ETHICS
The word ethics is derived from the Greek word “ETHOS” measuring custom or character.
DEFINITIONS:
Ethics is the branch of philosophy and theology; in the systematic study of what is right
and good with respect to conduct and character.
Ethics is the philosophy, of human conduct, away of stating and evaluating principles by which
problems of behavior can be solved.
INTRODUCTION: The dental profession is a vocation in which knowledge and skill is used for
the service of others. One of the characteristics of a profession is the adherence in a code of ethics.
Being a health care provider does carry with it a responsibility individual patients and society. The
special status that society offers on professionals requires then to behave in an ethical manner. This
responsibility should be at the core of professional’s ethical behavior.
ETICAL PRINCIPLES
Ethics in the part of philosophy that deals with moral conduct and judgment. To provide a
common basis for ethical reasoning. There are seven principals that healthcare professional must
be aware of in the practice of their profession.
TO DO NO HARM OR NONMALEFICENCE:
It is generally attributed to Hippocrates and is considered to be foundation of social
morality. One e.g. of a typical dilemma is whether a dental hygienist should use instruments that
have not been sterilized if the dentist employer tells the hygienist that sterilizing is not necessary.
Because the dentist is ultimately responsible each of us is responsible for our own actions. If we
knowingly do harm to our patients excusing our acts because some one else is legally responsible
we have still behaved in an unethical manner.
TO DO GOOD OR BENEFICENCE:
A concept also traced to hippocrates is required of all health care providers it should be the
role of dentist and dental hygienist to benefit patients as well as not to inflict harm. Unnecessary
anesthesia potential loss of sound tooth structure extra time in the chair and of course paying for
some thing that is unnecessary.
AUTONOMY
Is a principle that dictates that health care professional respect patients right to make
decision concerning the treatment plan. This concept requires that the following 4 elements be
present.
1. Disclosure of appropriate information including risks and benefits involved in
treatment, consequences of non-treatment and alternative treatments when applicable.
2. Comprehensive of the information by the patient.
3. Voluntary consent.
ETHICAL RULES FOR DENTISTS PRESCRIBED BY THE DENTAL COUNCIL OF
INDIA [DCI]
1. PRACTICE OF DENTISTRY: SECTION 2 (D) OF THE DENTISTS ACT, 1948
DEFINES THE PRACTICE OF DENTISTS AS FOLLOWS:
(i) The performance of any operation on and the treatment an any disease
deficiency or lesion of human teeth or jaw and the performance of
radiographic work in connection with human teeth or jaws or the oral
cavity.
(ii) The giving of any anesthetic in connection with any such operation or
treatment.
(iii) The mechanical construction or the renewal of artificial dentures or
restorative dental appliance.
(iv) The performance of any operation on or the giving of any treatment,
advise or attendance to any person preparatory to or for the purpose of
or in connection with the fitting, inserting, fixing construction,
repairing or renewing artificial dentures or restorative dental
appliances and the performance of any such operation and the giving
of any such treatment, advice a attendance as is usually performed or
given by dentists.
2. THE DUTIES AND OBLIGATIONS OF DENTIST TOWARDS THE PATIENT:
a) Every dentist should be courteous, sympathetic, friendly and helpful. He
should be ever ready to respond to the call of his patients and should be
mindful of the high character of his mission and responsibilities he holds in the
discharge of his professional duties. He should ever remember that the
treatment of the patient and cure of the disease depends on the skill and prompt
attention shown by him.
b) He should observe punctuality in fulfilling his appointments.
c) He should deem it a point of honour to adhere with much as uniformity as the
varying circumstances will admit, to the compensation for professional service.
d) The most worthy effective advertisement possible is the establishment of a well
merited reputation for professional ability and fidelity.
e) The welfare of the patient is permanent to every other consideration and should
be conserved to the utmost of the practitioner’s ability.
f) A dentist will not permit considerations of religion, nationality, race, party
polities or social standing to intervene between his duties and his patient.
g) Information of a personal nature which may be learned about or directory from
a patient in the course of dental practice should be kept in the utmost
confidence. It is also the obligation of the dentist to see that to his auxiliary
staff observed this rule.
3. DUTIES OF ENTISTS TOWARDS ONE ANOTHER:
a) Every dentist should cherish a proper pride in his colleagues and should not
disparage them either by at or word.
b) When the dentist is entrusted with the care of the patient of another during sickness
or absence, mutual arrangements should be made regarding remuneration.
c) Dentist called upon in any emergency to treat the patient of another dentist, should
when the emergency is provided for retire in favour of the regular dentist let shall be
entitled to charge the patient of his services.
d) If a dentist is consultant by the patient of another dentist and the former finds
indisputable evidence that such a patient is suffering from faulty treatment it is
his duty to institute correct treatment at once with as little comments as
possible and in such manner to avoid reflection on his predecessor.
e) No rule debars a dentist from charging another dentist for professional service
but ordinarily it should be regarded as pleasure and privilege to render
gratuitous. Service to a professional brother his wife and dependent children.
3. DUTIES OF DENTIST TO THE PUBLIC:
a) It is incumbent on the dentist under all conditions his leaning towards patients,
and the public should be characterized by the dignified department.
b) Police and law courts:
i. A dentist is not bound to disclose professional secret unless called upon by
the magistrate or judge to do so.
ii. Knowledge of a patient gained in the course of examination and treatment is
provided and should be disclosed without the consent of the patient or an
order from the presiding judge in a court of law.
5. PRACTICE BY UNREGISTERED PERSONS: save as provided in section 49 of
the dentist act 1948, the practice of dentistry except by registered dentist is
prohibited. The penalty for contravening this provision is for the first conviction an
imprisonment which may extend to six months or a fine not exceeding one thousand
rupees or both.
6. FALSE CLAIM TO REGISTRATION:
Under section 47 of the dentist act 1948, similar penalties as in rule 5 above are provided
for a person who not having lean registered falsely, represents that he is so registered or used in
connections with his name or title any words or letters reasonably calculated to suggest that his
name is so entered.
7. MIS-USE OF TITLES:
Under section 48 of the dentist act 1948, if any not being a person registered in a register of
dentists takes or use the description of dental practitioner, dental surgeon, surgeon dentist or
dentist or not possessing a recognized dental qualification uses a degree or a diploma or an
abbreviation indicating or implying a dental qualification, shall be liable to the same penalties as
prescribed in Rule 5 above.
8. UNETHICAL PRACTICES:
The dental council of India considers the following practices as unethical. This list
may be added to as and when demand necessary by the council.
a) Unregistered assistants and covering:
A dentist is not permitted to employ in the professional practice as assistant except a
Dental hygienist or a dental mechanic, which is not registered either in the dentist
register or in a medical register and to allow him to practice dentistry as defined in
rule 1. A dentist doing so renders himself liable on proof of the fact, to the erasure of
his presence countenance, advice, assistance, or co-operation has knowingly enabled
an unregistered person, whether described as assistant or other wise to practice
dentistry renders himself liable, on proof of the facts to have his name erased from the
register.
b) Styling the dental clinic – Styling a dental clinic or chamber by the name of
“Dental Hospital”.
9. CERTIFICATES : The dentist who shall be shown to have signed under his name
and authority any certificate which is nature, misleading or improper, is liable to have his name
removed from the dentists register.
10. ADVERTISING AND CANVASING:
advertising whether directly or indirectly for the purpose of obtaining patients or promoting his
own professional advantages or for any such purpose of procuring or sanctioning or acquiring in
the publication of notices. Commanding or directing attention to the practitioner professional skill,
knowledge, services or qualifications or of being associated with or employed by those who
procure or sanction such advertising or publication and of employing any agent or canvasser for
this purpose of obtaining patient or of sanctioning or of being associated with or employed by
those who sanction such employment are in the opinion of the council to be contrary to public
interest and discreditable to the profession of dentists and any dentist who reports to any such
practice renders himself liable on proof of the have his name erased from the dentists register.
The following amongst others, will be demand as advertising.
I. The use of exhibition of any sing other than a sign which in its character, position, size and
wording i.e., merely such as may reasonably be required to indicate to persons seeking them the
exact location of and entrance to the premises at which the dental practice is carried on.
II. The use of sign board larger than 3x2 and the use of such boards as “teeth” “patient extraction”
or the like of notice in regard to practice on the premises other than those in which a practice is
actually carried on of show cause of large light signs especially if intermittent, a dentists sign
should not show anything other than his name qualifications, titles and name of the specialty.
III. To affix sign board on a chemists shop or in places where he does not reside or work.
IV. The insertion of all paragraphs and notice in the press and also the announcement of same in
the trading lists and the display announcements at places of public entertainment.
V. Allowing his name to be used to designate commercial article should tooth paste, tooth brush,
tooth powder mouth washes, liquid cleaners etc or circular for such items or permitting publication
of his opinion on any such items in the general or by presence or journals.
VI. Telephone directory: printing of name in the telephone directory in the type other than that
used for ordinary subscribers.
11. ISSUNG CIRCULARS: A dentist being or having been in the employment of another dentist
shall not either during or after the termination of such employment send, cause or authorize to be
sent any letter, notice circular or written communication to or interview or cause to be interviewed
or approach any person whom he has professionally attended for or on behalf of his employee
during such employment.
12. USE OF BOGUS DIPLOMAS: A dentist can put after his name only the recognized dental
qualification as defined under section (2) of Dentist Act, (1948) he shall not insert on sign boards,
visiting cards letter heads or any where else an indication of his practice of any profession other
than dentistry provided that a dentist who is a qualified medical practitioner may insert his medical
qualification also.
13. ALLOWING COMMESSION: The council disapproves of a dentist paying or allowing
commission or discount to any other person or body of persons as a return for patients being sent
or recommended to him, or for dental services rendered by him to such patients and similarly of
his accepting any proprietary or patented drugs appliance and tooth pastes, powder etc.
14. GENERAL: The giving of false certificate immorally involving always of professional
relationship conniving at or aid in illegal practice by the giving of testimonials directly or
indirectly or indirectly concerning the supported virtues of secret therapeutic agents or medicines
promise of radical cares by the employment of secret methods of treatment are all unethical
practices.
15. ACTION FOR UNETHICAL CONDUCT: when information is received by a state dental
council of any dentist resorting to such unethical practice or practices the council may call upon
him to explain and after him a reasonable opportunity for being heard and after making such
enquiries if any as it may decide whether his action is tatamount to infamous conduct in any
professional respect and then determines the action to be taken under section 41 of the dentist act.
ETHICAL STANDARDS IN RESEARCH
Researches bear the responsibility for identifying and propagating truth in matters of science.
Much research involves studies with humans and human tissues, as well as with animals and there
are strict rules governing research with both.
Suggested ethical conventions for research involving human subjects :
1. The research must be scientifically sound with an identifiable prospect of benefit.
2. Human subjects must be selected equitably.
3. Risks to humans and the numbers of humans involved must both be minimized.
4. Voluntary informed consent must be obtained from all human subjects or from their
proxies before any research is started.
5. Human research subjects must be permitted to withdraw from research at any time and to
be assured that such withdraw will not prejudice any ordinary treatment they may be
receiving.
6. People must be withdrawn from a research project as soon as there is any indications of
possible harm, physical or psychological as a consequence of their being research subjects.
7. The privacy of research participation and the confidentiality of the data concerning them
must both be protected.
8. Research results must be written honestly and accurately.