Download Veracity (truthfulness)

Lecture two in ELP
Prof. Elsanousi M Taher
BDS, MSc., FFDRCSI
What are codes of ethics
Codes of practice: Written guidelines issued by an
official body or a professional organization to its
members to help them comply with its ethical
standards.
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In Business; On every new job you are given a Code of
Ethics for that specific company, explaining all the rules,
regulations and expectations the company demands from
each and every one of their employees.
Codes of ethics: is a standard of morals by
which a group makes decisions about what is
right or wrong.
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An example of code of ethics is a set of values
listed in a company's mission statement.
‫رسالة الجامعة‬
LIMU Mission
‫ وتتبني‬،‫الجامعة الليبية الدولية للعلوم الطبية مؤسسة أكاديمية تُطبق نظم إدارة الجودة‬
،‫استراتيجيات التعلم الذاتي المرشَّد والتعلم مدى الحياة وإنتاج المعرفة وخدمة المجتمع‬
‫ لديهم القدرة على تلبية حاجات‬،‫وتعمل على إعداد وتأهيل متخصصين ذوي كفاءة عالية‬
‫ وتؤكد على‬،‫ وتهتم بتنفيذ البحوث الصحية والعلمية وبرامج التطوير المهني‬،‫المجتمع‬
‫االلتزام باألخالقيات المهني‬
Libyan International Medical University (LIMU), is an academic
institute that applies Quality Management System, adopts
strategies of self-directed, lifelong-learning, knowledge production
and community service. LIMU endeavors to graduate competent
professionals equipped to satisfy community needs, and promotes
scientific research and programs of professional development.
LIMU is committed to professional ethical values and principles
‫قيم الجامعة‬
LIMU Values
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Many dental organizations have published codes
of ethical conduct to guide member dentists in
their practice.
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the American Dental Association has had a Code of
Ethics since 1866.
A code of ethics marks the moral boundaries
within which professional services may be
ethically provided.
Failure to follow the Codes of ethics and
professional guidelines and non-compliance can
result in sanctions from censure to loss of
professional status.
In Libya, there is no national codes for
professional ethics in dental practice
Ethical standard:
are the principles that when followed, promote value
such as trust, good behavior, fairness, and/or
kindness.
 There is not one consistent set of standards that all
companies or organizations follow, but each one has
the right to develop the standards that are
meaningful for their organization.
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Ethical standards are not always easily enforceable,
as they are frequently vaguely defined and somewhat
open to interpretation ("Men and women should be
treated equally, " or "Treat the customer with
respect and kindness."). Others can be more specific,
such as "Do not share the customer’s private
information with anyone outside of the company."
Components of ethics:
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The “four principles of ethics”
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Autonomy-self
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Beneficence-
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Non-maleficence
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Justice
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Veracity
determination or governance
good doing
and do no harm as Hippocrates suggested
(truthfulness): duty to communicate truthfully.
Autonomy:
The dentist has a duty to respect the
patient's rights to self determination to
make decisions about his or her won life
or health.
 Involve the patient in treatment
decisions: respecting the right to refuse
all or certain treatment options
 Patient involvement: the dentist should
inform the patient of:
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the proposed treatment
Treatment options
Benefits and risks
Costs
Time frame
Consequences of no treatment and any alternatives to make
decisions
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In Ozar and Sokol’s model of the patientdentist relationship, the dentist and
patient are equal and mutual partners in the
decision making process
Respect each others
 Each have set of value
 Share information
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Thus, it is essential that the dentist and
patient communicate and cooperate
effectively.
Autonomy-self determination:
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For years dentists enjoyed ‘professional or clinical
autonomy’ or what is called paternity
Respecting patient’s dignity and choices
Listen to patients (we have 2 ears, 2 eyes and 1
mouth)
Clarify their concerns
Work in both “transmit and receive mode “
Explain treatment options:
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Risks and benefits
Costs
Long-term outcome
Obtain consent: in UK most of problems are not
due to negligence but due to failure to have
consent !!!
Autonomy
Patients have the right to determine what should
be done with their own bodies.
 Because patients are moral entities they are
capable of autonomous decision-making.
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Respect for patient autonomy affirms this dynamic
in the doctor-patient relationship and forms the
foundation for informed consent, for protecting
patient confidentiality, and for upholding veracity.
The patient’s right to self-determination is not,
however, absolute. The dentist must also weigh
benefits and harms and inform the patient of
contemporary standards of oral health care.
Beneficence (do good):
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Refers to the principle of promoting or
doing good and behave and act in
accordance with the best interest of the
patient, his values and preferences
It is central massage of Hippocratic
writings
What is meant by the “best interests” of
our patients?
The “best interests” of our patients means that
professional decisions by the dentist must consider
patient’s values and personal preferences. This
requires that dentists carefully communicate with
their patients, and that listening is of paramount
importance.
 Sometimes patient desires conflict with
professional recommendations. Patients must be
informed of possible complications, alternative
treatments, advantages and disadvantages of
each, costs of each, and expected outcomes.
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Together, the risks, benefits, and burdens can be
balanced. It is only after such consideration that
the “best interests” of patients can be assured.
Nonmaleficence (do no harm)
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Essentially states that a dentist must not
cause unnecessary harm to a patient.
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Some pain may be acceptable
It is imperative that the dentist keep his
or her skills and knowledge of procedures
current, know their limitations, and know
when and under what circumstances it may
be acceptable to perform a procedure that
may cause a patient harm.
Balancing benefits against risks and costs
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Dentists have an obligation to:
use their knowledge, skills for improvement
of dental care of the public
 Be leaders in their community in a way to
maintain and elevate the esteem of the
profession
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Dentist should avoid interpersonal
relationships with his or her patients.
(affect judgment and exploits the trust)
Reporting symptoms consistent with
domestic violence and child abuse to the
proper authorities.
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Under this principle, and in its wide
perspective in encompass that dentist has
primary obligation to serve patient and public
at large
Refer patient if cannot complete or A
complication arise during the course of
treatment
Protect the health of the patient and not
expose a patient to increased risks.
Inform the patient if he exposed into
infectious risk during the course of treatment
Justice and fairness
 Dentists
have the responsibility to be fair
in their dealings with patients, colleagues,
and society.
 Might
be described variously as fairness,
accountability, equity or providing equality of
treatment and care
 Treating
people equally & justly and never
discriminate and deliver dental care without
prejudice.
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Ensure that all dental patients have access to at
least basic level of care regardless of income,
race, creed, colour, sex or social status
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Dentists are obliged to arrange to provide
emergency services to record and non record
patients
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Society often determines what is just and unjust,
therefore it is imperative that dentists rely on
cues from society to ensure ethical compliance.
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Dentist is required to provide professional
testimony if required without the interference of
personal opinion
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Adjacent to this is the responsibility of a
consulting dentist to provide care without
undermining the treatment given by a
previous treating dentist.
However, if the dentist notices gross or
continual faulty treatment by other
dentists, it is the responsibility of the
dentist to raise the issue properly for the
sake of public interest and reputation of
the profession, that is based in truth and is
without malice.
Veracity (truthfulness):
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Under this principle, the dentist’s primary
obligations including respecting the position of
trust inherent in dentist-patient relationship
communicating trustfully and without deception
and maintaining intellectual integrity.
This principle express the concept that
professionals have duty to be honest and
trustworthy in their dealings with people.
Veracity
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Veracity, often known as honesty or truth
telling, is the bedrock of a trusting doctorpatient relationship.
The dentist relies on the honesty of the patient
to gather the facts necessary to form a proper
diagnosis.
The patient relies on the dentist to be truthful
so that truly informed decision-making can occur.
Honesty in dealing with the public, colleagues and
self are equally important.
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Representation of care and fees:
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Waiver of co-payment ( ‫ (تنازل عن المشاركة في التسديد‬:
Overbilling
Fees
Unnecessary Dental procedures
Unnecessary services or referrals
it is unacceptable for a dentist to advertise or
communicate in such a way as to solicit ( ‫تستجدي أو تحاول‬
‫ ) (الحصول على‬a patient based on partial truths.
 Disclosure of conflict of interest
 Devices and therapeutic methods:
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Reporting of adverse reactions
Marketing or sale of products or procedures
Playing with credentials
Tolerance
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Dentists are challenged to practice within an
increasingly complex cultural and ethnically
diverse community.
Conventional attitudes regarding pain,
appropriate function, and esthetics may be
confounded by these differences.
Tolerance to diversity requires dentists to
recognize that these differences exist and
challenges dentists to understand how these
differences may affect patient choices and
treatment.
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15 years old girl attends dental
fractioned requesting veneers on upper
lateral incisors (which are slightly out of
line) because her classmates told her
that she would look better if she do that.
The dentist examines the girl and
identifies that orthodontic treatment
may be the best option for alignment of
the teeth without preparation of them
for veneers. Give your comments
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Because the girl is under age the
dentist asked her to see her mother
which when she come she was in
agreement with her daughter wishes.
When the dentist explains that
orthodontic treatment is the best
option they insist on veneers because
the orthodontic treatment will take so
long.
The dentist has to decide weather to
comply with their wishes. Discuss