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Ethical Questions in Dentistry, 2^nd ed.

Department of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, 305 West 12th Ave., Columbus, OH 43218-182375; Stevenson.113{at}osu.edu.

Ethical Questions in Dentistry, 2nd ed., presents a detailed overview of ethical theory and principles followed by eighty-eight clinical dentistry cases in which the moral or ethical obligations of professionals are in conflict and where arguments for differing courses of actions can be made. Readers are asked to determine the ethically correct response to such conflicts based on ethical reflection. The book is suitable for dental care providers at all levels.

The authors begin with discussion of basic ethics, including the structure of professions and the professional’s responsibilities, morality, and values. Then they provide a protocol or format for resolving ethical questions based on ethical principles and reflection. The clinical cases are grouped and discussed in a manner to help illustrate specific ethical ideals.

The first edition of Ethical Questions in Dentistry (1993) noted that some dental schools did not offer courses in ethics and that many that did emphasized jurisprudence. The book is intended to offer a "general approach to ethical reasoning in dental-related problem solving . . . to either the dental practitioner or the dental student." Many consider the first edition to be the first-ever textbook devoted to dental ethics.

The second edition contains twelve new cases that invite discussion on licensure, access to care, corporate sponsorship of graduate education, sexual harassment, advertising, and financial and HIV issues. An entirely new chapter on professions serves as a frame of reference. While there is still no consensus about what a profession actually is, the authors have added two new aspects to the first edition’s definition, including self-regulation and collegial discipline. Great emphasis is again placed on the fiduciary relationship between doctor and patient, in which "mutual expectations of trust are expected."

Clinical cases in part two illustrate general ethical principles such as doing good (beneficence), avoiding harm (nonmaleficence), fidelity, honesty, justice, and autonomy. Part three case studies involve special problems with issues in third-party financing, HIV and other blood-borne diseases, ethical concerns in schools of dentistry, and dealing with incompetent, dishonest, or impaired professionals.

The subject of fee-splitting is mentioned in the first edition but for some reason is absent in the second edition. Fee-splitting can take the form of lavish gifts or unduly generous favors as well as kickbacks and under-the-table payments. In effect, the referring dentist or referral service "sells" patients to the highest bidder. Withholding information from patients about any fee-splitting arrangements would seem to compromise the dentist’s veracity as well as obstruct the patient’s ability to render completely informed consent. The ADA Code mentions unethical fee-splitting twice, in Section 4.E and Section 5.F.4.

The first appendix contains the Hippocratic Oath, the preamble to the American Medical Association Code of Ethics, and the complete ADA Principles of Ethics and Code of Professional Conduct, including advisory opinions revised to January 2004. The second appendix presents a legal perspective of informed consent to complement chapter eight, which deals with issues of autonomy. The requirements of an "Adequate Informed Consent" are provided courtesy of Roger L. Eldridge, D.D.S., J.D., University of Maryland Dental School.

A glossary provides convenient reference for sixty-eight relevant terms and is helpful for those who encounter terms such as deontologism, consequentialism, and normative relativism for the first time.

The book is well supported by references at the end of each chapter. The first four chapter bibliographies total 121 citations, and the remaining ten chapters include more than 100. The book’s table of contents is available for online viewing at the publisher’s website, www.quintpub.com.

Overall, the book is well written and highly readable. The size of print is slightly larger than in the 282-page first edition. Page size has increased in the second edition, now eight by ten inches, with wider margins for notes. Case studies and discussions are set off in light blue screen, which helps distinguish them.

The book is not illustrated other than photos of the authors, but the addition of blue print for clinical cases makes it more colorful than the first edition. The paperback binding is sturdy and attractive. The text is suitable for pupils of dental ethics at every level, from dental students and patients to faculty and board examiners.

Ethical Questions in Dentistry, 2nd ed., is certainly appropriate for a communal dental library and highly recommended for any conscientious dental team member. Keep it chairside for quick reference to perplexing ethical predicaments.

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				R. B. Stevenson PATIENT REFERRALS J Am Dent Assoc, July 1, 2007; 138(7): 936 - 936. [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Stevenson, R. B. Search for Related Content PubMed Articles by Stevenson, R. B.