Questioning One's Ethics
Bernard Touati, DDS, MS
Unquestionably, the opportunity to acquire information on material and technical advances is one predominant factor that draws professionals together at contemporary society meetings and conferences. These venues simultaneously provide clinicians with access to differing perspectives and values that can be the topic of ongoing debate. Aesthetics will, by its very nature, continue to be the subject of much interpretation in the years to come, particularly among professionals from different geographical regions. Can the same be said of ethics? What exactly are the boundaries of the ethical aesthetic practice?
Ethics tend to be subjected to the same regional interpretations, values, and prejudices that influence the notion of aesthetics. In its strictest definition, ethics is the "discipline dealing with what is good and bad, and with more duty and obligation." For dental professionals, this sentiment is particularly valid as it relates to patient care. Consider, for example, slight to moderately discolored anterior teeth. Aesthetic care now permits a clinician to resolve such a condition in various manners. Some professionals would advocate the placement of 0porcelain veneers or even crowns over the discoloration. In other regions of the world, clinicians would treat the patient with a bleaching procedure rather than subjecting him or her to the irreversible prosthetic plan, which would be perceived as excessively invasive and unethical. Ultimately, it is critical for clinicians to remember that the patient brings the human dimension into consideration. It is this patient who has limiting factors (eg, understanding, time, financial resources) that must be addressed in the final treatment option.
What is certainly ethical for clinicians, then, is to provide the most accurate information about the full range of available alternatives. In order to do so, it is often necessary for dental professionals to consult with various specialists, understanding that optimum care may not involve their own initial diagnoses or treatment plans. Furthermore, it is even legally mandated in certain countries for clinicians to provide each patient with sufficient time to consider the benefits and limitations of these options. It is important for us to be humble and acknowledge that our goals and choices do not always match those of our patients.
By the same token, we have to extend such compassion to our fellow clinicians and lecturers. It is relatively simple to review a colleague's work in our practices or the lecture hall and pass judgment on its rationale, but such a critique certainly fails to account for the human element that faced said colleague chairside. If a well-informed patient is satisfied with a long-term result that doesn't jeopardize his health or the prognosis of his teeth, then the clinician's professional obligation has been fulfilled. In fact, the only person that can evaluate the success of dental treatment is the patient. It is no less important, however, for us to continue to question our treatment and consider the manner in which it was rendered. While there is no "right" answer to the underlying ethical/aesthetic dilemma, the solution lies in asking the question itself.