Ethically Thinking
Under the ADA Principles of Ethics & Code of Professional Conduct1, dental ethics is composed of five fundamental principles:
- Autonomy
- Non-maleficence
- Beneficence
- Justice
- Veracity
Of these five principles, we will focus on the ethical principles of autonomy and beneficence in this piece.
The Principle of Autonomy
First off, what do we mean by “autonomy”? This can be described as patient self-governance. A dentist must respect the patient’s rights to self-determination and confidentiality. “This principle illustrates that professionals must treat the patient according to the patient’s desires, within the bounds of accepted treatment, while also protecting the patient’s confidentiality. Under this principle, the dentist’s primary obligations include meaningfully involving patients in treatment decisions, with due consideration given to the patient’s needs, desires, and abilities, and safeguarding the patient’s privacy.”2
The Principle of Beneficence
Secondly, what do we mean by “beneficence”? We define this as the essential need to do good. “Dentists have a duty to promote their patients’ welfare. This principle conveys the idea that professionals must act for the benefit of others. According to this principle, the dentist's primary obligation is to serve both the patient and the public. The most crucial aspect of this obligation is the competent and timely delivery of dental care, which considers the clinical circumstances presented by the patient while also accounting for their needs, desires, and values. The same ethical considerations apply whether a dentist practices fee-for-service, managed care, or any other arrangement. Dentists may choose to enter contracts that govern the provision of care to a group of patients; however, contractual obligations do not excuse dentists from their ethical duty to prioritize the patient's welfare first.”3
A Real-Life Example of these Principles in Action
A dispute arose between a "general dentist" and their patient, which centered around a failed sinus augmentation procedure before implant placement. After receiving a treatment plan and cost estimate for the treatment, the patient called the office and queried the treating doctor's office about the sinus augmentation procedure listed on the treatment plan. The patient disclosed that she worked in a healthcare setting, and her colleagues were giving her information which prompted her questions. Specifically, she asked if she should go to an oral surgeon to have the augmentation performed.
The office staff responded that it wasn't necessary and that the treating doctor (a general dentist) had the training, expertise, and experience to perform this treatment. They also relayed that their fees were a little lower than a specialist’s. Unfortunately, the treatment provided by the general dentist resulted in a bad outcome and a dispute (threat of a lawsuit).
Conclusion
Your credibility is vital when addressing and defending a lawsuit, board action, or other claims. Violating basic ethical principles undermines your credibility and could place you in a difficult situation.
Use the moral principles of patient autonomy, beneficence, and the best interest of the patient as your guide. These principles remind every dentist about "…due consideration being given to the needs, desires, and values of the patient."4
Beneficence encourages you to act in the patient's best interest, foregoing any other benefit. When a patient asks if they should see a specialist for a particular procedure, encourage them to do so—for their best interest—which is a duty you owe to the patient. Discouraging them (as occurred in the situation described above) undermines your ethical and possibly legal responsibility to them. It damages your credibility and your ability to effectively defend against allegations that your treatment failed to meet accepted standards of care.
1. American Dental Association Council of Ethics, Bylaws and Judicial Affairs. Principles of Ethics and Code of Professional Conduct, with official advisory opinions, revised to March 2023.
2. Ibid.
3. Ibid.
4. Ibid.
The information contained on the DentistCare Blog does not establish a standard of care, nor does it constitute legal advice. The information is for general informational purposes only. We encourage all blog visitors to consult with their personal attorneys for legal advice, as specific legal requirements may vary from state to state. Links or references to organizations, websites, or other information is for reference use only and do not constitute the rendering of legal, financial, or other professional advice or recommendations. All information contained on the blog is subject to change.
