The Dentist’s Legal Responsibilities to the Patient

The Dentist’s Legal Responsibilities to the Patient Dental Law and Ethics

Responsibilities of the Dentist and the Assistant: • Proper licensure: • All legal requirements have been met for the dentist to practice • If required by state law, the assistant must be registered or certified in radiation health and safety • Exercising reasonable judgment and skill: • Skill: refers to knowledge plus the ability to use such knowledge • Care: relates to the manner in which skill is used • Judgment: refers to the decision making process in the choice of procedural methods

Legal Responsibilities Dentist’s responsibilities to patient Patient’s responsibilities to dentist All instructions will be followed, e.g., postoperative instructions; home-care instructions; cooperation with treatment such as wearing elastics, controlling diet, conducting oral hygiene, etc. • Appointments will be kept. • Fees for services will be paid. • Patients will conform to generally accepted modes of behavior. • Patients will be truthful regarding their health history and other administrative inquiries. • Properly licensed • Skill, care, judgment • Patient autonomy • Do not abandon patient • Refer to specialist • Standard techniques, materials, drugs • Reasonable results within reasonable time • Patient privacy • Adequate instructions • Reasonable fees

Responsibilities of the DA: • Develop and maintain skills through CEU’s • Maintain current CPR certification • Perform duties to best of ability each time • Exercise good judgment • Think before you say or do anything • Use reasonable care at all times

Skill, Care, Judgment • Knowledge plus ability to use such knowledge • Manner in which the skill is used • Decision-making process in making choice of procedural methods

Patient Autonomy Patient must give consent for doctor to provide any treatment Patient autonomy and informed consent

Consent requires: • Patient must be legally competent • It must be an informed consent • The consent is only for a specific treatment • The act consented to must be legal • The consent is not established by a fraudulent means

Consent: Informed consent Implied consent refers to the consent that is presumed by the actions of the patient Patient enters office and sits in dental chair, indicates implied consent for dentist to examine, diagnose, and consult Further treatment requires informed consent from patient • given after the patient has been given reasonable information to make an educated choice of treatment • Nature of condition • Proposed treatment • Risks involved • Chances of failure • Likely results if patient remains untreated • Alternative procedures that could be employed

What happens to consent during an emergency? implied consent

What happens to consent during an emergency? • Implied consent is used in an emergency when immediate care is necessary • Emergency = patient is in danger of death or serious bodily harm and is unable to give consent verbally or in writing • Implied consent would also be used in an emergency when a parent cannot be reached to give consent for a minor

Written Consent Required: • When new drugs are used • Experimental clinical testing is involved • Whenever a patient photograph may be used • For the use of general anesthesia • When minors are being treated in a public program • When treatment will take more than one year to complete

If the doctor is not available: • Abandonment = desertion, or the dentist’s not being accessible to a patient under treatment (patient of record) at any time the patient may reasonably require assistance • Arrange for coverage from another dentist • Arrange “on call” coverage when office is closed • Arrange schedule so that patients can get appointments without unreasonable delays • Daily “buffer time” for emergency calls • Failure to pay does not allow dentist to refuse to complete patient of record treatment • The dentist must address the patient when they call, and be available to address their questions

Withdrawing from a Case: • The dentist’s intentional withdrawal from treatment of a patient prior to completion of current treatment plan • A written notification must be sent • The letter must be sent by certified mail, return receipt requested (documented proof that letter was sent and received) • Copy of letter and signed postal receipt kept with patient chart • Letter must include • Notification of intent to withdraw and the reason • Failure to follow advice or to keep appointments are often the case • The withdrawal date (allow about 30 days) • Dentist must continue to provide care if patient seeks it, for this time • The need for further care and results of not receiving that care • An offer to help (transfer dental records to another dentist or suggesting another dentist) • The doctor’s signature

Referrals: • General dentists may perform all dental treatments • Good judgment must be made in regard to the dentist’s level of abilities • Dentist should refer to specialist • when he/she does not possess required knowledge or skill to treat the condition • Failing to refer patient in timely manner = malpractice • Documentation in patient chart: • Date of referral and name of recommended specialist • Copy of consultation report and any other correspondence from specialist • Signed informed refusal form if patient refuses doctor’s recommendations

Standard of Care • responsibility to use current techniques used by other dentists in the area • proper use of drugs requires

Achieving a Reasonable Result • Law = dentist fulfill a legal duty to exercise the standard of care • Unrealistic expectations can lead to lawsuits • Treatment should be completed within a reasonable amount of time, and should not extend beyond one year • HIPAA laws protect patient’s privacy

Provide adequate instructions • Written and verbal instructions to patient for post-operative care • Explained in language and manner that patient can understand

Reasonable fees • Reasonable = fee that dentist and patient have agreed upon • Completed dental work becomes personal property of patient

The Dentist’s Legal Responsibilities to the Patient