2.2 Nonmaleficence

Question 1

“do not harm” the dentist has a duty to abstain from doing harm (to patients)

Answer 1

non-maleficence

Question 2

under this principle, dentist’s primary obligations include keeping knowledge and skills current

Answer 2

nonmaleficence

Question 3

this principle is knowing one’s own limitations and when to refer a specialist of other professional

Answer 3

nonmaleficence

Question 4

this principle is knowing when and under what circumstances delegation of patient care to auxillaries is appropriate

Answer 4

nonmaleficence

Question 5

what are violations of nonmaleficence

Answer 5

• 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

Question 6

what is a favorable risk-benefit ratio

Answer 6

• 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

Question 7

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

Answer 7

principle of double effect

Question 8

what is the largest group of nonprofit health care providers in nation

Answer 8

Catholic Health Association (CHA)

Question 9

T/F: beneficence is interwoven w/ nonmaleficence

Answer 9

TRUE

Question 10

T/F: in most instances, nonmaleficence requires only restraint from harmful acts

Answer 10

TRUE

e.g. restraint from recommending esthetic bonding when it is obvious that the pt does not believe there is an esthetic problem

Question 11

pure utilitarian theory includes what

Answer 11

only principles of beneficence and non-maleficence

Question 12

critisisms against utilitarianism

Answer 12

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

Question 13

what is the right action which produces the greatest happiness for the greatest number

Answer 13

utilitarianism

Question 14

consequentialism or teological ethics follows what

Answer 14

utilitarianism

Question 15

example of balancing benefits against harms in dentistry

Answer 15

injection of local anesthetic to avoid larger pain of cavity prep

Question 16

the balancing process requires that ___ and ___ be taken into consideration because they influence nature and amount of the food produced

Answer 16

patients values and viewpoints

Question 17

the privilege of dentists to be ___ rests primarily in knowledge, skill and experience with which they serve their pts and society

Answer 17

accorded professional status

Question 18

all dentists have the obligation of keeping ___

Answer 18

their knowledge and skill current

Question 19

must specialists and consulting dentists return their patient upon completion of their care

Answer 19

YES

Question 20

The specialists should be obliged when there is no referring dentist and upon completion of their tx to inform patient ___

Answer 20

there is a need for further dental care

Question 21

should the dentist rendering a second opinion have a vested interest in ensuring recommendation

Answer 21

NO

Question 22

dentists should be obliged to protect health of their patients by only assigning to ___

Answer 22

qualified auxillaries those duties which can be legally delegated

Question 23

2 most pressing issues in dental profession

Answer 23

1. overtreatment
2. student debt

Question 24

dentists are required to provide pt with what type of opinion

Answer 24

disinterested opinion (benefits patient, that is in their best interest)

Question 25

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

Answer 25

1. dentist overlooks patients, staff and ethical compass
2. pt seen as dollar signs rather than person

Question 26

common procedures misused

Answer 26

1. crowns for every cracked tooth
2. crowns when restoration would suffice
3. endo for every close lesion to pulp
4. insurance code maniupulation
5. perio tx for every instance when prophy or scaling could be performed
6. stain vs. demineralization
7. using pt insurance benefits by maxing them out
8. repair vs replace restoration especially around crown margins
9. panorex for every pt when full mouth radiographs are better
10. radiographs too often or radiographs not complete

Question 27

can patients choose their level of risk

Answer 27

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’

Question 28

age of patient minus when tooth erupted helps determine what

Answer 28

rate of caries progression

look at previous radiographs to help determine rate of progression

Question 29

it is unethical for a dentist to practice while abusing ___

Answer 29

controled substances, alcohol or other chemical agents

Question 30

dentists with first-hand knowledge that a coleague is practicing dentistry when so impaired have an ethical responsibility to report such evidence to ___

Answer 30

professional assistance committee of a dental society

Question 31

example of impairments

Answer 31

controlled substance, age, vision, not able or chooses not to meet standard of care

Question 32

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

Answer 32

YES

Question 33

upon exposure, what was the practitioner do

Answer 33

present a postexposure evaluation and follow up

Question 34

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

Answer 34

YES