Dentist-patient relationship

MEDICAL ETHICS I

Dentist-patient relationship

Dr SAKER 2020/2022

Course objectives

Define the ethical principles of the medical profession, the obligations of the doctor and the rights of patients

1. Introduction – Definition
   • Medical ethics has very ancient roots dating back to the time of Hippocrates.
   • It comes from the Greek words “Deontos” (what to do) and “Locos” (Speech).
   • It is defined by art. 01 of the CDM as:
   • “the set of principles, rules and practices that every doctor, dental surgeon and pharmacist must observe or from which he draws inspiration in the exercise of his profession”.
2. HISTORY:

Hippocrates Roots 500 years BC (codifies medical morality).

The prayers of Maimonides, 12th century.

1948  Adoption of the Geneva Oath.

In Algeria :

• Before independence French decree of 1947
• 1971 : creation of the UMA (responsible for surveillance)
• 1976 : 1st Code of Medical Ethics included in the CSP
• 1985 : Repeal of the CDM by Law 85-05 (LPPS)
• 1990 : Creation of national and regional councils and a CDM is planned.
• 06.07.1992 : Executive Decree 92-276 establishing CDM.*
• 1998 : installation of the National DM Council.

3. Code of Medical Ethics:

(Executive Decree 92-276 of 06.07.1992)

• Part of the official regulations in force, it is required of all doctors, dental surgeons, pharmacists and students.
• It contains 228 articles divided into four titles: Title I : DM Rules

Title II : DM Advice Title III : Discipline

Title IV : Transitional provisions

• The doctor, but also the dental surgeon and pharmacist, undertake by oath to respect it (art. 5) subject to disciplinary sanctions.

4. The rules of Medical Ethics

1. General Duties of the Dentist (art.6 to 35)
   • The dentist is at the service of the individual and public health (art. 6)
   • Exercise with respect for life and human dignity without discrimination (art. 6, 7)
   • Alleviate the suffering of individuals and preserve their physical and mental health (art. 7)
   • Providing assistance to a person in danger (art. 9)
   • Maintaining knowledge (art. 15) and obligation of competence (art. 16)
   • Cannot practice dentistry as a business (art. 20)
   • Protect minors, incapacitated adults and those deprived of their liberty and report mistreatment against them (art. 12, 53, 54)
   • Acting under his true identity, he is responsible for his actions (art. 13) He is prohibited from :
   • To undertake care beyond his/her skills (art.16)
   • To subject the patient to unjustified risks (art. 17)
   • The practice of fairground medicine and quackery (art.21,30,31,32)
   • Any act likely to provide the patient with an unjustified advantage (art.24)
   • Distribution of harmful substances or illusory remedies (art.28,31)
   • Any advertising process (art.20)
2. Professional secrecy (art.36 to 41)

Art. 36 to 41 of the CDM

• Secrecy is established in the interest of the patient and the community, and is required of every dentist.
• It covers everything that the dentist saw, heard, understood or was told in the exercise of his profession.
• Medical confidentiality is not abolished by the death of the patient except to assert one’s rights.
• The dentist must ensure that the clinical records and documents he holds concerning his patients are protected against any indiscretion.

3. Duties towards patients (art.42 to 58)
   • Respect the patient’s freedom of choice of dentist (art.42)
   • Fair and intelligible information (art.43)
   • Obtain free and informed consent, except in extreme emergencies (art.44)
   • Provide conscientious, attentive care, in accordance with recent scientific data. (art.45)
   • Respect the dignity of the patient (art.46)
   • Ensure that the patient understands their prescriptions (art.47)
   • Respect the refusal of care (art.49)
   • Ensuring continuity of care (art.50)
   • Obtain consent from legal guardian if applicable (art.52)
   • Defending the sick child (art.53)
   • Facilitate the obtaining of social benefits to which the patient’s state of health entitles him (art. 57)
   • Prohibition on issuing biased reports or certificates of convenience (art.58)
4. Organization of medical ethics
   • One national council and 12 regional councils.
   • 03 national ordinal sections and 48 regional ordinal sections (ordinary offices).
   • The regional council exercises its disciplinary power through the SORs which compose it and which represent the first disciplinary authority.
   • No one may practice if they are not registered on the register (art. 204 CDM) exception: military doctors and foreign doctors authorized by the ministry.
   • The ordinal sections and councils can be contacted by any natural or legal person (minister, justice, doctor, patient, etc.)
   • They: – exercise disciplinary power,
     • ensure compliance with ethical rules,
     • ensure the defense of the dentist, the control of private establishments records registrations,…
5. CONCLUSION :

The dentist has a moral contract to fulfill in front of his patient. He must practice his profession in the interest of the patient and public health while respecting life and human dignity.

Dentist-patient relationship

Dentist-patient relationship

  Untreated cavities can lead to tooth loss.
Dental veneers restore a harmonious smile in just a few sessions.
Misaligned teeth can cause joint pain.
Dental implants are fixed into the bone for optimal stability.
Chlorhexidine mouthwashes treat gum infections.
Damaged baby teeth can affect speech and chewing.
A toothbrush replaced every three months ensures effective hygiene.