Ethics and Professionalism
What this domain tests
The principles that govern clinical decision-making, consent, confidentiality, professional boundaries, and the dentist's obligations to patients, colleagues and the regulator.
Core rules
- Four principles: autonomy (the patient's informed choice), beneficence (act in their interest), non-maleficence (do no harm), and justice (fair use of resources and fair treatment).
- Informed consent requires capacity, adequate information (nature, risks, benefits, alternatives, consequences of refusal) and voluntariness. It is a process, not a signature. For minors, consent is normally given by a parent or guardian, with the child's assent sought according to age and understanding.
- Confidentiality may be breached only where there is a legal requirement, a serious public health risk, or a risk of serious harm to the patient or others - and then only to the minimum necessary extent.
- Scope of practice: refer when a case exceeds your competence or the available facilities. Referral is a professional duty, not a failure.
- Records must be contemporaneous, legible, factual and retained as required by local regulation.
- Professional boundaries: avoid dual relationships, do not guarantee outcomes, and declare any conflict of interest.
Worked example
A 15-year-old requests extraction of a painful tooth and asks that the parent not be informed. Reasoning: the patient has capacity to assent but the parent or guardian must consent for the procedure under most jurisdictions for a minor, and the parent must be involved. Confidentiality is maintained about unrelated matters, and the immediate clinical need (pain relief) is addressed in consultation with the guardian.
Traps
- Treating a signed form as sufficient consent without a discussion.
- Disclosing clinical information to an employer or insurer without consent.
- Continuing treatment beyond your competence instead of referring.