Step-1: Identify the Ethical Principles at Stake
* Caring about and acting to promote the good of another
* The hygienist must always give priority to the best interests of his/her clients
* In this scenario the hygienist must care for and act to promote the health of his/her clients, rather than giving more importance to the monetary interests of the dentist.
* Pertains to the right to make one’s own choice
* By communicating the relevant information openly and truthfully, dental hygienists assist client’s to make informed choices and to participate in achieving and maintaining optimum oral health.
* The hygienist must communicate openly and honestly with the clients about all the treatment options available and their pros and cons to gain optimum oral health rather than promoting the most expensive option recommended by the dentist.
* Professionalism means being competent, honest and fair
* Competence: refers to providing high quality care
* Honesty: being truthful both in your statement and your omission.
* Fairness: appropriately balancing competing interest
* In this scenario the dental hygienist must be completely honest and fair to her clients even when it competes with her personal monetary interests and employer pressure.
- Conflict of Interest
* A conflict of interest occurs when a dentist/dental hygienist has a personal interest (monetary, moral or personal belief) that a reasonable person might think could improperly influence his/her professional judgment
* In this situation the hygienist must not allow her personal monetary interests or employment prospects to jeopardize the client’s oral health or influence her professional judgment.
Step-2: Identify the various options for action
* Take no action and do as the doctor has mentioned
* Advise the client to research his or her options and decide what is best for them.
* Try again by explaining to the dentist about why you think the policy is not in the best interest of the clients
* Call the regulatory authority and report the dentist and or ask for their recommendations in solving the issue
* Follow the right informed consent way by telling the various options of treatment and advantage and disadvantage of each treatment.
* Leave the office and find another that is suitable to your ethics.
Step-3: Assess Options
* You are misleading the dentist by being silent, and preventing the office from taking appropriate steps to ensure appropriate treatment measures are in place and are failing to look after the best interest of your client. Harm the client loose reputation from your client.
* You may lose clients
* You may lose the dentists trust
* The dentist may agree or disagree with your opinion.
* If you call the regulatory authority to report the dentist, his license may get revoked
* If you leave the present job you will be relieved from the present ethical dilemma
Step-4: Implement the action
* Provide various procedure to correct or remedy his/her dental issue.
* Provide information about the necessity of performing each procedure on the client.
* Enumerate the benefits of the procedure.
* Enumerate any harmful effects of the procedure according to the medical condition of the client even if those effects are minor or negligible.
* Inform about the cost of each procedure.
* Inform the client about the gain sharing policy of the practice
* Tell the client that his/her choice of procedure will contribute proportionately to the offices gain sharing policy.
Step-5: Evaluate outcomes
* The Dental hygienist will gain the client’s trust for her being honest.
* The Dentist could lose the client’s trust because he/she would think that the office’s primary goal is to optimize its profit margin.
* Client might check the costs of similar procedure at other offices and potentially have/his treatment done at a different office.
* Dentist/Dental hygienist might lose clients.
* Dental hygienist might lose his/her job.
The information is based on CDHO guide updated in 2008.