DCA05DE Dental Ethics and the Digital Age, 3rd Edition _ _________________________________________
Advertising has been a hot topic in dentistry since “Painless Parker” began his marketing campaign near the end of the 19th century. According to Peltier (2007), who wrote on Pain- less Parker’s legacy, Parker was a dentist with a questionable reputation among his colleagues; some called him a quack and charlatan, and they believed he was a menace to the dignity of the profession. He owned 30 dental practices, and his dubious ethics were a hot topic. He was famously photographed wear- ing a necklace of 357 teeth, which he extracted in one day. He also did much advertising (Billock, 2016; Peltier, 2007). In that era, there was a strong aversion to publicly advertising dental and other professional services. Some providers accused professionals who advertised of cheapening their profession. Advertising by professionals, including dentists, was considered beneath the dignity of professionals. It implied that only those with inadequate clinical skills and who lacked an adequate patient volume would need to advertise their services to the public. In the 1970s, the Federal Trade Commission began interpreting professional bans on advertising as being unfairly restrictive. Advertising has been legal since then, provided the messaging is truthful, accurate, and not misleading. Under the principle of veracity, the ADA Code (2023) offers extensive guidance on advertising in dentistry. The code states that any dentist may advertise, but no dentist shall advertise or solicit patients in any form of communication that is false or mislead- ing. The digital era has once again challenged the boundaries of acceptable advertising. Internet advertising is more abundant and comes in many forms. It is the dentists’ responsibility to ensure that they uphold ethical principles. A recent electronic advertising trend and a new challenge to the profession is selling group discount coupons for dental services. Daily-deal websites, such as Groupon and LivingSo- cial, offer professionals the opportunity to mass market their services at a discounted rate. Potential patients buy discounted services directly through these websites, the websites pay the professional a flat fee, and the website gets a financial profit cut. The patient pays the third-party entity, rather than the dentist directly, for these services. Ethical challenges come to light upon closer examination of these transactions. The first issue with this advertising is that some may perceive it as unprofessional. For example, the websites may offer dental services next to movie tickets, body massages, hair coloring, bowling games, etc. Thus, this type of advertising moves the dental profession to a merchant-level occupation. When refer- ring to what it means to be professional and have professional obligations, this situation raises an “ethical red flag.” In an Advisory Opinion, the ADA Code (2023) clearly states that the prohibition against a dentist accepting or tendering rebates or split fees extends to a dentist’s dealings with any third party, not just other dentists. The Advisory Opinion specifically addresses the use of “social coupons” and explicitly prohibits their use if a third party receives a portion of the fee from the patient.
Healthcare Consideration When facing an ethical dilemma, dentists must carefully bal- ance legal requirements with ethical standards, recognizing that what is legal may not always align with what is ethically right. In such situations, the guiding principle should be the welfare and best interests of the patient, even if this requires navigating complex legal landscapes. Dentists should seek to uphold the highest ethical standards while ensuring compli- ance with the law, consulting legal and ethical advisors when necessary to make informed, patient-centered decisions. EMERGING ETHICAL CHALLENGES DUE TO ADVANCING DIGITAL TECHNOLOGY Dentistry has always had its ethical challenges, but in today’s world, these challenges are more numerous and complex. Just as events forced the need to examine medical ethics in the 20th century, the 21st century brings new challenges. This course will cover the following emerging issues related to digital technologies, and case studies will illustrate how dental practitioners can navigate these complex issues: • Advertising on Social Media • Dual Relationships and Digital Communication
• Privacy issues • Teledentistry • Cyberbullying • Consumer Review Websites • Artificial Intelligence
ADVERTISING ON SOCIAL MEDIA Social media (SM) is commonly used to describe a wide range of online platforms, including blogs, business networks, col- laborative projects, enterprise social networks (SN), forums, microblogs, photo sharing, product reviews, social bookmark- ing, social gaming, video sharing, and virtual worlds. Given the wide range of SM platforms, SM applications are highly diversified and go beyond sharing vacation photos or advertis- ing and promotion (Aichner et al., 2021). There is no doubt that the advent of SM has changed the way dental practices market their businesses. The digital genera- tion wants to shop online for just about everything, including healthcare providers. Web pages can speak volumes about professional offices; not having one may say even more. The advantages of advertising online and having a dynamic Web presence are apparent. The sheer number of people whom dental practices can reach this way is astounding. It is also convenient for patients to peruse practices and compare ser- vices when searching for a new dental provider. Advertising by a dentist cannot be misleading, misrepresent facts or fees, imply specialty certification where there is none, create false expectations, and not guarantee results (ADA, 2023).
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