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As dental professionals, we may encounter ethical dilemmas that require careful consideration. While the prevalence of these dilemmas is difficult to quantify, Boards of Dentistry often identify ethics as a contributing factor in cases brought before them. Each situation is unique, with its own set of distinguishing factors. In this article, we explore some common ethical dilemmas in dentistry and discuss a decision-making model to navigate these complex scenarios.
Categories of Ethical Dilemmas
Ethical dilemmas can arise in various aspects of dental care. Here are some categories that have been acknowledged in the dental ethics literature:
- Breaches of confidentiality
- Failure to disclose dental mistakes
- Over-treatment and poor quality dental treatment
- Requests for fraudulent documentation
- Requests for narcotic medications
- Requests for inappropriate treatment
- Deceptive dental marketing and advertisements
- Impaired or dishonest colleagues
- Challenges with capacity and informed consent
- Conflict or unethical behavior among clinicians
- Challenges arising from management, finance, or legal issues
It is important to recognize that ethical issues can manifest differently in each clinical situation.
Applying the Ethical Decision-Making Model
To address ethical challenges effectively, dentists can apply a systematic decision-making model. Let’s walk through the steps using a hypothetical scenario:
Step 1. What is the ethical question?
Imagine a situation where a dentist suspects dental neglect in children. The question arises: Should the dentist report this neglect to child protective services? Assessing the responsibility towards the children and their parent becomes crucial.
Step 2. Collect information
To make an informed decision, gather relevant information. Consider the family’s history, their background, and the dental practice’s relationship with the local church. Assess the guidance provided by the church and whether they cover the cost of care. Also, evaluate the overall well-being of the children and the parent’s involvement in their care.
Step 3. State the options
Once armed with information, identify the available options. In this case, the options might include:
- Treat the children.
- Report the cases of dental neglect to child protective services.
- Seek information and guidance from child care services.
- Monitor the children’s return visits to ensure timely dental care.
- Educate the mother about dental disease and prevention.
Step 4. Apply the principles
Now, let’s consider how each option aligns with ethical principles:
- Treating the children respects the autonomy of the parent to choose for their minor children.
- Reporting the cases to child protective services honors the principles of nonmaleficence and veracity, as dental neglect is harmful and negligence should be reported.
- Seeking information and guidance from child care services aligns with the principles of beneficence and legal compliance.
- Monitoring the children’s return visits respects the mother’s autonomy and choice for her children.
- Educating the mother about dental disease and prevention promotes beneficence and justice, considering her background and cultural differences.
Step 5. Make the decision
Based on the assessment, a decision needs to be made. In our hypothetical scenario, the first option would be chosen as the children are present in the dental office, and the mother is likely to proceed with treatment. Reporting to Child Protective Services might not expedite dental care for the children. Option 5, educating the mother, can also be included in the treatment plan.
Step 6. Implement the decision
Once a decision is made, it is important to implement it accordingly. In this case, the dentist would proceed with providing dental treatment to the children.
Remember, discussing complex cases with colleagues can provide additional perspectives and options. The decision-making process is dynamic, and new information may require reevaluation.
For more insights and information on ethical dilemmas in dentistry, visit Make You Smile. We are committed to promoting ethical practices and providing valuable resources for dental professionals.
Let’s navigate the complexities of dental ethics together, ensuring the highest standards of patient care and professional integrity.