214: LEGAL RELATIONSHIPS

LEGAL RELATIONSHIPS:

Patient-dentist relationship

- Patient responsibilities to the dentist

- Terminating the dentist-patient relationship

- Elements of legal abandonment

LEGAL RELATIONSHIPS:

Hygienist

- Hygienist-Patient Relationship

- Hygienist-Dentist Relationship

ETHICAL RELATIONSHIPS

- Dentist-Hygienist Relationships

- Hygienist-Hygienist Relationships

- Degreed Hygienist-Preceptor Relationships

RESOLVING ETHICAL PROBLEMS

- Ethical Decision Making

-Establish an ethical position

- Justify and defend the alternative

- Act on the choice

Ethical Decision Making

- Define problem

- Identify ethical issues

- Gather information

- Identify alternatives

Patient-dentist relationship:

mutual contractual agreement, in accepting a patient, the dentist promises to

1. Be licensed

2. Use the standard of care

3. Do not use experimental procedures

4. Complete care within a reasonable time

5. Never abandon the patient

6. Obtain informed consent

7. Arrange care in the absence

8. Ensure care is available during emergencies

9. Make referrals

10. Maintain confidentiality

11. Keep clients informed of health status

12. Never permit anyone to practice unlicensed dentistry

13. Inform the patient of the disadvantages of the treatment

14. Keep accurate records

15. Comply with laws on dentistry

16. Be ethical

17. Charge a reasonable fee

18. Don't attempt service unqualified for

Patient responsibilities to the dentist

- cooperate and follow instructions

- pay a reasonable fee

- don't stop in the midst of treatment

Terminating the dentist-patient relationship:

Elements of legal abandonment

- ways to prevent abandonment

- both parties to agree to end the relationship

- The dentist is recommending care, and the patient does not agree with the care, and both decide it's best to go to another dentist.

- EX: an oral surgeon takes on a patient to remove wisdom teeth; once the wisdom teeth are removed, that's the end of the relationship.

- for multiple broken appointments, failure to pay or comply. A letter is sent discussing the reason for termination. The pt can stay under the care for a period of time for emergencies.

Letter of termination

- "We are going to discontinue having you as a patient."

Reason for termination

- You have the next 30 days, and we will be available if you have a dental emergency only

- Patient needs to find another dentist in the meantime

- copy of letter placed in pt file

- certified mail copy sent (pt has to sign for it)

Hygienist-Patient Relationship

- A hygienist must fulfill legal duties and meet the standard of care in: assessing, planning, implementing, and evaluating patient care, confidentiality, defamation

Hygienist-Dentist Relationship Legal

- Discrimination cannot terminate or refuse to hire based on sex, color, race, religion, or pregnancy

- Respondeat Superior, Sexual Harassment

- Termination of employment-give sufficient notice of termination

Dentist-Hygienist Relationships Ethical

- don't agree on pt care

- The hygienist is forced to provide substandard care because of office polices

-EX: not having enough time with recall/prophy patients, and the hygienist doesn't feel like they can provide the proper standard of care

Hygienist-Hygienist Relationships: Ethical

- Colleges are working together

- Standard of care may be an issue; one is not working to the standard of care that the other perceives as important

- Compromising patient care/ not being thorough enough

- When looking at an ethical dilemma, look at both sides

- Involve the dentist

- Be open to changes/improving

Degreeed Hygienist-Preceptor Relationships: Ethical

- See what kind of care they provide

- ADHP

- Quality depends on how much of a self-learner the student is and how involved the dentist is in their education

Resolving Ethical Problems: 1. Ethical decision making

- Define problem: legal or ethical issue

- Identify ethical issues: autonomy, beneficence, nonmaleficence, veracity, justice

- Gather information: what exactly is going on; what is the normal standard of care for this situation, and what is the deviation from that normal standard of care

- Identify alternatives: list courses of action; take into consideration all the risks and all the parties that are involved

Resolving Ethical Problems: 2. Establish an ethical position

- choose alternatives

- keeping in mind all of the consequences

- going to decide what your stand is on the issue

Resolving Ethical Problems: 3. Justify and defend an alternative

- inner conversation with yourself/ on paper

- prior to acting on your choice

- Review your decision

- Consequences are so negative; another alternative might be better consideration

Resolving Ethical Problems: 4. Act on the choice

- take action

- act on the ethical choice/ the decision you have made

- can be the most difficult; the dentist may cooperate or may deny that there's any issue, or they may fire you