It is important to reiterate the context in which my observations were made in my interview with the Journal. They related to the special responsibility of all professional service providers – financial, legal, health, etc. – who have superior knowledge to their clients/patients. This can apply to a range of professions. Potentially, this superior knowledge could make the client/patient particularly vulnerable as service providers could be in a position to take undue advantage. Possible overtreatment in dentistry, arising from the unequal relationship between practitioner and patient, was given by me as a valid example.
As for “scientific studies” to support my comments, the very nature of professional misconduct can be clandestine and the victim may be unaware that misconduct has occurred. Thus, this issue is not really open to scientific study. Of course, a central point of the interview was to emphasise how professional integrity is a strong protection against the kind of misconduct instanced.
I should add that when preparing for my interview with the Journal, I had discussions on aspects of professional ethics with a number of dentists.
Thank you for forwarding on to Dental Protection the letter regarding the case study ‘Handling a complaint after a patient has moved’. A case study such as this is useful because it can often generate discussion as it reflects a type of situation that can arise in everyday practice.
Colleagues will be well aware that individual clinical opinions are formed within a spectrum of evidenced fact and personal experience. They may not be identical in all respects and the skill sometimes lies in weighing them up and coming to a consensus.
A classic example is the old amalgam, which has been in place for a number of years. Some clinicians will adopt a careful monitoring approach, whereas others prefer early intervention. Similarly, some clinicians prefer to provide crowns to heavily restored teeth at an earlier stage than others.
In this particular scenario, Dr B appeared to have been of the genuine clinical opinion that his treatment was necessary. Dr A had a greater weight of evidence to support his clinical opinion. The decision on how to proceed was entirely a choice for the patient who, in this particular case, found Dr A’s explanation and openness, in showing her the serial radiographs, to be persuasive. As is so often the case, the transparent nature of the communication helped the patient to develop trust in the clinician.
With kind regards,
Sue Boynton, Senior Dento-Legal Adviser, Dental Protection
Re: O’Higgins, E. Ethics and dentistry. JIDA 2014: 60 (4): 186
Congratulations on choosing such a splendid, informative, authoritative article. You should be very proud to encourage your protégés to read it. For a youngster to carry such intellectual awareness in the head would/must greatly ease the pressures of practising and learning, and being examined and tested.
It might be useful to get the authors to speak to undergraduates – say, annually?
Good choice and many thanks for making me think – again!
Aidan O’Reilly BDS FFD
Mews No. 12, Waterloo Lane, Ballsbridge, Dublin 4