Ethics - Hippocratic Oath

what is involved with veracity in advisory opinions?

- ADA; amalgam removal to eliminate "toxic substances" solely at DDS recommendation is improper and unethical - cannot falsely claim tx will diagnose/cure/alleviate condition - waive copayment without disclosing to insurer = overbilling - cannot increase fee because patient has dental benefits - cannot report incorrect dates or codes to obtain benefits - cannot recommend/perform unnecessary procedures - must report adverse rxn to drug/device

what is beneficence?

- act for good of others - primary obligation is to patient and public-at-large - competent and timely care - can enter into contract for care but does not excuse from ethical duties to put patient first

what involves beneficence and code of professional conduct?

- community service - government of a profession; self regulate - research and development to safeguard/promote health - patents and copyrights; not to restrict research/care - abuse and neglect; know signs and report - professional demeanor in the workplace; respect/communication/collaboration -> optimal care

what involves non maleficence in advisory opinions?

- dentist rendering 2nd opinion should not have vested interest - dentist with disease/impairment that might endanger patients/staff shall limit activities to areas that to do endanger patients/staff - dentist advised to limit activities should monitor condition -> additional limits to activities prn

what is veracity?

- duty to be honest/trustworthy dealing with people - primary obligations: a) respecting position of trust inherent in dentist-patient relationship b) communicating truthfully/without deception c) maintaining intellectual integrity

what is justice?

- duty to treat patients/colleagues/society fairly - deal with people justly and deliver dental care without prejudice - actively seeks allies to improve access to care

what involves non-maleficence?

- education: keep knowledge and skills current - know limitations - know when to refer to specialist or other professional - delegate patient care to auxiliaries appropriately

what involves beneficence in advisory opinions?

- elective and non-emergent procedures during public health emergency - reporting abuse and neglect - disrupt behavior in workplace

what are the principles of ethics?

- explains aspirational goals of the profession - A/B/V/J/V - principles can overlap each other - principles can compete with each other for priority

what is the code of professional conduct?

- expression of specific that are required or prohibited - result from resolutions adopted by ADA's house of delegates - binding on ADA members; violations may result in disciplinary action

what involves autonomy in advisory opinions?

- furnishing records - gratuitously or for nominal cost - cannot withhold if patient owes $$$ - confidentiality of records

what are advisory opinions?

- interpretations applying code of professional conduct to specific situations - ex; how the council might interpret code of professional conduct in a disciplinary proceeding

what are examples of false or misleading?

- material misrepresentation of fact - omission of necessary fact - deliberately intend or be likely to create an unjustified expectation about results - express or implied representation that services are superior to those of other dentists, if cannot substantiate

where can principle 6 be applied in other areas?

- needed oral health care - interpersonal dentist, patient, staff member, and community relationships - digital records and communication - emerging technologies such as nanotechnology and artificial intelligence

what is respect for human dignity?

- new era of genetics in dental research/education/practice - ethical/legal/social concerns regarding issues of confidentiality, discrimination, informed consent, risk communication, and professional and continued education as they regard the use of genetic information int he practice of dentistry - principle 6: foundation of guidelines on questionable gene-based scientific research projects and clinical protocols

what involves justice and the code of professional conduct?

- patient selection; reasonable/non-discriminatory - emergency care; must make reasonable arrangements for patients of record or not - must report gross or continual faculty treatment by other dentists - must inform patients of present oral health status without disparaging comment about prior services - justifiable criticism; know the facts - expert testimony; just and fair - rebates and split fees

what involves justice with advisory opinions?

- patients with disabilities/bloodborne pathogens - "justifiable" - cannot split fees in advertising and marketing services

what are the three main components of ethics?

- principles of ethics - code of professional conduct - advisory opinions

what involves veracity and code of professional conduct?

- representation of care and fees; not false/misleading - disclosure of any conflict of interest (COI) - devices and therapeutic methods - professional announcement; no misrepresentation - advertising; not false or misleading - name of practice; previous DDS name only 1 year - specialization/practice limitation; recognized only

what is the hippocratic oath summarized?

- respect your teachers - pledge your life to the service of others - place your patients' interests before your own - protect your patients from harm and injustice - treat all patients equally - respect patient's right to make decisions (autonomy) - continue to improve the care you give - do not become intimate with patients - try to prevent as well as cure disease - protect your patients' confidentiality - impart your medical knowledge to others

what involves patient autonomy?

- self governance - duty to respect patient's right to self determination and confidentiality - involve patients in treatment decisions in meaningful way

what involves non maleficence in the code of professional conduct?

- speciality/consultant should return patient to referrer at completion of care - specialist obliged to inform patient of need for further care - only assign duties which can be delegated to qualified auxiliaries - cannot practice while impaired - obliged to urge impaired colleagues to seek treatment - immediately inform patient with potential infectious exposure - cannot discontinue treatment without providing adequate notice and opportunity for care - avoid interpersonal relationships that could impair professional judgement or risk the possibility exploiting patient confidence

what types of issues dealing with respect for human dignity?

- third party access to genetic information - genetic testing/counseling - genetic testing of children - research in gene therapy and genetic engineering

what is principle 3?

beneficence (do good)

what should you do if you think a member of the ADA was unethical?

bring to appropriate constituent (state) or component (local) dental society

why are there changes to the code of ethics?

due to shifts in technology which are being used more often

what does the preamble talk about?

follow high ethical standards; benefit of patient is primary goal; provide advocacy to and care of the underserved

what involves autonomy in the code of professional conduct?

for patient records: - safeguard confidentiality - upon request of patient/other practitioner, provide information benefitting future treatment of patient - in accordance with applicable law; ex. HIV status

what is principle 4?

justice (fairness)

what happens if a member is found guilty?

may censure/suspend/expel from ADA

what is principle 2?

non-maleficence (do no harm)

what is principle 1?

patient autonomy

what is principle 6?

respect for human dignity

what level are ethic questions resolved at?

the state or the local level

what is principle 5?

veracity (truthfulness)