The dental profession is a vocation in which knowledge and skill is used for the service of others. One of the characteristics of a profession is adherence to a code of ethics. Being a health care provider it carrier with it a responsibility to individual patients and society confers on the professionals requires them to behave in an ethical manner.

2. IN DENTISTRY

3. CONTENT
 INTRODUCTION
 DEFINITION OF ETHICS
 DENTAL ETHICS
 HISTORY OF ETHICS
 ETHICAL PRINCIPLES
 UNETHICAL PRACTICES
 SOME UN ETHICAL STUDIES IN HISTORY
 UNETHICAL EXPERIMENTS IN TODAY'S MEDICINE
 The IDA Code of Ethics
 CONCLUSION
 REFERENCE

4. INTRODUCTION
The dental profession is a vocation in which knowledge and
skill is used for the service of others.
One of the characteristics of a profession is adherence to a
code of ethics. Being a health care provider it carrier with it a
responsibility to individual patients and society confers on the
professionals requires them to behave in an ethical manner.

5. ‘ETHICS’
‘ETHOS’ (Greek)
Custom /
Character
It is the philosophy
of human conduct, a
way of stating &
evaluating principles
by which problems
of behaviour can be
solved.

6. Ethics is concerned with standard judging
whether actions are right or wrong.

7. What is Ethics?
It’s a branch of philosophy concerned with the study of those
concepts that are used to evaluate human activities, in
particular the concepts of goodness and obligation.
Dental ethics would mean moral duties and obligations of
the dentist towards his patients, professional colleagues and
to the society

8. Definition of Ethics
Is defined as "the science of the ideal human character
and behavior in situations where distinction must be made
between right and wrong, duty must be followed and
good interpersonal relations maintained".

9. DENTAL ETHICS
Dental ethics simply means moral duties and
obligations of the dentists towards the patients
,professional colleagues and to the society.
These help support autonomy and self
determination , protect the vulnerable and promote
the welfare and equality of human beings.
It deals with choices made by both clinicians and
patients

10. Ethical
principal
Micro ethical
principal
Macro ethical
principal

11. Micro-ethical principles
They focus primarily on individuals’ rights and
duties and do not see individuals as part of a
wider social order

12. Macro-ethical principles
These are a set of principles designed to protect
the human dignity, integrity, self determination,
confidentiality, rights and health of populations
and the people comprising them.

13. History of Ethics
Ancient Greek ethics
Hippocratic oath is the first ethical standards given by
Hippocrates, the father of medicine, in the 4th century BC
It is perhaps the most widely known of Greek medical texts.
 It requires a new physician to swear upon a number of healing
gods that he will uphold a number of professional ethical
standards. It also strongly binds the student to his teacher and
the greater community of physicians with responsibilities similar
to that of a family member

14.  Over the centuries, it has been rewritten often in order to
suit the values of different cultures influenced by Greek
medicine.
 Contrary to popular belief, the Hippocratic Oath is not
required by most modern medical schools, although some
have adopted modern versions that suit many in the
profession in the 21st century

15. Ancient Greek ethics
Socrates (5th century BC) –
 Some problems are resolvable by data (e.g., geometry), while
others are moral issues (e.g., justice system)
 Socrates, as portrayed in Plato's Republic, articulates the greatest
good as the transcendent "form of good itself".
 The good, Socrates says, is like the sun. The sun gives light and
life to the earth, the good gives knowledge and virtue to the
intelligible world. It is the cause of goodness in people and
actions, and it also is the cause of existence and knowledge.
 The pursuit of and love of the good itself (rather than any
particular good thing) Socrates thought was the chief aim of
education and (especially) of philosophy.

16. Plato (5th-4th century BC)
 Like most other ancient philosophers, Plato maintains a
virtue-based eudaemonistic conception of ethics.
 That is to say, happiness or well-being (eudaimonia) is
highest aim of moral thought and conduct, and the
virtues ( ‘excellence’) are the requisite skills and
dispositions needed to attain it.
 Let’s give everyone the benefit of the doubt: ‘No one
knowingly harms himself or does evil things to others
because that would harm his soul.

17. Aristotle (4th century BC)
 Aristotle's ethics builds upon Plato's with important variations.
Aristotle's highest good was not the good itself but goodness
embodied in a flourishing human life.
 His ethics are based on eudaimonia, variously translated as
"prosperity," "flourishing," or "success."
 A "great-souled" citizen who lives a life of virtue can expect to
achieve eudaimonia, which Aristotle argues is the highest good for
 Following Plato, Aristotle gives a significant role in moral life
fixed habits of behavior that lead to good outcomes.
 the main virtue are courage , justice, prudence and temperance . The
highest form of life is, however,
purely intellectual activity.

18. Kantian ethics
 Immanuel Kant, in the 18th century, argued that right and
wrong are founded on duty, which issues a Categorical
Imperative to us, a command that, of its nature, ought to
be obeyed.
 An action is only truly moral if done from a sense of duty,
and the most valuable thing is a human will that has
decided to act rightly. To decide what duty requires, Kant
proposes the principle of universalizability correct moral
rules are those everyone could adopt.

19. Natural law ethics
In the Middle Ages , Thomas Aquinas
developed a synthesis of Biblical and Aristotelian
ethics called natural law theory
According to which the nature of humans determines
what is right and wrong. For example, murder is wrong
because life is essential to humans so depriving
someone of it is inherently an evil.
Education is needed for humans, and is their right,
because their intellectual nature requires developing

20. Utilitarianism
 In 19th century Britain, Jeremy Bentham and John Stuart
Mill advocated utilitarianism, the view that right actions are those
that are likely to result in the greatest happiness of the greatest
number. Utilitarianism remains popular in the twenty-first century.
 Both Kantianism and Utilitarianism provide ethical theories that can
support contemporary liberal political developments, and
enlightenment ways of conceiving of the individual.

21. In India, the Dentist Act of 1948 was amended via section 17A
empowering the Dental Council of India to prescribe
standards of professional conduct & etiquette.
 The Code of Ethics was framed by the Dental Council in 1975
& later notified by the Government of India as “ Dentists
(code of ethics) Regulations 1976.
It is in force from August 1976.

22. ETHICAL PRINCIPLES
To do no harm [ non-maleficence ]
To do good [ beneficence ]
Respect the person
Justice
Veracity or truthfulness
Confidentiality

23. To do no harm [ non-maleficence ]
Considered to be the foundation of social morality.
Actions of the healthcare provider should not harm the
patients in anyway

24.  Iatrogenic diseases-doctor induced illness.
• Use of unsterilized instruments
• Iatrogenic diseases (underfilling, overfilling etc)
• Doing procedures beyond his competency
 The dentist, in cases where pain cannot be avoided, can make
to minimize the pain. If feasible, the alternative of minimal or no
treatment can be presented to the patient.
 Iatrogenic diseases-doctor induced illness.
• Use of unsterilized instruments
• Iatrogenic diseases (underfilling, overfilling etc)
• Doing procedures beyond his competency
 The dentist, in cases where pain cannot be avoided, can make
attempts to minimize the pain. If feasible, the alternative of minimal or
no treatment can be presented to the patient.

25. To do good [ beneficence ]
 Prime responsibility of all dentists to benefit his patients as well as not to
inflict harm
 The patient expects that the care provider will initiate beneficial action & that
there is an agreement between the doctor and the patient that some good
will result
 In the process of treating a patient what has to be weighed are the
consequences of treatment Vs no treatment.
E.g. in questionable dental caries - the attempts should be
to maximize the benefits and minimize the harm.

26. Respect the person
It incorporates at least 2 fundamental
ethical considerations :
• Autonomy
• Informed Consent

27. a) Autonomy
 The health care professionals respect the patient’s right to make
decisions concerning the treatment plan.
 Patients should not be bystanders in their treatment , but active
participants
 Dentist’s sometimes direct a patient towards a certain mode of
treatment by stressing certain advantages and not mentioning
the disadvantages
 It is unethical to mislead or misinform patients.

28.  Dentists are often trained in a paternalistic setting.
 Paternalism is the principle of government as by a father, ie
a dictatorial “father knows best” attitude.
 Paternalism in health care can take the form of withholding
information, restricting choices, or making the choice for the patient.
 We may be able to justify paternalistic laws as being in the public’s
interest, but we should recognize that these laws limit the rights of a
segment of the public because we judge that the laws are in their “best
interest”.

29. b)Informed Consent
 Informed Consent is the first stated and the largest principle of the
Nuremberg Code
 The Nuremberg Code identifies 4 attributes of consent without which
consent cannot be considered valid.
 Consent must be :
 voluntary
Legally competent
Informed
comprehending

30. Informed consent is a 2 step process.
i. Information is presented to the patient by
the doctor
ii. Patient satisfies himself/herself that he/she
understands & based upon this
understanding either agrees or refuses to
undergo treatment

31. Informed Consent consists of :
• A description of procedures to be carried out
• A description of any reasonably foreseeable
risks/discomforts to the subject
• A description of any benefits to the subject or to the others
which may reasonably br expected from the treatment
• A disclosure of appropriate alternative procedures or courses
of treatment, if any, that might be advantageous to the
subject

32.  A statement describing the extent, if any, to which
confidentiality of records identifying the subject will be
maintained.
 A statement that the patient has understood the procedure
and is willing to undergo the treatment
 The signature of the patient and of a witness

33. Justice
 It is often described as fairness / equal treatment,
giving to each her or his right or due .
 Primary duty of the health professional is service
irrespective of class, creed etc
 The principal of justice calls for an obligation to
protect the weak and to ensure equity in rights and
benefit, both for groups and for individuals

34. Veracity or truthfulness
 The patient – doctor relationship is based on trust.
 Lying shows disrespect to the patient and threatens
relationship
 It is a principle that one would expect to go
unquestioned, yet many health care professionals
practice in a less than truthful way

35. Confidentiality
 Patient have the right to expect that all
communications and records pertaining to their care
will be treated as confidential.
 It is very natural to want to gossip about a patient,
particularly if it is someone famous or possibly a
neighbour ,but to do so that would break a bond of
trust between the dental professional and the patient.

36. WHY CODE OF MEDICAL AND DENTAL ETHICS?
 Professions adopt ethical standards because that is part of
the professional charge.
 A patient’s trust in a professional comes in part from the
expectation that the professional’s behaviour is governed by
norms prescribed by the group.
 It is also a public expectation that ethical standards be
developed and enforced by any profession, a requirement
that comes with the privilege of self-regulation.

37.  A systematic body of rules is needed “in order that dignity and honour
of the dental profession may be upheld, its standard exalted, its sphere
of usefulness extended and the advancement of dental sciences
promoted and that the members of the dental association may
understand clearly their duties and obligations to the dental
profession, to their patients, and to the community at large” (Indian
Dental Association-Constitution, bylaws and code of ethics, 1988).

38. EHICAL RULES FOR DENTISTS
[given by DCI]
Duties of dentist towards patients
Duties of dentists towards one another
 Duties of dentists towards the public

39. DUTIES OF DENTIST TOWARDS PATIENTS
 Dentists should be courteous, sympathetic, friendly and helpful.
 Observe punctuality in fulfilling his appointments.
 He should establish a well merited reputation for professional
ability and fidelity.
 Should not permit considerations of religion, nationality, race,
party politics or social
 Information of a personal nature which may be learned about
or directly from a patient in the course of dental practice should
be kept in the utmost confidence. It is also the obligation of the
dentist to see that his auxiliary staff observe this rule.

40. Duties of dentists towards one another
 Every dentist should cherish a proper pride in his/her colleagues
and should not disparage them either by act or word
 A dentist called upon in any emergency to treat the patient of
another dentist, should, when the emergency is provided for, retire
in favour of the regular dentist but shall entitled to charge the
patient for his services

41.  When the dentist is entrusted with the care of the patient of
another, during sickness or absence, mutual arrangements
should be made regarding renumeration.
 If a dentist is consulted by the patient of another dentist and
the former finds that the patient is suffering from previous
faulty treatment, it is his duty to institute correct treatment at
once with as little comments as possible and in such manner
as to avoid reflection on his predecessor

42. Duties of dentists towards the public
 Dentist should take leadership roles in the communities on
matters related to dental health

43. UNETHICAL PRACTICES

44. Practice by unregistered persons employed by the dentist
Dentist signed under his name and authority issuing any certificate
which is untrue, misleading or improper
Dentist advertising whether directly, or indirectly, for the purpose
of obtaining patients or promoting his own professional
advantage
Use of bogus diplomas etc.
Allowing commission

45.  Paying or accepting commissions
 Undercutting of charges in order to solicit patients
 If planned treatment is beyond the dentist’s skill, the patient is not
referred to a consultant
 In case of an emergency consultation during the temporary absence
of the patient’s dentist, temporary service is provided and the patient
is not sent back
 If consulted, the dentist accepts charge of the case without request of
the referring dentist

46. Some un ethical studies in history

47. 1)The Tuskegee Study
 The Tuskegee Study of Untreated Syphilis in the
Negro Male was an infamous and unethical clinical
study conducted between 1932 and 1972 by the U.S.
Public Health Service.
 The purpose of this study was to observe the natural
history of untreated syphilis the African-American men in
the study were told they were receiving free health care
from the United States government
 The Public Health Service started working on this study in
1932 in collaboration with Tuskegee University,
a historically black college in Alabama

48. ETHICAL PRINCIPLES NOT MET:
 Respect for Human Dignity
 Informed Consent
 Respect for vulnerable persons
 minimizing harm and maximizing benefit
 Independence of research and conflicts of interest or partiality
must be explicit.

49. 2)The Monster Study (1939)
 The Monster Study was a stuttering experiment on 22
orphan children in Davenport, Iowa, in 1939 conducted
by Wendell Johnson at the University of Iowa.
 Johnson chose one of his graduate students, Mary
Tudor, to conduct the experiment and he supervised
her research.
 After placing the children in control and experimental
groups, Tudor gave positive speech therapy to half of
the children, praising the fluency of their speech, and
negative speech therapy to the other half, belittling the
children for every speech imperfection and telling them
they were stutterers.

50.  Many of the normal speaking orphan children who received negative
therapy in the experiment suffered negative psychological effects and
some retained speech problems during the course of their life.
 Dubbed “The Monster Study” by some of Johnson’s peers who were
horrified that he would experiment on orphan children to prove a
theory, the experiment was kept hidden for fear Johnson’s reputation
would be tarnished in the wake of human experiments conducted by
the Nazis during World War II. The University of Iowa publicly
apologized for the Monster Study in 2001.

51. 3) THE INHUMAN NAZI EXPERIMENTS
 Nazi human experimentation was a series
of medical experiments on large numbers of
prisoners, including children, by Nazi
Germany in its concentration camps in the
early to mid 1940s, during World War II and the
Holocaust.
 Chief target populations
included Romani, Sinti, ethnic Poles, Soviet
POWs, disabled Germans, and Jews from across
Europe.
3) THE INHUMAN NAZI EXPERIMENTS
 Nazi human experimentation was a series
of medical experiments on large numbers of
prisoners, including children, by Nazi
Germany in its concentration camps in the
early to mid 1940s, during World War II and the
Holocaust.
 Chief target populations
included Romani, Sinti, ethnic Poles, Soviet
POWs, disabled Germans, and Jews from across
Europe.

52. Nazi physicians and their assistants forced prisoners into
participating; they did not willingly volunteer and no consent
was given for the procedures.
Typically, the experiments resulted in
death, trauma, disfigurement or permanent disability, and as
such are considered examples of medical torture.

53. ETHICAL PRINCIPLES NOT MET:
 Respect for Human dignity
 Informed Consent
 Privacy
 Respect for Vulnerable persons
 Minimizing harm and maximizing benefit

54. Experiments
 Malaria experiments
 Immunization experiments
 Epidemic jaundice
 Mustard gas experiments
 Sulfonamide experiments
 Experiments on twins
 Bone, muscle, and nerve transplantation experiments
 Experiments with poison
 High altitude experiments
 Blood coagulation experiments

55. Malaria experiments
 From about February 1942 to about April 1945, experiments were
conducted at the Dachau concentration camp in order to investigate
immunization for treatment of malaria.
 Healthy inmates were infected by mosquitoes or by injections of
extracts of the mucous glands of female mosquitoes. After contracting
the disease, the subjects were treated with various drugs to test their
relative efficiency.
 Over 1,200 people were used in these experiments and more than half
died as a result. Other test subjects were left with permanent disabilities

56. Epidemic jaundice
 From June 1943 till January 1945 at the concentration camps,
Sachsenhausen and Natzweiler, experimentation with
epidemic jaundice was conducted.
 The test subjects were injected with the disease in order to
discover new inoculations for the condition.
 These tests were conducted for the benefit of the German
Armed Forces. Many suffered great pain in these experiments

57. Mustard gas experiments
 At various times between September 1939 and April 1945, many
experiments were conducted at Sachsenhausen, Natzweiler, and other
camps to investigate the most effective treatment of wounds caused
by mustard gas.
 Test subjects were deliberately exposed to mustard gas and other
vesicants (e.g. Lewisite) which inflicted severe chemical burns.
 The victims' wounds were then tested to find the most effective
treatment for the mustard gas burns

58. Sulfonamide experiments
 From about July 1942 to about September 1943, experiments to investigate the
effectiveness of sulfonamide, a synthetic antimicrobial agent, were conducted at
Ravensbrück.
 Wounds inflicted on the subjects were infected with bacteria such as Streptococcus,
Clostridium perfringens (a major causative agent in gas gangrene) and Clostridium
tetani, the causative agent in tetanus.
 Circulation of blood was interrupted by tying off blood vessels at both ends of the
wound to create a condition similar to that of a battlefield wound. Infection was
aggravated by forcing wood shavings and ground glass into the wounds. The
infection was treated with sulfonamide and other drugs to determine their
effectiveness.

59. Bone, muscle, and nerve transplantation
experiments
 From about September 1942 to about December 1943 experiments were
conducted at the Ravensbrück concentration camp, for the benefit of the
German Armed Forces, to study bone, muscle, and nerve regeneration,
and bone transplantation from one person to another.
 Sections of bones, muscles, and nerves were removed from the subjects
without use of anesthesia. As a result of these operations, many victims
suffered intense agony, mutilation, and permanent disability

60. Blood coagulation experiments
 Sigmund Rascher experimented with the effects of Polygal, a substance
made from beetroot and apple pectin, which aided blood clotting.
 He predicted that the preventive use of Polygal tablets would reduce
bleeding from gunshot wounds sustained during combat or during surgery.
 Subjects were given a Polygal tablet, and shot through the neck or chest, or
their limbs amputated without anaesthesia.
 Rascher published an article on his experience of using Polygal, without
detailing the nature of the human trials and also set up a company to
manufacture the substance, staffed by prisoners
Blood coagulation experiments

62. THE NUREMBERG CODE
 It is a set of research ethical principles for human experimentation set as a
result of the Nuremberg trials at the end of 2nd World War.
 Specifically they were in response to the inhumane Nazi human
experimentation on un consenting prisoners during the 2nd World War.
 The code designed to protect the integrity of the research subject, set out
conditions for the ethical conduct of research involving human subjects,
emphasizing their voluntary consent to research.

63.  Voluntary informed consent of the human subject is absolutely
essential . The duty & responsibility for ascertaining the quality of
the consent rests upon each individual who initiates, directs or
engages in the experiment. It is a personal duty and responsibility
which may not be delegated to another with impunity
 The experiment should be such as to yield fruitful results for the
good of society, unprocurable by other methods or means of
study, and not random and unnecessary in nature

64.  The experiment should be designed and based on the results
of animal experimentation and a knowledge of the natural
history of the disease or other problem under study that the
anticipated results justify the performance of the experiment
 The experiment should be so conducted as to avoid all
unnecessary physical and mental suffering and injury
 No experiment should be conducted where there is a prior
reason to believe that death or disabling injury will occur.

65.  The degree of risk to be taken should never exceed that determined
by the humanitarian importance of the problem to be solved by the
experiment
 Proper preparations should be made and adequate facilities
provided to protect the experimental subject against even remote
possibilities of injury, disability or death.
 The experiment should be conducted only by scientifically qualified
persons. The highest degree of skill and care should be required
through all stages of the experiment of those who conduct or
engage in the experiment

66.  During the course of the experiment the human subject
should be at liberty to bring the experiment to an end if he
has reached physical or mental state where continuation of
the experiment seems to him to be impossible.
 During the course of the experiment the scientist in charge
must be prepared to terminate the experiment at any stage, if
he has probable cause to believe, in the exercise of the good
faith, superior skill and careful judgement required of him,
that a continuation of the experiment is likely to result in
injury, disability or death to the experimental subject.

67. DECLARATION OF GENEVA
 Was taken in the 2nd General Assembly of World Medical Association ,
Geneva 1948.
 This oath seems to be a response to the atrocities committed by
doctors in Nazi Germany.
 Notably this oath requires the physician to “not use (his) medical
knowledge contrary to the laws of humanity”
 It is also called as Physician’s Pledge.

68. At the time of being admitted as a member of the medical profession:
The pledge reads :
 I SOLEMNLY PLEDGE to dedicate my life to the service of humanity
 THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration
 I WILL PRACTICE my profession with conscience and dignity.
 I WILL RESPECT the secrets that are confined in me, even after the patient has died.
died.

69.  I WILL MAINTAIN by all means in my power , the honour and the noble
traditions of the medical profession.
 MY COLLEAGUES will be my sisters and brothers.
 THE HEALTH AND WELL-BEING OF MY PATIENT will be my first
consideration
 I WILL MAINTAIN the utmost respect for human life.
 I WILL NOT USE my medical knowledge to violate human rights and civil
liberties, even under threat;
 I MAKE THESE PROMISES solemnly, freely and upon my honour

70. WORLD MEDICAL ASSOCIATION
INTERNATIONAL CODE OF MEDICAL ETHICS
 Adopted in the 3rd General Assembly of World Medical
Association , London October 1949
 It states the duties of physician in general, to patients and to
colleagues

71. DECLARATION OF HELSINSKI – 1964
 Declaration of Helsinki is a set of ethical principles regarding human
experimentation developed for the medical community by the World Medical
Association (WMA).
 It is widely regarded as the cornerstone document on human research ethics.
 The Declaration of Geneva of the WMA binds the physician with the words,
“The health of my patient will be my first consideration,” and the International
Code of Medical Ethics declares that, “A physician shall act in the patient’s best
interest when providing medical care.”
 Research should be based on a thorough knowledge of the scientific
background

72.  Conducted by suitably trained investigators using approved protocols,
 While the primary purpose of medical research is to generate new knowledge,
this goal can never take precedence over the rights and interests of individual
research subjects.
 Information regarding the study should be publicly available
 Medical research should be conducted in a manner that minimizes possible
harm to the environment.
 methods, but under certain circumstances a placebo or no treatment group
may be utilised

73. Unethical experiments in today's medicine
 Updated January 22, 2019
 Chinese scientist He Jiankui sent shockwaves around the
world last year with his claim that he had modified twin
babies' DNA before their birth. and made the babies
resistant to HIV.
 Scientists from China and around the world spoke out
about the experiment, which many say was unethical
and not needed to prevent the virus. The scientist had
also been warned by peers not to go down this path.

74. Bombshell: Secret American Laboratory Performs Deadly
Human Experiments in Caucasus’ Georgia
 At a recent international meeting in Geneva,
representatives of Georgia’s breakaway region of
South Ossetia expressed concern that the “Lugar
Laboratory” in Tbilisi was contributing to increased
outbreaks of dangerous diseases in South Ossetia

75.  However, Russia’s former Chief Sanitary Inspector, Gennady
Onishchenko, suggested last year that the United States may be
spreading Zika-infected mosquitos in Georgia’s breakaway Abkhazia
region as a form of biological warfare against Russia
 He told the BBC Russian Service that the discovery of Zika-infected
mosquitoes in Abkhazia’s Black Sea coast “worried” him “because about
100 kilometers from the place where this mosquito now lives, right near
our borders, there is a military, microbiological laboratory of the Army of
the United States.”

76. RECENT UN ETHICAL TRIALS IN INDIA
 The question whether all human clinical trials undertaken in India are
conducted ethically has been answered. The final report of the three-
member committee appointed by the central government to go into the
alleged irregularities in the conduct of the human papilloma virus (HPV)
vaccine trial reveals gross ethical violations.
 The trial, suspended since March 2010, was carried out by the Program for
Appropriate Technology and Health(PATH), an NGO, in collaboration with
the Andhra Pradesh and Gujarat governments and the Indian Council of
Medical Research.
 It was conducted on nearly 23,500 girls in the 10-14 years age group in
Khammam district (Andhra Pradesh) and Vadodra (Gujarat). The “casual
approach,” which saw the informed consent forms, the most sacrosanct trial
documents, being filled “very carelessly” with “incomplete and probably
inaccurate” information is shocking.

77.  In Andhra Pradesh, nearly 2,800 consent forms were signed by a hostel
warden or headmaster, as the ‘guardian'. Since students have “reduced
autonomy,” the fact that teachers played a “primary role” in explaining and
“obtaining consent” meant that the consent was obtained under duress, in
a legally untenable way
 The trial came under scrutiny following a public outcry over the death of
seven children. Although the cause of the deaths was found to be
unrelated to vaccination, the incident revealed a total failure of the
mechanism to monitor the ‘volunteers' for both serious and non-serious
adverse events following vaccination. There was a five-month delay in
reporting a death, while two deaths in Khammam district went unreported.

78. The IDA Code of Ethics
 The IDA Code of Ethics is a comprehensive directive on the ethical codes
of conduct an IDA dentist member is expected to follow.
 The IDA code of ethics has been formulated keeping in mind the DCI
Code of Ethics i.e. Dentist’s Act amended in 2016 and adopted from
various international Dental Associations promoting high standards of
patient care matching global standards.
 IDA strives to put India on the global map by holding its members to a
very high standard through the adoption of this Code of Ethics
 These regulations may be called the Revised IDA Code of Ethics , 2014.

79. Codes of ethics
1.Declaration:
Every dentist who has been registered (either on Part A or Part B of the
State Dentists Register) shall, within a period of thirty days from the date
of commencement of these regulations, and every dentist who gets
himself registered after the commencement of these regulations shall,
within a period of thirty days from such registration, make, before the
Registrar of the State Dental Council, a declaration in the form set out for
the purpose in the Schedule to these regulations and shall agree to have
read, understood and thence to abide by the same.

80. 2. Duties and Obligation of Dentists in General
4.1 Character of Dentist / Dental Surgeon
 In view of the important role of a Dentist/ Dental Surgeon as a health professional
educated and trained in surgical and medical treatment of diseases of the Oral cavity,
he shall:
 (4.1.1) Be mindful of the high character of his mission and the responsibilities he holds
in the discharge of his duties as an independent healthcare professional and shall
always remember that care of the patient and treatment of the disease depends upon
the skill and prompt attention shown by him and always remembering that his
reputation, professional ability and fidelity remain his best recommendations;
 (4.1.2) Treat the welfare of the patients as paramount to all other considerations and
shall conserve it to the utmost of his ability;
 (4.1.3) Be courteous, sympathetic, friendly and helpful to, and always ready to respond
to the call of his patients, and that under all conditions his behavior towards his
patients and the public shall be polite and dignified.

81. 4.2 Maintaining good Clinical Practices:
 The Principal objective of the Dental profession is to render service to humanity
with full respect for the dignity of profession and man. Dental Surgeons should
merit the confidence of patients entrusted to their care, rendering to each a full
measure of service and devotion
 (4.2.1)The Dentist/ Dental Surgeon should practice methods of healing founded on
scientific basis and should not associate professionally with anyone who violates
this principle.
 4.2.2) Membership in Dental and Medical Associations and Societies: For the
advancement of his/her profession, a Dental Surgeon should be encouraged to
affiliate with associations and societies of dental, oral and allied medical
professionals and play a proactive role in the promotion of oral health in particular
and health of an individual in general.

82. 4.3 Maintenance of Dental/Medical records:
 (4.3.1) Every Dental surgeon shall maintain the relevant records pertaining to his out-
patients and inpatients (wherever applicable). These records must be preserved for a
minimum period of three years from the date of commencement of the treatment in a
format determined by the Council or accepted as a standard mode of documentation.
 (4.3.2) If any request is made for medical or dental records either by the
patients/authorized attendant or legal authorities involved, the same may be issued to
competent authority within 72 hours after having obtained a valid receipt for all
documents.
 4.3.3) A Registered Dental practitioner shall maintain a Register of Medical Certificates
giving full details of certificates issued.

83. 4.4 Display of Registration Numbers:
 Every Dental practitioner shall display the registration number accorded to him
the State Dental Council in his clinic and in all his prescriptions, certificates and
money receipts given to his patients.
4.5 Prescription of Drugs:
 Every dental surgeon should take care to prescribe and administer drugs in a
responsible manner and ensure safe and rational use of drugs. He should as far
possible, prescribe drugs in a generic form.
4.6 Highest Quality Assurance in patient care:
 Every Dental practitioner should ensure quality treatment that does not
compromise the outcome of treatment.
 All practitioners should be aware of unethical practices and practices by
unqualified persons.

84. 4.7 Exposure of Unethical Conduct:
 A Dental Surgeon should expose, without fear or favor, incompetent or corrupt,
dishonest or unethical conduct on the part of members of the profession.
 It is the responsibility of the dental surgeon to report to the competent
instances of quackery and any kind of abuse including doctor-patient sexual
misconduct, misuse of fiduciary relationship, child abuse and other social evils
may come to their attention.
 4.8 Payment of Professional Services: The personal financial interests of a dental
surgeon should not conflict with the medical interests of patients. A dental
practitioner should announce his fees before rendering service and not after the
operation or treatment is under way .

85. 4.9 Observation of Statutes:
 The Dental Surgeon shall observe the laws of the country in regulating the practice of
his profession including the Dentists’ Act 1948 and its amendments and shall also not
assist others to evade such laws.
 He should be cooperative in observance and enforcement of sanitary laws and
regulations in the interest of public health.
 He should observe the provisions of the State Acts like Drugs and Cosmetics Act,
Pharmacy Act, 1948; Narcotic Drugs and Psychotropic substances Act, 1985;
Environmental Protection Act, 1986; Drugs and Magic Remedies (Objectionable
Advertisement) Act, 1954; Persons with Disabilities (Equal Opportunities and Full
Participation) Act, 1995 and Bio-Medical Waste (Management and Handling) Rules,
1998 and such other Acts, Rules, Regulations made by the Central/State Governments
or local Administrative Bodies or any other relevant Act relating to the protection and
promotion of public health.

86. 4.10 Signing Professional Certificates, Reports and other Documents:
 A Registered Dental Surgeon involved independently in the treatment of
and oral surgical problems may be called upon to sign certificates,
reports etc. He is bound to issue such certificates and to sign them.
relating to disability, injury in the oral and maxillofacial region and deaths
occurring while under the care of such dental surgeons should be signed by
them in their professional capacity for subsequent use in the courts or for
administrative purposes etc.
 Any registered dental surgeon who is shown to have signed or given under
name and authority any such certificate, notification, report or document of a
similar character which is untrue, misleading or improper, is liable to have his
name deleted from the Register.

87. CONCLUSION
 A profession consists of a limited group of persons who have
acquired some special skill and are therefore able to perform that
function in society better than the average person.
 A professional person is expected to have respect for human
beings, competence in his chosen field, integrity and a primary
concern with service rather than with prestige or profit.
 Ethical codes are the result of an attempt to direct the moral
consciousness of the members of the profession to its peculiar
problems.
 Ethical codes are important in developing higher standards of
conduct, for they are based on the correct attitude and the
correct procedure.

88. REFERENCE
 Essentials of Public Health Dentistry – Soben Peter – 5th Edition
 Ethics and Research – Dr.JayakrishnanThavody
 ETHICS IN DENTISTRY; Dr. Shika Swaroop Alva, Dr Shruthi Bhandary, Dr. Aftab
Damda International Journal of Current Research Vol. 9, Issue, 01, pp.45692-
45695, January, 2017