ETHICS IN DENTISTRY

Ethics is a branch of Philosophy, Theology and Theosophy.

IN GREEK, “ETHOS” MEANS CUSTOM OR CHARACTER, ETHICS IS A

BRANCH OF PHILOSOPHY

WHICH DEALS WITH THE EXAMINATION OF HUMAN CONDUCT.

“Ethics is a code of values which guide our choices and actions and
determine the purpose and course of our lives.” — Ayn Rand,
American novelist and philosopher(1905-1982)

ETHICS IS DEFINED AS THE SCIENCE OF IDEAL HUMAN CHARACTER AND

BEHAVIOR IN SITUATIONS WHERE DISTINCTION MUST BE MADE BETWEEN
THE RIGHT AND WRONG, DUTY MUST BE FOLLOWED AND GOOD
INTERPERSONAL RELATIONS MAINTAINED.

Defn: DENTAL ETHICS IS THE STUDY OF MORAL VALUES AS THEY APPLY

TO DENTISTRY.

MAJOR ETHICAL PRINCIPLES

1.NON – MALEFICENCE

2. BENEFICENCE

3.AUTONOMY

4. JUSTICE

5.TRUTHFULNESS

6. CONFIDENTIALITY

1.NON – MALEFICENCE
( TO DO NO HARM)

"FIRST, DO NO HARM"

(PRIMUM NON NOCERE).

EXAMPLES FOR MALEFICENCE

• IATROGENIC DISEASES

• DENTIST PERFORMING A SKILL BEYOND HIS COMPETENCY

• 2. BENEFICENCE
(TO DO GOOD)
 • A PRACTITIONER SHOULD ACT IN THE BEST INTEREST OF THE
PATIENT.

3.AUTONOMY

THE PATIENT HAS THE RIGHT TO REFUSE OR

CHOOSE THEIR TREATMENT.

EXAMPLES FOR VIOLATION OF AUTONOMY

 FORCING DECISIONS ON PATIENTS

 FAILURE TO OBTAIN INFORMED CONSENT

CONSENT

“WHEN 2 OR MORE PERSONS AGREE UPON THE SAME THING IN THE SAME
SENSE”

…INDIAN CONTRACT ACT 1872

WHO CAN GIVE CONSENT?

ANY PERSON WHO IS CONSCIOUS, MENTALLY SOUND AND IS OR ABOVE

THE 12 YR. OF AGE

… IPC 1860 SECTION 88 & 90

IS OR ABOVE THE 18 YR. OF AGE

… INDIAN CONTRACT ACT 1872 SECTION 11

CONSENT IS NOT VALID WHEN…

 GIVEN UNDER FEAR

 MISPRESENTATION OF FACTS/FRAUD

 AGE LESS THEN 18 YRS. (12 YRS IPC)

 PATIENT UNDER SEDATION

TYPES OF CONSENT

1. IMPLIED CONSENT

2. EXPRESS CONSENT

3. INFORMED CONSENT

4. PROXY CONSENT
IMPLIED CONSENT
(TACIT CONSENT)

PATIENT COMES TO A DOCTOR …

AGREE FOR MEDICAL/DENTAL EXAMINATION

INSPECTION, PALPATION, PERCUSSION, AUSCULTATION & ROUTINE X-

RAY /SONOGRAPHY.

EXPRESS CONSENT

EXPRESS ORAL CONSENT

EXPRESS WRITTEN CONSENT

INFORMED CONSENT

ALL INFORMATION MUST BE EXPLAINED IN COMPREHENSIVE

NON MEDICAL TERMS PREFERABLY IN LOCAL LANGUAGE ABOUT THE…

1. DIAGNOSIS

2. NATURE OF TREATMENT

3. RISK INVOLVED

4. PROSPECTS OF SUCCESS

5. PROGNOSIS IF PROCEDURE IS NOT PERFORMED

6. ALTERNATIVE METHODS OF TREATMENT

PROXY CONSENT

1. CHILD

2. MENTALLY UNSOUND

3. UNCONSCIOUS PATIENT

CONSENT MAY NOT BE OBTAINED…

1. MEDICAL EMERGENCIES

2. PERSON SUFFERING FROM NOTIFIABLE DISEASES

3. PRISONERS

4. REQUEST BY POLICE
 5. ORDER BY COURT

4. JUSTICE

THE DENTIST HAS A DUTY TO TREAT PEOPLE WITHOUT PREJUDICE.

VIOLATION OF JUSTICE

• DISCRIMINATING BETWEEN PATIENTS BASED ON CASTE ,CREED

,RELIGION OR SOCIO ECONOMIC STATUS ETC,.

5.TRUTHFULNESS (VERACITY)

BEDROCK OF TRUSTING DOCTOR-PATIENT RELATIONSHIP.

VIOLATION OF VERACITY

• HIDING TREATMENT FAILURES

• GIVING FALSE INFORMATION

6. CONFIDENTIALITY

BREACH OF CONFIDENTIALITY

• DISCLOSING PATIENT INFORMATION WITHOUT CONSENT

ETHICAL RULES FOR DENTISTS

(PRESCRIBED BY DENTAL COUNCIL OF INDIA)

1. Duties of dentist towards patient.

2. Duties of dentist towards one another.

3. Duties of dentist towards public

Ethical rules for dentists (prescribed by the DCI)

I. The duties and obligations of dentist towards patientse patients:

1. Every dentist should be courteous, sympathetic, friendly and

helpful.

2. He should observe punctuality in fulfilling his appointments.

 3. He should establish a well merited reputation for ability and
fidelity.

4. The welfare of the patient should be conserved to the utmost

of practitioners ability.

5. Dentists should not permit considerations of religion,

nationality, race, party politics or social standing to intervene
between his duties and his patients.

6. Information of the personal nature which may be learned

about or directly from a patient in the course of dental
practice should be kept in the utmost confidence

II. Duties of dentists towards one another:

1. Every dentist should cherish a proper pride in his /her

colleagues and should not disparage them either by act or
word.

2. When the dentist is entrusted with the care of the patient of

another, during sickness or absence, mutual arrangements
should be made regarding remuneration.

3. A dentist called upon on any emergency to treat the patient of

another dentist, should, when the emergency is provided for,
retire in favor of the regular dentist but shall be entitled to
charge the patient for his service.

4. If a dentist is consulted by patient of another dentist and the

former finds that the patient is suffering from a previous faulty
treatment it is his duty to institute correct treatment at once
with as little comments as possible and in such manner as to
avoid reflection on his predecessor.

III. Duties of dentist to the public:

Police and Law courts –

1. A dentist is not bound to disclose professional secrets unless

called upon by the magistrate or judge to do so.

2. Knowledge of the patient gained in the course of examination

and treatment is privileged and should not be disclosed with
out the consent of the patient or order from the presiding
judge in a court of law.

UNETHICAL PRACTICES
 QUACKERY

 PRACTICE BY UNREGISTERED PERSONS

 FALSE CLAIMS OF REGISTRATION

 ADVERTISING TO PRAISE THE PROFESSIONAL ABILITIES

 USE OF BROKERS OR AGENTS TO CANVAS AND DRAW PATIENTS TO

PRACTICE

 USE OF BOGUS DIPLOMAS

 ISSUING OF CERTIFICATES WHICH IS UNTRUE OR MISLEADING

 EMPLOYING UNQUALIFIED ASSISTANTS

 PRACTICE UNDER THE INFLUENCE OF ALCOHOL OR DRUGS

 TAKING OR GIVING COMMISION