Discouraging remarks about other dentists

Ethics Discouraging remarks about other dentists Background.—Is it ethical for a dentist to refuse a patient’s request for records? Suppose the dentist in question bases the refusal on a personal belief that the patient is making a mistake by seeking an opinion from a dentist whose methods differ from his own—and then tells the patient the dentist he or she wishes to consult engages in dangerous practices, implying the dentist is not a careful practitioner. Is that unethical? These questions were considered in light of the values expressed in the American Dental Association Principles of Ethics and Code of Professional Conduct (the Code). Refusal to Send Records.—The Code requires dentists to forward any radiographs and treatment records at the request of either the patient or another dentist, obeying applicable laws. There may be a charge for the records, or they may be provided gratuitously. Records should be disbursed even if the patient’s account is not paid in full. Providing such copies as requested is in the best interest of the patient and supports the ethical principle of autonomy. Not providing them is unethical. Reason for the Refusal.—Dentists are required under the Code to have traits of character that foster adherence to ethical principles. This includes honesty in all interactions with patients. The dentist must also treat the patient according to the patient’s desires, within the limits of accepted practices. These principles mean the dentist should offer a balanced explanation of his or her concerns to the patient. In addition, the various treatment options should be presented honestly, whether or not the dentist agrees with all of them. Professional Behavior.—Dentists tend to prefer particular treatments over others, but if the evidence supports both options, then they should not criticize practitioners who choose other options. In addition, dental practitioners must be careful not to criticize other dentists or to treat

another practitioner unfairly. Making disparaging remarks about another practitioner or a previous treatment is unethical behavior. Course of Action.—In the situations presented, the dentist whose methods are being disparaged should personally discuss the issue with the offending dentist. The communication should be frank and focused on each practitioner respecting the other. If this approach does not produce a satisfactory result, the local dental society’s ethics review panel may be contacted.

Clinical Significance.—Dentists are obligated to truthfully and honestly provide patients with the available treatment options and the evidence to support or not support each one. If patients choose an option the dentist does not care for or takes another course of action, such as seeking a consultation with another dentist, the dentist can express his or her disagreement but act to facilitate the desires of the patient. Dentists are ethically obligated to provide records upon request to patients or other dentists, within legal boundaries. They are also ethically obligated to refrain from making disparaging remarks about other practitioners.

Himmelberger LK: Justifiable criticism and dental amalgam. J Am Dent Assoc 146:646-647, 2015 Reprints available from the American Dental Association, Council on Ethics, Bylaws and Judicial Affairs, 211 E Chicago Ave, Chicago, IL 60611

HIPAA Patient information confidentiality rights Background.—Patients must be informed of their rights as set forth in the federal Health Insurance Portability and Accountability Act (HIPAA), which covers the disposition of protected health information (PHI). Notice of Privacy Practices forms are distributed to patients in both medical

and dental offices. The actions dental offices can or must take were reviewed. Limiting PHI Disclosure.—Patients have the right to request that a covered entity limit the use or disclosure of

Volume 61



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2016

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