- Email: [email protected]
Setting and keeping boundaries
concerning treatment outcomes and the influence of praise for replanting the tooth. When the decision is made, the dentist must perform the procedure with the best technical expertise according to the best evidence available. Discussion.—Whether to replant is an area not well supported by the available literature. Faced with the situation, parents and children must be given the best and most accurate information possible concerning the likely outcomes of injury management. Based on this information and their understanding of the child’s specific risk factors, it is their informed decision to make. Dentists should remain critical and active consumers of dental literature to stay current with practice findings and be able to provide the needed support for the parents’ decision-making process.
Clinical Significance.—Much has been written about replanting avulsed teeth, and much confusion still exists. Considering the guarded prognosis, potential expense and viable alternatives, patients and parents should be appropriately advised before pursuing this option.
Kenny DH, Casas MJ: Medicolegal aspects of replanting permanent teeth. J Can Dent Assoc 71:245-248, 2005 Reprints available from DJ Kenny, Dept of Dentistry, The Hosp for Sick Children, 555 Univ Ave, Toronto, ON M5G 1X8; e-mail: dkenny @sickkids.ca
Setting and keeping boundaries Background.—Boundaries and ethics are both terms that can be used to define an individual physically, mentally, emotionally, and spiritually. A boundary refers to a method for simplifying life, whereas ethics refers to responsibilities. Dentists choose internal boundaries in line with personal and professional ethical beliefs. These choices influence the perceptions of others concerning the dentist personally, the physical and emotional atmosphere of the dental office, and how services are provided. Interactions.—Patients bring needs and desires into the dental practice with the hope of satisfying them. Some needs and desires fall into the realm of the dentist’s ethical duty to satisfy them immediately, such as an emergency related to a broken tooth. Some nonemergency situations also can be addressed quickly. However, complex situations involving the clinical presentation and/or the patient may require time for reflection and the exploration of options. Patients must understand this principle and respond accordingly. Challenges.—Patients can challenge dentists’ boundaries and thus their ethics. Surrendering to the patient by abandoning commitments to a personal ethical system and adherence to boundaries is not an appropriate choice. Both the dentist and patient are more likely to benefit if the dentist adheres to ethical positions and boundaries based on personal and professional beliefs. Sometimes a treat-
10 Dental Abstracts
ment may not be wrong in itself, but its timing may be off. If a patient insists on treatments out of sequence and the dentist acquiesces, both may be dissatisfied with the process and ultimately with the result. Discussion.—Complex cases require a combination of time, exploration, and reflection to ensure that the proper choice of treatment is made. The dentist has the ethical privilege and responsibility to set boundaries that define his or her personal practice. These boundaries should be actively enforced without the influence of undue pressures from patients. Technically and ethically, sound treatment comes from setting and sticking by your principles.
Clinical Significance.—Our goal should be to serve the best interests of our patients. That goal is in everyone’s best interests. Sometimes patients request procedures that are out of sequence, or not appropriate. We are ethically bound to provide only treatment we know will do no harm.
Nicols PS, Winslow G: Time and boundaries. Gen Dent 53:102, 2005 Reprints available from D Bushore: phone: 866-879-9144, ext 156; e-mail: [email protected]
Clinical Significance.—Much has been written about replanting avulsed teeth, and much confusion still exists. Considering the guarded prognosis, potential expense and viable alternatives, patients and parents should be appropriately advised before pursuing this option.
Kenny DH, Casas MJ: Medicolegal aspects of replanting permanent teeth. J Can Dent Assoc 71:245-248, 2005 Reprints available from DJ Kenny, Dept of Dentistry, The Hosp for Sick Children, 555 Univ Ave, Toronto, ON M5G 1X8; e-mail: dkenny @sickkids.ca
Setting and keeping boundaries Background.—Boundaries and ethics are both terms that can be used to define an individual physically, mentally, emotionally, and spiritually. A boundary refers to a method for simplifying life, whereas ethics refers to responsibilities. Dentists choose internal boundaries in line with personal and professional ethical beliefs. These choices influence the perceptions of others concerning the dentist personally, the physical and emotional atmosphere of the dental office, and how services are provided. Interactions.—Patients bring needs and desires into the dental practice with the hope of satisfying them. Some needs and desires fall into the realm of the dentist’s ethical duty to satisfy them immediately, such as an emergency related to a broken tooth. Some nonemergency situations also can be addressed quickly. However, complex situations involving the clinical presentation and/or the patient may require time for reflection and the exploration of options. Patients must understand this principle and respond accordingly. Challenges.—Patients can challenge dentists’ boundaries and thus their ethics. Surrendering to the patient by abandoning commitments to a personal ethical system and adherence to boundaries is not an appropriate choice. Both the dentist and patient are more likely to benefit if the dentist adheres to ethical positions and boundaries based on personal and professional beliefs. Sometimes a treat-
10 Dental Abstracts
ment may not be wrong in itself, but its timing may be off. If a patient insists on treatments out of sequence and the dentist acquiesces, both may be dissatisfied with the process and ultimately with the result. Discussion.—Complex cases require a combination of time, exploration, and reflection to ensure that the proper choice of treatment is made. The dentist has the ethical privilege and responsibility to set boundaries that define his or her personal practice. These boundaries should be actively enforced without the influence of undue pressures from patients. Technically and ethically, sound treatment comes from setting and sticking by your principles.
Clinical Significance.—Our goal should be to serve the best interests of our patients. That goal is in everyone’s best interests. Sometimes patients request procedures that are out of sequence, or not appropriate. We are ethically bound to provide only treatment we know will do no harm.
Nicols PS, Winslow G: Time and boundaries. Gen Dent 53:102, 2005 Reprints available from D Bushore: phone: 866-879-9144, ext 156; e-mail: [email protected]