w 10

Foundations of Ethical Decision Making

  • Morality, moral problems, and moral judgments are encompassed by ethics.
  • Ethics asks what one should do and why.

Ethics and Jurisprudence

  • Ethics: branch of philosophy to understand morality, distinguish right from wrong, and regulate behavior.
  • Jurisprudence: theory and philosophy of law; foundation and function of law; rights and duties; justice.

Normative Ethics and Descriptive Ethics

  • Normative ethics: arrives at moral standards that regulate right and wrong conduct; search for an ideal litmus test of proper behavior.
  • Descriptive ethics: what people ought to believe at the present moment based on current principles and arguments; state of a population’s beliefs.

Professional Ethics

  • Rules or standards of conduct for a profession.
  • RDHs face professional and personal problems; need ethical theories to guide decision making.

Three Broad Ethical Philosophies

  • Consequentialism / Utilitarianism: focus on harms and benefits; maximize good outcomes.
  • Deontological ethics: duty- and rights-based; actions judged by adherence to duties irrespective of outcomes.
  • Virtue ethics: focus on character and virtues; what kind of person one ought to be.

Consequentialism / Utilitarian Ethics

  • Maximize good consequences; consider outcomes of each action.
  • Rightness depends on outcomes, not the act itself; aim for greatest good for the greatest number.
  • Example: fluoridation of public water supply.

Deontological Ethics

  • Nonconsequentialist; actions are right or wrong independent of consequences.
  • Based on duties and obligations to others; upholds commitments (e.g., contractual duties).
  • Example: RDH contract may constrain options (e.g., limited restorative choices).

Virtue Ethics

  • Emphasizes virtues and character (benevolence, compassion, conscientiousness).
  • Guides what kind of person you ought to be rather than specific actions.
  • Example: RDH volunteering as an expression of virtuous character.

Normative Principles in Health Care

  • Four core principles: Nonmaleficence, Beneficence, Autonomy, Justice.
  • Supporting concepts: Veracity, Paternalism, Informed Consent, Confidentiality, Fidelity, Societal Trust.

Nonmaleficence

  • Do no harm; prevent and remove harm; adhere to standards of practice.
  • Examples: avoid procedures beyond qualification; follow standard precautions.

Beneficence

  • Actively promote good and prevent harm; use reasonable means to benefit the client.
  • Examples: minimize radiographs; maintain equipment; participate in health programs.

Autonomy

  • Right of individuals to make their own decisions about their health.
  • RDH must provide full information for informed choice and consequences of actions.

Justice

  • Fairness and equality; treat all clients equally; provide access to care for all.

Supporting Concepts

  • Veracity: truth-telling and integrity; foundation of trust.
  • Paternalism: acting in the patient’s best interest; can conflict with autonomy.
  • Informed Consent: legal and ethical; patient decision-making requires full information and understanding; two parts: information disclosure and voluntary decision.
  • Confidentiality: protect client information; exceptions include emergencies, public health, safeguarding others, and legal requirements.
  • Fidelity: loyalty and faithfulness; keeping promises.
  • Societal Trust: public expects high standards; professionals must maintain trust.

Ethical Dilemmas

  • Occurs when two or more ethical principles conflict (e.g., nonmaleficence vs autonomy).

Intellectual Tools for Ethical Decision Making

  • Ethical principles guide decision making; balance competing principles in each situation.
  • RDH must weigh and balance principles to determine the best course of action.

Fundamental Ethical (Normative) Principles & Supporting Concepts

  • Nonmaleficence, Beneficence, Autonomy, Justice
  • Veracity, Paternalism, Informed Consent, Confidentiality, Fidelity, Societal Trust

Client’s Bill of Rights (Dental Hygiene Context)

  • Right to choose the RDH providing care; know credentials.
  • Care based on current standards and code of ethics; confidentiality.
  • Treated with respect; understand and participate in care decisions; be referred as needed.
  • Have concerns heard by the regulatory body.

Standards Statements (From Week 8)

  • 1) Obtain informed consent before initiating care.
  • 2) Practice safely.
  • 3) Assess the client’s needs.
  • 4) Analyze assessment information and diagnose dental hygiene needs.
  • 5) Plan care based on assessment data and diagnosis.
  • 6) Implement the plan or adjust with client consent.
  • 7) Evaluate during and after care to determine outcomes.
  • 8) Document the care following practice protocols.

Code of Ethics and Critical Thinking

  • Codes of ethics guide but do not provide all answers.
  • RDHs must read, assimilate, and apply principles to challenges.

Next Steps in Education

  • Week ahead: study BCCOHP and CDHA codes of ethics and dilemmas.