ADAT Patient Management & Ethics 2 — Questions and Answers
Question 1: A patient who speaks limited English needs a tooth extraction. What is the most appropriate way to obtain informed consent?
- Have the patient sign a standard English consent form
- Use a professional interpreter and provide information in the patient's language (Correct answer)
- Ask a bilingual staff member to quickly translate the key points
- Have an adult family member translate and sign as proxy
Correct answer: Use a professional interpreter and provide information in the patient's language
Professional interpreters ensure accurate, unbiased translation; family members may filter information or have conflicts of interest, compromising true informed consent.
Question 2: Which principle of the ADA Code of Professional Conduct addresses the dentist's duty to improve the overall health of the public?
- Autonomy
- Beneficence
- Nonmaleficence
- Justice and societal trust (Correct answer)
Correct answer: Justice and societal trust
The principle of justice in the ADA code includes the duty to improve the oral health of the public and address barriers to care, reflecting dentistry's societal obligations.
Question 3: When a patient is unconscious in an emergency and cannot give consent, which doctrine permits emergency treatment?
- Substituted judgment doctrine
- Implied consent in emergency situations (Correct answer)
- Therapeutic privilege
- Advance directive
Correct answer: Implied consent in emergency situations
Implied consent allows providers to treat unconscious patients in emergencies, based on the presumption that a reasonable person would consent to life-saving treatment.
Question 4: A dentist notices a colleague consistently coming to work smelling of alcohol. According to the ADA Code of Ethics, what is the observing dentist's responsibility?
- Report the colleague anonymously to state dental board immediately
- Confront the colleague directly and, if the problem persists, report to the appropriate authorities or peer assistance program (Correct answer)
- Maintain confidentiality as it is a personal matter
- Only take action if a patient complains about the colleague
Correct answer: Confront the colleague directly and, if the problem persists, report to the appropriate authorities or peer assistance program
The ADA Code obligates dentists to report colleagues whose conduct may put patients at risk, but direct intervention first is appropriate when safe to do so, with escalation if needed.
Question 5: Which document legally authorizes a designated person to make healthcare decisions for a patient who becomes incapacitated?
- Living will
- Durable power of attorney for healthcare (healthcare proxy) (Correct answer)
- Do-not-resuscitate (DNR) order
- POLST form
Correct answer: Durable power of attorney for healthcare (healthcare proxy)
A durable power of attorney for healthcare designates a specific person (healthcare proxy/agent) to make medical decisions when the patient cannot do so.
Question 6: What is 'therapeutic privilege' and when, if ever, is it ethically justifiable?
- Providing treatment at reduced cost to underserved patients
- Withholding information that would harm the patient if disclosed — rarely justifiable and is largely rejected in modern ethics (Correct answer)
- Prescribing placebo treatments that the patient believes are active medications
- Prioritizing high-risk patients in emergency triage situations
Correct answer: Withholding information that would harm the patient if disclosed — rarely justifiable and is largely rejected in modern ethics
Therapeutic privilege once allowed withholding harmful information from patients, but modern bioethics largely rejects it as a violation of patient autonomy, except in rare cases of extreme psychological harm.
ADAT Patient Management & Ethics 2
A patient who speaks limited English needs a tooth extraction.
What is the most appropriate way to obtain informed consent?