● Consider improving the practice in areas frequently reviewed as negative. Online review websites may serve as a kind of “focus group” and help providers assess their performance. Such feedback could be a practice asset in disguise.
Getting past the emotional aspect of consumer review websites may be a challenge for some. People do not like to see their work criticized. However, if providers can overcome this obstacle, they may actually be able to use these websites to their advantage.
ETHICAL DECISION-MAKING MODELS
decision making include, but are not limited to, the dental provider’s: ● Upbringing. ● Religious or faith-based influences. ● Professional training or codes of ethics. ● Practice type and location. ● Patient expectations. Many ethical decision-making models are available. All of them aim to guide the user to the most beneficial outcome of any scenario. Dilemmas are often complex and convoluted. In any case, it is important to consider: ● The professional relationship involved. ● The ethical principles involved. ● The professional obligations and conflicts involved. ● The central values of the dental practice. ● Potential personal biases. ● Alternative courses of action available. ● Appropriate actions to take. ● Social customs. ● Societal norms. (Beemsterboer, 2018) The ACD Ethics Handbook for Dentists (2016) offers several user-friendly ethical decision-making models that provide a useful quick reference for dental practitioners. (A PDF version of the book is available at https://www.dentalethics.org/ ethicshandbook.htm). To resolve the ethical dilemmas in the case studies presented later in this course, readers will use the decision-making model shown in Table 5. This same decision-making model also appears in the Appendix. Learners can photocopy the model and use it as a helpful tool when working through the ethical dilemmas they will encounter in their practices.
Ethical problems are complex and constantly changing. For example, the notions of cyberbullying and social media couponing were unheard of until the early years of the 21st century. The dental practitioner has an obligation to navigate through complex ethical problems and come to reasonable solutions. Reliance on a set of ethical principles greatly aids this process of ethical decision making. In navigating through the process of solving ethical dilemmas, it is important to take a systematic approach. This practice helps the professional avoid overlooking an important aspect of the case as he or she formulates a solution. Ethical decision-making models provide a framework for case-by-case ethical reasoning. One of the most difficult ideas to grasp about ethics is that ethical decision-making is rarely black and white; in fact, it is mostly gray. This apparent ambiguity does not mean that there is not a best answer for any particular situation. Dental practitioners must formulate a solution and be willing to act on it to properly perform their duties. An ethical dilemma occurs when competing obligations confront the provider and he or she has to weigh two or more options to resolve it (Beemsterboer, 2017). Weighing the options involves a moral evaluation, not one based on clinical skills or scientific judgment. Ethical decision making is multifaceted. Dental providers do not function in a vacuum. They bring to their practices of dentistry a personal world that influences perspectives and decisions when dilemmas occur. It is important to acknowledge the existence of potential bias resulting from these personal experiences and perspectives. By consciously making this acknowledgment, the dental professional may gain a more objective view of the particular scenario and eventually come to a more logical conclusion. Personal experiences that may influence ethical
Table 5: Ethical Decision-Making Model Step Procedure
Working up the Case (fill in below)
1 • Identify the problem and the professional relationship(s) affected . • Gather all relevant facts: ○ Dental. ○ Medical. ○ Social. ○ Identify stakeholders.
○ Examine potential personal biases. ○ Additional necessary information.
2 • Identify the ethical principles and central values involved: ○ Identify those that conflict. ○ Identify those that should take priority. • Identify any professional obligations involved:
○ Refer to relevant professional codes of ethics (ADA, ADHA) as necessary. • Identify legal issues (civil, criminal, and administrative). 3 • List the possible courses of action available. • Answer the question, “What action could be taken?” • Rank the courses of action in light of information gathered in steps 1 and 2. 4 • Select the best solution from the list of possible actions and be willing to act on it. ○ Answer the question, “What action should be taken?" 5 • Prepare a defense for the chosen course of action: ○ Complete the sentence, “I chose this course of action because …” Note . Adapted from American College of Dentists. (2016). Ethics handbook for dentists. Gaithersburg, MD: Author. Retrieved from https://www. dentalethics.org/ethicshandbook.htm
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