DENF 1621 Ethics in Dentistry - Final Exam Review Outline - Review details of note:
Note: In addition to this review outline, you must study the ADA Principles of Ethics, and their corresponding Code of Professional Conduct, in their entirety (but not the Advisory Opinions).
The three sections or parts of the ADA Principles of Ethics and Code of Professional Conduct are
A: The Principles of Ethics, the Code of Professional Conduct and the Advisory Opinions.
The correct five fundamental principles that form the foundation of the ADA Principles of Ethics and Code of Professional Conduct:
A: 1) Patient autonomy,
4) justice and:
The ethical duty as a dentist with respect to patient autonomy(self-governance) is best described as:
The dentist has a duty to respect the patient's rights to self-determination and confidentiality.
The ethical duty as a dentist with respect to nonmaleficence (do no harm) is best described as:
The dentist has a duty to refrain from harming the patient.
The ethical duty as a dentist with respect to beneficence (do good) is best described as:
The dentist has a duty to promote the patient's welfare.
The ethical duty as a dentist with respect to justice (fairness) is best described as:
The dentist has a duty to treat people fairly.
Your ethical duty as a dentist with respect to veracity (truthfulness) is best described as:
The dentist has a duty to communicate truthfully.
For the dental professional, the following are ethical considerations of informed consent:
a. Comprehensive knowledge on the part of the practitioner;
b. Unbiased presentation of all reasonable alternatives and consequences, including costs and the probability of outcomes;
c. The ability of the practitioner to communicate clearly on a level assuring comprehension by the patient or appropriate authority;
d. Reasonable assurance by the dentist that the patient is competent and has sufficient understanding to render a decision.
The Term "Profession" has been defined as:
an occupation involving relatively long and specialized preparation on the level of higher education and governed by a special code of ethics.
The term "professional" refers to one who:
has special knowledge and skills used to benefit the public, regardless of personal gain.
The four key features of a profession have been described as:
1. possesses an important and exclusive expertise
2. has an internal and external structure
3. allows for self-regulation
4. its members accept a set of professional obligations.
The process of ethical decision making includes the following 4 items:
a. Balancing Conflicting Principles and Obligations
b. Clarifying the Ethical Problem
c. Determining the Stakeholders
d. Examining the Process of Decision Making
When clarifying an ethical problem, a dental professional should consider the following 4 items:
a. Consider the ethical implications of each alternative.
b. Consider what type of conflict is present.
c. Consider the nature of the choices involved.
d. Consider who will make the decision.
Ethics are the moral principles or virtues that govern the character and conduct of an individual or a group.
What are a dentist's obligations with regard to furnishing copies of records?(4 of them)
a. A dentist has the ethical obligation on request of either the patient or the patient's new dentist to furnish in accordance with applicable law, gratuitously or for nominal cost, such dental records or copies or summaries of them, including dental X-rays or copies of them, as will be beneficial for the future treatment of that patient.
b. This obligation exists whether or not the patient's account is paid in full.
c. Dentists are obliged to safeguard the confidentiality of patient records.
d. Upon request of a patient or another dental practitioner, dentists shall provide any information in accordance with applicable law that will be beneficial for the future treatment of that patient.
Why do dentists have an obligation to keep their knowledge and skill current?
From an ethical perspective, all dentists have the obligation of keeping their knowledge and skill current because the privilege of dentists to be accorded professional status rests primarily in the knowledge, skill and experience with which they serve their patients and society.
What is the ADA Code of Professional Conduct stance with regard to patient abandonment?
once a dentist has undertaken a course of treatment, the dentist should not discontinue that treatment without giving the patient adequate notice and the opportunity to obtain the services of another dentist.
What is Dr. Long's "equation for success" in dental practice?
S =[(IR+EBS)/(ADA+PC)]^(E+L), where, S=Success; IR=Interpersonal Relationships; EBS=Effective Business Systems; ADA=Organized Dentistry; PC=Professional Competence; E=Ethics; and L=Leadership
Dr. Shepherd's Parting thoughts on the exam:
One question will come from each lecture. Apart from that, if it is not mentioned above in this review then it is not on the exam. (Example: You do not need to review the posted online articles).
Section 1 PRINCIPLE: PATIENT AUTONOMY (“self-governance”) says you should respect patient's rights to...
(1) self-determination and (2) confidentiality (according to the patient’s desires, within the bounds of accepted treatment).
T/F: You should Inform patient of the proposed treatment and reasonable alternatives but don't have to involve patient in treatment decisions.
False: you should Inform patient of the proposed treatment and reasonable alternatives and involve patient in treatment decisions.
Section 1.B. PATIENT RECORDS. This provision requires dentists to do what?
Maintain patient records in a manner consistent with the protection of the welfare of the patient.
T/F Upon request of a patient or another dental practitioner (re: his treatment) you must provide any information in accordance with applicable law.
Section 2 PRINCIPLE: NONMALEFICENCE (“do no harm”). has 4 tenets, they are:
(1)Refrain from harming the patient (protect the patient from harm,
(2) keep knowledge and skills current, know own limitations,
(3)know when to refer to a specialist, and
(4)know what patient care is appropriate to delegate to assistants).
2.A. EDUCATION. All dentists shall keep:
All dentists shall keep their knowledge and skill current.
2.B. CONSULTATION AND REFERRAL. When do you need to seek assistance from specialists or consulting dentists?
If needed to care for a patient, seek consultation from specialists.
T/F: After treatment, the specialists or consulting dentist doesn't have to return the patient to the dentist of record for future care.
False - the specialist shall return the patient to the dentist of record for future care.
T/F: If no referring dentist, the specialists shall inform patients of any need for further dental care.
2.C. USE OF AUXILIARY PERSONNEL. State the Rule: Only assign those duties that can be…
Only assign duties that can be legally delegated to qualified assistants and supervise the patient care provided by staff.
2.D. PERSONAL IMPAIRMENT. If you have first-hand knowledge that someone is practicing under the influence, you should:
report such evidence to the professional assistance committee of a dental society.
2.E. POSTEXPOSURE, BLOODBORNE PATHOGENS. If any patient may have been exposed to blood or other potentially infectious material you should take these two steps:
(1) immediately inform patient of the need for postexposure evaluation;
(2) and immediately refer the patient to a qualified health care practitioner for treatment.
T/F: If the source of pathogen, Dentist should provide information concerning the dentist’s own bloodborne pathogen status to the patient.
False: Dentist should provide such information to the health care provider treating the patient for possible exposure.
2.F. PATIENT ABANDONMENT. T/F You can discontinue treating a patient at any time by simply telling them.
False: Do not discontinue treating a patient w/o giving them notice and the opportunity to obtain the services of another dentist. The patient’s oral health shouldn’t be jeopardized in the process.
2.G. PERSONAL RELATIONSHIPS WITH PATIENTS. T/F: according to the code recommendations it is okay to become romantically involved with a patient, so long as you do not use any personal/hipaa information for advantage.
False: Avoid interpersonal relationships that could impair their professional judgment or risk the possibility of exploiting the confidence placed in them by a patient.
Section 3 PRINCIPLE: BENEFICENCE (“do good”). Promote the patient’s welfare. This principle states you should serve whom?
Serve the patient and the public-at-large with competent and timely delivery of dental care within reason (mindful to the needs, desires and values of the patient).
3.A. COMMUNITY SERVICE. Since dentists (1) have an obligation to use their skills, knowledge and experience for the improvement of the dental health of the public and (2) are encouraged to be leaders in their community, dentists shall...
conduct themselves in such a manner as to maintain or elevate the esteem of the profession.
3.B. GOVERNMENT OF A PROFESSION. What does this section say about participating in organized dentistry?
Dentists should make themselves a part of a professional society and observe its rules of ethics.
3.C. RESEARCH AND DEVELOPMENT. T/F You must make the results and benefits of your research available to all.
False: you must make research results available to all only when it is useful in safeguarding or promoting the health of the public.
3.D. PATENTS AND COPYRIGHTS. What does this section say about patents?
Dentists can obtain patents, but shall not be used to restrict research or practice.
3.E. ABUSE AND NEGLECT. What are the dentists obligations under this sec ion? Be familiar with...
Be familiar with the signs of abuse and neglect and report suspected cases to the proper authorities, consistent with state laws.
3.F. PROFESSIONAL DEMEANOR IN THE WORKPLACE. State the principle:
Provide a workplace environment that supports respectful and collaborative relationships for all those involved in oral health care.
Section 4 PRINCIPLE: JUSTICE (“fairness”). This says you should:
Treat people _______________, deal with people ___________ and deliver care w/o ______________.
Treat people fairly, deal with people justly and deliver dental care without prejudice; seek allies throughout society on activities that will help improve access to care for all).
4.A. PATIENT SELECTION. State the rule: Dentists may ________________________________, but can't _____________________________________.
Dentists may exercise reasonable discretion in selecting patients, but can’t refuse to accept patients because of the patient’s race, creed, color, sex or national origin.
4.B. EMERGENCY SERVICE. What are dentists obligations with regard to his/her patients? what about non-patients?
Patients: Make reasonable arrangements for their emergency care.
Non-patients: make reasonable arrangements for emergency care and if treatment is provided, return the patient to his or her regular dentist.
4.C. JUSTIFIABLE CRITICISM. What should you report to the appropriate agency?
Report instances of gross or continual faulty treatment by other dentists to the appropriate reviewing agency.
T/F: You shouldn't talk trash about a patient's previous dental care.
True - Patients should be informed of their present oral health status without disparaging comment about prior services.
What does the code say about issuing a public statement as a dentist, in your professional capacity?
Dentists issuing a public statement with respect to the profession shall have a reasonable basis to believe that the comments made are true.
4.D. EXPERT TESTIMONY. Dentists may provide expert testimony when that testimony is _____________ to a __________ and ____________ disposition of a judicial or administrative action.
Dentists may testify when it is essential to a fair and just disposition of a judicial or administrative action
4.E. REBATES AND SPLIT FEES. T/F: Dentists can accept or tender “rebates” or “split fees.”
False: Dentists shall not accept or tender split fees or rebates.
Section 5 PRINCIPLE: VERACITY (“truthfulness”). What are the 4 key elements this principle?
(1) Be honest and trustworthy in their dealings with people;
(2) respect the position of trust inherent in the dentist-patient relationship;
(3) communicate truthfully and without deception, and
(4) maintain intellectual integrity.
5.A. REPRESENTATION OF CARE. State the rule:
Do not represent the care being rendered to their patients in a false or misleading manner.
5.B. REPRESENTATION OF FEES. State the rule on representation of fees:
Do not represent the fees being charged for providing care in a false or misleading manner.
5.C. DISCLOSURE OF CONFLICT OF INTEREST. If presenting educational or scientific information in an article, seminar or other program you should:
You should disclose to the readers or participants any conflict of interest, monetary or otherwise.
5.D. DEVICES AND THERAPEUTIC METHODS. State the Rule:
Prescribe, dispense, or promote only those devices, drugs and other agents whose complete formulae are available to the dental profession (except for formal investigative studies).
T/F Dentists should not hold a procedure out as “exclusive” if that representation would be false or misleading.
5.E. PROFESSIONAL ANNOUNCEMENT. What does this rule dictate regarding representation or a dentist's professional training?
Dentists should not misrepresent their training and competence in any way that would be false or misleading in any material respect.
5.F. ADVERTISING. Although any dentist may advertise, no dentist shall advertise or solicit patients in any form of communication in a manner that is:
false or misleading in any material respect.
T/F: A practice may use of the name of a dentist no longer actively associated with the practice may be continued for a period of up to 3 years.
False - you can only use that dentist's name for one year.
5.G. NAME OF PRACTICE. What does this say about misleading trade names or assumed names for a practice?
The use of a trade name or an assumed name that is false or misleading in any material respect is unethical.
5.H. ANNOUNCEMENT OF SPECIALIZATION AND LIMITATION OF PRACTICE. T/F those specialties recognized by the American Dental Association are governed by the "ethical specialty announcement and limitation of practice" guidelines in the code of ethics.
Name at least five of the eight specialties recognized by the ADA:
dental public health, endodontics, oral and maxillofacial pathology, oral and maxillofacial radiology, oral and maxillofacial surgery, orthodontics and dentofacial orthopedics, pediatric dentistry, periodontics and prosthodontics.
T/F Dentists who choose to announce an ADA specialization shall limit their practice exclusively to the announced dental specialties.
True: Dentists who choose to announce specialization should use “specialist in” or “practice limited to” and shall limit their practice exclusively to the announced dental specialties, provided at the time of the announcement such dentists have met in each recognized specialty for which they announce the existing educational requirements and standards set forth by the American Dental Association.
Name the 3 general standards that are included within the standards of the American Dental Association for determining the education, experience and other appropriate requirements for announcing specialization and limitation of practice:
1. The special area(s) of dental practice and an appropriate certifying board must be approved by the American Dental Association.
2. Dentists who announce as specialists must have successfully completed an educational program accredited by the Commission on Dental Accreditation, two or more years in length, as specified by the Council on Dental Education and Licensure, or be diplomates of an American Dental Association recognized certifying board.
3. The practice carried on by dentists who announce as specialists shall be limited exclusively to the special area(s) of dental practice announced by the dentist.
T/F: Dentists who wish to announce in an additional specialty area must submit to the appropriate constituent society documentation of successful completion of the requisite education in specialty programs listed by the Council on Dental Education and Licensure or certification as a diplomate in each area for which they wish to announce.
5.I. GENERAL PRACTITIONER ANNOUNCEMENT OF SERVICES. General dentists who wish to announce the services available in their practices are permitted to announce the availability of those services so long as they:
avoid any communications that express or imply specialization and state that the services are being provided by general dentists.