Course talk:DHYG400/September2009

Group D - Nicolel, AmyItalic text, Christine, Rosie, Willena, MarianneBold text

1. What are the similarities and differences between CDHA and IFDH Codies of Ethics?

Similar: -they both promote the importance of dental hygiene for the client’s health

Different: -CDHA code of ethics is more focused on client benefits while IFDH Code of ethics is more focused on the profession

2. What Ethical Philosophy or Framework best informs your practice? Why?

The framework that best describes my practice is the formalist framework. When practicing as a dental hygienist I have the goal that my client obtains optimal oral health. But in many aspects of the process of assessing, planning, implanting and evaluating I deal with different options. During assessment I must be accountable while gathering needed information (eg. Probing, calculus assessment) allowing the clients to see the information (autonomy). In the planning process I must have the clients best interests (beneficence) and personal choices (autonomy) as the focus in a professional manner. When implanting it is important to educate clients on what is being done and why it is important. (professional) The successful or unsuccessful treatment must then be evaluated and discussed with the client to determine the next step. (autonomy) This must be discussed in confidential manner protecting client privacy if necessary. This shows that every aspect of my practice is performed in a ethical manner and is therefore FORMALIST.

The philosophy that best informs my practice is the Deontology philosophy combined with Ethics of Care. Deontology view believe that individuals have the right to 1) Freedom of conscience, 2)Freedom of Consent, 3)Freedom of privacy, 4)Freedom of speech and 5)due process. As dental hygienists I have the duty to inform all patients of all necessary procedures to be done in order to provide them with adequate care. It is up to them to decide whether to consent with the treatments or not. All information is kept in confidential and private from others. As a health care provider and also being female, the philosophy of ethics of care plays a role in my daily duties in that I try to connect with my patients in compassionate way and treat them like I would of a friend or family member.

Rosie's addition to Q2:

Personally, I believe that there are 3 frameworks of ethical philosophy that pertain to dental hygiene practice; Deontology, Utilitarianism, and Ethic of Care. -Deontology coincides with duties and rights and acting in relation to others that apply universally to all people including ourselves. We treat others how we would want to be treated. -Utilitarianism deals with harms and benefits and is fundamentally directed to promote the greatest good for as many people as possible. -Ethic of Care relates to preserving and enhancing relationships and services to others. If I had to pick one, I would choose Ethic of care since I believe in the client-hygienist relationship. This professional bond has great potential for trust and learning when it comes to the health of a client’s dentition and peridontium. We spend the most time with a client in when they come for a scaling and dental exam so we build trust with them. When we offer some information about how the client can take care of their dentition or gingiva, they are more likely to consider changing or correcting them.

3. What variables affect your ethical decision making in your professional life?

I’m not exactly sure what this question is asking, but I’ll attempt to answer it…

Time – or scheduling of patients Cost of treatment Insurance coverage Emotional state of client Pervious experience of client with dental personal (fear of… ) Frustration of unsuccessful treatment (usually due to lack of oral care at home), unwillingness of client to change, people who don’t want to hear oral health education (smokers?)

(I think you're on the right track here. I have also included the following): Emotions: This might sound unprofessional but sometimes I have found that when I am having a bad day or noticed others are having a bad day, the quality of work decreases or attentiveness towards the patients needs is less compared to when the day is going well.

Just to add my 2 cent:

1. 2 What ethical philosophy/framework best informs your practice?

I think my practice would be based on the ethical theory of Deontology. Even before I became a RDH, I’ve tried to follow the ‘do unto others as you would have done to you’ rule. For example, with elderly clients who enjoy the social aspect of the appointment, I might have to sit through a story about their grandchild for the 8th time! Tempting as it is to just cut the conversation short, I try to remember that in another 50 years it may be me repeating a story, over and over again, to someone too. Would I want to be rushed or treated impatiently myself? No. So, within the confines of the appointment time, I try my best to listen and be patient with these clients.

1. 3 What variables affect your ethical decision-making in your professional life?

I wasn’t quite sure about this question either, but Willena’s answers make sense. I think that there are a lot of things that go on during the day that could effect how we deal with clients, and force us to make ethical decisions.

  Time:  lack of time may mean deciding whether or not to review a certain aspect of oral home care at that appt., vs. leaving it until the next visit.

Insurance issues: ie. tailoring treatment to fit the insurance coverage, withholding treatment or adding more treatment than is actually necessary. Autonomy – allowing the client to make their own decisions re. their oral health based on what they actually require vs. proceeding with only that treatment which their insurance will pay for.

#2 Deontological ethics (Immanuel Kant) best informs my practice because I emphasize on the goodness of an act rather than the consequences. Example: Dental office does composite fillings only, when based on professional assessments, the practitioner believes another restoration, such as an amalgam would better meet the client’s needs. I would inform the client has other options besides composites.

1. 3 Other variables that affect ethical decision-making in your professional life?

Culture Religious beliefs EnvironmentL Limitations to finances Pressures from critical groups (peers, employer)

Just to add a bit to question 3 Another variable that affects my ethical decision-making is my choice to pursue continuing education. In my case it is working towards a degree; for others, it can be attending seminars, courses etc. No matter what form of continuing education, it is important to stay current with new and relevant information for my clients. This is a variable that affects my decision making because the CDHA code of ethics states: “Professionalism is the commitment to use and advance professional knowledge and skills to serve the client and the public good” (p. 4) Professionalism (along with beneficence autonomy, privacy and accountability) is one of the principles of the code of ethics.''

Rosie's addition to Q3:

Dentist - being an authority figure in the practice. Sometimes RDH has a tendency to listen to every word he/she says. This is not the best situation to be in since you could be making unethical choices. Ideally the RDH and DDS should be working in a team environment.

Time - huge variable. This could have an effect of which procedures you choose to complete in the allotted amount of time per client. Maybe probing is skipped since you don’t have time to complete it. This could lead to supervised neglect if there are pocket depths that are of concern. Time could also play a part in not completing scaling and the RDH does not bring the client back to complete treatment.

Insurance - billing for the sake of collecting insurance money for scaling units not actually completed but recorded. I have temped in offices that have recall exam, 2usc, 2urp, pol/fl, 2bw listed from a previous appointment that lasted 1 hr. There is no physical way that all of that could have been completed in an hour.