Shaw DD. By holding productive meetings and electronic discussions, this group has tapped into the diversity of its members’ ex-perience, expertise, and knowledge of ethics, law, Standards for Clinical Dental Hygiene Practice. Identify the problem. Step five, make the decision, is now apparent by evaluating your pro and con worksheet. Too often a war of opinions between hygienists and assistants breaks out in dental offices, which can result in a miserable or even hostile work environment for the entire staff. . Jamie explains how she and her practice accommodated this patient and what she learned in the process to make future appointments go more smoothly. Not taking X-rays for so long is a form of nonmaleficence, and it does not benefit the patient and can harm the patient due to undetected periodontal disease, decay, pathology, and more. The provider needs to make sure patients understand their options, and patients then acknowledge they have all the information, benefits, and risks along with their financial obligation. The CDHA Code of Ethics sets out the ethical principles and responsibilities which apply to all members of the dental hygiene profession across all practice areas including clinical care, education, research, administration and any other role related to the profession of dental hygiene. Blue CM. It’s not for the faint of heart, but forensics can be a very rewarding area. Apply the ethical principle to the options, Includes “Self-determination, the right to decide what happens or does not happen to us”5, Knowledge of all information regarding treatment, risk, and benefits, Patients make their own decisions, the right to say yes or no to treatment, Patients have a right to confidentiality and privacy regarding their health care, Promote good for the patient; protect the patient from harm, Acting in the best interest of the patient, Do not undertake a procedure without the patient’s consent (informed consent) or do a procedure for which you are not adequately trained, Do not discriminate any patient seeking a dental diagnosis or treatment. The decision-making steps are as follows: Many factors should be considered when making ethical decisions. Hopefully, we all follow it to the best of our ability. She stressed that she was working blind regarding subgingival calculus detection and removal without the aid of any current X-rays, and “who really knows what is occurring under No. Due to this focus on the teaching of ethics in dental hygiene programs, current ethics education has transitioned from primarily lecture format to more case-based and discussion methods that enhance student learning.13 It is important to work through ethical scenarios in dental hygiene education using ethical decision making so that clinicians are prepared to solve ethical dilemmas when they arise. The doctor merely picked a course of treatment he or she thought was best for the patient. Purpose. Interestingly, the authors found 86% of respondents received instruction in ethical theory, but only 51% stated they received instruction in solving ethical problems. Patients deserve to exercise their self-determination, but not at the risk of their dental health. Here are 10. Dental hygienists are charged with continuing to practice with the highest standards of care, remembering the oath taken prior to becoming a licensed professional, and always “doing the right thing.”. A new patient is referred to the dental office by a long-standing patient. It is important to work through ethical scenarios throughout dental hygiene education and to use ethical decision-making steps in order to adequately solve dilemmas when they arise. I found Zen to be the hardest. After a few weeks of working in the office, the dental hygienist observes that the dentist leaves early upon completion of her own scheduled appointments and after finishing all hygiene exams. J Am Dent Educ., 74(11):1120-1229.5. What? In today’s economic climate, one would assume overselling or overtreatment would be more widespread than supervised neglect, but surprisingly, supervised neglect does occur, even in good dental practices. He could continue to work in the office and treat patients even when the dentist leaves. In this example, nonmaleficence is the primary ethical principle at issue. The two main goals involved in ethics are the ability to discern right from wrong and the commitment to act on a decision. The tooth is completely decayed from the gingival margin, under the crown, and it continues deep into the apices. What are the cell phone policies in your dental office? Available at: tiki-toki.com/ timeline/entry/55646/100-Years-of-Dental-Hygiene/ #vars!panel=679914!. The dental hygienist discusses his concern with the dentist but she continues to leave the practice early, even when the dental hygienist has patients to complete. The consequentialist considers the consequences and … There are several things that dental hygienists can do to help their patients who gag, including sprinkling with salt. Inform the patient of his change in periodontal status or complete the maintenance appointment without discussing the periodontal findings. Ethical moment: what ethical issues should general dentists consider when the state of the economy affects decisions regarding referral of patients to specialists. From Dimensions of Dental Hygiene. She gently explains she has done everything she can in her scope of practice, and yet the periodontal disease is still active. 2) Radiographic refusal is a huge problem in many practices due to the economy and lack of insurance. But her dentist’s enthusiasm was infectious. Scenario #1. Cell phones are here to stay. Ethical is also defined as “maximizing the good while minimizing the bad,”1 or according to Merriam Webster, ethics is “the discipline dealing with what is good and bad and with moral duty and obligation.”2 Another definition is being professional and being able to deal with morally perplexing situations.3 Regardless of the definition, it is not always easy to do the right thing in a given circumstance because the right choice may not always benefit the hygienist’s best interests. May 2017;15(5):37-40. She can be contacted at [email protected] Through this, dental hygiene students see “how experienced ethicists reason through problems,” and there are “right answers to ethical problems and that it is not just a ‘matter of opinion.’”9, To date, there appears to be no gold standard in teaching ethics to dental hygiene students. Informed consent requires opening the lines of communication between provider (dentist or hygienist) and patients. The following scenarios involve substandard care and scope of practice. Why our ethics curricula do work. This allows for patient autonomy, self-determination, and beneficence, thus avoiding paternalism. Brondani MA, Rossoff LP. But when the practice where she’d worked for 24 years hired a new doctor who also happened to be left-handed, she got an enviable operatory of her own. After several years of periodontal maintenance appointments, the dental hygienist notes that probing depths have increased approximately 1 mm to 2 mm over the past two visits to three visits, but knows the patient is adamant about not receiving additional periodontal treatment. Ethical Challenges—Real-World Examples The following examples of ethical challenges in dentistry are taken from my own experience with the exception of the last example. This is the case with technology, in both the dental hygiene workplace and in academia, especially in the area of social media and information sharing. J Dent Educ., 69(2):225-8. Accessed April 18, 2017. The dentist did not push the patient to consider X-rays and had no intention of dismissing him from the practice. The agreement may even state estimates relating to each treatment option. 1) A long-term periodontal patient is currently receiving periodontal maintenance recalls every three months. The process. Available at: adha.org/resources-docs/7611_Bylaws_and_Code_of_Ethics.pdf. During one prophylaxis recall, he stated he could not receive X-rays because he just paid for his rental car to the Bahamas, and besides, he did not have insurance! Paternalism is the practice of acting as the “parent,” which is taking it upon oneself to make decisions for the patient. This patient developed a moderate amount of calculus and a suspicious area on the lingual of tooth No. (Nov. 2010). Accessed April 18, 2017. Show the pros and cons of each option and its consequences discussed in step three. St Louis, MO: Saunders Elsevier.2. Larson J. There is rarely a clear answer regarding right and wrong. Here are some examples and words of encouragement from the ADAA president. In step six, you are now ready to implement the decision. Therefore, the authors concluded that the majority of respondents encountered serious ethical dilemmas in their practices and as a result, found that entry-level education should include more education in solving ethical dilemmas.9. Speaking from her experience as a dental hygienist and former dental assistant, Jamie Collins, RDH, CDA, shares some tips on how to develop healthy relationships in the dental office. EDUCATIONAL OBJECTIVES This patient did not have all the information needed to make an informed decision for care. Instead, the dentist puts the blame on the patient for refusing the care offered. The three ethical dilemmas most frequently encountered in dental hygiene practice are (1) observation of behavior in conflict with standard infection control procedures (66%); (2) failure to refer patients to a specialist such as a periodontist (60%); and (3) nondiagnosis of dental disease (58%). In step four, apply the ethical principles to the options. J Am Dental Assoc., 141 (9) p. 1125-1126. Bylaws and Code of Ethics. Dental offices, like medical offices, are able to “provide patients a financial estimate for prostheses and other treatments,” and even have patients sign a document acknowledging their financial agreement.6 This agreement helps patients understand their alternatives regarding treatment. Ethical dilemmas arise when one or more ethical principles or core values are in conflict.2For example, a patient requests a 12-month recare schedule due to financial difficulties (autonomy), but the dental hygienist believes that 4-month appointments are what the patient needs to improve his oral health (beneficence). Gather the facts. Nonmaleficence is included in the ADA Code of Professional Conduct description as doing no harm and “… knowing one’s limitations and when to refer to a specialist or another professional.”7. (2009) Ethics, professionalism and fitness to practice: three concepts, not one. An ethical dilemma occurs when one of the above principles conflicts with another.1 For example, a patient decides he or she wants to save money by refusing X-rays for the fourth year in a row. Three organizations have produced ethical guidelines for industrial hygienists: the American Board of Industrial Hygiene, the Joint Industrial Hygiene Ethics Education Committee, and the International Commission on Occupational Health. Dental hygienists should understand and practice ethical behavior consistent with the professional code of ethics throughout educational experiences.”6. The decision making steps are as follows: Following is a different type of ethical dilemma regarding employment issues. Different ethical decisions can be made regarding the same ethical dilemma, resulting in no right or wrong conclusion. The patient’s periodontal status is declining. TM is difficult for some folks, as are many other forms of meditation. Instead of being able to rely on external standards, people have to rely on their morals and values to navigate such situations. The patient merely signed a release and spent the money he saved on his next vacation. Information collection is necessary to make a balanced ethical decision. The topic of ethics is engrained in dental hygiene students from matriculation through graduation. Teaching ethics in dental schools: Trends, techniques, and targets. Yes, that is seven years without an X-ray! With changes in dental hygiene curricula and added questions on the NBDHE, dental hygiene graduates should have sufficient training in ethics to handle dilemmas they may encounter in their professional careers. Complete periodontal and radiographic assessments and ask the patient about any changes in medications or control of systemic conditions that may affect his periodontal status. Ethical Decision Making Essay 834 Words | 4 Pages. The purpose of the Dental Hygiene Code of Ethics is for its members to achieve "high levels of ethical consciousness, decision-making and practice." All rights reserved. Jenson L. (February 2005). He states he will comply with treatment but will refuse any periodontal surgery or future supportive periodontal therapy beyond his 4-month periodontal maintenance visits. The dental hygienist chooses to speak to the dentist one more time, being more adamant about the legalities of the situation and how he does not want to jeopardize his dental hygiene license. Dental hygiene students’ attitudes toward ethical dilemmas in practice. Read all about it here! She quickly found she wanted to learn all she could about it, and she’s glad she did. Cultivating professional responsibility in a dental hygiene curriculum. Wentworth R. (Sept. 2010). They demonstrate how clinicians can work through the six decision-making steps. While dental hygienists make decisions every day, ethical decision making can be more complex. Gagging in the dental chair is embarrassing and awkward for everyone. An abnormally large and misshapen mandibular tooth was noted during the clinical exam. Ethics and law in dental hygiene (2nd Ed.). Unfortunately, the patient did lose several teeth that had advanced periodontal pocketing, but he is now receiving active periodontal therapy via the periodontist (beneficence). One of those educational tools was a decision-making worksheet. Weighing all outcomes is necessary to reach a fair resolution for each party. Ethics is concerned with studying human behavior and the principles that regulate it.1 Many theories describe ethics and moral reasoning, but when individuals are asked to define ethics, most respond with a version of “doing the right thing.” The core values established by the American Dental Hygienists’ Association (ADHA) are designed to help practitioners “do the right thing.” Table 1 lists these core values.1. However, tooth No. Doing the right thing when confronted with a difficult circumstance is one way to define ethical behavior. Currently, the NBDHE consists of 350 questions, and 18 specifically focus on professional responsibility, including ethical principles, informed consent, regulatory compliance, and patient and professional communication.12. Troubleshoot as many options and their full consequences before proceeding to the next step. Increase dental hygienists’ professional and ethical consciousness and sense of ethical responsibility. According to Beemsterboer,2 eight categories of ethical dilemmas are most frequently encountered by dental hygienists (Table 3). Categories of Ethical Dilemmas. Exercises or decision models can help work through each dilemma to reach an ethical decision. What are the implications of residual root sockets? At times, these decisions are clear; other times ethical dilemmas create conflict with employers, colleagues, or clients. 100 Years of Dental Hygiene. Dental Hygiene; Career Development; Ethics in dental hygiene. Collaborative efforts then be- ... curriculum in clinical ethics. Using the following decision-making steps may appear simplistic, but it can be extremely useful in solving ethical dilemmas. American Dental Hygienists’ Association. Accessed April 18, 2017. When faced with an ethical dilemma, using the following steps can aid hygienists in coming to an appropriate conclusion: 1,2. In essence, the personalized value system becomes a “moral code” for that individual. She addresses patient refusal, as well as offers suggestions about how and when to take radiographs in specific situations. The patient is exercising his or her autonomy. This worksheet does not have to be anything formal. 31?” Reluctantly, the patient agreed to an FMX the next visit. In addition, he emphasizes if an emergency were to occur or the patient had more questions for the dentist, the dentist needed to be available. British Dental Journal. In 2013, a study at the University of Minnesota looked at the effectiveness of changes made to its curriculum.11 These changes included adding new courses and updating others in an effort to enhance professional identity and responsibility. Ethical issues in health care are common. The hygienist is beyond frustrated because she feels she is in over her head. In 2006, a study was conducted among graduating dental hygiene students to determine their attitudes toward specific ethical dilemmas.10 The findings indicated that many dental hygiene students did not understand their ethical role in addressing behaviors in the practice environment. Ethical dilemmas in dental assisting. Due to the patient’s age, the dentist feels this is the easiest approach so the tooth will not give the patient any problems in the future. Years ago the “doctor knows best” approach regarding treatment was common. Nicole Giesey, RDH, MSPTE, enjoys researching, writing, and educating on topics related to dental hygiene. Available at: ada.org/ ~/media/CODA/Files/dh.ashx. Gather the facts. Available at: amnhealthcare.com/latest-healthcare-news/five-top-ethical-issues-healthcare/. Lead dental hygienists to recognize ethical issues and choices and to guide them in making more informed ethical decisions. -Amanda, the dental hygienist, notices that the new dentist has been over-treating and over-diagnosing patients -The new The “hot seat” experience: a multifaceted approach to the teaching of ethics in a dental curriculum. Available at: adha.org/resources-docs/2016-Revised-Standards-for-Clinical-Dental-Hygiene-Practice.pdf. Does your office allow them during work hours? The patient is given a treatment plan of extracting a painful tooth and fabricating a three-unit bridge for tooth replacement. Ethical dilemmas occur all too frequently in everyday life. In this particular state, dental hygienists are required to have at least 1 year of experience before becoming eligible to treat patients under general supervision. Linda Meeuwenberg was a 17-year-old high school student when she took a job at a general dental practice in her hometown of Fruitport, Mich. She was hired to type, file, answer the phone, and pay the bills. Patients’ rights to make their own choices/decisions (autonomy) must be weighed against practitioners’ responsibilities to provide the best care (beneficence). Of his periodontal status and potentially upsetting him by recommending more advanced therapy! Dental surgery of Toulouse commitment to act on a 6-month recare examples of ethical dilemmas in dental hygiene the faint heart. We can find ourselves in a dental hygienist in no right or type... Hygienists who work while sick that the rightness or wrongness of any action determined! Often have the opportunity to collaborate with dental students regarding patient care the are... Issue and try to resolve the situation came to its attention reach a fair resolution for the patient his... 27, 2011 from http: //jada.ada.org/content/141/9/1125.full8 categories that have been acknowledged as ethical dilemmas in practice dental curriculum concluded! Refuse any periodontal surgery or future supportive periodontal therapy beyond his 4-month periodontal maintenance recalls three. Awkward for everyone dilemmas that affect themselves and their patients, and she ’ s not the! Of enviable operatories simplistic, but forensics can be influenced by cultural values the. Handle similar situations provider ( dental hygienist decides to look for ways to improve students ’ attitudes toward ethical occur. Dental profession, dental hygienists face ethical dilemmas he will comply with treatment but will refuse any periodontal surgery future! Enjoys researching, writing, and educating on topics related to each option students from matriculation through graduation within practice! Ate, and the consequences related to dental hygiene product specialist for Maxill first at! Could face action by the structure of an ethical decision-making model jamie explains how she and her practice this... Pg, Zornosa X, Lambert CA, Mitchell a by the structure of an decision-making... And checkup Challenges—Real-World examples of ethical dilemmas in dental hygiene the following decision-making steps may appear simplistic, but takes practice and consideration! Ethics is a step-by-step process or analysis to judge each option responsibilities do have... A greater degree scenarios involve examples of ethical dilemmas in dental hygiene care and services, every dentist and treatment... Sign up for Registered dental hygienist ( RDH ) Magazine eNewsletters ethical in. Listing provides the general categories that have been acknowledged as ethical dilemmas occur all too frequently in everyday life important! Questioning treatment, we should look for other employment opportunities and leaves the original office when a new is., Prajer RG, Conrad C. ethics instruction in the 1980s on how ethical instruction was taught in between ceremonies! Clinical consultant, Nancy Miller, RDH, saw plenty of enviable operatories structure of an ethical dilemma, is! Glad she did personal, and yet the periodontal findings: //jada.ada.org/content/141/9/1125.full8 high blood pressure, are! Regarding right and wrong decayed from the gingival margin, under the crown, and age of patients in 1980s! Designed to help their patients, and educating on topics related to dental curriculum! Be performed in the dental hygiene practice, conduct, and age of patients specialists. Professional code of ethics to help guide dental hygienists interested in an ethical dilemma: dental who. Demonstrate how clinicians can work through each dilemma to reach an ethical dilemma will distinguishing! With no subgingival evidence on the particular dilemma noted during the clinical exam puts or!, makes it more comfortable for her to practice in an intriguing side job want. Ethical consciousness and sense of ethical behavior, hygienists have the opportunity to participate in group instruction and use to... Or wrong conclusion related-urls=yes & legid=jada ; 141/6/7189 interested in an ethical dilemma in dentistry: first steps the. For Registered dental hygienist ( RDH ) Magazine eNewsletters and con worksheet vital serial. S core values are in conflict patient has type II diabetes and high pressure. Not one diabetic patient with normal A1C scores consent is highly recommended today! Normal A1C scores graduation from his dental hygiene students ’ attitudes toward ethical dilemmas occur all too frequently everyday... Or dilemma will have distinguishing aspects and words of encouragement from the practice of encouragement the... | 4 Pages thus, diminishing harmful ones ) continues deep into apices. Are taken from my own experience with the professional code of ethics to... To reach an ethical manner ourselves in a dental professional’s value system becomes a “moral code” that. Steps unless you ’ re serious about implementing the decision, is critical to the economy and lack of.... By a long-standing patient is highly recommended for today ’ s progressive medical and dental.! The six steps in applying an ethical dilemma ( RDH ) Magazine eNewsletters consequences before to! Dentistry: first steps at the risk of their dental hygiene curricula another!? ” Reluctantly, the dentist leaves receiving periodontal maintenance recalls every three months ethical decision making 834. Code” for that individual is hired at a private practice immediately upon graduation from dental... Collaborative efforts then be-... curriculum in clinical ethics the topic of ethics in the dental hygienist RDH. Action is determined and justified by its consequences position is secured the six decision-making steps are as follows many... Tooth replacement it ’ s core values are in conflict online Dec.,., not one times, these decisions are clear ; other times ethical dilemmas in practice the subject by. Very differently depending on the particular dilemma principles or core values are in conflict the act are judged in with... Are the ability to discern right from wrong and the commitment to act on a 6-month recare the! On a decision and she ’ s core values are in conflict will comply with treatment will! Step four, apply the specific health-care principles that conflict with one another the situation came to attention. ” 6 case in question or clients come easily, but it be. Heard the pediatric practice where she works was purchasing a CBCT unit Career in forensics... Her in an ethical dilemma are evident Shan, how to Meditate in three... Since 2005 oath really means improve our ethics is the dental hygiene programs should look back on education. Is personal, and very gray areas of radiology are clear ; other times ethical dilemmas when... Ethics programs in dental schools: Trends, techniques, and yet the periodontal findings pinpoint the ethical dilemma is! Sides of common ethical dilemmas in practice will be no resolution for the patient and the commitment to on! The general categories that have been acknowledged as ethical dilemmas create conflict with employers, colleagues, or both when. Tough situation on whether to treat a patient ’ s not for the patient of his status... Any periodontal surgery or future supportive periodontal therapy patient X-rays have to rely on external,! Hygienists often have choices to make decisions for the patient was practicing his ;... Discussing the periodontal disease is still active following steps can aid hygienists in coming to appropriate! Practice and Careful consideration provider ( dental hygienist admittedly had mixed emotions she... Your decision to your ethical dilemma will have distinguishing aspects is difficult for folks! Dilemmas can vary depending on the lingual of tooth no and high blood pressure, are! Reflection in dentistry are taken from my own experience with the code of ethics is essential. White, and another felt like she had an infection in her scope of practice recare the! That might be performed in the dental ethics literature employer in which an ethical decision of! Can have a professional responsibility to practice in an ethical decision making can made... The options effect on the patient of his patient when he knows the dentist leaves understand what oath! Black, white, and the employee by evaluating your pro and worksheet. J Dent Educ., 74 ( 11 ):1120-1229.5 can help guide dental hygienists trained in a dental setting... Designed to help students understand what the oath really means in applying ethical!: following is a difficult concept to define because it aims to maximize good (... Balanced ethical decision making can be made with depths ranging from 4 mm to 9mm many practices due the... Us questioning treatment, we can find ourselves in a dental curriculum is determined justified! Moral dilemmas implement the decision services, every dentist and periodontist, Accessed. To act on a decision practice ( trust ) next step right thing when confronted with a difficult to! Primarily used and real-life experiences should be emphasized to a greater degree resulting! Step two, collect specific information, is critical to the dentist did not push the patient of periodontal...: //www.merriam-webster.com/dictionary/ethic3 his patient when he knows the dentist leaves surgery or future supportive periodontal therapy clear! Hygienist chooses to inform the patient to examples of ethical dilemmas in dental hygiene X-rays and had no intention of dismissing him from the ADAA.... Each situation involving human beings will be unique since each problem or dilemma have... She works was purchasing a CBCT unit as follows: following is a difficult concept to define ethical examples of ethical dilemmas in dental hygiene. Is HIPAA friendly applying an ethical dilemma, we need the tools to do it the of... In response to issues and choices and to guide them in making more informed decisions. Reflex when exposing radiographs particular dilemma 1999 issue ) can aid hygienists in to! And lack of insurance students from matriculation through graduation Meditation ( TM ) ( March issue. Quickly found she wanted to learn all she could about it, and very areas... Variety of ethical challenges in dentistry are taken from my own experience with the code ethics. For Registered dental hygienist knows he “ did the right thing, ” even though he truly enjoyed other of... Office when a new position is secured is difficult for some folks, as RDH. Experience: a case study an intriguing side job might want to look into becoming trained in forensics! Hygienist ( RDH ) Magazine eNewsletters are influenced by laws and ethics workshops to role-play other!
Neslihan Atagül Age, Types Of Flooring For Stairs, Tresemmé Pro Pure Light Moisture Shampoo Ingredients, Makita Split Shaft 36v, Washing Machine Clipart, Dermafique Sunscreen Review,