_________________________________________________________________ Dental Ethics: A Brief Review
VERACITY Veracity involves truthfulness and keeping promises. Dental professionals are obligated to be truthful with patients and/or their families and to avoid withholding information or repre- senting care in a false or misleading manner. Dentists should avoid making representations or suggestions to their patients for treatment that is not based on scientifically accepted prin- ciples or research. It is unethical for a dentist to recommend unnecessary dental procedures to their patients. Advertising One case regarding advertising disclaimers almost went as far as the U.S. Supreme Court. In the case Borgner v Brooks , a dentist obtained certification as an implant dentistry specialist from the American Academy of Implant Dentistry (AAID) [9]. However, neither the ADA nor state of Florida recognized this specialty. The dentist then sued both for the right to recognize his specialty (as a protected First Amendment right) and won. The Florida Board of Dentistry appealed, and a three-judge panel in the 11th U.S. Circuit Court of Appeals ruled in favor of the state [9]. The Supreme Court subsequently declined to hear the case, although Justices Thomas and Ginsburg believed that the case presented an opportunity to clarify recurring issues in the First Amendment treatment of com- mercial speech [9]. Many states prohibit paid advertising in which a dentist claims that his or her services or practice is better or exceeds the standards of another dental professional. However, advertising regarding having been voted the top dentist may be allowed. HIV/AIDS Status The ADA is against dentists seeking to attract patients by adver- tising their HIV/AIDS-free status. This position is based on the idea that such a statement would be misleading, as it only pertains to the dentist’s status at the time of the test. However, a dentist could satisfy his or her obligation under this advisory opinion to convey additional information by clearly stating in the advertisement or other communication: “This negative HIV test cannot guarantee that I am currently free of HIV” [1]. Billing The ADA, in their Advisory Opinions, speaks specifically to issues of fees and overbilling and calls upon dentists to follow high ethical standards with the benefit of the patient as the primary goal. Increasing fees because the patient has dental health plan coverage or nondisclosure of co-payment waiver to a third-party payer is unethical [1]. A dentist should carefully evaluate recommendations to patients that are influenced by the patient’s participation in a capitation health plan. The minimal yet clinically acceptable therapy may not be sufficient or acceptable to the patient and presents a burden on the care- giver, as patients may not understand the limitations of their coverage until a procedure is necessary. It may be the dentist or his or her staff that must intercede with the insurer as an advocate for the patient’s general health and quality of life [3].
Of these, the interactive model represents the ideal dentist- patient relationship [3]. In this model, the dentist and patient each have standing and deserve each other’s respect, and each has a set of values by which to live. In addition, each comes to the decision-making process about the patient’s oral health with the understanding that information must be shared. This can only be achieved through communication and mutual cooperation. They summarize [3]: In the Interactive Model, the patient and dentist are equally respected contributors to the decisions to be made, though their contributions are different and, in important ways, asymmetrical. Their respective contributions cannot, furthermore, be put together without careful communication on both sides and effective dialogue between them. Federal privacy standards to protect patients’ medical records and other health information provided to health plans, doc- tors, hospitals and other healthcare providers took effect on April 14, 2003. Congress called on the U.S. Department of Health and Human Services (HHS) to issue patient privacy protections as part of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. HIPAA includes pro- visions designed to encourage electronic transactions and requires new safeguards to protect the security and confiden- tiality of health information [4]. These standards provide patients with access to their medical records and more control over how their personal health infor- mation is used and disclosed. They represent consistent federal privacy protections for consumers across the country [4]. The HHS has issued extensive guidance and technical materials to explain the privacy rule, including an extensive, searchable collection of frequently asked questions that address major aspects of the rule. HHS will continue to expand and update these materials to further assist covered entities in complying. These materials are available at https://www.hhs.gov/hipaa. The efficiencies of electronic recordkeeping are obvious. There is, however, a downside that accompanies these efficiencies, including inappropriate and unknown-to-the-patient data transfer resulting from numerous linked locations, such as third-party financial entities and employers. As paper-based recordkeeping has transitioned to electronic, the risk of unin- tentional privacy violations related to new-user lack of expertise has increased. Precautions should also be in place to prevent intentional misuse of patient data. This presents an additional burden for dentists and other healthcare providers from both internal staff (on-site) and external service providers (off-site), not to mention deliberate electronic intruders.
7
EliteLearning.com/Dental
Powered by FlippingBook