Free NDEB Professionalism and Ethics Questions and Answers — Questions and Answers
Question 1: A dentist presents a single, high-cost treatment plan involving implants to a patient for multiple missing teeth. The dentist fails to discuss or present a functionally viable, less expensive alternative, such as a removable partial denture. Which primary ethical principle is most directly violated by this omission?
- Justice
- Beneficence
- Autonomy (Correct answer)
- Non-maleficence
Correct answer: Autonomy
The principle of Autonomy requires that dentists respect the patient's right to self-determination. This is accomplished through a process of informed consent, which involves presenting all reasonable treatment options, along with their respective risks, benefits, and costs. By omitting a viable alternative, the dentist limits the patient's ability to make a fully informed choice, thereby violating their autonomy.
Question 2: A patient's adult child calls the dental office requesting specific details about their parent's recent restorative treatment for a school project. The patient has not provided any consent for this disclosure. According to Canada's Personal Information Protection and Electronic Documents Act (PIPEDA), what is the most appropriate response?
- Provide general information about the procedure but omit the patient's name.
- Ask the child to describe the project to determine if sharing is justified.
- Provide the information, as it is for a harmless educational purpose.
- Explain that without the patient's express written consent, no health information can be released. (Correct answer)
Correct answer: Explain that without the patient's express written consent, no health information can be released.
PIPEDA and provincial privacy laws mandate that personal health information is confidential and cannot be disclosed to a third party, including family members, without the patient's explicit consent. The reason for the request, such as a school project, does not override this fundamental privacy requirement.
Question 3: During an endodontic procedure, a dentist fractures a small file tip in the apical third of a root canal. The dentist successfully seals the canal, and the prognosis is considered good. Which of the following actions best demonstrates the ethical principle of veracity?
- Monitoring the tooth at recall appointments without informing the patient to avoid causing unnecessary anxiety.
- Informing the patient of the incident, discussing the potential prognosis, and documenting the conversation in the chart. (Correct answer)
- Referring the patient to an endodontist for follow-up without explaining the specific reason for the referral.
- Documenting the event in the chart but only informing the patient if symptoms develop in the future.
Correct answer: Informing the patient of the incident, discussing the potential prognosis, and documenting the conversation in the chart.
Veracity, or truthfulness, obligates dentists to be honest with patients about all aspects of their treatment, including procedural complications or adverse events. Informing the patient about the separated instrument, discussing the prognosis, and documenting this communication respects the patient's autonomy and upholds the principle of veracity.
Question 4: A dentist has a significant financial ownership stake in a specific dental implant manufacturing company. The dentist's treatment recommendations consistently and exclusively favor this company's products, even in clinical situations where alternatives might be more suitable. This situation primarily creates a conflict between the dentist's professional duties and their:
- Personal financial interests (Correct answer)
- Obligation to the regulatory authority
- Continuing education requirements
- Relationship with dental colleagues
Correct answer: Personal financial interests
A conflict of interest arises when a professional's personal interests, such as financial gain, could reasonably be seen as influencing their professional judgment. The primary duty to act in the patient's best interest (beneficence) is compromised by the competing personal financial interest in promoting a specific product.
Question 5: A new dentist acquires a practice and, upon reviewing patient records, discovers a pattern of substandard treatment and fraudulent billing by the previous owner that has caused harm to patients. What is the new dentist's primary ethical obligation?
- To contact the previous dentist directly to demand an explanation before taking any other steps.
- To correct the faulty work at no charge to the patients to protect the practice's reputation.
- To inform the affected patients of the findings and report the previous dentist to the provincial dental regulatory authority. (Correct answer)
- To ignore the past issues and focus solely on providing excellent care from this point forward.
Correct answer: To inform the affected patients of the findings and report the previous dentist to the provincial dental regulatory authority.
A dentist's foremost ethical duty is to protect the public and ensure patient safety. This includes a responsibility to report incompetent or unethical conduct by other professionals to the appropriate provincial regulatory body (e.g., RCDSO, CDSA). This duty to the public supersedes professional courtesy.
Question 6: Which of the following scenarios constitutes a dual relationship that would be considered professional misconduct by most Canadian dental regulatory bodies?
- Providing dental treatment to a colleague from a different dental office.
- Entering into a romantic relationship with a current patient of the practice. (Correct answer)
- Treating a high school acquaintance who you have not seen in over 10 years.
- Bartering dental services for professional accounting services with a patient who is a CPA.
Correct answer: Entering into a romantic relationship with a current patient of the practice.
Engaging in a romantic or sexual relationship with a current patient is a clear boundary violation and is considered professional misconduct. The inherent power imbalance in the dentist-patient relationship can impair professional judgment and risk exploitation of the patient's trust. To avoid this, the professional relationship must be formally terminated and care transferred before a personal relationship begins.
Free NDEB Professionalism and Ethics Questions and Answers
A dentist presents a single, high-cost treatment plan involving implants to a patient for multiple missing teeth.
The dentist fails to discuss or present a functionally viable, less expensive alternative, such as a removable partial denture.
Which primary ethical principle is most directly violated by this omission?