a short presentation on Ethics in orthodontia/ ethics in dentistry by Dr. Akhter Gul Govt Dental college & Hospital Srinagar J&K

1. 1
Presented by :
Dr Akhter Gul
Ethics
in orthodontics
Govt Dental College
& Hospital Srinagar

2. CONTENTS
 Introduction.
 Philosophy of Ethics.
 Objectives of Ethics.
 The ethical principles
 Codes of Ethics.
 Ethical vs. Legal.
 Orthodontic-patient relationship
 International Ethical Principles : FDI
 Ethical Reasoning in Decision- making.
 Conclusion.
 Bibliography.
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3. INTRODUCTION
Orthodontist;Orthodontist;
…… the king of beautiful smiles……..
Ethics: Greek word : Ethos : Custom or Character.
‘Ethics’ 1
: It is a branch of philosophy that deals with moral conduct a
judgment. It evaluates human activities in terms of goodness and
obligation;and whether the actions are right or wrong.
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4. PHILOSOPHY OF ETHICS
‘Ethics’ evaluate human activities in terms of
good or bad .
Professional ethics contain an expected standard of behavior that
involves moral duties and obligations of the orthodontist towards
his patients, professional colleagues and to the society.
They protect the weak; and promote equality of human beings.
They focus on individual’s rights and duties.
Regulate moral conduct and judgment in the profession.
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5. OBJECTIVES
 They guide orthodontists about the legal processes
that enable them to work efficently.
 They enable orthodontist to differentiate between
ethical and legal concepts that are important for their
clinical decision making and practice.
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6. The ethical Principles
TYPES1
Micro- ethical Principles Macro- ethical
Principles
Ethical principles focus mainly It includes a set of
principles
on individual’s rights and duties. that protect human
dignity,
integrity, self-
determination,
They establish positive moral confidentiality, rights
and
responsibilities of persons, and health of population .
authorities who supervise researches
on people treatment needs. 6

7. CODES OF ETHICS 2
Significance of Codes:
As stated by Indian Dental Association, 1988:
A systematic body of rules is needed - “ in order that dignity and
honor of the Profession may be upheld, its standard exalted,
its sphere of usefulness and the advancement of dental
science promoted and that of members of the dental
association may understand clearly their duties and
obligations to the profession, to their patients, and to the
community at large.”
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8. orthodontist as a profession:
0rthodontist is treated as a king of smiles…..
A professional person has acquired special knowledge
by
training or experience so that he may advice or serve
others
in that special field.
He should :
Be efficient in his field.
Provide services to other people.
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9. ETHICAL Vs LEGAL 4
Mis-conceptions sometimes occur whether a problem
is
ethical or illegal in nature.
‘Legal’ : The goals of law shows values of society
and profession so that the most satisfactory treatment is provided.
‘Ethics’ : They are the norms that dictate morality in the profession.
But attitude towards the health care is changing within the society.
Instead of law as a guide for providing treatment, which is in
interest of patients.
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10. DUTIES
OF
Orthodontist
TOWARDS
PATIENTS6
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11. Duties of a orthodontist towards his patient1
:
 Reasonable care of the patient as per available services.
 Be properly licensed and registered, and fulfill all the legal
requirements .
 Employ skillful staff and supervise them regularly.
 Updated in recent advances and current knowledge in the
profession.
 Use treatment methods that are acceptable to current trends.
 Not to do experiments on patients.
 Obtain consent from the patient before starting a case.
 Not to dis-respect the patient.
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12.  Not to exploit the patient.
 Not to indulge in un-lawful acts.
 Keep the patient informed of his or her progress..
 Complete the care on time.
 Keep the records of treatments carried out on patient.
Maintain confidentiality of patient information.
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13. He should follow home care instructions .
He should maintain appointments .
He should tell orthodontist about the improvement or any
problem during the treatment.
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Duties owed by the patients towards his
ORTHODONTIST 1
:

14. INTERNATIONAL ETHICAL PRINCIPLES (FDI) 2
Whenever there is professional dilemma, ethical reasoning takes
the stand for decision making.
The major principles are:
To do no harm ( non- maleficence ).
To do good ( beneficence).
Respect for others.
Justice.
Veracity or truthfulness.
Confidentiality.
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15. Duties and Obligations :
i.) Towards Patient:
a.) To do no harm : Non- maleficence:
It is the foundation of social morality.
It is the duty of orthodontist to work carefully so that there is no
harm to the patient i.e. ‘Iatrogenicity’ is avoided.
b.) To do good or Beneficence:
It is the duty of orthodontist to benefit the patient and do no harm.
There should be no compromise in the treatment procedures due
to any reason .
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16. c.) Autonomy:
ItIt is the principle that respects patient’s right to
make decisions regarding the treatment plan.
Patients should be well informed about the benefits as well as
harms of the treatment they will undergo. Hence, they are able
to make right decisions.
There should be no paternalism i.e. any information should not be
hidden and no pressure on the patient to undergo any particular
treatment.
Hence, desires and needs of the patient are important than those of
the investigator.
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17. d.) Justice:
It means fairness or equal treatment to all.
It calls for protection to weak and Equality in rights
and
benefits.
It may be impractical to serve every one in need but as far as
possible, there should be an even distribution of services .
orthodontist should participate in screening procedures to make
ethical decisions to serve weaker sections efficiently and
effectively , by carrying out Local or Statewide programs.
A Jewish Oath puts whole as :
“ Preserve the strength of my body and soul that they ever be
ready to cheerfully help and support rich and poor, good and
bad, enemy
as well as friend. In the sufferer , let me see only the human
being.”
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18. e.) Truthfulness or Veracity:
The patient - doctor relationship is based on trust.
Lying shows dis-respect to the patient and their
autonomy,
violates clear agreements,
threatens the relationship based on trust.
Ultimately, it will be the orthodontist found guilty of violating
a major ethical principle.
“ THOUGH OUTDATED……
HONESTY IS STILL THE BEST POLICY……….!!! ”
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19. f.) Confidentiality:
It is the principle that holds its position in
International
Codes; and includes the Principles laid by various
Associations like ADA, IMA etc.
In order to undergo certain treatment, patient may require to
disclose his personal secrets to his orthodontist.
These records must be kept confidential. Without patient’s
consent, this information should not be passed on to anyone
except
in accordance with Court of Law, or
if , patient changes the dentist; or
where disclosure is necessary to
prevent danger to others.
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20. ii.) Towards Profession/ Professional colleagues:
Treatment and cure of the disease depends on the skill
and
quick attention of othodontist to his patient.
he should be sober, courteous, sympathetic, helpful, modest and
punctual.
He should be morally, mentally and physically clean; and should be
updated in professional knowledge and skills.
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21. An orthodontist should stick to certain ethics :
 Should not accept any commissions.
If planned treatment is beyond his skill, the patient should be
referred to a consultant.
In case of emergency, some temporary service should be
provided to the patient,example obturator
If consulted, an orthodontist should not accept charge of case
without request from the referring dentist.
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22.  Patient Autonomy:
A patient has full right to make choice for his
treatment.
Hence, no information should be hidden and there
should
be no pressure on patient .
Preferred practice values:
An orthodontist should be more concerned about esthetic pain –
free and efficient oral functions; and longevity of the treatment ,
non relapse .
In case, a patient chooses the treatment plan which is not favored
by the orthodontist ; the concept of ‘Preferred Practice Values’
suggests that the he should compromise as per patient’s will,
example removable appliances.
Esthetic Values:
Factors like pain-free and normal oral functioning are more
important than esthetics.
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23.  External Factors:
Occasionally, 0rthodontist’s decision depends upon
certain
factors not related to dentistry.
They may be:
social and cultural influences,
public welfare,
factors of social justice and also,
his own personal responsibilities.
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24. ETHICAL REASONING IN DECISION MAKING 2
Ethics give insight into different ways of looking at
issues.
Harron et al have given a model of ethics for decision making:
Analyzing: Divide a problem into possible alternatives.
Weighing: Assess the strengths and weaknesses of alternatives.
Justify: Provide a strong and sufficient moral reason to support
the decision.
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25.  Choosing: Select one or more alternatives for
justification.
 Evaluating: Re- examine the choices and their
justifications based on other moral cases.
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26. CONCLUSION
Although orthodontist have well recognized legal , professional
and ethical responsibilities, their role and
responsibilities increase as demands from dentistry increase.
Hence, being orthodontist, efforts must be made to provide best
possible treatment modalities to the patient while maintaining
the status of profession and associated public trust.
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27. BIBLIOGRAPHY
1. Soben Peter-Essentials of Preventive and Community
Dentistry, Arya Publishers, 2004, 2nd
edn. – 693-704.
2. George M. Gluck- Jong’s Book of Community Dentistry
Health , Mosby Publications, 2003, 5th
edn, 425 – 488.
3. A.N. Radhakrishnan – Preventive and Social Dentistry made
Easy, Ganjana Publishers, 2000, 3rd
edn. , 376 – 389.
4. Ozar D T, Schiedremayer D L, Siegler M. ; Values in
Clinical Dental Ethics. J. Am. Dent. Assoc. 1988;
116: 365-368.
5. www.imagesgoogle.com
6. www.toon.com 27

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Thank You…
Presented by:
Dr.Akhter Gul
Govt Dental College & Hospital Srinagar