_________________________________________________________________ Dental Ethics: A Brief Review
David T. Ozar, David J. Sokol, and Donald E. Patthoff, in Dental Ethics at Chairside: Professional Obligations and Practical Applications , suggest that while there is encouragement for ethi- cal dental practice, there is little support available to dental professionals who are trying to practice ethically in a complex situation [3]. Ozar, Sokol, and Patthoff present representa- tive ethical decisions dentists regularly face with the goal of increasing the dental professional’s attention to and reflec- tion on these problems. Whether it is a dentist finding the work of another dentist inferior, warning a patient about the dangers of smoking when the patient is unwilling to change, or manipulating data on an insurance form to secure better treatment for the patient, the dentist is faced with a myriad of ethical decisions [3]. ETHICS AND LAW A discussion of professional ethics and law requires background knowledge of ethics and the definition of ethical principles. Ethics is a branch of philosophy that considers and examines the moral life. The word ethics comes from the Greek ethos and originally meant character or conduct; the word morals comes from the Latin mores , which means customs, values, or habits. These two terms are frequently used interchangeably; however, simply put, ethics are the standards of conduct an individual uses to make decisions and morality involves the judgment or evaluation of an ethical system, decision, or action based on social, cultural, or religious norms [14; 15]. They both incor- porate notions of approval or disapproval and in some cases are also applied to the character or virtues of the individual. Although law and ethics have similarities, law may be better defined as the total of rules and regulations by which a society is governed. Ethics, on the other hand, are informal or formal rules of behavior that guide individuals or groups of people. Legal rights are grounded in the law, and ethical rights are grounded in ethical principles and values. Where the law might say, for example, that it is illegal to commit suicide/ murder under any circumstance, even when a terminally ill patient has no quality of life and intractable pain, ethics may guide a physician to administer a lethal dose of morphine. Ethics often shapes law; as of 2023, 10 states (e.g., Oregon, California, New Jersey) and the District of Columbia have adopted “death with dignity” acts, whereby an individual with a medically confirmed terminal disease may request medication to end their life [21].
INTRODUCTION Every profession that deals with human rights and liberties develops a professional code of ethics to guide the responsible behavior of its members. In addition, most regulatory boards that oversee the practice of healthcare professionals require their members to be cognizant of the specific rules of con- duct relating to their profession. In dentistry, the American Dental Association (ADA) has developed the ADA Principles of Ethics and Code of Professional Conduct to express the “obligations arising from the implied contract between the dental profession and society” [1]. Additionally, the American Dental Hygienists’ Association (ADHA) has developed its own code of ethics [8]. With cases of dental insurance fraud and malpractice cases receiving national attention, it is imperative that dental profes- sionals understand the role that ethics play in the legitimacy of the profession.
RESPONSIBILITIES AND COMPETENCE
According to the ADA, dentistry is defined as [2]: The evaluation, diagnosis, prevention, and/or treat- ment (nonsurgical, surgical, or related procedures) of diseases, disorders, and/or conditions of the oral cavity, maxillofacial area, and/or the adjacent and associated structures and their impact on the human body; provided by a dentist, within the scope of his/her education, training and experi- ence, in accordance with the ethics of the profes- sion and applicable law. The dentist is responsible for all services provided to the “patient of record,” which is a patient upon whom a dentist has taken a complete medical history, completed a clinical examination, recorded any pathologic conditions, and pre- pared a treatment plan. Depending on state regulations, dental hygienists may be del- egated the task of removing calculus deposits, accretions, and stains from exposed surfaces of the teeth and from the gingival sulcus. They may also perform root planing and curettage. In addition, dental hygienists may expose dental x-ray films, apply topical preventive or prophylactic agents, and perform all tasks delegable by the dentist. However, the dentist remains responsible for the care of the patient.
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