Rachel Richards #1625

DH 252 Ethical Decision-Making Paper

In my article, the patient of a dentist was referred to an oral surgeon for a
consultation on placement of an implant. After the consultation, the patient
requested a second opinion. The first oral surgeon recommended placing a bone
graft before placing the implant. The second specialist did not recommend
placing a bone graft before the placement of the implant, and the price was lower
than that of the first. The ethical dilemma or problem is the patient wants the
referring dentist to recommend the best option for her. The dentist states he is
not familiar with the reasons why or why not to place a graft, and is afraid of
offending the professional judgment of one of the surgeons. Should the dentist
call each of the oral surgeons to get more information for the patient, or should
the dentist give his recommendation to the patient based on the information he
knows?
All pertinent information to this issue is; the patient has seen two oral
surgeons for consultations of an implant. One specialist recommended placing
an implant with a bone graft and the other didnt. The price of the second opinion
was cheaper. The referring dentist doesnt feel he is knowledgeable enough on
whether placing a bone graft before the implant is needed. He also doesnt want
to offend the specialists, but wants the patient to make the best decision.
The legality of the issue is whether or not the dentist should make a
decision based on his lack of expertise in the area, or if he should refer to a third
specialist. According to the ADA Code Section 3, Principles and Beneficence
and ADA Code Section 5, Principle, Veracity, You are ethically obligated to
promote what you believe is in the patients best interest and to be completely

honest in doing so (JADA, Vol. 140. July, 2009). The options that exist are: The
dentist can make a decision based on the little knowledge he has; Call each of
the referring specialists to get clarification on their reasoning to better inform the
patient; Refer the patient to a third specialist; or do nothing and tell the patient
that is their decision to make.
The ethical principles to the options is the dentist has the obligation to do
no harm to the patient under nonmaleficence and not make a decision if he is not
sure of the right one. He also has the right to beneficence, or doing good for the
patient. The patient also has the right to autonomy, by choosing actions or
treatment relevant to their needs, and being informed of all outcomes of
treatment options. The patient has the right to veracity and paternalism by having
the professional be truthful to them, and be able to participate in the decision
making process. Informed consent is also important to provide the patient with all
relevant information, and most of all confidentiality.
My decision for this patient would be to talk to both of the specialists to
hear their professional opinion on the treatment option they provided, so I could
better inform the patient of the best treatment options. If I were still unclear of the
best option, I would refer the patient to a third specialist.
To implement my decision and take appropriate action, I would call both of
the specialists to get more information and better understand the indications for
placing a bone graft or not before the implant. The patient has the right to
autonomy. Two positive outcomes in this case are the patient and dentist will
have all the knowledge possible from the specialists to make the best decision on
the implant. The patient will have confidence in the dentist by gathering all the
information.