ETHICAL ISSUES IN CURRENT ORTHODONTIC PRACTICE. CASE REPORT
Abstract
Orthodontic practice as any other dental and medical specialty is covered by certain fundamental ethics which will be taken strictly in consideration and strictly respected. When treating children, important ethical issues may arise relating to the best interests of the child and medical decisions making for minors. In this study we present the case of a 14-year-old girl whose parents refused extraction of four permanent teeth required for treating her Angle Class II/2 malocclusion. The parents believed the extraction of permanent teeth would have a negative impact on masticatory efficiency. As the parents decided to postpone the orthodontic treatment for another 2 years, their daughter’s dental status worsened. Ethical dilemmas include the conflict between the orthodontist obligation to the child and the need to respect parental autonomy. Assessing the ethical aspects of a case is needed to have a clear view of the benefits or burdens of possible treatment as well as the consequences of no treatment. When the patient returned 2 years later for orthodontic treatment, the treatment plan had to be changed due to the worsening of the dental status of 2 permanent molars. The orthodontist should take the responsibility for promoting the patients’ interests and protect the patients from harm. He should take specific steps to ensure that needed care is actually received.
References
2. Jonsen AR, Siegler M, Winslade WJ. Clinical ethics. 4th edition. New York : McGraw Hill Health Professions Division, 1998; 1-12, 13-45, 51-52, 87, 90-92, 112-113.
3. ***American Dental Association, Code of ethics and professional conduct. Chicago: ADA, 2018.
4. Astramskaitė I, Poškevičius L, Juodžbalys G. Factors determining tooth extraction anxiety and fear in adult dental patients: a systematic review. Int J Oral Maxillofac Surg 2016; 45(12): 1630-1643.
5. ***Principles of ethics, code of professional conduct and advising opinions of the American Associa-tion of Orthodontists, May 2018. Section 5.A(i).
6. Fishman M, Paquette ET, Gandhi R, et al. Surrogate Decision Making for Children: Who Should Decide. J Pediatr 2020; 220: 221-226.
7. ***American Medical Association, Council on Ethical and Judicial Affairs: Code of medical ethics, 170th Anniversary Edition. AMA, 2017.
8. Rule JT, Veatch RM. Ethical Questions in Dentistry. 2nd edition Chicago: Quintessence, 2004: 58-60.
9. Marshman Z, Eddaiki A, Bekker HL, Benson PE. Development and evaluation of a patient decision aid for young people and parents considering fixed orthodontic appliances. J Orthod 2016; 43(4): 276-287.
10. Parker K, Cunningham SJ, Petrie A, Ryan FS. Randomized controlled trial of a patient decision-making aid for orthodontics. Am J Orthod Dentofacial Orthop 2017; 152(2): 154-160.
11. Brignardello-Petersen R. Decision aid did not reduce decision conflict in adolescents considering receiving orthodontic treatment with fixed appliances at an orthodontic clinic. J Am Dent Assoc 2017; 148(12): e208.
12. Greco PM. Communicate, communicate, communicate. Am J Orthod Dentofacial Orthop 2011; 139(Suppl 4): S15.
13. Romanec C, Dorobăţ V, Zetu IN. The autonomous patient and his competence in orthodontics practice. Revista Română de Bioetică 2013; 11(3): 66-73.
14. Bucur SM, Chibelean M, Păcurar M, Sita DD, Zetu IN. Ethical considerations in orthodontics and dentofacial orthopedics. Revista Română de Bioetică 2014; 12(1): 80-84.
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