Knowledge, attitudes and practice of healthcare ethics and law among dental graduates at the RV dental college, Bengaluru.

OBJECTIVE: To assess knowledge, attitudes and practices among the dental graduate in relation to healthcare ethics and law. MATERIALS AND METHODS: A cross-sectional study design was employed using a self-administered questionnaire. A 15 item questionnaire about law and ethics was devised; tested and made available to all levels of graduates including teaching staff, postgraduates and intern at dental college in Bengaluru. A total of 116 graduates participated, with a response rate of 96.5% (n = 112). RESULTS: Seventy-six percent of the participants said that they are legally bound to treat all the patients who approach them for the treatment. Nearly 32% of the participants have mentioned the various other reasons for the rejection apart from the reason like HIV+, poor patients and patients with the contagious disease. CONCLUSION: The study points to the need for appropriate training among graduates including the professional staffs and other graduates, and to devise means to sensitize them to issues of law and ethics in the workplace.

Would it be ethical or legal for doctors in South Africa to administer testosterone-reducing drugs to Caster Semenya?

The Court of Arbitration for Sport recently confirmed that the decision by the International Association of Athletics Federations to require hyperandrogenic female athletes such as Caster Semenya to reduce their testosterone levels to compete in certain races has been widely condemned. The World Medical Association has warned doctors not to assist in implementing the decision, as it would be unethical. The same would apply in terms of the Health Professions Council of South Africa's rules of professional conduct. Such treatment is 'futile' in medical terms, and does not serve the purpose of providing healthcare. Therefore, doctors may lawfully refuse to prescribe it. The decision is a violation of Semenya's constitutional rights and would be regarded as unethical should doctors comply with it. However, the prescription of such drugs would not be unlawful if Semenya gave informed consent to taking them. Such consent would not be a defence to a disciplinary hearing on unprofessional conduct, but would be a good defence to any legal action arising from unpleasant side-effects - provided they were explained to her.

Risk management in oral and maxillofacial surgery.

The goal of risk management in the oral and maxillofacial surgery practice is to reduce the risk of care rendered to patients. Of all the elements of risk management, communication and documentation are two of the most important. Ensuring that a patient is truly educated about all facets of procedures to be performed and thoroughly documenting all aspects of the care that is rendered can greatly reduce the risk of claims. Oral and maxillofacial surgeons should practice these principles regularly and not wait for a claim to occur to teach them their benefits.

The intersection of dental ethics and law.

Dentists are regularly confronted with situations that involve interrelated ethical, risk management, and legal and regulatory compliance issues. This article discusses six of the most common such situations where dentists must sort out various ethical and legal issues. Sometimes taking steps to minimize exposure to liability or comply with legal and regulatory mandates is also consistent with applicable ethical standards. At other times, however, in order to meet the highest ethical standards, dentists must go beyond mere legal compliance and risk management. By acting in accordance with the highest ethical standards, dentists ensure they are protecting not just their own interests but their patients' interests as well.

[Does reluctance to perform mouth-to-mouth ventilation exist among emergency healthcare providers as first responders?]. / Esiste la riluttanza a praticare la rianimazione con ventilazione bocca a bocca senza mezzi di barriera tra gli operatori sanitari intervenuti come first responders?

BACKGROUND: Only 30% of survivors from out-of-hospital cardiac arrest receive basic life support (BLS) before the arrival of emergency personnel. This is also due to reluctance to perform BLS, especially mouth-to-mouth ventilation without barrier devices in victims who are unknown to the rescuer (either layperson or healthcare provider). METHODS: To evaluate the incidence of reluctance to perform mouth-to-mouth ventilation without barrier devices and its consequences in a simulated BLS scenario proposed by a questionnaire to healthcare providers of critical area in a public general hospital. RESULTS: Answers were collected from 128 of 165 (77.5%) interviewed healthcare providers. Physicians were 46 of 128 (35.9%), professional nurses were 78 of 128 (60.9%) and 4 of 128 (3.2%) were other health workers devoted to patient assistance. Seventy-five of 128 (58.6 %) were reluctant to perform mouth-to-mouth ventilation without barrier devices; 68 of 75 (90.6%) would perform BLS only by chest compression. Compared with non-reluctant providers, they would have been available to perform assisted ventilation by non-validated alternative methods (54.2 vs 18.8% respectively, p < 0.001). Seven of 75 (9.6%, no physician among them) would perform no BLS at all. The most significant predictors of reluctance were age < 40 years (p = 0.07) and previous attendance of BLS-BLSD courses (p = 0.07). CONCLUSIONS: Reluctance to perform mouth-to-mouth ventilation without barrier devices is frequent and may reduce the number of potential BLS providers. Because of the concern about disease transmission between victim and rescuer, rescuers with a duty to respond such as healthcare providers should follow precautions including the use of barrier device also outside their workplace. When barrier devices are unavailable first responders should consider chest compression alone instead of not performing any BLS maneuvers. BLS training should help give a greater emphasis on this topics.

Patient rights, provider rights: balancing the conflict.

A federal appeals court decision in an HIV discrimination case raises tough questions about the rights of providers vs. the rights of patients.

Infectious disease in dental practice--professional opportunities and obligations.

This article presents one author's view of the dentist's obligations to patients, to the community, to the profession, and to the principles of ethics in a highly troubling time of serious infectious diseases. It essentially is an optimistic view that, while the epidemic of AIDS will continue and tuberculosis may become a graver problem in certain health care settings, the dental profession possesses the education, ethical insights, and technical training needed to meet with grace and authority the challenges of practice in this era of infectious disease.

Dentist can demand patients take HIV test to receive care.

AIDS: A Pennsylvania dentist who required AIDS testing for 2 patients prior to treatment did not discriminate against them, according to an Allegheny (PA) County judge. The patients' son died of AIDS. The dentist did not refuse treatment, but required the test to determine treatment options and protect his staff. The court found it reasonable to identify health risks before treating a patient with an infectious illness.^ieng

Jury says dentist did not regard patient as HIV-positive.

AIDS: A Pennsylvania Federal jury ruled that dentist [name removed] did not violate the Americans with Disabilities Act or the Rehabilitation Act by requiring that a gay patient undergo HIV testing prior to treatment. [Name removed] [name removed], the patient, had been seeing Dr. [name removed] for 8 years. The dentist learned [name removed]'s roommate was gay. He asked [name removed] if he was gay. When the answer was affirmative, Dr. [name removed] sent [name removed] away without treatment with a prescription for HIV testing. [Name removed] sued. The dentist said that a patient's HIV treatment and status could affect his dental treatment, including antibiotic therapy, and that he did not refuse treatment to the patient. U.S. District Chief Judge Donald E. Ziegler refused to grant summary judgment to the dentist, sending the case to trial. Jurors, who were questioned as a group about their views on homosexuality, found for the dentist. Contact information is provided.^ieng