Ethics Case Studies
1. Get help from either the dentist or the dental hygienist who trained you.
Overusing employer resources and showing independence is almost certainly
not intended to apply to this situation. In fact, your employer will probably want
you to consult with someone on this issue. If you explained your role properly
to the client at the beginning, you almost certainly have actual or at least
implied consent to discuss difficult issues with your colleagues: Scenario 1-1
"Stretching the Limits of Competence" You have worked in a restorative office for 18
years. The dentist has retired and the office has closed. After a long search, you have
been hired by a dentist working in orthodontics. You have not done any orthodontics
since school. You have been trained by another dental hygienist in the office. Your
probationary period is coming to a close and your employing dentist has indicated
that you will be getting your own caseload now. You get the sense that the dentist
is getting tired of "holding your hand" and is concerned that you are taking up too
much of the other dental hygienist's time. On the first day by yourself you see a client
on a follow-up visit who complains that the appliance is causing constant pain. Your
assessment does not reveal any. obvious tissue injury but you wonder about the
possibility of internal trauma. What should you do?
2. see questions: Scenario 1-2You work in a large and very busy office. Dental
assistant, Julia, who you consider a friend, is responsible for sterilizing instruments.
You noticed a failed 'spore test' report lying on counter you asked Julia about what
dentist had said about it. Julia looked embarrassed and said it was a blip and not
to mention it to dentist (who has been a little hard on Julia). Since then you have
noticed small signs of Julia's disorganization in sterilization area (e.g., supply of
sterilized instruments always seems to be low, colour strip hasn't always changed,
and sterilizer appears overloaded). You have tried to help out a bit, little seems to
be changing. You have hesitated speaking w/ Julia. At a staff meeting on Julia's day
off, dentist asks for feedback for a performance review for Julia and says "Well she
seems to be doing OK on sterilization of instruments because we never seem to run
out."
3. best answer is (a). This scenario is a classic case of competing obligations.
However, when all is said and done, the ultimate "clients" of your services
are the patients you and your colleagues serve. It is for their benefit that
your expertise is sought: In Scenario 1-2 "Sterilization Backlog", to whom are you
primarily accountable?
a. The clients.
b. The dentist.
c. Julia.
d. Equally to the clients, the dentist and Julia
, Ethics Case Studies
4. your role would be to advocate for the client's right to make a fully informed
choice of treatment, but not to control the final decision that is made.: You have
a follow up dental hygiene visit with a client on social assistance. She tells you that
yesterday the dentist said that a tooth with an infected, painful root has to come out.
Welfare only covers an extraction and not a root canal. This will result in the client
having three missing molars on this, the most dentate side of her. mouth. You learn
that the root canal option was not discussed. The client says to you, "I really hate to
lose this tooth, now I won't be able to chew on either side of my mouth." You know
from past conversations with the dentist that she, and the endodontist she refers
clients to, have been burned quite a few times by clients who promise to pay over
time. What do you do?
5. d. All of the above: Which of the following best describes the differences between
a Code of Ethics and a professional misconduct regulation:
a. Should Not vs. Must Not.
b. Goals vs. Bare Minimum.
c. Ideals vs. Law.
d. All of the above
6. best answer is (b). You might also explain that the dental assistant should
only be reading the chart if s/he has a professional reason for doing so.
Access to your records is on a need-to-know basis and those who read them
are bound by confidentiality: A client asks you not to record anything about her
HIV positive status because the client's friend works as a dental assistant at your
workplace and has access to the records. The dental assistant works primarily with
supplies and chair-side assistance to. dentists and is unlikely to have professional
contact with your client during your course of treatment. Should you:
a. Tell the client that anything s/he says will be recorded because of your duty of
honesty.
b. Tell the client that only relevant information will be recorded. This diagnosis is
relevant and needs to be recorded.
c. Tell the client that this diagnosis is relevant and needs to be recorded, but you will
keep it separate from the chart.
d. Say nothing but record the information
7. best answer is (a). This question raises issues related to both competency
and honesty. The starting point is to ensure that the client knows his options
and can make an informed choice. Even if you strongly believe that the client
needs two hours of services, the client has the final choice as to what services
he will receive. This option also involves a willingness to advocate on behalf
of the client: A client is on social assistance. It will only cover half an hour of dental
hygiene services. The client needs at least two hours of dental hygiene services to
1. Get help from either the dentist or the dental hygienist who trained you.
Overusing employer resources and showing independence is almost certainly
not intended to apply to this situation. In fact, your employer will probably want
you to consult with someone on this issue. If you explained your role properly
to the client at the beginning, you almost certainly have actual or at least
implied consent to discuss difficult issues with your colleagues: Scenario 1-1
"Stretching the Limits of Competence" You have worked in a restorative office for 18
years. The dentist has retired and the office has closed. After a long search, you have
been hired by a dentist working in orthodontics. You have not done any orthodontics
since school. You have been trained by another dental hygienist in the office. Your
probationary period is coming to a close and your employing dentist has indicated
that you will be getting your own caseload now. You get the sense that the dentist
is getting tired of "holding your hand" and is concerned that you are taking up too
much of the other dental hygienist's time. On the first day by yourself you see a client
on a follow-up visit who complains that the appliance is causing constant pain. Your
assessment does not reveal any. obvious tissue injury but you wonder about the
possibility of internal trauma. What should you do?
2. see questions: Scenario 1-2You work in a large and very busy office. Dental
assistant, Julia, who you consider a friend, is responsible for sterilizing instruments.
You noticed a failed 'spore test' report lying on counter you asked Julia about what
dentist had said about it. Julia looked embarrassed and said it was a blip and not
to mention it to dentist (who has been a little hard on Julia). Since then you have
noticed small signs of Julia's disorganization in sterilization area (e.g., supply of
sterilized instruments always seems to be low, colour strip hasn't always changed,
and sterilizer appears overloaded). You have tried to help out a bit, little seems to
be changing. You have hesitated speaking w/ Julia. At a staff meeting on Julia's day
off, dentist asks for feedback for a performance review for Julia and says "Well she
seems to be doing OK on sterilization of instruments because we never seem to run
out."
3. best answer is (a). This scenario is a classic case of competing obligations.
However, when all is said and done, the ultimate "clients" of your services
are the patients you and your colleagues serve. It is for their benefit that
your expertise is sought: In Scenario 1-2 "Sterilization Backlog", to whom are you
primarily accountable?
a. The clients.
b. The dentist.
c. Julia.
d. Equally to the clients, the dentist and Julia
, Ethics Case Studies
4. your role would be to advocate for the client's right to make a fully informed
choice of treatment, but not to control the final decision that is made.: You have
a follow up dental hygiene visit with a client on social assistance. She tells you that
yesterday the dentist said that a tooth with an infected, painful root has to come out.
Welfare only covers an extraction and not a root canal. This will result in the client
having three missing molars on this, the most dentate side of her. mouth. You learn
that the root canal option was not discussed. The client says to you, "I really hate to
lose this tooth, now I won't be able to chew on either side of my mouth." You know
from past conversations with the dentist that she, and the endodontist she refers
clients to, have been burned quite a few times by clients who promise to pay over
time. What do you do?
5. d. All of the above: Which of the following best describes the differences between
a Code of Ethics and a professional misconduct regulation:
a. Should Not vs. Must Not.
b. Goals vs. Bare Minimum.
c. Ideals vs. Law.
d. All of the above
6. best answer is (b). You might also explain that the dental assistant should
only be reading the chart if s/he has a professional reason for doing so.
Access to your records is on a need-to-know basis and those who read them
are bound by confidentiality: A client asks you not to record anything about her
HIV positive status because the client's friend works as a dental assistant at your
workplace and has access to the records. The dental assistant works primarily with
supplies and chair-side assistance to. dentists and is unlikely to have professional
contact with your client during your course of treatment. Should you:
a. Tell the client that anything s/he says will be recorded because of your duty of
honesty.
b. Tell the client that only relevant information will be recorded. This diagnosis is
relevant and needs to be recorded.
c. Tell the client that this diagnosis is relevant and needs to be recorded, but you will
keep it separate from the chart.
d. Say nothing but record the information
7. best answer is (a). This question raises issues related to both competency
and honesty. The starting point is to ensure that the client knows his options
and can make an informed choice. Even if you strongly believe that the client
needs two hours of services, the client has the final choice as to what services
he will receive. This option also involves a willingness to advocate on behalf
of the client: A client is on social assistance. It will only cover half an hour of dental
hygiene services. The client needs at least two hours of dental hygiene services to
