Ethical issues

[DMD to Be]

---

Members don't see this ad.

What are some ethical issues in dentistry that concern you? Personally, I'm somewhat concerned with the HIV scenario. How could you work on a patient and not think about that?

 

[Lemming]

Actually that has never crossed my mine. Maybe it will take blood to bring about this concern, but I've been an EMT for awhile and it really hasn't bothered me. I think it just affects people in different ways, but it definitely is a concern.

 

[54807]

Actually that has never crossed my mine. Maybe it will take blood to bring about this concern, but I've been an EMT for awhile and it really hasn't bothered me. I think it just affects people in different ways, but it definitely is a concern.

Yeah, I used to work in organ donation recovery. I used to get elbow deep in tissue/blood. It was a primary concern of mine every time to be safe and make sure my fellow staff is safe.

I work in an oral surgery office and we have HIV patients come in who are loosing their entire dentition. Not only are they HIV+ but lots of them are past drug users and have extremely high tolerances to the opiods and narcotic sedatives. They can get extremely combative.

I would say something like "I am entering a health profession and exposure to bodily fluids is part of the job. It is my responsibility as the highest level healthcare providor at my private practice to ensure that transmission of any disease does not occur through improper safety protocol, PPE use, or improper sterilization."

It's not a hard question at all. Just don't say..."I'd turn the HIV patient away." I better people do though.

 

[UTEMAN21]

Every dentist that I know does not see HIV patients-though you will see them in dental school, and the law says that you cannot double glove-discrimination.

I think some other important ethical issues is how some dentists say that something is wrong or need to be fixed but nothing is there and it does not need to be fixed. Also false advertising from dentist and other specialists

 

[DMD to Be]

Every dentist that I know does not see HIV patients-though you will see them in dental school, and the law says that you cannot double glove-discrimination.

I think some other important ethical issues is how some dentists say that something is wrong or need to be fixed but nothing is there and it does not need to be fixed. Also false advertising from dentist and other specialists

Oh I totally agree with that. You know there are dentists out there who convince their patients to go for the ultimate (most expensive) form of treatment, when a more cost effective plan of action would serve the patient just as well.

 

[reapply2007]

Refusal to take Medicaid patients at all.

 

[armorshell]

With Universal Precautions, you treat every patient as a potential HIV+ patient. The only difference is that when it actually shows up in the medical history, you have to treat them differently because of their immune situation.

I think there are fewer ethical issues in dentistry then medicine, but they still exist. Informed consent, managed care, etc...

 

[You]

Let thyself be true! Why do you want to be a dentist?

 

[54807]

Every dentist that I know does not see HIV patients-though you will see them in dental school, and the law says that you cannot double glove-discrimination.

I think some other important ethical issues is how some dentists say that something is wrong or need to be fixed but nothing is there and it does not need to be fixed. Also false advertising from dentist and other specialists

I didn't realize there was a double glove rule.

Isn't it similar to working in a lab...you always wear safety goggles. But, when you bring out the real nasty chemicals you put on an extra face shied. No one plans on splashing their eyes, you weigh the risks of not wearing the shield all the time with the great visibility and comfort.

Is it an actual law or is it just tacky. If I was HIV+ and I had a physician or dentist working on me the first think out of my mouth would be. "I have HIV, protect yourself!...this virus is $xxtty!!"

 

[You]

Every dentist that I know does not see HIV patients-though you will see them in dental school, and the law says that you cannot double glove-discrimination.

I think some other important ethical issues is how some dentists say that something is wrong or need to be fixed but nothing is there and it does not need to be fixed. Also false advertising from dentist and other specialists

I'm curious, which state or what link says you can not use double-glove?

I just google search and it seems like most recommend double-glove (i.e...
http://www.acoem.org/guidelines/article.asp?ID=42 )

This one in the search got sued for not double-gloving...
http://www.med.uscourts.gov/opinion....pdf#search="double glove discrimination law"

 

[dddsmack]

With Universal Precautions, you treat every patient as a potential HIV+ patient. The only difference is that when it actually shows up in the medical history, you have to treat them differently because of their immune situation.

I think there are fewer ethical issues in dentistry then medicine, but they still exist. Informed consent, managed care, etc...

This is a respectable comment, that is what I was going to say.

 

[djeffreyt]

Every dentist that I know does not see HIV patients-though you will see them in dental school, and the law says that you cannot double glove-discrimination.

I think some other important ethical issues is how some dentists say that something is wrong or need to be fixed but nothing is there and it does not need to be fixed. Also false advertising from dentist and other specialists

I don't know anything about the double glove discrimination thing, but I do know that you aren't allowed to refuse service to an HIV-positive patient based solely on that person being infected...I'm a little shocked that you know several dentists who do that.

THis is off the ADA website:
Duty to Treat

As a general rule, dentists have a legal obligation to treat HIV-infected individuals, including patients of record and other persons who seek treatment when the office is accepting new patients. Under the Americans with Disabilities Act (AwDA) and many similar federal, state and local laws, a person with HIV is considered as having a "disability," as are persons who are perceived to have HIV, which may include patients who have had blood transfusions and openly homosexual patients. at should be noted that HIV is only one of many infectious diseases that are considered as disabilities under the AwDA and similar laws; e.g., hepatitis B and tuberculosis are also treated as disabilities). In a case decided shortly before the publication of this text, the first federal court ruling on a charge of HIV discrimination against a dentist upheld the constitutionality of the AwDA. [1]

Title III of the AwDA, which went into effect in January 1992, makes it illegal to discriminate against persons with disabilities, and those with whom they associate, in the provision of services in "places of public accommodation." The office of a health care provider is a place of public accommodation under the AwDA. The general rule prohibiting discrimination against persons with disabilities by places of public accommodation states:

"No individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods. services. facilities, privileges, advantages, or accommodations of any place of public accommodation by any person who owns, leases (or leases to), or operates a place of public accommodation."[2]

Thus, it is unlawful discrimination to refuse to provide care to an individual because s/he is, or is perceived to be, HIV-infected. [3] To date, no court or administrative agency has ruled that it is acceptable to refuse care solely because of the patient's HIV status. [4] The AwDA also prohibits behavior that constitutes discrimination such as a denial of participation, participation in unequal benefit, and provision of separate benefit

Cases have been prosecuted under both federal and state laws against dentists for refusal to provide care to HIV-infected patients.