Ethics Question

[Guest guest]

Hi,Q: You are a dentist in a practice, visited by a patient with is carer. Patient is with sever Down Syndrome. How you take consent and proceed with your treatment?1- Explain treatment to carer and take consent from Carer.2- Explain the treatment to carer and patient, but due to patient condition this will preclude a valid consent to be taken.3- Explain treatment to patient and take consent from patient.4- If patient understands the treatment, take consent from patient.

[Guest guest]

You are a dentist in a practice, visited by a patient with is carer. Patient is with sever Down Syndrome. How you take consent and proceed with your treatment?

1- Explain treatment to carer and take consent from Carer.

2- Explain the treatment to carer and patient, but due to patient      condition this will preclude a valid consent to be taken.

3- Explain treatment to patient and take consent from patient.

4- If patient understands the treatment, take consent from patient.

[Guest guest]

Hi,i think you should not disclose..this is from GMC regulationInforming sexual contacts of patients with a serious communicable disease

10 You may disclose information to a known sexual contact of a patient with a sexually transmitted serious communicable disease if you have reason to think that they are at risk of infection and that the patient has not 

informed them and cannot be persuaded to do so.in such circumstances, you should tell the patient before you make the disclosure, if it is practicable and safe to do so. You must be prepared to justify a decision to 

disclose personal information without consent.11 When you are tracing contacts and notifying partners, you should not disclose the identity of the patient, if practicable.  but there is a clause there which is,

The NHS (Venereal Diseases) Regulations 1974, The NHS Trusts (Venereal Diseases) Directions 1991 and The NHS Trusts and Primary Care Trusts (Sexually Transmitted Diseases)Directions 2000 state that various NHS bodies in England 

and Wales must ‘take all necessary steps to secure that any information capable of identifying an individual… with respect to persons examined or treated for any sexually transmitted disease shall not be disclosed except – (a) for 

the purpose of communicating that information to a medical practitioner, or to a person employed under the direction of a medical practitioner in connection with the treatment of persons suffering from such disease or the 

prevention of the spread thereof, and ( for the purpose of such treatment and prevention’. There are  different interpretations of  the Regulations and Directions, and concerns about their compatibility with the European 

Convention on Human Rights. In particular, there have been concerns that a strict interpretation would prevent the disclosure of relevant information, except to other doctors or those working under their supervision, even with the 

patient’s consent or to known sexual contacts in the public interest. Our view is that the Regulations and Directions do not preclude disclosure if it would otherwise be lawful at common law, for example with the patient’s consent or in 

the public interest without consent On Wed, Mar 7, 2012 at 3:23 PM, Shipra Bapna <bapnashipra@...> wrote:

 

If patient is HIV positive..and does not want this information to be disclosed to anyone..is it the moral duty of the dentist to inform his/her spouse ?

[Guest guest]

Absolutely not From: Shipra Bapna <bapnashipra@...> " " < > Sent: Wednesday, 7 March 2012, 15:23 Subject: Ethics question

If patient is HIV positive..and does not want this information to be disclosed to anyone..is it the moral duty of the dentist to inform his/her spouse ?

[Guest guest]

No I haven`t ever read anything like this but you can`t disclose the pt info to anyone even for the court they need to provide a court order first.even if the pt suffering from a communicable diseaseI will search for additional info and let u knowbest regardsebtisam From: Shipra Bapna <bapnashipra@...> " " < >

Sent: Wednesday, 7 March 2012, 18:13 Subject: Re: Ethics question

But isn't breach of confidentiality justified here as the spouse is at a high risk of being infected..

[Guest guest]

Thanks ebtessam for clearing the doubt..

From:

ebtessam elhamalawy <ebtessamhamalawy@...>;

To:

Shipra Bapna <bapnashipra@...>;

Subject:

Re: Ethics question

Sent:

Wed, Mar 7, 2012 8:58:21 PM

HI GO THROUGH THE BDA SHEET FOR ETHICS IN DENTISTRY ITS explained better in the BDA sheet, that in case of public intrest ( the pt has committed a crime) u can disclose his info to the police after getting advice from the defense organization. bets regardsebtisam From: Shipra Bapna <bapnashipra@...> " ebtessamhamalawy@... "

<ebtessamhamalawy@...> Sent: Wednesday, 7 March 2012, 19:21 Subject: Re: Ethics question On pg 661pink bk ..it says that breach can be justified for public interest..dats why I am confused

[Guest guest]

THANK YOU! From: Anu Arora <dr.anuarora@...> Sent: Thursday, 8 March 2012, 16:31 Subject: Re: Ethics question

The technique of patency filing involves passively inserting a small file, size 08 or 10, 2 mm beyond the established working length. No attempt is made to instrument the foramen, merely to keep it open or patent by deliberately extruding the debris into the periradicular tissues.

flexible files are used to prevent apical blockage w/o enlarging apical

foramen the disadvantes are longer

appointments and inability to control exudateshope it helpsAnuOn Thu, Mar 8, 2012 at 7:09 PM, Sajithakumari Sivaprem <ssajithakumari@...> wrote:

patency preparation in endo is cleaning the whole length of the canal so as not to produce an apical blockage...done using a small file....so apical foramen is not widened...

From: ARTHUR TADEVOSYAN <arthur_tadevosyan@...> " " < >

Sent: Thursday, 8 March 2012 1:13 PM Subject: Re: Ethics question

WHAT IS PATENCY OR POTENCY PREPARATION? THANK YOU.

From: manochitra d <manochithradurairaju@...>

To:

Sent: Wednesday, 7 March 2012, 17:16 Subject: Re: Ethics question

Hi,i think you should not disclose..this is from GMC regulationInforming sexual contacts of patients with a serious communicable disease

10 You may disclose information to a known sexual contact of a patient with a sexually transmitted serious communicable disease if you have reason to think that they are at risk of infection and that the patient has not

informed them and cannot be persuaded to do so.in such circumstances, you should tell the patient before you make the disclosure, if it is practicable and safe to do so. You must be prepared to justify a decision to

disclose personal information without consent.11 When you are tracing contacts and notifying partners, you should not disclose the identity of the patient, if practicable.

but there is a clause there which is,

The NHS (Venereal Diseases) Regulations 1974, The NHS Trusts (Venereal Diseases) Directions 1991 and The NHS Trusts and Primary Care Trusts (Sexually Transmitted Diseases)Directions 2000 state that various NHS bodies in England

and Wales must ‘take all necessary steps to secure that any information capable of identifying an individual… with respect to persons examined or treated for any sexually transmitted disease shall not be disclosed except – (a) for

the purpose of communicating that information to a medical practitioner, or to a person employed under the direction of a medical practitioner in connection with the treatment of persons suffering from such disease or the

prevention of the spread thereof, and ( for the purpose of such treatment and prevention’. There are different interpretations of the Regulations and Directions, and concerns about their compatibility with the European

Convention on Human Rights. In particular, there have been concerns that a strict interpretation would prevent the disclosure of relevant information, except to other doctors or those working under their supervision, even with the

patient’s consent or to known sexual contacts in the public interest. Our view is that the Regulations and Directions do not preclude disclosure if it would otherwise be lawful at common law, for example with the patient’s consent or in

the public interest without consent On Wed, Mar 7, 2012 at 3:23 PM, Shipra Bapna <bapnashipra@...> wrote:

If patient is HIV positive..and does not want this information to be disclosed to anyone..is it the moral duty of the dentist to inform his/her spouse ?