Principles and Central Values Flashcards
Ozar’s Central Values
1) Patient’s life and general health
2) Patient’s oral health
3) Patient’s autonomy
4) Dentist’s preferred pattern of practice
5) Esthetic values
6) Efficiency in the use of resources
4 Doctor-Patient Relationship Models
1) Guild model
2) Agent model
3) Commercial model
4) Interactive model
- Relationship based on dentist’s expertise and the patient’s lack of it
- Patient does not make any contribution to dental decisions
- Dentist is the judge of the patient’s needs
Guild Model
- All dental decisions made by patient
- Dentist provides service for patient choices
- Not much basis in reality
Agent Model
- Dentist has something to sell; patient may or may not want to buy it
- Standard “market place” principles apply
- Patient’s need for care is not the direct determinant of the dentist’s actions
- Dentist and patient on equal ground
Commercial Model
- Dentist and patient are equal partners
- Preservation and maximization of patient autonomy
- Dentist enhances patient’s decision making capacity
- Dentist contributes expertise into the decision-making process
Interactive Model
5 ADA Principles of Ethics
1) Patient autonomy
2) Nonmaleficence
3) Beneficence
4) Justice
5) Veracity
3 Main Components of ADA Principles
1) Principles of Ethics
2) Code of Professional Conduct
3) Advisory Options
goals of the profession, provide guidance and offer justification
Principles of Ethics
conduct that is required or prohibited
Code of Professional Conduct
interpretations that apply the code of professional conduct to specific fact situations
Advisory Options
“self governance” ; The dentist has a duty to respect the patient’s right to self-determination and confidentiality. Professionals have a duty to treat the patient according to the patient’s desires, within the bounds of accepted treatment.
Patient Autonomy
“do no harm” ; Duty to refrain from harming the patient. Dentist’s primary obligations include keeping knowledge and skills current, knowing one’s own limitations and when to refer to a specialist or other professional, knowing when delegation of patient care to auxiliaries is appropriate.
Non-maleficence
“do good” ; Duty to promote the patients welfare. Serve the patient and public-at-large. Competent and timely delivery of dental care within the bound of clinical circumstances presented by the patient. (contract obligations do not excuse dentists from their ethical duty to put the patient’s welfare first)
Beneficence
“fairness” ; Duty to treat people fairly. Duty to be fair in the dealings with patients, colleagues and society. Dealing with people justly and delivering dental care without prejudice.
Justice definition
“truthfulness” ; The dentist has a duty to communicate truthfully. Duty to be honest and trustworthy in their dealings with people. Obligations include respecting the position of trust inherent in the dentist-patient relationship, communicating truthfully and without deception, and maintaining intellectual integrity.
Veracity
Patient involvement- patient should be informed of treatment plans
Patient Autonomy
Patient records- confidentiality of patient records. Dentists shall provide information when applicable with the law that will benefit future treatment of patient
Patient Autonomy
Furnishing copies of records- ethical obligation on request of patient or patient’s doctor to furnish records (can be at a reasonable cost) and the obligation exists even if the patient’s account is not paid in full.
Patient Autonomy (patient records)
Confidentiality of patient records- relevant information in the records should be released to another dental practitioner- assuming dentists requesting the information is the patient’s present dentist.
Patient Autonomy (patient records)
Education- keeping their knowledge and skill current
Nonmaleficence
Consultation and referral- seeking consultation. Specialists or consulting dentist should return the patient upon completion of care.
Nonmaleficence
Second opinions- a dentists who has a patient referred by a third party for a second opinions should render the requested opinion. The third party dentists should not have a vested interest.
Nonmaleficence (consultation and referral)
Use of Auxiliary personnel- dentists are obliged to protect the health of their patients by only assigning to qualified auxiliaries (hygienists/ assistants) those duties which can be legally delegated
Nonmaleficence
Personal impairment- unethical to practice while abusing controlled substances, alcohol, or other chemical agents which impair the ability to practice. Have a ethical responsibility to report first hand knowledge.
Nonmaleficence
A dentist who contracts any disease or becomes impaired in any way that might endanger patients or staff, shall limit the activities of practices to those areas that do no endanger patients or dental staff.
Nonmaleficence (personal impairment)
exposure, bloodborne pathogens¬- dentists have an obligation to inform patient who may have been exposed to blood or other potentially infectious material in the dental office. If this happens dentist shall provide information concerning their bloodborne pathogen status.
Nonmaleficence
Patient abandonment- once a dentist has undertaken a course of treatment, the dentist should not discontinue that treatment without giving the patient adequate notice and the opportunity to obtain services at another dentist.
Nonmaleficence
Personal relationships with patients- should avoid sexual/ interpersonal relationships.
Nonmaleficence
Community service- obligation to use their skills, knowledge and experience for the improvement of the dental health of the public, be leader in their community and maintain or elevate the esteem of the profession.
Beneficence
Government of a profession- (regulate itself) obligation to make themselves a part of a professional society and of observing its rules of ethics. SELF REGULATION
Beneficence
Research and development- make the results and benefits of their ‘results’ available to all when they are useful in safeguard or promoting the health to the public.
Beneficence
Patents and copyrights- can be obtained as long as they are not used to restrict research or practice.
Beneficence
Abuse and neglect- become familiar with signs of abuse and neglect and report suspected cases to authorities
Beneficence
Reporting abuse and neglect- ethically obligated to identify and report suspected cases of abuse and neglect to the same extent as they are legally obliged to do so in the jurisdiction where they practice. Respect the wishes of an adult patient who asks that a suspected cause of abuse/neglect not be reported.
Beneficence (abuse and neglect)
Professional demeanor in the workplace- provide a workplace environment that supports respectful and collaborative relationships for all those involved in oral health care.
Beneficence
Disruptive behavior in the workplace- dentists are leaders and their behavior in the workplace is important for establishing and maintaining a practice environment that supports mutual respect, good communication, and high levels of collaboration.
Beneficence (professional demeanor in workplace)
Patient Selection- reasonable discretion in selecting patients for their practices, dentists shall not accept/deny patients based on: race, creed, color, sex, or national origin
Justice
