Ethics Flashcards
When can dentists break confidentiality?
•as a dentist there is an ethical and legal obligation that you protect your patients info and even if u are disclosing info with people involved in the patients care you must do it so that others cannot hear you/identify patient. This ensures patient-dentist trust is maintained
•there are some circumstances that you may need to break confidentiality which are stated in the GDC e.g when it’s ordered by the court/police= legal obligations or if you believe a patient is likely to cause harm to themselves or someone else
•it is also important that you try to inform your patient that info may need to be disclosed and you may also try to encourage patients to disclose things themselves = this maintains patient-dentist trust
What kind of issues might cause a dentist to be struck off the professional register?
•as a dentist you must follow all the GDC guidelines and if you deviate from a lot of its principles you are at risk of being struck off e.g breaking patient confidentiality and sharing info that should not be given to others unless situation calls for it (when I volunteered at a hospice I also had the responsibility to not share private info and I did uphold by this and made sure that I did not discuss sensitive info like this to anyone at any circumstances)
•not being physically able to do procedures e.g manual dexterity may be effected and this could pose a safety risk on your patients. It is important that you are honest to the GDC and let them know right away so that they may find a solution e.g many ways for you to continue in your career e.g more involved in public health/business
What precautions need to be taken with patients who are HIV +ve?
•HIV can be spread though sharing injections/coming into contact with cuts and sores on the patients mouth and also though the thin lining of the mouth
•as a dentist you must therefore be very carefully that it cannot be transmitted to urself and your other patients e.g wearing gloves and replacing them if they become torn. Wear masks and eye protection to prevent splatter of blood/saliva. Wash you hands between patients throughout procedure e.g before and after
If someone wants an alternative treatment that could harm them what would you do?
•follow GDC guidelines which prioritise safety and ethical practice = explain clearly how the the proposed treatment could have negative consequences. Throughly explore the risks and emphasise your duty of ensuring their well being.
•document your conversation carefully = note patients decision and your professional advice.
•refer your patient to a specialist or get a second opinion = more responsible than going ahead with a potentially harmful procedure
How would you cope with the death of a patient as a result of your mistake?
•dentistry can be quite challenging. My first priority would be to taking responsibility of my actions= talk to family and friends of patient to apologise. They would be evidently emotional and angry so it it important to give them time to ask questions at own pace
•talk to a senior and let them know what has happened
•I would reflect and recognise what my mistakes were and how I can prevent it next time
•this would also be emotionally taxing for myself so it i’s important to have a support network
How would you treat a patient who is not fluent in your native language?
•I would initially see the extent at which they do not know English e.g if they can maybe understand me but not speak it.
•be more mindful of my body language as my patient will use this as a form of communication
•I will get an interpreter involved to relay info on diagnosis and treatment plans and ensure that the patient fully understands by asserting it frequently
•maybe get a relative involved if they can help with the translations as I’ve seen this being used effectively in my work experience
Your consultant in charge turns up smelling of alcohol. What do you do?
•talk to them privately (solve locally) and ask them is they have been drinking, why and if they have other problems they may want to talk about
•let them know that this will compromise patient safety so they must not work with patients but instead should take the day off, ensuring their shift has been covered
•if I see that it is a long term problem it i’s important that you suggest to them to get extra support e.g from a gp/ you can also speak to someone higher up if you suspect that harm may be inevitable to patients
What is the role of the GDC?
•Organisation registers dentists and regulates dentists to make sure that they are practicing safely and are providing the best care possible for the public that ensures professionalism and trust.
•important for continuing professional development
Have you come across any examples of poor professional behaviour from dentists?
•I have not come across any examples of poor professional behaviour during my work experience. However I do understand that professionalism is very important
•maintain patients trust e.g by not forming personal relationships and not accepting gifts
•maintain good relationships with colleagues and respect each other
•maintain good hygiene and good communication throughout procedures/treatments
A 15-year-old girl attends your practice with her Mother and is complaining of toothache. After your initial examination, you decide to take an x-ray of the tooth. As part of the routine procedure, you ask the patient if there is any chance, she could be pregnant. She originally says no, but once her Mother has left the room informs you that she has recently discovered that she is pregnant and is scared that the treatment may harm her baby. Discuss with us how you would react
•speak to the patient privately to ask if she is safe and to assess her competence (as she is a minor)
•if you suspect abuse you can report it without getting consent but you should try to encourage the patient to report the abuse
•confidential so I cannot involve the mother. I should tell my patient the risks of the treatment plan and let her give informed consent or refuse it
Is it ever okay to lie to a patient
What are the arguments for and against tobacco sales?
How can the sugar tax tackle dental disease
Have you observed or researched any incidents where patient confidentiality has been broken?
A 25-year-old woman comes to your dental practice because she is unhappy with the appearance of her teeth as she feels they look crooked.
On examination, there is no clinical indication that she needs braces, so she does not fit the criteria for braces on the NHS. The woman explains to you that her teeth make her very self-conscious and is causing her to feel depressed. Do you think this woman should be given braces on the NHS?
•I do understand that braces are provided based on clinical needs and in her case = cosmetic which the NHS cannot afford to cover based on limited resources/money (so it is important to express this to patient)
•priority as a dentist is that the patient is listened to and supported (explore her concerns/compassionately help her understand why NHS may not be able to cover it)
•give alternatives e.g other procedures may be covered by nhs or she could opt for private care
•be professional throughout = be truthful and respectful
Is it right for dental students to provide public health advice on social media?
•important that dental students promote public health awareness but info must be accurate and fully evidence based and within their scope of knowledge • misleading info can harm the public and damage trust in healthcare professionals
•they must also make it clear that they are students and not fully qualified professionals
•when done properly it can help address public health challenges, reduce dental inequalities and can engage younger audiences to be better informed and reduce preventable problems
Discuss an ethical dilemma experienced
•treatment needed to improve oral health but patient refuses
Dilemma=
•autonomy so must respect patient
•if you follow beneficence and non-maleficence than you should try to provide the treatment to do what’s best for your patient = however your patient is a competent adult so agreeing with them is what’s best for them (problematic)
What do you think about cheating and how would you handle someone cheating?
•unethical as it is unfair for other students and can cause them to get penalised. It has long term complications = gap in knowledge for student and will affect their ability to be good dentists as it can put patients at risk = breach non-maleficence and can break patient-dentists trust and damage image of healthcare professionals
•try to solve locally= encourage them to confess and be empathetic to their situation. If you see again you should report it as long term implications
A patient has sued another dentists and comes to see you; would you treat this patients and how would you deal with them?
•patient has the right to receive dental care regardless of personal circumstances. But I would try to actively keep my ethical obligations in mind and be as professional as possible
•focus on the patients immediate care needs = priority is to address their dental concerns
•maintain professional boundaries so I would refrain from discussing malpractice case/ if patient brings it up I would let them know politely that my role if to provide dental care and not to intervene in legal disputes
•you can also get advice from seniors or the GDC on what to do next e.g could start providing clear and comprehensive documentation
If you have 2 patients who are in dire need of help, what factors would you look at to determine who would be treated first?
•my first priority is that I would not have personal bias but instead am looking at it subjectively to see who is in need of the most help
•I would prioritise the patient whose conditions pose immediate risk to life/health e.g severe bleeding or difficulty breathing
•asses resources e.g resources may allow for simultaneous treatment e.g if one patient can be stabilised quickly I can focus on the second one
•see how vulnerable the patient is due to e.g age or pre existing conditions where e.g a child or elderly patient might be more vulnerable and should be prioritised
•I would communicate the situation to both and explain clearly so that trust can be maintained
You have a colleague known for overcharging patients and manipulating items on bills for his favour. What do you do?
•initially it is important to assess the situation clearly as it could be a misunderstanding so I would review evidence
•private and professional conversation with the colleague (non-confrontational and allows for e.g misunderstandings to be cleared)
•if it is confirmed then I should report it to appropriate authority as it is compromising patient safety and undermines their trust (seniors or GDC)
•throughout I would handle it discreetly to protect the colleagues reputation as confidentiality i’s important to maintain professionalism and avoid unnecessary harm
How would you deal with anxious patients?
•get nurse involved as they may feel less intimidated
•provide them with cognitive behaviour therapy to help them in the long run
•speak to them about concerns, expectations, ideas
•let them understand their autonomy and only when they consent will anything be done = reassuring (informed consent after letting them know benefits and risk)
•tell-show-do technique
