ETHICS IN DENTISTRY

G.Ramakanth Reddy

CONTENTSINTRODUTION• HISTORY• WHY CODE OF DENTAL ETHICS ?• ETHICAL PRINCIPLESETHICAL RULS FOR DENTISTSSOME UNETHICAL PRACTICESDOCTOR-PATIENTS CONTRACTCONCLUIONREFERENCE

INTRODUCTIONThe dental profession Is a vocation in which

knowledge and skill is used for the service of others.

Characteristic of profession is adherence to code of ethics.

The word ethics derived from Greek word “ETHOS” meaning custom or character.

Ethics is philosophy of human conduct, a way of stating and evaluating principles by which problems of behavior can be solved.

It is a science of what morally right

Ethicsethics is a branch of philosophy concerned with

the study of those concepts that are used to human activities , in particular the concepts of goodness and obligation.

Dental ethics would mean moral duties and obligations of

the dentist towards his patients ,professionals and colleagues and society.

These help support autonomy and self determination , protect the vulnerable and promote the welfare and equality of human

beings.

Micro ethical principlesFocus primarily on individual's right and

duties and do not see individual's as a part of a wider social order.

Macro ethicsSet of principles designated to protect human

dignity ,integrity , self-determination, confidentiality, rights, and health of population and people comprising them.

[ethics and epidemiology-international guidelines, 1998]

Macro ethical principlesGuide the conduct of population-based

research and practice.Establish positive moral responsibilities of

persons, authorities who sponser,conduct or oversee research on population

Philosophy of ethics• ethical concept based upon MYSTICISM.• Man’s interest in destiny & belief in life

found in history of EGYPT then BABYLONIA.

• 3500 BC Egyptian “BOOK OF DEAD”.• 1000 BC- India produced Vedas.• Upanishads describe about ethics, god, death&

immortality.• 470 BC Greek philosophers

ARISTOTLE,PLATO&SOCRATES.• European civilization influenced philosophy of

ethics.

History of ethicsHIPPOCRATIC OATH: has been regarded as

summing of a standard of professional ethics.Theory of utilitarian ethicsTheory of dentologic ethicsVirtue ethicsDescriptive theory;

PRESCRIPTIVE THEORY;

those that define ethical terms in as carrying mandatory force enjoined by some kind of authority.

e.g. ; ethical rules of dentists initially formed by

Dental council of India.

The code of ethics framed by dental council in 1975 and later notified by government of India as “dentists (code of ethics )regulations 1976” which is force from 1976.

WHY CODE OF DENTAL ETHICS?

A systemic body of rules is needed “IN ORDER THAT DIGNITY AND HONOUR OF THE DENTAL PROFESSION MAY UPHELD,ITS STANDARDS EXALTED,ITS SPHERE OF USEFULNESS EXTENDED AND THE ADVANCEMENT OF DENTAL SENSE PROMOTED AND THAT THE MEMBERS OF THE DENTAL ASSOCIATION MAY UNDERSTAND CLEARLY THEIR DUTIES OBLIGATIONS TO THE DENTAL PROFESSION,TO THEIR PATIENTS,AND TO THE COMMUNITY AT LARGE”[Indian dental association-constitution, by laws and code of ethics 1988]

DENTISTRY AS APROFESSION:Professional person is expected to have

respect for human beings ,competence in this chosen field, integrity and primary concern with service rather than with prestige or profit.

In dentistry the code of ethics Is the American dental associations principles of ethics and code of professional conduct.

FIVE MAJOR SECTIONS:1)service to the public and quality of care2)education3)government of a profession4)research and development5)professional announcement

DUTIES AND OBLIGATIONS OF A DENTIST

TOWARDS PATIENTS OR POPULATION:

Doctor first duty is to his or her patients (HIPPOCRATIC OATH)A)To do no harm; (non-maleficence)

doctor induced illness should be avoided

B)To do good (beneficence)It should be the role of dentist and dental hygienist

to benefit patient as well as not to inflict harm.There is an agreement between doctor and patient

that some good will result.

C)RESPECT FOR PERSONS:1)AUTONOMY: health care professionals respect

the patients right to make decisions concerning the treatment plan

2)INFORMED CONSENT: first stated and ,by for , the largest principle of NUREMBERG code.

FOUR ATTIRBUTES OF IT:Consent must be “voluntary, legally competent ,

informed and comprehending”

D)JUSTICE:The primary duty of health professional is

service irrespective of class, creed etc…….It demands that each person is treated

equallyDentist can provide some free or discounted

care in their offices to those who are truly needy, or they can provide financial support or donate some time to clinics for low income patients

E)TRUTHFULLNESS:Patient doctor relationship based on trustLying fails to show respect for persons and

their autonomy, violates explicit agreements and treatment relationship based on trust

F)CONFIDENTIALITY:patients have the right to expect that all communications and records pertaining to their care will be treated as confidential

TOWARDS PROFESSION OR PROFEESSIONAL COLLEGUES:

The dentist has to be sober, courteous, sympathetic , helpful, modest and punctable.

He has to be morally, mentally and physically clean.

It is unethical to “PUT DOWN” another dentist to the patient

TOWARDS THE SOCIETYDentist has to assume leadership in the

community on matters pertaining to dental health.

SOME UNETHICAL PRACTICESPractice by unregistered persons.Untrue, misleading are improper certificate

issued by dentist under his sign.Use of bogus diplomasAllowing commissionAny contravention of the drugsImmorally involving abuse professional

relationshipAiding in any kind of illegal practicesEmploying any agent for the purpose of obtaining

patients

• Promise of radical cure by employment of secret methods of treatment

• Mentioning after the dentist name any other abbreviation except those indicating dental qualifications as

• 1)RDP• 2)MIDA• 3)FICD• 4)MICD• 5)FACD• 6)MRSH

Ethical rules for DENTISTS;

(prescribed by DCI)Duties and obligations of dentist towards the

patient.1. Every dentist should be courteous, sympathetic,

friendly & helpful.2. Should observe punctuality in fulfilling his

appointments.3. The welfare of the patient should be conserved to

the utmost of the practitioners ability. 4. Dentist should not permit considerations of religion ,

nationality, race, party politics or social standing to intervene btwn his duties & his patients.

5. Information of personal nature which he come to know about patient directly or indirectly in the course of professional practice should be kept in utmost confidence.

Duties of dentist towards one another

1. Dentist should cherish proper pride in his or her colleagues & should not disparage them either by act or word.

2. Mutual arrangements should be made regarding remuneration.

3. Dentist called upon emergency to treat the pt of another dentist , retire in favour of regular dentist.

4. Institute correct treatment with the least comment.

Duties of dentist to the public (police & law courts)1. A dentist should not bound to disclose

professional secrets untill called upon by magistrate or judge to do so.

contract Doctor-patient relationship when it begins ? At the movement a dentist expresses a

professional opinion to an individual when it ends ?1. Both parties agree to end2. Death of dentist or patient3. Patient cured4. Patient ends by words or by act5. Dentist unilaterally terminates

EXPRESS TERMSA written agreement to prevent

misunderstanding It define items such as Fee, treatment and Manner in which payments are to be

made

conclusion“Ethics warms the heart and cools the

mind”

Ethics means that majority of professional accept the right and also condemn the wrong

Ethics can be printed , can be sermonized, can be dictated, or even documented ,but if not practiced it is only words.

Ethics is not an object , it can’t be bought or sold or bartered, but it can be shared.

REFERENCE “ Ethics hand book for dentists” -

JOHN.E.GURLEY “Essentials of preventive and community

dentistry” - SOBEN PETER