Dental Ethics Case Presentation:
Step 1 - The nature of the problem
Defining the ethical question. Preliminary information:
short description of the ethical problem,
why it is a problematic situation,
accompanying circumstances...
Formulate the question in one of the following forms:
Given that description of the situation , what would be required or justified from the perspective of the ethical aspects of the situation? or
Given that description of the situation , would it be justified to proposal for action ?
Step 2 - Ethical Case Description
Medical Description. Describe the situation as accurately as possible. How can this patient be benefited by dental or nursing care, and how can harm be avoided? In particular, explain:
What is the patient's health problem, medical history, diagnosis, prognosis?
Is the problem acute, chronic, critical, emergent, reversible?
What are realistic goals of treatment?
What are the probabilities of success of each of those treatments?
What are plans in case of therapeutic failure?
Step 3 - Systematic Case Description
Patient's Preferences. Is the patient's right to choose being respected to the extent possible in ethics and law?
What has the patient expressed about preferences for treatment?
Has the patient been informed of benefits and risks of possible treatments, understood them, and given consent?
Is the patient mentally capable and legally competent? If no, what is the evidence of incapacity?
If incapacitated, who is appropriate surrogate? Is the surrogate using appropriate standards of decision making?
Is the patient unwilling or unable to cooperate with the dentist? If so, why?
Quality of Life
What are the prospects, with or without treatment, for a return to patient's normal quality of life?
Are there biases that might prejudice provider's evaluation of patient's quality of life?
What physical, mental, and social deficits is the patient likely to experience if treatment succeeds?
Is there any plan and rationale to forgo treatment?
Step 4 - Discussion and Analysis
Clarify, explore, and explain the key issues and reasons for uncertainty or conflict in the case. In particular:
state clearly the moral values, rights, and obligations of the individuals involved (if possible and justified, refer to appropriate ethical standards, applicable codices or current practices),
explain how the moral values, rights, and obligations are in conflict or what exactly is the source of uncertainty in the situation,
explain relative priority of those moral values, rights, and obligations,
restate patient's preferences and expectations of other identifiable individuals vis a vis those moral values, rights, and obligations.