n South African Dental Journal - Constructing the consultation chair - balancing the four (E)-legs - ethics

Volume 75 Number 1
  • ISSN : 1029-4864
  • E-ISSN: 2519-0105



Reflecting on the past 80 years in dentistry with 20:20 vision, we observe a number of changes in materials, techniques, medicaments, facilities, patient desires, and treatment options. What has not changed is the duty of the clinician to “promote and safeguard the health of all patients, using their knowledge and conscience to fulfil this duty” (Declaration of Helsinki). This philosophy is considered so sacrosanct that it has been incorporated into The Declaration of Geneva of the World Medical Association which states “The health of my patient will be my first consideration,” and the International Code of Medical Ethics which declares that “A physician shall act only in the patient’s interest when providing medical care which might have the effect of weakening the physical and /or mental condition of the patient.” In practice, all healing carries the risk of harm, and almost every prophylactic, diagnostic, and therapeutic procedure involves certain risks and burdens. The onus is on the clinician to determine the most suitable and beneficial treatment option with the least risks for each patient. This is not always easy as there are a number of external factors that have to be considered. The levels of training, skills and experience of dentists, their preferences, their ethical standards, the availability of materials and facilities, and the time and costs of treatment will all influence planning and decision making. Of importance also to be taken into account are patient factors such as their level of education and understanding, family and peer pressure and their desire to conform to social media standards together with consideration of their actual needs versus their wishes and demands.

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