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Dental Hygiene Ethics: Core Concepts and Vocabulary
What You'll Learn
Understand and use every part of the Dental Hygiene (DH) Code of Ethics.
See how laws, ethics, and your personal feelings all affect how you practice DH.
Learn how to use a step-by-step process to make ethical choices in everyday and tricky situations.
Recognize and apply the main Core Values that guide professional dental hygiene work.
The Dental Hygiene Oath
This oath is a special promise dental hygienists make. It has two main parts:
Public Promise - This is about helping the community and improving people's oral health.
It means working to improve the art and science of dental hygiene.
It also means promoting high standards for the quality of care given.
Personal Promise - This is about continually improving your own knowledge and skills as a professional.
It means giving your full effort and service to every patient.
It also means always acting with the highest level of professional skill and personal good behavior, for the benefit of both your profession and society.
Why is it important? It's like the Hippocratic Oath that doctors take.
It acts as your inner guide, shaping all your actions when treating patients and interacting with others.
What Exactly Is Ethics?
Ethics is a part of philosophy that looks at what is right and wrong, moral problems, and how we make moral judgments.
In a professional job like dental hygiene, ethics helps us figure out what we should do, not just what we are legally allowed to do.
There are three main areas where ethics applies in your professional relationships:
Professional with Patient: This involves respecting what the patient wants (patient autonomy), building trust, and getting their permission for treatment (consent).
Professional with Other Professionals: This means showing respect to your colleagues and consulting with them when needed.
Professional with Society: This includes your responsibilities to public health and maintaining society's trust in your profession.
Dental Hygiene Ethics: What Makes It a Profession?
Ethics sets the general rules for what is right and wrong, guiding how DH members behave.
What makes DH a profession?
It requires a lot of specialized education.
You need to master a complicated body of knowledge that's based on research.
It's a service job focused on helping others (the common good).
Members belong to professional organizations like ADHA, NDHA, CDHA, and IFDH.
Professionals have the ability to make their own judgments and regulate themselves.
They agree to follow a clear Code of Ethics.
Having an ethical perspective is what raises dental hygiene from just a technical job to a respected profession.
The Code of Ethics (Using ADHA's Code as an Example)
What's its purpose?
To make everyone more aware of ethical issues.
To give you a way to make decisions.
To guide how you provide clinical care and behave professionally.
How is it structured? It's divided into categories called Standards of Professional Responsibility (for example, responsibilities to patients, colleagues, the community, and yourself).
Within each category, the responsibilities cover broad topics (like keeping patient information private, being skilled, or maintaining public trust).
A Tool for Self-Policing: The Code allows the profession itself, rather than outside groups, to define and oversee what is considered acceptable behavior.
Accountability
Definition: Being able to explain and take responsibility for your actions.
Why is it important?
To evaluate new or existing ways of practicing.
To maintain and set benchmarks for the quality of care.
To help you constantly reflect on your actions and grow.
To give a logical reason for your ethical decisions.
To show your professional qualities to the public, courts, and regulators.
To make you more aware of the subtle ethical details in your daily work.
Responsibility
As hygienists, you must study, understand, and apply the codes of all the associations you are a member of.
Key organizations and where to find their codes online:
American Dental Hygienists’ Association (ADHA)
National Dental Hygienists’ Association (NDHA)
Canadian Dental Hygienists’ Association (CDHA)
International Federation of Dental Hygienists (IFDH)
Standard of Conduct
Ethical awareness should be present in all aspects of your work and life:
When you're treating patients at the dental chair.
During research activities.
When doing community outreach.
In your personal life and how you act online (social media professionalism).
This ethical standard helps you stay strong when you face conflicts, like having to choose between meeting productivity goals and what's best for the patient.
Fundamental Ethical Principles in Health Care
These are the basic rules or beliefs that guide ethical behavior in healthcare:
Autonomy: Respecting individuals' right to make their own decisions.
Beneficence: Actively working to do good for others.
Nonmaleficence: The principle of doing no harm.
Justice: Ensuring fairness and an equal distribution of care.
Veracity: Being truthful.
Fidelity: Being faithful to your promises and professional duties.
Core Values in Professional DH Practice
These are selected ethical behaviors that are central to any professional code:
Autonomy & Respect
Confidentiality
Societal Trust
Nonmaleficence
Beneficence
Justice/Fairness
Veracity
Fidelity (sometimes included under veracity or beneficence in other ethical frameworks)
Autonomy & Respect
Patients have a right to:
Be treated with basic dignity.
Receive all important information about their condition and treatment options.
Give informed consent or refuse treatment (declination).
Valid Consent=Disclosure (giving info)+Comprehension (understanding)+Voluntariness (choosing freely)Valid Consent=Disclosure (giving info)+Comprehension (understanding)+Voluntariness (choosing freely)
Confidentiality & Societal Trust
Confidentiality: Protecting patient information. Breaking this privacy is only acceptable in serious cases, like if there's an immediate risk of harm.
Societal Trust: This is how the public views the honesty and trustworthiness of dental hygienists as a group. It's delicate and built up over time, case by case, through your actions.
Nonmaleficence & Beneficence
Nonmaleficence: Your duty to avoid causing harm (e.g., taking precautions for a patient with a latex allergy).
Beneficence: Your duty to actively promote the well-being of the patient and the public (e.g., giving advice on how to stop smoking).
Justice/Fairness & Veracity
Justice: Ensuring fair and equal access to oral health resources, and addressing differences in care.
Veracity: Being truthful, which helps patients make informed decisions. This is closely related to practicing evidence-based care.
Personal Values & How They Develop
It's crucial to assess yourself and make sure your personal morals align with your professional standards.
Your values are shaped by:
Your family upbringing.
The norms and expectations of society.
Your economic situation.
The values you learn early on highlight how important professional training is in shaping you as a dental hygienist.
Patient-Centered Care
Definition: Always putting the patient's interests first in every decision you make.
This is a legal and ethical requirement for non-discrimination, meaning you must treat all patients equally regardless of their race, gender identity, financial situation, disability, and so on.
Ethical thinking must be involved in every step of patient care: assessment, diagnosis, planning, implementation, evaluation, and documentation.
Lifelong Learning – An Ethical Duty
Why is continuous learning an ethical obligation?
To maintain your skills and knowledge.
To incorporate the latest research into your practice for evidence-based care.
To ensure your ethical reasoning stays current with new challenges (like teledentistry or AI in healthcare).
To uphold patients' rights to receive the best possible care.
Ongoing continuing education (CE) is similar to how other health professions require you to maintain your certification.
Ethical Issues vs. Ethical Dilemmas
Ethical Issue: This is a clear problem with an obvious solution that is commonly accepted and often supported by law.
Example: Using improper sterile technique. The solution is clear and dictated by rules from organizations like OSHA and CDC.
Ethical Dilemma: This is a situation where you have two or more choices, all of which seem morally justifiable, but each choice will lead to a different outcome.
There's no single "correct" answer; it requires carefully balancing different principles (for example, choosing between respecting a patient's wishes vs. what you believe is medically best for them).
Model for Resolution (How to Solve Ethical Dilemmas)
When you face an ethical dilemma, here’s a step-by-step model to help you make a good decision:
Identify the facts of the situation: What exactly happened? What are the objective details?
Identify stakeholders: Who are the people involved or affected by this situation? (e.g., the patient, your colleagues, other people).
List options/alternatives: What are all the possible actions you could take?
Rank or choose the best option: Look at your options and decide which one seems best, checking it against the Code of Ethics and the core values we just discussed.
Defending Your Decision
After you’ve made a choice, you should always ask yourself: “Is my action morally defensible?” This means, can you explain and justify why you made that decision to different groups of people?
Here are the potential audiences you might need to defend your decision to:
The patient and their family.
Your supervising dentist or other dental partners.
Your dental hygiene colleagues.
The state board of dental examiners or even a court of law.
When defending your decision, you must meet or exceed the Standards of Practice for dental hygiene and dentistry. This means your actions should be as good as, or better than, what is expected from a competent professional.
Legal Factors in Practice
It’s crucial to know that the “scope of practice” (what you are legally allowed to do) for a dental hygienist can be different in every state or jurisdiction. Ignorance of the law is not an excuse for breaking it.
As a hygienist, it’s your responsibility to:
Stay informed about any changes in laws that affect your practice.
Get involved with your state and local professional associations to get updates and advocate for your profession.
Applied Multiple-Choice Scenarios (Key Principles Tested)
Let’s look at some examples to see which ethical principles apply:
Scenario: Keeping a promise to review radiographs. The principle here is Fidelity (meaning faithfulness to promises).
Scenario: Explaining the pros and cons of a treatment and allowing the patient to choose. This demonstrates Autonomy (respecting the patient's right to make their own decisions).
Scenario: Giving equal care to all patients, regardless of their financial status or background. This is an example of Justice (fairness and equitable distribution of care).
Scenario: Taking precautions to prevent harm, like knowing a patient has a latex allergy and using non-latex products. This is Nonmaleficence (doing no harm).
Scenario: Having a truthful discussion with a patient about their smoking habits. This is Veracity (truthfulness).
Scenario: Spending extra time teaching a patient how to properly care for their teeth at home. This is Beneficence (actively promoting good and welfare).
Everyday Ethics Case Study – Health-Fair No-Show
Let’s consider a real-life situation:
Scenario: Annette, a dental hygienist, committed to volunteering at a community health fair but didn't show up.
Classification: This is primarily a professionalism issue. It’s a breach of reliability and faithfulness, not really an ethical dilemma. There aren't two conflicting moral options; Annette simply failed to fulfill a commitment.
Core Values Involved:
Fidelity: Annette broke her promise to her colleagues and the community.
Beneficence: She withheld the potential health benefits she could have provided to the public.
Responsibility & Societal Trust: Her actions erode the public's trust in dental hygiene volunteers.
How the Code of Ethics Supports Colleagues’ Actions to Address This:
The Code's section on Community & Society emphasizes the obligation to provide health promotion.
The section on Professional Relationships encourages supporting colleagues in fulfilling their commitments.
Accountability clauses in the Code mean Annette should be transparent about why she couldn't serve.
Professional Growth Takeaway: This situation shows that good time management and open communication could have turned a conflict (like prioritizing income over service) into a resolved dilemma. For example, Annette could have found a replacement volunteer instead of just not showing up.