with the patient. Although it may not be necessary to discontinue this practice completely, Dr. Jones should be careful to obtain consent from patients first and carefully consider what Conclusion This course has provided a comprehensive overview of dental ethics and current ethical challenges facing the dental profession today. After exploring important historical events that framed the development of ethical standards along with early ethical theories, legal concepts, and today’s professional codes of conduct, dental practitioners should have a greater appreciation for their profession and a clearer understanding of their professional obligations. One of the important concepts discussed was the relationship that dentistry maintains with society, which places trust and confidence in the dental profession because of practitioners’ knowledge, training and commitment to the public’s health. If the trust inherent in this relationship is lost, the professional status dentistry enjoys will also be lost. Dental providers must respect and honor this trust to safeguard dentistry’s status as a learned profession. Constant advancement and widespread use of modern technology and electronic communication can cause the boundaries of professional and personal relationships to blur. Now more than ever, dual relationships with patients, privacy concerns, and marketing strategies are pushing the boundaries
will be written in text form. Patient confidentiality should be respected at all times.
of acceptable professional behavior. This course explored some of the major ethical issues associated with the use of these new technologies, including social media communication, advertising, teledentistry, and cyberbullying. The course went on to introduce the concept of ethical decision making, and it provided learners with an ethical decision-making model to help them navigate complex dilemmas. The course also offered case studies to help reinforce important ideas and provide a practical application of the concepts. Ethical challenges have increased significantly as society has become more complex. Dental professionals have the obligation to continue their education in this area, stay current with new trends and ethical challenges to the profession, and be mindful of professional standards related to the use of new technologies. Dental providers should equip themselves with the ethical tools necessary to protect patients and the profession from harm, as well as protect their individual professional integrity. The ability to systematically analyze and solve any ethical dilemma is arguably as important as the technical skills required to perform clinical dentistry.
APPENDIX BLANK 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 Resources Ethics ● The American Dental Association Principles of Ethics and Code of Professional Conduct (2018) https://www.ada.org/~/media/ADA/Publications/Files/ADA_Code_ of_Ethics_2018.pdf?la=en ● The American Dental Hygienists’ Association Bylaws and Code of Ethics (2016) http://www.adha.org/resources-docs/7611_Bylaws_and_Code_of_ Ethics.pdf ● AMA Code of Medical Ethics (Accessed July 6, 2018) https://www.ama-assn.org/delivering-care/ama-code-medical-ethics Ethical Decision Making ● American College of Dentists Ethics Handbook for Dentists (2016) https://www.acd.org/ethics/publications/ethics-handbook/ Prominent Cases Involving Ethical Issues ● Nancy Beth Cruzan Case and the Patient Self-Determination Act P. J. Greco, K. A. Schulman, R. Lavizzo-Mourey, and J. Hansen- Flaschen. (1991). The Patient Self-Determination Act and the Future of Advance Directives. Annals of Internal Medicine, 115 (8), 639-643. ● Terri Schiavo Case T. E. Quill. (2005). Terri Schiavo – A Tragedy Compounded. New England Journal of Medicine, 352 , 1630-1633. Social Media and Young Patients ● E. Englander and P. Raffalli. (2011). Tips for Pediatricians: Addressing Bullying and Cyberbullying in Your Practice https://www.mdedge.com/pediatricnews/article/46812/tips- pediatricians-addressing-bullying-and-cyberbullying-your-practice
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