1|Page

Lecture 1

23-June-2013

Introduction to dental ethics

Welcome to the new course of Dental ethics, jurisprudence and law, dent 303. What is the difference between ethics and law? Ethics is something you do because you think it is true, law is something you have to do. Well it is not the exact answer. Because sometimes the law tells you to do something but you dont do it, you dont obey the law; however you follow your ethical decision. Dental ethics is not a unique science; we have bio-ethics which relates to ethics of all biomedical sciences. But because dental specialty has special circumstances we have adapted some ethics to dental practice. So today we will talk about introduction to dental ethics. You have to know, what is the meaning of ethics? What is the difference between ethics and morality? What is the difference between ethics, professionalism and law? Why do we have to study ethics? And examples about situations in which you have to ethically behave. So at the beginning what is the meaning of dental ethics or ethics in general? In Arabic it means ( , ,), and in English you can translate it as good behavior, virtue, morality. It is an internal component of dental practice; it is the principles that will govern your conduct, your actions. Ethics relates to good and bad action, your responsibility and the right of the patient. Morality seems to be something relates to doing while ethics relates to knowing. Dental ethics is not separated from medical ethics or bioethics, all these principles is extracted from bioethics and adapted to dental situations. Because in dental practice we find some circumstances that are not present anywhere else. You are dealing with fillings, endodontic treatment, extractions, and minor oral surgeries. Q: Why do we have to study ethics? Do we need to study ethics? A: Yes, because we have to know what the right and wrong things to do are.

2|Page

Q: Can we know and learn the right and the wrong things from the behavior of seniors, for example fifth year students? A: Yes, you can. However it is not the best way. They have some ethical conduct but you cannot guarantee that all your seniors are following ethical principles. So this is one reason why we have to study ethics, because it is something that cannot be learnt from seniors Ethics also cannot be learnt 100% from the family. Family teaches you the good and the bad behaviors to apply it to dental situations, family cannot teach you everything. To be a good dentist also this is not enough to say that you have a good ethical conduct. You can make good fillings and endodontic treatment and you are professional, this is technique, but ethics is behavior, and they are not the same. Example: you do composite fillings perfectly. But onetime you find a defect in your restoration, there is space between the tooth structure and the filling. Now it is something relating to ethics, you finished your technical part and now your ethical part. Do I have to redo the filling at this visit, or telling your patient that everything is ok and next time when he come to your clinic, you say oh! You have fractured your filling! and you will redo the filling now, and get a new money. You will face many situations like these, and your ethics will decide what you should do. So there is difference between ethics and professionalism. When you graduate, you will swear that you will protect the patients' privacy and you will do good things for the patient. The patient is the most important. And you will not betray your virtues and your good behavior. This is the oath "" This is separated from your professionalism. It is something you have to learn. Society can affect your ethics, how? Example: 1. you will do things perfectly for a Person you know, while for others you will do them just ok or maybe less. 2. Usually in private clinics we charge for our work, for example you worked for a person you know, and you asked the accountant not to charge from him, here the law will affect, the accountant will tell the manager that this doctor did this, so you will be judged for that and punished, and the law will affect your ethical behavior. And since you fear the law, then you will not do it.

3|Page

Ethics is the good behavior, the way of making ethical decisions for the sake of a patient and your career. The law will govern your actions. The law usually is different from one country to another while ethical principles are common. Sometimes the law will not punish you if you dont do ethical decisions, so there are differences. You have to know the law in the country that you are going to work in. How to get the license? What are the requirements for a private clinic? How many dental chairs can be in a clinic? Can you open two clinics at the same time? This is governed by law more than ethics.

Ethical example related to radiology: To change gloves, film holders, etc between patients. follow infection control procedures A patient is in need for an implant, normally you can ask the patient for a periapical radiograph or panoramic radiograph to see if there is enough bone for the implant. However some doctors do unethical actions by asking the patient to go outside the clinic to make a cone beam CT image, this is unethical, why? Because you give a very high dose to the patient unnecessary, and you dont know if there is enough bone initially by a periapical or panoramic radiograph. Another reason why the dentist did that, maybe the center to which he referred the patient to do the image is for him, and he is gaining money by doing this. Other Examples: Dentists make bad fillings just for the sake of money. A dentist is trying a new type of medicine or fillings on patients before it has been tried on animals. A general dentist convinced his patient that he is capable of extracting his impacted third molar, and then he injured his alveolar nerve. This is unethical because the patient has lost his sensation, tooth sensation, paralysis of the lower lip, etc. Sometimes it is easy to take ethical decisions and sometimes it is difficult. So there are a lot of ethical dilemmas.

4|Page

 For example I am working with my friend in a governmental hospital, my friend is not doing his work perfectly, for example he always do short endodontic fillings just to finish as many patients as he can, just for the sake of money. While I am taking care of my work, I do one endodontic case per day, I dont get as much money like him, I am caring about quality not the money. While my friend is doing something wrong. Do I have to report this?

Note: 4 lectures will be for the mid exam out of 40, and then you will have 3 lectures for the final exam which will be about out of 60. In your exam you will find many cases of ethical dilemmas. Reference for the introduction is the manual. -Lecture will always start always at 8:00 -The required pages from the book are pages 14 to 21.

END OF LECTURE, GOOD LUCK Done By: Sawsan Jwaied

5|Page