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Ethics and dental research.

Dentistry is a Hippocratic profession and is therefore committed to ongoing research into the causes and treatments of disease. This research embodies ethical standards which place a high value on a respect for persons. Those standards emphasize that we obtain informed consent from individuals selected to participate in research. The relevant information required for informed consent varies from situation to situation but should take into account the need for participants to make a reasoned decision about their involvement. Where community research is involved, there should be consultation with appropriate representatives. In all contemporary medical research, there is an inherent conflict between the ethical requirement that we share information which will help those who are suffering and the need to preserve rights to competitively sensitive information related to product development and academic funding. These various pressures on research emphasize the need for an active and lively appreciation of ethical issues in contemporary biomedical sciences.

Clinical Trials as Topic↗

A call for ethics committees in dental organizations and in dental education.

It is argued that dental organizations need ethics committees to address growing concerns among the public regarding ethical conduct. Such committees could provide education, help formulate policy and guidelines, and develop case review and consultation, as well as create useful networks. The results of a survey of Canadian faculties of dentistry regarding ethics resources are presented.

Canada↗

The HIV-infected dental professional. A challenge to law, ethics, and the dental profession.

This article explores the legal and ethical dilemmas posed when a dental professional becomes infected with the AIDS virus. The author addresses existing ethics policies of professional associations, the importance of evaluating the risk of exposure to patients, informed consent, and regulatory issues. The paper also considers practical problems and employment status.

Dental Auxiliaries↗

Overservicing in dental practice--ethical perspectives.

Overservicing or the acceptance of unnecessary, inappropriate, excessive or fraudulent treatment is regarded as sanctioned lying, cheating or stealing and thus constitutes unethical conduct and a breach of the integrity of the profession. During the past year the media have repeatedly reported that the private sector is bloated with overservicing: one of the most important factors contributing to the increasing inflation of health care costs. Overservicing is an ethical problem presenting with a conflict situation among the interests of the patient, the provider and the funder. For example, since dentists are in a position to gain financially from their professional recommendations, they are at risk of having a conflict of interest: by overservicing they collect more fees. Low medical aid tariffs, delayed payment of benefits, oversupply of dentists, decreasing business and the spiralling costs of dental materials and equipment are the primary causes of high practice overheads and low cash-flow levels. Dentists may seek alternatives such as overservicing or unnecessary treatment to generate income and to improve their cash flow and/or profit. The main motives for overservicing are economic survival and financial gain. Some dentists may overtreat unintentionally due to out-dated treatment philosophies or where criteria for diagnosis and effective care are not clear, leading to variation in treatment decisions. Some overservicing may be due to patient-initiated demand. Dentists are largely unregulated as to the appropriateness or necessity of treatment decisions because of their professional status. Society trusts that their professionals will put the benefit of those they serve above their own self-interests. The aim of this review is to provide dentists with some guidance to the process of ethical decision making, the ethical principles involved, moral rules, and guidelines for professional standard of care. Business considerations whether profit, financial gain or economic survival should never justify overservicing by the dentist. If the patients' best interests are always considered, the profession of dentistry can ethically exist within a business structure.

Decision Making↗

Ethics in dental practice.

To gain patients' confidence, these moral guidelines offer specific consideration in presenting treatment choices, gaining consent, and responding to patients' decisions. When the dentist-patient relationship is one of mutual trust, unusual and difficult situations are easier to solve.

Adult↗

[The ethics of dental records].

This article highlights five aspects of necessary record-keeping in practices: ethicolegal requirements, confidentiality and disclosure, risk management and consent, accounts and practice management, and forensic functions. Patient records therefore have ethical, moral, legal and management implications. Unfortunately, they are often underestimated or ignored by practitioners. In the light of increasing litigation and disciplinary hearings, it is necessary to remind practitioners that every clinical action also contains an administrative component which has to fulfill many requirements.

Accounting↗

Ethical dilemmas reported by fourth-year dental students.

Ethics education in dentistry is a requirement for accreditation. Despite universal adoption of ethics courses, there is ongoing discussion about the appropriate content of these courses and about methods to engage students. Faculty who teach ethics must select a limited set of topics from the broad fields of professional ethics, bioethics, and the humanities. The purpose of this article is to describe the ethical issues reported by fourth-year dental students during community-based extramural clinical experiences. Senior dental students (n=123) wrote essays describing an ethical issue they encountered during one of two extramural rotations. Ethical issues were categorized and coded by consensus between two faculty authors. Students most often reported perceived dilemmas related to patients' limited resources (25 percent), conflict between professionals (19 percent), clinic policy or procedures (15 percent), and decision making by patients' surrogates (13 percent). One student (<1 percent) reported encountering no ethical issues. Students' perceptions of ethical issues in clinical practice offer faculty a foundation for designing a dental ethics curriculum that is practical and immediately relevant to the experience of a dental student. Students' reports may also yield a method for systematic assessment of students' abilities to apply classroom ethics instruction to clinical practice.

Education, Dental↗