Legal and Ethical Issues in the Dental Business Office

Elsevier items and derived items Copyright © 2016, 2011 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Legal and Ethical Issues in the
Dental Business Office
Chapter 4
1

Legal and Ethical Issues in the Dental
Business Office
1. Define the key terms in this chapter.
2. Understand the definition and classifications of law in
relation to dentistry and the important terms involved
with litigation.
3. Discuss crimes and torts with regard to the standard of
care in a dental office.
4. Understand the dental practice act.
5. Discuss professional standards that dental assisting
uses including accreditation, certification, and
licensure.
Lesson 4.1
2

Business Office (Cont.)
6. Describe the code of ethics of professional dental
organizations.
7. Discuss the ethical and legal considerations for the
administrative assistant.
8. Explain various types of consent.
9. Understand managed care and risk management
programs as they relate to dentistry.
Lesson 4.1
3

Business Office (Cont.)
10. Understand the legal responsibilities of a dental
practice and list business office activities that could
lead to potential litigations, including abandonment,
fraud, records management, defamation of character,
negligence, invasion of privacy, Good Samaritan Law,
Americans with Disabilities Act and computer security.
11. Identify 12 steps in making ethical decisions.
Lesson 4.1
4

Professional and Legal
Regulations of Dentistry
 Standards for dental care may arise from
both common law (judicial decisions) and
statutory law (enacted by a legislative body)
 The dental professional is also governed by
voluntary standards, such as the principles of
ethics, developed and implemented by the
dental profession itself
 Membership in a professional organization is
voluntary; therefore, the standards of these
organizations are considered voluntary
5

Definition of Law
 Law consists of enforceable rules governing
relationships among individuals and between
individuals and their society
6

Definition of Law
 Law relative to dentistry
 Each state’s board of dentistry has the
responsibility of enforcing laws within the agency
and making rules and regulations that conform to
enacted laws
7

Definition of Law
 Classifications of law
 Civil law
 Criminal law
8

Definition of Law
 Litigation
 Litigation is the process in which a plaintiff brings
a lawsuit against a defendant
 A fact witness must provide only firsthand
knowledge of facts or events
 An expert witness testifies as to whether the
dental care met acceptable standards
9

Crimes and Torts
 Crime
 Wrongdoing against society as a whole
 Typically involves the performance of a prohibited
act with a specified state of mind or intent
• Misdemeanor
• Felony
10

Crimes and Torts
 Tort
 Civil wrongdoing
• A breach of a legal duty
• Usually resolved with monetary compensation
 Torts may be intentional or unintentional acts of
wrongdoing
11

Crimes and Torts
 Tort (Cont.)
 Negligence is an unintentional tort that includes
the following four elements:
1. A duty existed to follow a standard of care
2. This duty was breached
3. The plaintiff suffered an injury
4. The injury was a direct result of that breach of duty
12

Crimes and Torts
 Tort (Cont.)
 Malpractice is considered a form of negligence,
but it can also refer to any professional
misconduct, evil practice, or illegal or immoral
conduct
 Malpractice can be either unintentional or
intentional
13

Dental Practice Act
 The legal requirements necessary to practice
dentistry and the scope of what can be
practiced are developed through legislative
action in each state and are identified in the
state dental practice act
 To completely understand the scope of
practice and supervisory requirements,
carefully read all definitions and descriptions
in the dental practice act
14

Professional Standards
 Credentialing is a generic term that refers to
the ways in which professionals can measure
and maintain their competence
 The processes used in credentialing include
accreditation, certification, and licensure
15

Code of Ethics
 Ethics is a branch of philosophy and is a
systematic, intellectual approach to the
standards of behavior
 A professional code of ethics helps members
of the profession achieve high levels of
behavior through moral consciousness,
decision making, and practice by members of
the profession
16

ADA Principles of Ethics and
Code of Professional Conduct
 Each organized group within the profession of
dentistry, including the American Dental
Association (ADA), American Dental
Assistants Association (ADAA), and American
Dental Hygienists’ Association (ADHA), has
developed a code of ethics for its members
17

Ethical and Legal Considerations
for the Administrative Assistant
 Vigilance
 The administrative assistant must be constantly
vigilant about changes taking place in the laws
affecting dentistry
18

Ethical and Legal Considerations
for the Administrative Assistant
 Assignment of duties
 The licensed dentist is responsible for assigning
specific procedures to dental auxiliaries
 Before assigning duties to staff members, the
dentist should:
• Review the appropriate credentials
• Retain the staff member’s credentials on file
• Avoid employer-employee conflict in the assignment
19

Consent
 Consent is the voluntary acceptance or
agreement of what is planned or done by
another person
 The deliver of dental care involves two forms
of consent – informed and implied
 Unauthorized touching without the patient’s
consent is considered battery
20

Informed Consent
 Every adult of sound mind has the right to
determine what can and cannot be done with
his or her body
 To be legally valid, consent must be informed
and given freely, and the patient must be an
adult of sound mind
21

Informed Consent (Cont.)
 Elements of informed consent
 Must be freely given
 Information about the procedure, treatment, and
diagnosis must be in understandable language
 Risks and benefits, estimate of success,
alternatives, options, and prognosis for no
treatment
 The patient has the right to ask questions
22

Informed Consent (Cont.)
 When a minor is treated, only the parent or
guardian may grant consent; this excludes
grandparents, babysitters, and siblings
23

Express Consent
 Achieved when a dentist prepares a
treatment plan, writes it down, presents it to
the patient, and presents the patient with a
copy to sign after providing a description to
satisfy informed consent
24

Implied Consent
 Agreements that flow automatically from the
relationship between the patient and the
dental professional
 Implied consent responsibilities are twofold:
 Those that the dentist owes to the patient
 Those that the patient owes to the dentist
25

Informed Refusal
 A patient may decline a recommended
procedure or referral from a dentist
 An office should document this refusal for
recommended care in writing
26

Managed Care
 Managed care refers to a cost-containment
system of healthcare insurance
 Limitations imposed by managed care
companies generally are directed at payment
for services, but the policies may also limit the
actual services a patient may receive
27

Risk Management Programs
 Risk management programs aid the dental
professional in identifying, analyzing, and
dealing with risks in the dental office
 Topics include information on operating safety,
product safety, quality assurance, and waste
disposal
28

Abandonment
 Abandonment is the severance of a
professional relationship with a patient who is
still in need of dental care and proper
transfers or referrals
29

Fraud
 Fraud is a deception that is deliberately
practiced to secure unfair or unlawful gain
30

Records Management
 Nothing can be more valuable in defending
against potential litigation than clear, concise
records
 Through, accurate, and objective
documentation is your best defense in
litigation
31

Defamation of Character
 Defamation of character is the
communication of false information to a third
party about a person that results in injury to
that person’s reputation
 Such communication can be
• Verbal (slander)
• Written (libel)
32

Negligence
 To prove negligence, the plaintiff must show
 That there was an obligation to provide care
according to a specified standard
 That there was failure to meet that standard
 That the failure to meet the standard led to injury
 That there was in fact an actual injury to the
patient
33

Invasion of Privacy
 Invasion of privacy is a tort that refers to a
number of wrongs involving the use of
otherwise private information
 All staff must adhere to HIPPA regulations
and recognize that any information a patient
provides to the dental staff must remain
confidential in the office
34

Good Samaritan Law
 The Good Samaritan law is legislation that
grants immunity for acts performed by a
person who renders care in an emergency
situation
 This law does not provide protection for a
negligent healthcare provider who is being
compensated for services
35

Americans with Disabilities Act
 The Americans with Disabilities Act protects
persons with some degree of disability from
discrimination and requires dental offices to
modify their facilities and make
accommodations to allow access to dental
care
36

Computer Security
 Computer security refers to safeguards
implemented to prevent and detect
unauthorized access or deliberate damage to
a computer system and data
 A computer crime is the use of a computer to
commit an illegal act
37

Ethical Decision Making Model
1. Specifically identify the ethical issue or dilemma.
Dilemmas occur when a practitioner is caught between
competing obligations and has to weigh two or more
options to resolve the situation.
2. Gather and review important facts or information pertinent
to the situation.
3. List alternatives that could be used to resolve the
problem.
4. Evaluate each alternatives using ethical principles, codes,
laws and regulations to determine the best alternative.
5. Make a decision choosing the best alternative that is
ethically and legally appropriate.
6. Act on the decision.
38

Questions?
39

Legal and Ethical Issues in the Dental Business Office

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