Table 2: Website Addresses for Selected Professional Codes American College of Dentists Ethics Handbook for Dentists
http://acd.org/ethicshandbook.htm
American Dental Association Principles of Ethics and Code of Professional Conduct
https://www.ada.org/en/about-the-ada/principles-of-ethics-code-of- professional-conduct
American College of Dentists Ethics Handbook for Dentists
http://acd.org/ethicshandbook.htm
American Dental Hygienists’ Association Bylaws and Code of Ethics
http://www.adha.org/resources-docs/7611_Bylaws_and_Code_of_Ethics.pdf
American Medical Association Telemedicine Coverage and Payment Guidelines
http://mb.cision.com/Public/373/9600400/99c2f1db96d7fec3.pdf
PROFESSIONALISM AND CODES OF ETHICS
Defining professionalism Although dental ethics and professionalism are intertwined in many ways, they are not exactly the same. Ethical principles lay the foundation for professional practice. The principles in and of themselves do not mean anything unless the professional honors them. Professionalism is sometimes hard to define, but it is recognizable. To be a professional implies practicing one’s lifework at a higher level. But at what higher level? One who is a professional undergoes a length and specialized academic curriculum coupled with clinical rotations for those who are involved in the health professions (Prassad, et. al., 2019). The ACD Ethics Handbook for Dentists (ACD, 2016) describes professionals as having the following traits: A professional respects patients for their unique needs and values. A professional places patients’ interests first and foremost, with only rare, legitimate exceptions. A professional always considers patients’ values and relevant personal preferences. A professional has integrity. A professional is honest. A professional is competent. A professional strives to improve personally and to effect improvement in the profession. A professional actively supports professional organizations. A professional is
concerned about conduct and perceptions of conduct. A professional is ethical. (p. iv) The relationships among dentists, patients, and society are based on trust. Dentists and dental hygienists have the specialized knowledge and skills necessary to perform dental procedures within their scope of practice. Members of the public do not. In fact, dentists are some of the most highly educated individuals in terms of years of training required to practice in their field. Even after training is complete, the dentist must then become licensed. The scope of professionalism and professional responsibility does not end with initial education and licensing, however. Patients and society trust that dental practitioners will provide care that is appropriate, safe, and in the best interest of their patients at all times. To maintain competence, dental professionals must also be lifelong learners. Science and technology are constantly changing. It is the dental practitioner’s responsibility to ensure that the care he or she provides to patients is within the present standard of care. The ADA, ACD, and ADHA codes of ethics are guidebooks to help practitioners to function at a high ethical and professional level. Dental professionals must be careful not to lose the public trust.
Commercial versus care model of dental practice: Ethical implications Dentistry is a profession, but it is also a business. Later in this course, learners will examine this point, which is often the biggest professional challenge to practitioners. Table 3
compares a typical commercial model with a care model for dental practice.
Table 3: Commercial Versus Care Model of Dental Practice Commercial
Care
• Profit is goal. • Money is primary. • Customer is a “means.” • Competitive: ○ Between companies.
• Care is goal (fiduciary). • Money is derivative. • Patient is the “end.” • Cooperative: ○ Between doctors.
○ Between buyer and seller.
○ Between doctor and patient. • Buyer cannot compete (trust). • Focuses on treatment/prevention. • Monopoly is status. • Relies on science and empiricism. • Focuses on life or death and on health.
• Caveat emptor. • Creates needs and wants. • Monopolies are prohibited. • Relies on endorsements and testimonials. • Focuses on commodities and things.
Note . Used with permission of Bruce Peltier, MBA, PhD and Cindy Lyon, BSDH, DDS, EdD In the care model, patient welfare always comes before commercial gain. This model also honors respect for patient autonomy, veracity, and nonmaleficence at all times (Lee, et al., 2018). Practicing under the principles of the care model will help a practitioner maintain perspective and support professional
ethical practice as it embodies the aforementioned ACD-defined traits. Using the care model, the dentist can deliver dental services, earn a good living, and at the same time honor ethics and professionalism.
Professional codes of ethics There are common themes and subtle differences throughout all the professional codes in dentistry and other health professions. To work through the solution of an ethical problem, it is important to know the definitions of the major principles. This
course employs the ADA Code and professional obligations as guides to solving ethical dilemmas. Table 4 defines the major principles of the ADA Code (ADA, 2020a). The concept of professional obligations will follow.
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