Dental Jurisprudence, Ethics and Professional Practice
Dental Jurisprudence
Statutory framework
Dental practice in the Philippines is regulated by the Philippine Dental Act, which establishes the Board of Dentistry under the Professional Regulation Commission. The Act defines the scope of dental practice, licensure requirements, grounds for suspension or revocation of a licence, and penalties for practice without a licence or for practice beyond scope. Know the pattern rather than isolated numbers: the Board sets and administers the licensure examination, issues certificates of registration, investigates complaints, and enforces continuing professional development requirements. Verify current thresholds against the latest implementing rules, since these are amended.
The legal relationship
A dentist-patient relationship begins when the dentist accepts the patient for care and creates duties of reasonable skill and care, confidentiality, and non-abandonment. Negligence requires four elements: a duty owed, a breach of that duty (the standard of a reasonably competent practitioner in similar circumstances), causation, and damages. Res ipsa loquitur allows the inference of negligence where the injury would not ordinarily occur without negligence - for example, a retained instrument or a wrong-site extraction.
Records and consent
Contemporaneous, legible records are the practitioner's best defence, and patients have a legal interest in their contents subject to privacy legislation. Valid informed consent requires capacity, adequate disclosure of risks, benefits and alternatives, comprehension, and voluntariness; document it. Minors and incapacitated adults require a legally authorised representative.
Rule of thumb
When a stem describes a bad outcome, ask whether it was a recognised complication (not negligence) or a departure from the standard of care (negligence). Vicarious liability can extend to an employer for the acts of staff acting within their employment.
Ethics and Professional Practice
Core principles
Autonomy (the patient decides), beneficence (act in the patient's interest), non-maleficence (first do no harm), justice (fair access and fair dealing), veracity (honesty) and confidentiality. These principles frequently compete; examination questions usually hinge on which one dominates. When a competent adult refuses recommended treatment, autonomy wins - provided the refusal is informed and documented.
Common ethical scenarios
Advertising must be truthful and not sensational or comparative; fee-splitting and paying for referrals are improper. A second opinion should be welcomed, not obstructed. Abandonment occurs when care is withdrawn without reasonable notice, without arranging a substitute, or when the patient still needs continuing care. Patients must not be discriminated against on the basis of infectious status; universal precautions apply to all. Impaired colleagues should be reported through the appropriate channel, with concern for patient safety and for the colleague's rehabilitation. Suspected child or elder abuse must be reported under mandatory reporting law.
Consent and minors
Consent requires capacity. For a child, a parent or legal guardian consents, but the child's assent should be sought in age-appropriate language. In a true emergency, treatment may proceed under implied consent to prevent serious harm.
Research and record ethics
Research involving patients requires ethics review, valid consent, and the right to withdraw. Records must be accurate, contemporaneous, secure, and retained for the period required by regulation; disclosure to third parties requires patient authorisation unless legally compelled.
Rule of thumb
When a scenario offers a choice between what is convenient for the dentist and what respects the patient's autonomy, choose autonomy and document the discussion.