Navigating ethical dilemmas as a new dentist

         Is it ethical to date a patient?

What are the ethical implications of using social coupons to expand my patient base?

What should I do when I suspect a patient may be abusing prescription drugs?

Are you caught between a rock and a hard place?

“There are always things that come up that make us do a gut check,” said Dr. Lindsay M. Compton, member of the ADA New Dentist Committee and its new dentist member to the Council on Ethics Bylaws and Judicial Affairs, or CEBJA. “Especially as new dentists, we’re still trying to figure things out.”

In the early years after dental school, Dr. Compton said she shadowed in several offices that she respected and admired.

“However, I could tell that employment wasn’t always based on skill and marketing tactics were more prioritized than patient care,” she said.

Although ADA resources are not replacements for legal resources and legal advice, they offer member dentists, especially new dentists, a service to help navigate and resolve ethical dilemmas.

These services include the ADA Ethics Hotline (1-800-621-8099), which is designed to assist dentists in managing ethical challenges that may arise in day-to-day practice.

A joint venture with the New Dentist Committee and CEBJA, the hotline launched in February 2013 and is available to member dentists. Members with ethics related questions are matched with a CEBJA member who will provide consultation regarding the ethical issue being raised, while using the ADA Principles of Ethics and Code of Professional Conduct as a guide.

“I will say that the number one reason to use the hotline is that it’s anonymous,” Dr. Compton said. “As new dentists, we think that if we ask a question out loud, will we sound stupid? We feel everyone knows the answer but us. But sometimes, we just need to talk to somebody about it. That’s what makes the hotline a great resource.”

In 2017, a hotline caller raised an issue with Section 4.A. of the ADA Code of Ethics, stating that it didn’t seem broad enough to cover a patient’s gender identity and sexual orientation.

Previously, Section 4.A. of the code, which deals with patient selection, provided guidance to dentists to “not refuse to accept patients into their practice or deny dental service to patients because of the patient’s race, creed, color, sex or national origin.”

Because of this caller, along with additional research and analysis, CEBJA proposed a resolution to the ADA House of Delegates to replace “sex” with “gender, sexual orientation and gender identity.” The ADA Board of Trustees voted unanimously to approve Resolution 6. It later passed in the ADA House of Delegates meeting in Atlanta.

In addition to the hotline, CEBJA contributes a series of articles discussing ethical dilemmas confronted in the practice of dentistry to the Journal of the American Dental Association. The articles are vignettes on ethics-based situation and the appropriate manner to resolve them using the code of ethics.

Ethical dilemmas covered this year include: How to ethically handle a patient who insists on making treatment decisions based on incomplete, inaccurate or wrong information; should I be calling in sick?; and the ethics of using live patients for licensing board examinations.

“Many of these scenarios are very topical for new dentists,” Dr. Compton said. “We encounter ethical dilemmas every single day. We’re always giving patients options, weighing risks and rewards and ensuring we’re doing no harm. It never hurts to ask. Having health conversations about ethics and ethical dilemmas are always better than making assumptions.”

To read JADA ethical moment articles, visit ADA.org and search “JADA Ethical Moments.” To contact the ADA Ethics Hotline, call 1-800-621-8099. In addition, the ADA Success program offers a module on Leadership and Ethics in Dentistry, which is available for free to dental schools and residencies, as well as other venues if it is of interest. Sign up at ADA.org/successprograms.