Ethical and Legal Practice Flashcards

A 15-year-old patient comes to the dental office alone for a routine cleaning and examination. The dental assistant notes that the patient's file indicates their parents have consented to this type of routine care in the past. According to Canadian legal principles, what is the most appropriate next step?

Answer: Assess the patient's capacity to understand the treatment and its consequences before proceeding.

In most Canadian provinces, there is no specific age of consent for medical or dental treatment. Instead, the concept of 'capacity' is used. A healthcare provider must determine if the minor is capable of understanding the nature of the proposed treatment, its risks and benefits, and the consequences of accepting or refusing it. If the 15-year-old is deemed to have this capacity, their own consent is sufficient for routine care.

A dental assistant overhears a conversation in the staff room where a colleague discusses a patient's extensive restorative treatment and financial difficulties with another team member who is not involved in the patient's care. This action is a breach of which of the following?

Answer: The Personal Information Protection and Electronic Documents Act (PIPEDA).

The Personal Information Protection and Electronic Documents Act (PIPEDA) is a Canadian federal law that governs how private sector organizations, including dental offices, collect, use, and disclose personal information in the course of commercial activities. Disclosing a patient's personal health and financial information to an uninvolved party is a direct violation of the privacy and confidentiality principles outlined in PIPEDA.

Which of the following scenarios best illustrates the ethical principle of 'Non-maleficence' in dental assisting practice?

Answer: Identifying and correcting a tear in a sterilization pouch before the instruments are used.

Non-maleficence is the ethical principle of 'do no harm'. Identifying and replacing a compromised sterilization pouch prevents the use of potentially non-sterile instruments on a patient, thereby avoiding harm and upholding this core principle. The other options relate to beneficence (acting for the patient's benefit), autonomy (respecting the patient's right to choose), and professional competence.

A dentist asks a Level II dental assistant to take final impressions for a crown, a task that is outside the assistant's legal scope of practice in their province. If the assistant complies and the patient is harmed as a result, who could be held liable for professional negligence?

Answer: Both the dentist and the dental assistant.

Dental assistants are responsible for practicing within their legal scope of practice, regardless of who delegates a task. The dentist is liable for improper delegation and for the actions of their employee under the doctrine of vicarious liability. The dental assistant is also liable for knowingly performing a task for which they are not legally authorized. Therefore, both parties share liability.

A patient requests a copy of their dental records to be sent to a new dental office. According to the CDAA Code of Ethics and privacy legislation, the dental office must:

Answer: Obtain the patient's written consent specifying what is to be released and to whom.

The CDAA Code of Ethics emphasizes patient confidentiality and the right to privacy. Legally, under privacy acts like PIPEDA, personal health information cannot be disclosed without the individual's knowledge and consent. The proper procedure is to obtain a signed, written consent form from the patient that clearly authorizes the release of their specific records to the designated third party.

In the context of obtaining informed consent, which of the following is the primary responsibility of the dental assistant?

Answer: To witness the patient's signature on the consent form.

While the dentist is ultimately responsible for the informed consent discussion (explaining risks, benefits, alternatives), dental assistants play a crucial supporting role. A key legal and ethical function for the assistant is to act as a witness, confirming that the patient has signed the consent form. They may also help by providing supplementary educational materials and ensuring the signed form is correctly filed in the patient's record.