Dental Law and Ethics for RDA Exam

Flashcards for reviewing key concepts in dental law and ethics in preparation for the RDA exam.

What must members do to retain their rights upon receiving their dental license?

Conduct themselves in accordance with a professional code of ethics, supported by state law.

Define professionalism in the context of dental practice.

A quality set in standards and methods of performance demonstrating skill, knowledge, and professional ability consistently.

What is the definition of 'regulation'?

A principle, rule, or law designed to control or govern conduct

Define 'character' in the context of a professional.

A description of a person’s attributes, traits, and abilities; the qualities that define a person or group; could be used to define moral or ethical strength.

Name the 5 principles of the ADA Code of Ethics.

Patient Autonomy, Nonmaleficence, Beneficence, Justice, Veracity

What is Patient Autonomy?

Gives patients the right to understand and consent to treatment; allows decisions to be made by the patient.

What is a key limitation regarding patient autonomy?

Dentists cannot practice below the Standard of Care simply because the patient requests it.

What is informed consent?

What a reasonable patient would want to know, what the patient actually asks about, and what the patient agrees to without coercion.

How should informed consent be obtained?

Verbally or in writing, to ensure the understanding of the patient, as to the nature of proposed treatment, financial responsibilities, potential risks, options for treatment, potential outcomes, and impact on the patient’s physical and oral health.

When is written consent required?

Prior to performing any experimental treatment or drug; when a patient photo is used; or when treatment takes more than a year to complete (if procedure is expensive).

What is implied consent?

By nature of being present in the treatment facility (dental office), it is implied that the patient is seeking treatment; a dentist may not communicate the full details of the treatment plan; therefore treatment may begin with implied consent without agreeing in writing or verbally.

What are an RDA's duties regarding patient autonomy?

Respect the autonomy of each patient to decide from among treatment options, including refusing treatment; respect the legal and personal rights, dignity, and privacy of all patients in whose treatment you assist; maintain professional boundaries in relationships with patients.

What is an RDA's duty regarding patient confidentiality?

To respect each patient’s right to confidentiality; safeguard and hold in confidence patient information.

What is a 'Patient of Record'?

A patient who has been examined; has had a medical and dental history completed and evaluated; has had oral conditions diagnosed and a written plan developed by dentist of record.

What must be included in patient records?

Maintain adequate patient record stating the dentist of record; keep written treatment records and medical history records justifying the course of treatment (ALWAYS SIGN YOUR ENTRIES); ensure professional services rendered have been duly authorized by the patient or patient’s legal representative.

What are the 3 main parts of HIPAA?

Privacy standards, patients' rights, and administrative requirements.

What does Nonmaleficence mean?

Hippocratic Oath 'First Do No Harm.' A state of non-injury to a patient during dental care.

How can dental professionals uphold the principle of Nonmaleficence?

Keeping knowledge and skills current (Continuing Education); knowing when to refer to a specialist (Know Limitations); knowing when delegation of patient care to auxiliaries is appropriate (Duties of DA, RDA, RDAEF).

What is an 'Impaired Professional'?

A professional healthcare provider who is no longer able to perform functions in a professional capacity and with competence; may be impaired by drugs or alcohol.

What is a dentist's ethical obligation regarding impaired colleagues?

All dentists have an ethical obligation to urge chemically impaired colleagues to seek treatment. If a dentist has first hand knowledge of dental professionals use of drugs and/or alcohol then ethical responsibility to report to dental society

What actions should a dentist take if they contract any disease that endangers patients or staff?

With consultation from physician, need to limit the activities of his/her practice to those areas that do not endanger patients or dental staff.

If a patient is potentially exposed to blood, what are the responsibilities?

Immediately inform patient who may have been exposed to blood or other potentially infectious material; refer to qualified healthcare practitioner who can provide post-exposure follow up; provide own information concerning your status if you are the source of the pathogen (ethical obligation).

What does Beneficence mean?

"Do good" - Promote the patient’s welfare; the state or quality of being kind, charitable and promoting good will.

What does Beneficence include?

Competent and timely delivery of dental care; within the bounds of the clinical circumstances presented by the patient; being given to the needs, desires and values of the patient with due consideration

What does Beneficence also include regarding legal responsibilities?

Reporting abuse and neglect; RDA is a mandated reporter.

How is child abuse legally defined?

Any act of omission or commission that endangers or impairs a child’s physical or emotional health and development; these acts include physical abuse or punishment resulting in an injury, emotional abuse, physical neglect and/or inadequate supervision, and sexual abuse.

What are the penalties for a mandated reporter failing to report child abuse?

Guilty of a misdemeanor punishable by up to six months confinement in a county jail or by a fine of one thousand dollars, or both imprisonment and fine. If a mandated reporter intentionally conceals his or her failure to report an incident, known by the mandated reporter to be abuse or severe neglect, the failure to report is a continuing offense until an agency discovers the offense.

What legal protection is provided to mandated reporters?

Immunity is granted in those states that legally require reporting suspected child abuse. All healthcare workers are required to report Due to Child Abuse Prevention and Treatment Act; this means that you cannot be sued for reporting your suspicions in order to protect a child.

What is the principle of Justice in healthcare?

Fairness in the allocation of health care services.

What are an RDA's duties regarding justice?

Treat patients fairly; behave in a manner free from bias; no discrimination on any basis; report unethical acts of others.

What is unethical and illegal regarding bloodborne pathogens?

A decision not to provide treatment to an individual based on the patient’s positive status of a bloodborne pathogen.

Define Discrimination.

Treatment or consideration placed on class or category rather than individual merit; treating persons differently based on their physical, mental or emotional state, race or gender.

How does Justice extend to fellow professionals?

A difference of opinion as to preferred treatment should not be communicated to the patient in a manner which would unjustly imply mistreatment by previous provider.

Define Defamation.

To damage the reputation, character or good name of another by slander or libel; making of false statement maliciously.

What is VERACITY?

Truth telling and honesty. Requires honesty in all dealing with patients and the community. Patients need to know risks as well as benefits, financial impact, etc.

What does veracity include regarding unnecessary procedures?

Never recommending unnecessary procedures; never misrepresent training.

How does veracity relate to insurance?

A dentist who accepts a third party payment under a copayment plan as payment in full without disclosing to the third party that the patient’s payment portion will not be collected is not following the principle of veracity. All treatment dates and procedures submitted to insurance companies MUST be correct.

What happens when the principles of ethics overlap?

These five universal principles sometimes overlap and compete with one another, resulting in ethical dilemmas that require difficult choices; when this occurs the law serves as a guide to the correct choice.

What is the difference between Law and Ethics?

Ethics is a set of principles of right conduct; the general nature of morals and of the specific moral choices made by a person. Legal standards are concerned with law and state statutes that govern the profession in order to enforce moral and ethical principles.

What are the Categories of Law?

Civil and Criminal

Describe Civil Law.

1 person to another (lawsuit). Includes: Contract law (written contract violation), Administrative law (against regulations established like OSHA), and Torts (wrongful act that results in injury to one person by another - omission or commission).

What elements MUST be present for a malpractice lawsuit to be successful?

Duty, Negligence, Direct Cause, and Damages.

Define Negligence.

To exercise the degree of care considered reasonable under the circumstances resulting in an unintended injury to a patient.

Define Malpractice.

Improper or negligent treatment of a patient resulting in injury, damage or loss and without reference to ethical standards.

What is Due Care?

Proper and sufficient care or the absence of negligence; dentist must be knowledgeable about the drugs being used and prescribed; the dentist must read and update the health history each time the patient is seen. Also known as the Standard of Care.

Define Fiduciary Responsibility.

Holding of something of trust to another; a responsibility between patient and health care provider.

Define Abandonment.

Discontinuation of a patient/provider relationship once it has been established or discontinuing treatment once begun without cause or notification to the patient.

Define Harassment.

The act of annoying or threatening a person; the act of repeatedly tormenting or persistently irritating.

What is Respondeat Superior?

Employer is responsible. In a dental practice: patient may sue the dentist for an error committed by the RDA.

When is an RDA responsible?

When they do an illegal act.

Describe Criminal Law.

Violations of the law that are offenses against the state or government. Includes Felony, Misdemeanor, and Infraction.

Define Battery.

The commission of bodily harm against another; unlawful touching or striking of another person.

Under what conditions can The Dental Board of California can suspend or revoke your license?

Unprofessional conduct, incompetence, gross negligence or repeated acts of negligence; conviction of a crime substantially related to the functions of a registered dental assistant.

What is 'Scope of Practice'?

The range of duties and functions legally allowable under the defined areas of providership such as type of license, permit or certificate held set forth by the state Dental Practice Act and the laws of the state.

What is 'Competency'?

Having the knowledge, skill and ability to perform a specific task or duty independently; the state of being knowledgeable and well-qualified.

Describe Direct Supervision.

A licensed dentist must be physically present in the treatment facility during the performance of the function; the function must be checked and approved by the supervising dentist prior to dismissal of the patient from the office.

Describe General Supervision.

Does not require the physical presence of the dentist during the performance of those procedures based on instructions given by the supervising dentist.

What are the responsibilities of all licensees, including Registered Dental Assistants, regarding violations of the scope of practice?

Reporting violations of the scope of practice and additional acts of unprofessional conduct, including, but not limited to a violation of any federal or state statute, rule, or regulation regulating dangerous drugs or controlled substances; failure to keep the licensee’s or registrant’s premises and all equipment clean and sanitary; aiding or abetting in any acts that are in violation of any of the provisions of the dental practice act, including the aiding and abetting of the illegal practice of dentistry; and the employment of fraud, misrepresentation, or deception in obtaining the license or registration.

What are the dentist's responsibilities regarding RDA's, RDAEF's and RDH's?

Supervision: Ensure that the proper supervision is used at all times of an allied healthcare professional based on the laws of California that govern allied dental healthcare licensees and permit holders, not based on the dentist’s opinion as to what they want the licensee to perform. Delegation: It is the responsibility of the dentist to delegate only those duties and functions as defined in statute (law).