Ch. 5: Codes of Ethics

What addresses the discrepancy of the obligations of the health care professional vs. the rights of the pt. ?

Pt's bill of rights

A guideline for members of a professional group used for self-regulation of the group

Code of eithics

A duty to conform to a rule or custum

Obligation

A major purpose of this is to bind the members of a group together by expressing their goals and aspirations, as well as define expected standards of behavior.

Professional Code of Ethics

The concept that a professional who provides care for a pt, thereby establishing a provider-patient relationship, is not obligated to provide that care if it would involve performing unethical services.

Professional autonomy

Fundamental Principles

These fundamental principles, universal concepts, and general laws of conduct provide the foundation for our ethics. -*Universality* -*Complementarity* -*Ethics* -*Community* -*Responsibility*

Universality

The principle of universality expects that, if one individual judges an action to be right or wrong in a given situation, other people considering the same action in the same situation would make the same judgment.

What is a condition of membership to the ADHA?

Upholding the code of ethics -Code should be studied and referred to for guidance

ADHA Preamble

*1 Preamble* As dental hygienists, we are a community of professionals devoted to the prevention of disease and the promotion and improvement of the public's health. We are preventive oral health professionals who provide educational, clinical, and therapeutic services to the public. We strive to live meaningful, productive, satisfying lives that simultaneously serve us, our profession, our society, and the world. Our actions, behaviors, and attitudes are consistent with our commitment to public service. We endorse and incorporate the Code into our daily lives.

How many principles of ethics / aspirational goals does the ADA refer vs. the ADHA?

*ADA* = 5 *ADHA* = 7

What are the components to the *Dental Code*?

1. Principles of Ethics-Aspirational goals similar to hygiene but ADA refers to 5 principles where the ADHA refers to 7 adding confidentiality and societal trust 2. Code of professional conduct-delineates conduct required or prohibited 3. Advisory opinions-legal warning or suggestions for the dentist.

A code of ethics also is a set of commandments and, as such has what 2 principle functions?

1. Provides an enforceable standard of minimally decent conduct. 2. Helps the professional understand in general

The code can be amended at any meeting of the ADHA house of delegates...How much does the vote need to pass by?

2/3rds

The Dental code is divided into how many components?

3

In return for the power and prestige granted to the professions, a code of ethics is the promise of what?

A promise to society to uphold certain values and standards in the practice of the profession.

Who maintains the DH code?

ADHA -Committee to review and revise

When was the first code of ethics for dental hygienists created?

At the inception of the American Dental Hygienists Association (ADHA) in 1927

A set of rules or guidelines that address the ethical standards of a professional group

Code of ethics

What are the 2 aspirational goals the ADHA added that the ADA doesn't include?

Confidentiality Societal Trust

Community

This principle expresses our concern for the bond between individuals, the community, and society in general. It leads us to preserve natural resources and inspires us to show concern for the global environment.

This a a character trait; the assumption that if a person is this he or she will act virtuously

Virtue -Part of the selection process focuses on identifying virtue in the character of applicants

Nonmaleficence

We accept our fundamental obligation to provide services in a manner that protects all clients and minimizes harm to them and others involved in their treatment.

Veracity

We accept our obligation to tell the truth and expect that others will do the same. We value self-knowledge and seek truth and honesty in all relationships.

How does a person know whether codes of ethics are ever effective?

*3 things demonstrate how codes can be effective in shaping professional behavior.* 1. Professional schools of health care screening applicants 2. Character Traits 3. Obligation of professionals

To Family and Friends...

▪ Support the efforts of others to establish and maintain healthy lifestyles and respect the rights of friends and family.

Core Values

We acknowledge these values as general for our choices and actions. -*Individual Autonomy and respect for Human Beings* -*Confidentiality* -*Societal Trust* -*Nonmaleficence* -*Beneficence* -*Justice and Fairness* -*Veracity*

Beneficence

We have a primary role in promoting the well being of individuals and the public by engaging in health promotion/disease prevention activities.

When screening applicants what is considered for obligation of professionals?

After entering professional practice, it becomes the obligation of those professionals to help regulate their profession. -When violations occur, members of the profession who become aware of these violations have a duty to intervene in a substantive way. -This is a serious step and must be carefully considered; the reputation of the progression and the well-being of the public ultimately rests on a willingness to engage in meaningful self-policing of the profession.

This is the contract the profession makes with society outlining the standards it will adhere to and uphold.

Code of ethics

An oath, written by a physician in the 4th century, that is the foundation for most ethical codes in health care

Hippocratic oath

The first ethical code that dates back to the time of the Greek physician Hippocrates, and the influence of this oath is still reflected today in modern versions of ethical codes

Hippocratic oath

Do codes alone guarantee that everyone will behave with integrity?

No, but they do provide guidance and standards by which professionals can be judged. -They also serve as a touchstone by which all members of a profession can judge the acceptable parameters of behavior.

What do most codes stress obligations on?

Obligations of health care professionals not rights of the pt's

ADHA Key Concepts

Our beliefs, principles, values, and ethics are concepts reflected in the Code. They are the essential elements of our comprehensive and definitive code of ethics and are interrelated and mutually dependent.

To Ourselves as Professionals....

▪ Enhance professional competencies through continuous learning in order to practice according to high standards of care. ▪ Support dental hygiene peer-review systems and quality-assurance measures. ▪ Develop collaborative professional relationships and exchange knowledge to enhance our own lifelong professional development.

When screening applicants what does choosing a candidate with good character traits consist of

-Learning what is expected of that professional person reinforces character traits in the developing professional. -Often accomplished by introducing students to the institution's code of conduct, by familiarizing them with the profession's code of ethics and professional conduct, by faculty serving as positive role models, and by enforcing adherence to expected professional behaviors when professional codes have been violated.

What addresses the ares of personal integrity, dedication, and principled behavior?

Ethical codes

What does the acceptance and support of the prescribed principles and standards of behavior help do?

Helps to reinforce the significance of being a part of a special group of people who are committed to the same values and goals

Hippocratic Oath

I swear by Apollo Physician and Asclepios and Hygeia and Panacea and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant: To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art—if they desire to learn it—without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else. I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice. I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art. I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work. Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves. What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about. If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.

The written standards that detail the responsibilities of a particular group

Professional code

Responsibility

Responsibility is central to our ethics. We recognize that there are guidelines for making ethical choices and accept responsibility for knowing and applying them. We accept the consequences of our actions or the failure to act and are willing to make ethical choices and publicly affirm them.

This is one of the essential characteristics of a true profession

Code of ethics

Ethics

Ethics are the general standards of right and wrong that guide behavior within society. As generally accepted actions, they can be judged by determining the extent to which they promote good and minimize harm. Ethics compel us to engage in health promotion/disease prevention activities.

Individual Autonomy and Respect for Human Beings

People have the right to be treated with respect. They have the right to informed consent prior to treatment, and they have the right to full disclosure of all relevant information so that they can make informed choices about their care.

Confidentiality

We respect the confidentiality of client information and relationships as a demonstration of the value we place on individual autonomy. We acknowledge our obligation to justify any violation of a confidence.

To ourselves as Individuals...

▪ Avoid self-deception and continually strive for knowledge and personal growth. ▪ Establish and maintain a lifestyle that supports optimal health. ▪ Create a safe work environment. ▪ Assert our own interests in ways that are fair and equitable. ▪ Seek the advice and counsel of others when challenged with ethical dilemmas. ▪ Have realistic expectations of ourselves and recognize our limitations.

To the Dental Hygiene Profession

▪ Participate in the development and advancement of our profession. ▪ Avoid conflicts of interest and declare them when they occur. ▪ Seek opportunities to increase public awareness and understanding of oral health practices. ▪ Act in ways that bring credit to our profession while demonstrating appropriate respect for colleagues in other professions. ▪ Contribute time, talent, and financial resources to support and promote our profession. ▪ Promote a positive image for our profession. ▪ Promote a framework for professional education that develops dental hygiene competencies to meet the oral and overall health needs of the public.

To Clients

▪ Provide oral health care utilizing high levels of professional knowledge, judgment, and skill. ▪ Maintain a work environment that minimizes the risk of harm. ▪ Serve all clients without discrimination and avoid action toward any individual or group that may be interpreted as discriminatory. ▪ Hold professional client relationships confidential. ▪ Communicate with clients in a respectful manner. ▪ Promote ethical behavior and high standards of care by all dental hygienists. ▪ Serve as an advocate for the welfare of clients. ▪ Provide clients with the information necessary to make informed decisions about their oral health and encourage their full participation in treatment decisions and goals. ▪ Refer clients to other health care providers when their needs are beyond our ability or scope of practice. ▪ Educate clients about high-quality oral health care.

What are the specific objectives of the DH code of ethics?

▪to increase our professional and ethical consciousness and sense of ethical responsibility. ▪to lead us to recognize ethical issues and choices and to guide us in making more informed ethical decisions. ▪to establish a standard for professional judgment and conduct. ▪to provide a statement of the ethical behavior the public can expect from us.

In traditional medical codes of ethics what is emphasized on the physician?

(1) duties in the individual patient-physician relationship, including the obligation of confidentiality; (2) authority and duty of beneficence (i.e., acting for the patient's good); and (3) obligation to each other.

What are the 4 goals listed at the beginning that capture the essence of importance to RDH and the public we serve?

*1.* To increase our professional and ethical consciousness and sense of ethical responsibility *2.*To lead us to recognize ethical issues and choices and to guide us in making more informed ethical decisions *3.* To establish a standard for professional judgment and conduct *4.* To provide a statement of the ethical behavior the public can expect from us

What does the professional schools of health care screening applicants consist of?

-Screening applicant for admission to education programs, integrity and character are important criteria for acceptance -Admissions committees aim to select candidates who are the best qualified academically as well as candidates of good character.

Complementarity

The principle of complementarity recognizes the existence of an obligation to justice and basic human rights. In all relationships, it requires considering the values and perspectives of others before making decisions or taking actions affecting them

Why are codes of ethics aspirational in nature but not legal mandates.

They are typically powerful ethical statements, that can not be easily dismissed if there is a formal structure for self-regulation -Ideally, codes should create a relationship among members of a profession that is similar to the ties in a family, obviating the need for enforcement outside the group.

Standards of Professional Responsibility

We are obligated to practice our profession in a manner that supports our purpose, beliefs, and values in accordance with the fundamental principles that support our ethics. We acknowledge the following responsibilities: -*To Ourselves as Individuals* -*To Ourselves as Professionals* -*To Family and Friends* -*To Clients* -*To Colleagues* _*To Employees and Employers* -*To the Dental Hygiene Profession* -*To the Community and Society* -*To Scientific Investigation*

Societal Trust

We value client trust and understand that public trust in our profession is based on our actions and behavior.

Justice and Fairness

We value justice and support the fair and equitable distribution of health care resources. We believe all people should have access to high-quality, affordable oral health care.

To Employees and Employers

▪ Conduct professional activities and programs and develop relationships in ways that are honest, responsible, open, and candid. ▪ Manage conflicts constructively. ▪ Support the right of our employees and employers to work in an environment that promotes wellness. ▪ Respect the employment rights of our employers and employees.

To Colleagues

▪ Conduct professional activities and programs, and develop relationships in ways that are honest, responsible, and appropriately open and candid. ▪ Encourage a work environment that promotes individual professional growth and development. ▪ Collaborate with others to create a work environment that minimizes risk to the personal health and safety of our colleagues. ▪ Manage conflicts constructively. ▪ Support the efforts of other dental hygienists to communicate the dental hygiene philosophy and preventive oral care. ▪ Inform other health care professionals about the relationship between general and oral health. ▪ Promote human relationships that are mutually beneficial, including those with other health care professionals.

To the community and Society

▪ Recognize and uphold the laws and regulations governing our profession. ▪ Document and report inappropriate, inadequate, or substandard care and/or illegal activities by a health care provider, to the responsible authorities. ▪ Use peer review as a mechanism for identifying inappropriate, inadequate, or substandard care provided by dental hygienists. ▪ Comply with local, state, and federal statutes that promote public health and safety. ▪ Develop support systems and quality-assurance programs in the workplace to assist dental hygienists in providing the appropriate standard of care. ▪ Promote access to dental hygiene services for all, supporting justice and fairness in the distribution of health care resources. ▪ Act consistently with the ethics of the global scientific community of which our profession is a part. ▪ Create a healthful workplace ecosystem to support a healthy environment. ▪ Recognize and uphold our obligation to provide pro bono service.

To Scientific Investigation

▪Conduct research that contributes knowledge that is valid and useful to our clients and society. ▪Use research methods that meet accepted scientific standards. ▪Use research resources appropriately. ▪Systematically review and justify research in progress to insure the most favorable benefit-to-risk ratio to research subjects. ▪Submit all proposals involving human subjects to an appropriate human subject review committee. ▪Secure appropriate institutional committee approval for the conduct of research involving animals. ▪Obtain informed consent from human subjects participating in research that is based on specification published in Title 21 Code of Federal Regulations Part 46. ▪Respect the confidentiality and privacy of data. ▪Seek opportunities to advance dental hygiene knowledge through research by providing financial, human, and technical resources whenever possible. ▪Report research results in a timely manner. ▪Report research findings completely and honestly, drawing only those conclusions that are supported by the data presented. ▪Report the names of investigators fairly and accurately. ▪Interpret the research and the research of others accurately and objectively, drawing conclusions that are supported by the data presented and seeking clarity when uncertain. ▪Critically evaluate research methods and results before applying new theory and technology in practice. ▪Be knowledgeable concerning currently accepted preventive and therapeutic methods, products, and technology and their application to our practice.

ADHA Basic Beliefs

▪The services we provide contribute to the health and well-being of society. ▪Our education and licensure qualify us to serve the public by preventing and treating oral disease and helping individuals achieve and maintain optimal health. ▪Individuals have intrinsic worth, are responsible for their own health, and are entitled to make choices regarding their health. ▪Dental hygiene care is an essential component of overall health care, and we function interdependently with other health care providers. ▪All people should have access to health care, including oral health care. ▪We are individually responsible for our actions and the quality of care we provide.