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32241 Crown Valley Parkway #200
Dana Point, CA 92629 | Directions

ETHICS COMMITTEE

SEX and "misleading in a material respect"
The content of this article has nothing to do with sex and therefore, may be "misleading in a material respect." I suppose we've all experienced this ploy in advertising and at times may not even be aware of this manipulation. Although we haven't reached this point in our profession, there have been some significant changes in what we can and can't do in marketing our services to the public.

In 1979, the Federal Trade Commission (FTC) and ADA locked horns in regards to the use of advertising dental services to the public. When all was said and done, the ADA prudently retracted its long-standing prohibition of advertising in its "Principles of Ethics and Code of Professional Conduct." This move was considered prudent because the courts made it clear that the ADA would lose any effort to retain its previous policy and decided to avoid the costly legal battle to defend its position. The new revision to the ADA code of ethics was modified to state that dentists should not misrepresent their competence in any way that would be false or misleading in a material respect. Since this change, the subsequent proliferation of advertising is most certainly a sign of a much more competitive relationship between dentists.

This increased competition amongst ourselves perhaps may be one of the reasons the public has changed its view somewhat about our profession as it relates to the patient's interest. In addition, no doubt that today's patients are more educated and informed about dental services thus increasing their autonomy in the doctor-patient relationship. It behooves us as a profession to make a concerted effort to minimize the unfavorable change in the way the public views our profession in remaining true to the big picture of high public trust. We certainly do not want to follow the path of our medical colleagues who have suffered through their decline of public trust.

The following issues have been brought to our attention and the local component level relating to advertising guidelines that may prove useful in future advertising ventures:
  • "During the Judicial Council's most recent meeting, the council discussed Sections 8 and 9 of the code of ethics as they relate to announcement of services, specifically, general dentists who announce services under telephone directory specialty headings. While the council has had a long-standing policy regarding this topic, the council believes there may be some confusion at the component level, and hopes to clear up any confusion that may exist. Section 9 of the CDA Code of Ethics requires general dentists to state they are general dentists when announcing the services available in their offices. This requirement extends to general dentists who advertise services under specialty headings. Therefore, general dentists who choose to announce their services under telephone directory specialty headings must include a statement that they are general dentists. Without such a statement, potential patients may be misled about the qualifications of the dentist providing specialty services."
  • "No one is allowed to use the CDA logo in advertisement, including Yellow Page ads, even if they have received permission to use the member logo. As noted in the Logo Standards Manual, "The CDA.member logo may not be used in advertisements, direct mail promotions, signage/displays, office newsletters, garments, or other solicitation materials prepared on behalf of an individual member, practice, or on behalf of an informal association of members. Usage of the CDA corporate logo in advertising and promotional materials is restricted to the CDA and its components." Similar restrictions exist on use of the ADA logo.
If there are any questions or comments, please do not hesitate to call us on the OCDS doctors' line at 634-8992.

In the majority of cases, violations of the code of ethics as set by the ADA occur as a result of ignorance versus intent. It is not uncommon for a fellow colleague to call a member of the ethics committee in their struggle to seek out the ethical solution to a particular dilemma. This is not surprising in view of the fact that as of last year there have only been two books written on dental ethics, with one limited to issues of informed consent. The number of dental school faculty with formal training in ethics is also limited. Although as many as 80 percent of the American dental schools now have courses in professional ethics, they usually are oriented toward jurisprudence.

As we all know, our profession continues to be challenged on all fronts on various issues, an obvious sign of an increasingly complex society. One of these major challenges that continue to pose as a threat to our professional autonomy is increasing government intervention. Not only is health care reform an issue, but actions by the FTC against organized dentistry threatens to change the way we practice dentistry. If it were up to the FTC, dentistry would become a commercial free-for-all otherwise known as caveat emptor: the principle in commerce whereby, without a warranty, the buyer takes the risk of quality upon him/herself. Without overstating the obvious, the ethical ramifications are staggering. We've already witnessed what harm the large "buyer beware" dental mills have perpetrated under the supposedly Knox Kleen supervision.

By definition, to be a professional, we are obliged to take the responsibility of quality care upon ourselves in protecting the patient. The Hippocratic Oath, an oath embodying a code of medical ethics is diametrically opposed to the caveat emptor principle in that the burden of responsibility, risk if you will, rests upon the doctor. It is not by random chance that public opinion polls still show dentistry at near the top of the list with respect to public trust. To continue to preserve this accolade, it is incumbent upon us to meet this challenge in our ever-changing professional environment

The code of ethics is not a set of rules for which the ethics committee is commissioned to police and enforce, but rather a set of principles with far-reaching philosophical measures that pose as our conscience in continuing to provide the public with excellence in dental care.

These four principles require:
  • Regard for self-determination (respect for autonomy)
  • The avoidance of doing harm (non-malfeasance)
  • The promotion of wellbeing (beneficence)
  • Fairness in the distribution of goods and harms (justice)
Thankfully, the ADA and the American College of Dentists continue to take the role of leadership in defining the ethical standards of the profession, specifically in concern for excellence in the quality of care and the need to maintain public trust.

In the spirit of fostering our continued understanding of our professional ethics, it is one of the goals of the ethics committee to challenge our membership to become more active in understanding this code. We look forward to printing reactions, comments editorials, etc. to the ethics commentary that will appear on a regular basis in Impressions in the hope of establishing a dialogue with the membership in remaining sensitive to the needs of our Society. We hope this proactive strategy proves to be more beneficial than a reactive approach in translating our ethical principles to our daily practice of dentistry.

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