Ethics in dentistry

Ethics is defined as a branch of philosophy concerned

with the study of those concepts that are used to evaluate
human activities in particular the concept of goodness and
obligation..
Profession

the member of a specific profess to have

acquired special knowledge by training or experience, or

both, so that they may advise or serve others in that special
field.

Dentistry-a profession
Some characteristics of a profession:
i- to acquire the knowledge to the standards set by the
profession.
ii- to keep abreast of changing knowledge.
iii- to make commitment to the basic ethics of the profession.
iv- to abide by the profession's code of ethics.
v- to serve society.

Principles of ethics:
The American Dental Association outlines the ethical codes and the
corresponding code of conduct to be followed which are:
1. patient autonomy (self-governance)
2. nonmaleficence (do no harm)
3. beneficence (do good)
4. justice (fairness)
5. veracity (truthfulness)
6. fidelity
7. confidentiality

Patient autonomy
(self-governance)
It is based on the principles of respect for persons.
The dentist has the duty to respect the patient rights to selfdetermination and confidentiality.
Professionals have a duty to treat the patient according to the
patient's needs, within the limit of accepted treatment.
The dentist should include the patient in treatment decision,
according to patient need, desire, and abilities.

Code of professional conduct

1- patient involvement: inform the patient about
treatment plan and any reasonable alterations.
2- patient records: safeguard the confidentiality
of patient records. Upon request by another
practitioner provide information only if it is
beneficial to the patient.

Nonmaleficence
Do No Harm
Professionals have a duty to protect the patient from
harm, through the following actions:
1. keeping his knowledge and skills current
2. knowing his limitations and when to refer to a
specialist
3. knowing when and under what circumstances
delegation of patient care to auxiliaries is appropriate.

Code of professional conduct

1- continuing dental education by the dentist
2- consultation and referral: the specialist should return the

patient upon completion of their care, to the referring dentist.

3- Specialist who has referred a patient for second opinion by

a third party regarding a treatment plan has an obligation to

do so without any prejudice.
4- Dentist should protect health of their patients by assigning

qualified auxiliaries.

Beneficence
Do Good
The dentist has a duty to promote the patient welfare.
This

principle

expresses

the

concept

that

professionals have a duty to act for the benefit of

others and the dentist primary obligation is service to
the patient and the public at large.
The most important aspect of this obligation is the
competence (skill, knowledge, and experience) of the
dentist.

Code of professional conduct

1- dentist should evaluate if a service is good to the patient.
2- in population based research, the ethical question is not only

whether research is needed, but also whether it is wanted, whether is

relevant to the public health problem of the community.
3- it is unethical to carry out screening when no treatment is possible

or beyond financial reach.

4- make results and benefits of their investigations available to all

patients involved in the study. This helps in promoting health of the

public.

Justice
Fairness
The dentist has a duty to treat people fairly through the
following:
1. to be honest with patients
2. to give patients what they deserve
3. to give patients what they have right on.
Patient selection:
Dentist shall not refuse to accept patients into their practice
because of; patient's race, color, sex, or national origin.

Code of professional conduct

1- Dentist should not refuse to accept patients based on race, color,

gender, or nation of origin.

2- dentist should provide care to patients with AIDS or HIV

seropositive.
3- dentists are obligated when consulted in an emergency by patients

not of record.
4- if such treatment is provided then he is obligated to return the

patient to his regular dentist.

5- dentist should not accept/tender commissions, rebates or discounts.

Veracity
Truthfulness
This principle express the concept that professionals
have a duty to be honest and trustworthy in their
dealings with people.

Fidelity
It is the obligation to keep implied or explicit
promises.

Code of professional conduct

1- dentist should not represent the fees being charged for a case
in a false/ misleading manner.
2- it is considered as unethical for a dentist to increase fees to a
patient just because he is covered under a dental benefit plan as
also it is to perform unnecessary dental services or procedures.
3- dentists should not misrepresent their training and
competence in any in potentially misleading/false statements .

Confidentiality
Dental professionals have a legal and ethical duty to
keep patient information confidential.
Confidentiality

comprises

preservation

of

all

information concerning patient's disease and treatment.

Confidential information should be kept in a secure
place at all times to prevent unauthorized or accidental
disclosure.

Code of professional conduct

1- it is unethical and unnecessary to gossip
about a patient. In no instance other than in the
court of law or when the patient change the
dentist, should confidentiality be breached.

Duties and obligation of

dentists toward patient and
public

Every dentist shall:

1. be mindful that care of patient and treatment of disease
depends on his level of competence. And remember that
his personal reputation, professional ability and fidelity
remain his best recommendations.
2. be courteous, sympathetic, friendly and helpful to, and
always ready to respond to the call of his patients, and
under all conditions his behavior toward his patients and
public shall be polite.
3. make his best effort to fulfill his appointments.

 4. not permit considerations of religion, nationality,

race, politics or social standard to intervene in his
duties toward his patients.
5. keep all information of a personal nature which he
knows about a patient directly or indirectly during the
course of professional practice in confidentiality,
except with the consent of the patient or being
ordered by a court of law.

Duties of one dentist towards another

Every dentist shall:
1. Express proper pride of his colleagues, and shall not hart
them either by actions, deeds, or words.
2. honor mutual arrangements made regarding remuneration,
when one dentist is consulted by a patient of another dentist,
and if the later finds an evidence that such a patient is
suffering from previous faulty treatment.
3. regard it as a pleasure to render service to another dentist,
his wife and family members, although there is no legal
obligation to a dentist from charging another dentist for
professional service.

Unethical Practices
1. employment of a dentist in his practice any professional

assistant (as dental hygienist) whose name is not registered in

the State Dentist Register.
2. styling of any dentist or group of dentists his dental clinic

by the name of dental hospital.

3. signing under his name and authority any certificate which

is untrue.
4. aiding in any kind of illegal practice.
5- allowing commission.

 5. advertising, whether directly or indirectly, for the

purpose of obtaining patients.
6. allowing the dentist name to be used to designate
commercial articles such as tooth paste, toothbrush..or
permitting publication of his opinion on any such items.
7. mentioning after the dentist name any other
abbreviations

except

those

indicating

dental

qualifications as earned by him during his academic

career in dentistry.

 A dentist may perform a formal announcement

in the press, regarding the following:

1. on starting practice.
2. on changing type of practice.
3. on changing address.
4. on temporary absence from duty.
5. on succeeding to another practice.

American
dental
association
guidelines for basic principles of
ethics
in
research
involving
human subjects

1- any human based research which is based on scientific principles

and justification for research in lab and or animal experiments.
2- research should be conducted under the supervision of clinical
investigators who are scientifically qualified and experienced.
3- research should be carried out in such away that the rights and
welfare of participants are protected. Reasonable efforts must be
made to reduce possible risk to participants. Risk must be
outweighed by benefits.

4- informed consent must be obtained by adequate and

appropriate methods and the content of which are;
- general description in lay terms of the study and purpose. Fair and clear
explanation of all examinations and treatment procedure.
- an explanation of why the subjects have been invited and an assurance that
their findings will be kept confidential.
- description of any known discomforts or risks. And methods to compensate.
- description of benefits expected.
- An offer to answer queries during study. This is can be accompanied by
providing the titles and telephone number of the principal investigator.