Ethics Study Guide: Professional Identity: Ethics does not = Law Law: Ethics: Who you are as a doctor

Lowest guidance Higher aspirations, personal, reach-up, the systematic study of right and wrong

Professional: Obligatory trust with people in a vulnerable position, structure, autonomy, exclusive expertise Autonomy = Obligation to be (perceived as) trustworthy (or public opinion forces you) Standard of Care: What prudent dentists would do or see as correct in the same circumstance - Involves many sources Scope of Practice: Dentistry (within license) and Personal (competency/expertise) Ethics Theory: 4 Models: - Normative Principles (Kant): o Moral Weakness: principle conflicts desire o Moral Dilemma: conflicting principles o Moral Uncertainty: inadequate info - Utilitarian (Value Maximizing): weigh interests vs. consequences - Publicity and Driving Home Test Interest: Moral Behavior Determinants: - Sensitivity: Awareness - Judgment: decision-making - Motivation: willing to make the right choice - Character: bearing the sacrifice of that choice Dental Board Mission: Our mission is to protect the health and safety of consumers.

Commerce: - Profit, Money - Competitive relationship with buyer (and companies), customer as means o Self-Interests - Caveat Emptor (Buyer Beware), endorsements - Create Needs for things Care: - Care, Life - Money is derivative - Cooperative relationship with patient (and Drs), patient as end o Buyer cant compete (monopoly/fiduciary/trust), Patient-Interest - Research/empiricism = pt focused care Informed Consent: You give information, the patient gives consent/understanding (in the name) 1. Communication (cant be delegated to staff/must be dentist) 2. Documentation - Based on Patient Autonomy

You CAN show a videotape for inform Must be understandable and native language Exceptions: pt asks not to be informed, rare/minor complication, disclosure would harm

Quiz 2: Old Hippocratic Oath lacks: "Above all, do no harm" Principles/Code of Ethics: A documented operations, vehicle for education, reflection and discussion Violation of ADA/CDA: revoked membership and bad publicity Violation of Dental Board: revoked license. The interest of the dental board is the patient, not the dentist. Sending Chart: Cant withhold chart for payment (pt owns chart) Infectious Diseases: Med Consult, do not need to disclose to pt. as long as all precautions are taken. Relationships: Avoid if it changes professional judgment. Mandated Reporter: Must report abuse. Obligation to Serve: Yes, reasonable emergency services (referral) HIV advertising: Not Really, Must say no guarantee Im free of HIV Pt Selection: Can have reasonable selection, Must not decline based on status, race, gender Ads: Must not be false or misleading Transfers: (UoP) must have pts permission to transfer Oral health Status: pts should be informed of their oral health status, w/out (-) comments about previous dentist Insurance Fraud: Injustice to the patient Pts dont have the right: To know outcome of treatment, other dentists fees (before consenting) Selling Products: Dont exploit pt trust for financial gain Amalgam Removal: Only remove amalgams if patients ask for it, or you can suggest it for esthetics Split Fees: no referral fees Med Consults: must get pts permission for consults Student Advertising Online: No DDS, no logo Tips: Nothing of lasting value Colleague problem: Peer Review UoP unethical behavior: 2 levels: suspicion, strong reason to conclude violation Quiz 3: Informed Consent: Autonomy - Pathology - RBA of Tx - Side Effects - Cost - Consequences of no Tx Includes: - Face-to-face discussion - Documentation - The dentist - Education materials - A translator service(if needed) (ADA) Must give pt: - Time to think - Involvement in treatment decision

- Ability to decline treatment Minor: Parent/Guardian Cant delegate IC to staff Must be in: - Understandable language - Native language Difference in commerce/care: commerce wants safety (do no harm), care wants well-being (do good)