JACD 71-4 - American College of Dentists

Therefore, a dentist should not work on
patients, but rather work with them.
Dentists need to develop the teaching
skills for educating patients about the
condition of their mouth and teeth and
oral health. These teaching skills are
intrapersonal in nature, not dentotechnical.
They involve careful listening,
clinical flexibility, and sometimes
persuasion. One natural way to do this
well is to let the patient in on your
thinking and nurture their interest in
what you are doing. The principle of
respect for patient autonomy requires
that the patient has the final say about
what the dentist is to do for them. Of
course that does not mean that patients
should be going it alone; it is the dentist’s
job to help them make wise choices in
a relationship of respect.
Principle 4: Mistakes Will Be Made
This principle should come as no shock
to the experienced dentist. Obviously, no
one is perfect. Nonetheless, some dentists
and many patients seem to have an
unrealistic and perfectionist expectation.
But bad things happen when people
believe things that cannot possibly be
true, and serious negative consequences
derive from the false belief that doctors
never make errors. First of all, it puts
unnecessary pressure on the dentist;
second, it creates a strong temptation for
the dentist to be less than completely
honest with patients. This principle is
not a rationalization for carelessness,
of course. Dentists must make sure to
install as many fail-safe mechanisms as
possible into their practice habits. But
they must also be ready to take the
inevitable errors in stride and manage
them properly and effectively, which
brings us to Principle 5.
Journal of the American College of Dentists
Principle 5: Tell the Truth
Here is a very important, but very
challenging, guideline: never, ever tell
a false thing to a patient (or a staff
member, for that matter). Never, ever,
in your whole professional career. Aside
from principled reasons for veracity,
there are several instrumental or
pragmatic reasons to tell the truth. Once
you have told someone a lie, you have
changed your relationship to them
forever. You have switched from an
authentic person-to-person relationship
to the relationship of player-and-played.
You now have to “work” that person
forever. You have to maintain the lie and
never let them in on the fact that you
lied in the first place. You can never
be truly authentic with them again.
What a loss!
The idea sounds logical and simple
enough, but to follow the veracity guideline
permanently—and in every situation
where something other than the truth
might make life easier—that is extremely
challenging. Dentists obviously know
they are to tell patients the truth. But
doing so is not always so easy. There is
the potential for embarrassment, for loss
of revenue, and of course the potential
for lawsuits. But the fifth principle
proposes that a dentist should not let
those things prevent the truth from
being told. It will take creativity and
sometimes humility, but always find a
way to be honest in your work. This is
related to the next principle.
Principle 6: Be Assertive
As a psychologist in the bioethics arena,
one of my professional duties over
the past decade has been to offer
psychological, ethical, and behavioral
help to dentists who have lost their
licenses. In an attempt to better understand
these practitioners I recently I took
a look back at my files to see if there
Issues in Dental Ethics
Once you have told
someone a lie, you have
changed your relationship
to them forever. You have
switched from an
authentic person-to-person
relationship to that of
player-and-played.
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