Social media = Social networks + publishing In other words, social media consist of both relationship digital communication and broadcast communication. Often the line between what is a social network website and what is a broadcast communication website blurs. For instance, Telemedicine and teledentistry Along with other social changes, the digital explosion has led to patients and physicians communicating in new ways. Telemedicine, or virtual doctor visits, is a new phenomenon more common in medicine than dentistry. Texting, video conferencing, and email are just some of the ways that patients can interact and converse with their healthcare providers, eliminating the need to be always physically present at an office visit. The COVID-19 pandemic has undoubtedly increased the availability and use of telemedicine and teledentistry. In 2020 the estimated amount spent on these services was 10 billion dollars and is estimated to reach 43 billion dollars by 2026 (Arizton, 2021). The American Medical Association (AMA), in response to the increase in demand for electronic medicine services, has developed a set of guidelines to help the medical profession manage this new way of interacting with patients. These guidelines were Concil on Ethics and Judicial Affairs and involved the support from physicians across the United States. As with any other model of medical care the provision of competent medical care and the placement of the welfare of the patient above all else are the primary concerns (The American Medical Association, 2016). In 2017, the American Dental Association published a 10-page Guide to Understanding and Documenting Teledentistry Events. (See the Resources section of this course.) The ADA’s Comprehensive Policy Statement on Teledentistry (2020b) concerns the use of a variety of technologies and tactics for delivering virtual dental health care, education services, and the transmission of images. This combination of telecommunications and dentistry allows for the exchange of clinical information and images over remote distances for the Cyberbullying It is well known that not all digital communication is positive. As people find more ways to communicate and build relationships via the Internet and mobile devices of all types, they also acquire the ability to communicate in a negative way. Cyberbullying refers to bullying that occurs through electronic means. Whether it occurs through texting, social media, or picture messaging, cyberbullying is a form of abuse (stopbullying.gov, n.d.). Unlike face-to-face bullying at school, cyberbullying does not stop when the school day ends. Electronic media are always accessible. Just like physical bullying, cyberbullying can be devastating to the victim. Headlines tell a tragic tale of the effects of cyberbullying on the nation’s youth. Several highly publicized suicides of adolescents and young adults have taken place as a direct result of this type of abuse (CBSNews.com, 2016; Veloce, 2018; The Clever, 2017). Dental professionals may not think this topic is relevant to them; however, as will be shown, dentists are ethically obligated to be aware of this form of abuse. As healthcare providers, dentists and dental hygienists have not only an ethical obligation to report suspected cases of child abuse; they have a legal requirement. Dental professionals are mandated reporters. The ADA Code dictates this obligation, as do laws in all 50 states under the Child Abuse Protection Act of 1974 (ADA, 2020a; Fisher-Owens, et. al, 2017) (Full details about reporting policies and procedures are available at HHS’s Child Welfare Information Gateway [n.d.a] at https://www.childwelfare. gov/topics/systemwide/laws-policies/can/). All dental professionals need to consider how to handle cases of cyberbullying should they become aware of them in relation to patients in their practice. Later, this course will examine a specific case involving the relevant ethical issues regarding cyberbullying. When the ADA Code (2020a) addresses the topic of abuse, it does so under the principle of beneficence . Under
Facebook and other social networking sites also have advertising and newsfeeds available. In contrast, transaction digital communication mainly serves a utilitarian function, although it could involve aspects of social media. purposes of consultation and treatment planning. The ADA indicates that teledentistry can include, but is not limited to the following modalities: ● Live video : Two-way interaction between patient and provider. ● Store-and-forward : Transmission of recorded health information such as radiographs or digital impressions through a secure electronic communications system to a practitioner who uses the information to evaluate a patient or render a service outside of a live interaction. ● Remote patient monitoring : Personal health data collection from a patient in one location via electronic communication technologies, which is transmitted to a provider in a different location to support care of the patient. ● Mobile health care and education supported by mobile communication devices : Such as cell phones or tablets. Teledentistry has the potential to improve access and delivery of oral healthcare, lower the cost of dental care, eliminate disparities between rural and urban populations, help address shortages or geographic maldistribution of dentists, and open the door to a new era for dentistry (Moore and Rover, 2017). However, the dental profession must address ethical and legal issues that arise from the use of teledentistry. These may include confidentiality and privacy of information stored and transferred electronically; obtaining proper informed consent; risks of improper diagnosis or treatment due to a technology failure; and issues of licensure, jurisdiction, and malpractice (American Dental Association, 2020b). this principle, dentists have the ethical duty to put the patient’s welfare first. The code states: The public and the profession are best served by dentists who are familiar with identifying the signs of abuse and neglect and knowledgeable about the appropriate intervention resources for all populations. A dentist’s ethical obligation to identify and report the signs of abuse and neglect is, at a minimum, to be consistent with a dentist’s legal obligation in the jurisdiction where the dentist practices. Dentists, therefore, are ethically obliged to identify and report suspected cases of abuse and neglect to the same extent as they are legally obliged to do so in the jurisdiction where they practice. Dentists have a concurrent ethical obligation to respect an adult patient’s right to self- determination and confidentiality and to promote the welfare of all patients. Care should be exercised to respect the wishes of an adult patient who asks that a suspected case of abuse and/or neglect not be reported, where such a report is not mandated by law. With the patient’s permission, other possible solutions may be sought. Dentists should be aware that jurisdictional laws vary in their definitions of abuse and neglect, in their reporting requirements and the extent to which immunity is granted to good faith reporters. The variances may raise potential legal and other risks that should be considered, while keeping in mind the duty to put the welfare of the patient first. Therefore a dentist’s ethical obligation to identify and report suspected cases of abuse and neglect can vary from one jurisdiction to another. Dentists are ethically obligated to keep current their knowledge of both identifying abuse and neglect and reporting it in the jurisdiction(s) where they practice. (ADA, 2020a, page 8).
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