Dental Hygiene Ethics Final

Direct Supervision

-Prior diagnosis, Dentist's authorization

-Dentist on premises

-Dental exam following procedure

Indirect Supervision

-Prior diagnosis, Dentist's authorization

-Dentist on premises

-General supervision, dentist authorization only

Ethical Dilemma

-When one or more ethical principles are in conflict.

Principle

-General normative standard of conduct

-derived from common morality

Nonmaleficence

do no harm

Beneficence

-Requires that existing harm be removed

-Focuses on doing good for the patient

Autonomy

-Self-determination and the ability to be self-governing and self-directing

Justice

-Concerned with providing individuals or groups with what is owed, due, or deserved

Paternalism

-Arises from the Hippocratic tradition

-Closely related to the principles of nonmaleficence and beneficence

-The health care professional acts as a parent and makes decisions for the patient

-Paternalism and autonomy are in conflict

Veracity

-being honest and telling the truth

-Basis of the trust relationship

-Acknowledged in most code of ethics

Benevolent deception

-withholding of information because it would do more harm

-not supported by code of ethics

Fidelity

-belief that it is right to keep promises and fulfill commitments

-For the health care provider, it includes the duty to fulfill all portions of implied or expressed promises made to the patient in addition to holding to contractual agreements, not abandoning the patient before the completion of treatment, and keeping confidentiality.

Code of Ethics of ADHA 5 Principles

-Universality

-Complementarity

-Ethics

-Community

-Responsibility

Fundamental principles of ethics

-Nonmaleficence

-Beneficence

-Autonomy

-Justice

Values and Concepts used in ethical decision making

-Paternalism

-Veracity

-Informed consent

-Confidentiality

Code of Ethics

-Essential characteristics of a true profession

-It is a guideline for members of a professional group used for self-regulation of the group.

Code of Ethics principle functions

-Provides an enforceable standard of minimally decent conduct

-Indicates some ethical considerations for determining appropriate conduct

-Serves as a tool in self-regulation

-CANNOT address every situation

First code of ethics was created by

ADHA 1927

ADA code is divided into 3 components:

-Principle of ethics

-code of professional conduct

-advisory opinions

-Individuals employed by a dentist should be familiar with the ADA code as well as the ADHA code.

ADHA CODE

-Individual autonomy

-Beneficence

-Nonmaleficence

-Justice and Fairness

-Veracity

-Confidentiality

-Societal trust

ADA CODE

-Autonomy

-Beneficence

-Nonmaleficence

-Justice

-Veracity

Plaintiff

-Party bringing the claim

Defendant

-Party defending the claim

Discovery

-Evidence gathered from interrogatories and depositions

Trial

-Resolution of claims and allegations

Judge

Decides law

Jury

Decides facts

Criminal case

beyond a reasonable doubt

Civil Case

preponderance of the evidence

Civil Law

-Contract Law

-Tort Law

Contract Law

-Agreement to keep a promise

Tort Law

-Covers a civil wrong resulting from breach of legal duty by virtue of societal expectations, not via contract

Intentional Tort

-deliberate and purposeful act against person or property

Unintentional Tort

-Negligence

-no intent to cause harm, although harm does occur

Battery

harmful, nonconsensual, offensive contact with a person (physical invasion)

Assault

-causing apprehension (no physical contact)

Intentional Torts to Persons

-Battery

-Assault

-Misrepresentation

-False imprisonment

-Emotional distress

-Slander or libel resulting in defemation

Intentional Tort to property

-Physical intrusion without authorization

Negligence

-unintentional tort of a failure to act as a reasonable, prudent person under similar circumstances

Ex: Malpractice

Dental Hygienist's responsibility

-Current licensure for the state of practice

-License must be displayed

-Nonrenewal or denial of license renewal = cannot practice

-Perform only legally allowed duties with appropriate supervision

-Care must meet the professional standard

-Use professionally recognized drugs, materials, techniques

3 most common actions for health care injuries

-Failure to obtain informed consent

-Professional malpractice

-Breach of contract

Who can give informed consent?

-Competent adults

-Other authorized persons, when adult is deemed incompetent or incapacitated

-Age of majority 18

-Parent or guardian for minors

Malpractice

Failure by a health professional to meet accepted standards

Respondeat Superior(Res Gestae)

-Employers act through their employees

Statute of limitations

-Limits on the period within which an injured party can file a legal action

-Varies state to state

-Typically, 2-4 years from the date of alleged act, omission or neglect

-statutory provision that limits the period within which an injured party can file a legal action.

Breach of Contract

-most common

-A promise that the injury would not occur

At Will Employment

-indefinite duration

-Either party can terminate relationship

-Termination can occur without notice, severance pay, or rationale

Contract Employment

-covers a specific duration

-Cannot be terminated without cause

-Just cause=condition under which employment can be terminated

Risk Management

-Defined risk identification

-System of injury prevention

-Once a risk is identified, it is measured and a strategy to minimize or eliminate the risk is created

Risk identification

-Prevention requires knowledge of frequent occurrences of negative incidences

-Professional literature

-Incident reporting

This person receives the world's first dental hygiene license in connecticut

-Irene Newman

Father of Dental Hygiene

Dr. Alfred C. Fones

Dental Hygienist role

-provides educational, clinical, and therapeutic services supporting the total health of the patient through the promotion of optimum oral health. Because of these functions, the dental hygienist has been defined as a preventive oral health care professional.

Consequentialist approach

-the hygienist's actions, behaviors, and attitudes must be consistent with a commitment to public service, which is a commitment to benefit others.

-This commitment morally defines the healing professions and sets them apart from other occupations, such as architecture or engineering.

Ex: Beneficence

Deontology

Approach to ethics that judges the morality of an action based on the action's adherence to rules. Described as duty or obligation, because rules 'binds you to your duty'

Nonconsequentialists

-View justice as a duty for health care providers

Informed Consent

-Based on the patient exercising autonomy in decision making

-ethical and legal implications requires professionals to provide relevent facts and allows patients to make decisions based on those facts

Implied Consent

Type of consent in which a patient who is unable to give consent is given treatment under the legal assumption that he or she would want treatment.

Libel

A written defamation of a person's character, reputation, business, or property rights.

Slander

the action or crime of making a false spoken statement damaging to a person's reputation.

Informed Refusal

Occurs when the patient refuses treatment after he/she has been fully educated regarding the consequences of not receiving the treatment.

The golden rule

Do unto others as you would have them do unto you

Employment contract

a legal document that sets out the terms and conditions governing a worker's job

Employment agreement

A document specifying the terms of the work relationship between the employer and employee that indicates the rights and obligations of both parties. The employment agreement often takes the form of an official written offer letter.

Moral Weakness

- Moral responsibilities, conflict with personal inclinations (wanting to go to lunch)

Moral Uncertainty

-Question as to whether a moral obligation exists (dealing with a noncompliant periodontal patient)

Moral Dilemma

-Obligations and responsibilities are in conflict (dislike employer)

Statutory Law

-Legislative branch enacts the dental practice act

-May be a single law or compilation of laws

-Regulates the practice of dental hygiene

Criminal Law

-Violation of societal rule outlined by statutory law

Civil law

A law that governs relationships between individuals and defines their legal rights.

Technical Battery

treatment exceeds the consent given by the patient

Malign

to speak evil of

Abandonment

Leaving a patient after care has been initiated and before the patient has been transferred to someone with equal or greater medical training.

Misdemeanor

(n.) a crime or offense that is less serious than a felony; any minor misbehavior or misconduct

Felony

a crime, typically one involving violence, regarded as more serious than a misdemeanor, and usually punishable by imprisonment for more than one year or by death.

General Supervision

-Requires that the services being delivered be authorized by a dentist; however, the presence of the supervising dentist in the treatment facility is not required.

NYS supervision

-Some states require the dental hygienist to report the name and address of their supervising dentist.

-NYS uses Personal (Direct) and General Supervision levels only.

Licensure

A mandatory credentialing process established by law, usually at the state level, that grants the right to practice certain skills and endeavors

Core Values

the primary or dominant values that are accepted throughout the organization

Ethical Principles

standards of what is right/wrong with regard to important social values and norms

Social Justice

justice in terms of the distribution of wealth, opportunities, and privileges within a society.

Professional Liability Insurance

Insurance that covers persons engaged in various occupations against liability resulting from their rendering or failing to render professional services.

The patient record, radiographs, and financial information is property of the...

-Dentist

Duties of Board of Dentistry

-Examination of dental professionals

-License issuance

-License Renewal

-Investigation of disciplinary charges

How a dentist legally withdraws from a case:

-Written notification

-Proof of mailing

-Documentation of file

Reciprocity

Mutual agreement between 2 or more states to allow a person who is licensed in one state to receive a license in another without further examination, a license in a new state.