local or a global standard of care? Standards of care...

CHAPTER 3: THE STANDARD OF CARE  WHO DETERMINES HOW A DENTIST SHOULD BEHAVE? The Bolam case What if a patient wants treatment that is against the standard of care? Change of the standard over time  A local or a global standard of care? Standards of care and evidence- based dentistry Transparency of care, guidelines, and protocols  Shared decision-making, evidence-informed decision-making, and evidence-guided decision- making  Individualization and the standard of care based on a long-term goal for dental treatment In the field of dentistry it is not nearly as evident that most people subscribe to optimal oral health and are willing to submit to burdensome and costly treatments. If they choose to spend their money on alternative objectives, such as a family vacation or a new car, or if they lack dental insurance and simply cannot afford treatment, they will perhaps lose their teeth, but they will not die, and they can have a fairly normal life.  CHAPTER 4: THE DUTY TO TREAT  Dentists do not have a duty to treat, but a duty to offer treatment. Actual treatment is only possible after the consent of the patient The duty to treat may depend on several factors: The condition of the patient who asks for help The type of treatment that is requested The relationship between the dentist and the patient prior to the request for help PATIENTS OF THE PRACTICE OR REGULAR PATIENTS THE LOCAL RULES  Does the duty to treat depend on a prior relationship between dentist and patient? The relationship between a dentist and a patient may vary from country to country. In some countries, dentists and patients do not have a relationship at all. When they feel the need to seek treatment, patients go to whatever dentist they want. In other countries, dentists and patients have a relationship that can last for years. This relationship is based on the agreement that the patient will seek treatment from the dentist, and the dentist will deliver treatment on time and according to the standard of care  Dentist–patient relationship is beneficial for both the dentist and the patient. Dentists can assess their workload and their income patients are assured of help from a dentist or a dental practice they have chosen. all relevant information is kept in one record  The duty to treat: Patients of record versus prior unknown patients Dentists’ primary obligations are towards their own patients of record. Undermine the relationship of trust between the patient and dentist. Time and resources. Often the treatment of patients who are not patients of record is limited to treatment that stops pain, bleeding, or swelling, or the results of an accident. Requested treatment and the duty to treat  Duty to treat and the characteristics of the patient who seeks help Patients who cannot or do not want to pay Noncompliant patients Patients who pose a health risk to the dentist Aggressive patients Patients who cannot come to the dental office  Is a dentist obliged to accept a patient as a patient of record? When refusal would be discrimination, based on race, sex, or religion When a dentist had treated a patient in a way this patient was inclined to think he was a patient of record When accepting the patient is a duty based on a contract between, for instance, the dentist and the insurer of the patient.  Terminating the relationship with a patient of record Some reasons for termination could be: Aggressive behavior Refusal to pay Refusal to cooperate with the treatment The dentist plans to limit his practice