Patient Confidentiality and Ethical Behaviour as a Professional Commitment in Dentistry: A Case Study in a Genetic Disorder

Abstract

A professional commitment to patient confidentiality may sometimes contradict other principles of bioethics. Decision-making for doctors and their team can be challenging amidst such conflicting principles, and despite the practitioner’s best intentions, withholding information can result in potential consequences such as harm to others.

Conflicting ethical issues in dentistry

“…Failure to sustain ethical behavior leads to a lack of trust between health professionals and patients, which can jeopardize treatment performance and effectiveness. 1,2 The ethical principles in healthcare derived long ago when Hippocrates developed the fundamental principles of ethics. The famous Hippocratic Oath, a solemn duty to abstain from wrongdoing and to treat patients with confidentiality and to the best of one's ability, remains the foundation of the medical and dentistry professions' code of ethics.…”

“…Similarly, if a patient threatened to commit a felony that would probably lead to serious injury to another person, the health care practitioner would be required to break patient confidentiality and report to the concerned authority. 16 Consider another case scenario where a 25-year-old lady has been your patient for 5 years. She has an inherited disorder, amelogenesis imperfecta with an autosomal recessive pattern that causes her teeth to be deformed, severely discolored, and characterized by peculiar pits and grooves.…”

“…As a result, this illness does not fit the criteria for disclosing personal health information, and patient confidentiality must be preserved. 17,18 In complex situations like these, the guidance from the British Dental Association as well as the GDC ethical code of conduct is very helpful. 19 Patient autonomy is a cornerstone in dental ethics, and it is reflected in the provision to get the patient's voluntary and informed consent well before clinical intervention.…”