The code for dentists is embodied in the Principles of Ethics and Code of Professional Conduct of the American Dental Association (ADA).7 The code is maintained and updated by the association through its Council of Ethics, Bylaws, and Judicial Affairs. A code of ethics in dentistry has been in place since 1866 when the first code was simply stated in the words “The dentist should be ever ready to respond to the wants of his patients and should fully recognize the obligations involved in the discharge of his duties toward them.”8 The dental code followed medicine’s lead in laying out the primacy of the patient as the fundamental premise.
The introduction to the code begins with the statement that trust is special and critical to the position that dentistry holds within society. The code mentions the profession is granted privileges and that in return the profession will adhere to “high ethical standards of conduct.” The preamble again calls upon dentists to keep patients as their primary goal highlighting that knowledge, skills and competence and traits of character define the professional person.
The ADA Code is divided into three components: principles of ethics, code of professional conduct, and advisory opinions. The principles of ethics component sets out the aspirational goals of the dental profession, which are similar to the aspirational goals for other health care professions. The code is based on the five fundamental principles of autonomy, beneficence, nonmaleficence, justice and veracity.
|1||Patient autonomy||Patient involvement; patient records|
|2||Nonmaleficence||Education; consultation and referral; use of – support personnel; personal impairment; bloodborne pathogens; patient abandonment;|
Personal relationship with patients
|3||Beneficence||Community service; government of a profession; research and development; patents and copyrights; abuse and neglect; professional demeanor in the workplace|
|4||Justice||Patient selection; emergency service;|
Justifiable criticism; expert testimony; rebates and split fees
|5||Veracity||Representation of care, fees; disclosure of conflict of interest; devices and therapeutic methods; professional announcement; advertising; name of practice; announcement of specialization; general practitioner announcement of credentials|
The portion of the ADA Code that addresses conduct for dentists—the code of professional conduct—delineates conduct that is either required or prohibited. Each section of the code of professional conduct is followed by an advisory opinion. These opinions expand on an issue and often include legal warnings or suggestions for the dentist to seek further information or advice. Guidance is provided in the ADA Code for anyone who believes a member dentist has acted unethically, and the code further explains that censure or suspension can result from a fair hearing on any unethical conduct. The ADA Code, with current official advisory opinions is available at www.ada.org.