ETHICS IN DENTISTRY DENTAL ACT 2020 2024

ETHICS IN DENTISTRY DENTAL ACT 2020 2024

1. ETHICS IN DENTISTRY & DENTAL ACT DR. UMMI AMIRAH

2. INTRODUCTION Origin : The English word Ethics comes from the Ancient Greek word ethikos meaning ‘ relating to ones character’, which itself comes from the root word ethos which means ‘character or moral nature’ Definition of dental ethics : A system of principles governing dental practice; a moral obligation to render the best possible quality of dental service to the patient and to maintain an honest relationship with other members of the profession & society at large.

3. Ethics seeks to answer two basic questions: What should I do? Why should I do it? Ethics refers to what you should do, not what you must do. The law deals with what you must do “It would not be correct to say that every moral obligation involves a legal duty; but every legal duty is founded on a moral obligation” Lord Chief Justice Cole Ridge (1893)

4. To demonstrate to the public the standard of conduct that can be expected from its members To increase the ethical consciousness and ethical responsibility of its members To guide its members in making informed ethical decisions To establish a standard for professional judgment and conduct REASONS FOR A CODE OF ETHICS

5. LAW ETHICS Legal issues are settled with the use of laws and court decisions Ethical issues are subject to individual interpretation with regard to the right or wrong of a particular situation Laws are very specific and are written by people authorized to write them Ethics are less specific and have more gray areas. Ethics are the conscience of the profession The law is often referred to as being “black and white” or “right or wrong Laws set the minimum standard of behavior; ethics set the highest standard of behavior COMPARISON BETWEEN ETHICS AND LAW

6. To do no harm ( non-maleficence) To do good (beneficence) Autonomy Justice Veracity or truthfulness Confidentiality 6 PRINCIPLES OF ETHICS 1

7. To do no harm ( non-maleficence) 7 PRINCIPLES OF ETHICS Duty of health care professional is to ensure that his action do not harm the patient Instances that can harm the patient: Use of unsterilized instruments Under-filling or overfilling Carelessness in handling hard or soft tissues of the mouth

8. 2. To do good (beneficence) 8 PRINCIPLES OF ETHICS Health care professional has to place the interest of the patient above his own interest Plan a treatment or order investigation only if it is necessary At community level: Balance harms and benefits of programmes Make use of cost-benefit analysis to determine appropriate programmes

9. 3. Autonomy 9 PRINCIPLES OF ETHICS Patient is the prominent member in the proses of decision making Patient’s right to make decisions & free to determine what will happen to ones body Health care professional has to ensure that consent is obtained before any care is instituted Information which are relevant & easily understood are given to the patient

10. 3. Autonomy 10 PRINCIPLES OF ETHICS CONSENT Consent is the granting to someone the permission to do something they would not have the right to do without such permission. Informed consent can only be obtained by a practitioner who has sufficient training and experience to be able to explain the procedure, the risks and benefits and the alternatives. Implied consent It must be remembered that a patient who walks into a dental surgery gives implied consent only limited to clinical oral examination, consultation and diagnosis. Verbal consent Verbal consent is acceptable when the procedures are limited to treatment of the problem presented by the patient. It is necessary for a witness to be present during the explanation and the giving of the consent. Written consent Written consent is consent for treatment signed by the patient or the legal guardian, and duly countersigned by a witness.

11. 4. Justice 11 PRINCIPLES OF ETHICS Health care professional should provide equal treatment to all according to the needs Dental practitioners often found to be reluctant to treat the poor because they cannot afford or not treat special needs group as it takes longer time Dentist should provide care at a concessional rate or designated time However when resources are limited at community level, priorities should be set as equitable treatment cannot be given to all

12. 5. Veracity or truthfulness 12 PRINCIPLES OF ETHICS Patient-doctor relationship is based on mutual trust Truthful about information given, treatment rendered & prognosis

13. 6. Confidentiality 13 PRINCIPLES OF ETHICS A very important aspect in the health profession – we have an obligation to respect patient’s privacy Confidentiality in health care refers to the obligation of professionals who have access to patient records or communication to hold that information in confidence Conflicts involving the principle of confidentiality sometimes arise – a need to balance patient’s right to confidentiality (eg. reporting suspected child abuse)

14. Patient would expect conversations with health personnel be kept confidential 14 Confidentiality

15. The professional dentist: will practice according to the art and science of dentistry and to the principles of humanity will safeguard the oral health of patients irrespective of their individual status – the primary duty of the dentist should refer for advice and/or treatment any patient requiring a level of competence beyond that held must ensure professional confidentiality of all information about patients and their treatment FDI World Dental Federation International Principles of Ethics for the Dental Profession 15 PRINCIPLES OF ETHICS

16. must accept responsibility for, and utilise dental auxiliaries strictly according to the law must deal ethically in all aspects of professional life and adhere to rules of professional law should continue to develop professional knowledge and skills should support oral health promotion should be respectful towards professional colleagues and staff should act in a manner which will enhance the prestige and reputation of the profession www.fdiworl d ental.org FDI World Dental Federation International Principles of Ethics for the Dental Profession 16 PRINCIPLES OF ETHICS

17. Dental Act 2018 Passed in Parliament House of Representatives 1 st reading 27 Nov 2017 2 nd & 3 rd reading 2 April 2018 Senate 4 April 2018 Royal Assent 19 June 2018 Gazette 26 June 2018 17 Dental Act 3

18. Parts of the Dental Act 2018 1971 I Preliminary I II The Malaysian Dental Council II III The Malaysian Dental Therapists Board IV Registration of Practitioner III V Disciplinary Proceedings IV VI Offences VII Enforcement VIII Miscellaneous V + VII IX Repeal, Saving & Transitional VI 18 Dental Act

19. Part II - MALAYSIAN DENTAL COUNCIL 4. Functions of the Council 19 Recognise qualifications Approve postgraduate qualifications Register dental practitioners Register dental specialists Determine criteria to register dental specialists Regulate examination for dental surgeons Dental Act

20. Part II - MALAYSIAN DENTAL COUNCIL 4. Functions of the Council 20 Regulate period of compulsory service Regulate standards of practice Regulate ethics and professional conduct Regulate the scope of practice Other such things Dental Act

21. Part III – The Malaysian Dental Therapists Board Register dental therapists Register post basic dental therapists Regulate standards of practice Regulate ethics and professional conduct 21 Functions of the Board Dental Act

22. Guidelines Code of Professional Conduct Guidelines for Infection Control in Dental Practice Position Statement on the Use of Dental Amalgam Guidelines & Provisions for Public Information Guidelines for Oral Healthcare Practitioners Infected with Blood-borne Viruses Guidelines for Occupational Safety and Health in the Dental Laboratory Guidelines on Radiation Safety in Dentistry 22

23. Contains a set of ethical guidelines which should act as advice to dental practitioners on the principles of personal conduct and professional ethics With other MDC guidelines it assists dentist to exercise professional judgment and to accept personal responsibility To always act in the interest of public in general and his patients in particular 23 4 Code of Professional Conduct Code of Professional Conduct

24. Code of Professional Conduct Part A : Obligations & Responsibilities Part B : Practice Management Part C : Infamous Conduct 24 Code of Professional Conduct

25. PART A: OBLIGATIONS AND RESPONSIBILITIES 1. The Patient The Dental Profession Colleagues 4. The Public 25 Code of Professional Conduct

26. PART B: PRACTICE MANAGEMENT Establishment of Practice Professional Qualifications, Ranks & Awards Notice to Patients Advertising Infection Control 10. Contracts 11. Endorsement & Usage of Pharmaceutical & Dental Products 12. Dental Radiography & Radiation Protection 13. Statement of Certificates 26 Code of Professional Conduct

27. PART C: INFAMOUS CONDUCT Any behaviour which reflects adversely on the reputation of the profession such as dishonesty, indecency or violence, would be liable to have serious consequences 27 Code of Professional Conduct

28. INFAMOUS CONDUCT Done something reasonably regarded as disgraceful or dishonorable by his professional brethren Serious misconduct judged according to the rules, written or unwritten , governing the profession Neglect or disregard of Professional Responsibilities Abuse of Professional Privileges and Skills Conduct derogatory to the Reputation of the Profession Advertising, Canvassing and related offences 28 Code of Professional Conduct

29. 10 Golden Rules Upgrade professional knowledge and skills Good communications Kindness, ethics and honesty Doctor-patient confidentiality Good patient records Conscious of cost Second opinion & referrals Relationship with colleagues Avoid publicity, self-promotion Promote Global Health 29

30. THANK YOU