legal issues and the dental radiographer

Question 1

laws exist that govern the use of ionizing radiation in dentistry

Answer 1

• the dental professional must be informed of and comply with these regulations
• the possibility of negligent care exists when dental radiographs are not properly exposed or used

Question 2

federal and provincial regulations

Answer 2

• provincial QA programs from licensing body

- very similar to Safety Code 30

Question 3

licensure requirements

Answer 3

• provincial
• may include obtaining additional certification in dental radiography i.e. dental assistants
• and exposing radiograph only under direct supervision of the dentist

Question 4

legal issues and the dental patient

Answer 4

• risk management
• malpractice issues
• patient records
• how patients refuse radiographs

Question 5

risk management

Answer 5

extremely important in dental radiography. refers to:

• the policies and procedures that should be followed by the dental radiographer to reduce the chances that a patient will file legal action against the dental radiographer or the supervising dentist
• your legal responsibilities

Question 6

what is informed consent?

Answer 6

• persons seeking health care services have the legal right to make choices about the care they receive, including the opportunity to consent to or to refuse treatment
• this is defined as self-determination
• therefore, the patient should be informed on the needs of dental radiographs and the dentist should always be involved (exception here: self-regulated and self-initiated)

Question 7

what information must be presented to the patient in order to obtain informed consent?

Answer 7

• the purpose and potential benefits of the radiographs
• the person responsible for exposing the radiographs
• the number and type of radiographs
• the possible harm that may result if the radiographs are not exposed
• the risks associated with x-ray exposure
• the alternative diagnostic aids that may serve the same purpose as the radiographs

Question 8

what is disclosure?

Answer 8

• the process of informing the patient about the particulars of exposing dental radiographs

Question 9

what is informed consent?

Answer 9

• defined as consent given by the patient following complete disclosure

Question 10

what 4 things must happen in order for the patient to make an informed decision and provide consent (informed consent)?

Answer 10

1 - the patient should receive enough information to make informed choices
2 - the patient should have their questions answered before x-ray exposure
3 - must be obtained for every patient (minor=legal guardian consent)
4 - should be in the language that the patient readily understands

Question 11

4 elements of an informed consent:

Answer 11

1 - purpose of the procedure and who will perform it
2 - potential benefits of receiving the procedure
3 - potential risks involved in having the procedure performed, as well as the possible risks of not having it performed
4 - opportunity for the patient to ask questions and obtain complete information

Question 12

malpractice/negligence issues

Answer 12

• if the informed consent is not obtained from a patient before the exposure of dental radiographs, a patient may legally claim malpractice or negligence

Question 13

liability

Answer 13

• dentists are legally accountable or liable to supervise the performance of dental auxiliaries
• dental hygienists are also liable for negligence (you should always have malpractice insurance)

Question 14

malpractice issues

Answer 14

• malpractice: results when the dental practitioner is negligent in the delivery of dental care
• negligence: when the diagnosis made or the dental treatment delivered falls below the standard of care
• standard of care: the quality of care that is provided by dental practitioners in a similar locality under the same or similar conditions
• statute of limitations: the time period during which a patient may bring a malpractice action against the dentist or auxiliary

Question 15

patient records

Answer 15

• legal documents
• a dental record must be established for every patient
• must include all documentation of the exposure of dental radiographs
• documentation: informed consent, number and type of radiographs exposed, rationale for exposing such radiographs, diagnostic information obtained from the interpretation of the radiographs

Question 16

confidentiality

Answer 16

• all the information contained in the dental record, including dental radiographs is confidential
• the confidentiality law protects the information and prohibits the transfer of the information to non privilege persons
• it is absolutely not appropriate to discuss a patient’s case with another patient or staff members not involved in the treatment of the patient
• can only discuss with staff members involved and the dentist/or physician with whom the treatment is shared

Question 17

ownership and retention of dental radiographs

Answer 17

• legally, dental radiographs are the property of the dentist - indispensable to the dentist
• patients do that the right of reasonable access to their records
• request in writing, and placed in the chart as proof of the patient’s directive
• originals should not be forwarded, duplicates only
• usually, a copy is given to the dentist assuming responsibility for the patient’s care
• dental records and dental radiographs should be retained indefinitely - it is a legal document

Question 18

patients who refuse radiographs

Answer 18

• the situation must be carefully considered by the dentist
• the dentist must decide whether an accurate diagnosis can be made and whether treatment can be provided
• notation in chart including discussion