of Ethics Online Collection: None
PRINCIPLES OF ETHICS
The practice of dentistry first achieved the stature of a profession in the United States where, through the heritage bestowed by the efforts of many generations of dentists, it acquired the three unfailing characteristics of a profession; education beyond the usual level, the primary duty of service to the public and the right to self-government.
The maintenance and enrichment of this heritage of professional status place on everyone who practices dentistry an obligation which should be willingly accepted and willingly fulfilled. This obligation cannot be reduced to a changeless series of urgings and prohibitions for, while the basic obligation is constant, its fulfillment may vary with the changing needs of a society composed of the human beings that a profession is dedicated to serve. The spirit and not the letter of the obligation, therefore, must be the guide of conduct for the professional man, in its essence, this obligation has been summarized for all time and for all men in the golden rule which asks only that "whatsoever ye would that men should do to you, do ye even so to them."
The following statements Constitute the, Principle of Ethics of the American Dental Association. The constituent and component societies are urged to adopt additional provisions or interpretations in conflict with these Principle of Ethics which world enable them to serve more faithfully the traditions, customs and desires of the members of these societies.
REVISED OCTOBER, 1978
Section 1
Education Beyond the Usual Level. The right of a dentist to professional status rests in the knowledge, skill and experience With which he serves his patients and society. Every dentist has the obligation of keeping his knowledge and freshened by continuing education through all of his professional life.
Section 2
Service to the Public and Quality of Care. The dentist's primary obligation of service to the public shall include the delivery of quality care, competently and timely, within the bounds of the clinical circumstances presented by the patient. In his service to the public, the dentist shall conduct himself in such a manner as to maintain or elevate the esteem of the profession. Quality of care shall be a primary consideration of the dental practitioner.
In serving the public, a dentist may exercise reasonable discretion in selecting patients for his practice. However, a dentist may not refuse to accept a patient into his practice or deny dental service to a patient because of the patient's race, creed, color or national origin.
The dentist shall maintain patient records in a manner consistent with the protection of the welfare of the patient. Upon request of a patient or another dental practitioner, a dentist should provide any information that will be beneficial for the future treatment of the patient.
Section 3
Government of a Profession. Every profession receives from society the right to regulate itself, to determine and judge its own members. Such regulation is achieved largely through the influence of the professional societies, and every dentist has the dual obligation of making himself a part of a professional society and of observing its rules of ethics.
Section 4
Leadership. The dentist has the obligation of providing freely of his skills, knowledge and experience to society in those fields in which his qualifications entitle him to speak with professional competence. The dentist should be a leader in his community, including all efforts leading to the improvement of the dental health of the public.
Section 5
Emergency Service. The dentist has an obligation when consulted in an emergency by the patient of another dentist to attend to the conditions leading to the emergency and to refer the patient to his regular dentist who should be informed of the conditions found and treated.
Section 6
Use of Auxiliary Personnel. The dentist has an obligation to protect the health of his patient by not delegating to a person less qualified any service or operation which requires the professional competence of a dentist. The dentist has a further obligation of prescribing and supervising the work of all auxiliary personnel in the interests of rendering the best service to the patient.
Section 7
Consultation. The dentist has the obligation of seeking consultation whenever the welfare of the patient will be safeguarded or advanced by having recourse to those who have special skills, knowledge and experience. A consultant will hold the details of a consultation in confidence and will not undertake treatment without the consent of the attending practitioner.
In addition, when a patient visits or is referred to a specialist or consulting dentist for consultation:
1. It is the obligation of the specialist or consulting dentist, under ordinary circumstances, to observe the patient's post treatment condition and to then return the patient to the referring dentist for future care.
2. It is the obligation of the specialist when there is no referring dentist to refer the patient for general dental care when appropriate.
Section 8
Justifiable Criticism and Expert Testimony. The dentist has an obligation to report to the appropriate agency of his component or constituent dental society instances of gross and continual faulty treatment by another dentist. If there is evidence of faulty treatment, the welfare of the patient demands that corrective treatment instituted. The dentist may provide expert testimony when that testimony is essential to a just and fair disposition of a judicial or administrative action. A dentist has the obligation to refrain from commenting disparagingly, without justification, about the services of another dentist.
Section 9
Rebates and Split Fees. The dentist may not accept or tender "rebates" or "split fees." Section 10
Secret Agents and Exclusive Methods. The dentist has an obligation not to prescribe, dispense or promote the use of drugs or other agents whose complete formulae are not available to the dental profession. He also has the obligation not to prescribe or dispense, except for limited investigative purposes, any therapeutic agent, the value of which is not supported by scientific evidence. The dentist has the further obligation of not holding out as exclusive, any agent, method or technique.
Section 11
Patents and Copyrights. The dentist has the obligation of making the fruits of his discoveries and labors available to all when they are useful in safeguarding or promoting the health of the public. Patents and copyrights may be secured by a dentist provided that they and the remuneration derived from them are not used to restrict research, practice or the benefits of the patented or copyrighted material.
Section 12
Advertising. A dentist may advertise the availability of his services and the fees that he charges for routine procedures. No dentist shall advertise, in any form of communication, in a false, misleading, deceptive or fraudulent manner.
Section 13
Cards, Letterheads and Announcements. A dentist may properly utilize professional cards, announcement cards, recall notices to patients of record and letterheads when the style and text are consistent with the dignity of the profession and with the custom of other dentists in the community. Announcement cards may be sent when there is a change in location or an alteration in the character of practice, but only to other dentists, to members of other health professions and to patients of record. *(See Footnote No. 1)
Section 14
Office Door Lettering and Signs. A dentist may properly utilize office door lettering and signs provided that their style and text are consistent with the dignity of the profession and with the custom of other dentists in the community. *(See Footnote No. 1)
Section 15
Use of Professional Titles and Degrees. A dentist may use the titles or degrees, Doctor, Dentist, D.D.S. or D.M.D. and any additional advanced academic degrees earned in health service areas on cards, letterheads, and announcements. A dentist who has been certified by a national certifying board for one of the specialties approved by the American Dental Association may use the title "diplomats" in connection with his specialty on cards, letterheads and announcements. A dentist may not use his title or degree in connection with the promotion of any commercial endeavors.
The use of eponyms in connection with drugs, agents, instruments or appliances is generally to be discouraged. *(See Footnote No. 1)
Section 16
Health Education of the Public. A dentist may properly participate in a program of health education of the public involving such media as the press, radio, television and lecture, provided that such programs are in keeping with the dignity of the profession and the custom of the dental profession of the community. *(See Footnote No. 1)
Section 17
Contract Practice. A dentist may enter into an agreement with individuals and organizations to provide dental health care provided that the agreement does not permit or compel practices which are in violation of these Principles of Ethics.
Section 18
Announcement of Limitation of Practice. Only a dentist who limits his practice exclusively to the special areas approved by the American Dental Association for limited practice may include a statement of his limitation in announcements, cards, letterheads and directory listings consistent with the custom of dentists of the community, provided at the time of the announcement, he has met in each specialty for which he announces the existing educational requirements and standards set by the American Dental Association for members wishing to announce limitation of practice.*
The specialty areas of dentistry approved by the American Dental Association and the designation for ethical announcements of limitation of practice are:
Endodontics Oral Pathology
Oral and Maxillofacial Surgery
Orthodontics Pedodontics (or Dentistry for Children)
Periodontics Prosthodontics
Dental Public Health
In accord with the established ethical ruling that dentists should not claim or imply superiority, use of the phrases "Specialist in " or "Specialist on " in announcements, cards, letterheads or directory listings should be discouraged. The use of the phrase "Practice limited to ____________ " is preferable.
A dentist who uses his eligibility to announce himself as a specialist to make the public believe that specialty services rendered in his dental office are being rendered by ethically qualified specialists when such is not the case, is engaged in unethical conduct. The burden is on the specialist to avoid any inference that general practitioners who are associated with him are ethically qualified to announce themselves as specialists.
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*Footnote* to Section 18
General Standards
The following are included within the standards of the American Dental Association for determining the educational experience and other appropriate requirements for announcing a limited practice.
1. The indicated area of dentistry must be one for which there is a certifying board approved by the American Dental Association.
2. The dentist's practice must be limited exclusively to the indicated area (or areas) of dentistry.
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The dentist must have completed successfully, an educational program accredited by the Council on Dental Education, two or more years in length, as specified b the Council or be a diplomate of a national certifying
Additional Standards for Multi-Specialty
Announcing
Educational criteria for announcement of limitation of practice in additional specialty areas are the successful completion of an educational program accredited by the Commission on Accreditation of Dental and Dental Auxiliary Educational Programs in each area for which the dentist wishes to announce. Dentists who are presently announcing ethically limitation of practice in a specialty area, and who wish to announce in an additional specialty area and who are qualified educationally in more than one recognized dental specialty by virtue of three years of advanced training in oral surgery or two years of advanced training in one of the other recognized dental specialties prior to the accreditation of such programs in 1967, but who were not permitted to announce limitation of practice in more than one area prior to the 1974 revision of Section 18, must submit documentation to the appropriate constituent society of successful completion of the requisite education in programs listed by the Council on Dental Education in each area for which they wish to announce or their certification as diplomates in each special area they wish to announce.
( Trans.1977 ).
Section 19
Directories. A dentist may permit the listing of his name in a directory provided that all dentists in similar circumstances have access to a similar list and provided that such listing is consistent in style and text with the custom of the dentists in the community. *(See Footnote No. 1)
Section 20
Name of Practice. The name under which dentist conducts his practice may be a factor in the selection process of the patient. The use of a trade name or an assumed name could mislead laymen concerning the identity, responsibility and status of those practicing thereunder. Accordingly, a dentist shall practice only under his own name, the name of a dentist employing him who practices in the same office, a partnership name composed only of the name of one or more of the dentists practicing in a partnership in the same office or a corporate name composed only of the name of one or more of the dentists practicing as employees of the corporation in the same office.
Use of the name of a dentist no longer actively associated with the practice may be continued for a period not to exceed one year.
The use of dentists' names in directories is
covered entirely in Section 19. *(See Footnote No. 1)
Section 21
Corporate Designations. Corporate designations may be used. *(See Footnote No. 1)
Section 22
Judicial Procedure. Problems involving questions of ethics should be solved at the local level within the broad boundaries established in these Principles of Ethics and within the interpretation by the component and/or constituent society of their respective codes of ethics. If a satisfactory decision cannot reached, the question should be referred on appeal, to the constituent society and the Council on Bylaws and Judicial Affairs of the American Dental Association, as provided in Chapter XI of the Bylaws of the American Dental Association.
* Footnote Number One. At its 1978 Annual Session, the House of Delegates adopted Resolutions 115a-H and 115b-H:
115&-H. Resolved, that component and constituent dental societies be urged to refrain initiating disciplinary proceedings for alleged violations of Sections 13, 14, 15, 19, 20 and 21 of the Principles of Ethics until appropriate modifications can be considered by the 1979 House of Delegates.
115b-H. Resolved, that component and constituent dental societies be requested to refer suspected violations of Sections 13, 14, 16, 19, 20 and 21 of the Principles of Ethics entailing alleged false, misleading, deceptive or fraudulent representations to the proper state agency for appropriate action.
