Module 6) Ethical Decision Making in Dental Hygiene

Ethical Dilemmas

ethical problems arise in professional practice when the dental hygienist is caught between two competing obligations/principles

Ethical Awareness/Moral Sensitivy

Moral Weakness: Moral responsibilities conflict with personal inclinations

Moran Uncertainty: the question is whether a moral obligation exists

Moral Dilemma: obligations and responsibilities are in conflict

Moral Distress: Frustration results from perceived powerlessness when what is happening appears to be wrong and one cannot act ethically

Moral Distress

Ask: ask about distress, become aware of the situation

Affirm: affirm your distress and the commitment to take care of yourself

Assess: identify sources of distress and determine severity (benefits vs. risks)

Act: prepare personally and professionally to take action

Six-Step Decision Making: 1

Most critical step in the process. Many situations are simply never perceived to be ethical problems or dilemmas. Once the problem has been recognized, the decision maker must clearly state the ethical question, considering all pertinent aspects of the problem.

Six-Step Decision Making: 2

The decision maker must gather information to make an informed decision. This may be factual information about the situation as it developed, and it may come from more than one source. Information regarding the values of the parties involved, including those of the healthcare provider, is needed.

Six-Step Decision Making: 3

Brainstorming to identify as many alternatives or options as possible. Often the best decision is not the first one that comes to mind.

Six-Step Decision Making: 4

Focus on the ethical principles (autonomy, beneficence, nonmaleficence, and justice) and ethical values and concepts (paternalism, confidentiality, and informed consent). In general, one or more of these will be involved in any ethical decision. State how each alternative will affect the ethical principle or rule by developing a list of pros and cons.

Six-Step Decision Making: 5

Each option must then be considered in turn, with attention to how many pros and cons would attend each decision. The seriousness of the cons must then be weighed by the dental hygienist, remembering that, as a professional, he or she is obliged to put the patient’s interests first and do no harm

Six-Step Decision Making: 6

Acting on the decision that has been made. Many appropriate decisions are never implemented because this step is omitted

Common Ethical Dilemmas for the Dental Hygienist

• Substandard care

• Overtreatment

• Scope of practice

• Fraud

• Confidentiality breaches

• Impaired professional

• Sexual harassment

• Abuse