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 Table 6: Case Scenario and Solution Case: Martini Lunch The longtime staff members of Dr. Ross’s office knew he was a drinker. He frequented bars on the weekend, and the residents of town knew this. He often came back from lunch appearing red in the face; however, if his red face was due to drinking, it did not seem to affect his work or mood. In fact, he was often in a better mood on those days. The problem was not bad enough for patients to notice, and somehow he never smelled of alcohol. Angie, his hygienist, was new to the office and did not like this at all. She did not care if his work seemed unaffected. She grew up with an alcoholic father and knew what damage alcohol could do. When she asked the other staff members if this happened all the time, they assured her that, “It was no big deal, and he could handle his liquor just fine.” The staff really liked Dr. Ross. He treated them very well. One day, Angie followed Dr. Ross to lunch to see where he went. Sure enough, she saw him enter Billie’s Pub. That was it – she needed to do something. This was not acceptable to her. What should Angie do? Step Procedure Working up the Case 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. • Professional and professional. • Dr. Ross was drinking alcohol at lunch and coming back to treat patients. • The office staff, aside from Angie, did not seem to find fault with this behavior. • A potential bias is that Angie’s father was an alcoholic.
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• 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). • 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.
• One ethical principle is nonmaleficence (doing no harm). Dr. Ross’s drinking on the job could harm patients (most important principle in this case). • This situation involves veracity (truthfulness). Dr. Ross is not being honest with himself, his patients, or his staff concerning his drinking being a problem at work. • The central values involved include life and general health of the patient, oral health of the patient, and the dentist’s preferred patterns of practice. • Dentists have a professional obligation to put their patients’ needs before their own and to protect their patients’ safety at all times. • Dr. Ross could be providing care in a compromised capacity. He is potentially violating administrative law against the Dental Practice Act. • Angie could confront Dr. Ross and ask him directly if he is drinking alcohol at lunch. If he admits to it, she could ask him to quit and get help. If she does this, she may lose her job. • Angie could report Dr. Ross to her state dental society’s peer review committee. They may be able to assist him in getting the help he needs. • Angie could quit her job and go work elsewhere and not report him to the review committee. • Angie could quit her job, go work somewhere else, and report him to the review committee. • Ranked: 2, 1, 4, 3.
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Book Code: DHFL2624
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