● The dentist shall inform the patient that the markings are to be used for identification only and that the patient shall have the option to decide whether or not the dentures shall be marked. ● The dentist shall retain the records of those marked dentures and shall not release the records to any person except to enforcement officers, in the event of an emergency requiring personal identification by means of dental records, or to anyone authorized by the patient. The primary purposes of the statute have to do with management of patients in nursing homes and for forensic identification. Section 1700(c) of the Dental Practice Act stipulates that a person may be guilty of a misdemeanor and subject to disciplinary action if he or she “engages in the practice of dentistry without causing to be displayed in a conspicuous place in his or her office the name of each and every person employed there in the practice of dentistry.” Elsewhere the law provides that, while working, a healthcare professional must display his or her name and license status printed on a nametag in type that is at least 18-point or display his or her
license prominently in a practice or office (Dental Board of California, 2023j). Dental healthcare providers who violate the California Dental Practice Act may be subject to fines or imprisonment or both, depending on the nature and seriousness of the violation. Such violations may also result in temporary suspension of licenses, required educational programs, or permanent license revocation (California Dental Practice Act, 2020d) As of July 1, 2020, per Section 1673, in the case of certain violations, the Board requires a licensee to provide patients or patients’ guardians or healthcare surrogates with a separate disclosure that includes the licensee’s probation status, along with details and the Board’s telephone number, and an explanation of how patients can find further information on the licensee’s profile page on the Board’s online license information website. The information must be provided before a patient’s first visit following the probationary order while the licensee is on probation pursuant to a probationary order made on or after July 1, 2020. Section 1673 lists several situations in which this information need not be presented.
JURISPRUDENCE, ETHICS, AND MALPRACTICE
org/Home/Practice/Practice-Support/Resource-Library/ legal-resources-legal-reference-guide-chapter-5-patient- considerations). The dentist is also required to provide a full explanation of treatment. The California Code goes on to state: A dentist has the obligation to fully explain proposed treatment, reasonable alternatives, and the risks of not performing treatment to the patient. The dentist shall explain treatment in a manner that is accurate, easily understood, and allows patients to be involved in decisions affecting their oral health or their participation in a research project. (American Dental Association, 2023a) The ethical principle of autonomy is also relevant in situations in which the dentist’s ability to comprehend the patient’s request is hindered by a language barrier. In these circumstances, the dentist may be inclined to make unilateral decisions regarding the delivery of care, being unable to completely understand the patient’s communication. Autonomy dictates that the patient has the right to determine what treatment he or she wants to receive. Respect for the patient’s autonomy affirms the doctor-patient relationship and forms the foundation for informed consent. The patient’s right to self-determination is not absolute, however, and it must be weighed against contemporary standards of oral health care. (The American Dental Association, 2023b) Peer review committees are a means of resolving a dispute between a dentist and a patient via a medication process and are an attempt to avoid costly and lengthy litigation (Gallagher, 2023). If a satisfactory decision cannot be reached, an appeal is made, and the violation is referred to a higher authority: the Council on Ethics, Bylaws, and Judicial Affairs of the ADA. This procedure was established to ensure that all dentists carry out their professional lives and practices in accordance with the highest standards to which dentistry is held. The internal workings, documentation, and decision of a peer review committee of the California Dental Association are not subject to discovery in civil litigation (Evidence Code 1157.5). This means that if a patient sues a dentist for malpractice after filing a claim with a peer-reviewed
Every state board of dental examiners has developed a set of individualized laws that govern the practice of dental professionals operating within their respective states. These strictly enforced laws are not considered ethics; they are considered dental jurisprudence . Problems with record-keeping and communication are frequently the basis for dental malpractice claims. Professional liability issues most frequently raised in lawsuits against dentists involve prosthodontics, endodontics, restorative dentistry, diagnosis, implant complications, and oral surgery (Advantage Insurance Solutions, 2020). Charges filed against dental healthcare workers can stem from events ranging from mundane acts or omissions to wrongful death. But not all charges result from breaching laws. Sometimes charges are filed as the result of ethically inappropriate actions. Understanding the difference between what is ethical and what is legal is sometimes difficult. Sometimes malpractice claims involve both ethical and legal violations. The ADA Code of Ethics is a document that reflects the unwritten contract between the dental profession and society. The ADA defines ethics as the principles of the moral code under which the dental profession operates. One example of an ethical violation involves a situation in which a patient is not informed of the available treatment options and therefore cannot make an informed decision. The California Dental Association’s “Code of Ethics” specifically states: Fully informed consent is essential to the ethical practice of dentistry and reflects the patient’s right of self- decision. Except as exempted by state law, a dentist has the obligation to obtain the fully informed consent of the patient or the patient’s legal guardian prior to treatment, or the use of any identifiable artifacts (such as photographs, X-rays, study models, etc.) for any purpose other than treatment. Informed consent is also required when using a human subject for research. (American Dental Association, 2023a) If the patient is not fluent in a language that the dentist speaks, however, it is not possible for the dentist to obtain fully informed consent. In their Legal Reference Guide, the California Dental Association offers some ideas on how to handle such a situation (Chapter 5, 121: https://www.cda.
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