Legal odontology legal and illegal practice of dental medicine responsibility of the dentist
Legal Dentistry
Legal and illegal practice of dentistry
Responsibility of the dentist
Plan
Part One: Forensic Odontology
- The conditions of exercise
- Exercise regimes
- The rules of exercise
- Legal
- Illegal
Part Two: Responsibility of the Dentist
- Criminal liability
- Civil liability
FORENSIC DENTISTRY
FORENSIC DENTISTRY
Legal odontology regulates the profession of dentist with very strict conditions that will determine the legal and illegal practice of dentistry.
CONDITIONS OF EXERCISE
They are governed by Law No. 85/05 of February 16, 1985 relating to the protection and promotion of health and Law 90-17 of July 31, 1990 amending and supplementing that of 1985.
ARTICLES 197 – 198 – 199 – 200
Article 197
The practice of the profession of doctor, dental surgeon and pharmacist is subject to authorization from the minister responsible for health under the following conditions:
- Hold, as the case may be, one of the Algerian diplomas of doctor of medicine, dental surgeon or pharmacist or a recognized equivalent title.
- Not be affected by an infirmity or pathological condition incompatible with the exercise of the profession.
- Being of Algerian nationality, this condition may be waived on the basis of conventions and agreements made by Algeria and by decision of the Minister responsible for health.
Article 198
No one may practice as a specialist doctor, specialist dental surgeon or specialist pharmacist unless, in addition to the conditions required in Article 197 above, they have a medical specialty diploma or a recognized equivalent qualification.
Article 199 amended
To be authorized to practice, any doctor, dental surgeon or pharmacist meeting the conditions set out in Articles 197 and 198 above must register with the regional council of the order.
Article 200
During the period of the internship of the graduation studies, students of medicine, dental surgery and pharmacy are authorized to practice, respectively, medicine, dental surgery and pharmacy in public health establishments, under the responsibility of the practitioners, heads of structures.
Legal odontology legal and illegal practice of dental medicine responsibility of the dentist
EXERCISE REGIMES
Article 201
Doctors, dental surgeons and general or specialist pharmacists and university hospital specialists exercise their functions under one of the following regimes:
- As a full-time civil servant.
- In a private capacity.
Law No. 98/09 of 19 August 1998 amending and supplementing Law No. 85/05 of 16 February 1985 relating to the protection and promotion of health by the following articles: 201-1, 201-2, 201-3, 201-4 worded as follows.
Article 201-1
The bodies of university hospital specialists working in the public sector as:
- Teacher.
- Docent or Associate Professor.
- Assistant professor with five (5) years of actual experience in this capacity or holder of a state diploma in medical sciences (DESM).
- Public health specialists with five (5) years of actual practice in this capacity are authorized to exercise a complementary activity according to the conditions set out below.
Article 201-2
The complementary activity is carried out outside public health establishments; it is authorized at the level of:
Private health establishments.
Private laboratories.
From the parapublic sector.
Article 201-3
Without prejudice to the normal functioning of the medical services of public health establishments, the beneficiary is authorized to exercise the complementary activity within the limits of one day per week, in addition to the legal days off.
Article 201-4
The application of the provisions of this article, in particular the procedures for issuing and withdrawing the authorization to exercise the complementary activity as well as the control of the latter, is set by regulation.
A copy of the authorization decision is sent for information
to the Minister of Health – Directorate of Health Services.
to the territorially concerned DSPs.
to the Director of the relevant social security funds.
to the Dean of the relevant Faculty of Medicine.
It must indicate
The place(s) of exercise and the half-days identified precisely.
The nature of the activity (specialty concerned).
The specialist practitioner exercising within the framework of the complementary activity is required to mention on his prescription his capacity, his identity as well as the structure in which he exercises the complementary activity.
Legal odontology legal and illegal practice of dental medicine responsibility of the dentist
RULES OF EXERCISE
ARTICLES 205 – 206 – 207 – 208 209 – 210- 211- 212 – 213
Article 205
Any physician, dental surgeon or pharmacist whose right to practice their profession has been suspended is prohibited from giving consultations, writing prescriptions, preparing medications, applying treatment or administering any method of treatment relating to medicine or pharmacy in their capacity as a physician, dental surgeon or pharmacist except in cases where it is essential to provide urgent first aid care.
Article 206
Physicians, dental surgeons and pharmacists are required to observe professional secrecy, unless legal provisions expressly release them from this obligation.
Article 206 amended in Articles 206/1, 206/2, 206/3, 206/4, 206/5 These articles concern professional secrecy .
Article 207
Physicians, dental surgeons and pharmacists are required to practice their profession under their legal identity.
Article 207 amended in articles 207/1, 207/2 These articles concern forensic medicine and expert medicine.
Article 208
Private health activities are provided in
- Dental offices,
- Pharmaceutical pharmacies,
- Consultation and treatment offices,
- Medical analysis, medical optics and eyewear laboratories,
- Of medical prosthesis.
The nature and importance of the equipment required for private health activities are set by regulation.
Article 209
Doctors, dental surgeons and pharmacists are required to provide on-call service, in accordance with the terms set by the Minister responsible for health, under penalty of administrative sanctions.
Article 210
Subject to the provisions of Article 206 above, doctors, dental surgeons and pharmacists are required to comply with requisition orders from the public authority.
Article 211
- The fees for procedures performed by doctors, dental surgeons and pharmacists are set by regulation.
- Failure to comply with pricing will result in sanctions in accordance with legal and regulatory provisions.
Article 212
It is prohibited for anyone who is not legally practicing the profession to receive all or part of the fees or profits arising from the professional activity, in a private capacity, of a doctor, a dental surgeon or a pharmacist.
Article 213
Within the limits of their qualifications, doctors, dental surgeons and pharmacists are required to establish a file of their patients, to keep the archives, to provide the certificates, attestations and epidemiological information prescribed by the laws and regulations.
Article 213a
Physicians, dental surgeons and pharmacists practicing privately must practice their profession in conditions that allow them the regular use of facilities and the technical means necessary for their art, which cannot in any case compromise the health of the patient or the dignity of the profession.
ILLEGAL PRACTICE OF MEDICAL PROFESSIONS
Article 214
-Illegally practices medicine, dental surgery or pharmacy:
- Any person who exercises the activity of doctor, dental surgeon or pharmacist, not fulfilling the conditions set out in article 197.
PREMISES FOR USE IN MEDICINE, DENTAL SURGERY AND PHARMACY.
Article 215
Premises used for medicine, dental surgery and pharmacy must comply with the standards: Prescription, Construction, Hygiene, Safety, Equipment, set by regulation.
Article 216
Any change in the purpose of premises for medical, dental or pharmaceutical use is subject to prior authorization from the Minister responsible for health.
The medical liability of the dentist
This responsibility occurs at two levels: CRIMINAL AND CIVIL.
Criminal liability: this liability can be heavy,
The dental surgeon is in fact required to perform certain procedures which can sometimes cause serious damage to an individual’s body or even lead to the death of some people.
In these cases, the dental surgeon will be prosecuted for unintentional injury or negligent homicide before the criminal courts.
The dental surgeon may be prosecuted, in the same way as a doctor:
— For failure to assist a person in danger, if he refrains from treating an emergency while the patient who has just requested care and who has been refused care is suffering from serious complications.
— In the event of a breach of professional secrecy.
The obligation to provide assistance in an emergency will also allow the dental surgeon to be released from all the rules concerning the prescriptions which are permitted to him.
If the patient suffers from a heart attack that could not be detected by anything, the dentist must immediately treat the patient (he must alert a doctor – while waiting for his arrival, he must administer all the assistance at his disposal).
Article 288 of the Penal Code : “Anyone who, through clumsiness, imprudence, inattention, negligence or failure to observe the regulations, unintentionally causes a homicide or is unintentionally the cause thereof shall be punished by imprisonment of six months to three years and a fine of 1,000 to 20,000 DA”
Article 289 of the Penal Code “if the lack of skill or precaution results in blows and injuries or illness resulting in total incapacity for work lasting more than three months, the guilty party is punished by imprisonment of two months to two years and a fine of 500 to 15,000 DA or one of these two penalties only”.
Article 290 of the Criminal Code “the penalties provided for in Articles 288 and 289 are doubled when the perpetrator of the offence acted in a state of intoxication or attempted, either by fleeing, or by changing the condition of the premises, or by any other means, to escape the criminal or civil liability that he could incur.
Article 301 (law n°82-04 of February 13, 1982) “doctors, dental surgeons, pharmacists, midwives or any other person who is the custodian, by status or profession or by permanent or temporary functions, of the secrets entrusted to them, who, except in cases where the law obliges or authorizes them to act as whistleblowers, reveal these secrets, are punished by imprisonment of one to six months and a fine of 500 to 5000DA.”
CIVIL LIABILITY: perhaps of 2 types: tortious and contractual.
- Tort liability is established when a person has caused harm to another person (they have caused him damage) and there is no particular link between the two people.
- Contractual liability arises when a contract has been established between two people and one of the contracting parties has not fulfilled the obligations to which he had committed himself in this contract.
In both cases, liability is established if there is a wrongful act, damage and a causal link between the two (the damage must be clearly linked to the wrongful act).
Legal odontology legal and illegal practice of dental medicine responsibility of the dentist
Civil liability requires the presence of three fundamental elements :
- A mistake
- A damage
- A causal link between the fault and the damage
– The civil liability of a dental surgeon can be incurred for poor performance of his professional obligations.
– Even within his professional practice, the dental surgeon is responsible for his patient until he leaves the practice.
Between the practitioner and the patient, a contract is formed:
- The patient expects the practitioner to provide care that the latter must provide with the utmost caution.
- The counterpart of this obligation of care lies in the fees that the practitioner will be able to claim from his patient.
CONCEPT OF CONTRACT
It is a contract with an obligation according to the so-called means doctrine:
The dentist, like the doctor, undertakes to provide care with the utmost professional conscience but cannot undertake to obtain a specific result because in medical science we are not sure of obtaining a definitive cure in all cases.
NATURE OF THE CONTRACT
- It is a civil contract, not a commercial one, so it is not governed by commercial law.
- It is an oral contract, no formalities are necessary to establish the contract.
- It is a bilateral contract: each of the contracting parties has obligations, the patient has an obligation to pay the practitioner’s fees and to follow his prescriptions and the practitioner is subject to the obligations of care and information.
EXTRA CONTRACTUAL SITUATION
- In some cases no contract has been established between the practitioner and the patient.
- The reports are governed by civil liability.
- Absence of consent of the patient: case of care for an unconscious patient,
in minors or incapacitated persons.
Type of medical practice : if the practitioner practices the profession illegally, the contract is illegal, just as hospital practitioners and those of insurance funds do not establish a contract with the patient; the patient establishes a contract with the hospital or the insurance fund directly, and not with the practitioner.
Nature of the damage: it may be located outside the contractual scope:
Case of the patient who falls while leaving the office.
EXPERTISE
Experts must find the causal link between the fault and the damage so that the patient can obtain compensation following the defective care and because of the means that exist in the contract that connects them. It is up to the patient to demonstrate that the dentist was guilty of imprudence; inattention, negligence and disregard for his duties.
CIVIL CODE
Article 124 of the Civil Code “any act whatsoever of a person which causes damage to another obliges the person through whose fault it occurred to repair it”. (Liability for personal acts)
LIMITATION PERIOD This is the period beyond which it is no longer possible to take legal action.
Art. 133 “ The action for compensation is prescribed by fifteen years, from the day on which the damaging act was committed”
DISCIPLINARY RESPONSIBILITY
- This liability is incurred when there is a breach of the rules of medical ethics in relation to professional activity; even an act of private life can undermine the honour and morality of the profession.
- The sanctions are: warning, reprimand, temporary or permanent ban from exercising medical functions in the public and social sector, temporary ban from practicing medicine (3 years maximum), removal from the register of the order.
- The competent jurisdiction is the council of the order,
THE DIFFERENT ORDERS AND LAWS OF THE ALGERIAN CIVIL CODE
Ordinance No. 75-58 of September 26, 1975 relating to the Civil Code, amended and supplemented by:
- Law No. 80-07 of August 8, 1980.
- Law No. 83-01 of January 29, 1983.
- Law No. 88-21 of December 24, 1984.
- Law No. 33-14 of May 3, 1988.
- Law No. 89-01 of February 7, 1989.
- Law No. 05-10 of June 20, 2005.
- Law No. 7-05 of May 13, 2007.
THE DIFFERENT LAWS AND ORDERS OF THE ALGERIAN PENAL CODE
Order No. 66-156 of June 8, 1966, amended and supplemented by:
- Order No. 69-74 of September 16, 1969.
- Order No. 73-48 of July 25, 1973.
- Order No. 75-47 of June 17, 1975,
- Order No. 78-03 of February 11, 1978.
- Law No. 82-04 of February 13, 1982,
- Law No. 88-26 of July 12, 1988.
- Law No. 89-05 of April 25, 1989.
- Law No. 90-02 of February 6, 1990.
- Law No. 90-15 of July 14, 1990.
- Order No. 96-22 of July 9, 1996.
- Order No. 97-10 of June 6, 1997.
- Law No. 01-09 of June 26, 2001.
- Law No. 04-15 of December 10, 2004,
- Law No. 05-06 of August 23, 2005.
Wisdom teeth can be painful if they are misplaced.
Composite fillings are aesthetic and durable.
Bleeding gums can be a sign of gingivitis.
Orthodontic treatments correct misaligned teeth.
Dental implants provide a permanent solution for missing teeth.
Scaling removes tartar and prevents gum disease.
Good dental hygiene starts with brushing twice a day.