2.2 Nonmaleficence Flashcards
“do not harm” the dentist has a duty to abstain from doing harm (to patients)
non-maleficence
under this principle, dentist’s primary obligations include keeping knowledge and skills current
nonmaleficence
this principle is knowing one’s own limitations and when to refer a specialist of other professional
nonmaleficence
this principle is knowing when and under what circumstances delegation of patient care to auxillaries is appropriate
nonmaleficence
what are violations of nonmaleficence
- kiss sedated pt
- interpersonal relationships that could impair professional judgement
- intentionally infect pt
- overtreatment of patients or performing interventions requiested by pt known to be ineffctive or harmful
what is a favorable risk-benefit ratio
- NOT to inflict harm and reduce risks
- beneficence refers to acting for benefit of others and potential research should benefit both study participants and study as a whole
what is this an example of
do no harm - surgery to remove life threatening tumor in pregnant woman leads to loss of pregnancy, this is not an abortion but a ___ bc intent was to save both mother and child
principle of double effect
what is the largest group of nonprofit health care providers in nation
Catholic Health Association (CHA)
T/F: beneficence is interwoven w/ nonmaleficence
TRUE
T/F: in most instances, nonmaleficence requires only restraint from harmful acts
TRUE
e.g. restraint from recommending esthetic bonding when it is obvious that the pt does not believe there is an esthetic problem
pure utilitarian theory includes what
only principles of beneficence and non-maleficence
critisisms against utilitarianism
elevate doing all of the good that one possiblly do to a strict moral duty when we normally would consider there to be some limit on what is morally required of us
what is the right action which produces the greatest happiness for the greatest number
utilitarianism
consequentialism or teological ethics follows what
utilitarianism
example of balancing benefits against harms in dentistry
injection of local anesthetic to avoid larger pain of cavity prep
the balancing process requires that ___ and ___ be taken into consideration because they influence nature and amount of the food produced
patients values and viewpoints
the privilege of dentists to be ___ rests primarily in knowledge, skill and experience with which they serve their pts and society
accorded professional status
all dentists have the obligation of keeping ___
their knowledge and skill current
must specialists and consulting dentists return their patient upon completion of their care
YES
The specialists should be obliged when there is no referring dentist and upon completion of their tx to inform patient ___
there is a need for further dental care
should the dentist rendering a second opinion have a vested interest in ensuring recommendation
NO
dentists should be obliged to protect health of their patients by only assigning to ___
qualified auxillaries those duties which can be legally delegated
2 most pressing issues in dental profession
- overtreatment
- student debt
dentists are required to provide pt with what type of opinion
disinterested opinion (benefits patient, that is in their best interest)
what happens when practitioners are so overly focused on hourly cost to run their practices that their primary goal is to meet the hourly rate
- dentist overlooks patients, staff and ethical compass
- pt seen as dollar signs rather than person
common procedures misused
- crowns for every cracked tooth
- crowns when restoration would suffice
- endo for every close lesion to pulp
- insurance code maniupulation
- perio tx for every instance when prophy or scaling could be performed
- stain vs. demineralization
- using pt insurance benefits by maxing them out
- repair vs replace restoration especially around crown margins
- panorex for every pt when full mouth radiographs are better
- radiographs too often or radiographs not complete
can patients choose their level of risk
YES
- ask pt if they prefer to treat or wait and observe; share some of responsibility w/ pt and document in chart
- difference between ‘is it healthy’ vs ‘not perfect’
age of patient minus when tooth erupted helps determine what
rate of caries progression
look at previous radiographs to help determine rate of progression
it is unethical for a dentist to practice while abusing ___
controled substances, alcohol or other chemical agents
dentists with first-hand knowledge that a coleague is practicing dentistry when so impaired have an ethical responsibility to report such evidence to ___
professional assistance committee of a dental society
example of impairments
controlled substance, age, vision, not able or chooses not to meet standard of care
do all dentists, regardless of their bloodborne pathogen status have an ethical obligation to immediately inform any pt who may have exposed to blood or infectious material
YES
upon exposure, what was the practitioner do
present a postexposure evaluation and follow up
do dentists have an ethical obligation in the event of an exposure indicent extending to providing info concerning the dentist’s own bloodborne status to evaluating health care provider
YES
