Ethical considerations in Dentistry is mandatory to know and understand so that one could deliver dental services in rightful manner. Ethics constitute of major principles and codes which are important to carry any human research. Ethical practice includes guidelines set my Indian Council of medical research (ICMR) which is funded by govt of India. Ethics is knowing the difference between what you have the right to do and what is the right thing to do.

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Ethics in
Dentistry
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Lesson plan
 Objective: To introduce the concept of ethics in
research and to familiarize the audience with the
same.
 Evaluation: at the end of the class evaluate
knowledge of the audience regarding ethics in
research.
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Contents
• What is Ethics
• Nuremberg code of 1947
• Declaration of Geneva
• Declaration of Helsinki
• Indian Perspective 3

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What is ‘Ethics’ ?
 “Ethics” is derived from the Greek word
‘ethos’ meaning custom or character.
 Ethics is the philosophy of human conduct, a
way of stating and evaluating principles by
which problems of behaviour can be solved.
 Ethics is concerned with standards judging
whether actions are right or wrong.
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• ETHICS is defined as “the science of the ideal
human character and behaviour in
situations where distinction must be made
between right and wrong, duty must be
followed and good interpersonal relations
maintained”
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• The major principles are:
1. To do no harm (non- Maleficence)
2. To do good (Beneficence)
3. Respect for persons
4. Justice
5. Truthfulness (Veracity)
6. Confidentiality
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To Do No Harm
• Foundation of social morality.
• Overhanging restorations that cause periodontal diseases or
failure to sterilize instruments that can cause an infection.
• Incases where pain cannot be avoided , attempts should be
made to minimize it.
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To Do GOOD
• Benefit patient not to inflict harm.
• Weigh the consequences of treatment vs no treatment.(eg
questionable caries).
• Maximize the benefits and minimize harm.
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Respect for persons
• Autonomy
• Respect patient’s right to make decisions concerning the
treatment plan.
• Discuss advantages as well as disadvantages of a treatment
option.
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• Informed Consent
• Nuremberg Code
• Four attributes.
• Voluntary .
• Legally competent.
• Informed.
• Comprehending.
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Justice
• Service irrespective of Class, Creed, gender etc.
• Calls for obligation to protect the weak and ensure equity &
benefits .
• Each person be treated equally.
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Truthfulness (Veracity)
• Trust.
• Lying shows disrespect to the patient and threatens the
relationship.
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Confidentiality
• Communications & records should be kept confidential.
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History
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INTERNATIONAL DECLARATIONS
Nuremberg Code of 1947
Declaration of Helsinki 1964

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THE NUREMBERG CODE(1947)
• Set of research ethical principles for human
experimentation as a result of Nuremberg Trials
at the end of Second World War.
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DURING WORLD WAR II (1939-
1945)
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NAZI EXPERIMENTS – WW-II
[Concentration camps( Dacau, Auschtwitz,
Buchenwald & Sachsenhausen)]
Decompression chambers
freezing
experiments
gunshot wounds transplanted bones
ante-mortem dissection
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THE INTERNATIONAL MILITARY
TRIBUNAL IN NUREMBERG 1947
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NAZI DOCTORS’ TRIAL
• 23 Nazi physicians were charged
with War Crimes and Crimes against
Humanity.
• 16 defendants were convicted
• 7 were sentenced to death.
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THE NUREMBERG CODE
• Nuremberg Trial revealed evidence
of sadistic human experiments.
• The judgment included a set of
standards known as the
Nuremberg Code, an ethical
yardstick.
• First internationally recognized
code of research ethics.
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1. Voluntary informed consent .
2. Experiment should be such as to yield fruitful results for
the good of society.
3. The experiment should be so designed and based on the
results of animal experimentation and a knowledge of
natural history of the disease.
4. Unnecessary physical and mental suffering and injury
should be avoided.
5. No experiment should be conducted where there is prior
reason to believe that death or disabling injury will
occur.
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6. Degree of risk to the participants should never
exceed the “humanitarian importance of the
problem” and should be minimized through “proper
preparations”
7. Adequate facilities provided to protect the
experimental subject against even remote
possibilities.
8. Experiment should be conducted only by
scientifically qualified persons.
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9. The participants - always be at liberty to
withdraw from the experiments.
10. During the course of experiment the scientist in
charge must be prepared to terminate experiment at
any stage, if it is likely to result in injury, disability
or death.
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PURPOSE: It served as a blueprint for today’s
principles that ensure the rights of subjects in
medical research.
• The Nuremberg code has no legal force behind it.
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DECLARATION OF GENEVA
• Adopted by 2nd
General Assembly of the World Medical
Association, Geneva, Switzerland, September 1948.
• This oath seems to be a response to the atrocities committed
by doctors in Nazi Germany.
• Requires the physician to “not use (his) medical knowledge
contrary to the laws of humanity”.
• Adopted only three months before the United Nations
General Assembly adopted the Universal Declaration of
Human Rights (1948) which provides for the security of the
person.
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DECLARATION OF HELSINKI (1964)
• The World Medical Association (WMA) has
developed the Declaration of Helsinki as a statement
of ethical principles for medical research involving
human subjects.
• Declaration is addressed primarily to physicians, the
WMA encourages other participants in medical
research involving human subjects to adopt these
principles.
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• World Medical Association in 1964, adopted by
the 18th
World Medical Assembly , Helsinki,
Finland, June 1964, amended 9 times, latest at the
64th WMA General Assembly, Fortaleza, Brazil,
October 2013.
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• Helsinki codes-
• Biomedical research should follow scientific principles
and should be based on adequately performed laboratory
and animal experimentation
• The design of each experimental procedure involving
human subjects should be clearly formulated in an
experimental protocol to be reviewed by an independent
committee
• The experiment should be conducted by scientifically
qualified person(s) and under the supervision of clinically
competent medical experts
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• Biomedical research involving human subjects cannot
legitimately be carried out unless the importance of the
objectives can justify the inherent risk to the subject.
• Every biomedical research project involving human
subjects should be preceded by careful assessment of
predictable risks in comparison with foreseeable benefits
to the subject or others.
• The right of the research subject to safeguard his or her
integrity must always be respected. Every precaution
should be taken to respect the privacy of the subject.
• The accuracy of research results must be preserved
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• In any research on human beings, each potential subject
must be adequately informed of the aim, methods,
anticipated benefits and potential hazards of the study
• When obtaining informed consent for a research project,
no pressure or threat should be exercised.
• In case of legal incompetence, informed consent should be
obtained from the legal guardian in accordance with
national legislation.
• Subjects should be informed that they are free to abstain or
to withdraw from participation at any time
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• Indian Council of Medical Research introduced
Ethical Guidelines for Research on Human
Participants.
2000- ICMR guidelines
2006- Revised ICMR guidelines
Available at: http://www.icmr.nic.in
THE INDIAN PERSPECTIVE
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• The Indian Council of Medical Research the apex body
in India for the formulation, coordination and promotion
of biomedical research.
• The ICMR is funded by the Government of India through
the Department of Health Research,
Ministry of Health and Family Welfare
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• Several other national guidelines available :
Genome Policy and Genetic Research [2000],
Indian GCP [2001],
Amendment of Drugs and Cosmetics Act [2002],
Assisted Reproductive Technology [2005],
Stem Cell Research and Bio-­banking [2006]
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THANK
YOU
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