RESUMO
BACKGROUND: Given the imperative for dental practitioners to be familiar with the existing ethical principles and laws governing their practice, this study aimed to evaluate awareness and practice of the dentists (code of ethics) regulations 2014 and consumer protection act 2019 among dental practitioners in Andhra Pradesh state, India. METHODS: A cross sectional study was conducted among 384 dental practitioners in Andhra Pradesh state, India. A questionnaire consisting of 25 items was used to assess awareness and practice of the dentists (code of ethics) regulations and consumer protection act. The data collected were analysed using IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp. RESULTS: Only 53(13.8%) dental practitioners in the study were aware that the dentists (code of ethics) regulations had been revised in 2014. About 190 (49.5%) practitioners were aware of the precise period for mandatory preservation of patient records. Most dental practitioners (278, 72.4%) accepted commissions in the form of gifts or cash from laboratories, radiologists, or pharmacists and 306 (79.7%) dental practitioners used unregistered dental lab technicians as employees in their practice. Furthermore, 297 (77.3%) practitioners were found to provide or sell drugs to patients in their clinic/office. The new regulations under consumer protection act 2019 were unknown to 194 (50.5%) dental practitioners. CONCLUSIONS: The present study indicates that the awareness of dental practitioners towards the dentists (code of ethics) regulations 2014 and consumer protection act 2019 is inadequate. It highlights the need for training programmes and curriculum changes with a focus on ethical and legal issues in clinical dental practice.
Assuntos
Códigos de Ética , Odontólogos , Ética Odontológica , Humanos , Índia , Estudos Transversais , Odontólogos/ética , Odontólogos/legislação & jurisprudência , Inquéritos e Questionários , Masculino , Feminino , Adulto , Padrões de Prática Odontológica/ética , Padrões de Prática Odontológica/estatística & dados numéricos , Padrões de Prática Odontológica/normas , Padrões de Prática Odontológica/legislação & jurisprudência , ConscientizaçãoRESUMO
AIM: (1) To determine the repartition of criteria which can be considered as marks of lack of assent by the child with intellectual disabilities from the dentist's point of view and whether that influences the decision to examine the patient or not. (2) To explain the decision of practitioners and determine the ethical implications of these practices. METHODS: An anonymous and structured questionnaire was distributed online using the scenario of a 9-year-old child with moderate cognitive impairment with eight different oppositional behaviours. The practitioners were asked about their perception of the patient's lack of assent and about their decision to perform the dental examination or not. RESULTS: The proportion of them who performed a dental examination despite the patient's refusal represented between 13% and 28.8% of the population of respondents. CONCLUSION: There was an ambivalence among the practitioners who carried out a dental consultation when children were uncooperative. They adopted a teleological point of view. It calls for us to reflect on the ethical principles of autonomy and beneficence.
Assuntos
Ética Odontológica , Deficiência Intelectual , Padrões de Prática Odontológica , Humanos , Criança , Inquéritos e Questionários , Masculino , Feminino , Padrões de Prática Odontológica/ética , Europa (Continente) , Assistência Odontológica para a Pessoa com Deficiência/ética , Assistência Odontológica para Crianças/éticaRESUMO
Quackery and fraud in dental practice, seen in many countries, is also rampant in Nepal, and they are unethical practices. There is a growing need for strict enforcement of government policy measures to eliminate quackery and fraudulent dental practice in Nepal. The government should mobilize all dental workforce (dental specialists, dentists, and dental auxiliaries) and aware of their responsibilities and limitations. This article presents a brief review showing some cases of malpractice in dentistry in Nepal.
Assuntos
Assistência Odontológica/ética , Padrões de Prática Odontológica/ética , Charlatanismo , Credenciamento/ética , Credenciamento/legislação & jurisprudência , Assistência Odontológica/legislação & jurisprudência , Ética Odontológica , Fraude/ética , Fraude/legislação & jurisprudência , Regulamentação Governamental , Humanos , Imperícia/legislação & jurisprudência , Nepal , Padrões de Prática Odontológica/legislação & jurisprudência , Charlatanismo/ética , Charlatanismo/legislação & jurisprudênciaRESUMO
Technological innovations in the fields of medical imaging and communication have enabled the rise of dental telemedecine. By transforming the usual caring relationship, dental telemedicine virtualizes the medical procedure and generates a mutation of the classical relational model that rearticulates the relationship between the dentist and the patient. It introduces a positive lever that must stay up to the appraisal of the benefit-risk equation, that an ethical questioning will help to evaluate for every patient. Dental telemedicine must be understood as a mean, and not as an end. It must not be fantasized as a universal dental care model. It seems to be recommanded to investigate systematically the technological innovations and the development of protocols thanks to ethical guidelines in order to evaluate a priori and a posteriori any kind of progress that might be considered.
Assuntos
Atenção à Saúde , Ética Médica , Relações Médico-Paciente/ética , Telemedicina , Comunicação , Atenção à Saúde/ética , Atenção à Saúde/métodos , Atenção à Saúde/tendências , Humanos , Invenções , Saúde Bucal/ética , Saúde Bucal/normas , Padrões de Prática Odontológica/ética , Tecnologia Odontológica/ética , Tecnologia Odontológica/tendências , Telemedicina/éticaAssuntos
Competência Clínica/normas , Odontólogos/normas , Prática Odontológica de Grupo/ética , Administração da Prática Odontológica/ética , Calibragem/normas , Odontólogos/ética , Odontólogos/organização & administração , Humanos , Padrões de Prática Odontológica/ética , Padrões de Prática Odontológica/normasRESUMO
A Telangiectasia Hemorrágica Hereditária (THH) ou Síndrome de Rendu-Osler-Weber (SROW) é uma displasia fibrovascular sistêmica que apresenta alterações na camada muscular da parede dos vasos sanguíneos. Isto faz com que os vasos sejam sujeitos a rupturas frequentes.Este diagnóstico pode ficar a cargo do cirurgião dentista visto que os primeiros sinais podem ser observados em boca. Podem ser identificados telangiectasias e hemorragias na mucosa bucal.Por segurança, o manejo odontológico deste paciente deve ser focado na sua condição de saúde geral. Assim, este artigo tem por objetivo a descrição de um caso clínico de tratamento odontológico de uma paciente com SROW, esclarecendo as principais características dessa síndrome e relatando as peculiaridades do seu manejo.
The Rendu-Osler-Weber Syndrome or Hereditary Hemorrhagic Telangiectasia (HHT) is a rare systemic fibrovascular dysplasia, which causes a defect in the elastic and muscle layer of the blood vessel wall, turning them more vulnerable to traumas and spontaneous ruptures. The dentists can play an important role in this diagnostic because the first signs often appear in the mouth, such as telangiectasia and recurrent bleeding in the oral mucosa. The management of this patient should be appropriate to its systemic profile to ensure the safety and effectiveness of dental treatment. This work aims to describe the main characteristics of this syndrome, its peculiarities and limitations of management during dental treatment, followed by the presentation of a clinical case.
Assuntos
Humanos , Masculino , Feminino , Epistaxe/complicações , Malformações Arteriovenosas/complicações , Malformações Arteriovenosas/diagnóstico , Malformações Arteriovenosas/mortalidade , Padrões de Prática Odontológica/ética , Padrões de Prática Odontológica , Saúde Bucal , Telangiectasia Hemorrágica Hereditária/classificação , Telangiectasia Hemorrágica Hereditária/complicações , Telangiectasia Hemorrágica Hereditária/diagnósticoRESUMO
Background: Subjects regarding ethical questions in dental medicine are only slightly touched in the study of dental medicine or in the working regulations of the dentists' association. However, dentists are confronted with these matters in everyday working life. The empirical study at hand collects current data regarding the ethical knowledge about dental medicine in the practical experience of dentists in Saxony, Saxony-Anhalt, and Thuringia. Methods: The tool used in the survey was a structured questionnaire. Out of 600 randomly chosen and contacted dentists from Saxony, Saxony-Anhalt, and Thuringia, 290 replied (response rate: 48.3%). The anonymised assessment took place between June and November 2013. Results: Dentists frequently encounter ethical questions regarding dental matters. The dentists interviewed in the study are in favour of a participative relationship between patient and dentist. Simultaneously, the patient's health is predominantly seen as the good of higher value than his or her self-determination. The dentists show competent knowledge of ethical dental subjects, although increased uncertainties could be observed in more complex situations, e. g. considering contact with patients who are HIV-positive. Conclusions: Questions dealing with dental ethical questions do play a major role in the daily professional life of dentists. In order to further support and strengthen dentists in their individual dental ethical competence, we see a need for advanced training and further education regarding questions and problems in the area of ethics in dental medicine. Also, these topics should become a component in the curriculum of the study of dental medicine.
Assuntos
Competência Clínica/estatística & dados numéricos , Relações Dentista-Paciente/ética , Odontólogos/ética , Odontólogos/estatística & dados numéricos , Ética Odontológica , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Idoso , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Prática Odontológica/ética , Padrões de Prática Odontológica/estatística & dados numéricos , Inquéritos e Questionários , Adulto JovemRESUMO
Dentists justifiably bridle at having to compromise what they believe, based on evidence, is in the patients' best interests based on reimbursement rules of benefits providers. Benefits providers justifiably bridle at having to pay for services not contracted by those who purchase insurance. A particular case involving performing multiple quadrants of root planing at a single appointment is used as an example of this tension. One alternative is for the profession and the industry to seek to negotiate a win-win joint position. Another is for a few to game the system, which only makes it more difficult to reach ethical common ground.
Assuntos
Ética Odontológica , Seguro Odontológico/economia , Administração da Prática Odontológica/ética , Padrões de Prática Odontológica/ética , Procedimentos Desnecessários/ética , Codificação Clínica , Tomada de Decisões , Humanos , Estados UnidosRESUMO
BACKGROUND: Overtreatment (or unnecessary treatment) is when medical or dental services are provided with a higher volume or cost than is appropriate. This study aimed to investigate how a group of dentists in Switzerland, a wealthy country known to have high standards of healthcare including dentistry, evaluated the meaning of unnecessary treatments from an ethical perspective and, assessed the expected frequency of different possible behaviors among their peers. METHODS: A vignette describing a situation that is susceptible for overtreatment of a patient was presented to a group of dentists. The vignette was followed by five options. A questionnaire including the vignette was posted to 2482 dentists in the German-speaking areas of Switzerland. The respondents were asked to rate each option according to their estimation about its prevalence and their judgment about the degree to which the behavior is ethically sound. RESULTS: 732 completed questionnaires were returned. According to the responses, the most ethical and the most unethical options are considered to be the most and the least prevalent behaviors among dentists practicing in Switzerland, respectively. CONCLUSIONS: Suggesting unnecessary treatments to patients seems to be an ethically unacceptable conduct in the eyes of a sample of dentists in Switzerland. Although the respondents believed their colleagues were very likely to behave in an ethical way in response to a situation that is susceptible to overtreatment, they still seemed to be concerned about the prevalence of unethical behaviors in this regard.
Assuntos
Atitude do Pessoal de Saúde , Odontólogos/ética , Ética Odontológica , Padrões de Prática Odontológica/ética , Procedimentos Desnecessários/ética , Adulto , Feminino , Humanos , Masculino , Uso Excessivo dos Serviços de Saúde , Pessoa de Meia-Idade , Relações Médico-Paciente , Inquéritos e Questionários , SuíçaRESUMO
O Conselho Federal de Odontologia elaborou um novo Código de Ética Odontológica (CEO), vigendo desde janeiro/2013. O CEO é referencial normativo para cirurgiões-dentistas (CD) que atuam no País. O aumento da quantidade de processos éticos instaurados nos Conselhos Regionais de Odontologia justifica a necessidade da análise comparativa do antigo e do novo CEO, para melhor compreensão e aplicação pelos profissionais. Objetivo: Realizar análise comparativa entre o CEO em vigor até 2012, aprovado pela Resolução CFO nº 42/2003, e o seu substituto desde de 1º de janeiro de 2013, aprovado pela Resolução CFO nº 118/2012; fazendo ainda uma reflexão sobre os principais tópicos do novo CEO, relacionando-o com o cotidiano da clínica odontológica, visando propiciar o seu correto entendimento. Considerações Finais: As alterações do novo CEO demonstram adequação ao momento histórico atual e representam avanço na regulamentação e orientação dos profissionais quanto à conduta frente aos colegas, empregadores e pacientes. Insere os profissionais da odontologia nas equipes de saúde pública; divide a responsabilidade dos CDs com os técnicos; esclarece a necessidade de cumprir obrigações financeiras e manter dados cadastrais atualizados junto ao CRO; informa que o prontuário odontológico deve ser legível e atualizado, em cada avaliação; e que o CD deve arbitrar o valor da consulta; aborda doação, transplante, banco de órgãos, tecidos e biomateriais; traz alterações importantes quanto à propaganda, e finalmente esclarece que as penalidades aplicadas pelos CROs aos infratores do CEO podem ser agravadas ou atenuadas, conforme as circunstâncias...
Introduction: The Brazilian Federal Board of Dentistry (CFO, in Portuguese) has developed a new Code for Ethics in Dental Practice (CEO, in Portuguese), in force since January 2013. The CEO is a normative reference for dentist-surgeons (CD, in Portuguese) operating in Brazil. The increasing amount of ethical processes initiated in the Regional Council of Dentistry (CRO, in Portuguese) justifies the need of a comparative analysis between the old and the new CEO for a better understanding of it and its subsequent implementation by professionals. Objectives: Compare analytically the CEO in force until 2012, which was approved by the CFO Act 42/2012, and the one which replaced it on January 1st, 2013, which was approved by the CFO Act 118/2012; by reflecting further about the main topics of the new CEO and its relationship with the everyday practice of dental clinics, focusing to provide a correct understanding of it. Final Considerations: The changes made in the new CEO are in accordance with the current historical moment and represent advances in regulations and guidance for professionals towards the expected procedures to deal with colleagues, employers and patients. It includes professional dentists in the staffs of public health; it divides the responsibilities of the surgical procedures between CDs and technicians; it clarifies the need to meet financial obligations and keep registration data updated at CRO; it mentions that dental records must be legible and updated at each assessment; and that the CD must impose charged consultations as a common obligation for professionals; it also mentions donations, transplantations, bank of organs, tissues and biomaterials; it brings remarkable changes regarding propaganda, and in the end it clarifies that the penalties imposed by the CRO to CEO infractors can be strengthened or mitigated according to the circumstances of each case...
Assuntos
Humanos , Códigos de Ética/legislação & jurisprudência , Ética Odontológica , Legislação Odontológica , Brasil , Conselhos de Especialidade Profissional/legislação & jurisprudência , Padrões de Prática Odontológica/ética , Padrões de Prática Odontológica/legislação & jurisprudênciaRESUMO
Existen diferentes modalidades para recibir las remuneraciones en carreras liberales como odontología. En general, el pago se hace por acciones realizadas o por el tiempo dedicado a ejecutarlas. En algunos casos el monto del pago está directamente relacionado con el diagnóstico realizado al paciente. ¿Existe un conflicto de interés en alguna de las modalidades? Para responder esta pregunta se realizó una búsqueda bibliográfica sobre el tema, encontrándose escasa literatura al respecto. A partir de lo revisado podemos concluir que la existencia del conflicto de interés no es el problema, la resolución del mismo es el que aporta la dimensión ética al tema de las remuneraciones.
There are different modalities to receive remunerations in liberal careers such as dentistry. In general, payment is done for actions carried out by time dedicated to execute them. In some cases, the amount of payment is directly related to the diagnosis of the patient. There is a conflict of interest in some of these modalities? To answer this question a bibliographical search was carried out on the topic, finding scarce literature on it. From the revised material, we can conclude that the problem is not the existence of a conflict of interest, but what brings an ethical dimension to the topic of remunerations is its resolution.
Existem diferentes modalidades para receber as remunerações em carreiras liberais como odontologia. Em geral, o pagamento se faz por ações realizadas ou pelo tempo dedicado a executá-las. Em alguns casos o montante do pagamento está diretamente relacionado com o diagnóstico realizado ao paciente. Existe um conflito de interesse em alguma das modalidades? Para responder esta pergunta se realizou uma busca bibliográfica sobre o tema, encontrando-se escassa literatura a respeito. A partir do que foi revisado podemos concluir que a existência do conflito de interesse não é o problema, a resolução do mesmo é o que aporta a dimensão ética ao tema das remunerações.
Assuntos
Ética Odontológica , Honorários Odontológicos , Padrões de Prática Odontológica/economia , Remuneração , Salários e Benefícios , Conflito de Interesses , Assistência Odontológica , Odontólogos , Planos de Pagamento por Serviço Prestado , Padrões de Prática Odontológica/éticaRESUMO
This paper is structured around the following: autonomy and consent, confidentiality, disclosure, knowledge of patient and provider HIV status, the right to choose whom to treat, testing for HIV and the importance of HIV policies in the workplace to guard against discrimination. The emergence of the HIV/AIDS pandemic has challenged traditional ethical values of the health care profession. These include the infectious nature of HIV, the social stigma of the disease and its ethical and legal dilemmas. This paper addresses some of the pertinent questions related to HIV infection and AIDS. The three broad principles of ethics, namely, autonomy, beneficence and justice, provide the basic framework on which this paper is based. Advances in the biotechnology of rapid oral fluid testing particularly in the detection of HIV antibodies from patients in the dental setting have raised additional ethical and legal considerations in the subsequent management of HIV infected patients to include disclosure of test results to the patient and proper referral to physicians or nurse practitioners. The oral health care worker must thus have a solid foundation in the application of bioethical principles. A clinical case scenario related to HIV testing in the dental setting is presented to illustrate how a lack of understanding and the wrongful application of ethical principles may lead to patient harm and legal liability. Given the increasing infection rate of HIV worldwide, polices must be upheld and revised as needed to protect healthcare providers, patients, and society generally against discrimination.