Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-26T08:57:39.590Z Has data issue: false hasContentIssue false

Informed Consent in Dentistry

Published online by Cambridge University Press:  01 January 2021

Abstract

A review of literature regarding informed consent in dentistry reveals a paucity of information and minimal scholarship devoted to this subject. But this begs the question about informed consent somehow being different for dentistry than for medicine or other healthcare delivery. My account draws distinctions where appropriate but is rooted in the premise that informed consent is an ethical construct applicable to vulnerable people as patients independent of what type of treatment or body part being considered. This paper highlights the crucial importance of the process of informed consent and refusal in dentistry, underscoring its important place in oral healthcare. This paper will not address the unique circumstances involving consent in those without capacity or focus on informed consent in the research setting; our focus will be on those patients with full decisionmaking capacity in the clinical setting. I will emphasize the importance of disclosure of treatment options and highlight the benefits of shared-decision-making in the informed consent process.

Type
Symposium Articles
Copyright
Copyright © American Society of Law, Medicine and Ethics 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Chelouche, T., “Medicine and the Holocaust: Lessons for Present and Future Physicians,” Medicine and Law 27, no. 4 (2008): 787-804.Google Scholar
Schloendorff v. Society of New York Hospital, 211 N.Y. 125, 105 N.E. 92 (1914).Google Scholar
Canterbury v. Spence, 464 F.2d 772 (D.C. Cir. 1972).Google Scholar
Koapke v. Herfendal, 660 N.W. 2d 206 (N.D. 2003); American Dental Association, Principles of Ethics and Code of Professional Conduct: 2016, available at <http://www.ada.org/en/about-the-ada/principles-of-ethics-code-of-professional-conduct/conduct> (last visted August 28, 2016).+(last+visted+August+28,+2016).>Google Scholar
Berg, J. W., Applebaum, P. S., Lidz, C. W., and Parker, L. S., Informed Consent, Legal Theory and Clinical Practice, 2nd vol. (New York: Oxford Press, 2001).Google Scholar
Faden, R. R., and Beauchamp, T. L., A History and Theory of Informed Consent (New York: Oxford Press, 1986).Google Scholar
Beauchamp, T. L. and Childress, J. F., Principles of Biomedical Ethics, 6th vol. (New York: Oxford Press, 2009).Google Scholar
Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., Cording, E., Tomson, D., Dodd, C., Roll-nick, S., Edwards, A., and Barry, M., “Shared Decision-making: A Model for Clinica Practice,” British Medical Journal 341 (2010): 1361-1367.Google Scholar
Capron, A., “Informed Consent in Catastrophic Disease Research and Treatment,” University of Pennsylvania Law Review 340 (1974): 365-376.Google Scholar
See Beauchamp, supra note 7.Google Scholar
Katz, J., “Informed Consent: A Fairy Tale?” University of Pittsburgh Law Review 39 (1977): 139-174.Google Scholar
Lavelle-Jones, C., Byrne, D. J., and Rice, A., “Factors Affecting Quality of Informed Consent,” British Medical Journal 306 (1993): 885-890.CrossRefGoogle Scholar
Falaga, M. E., Korbila, I. P., Giannopoulou, K. P., Kondilis, B. K., and Peppas, G., “Informed Consent: How Much and What Do Patients Understand?” American Journal of Surgery 198 (2009): 420-435.CrossRefGoogle Scholar
Furrow, B. R., Greaney, T. L., Johnson, S. H., Jost, T. S., and Schwartz, R. L., Health Law, Cases, Materials, and Problems (St Paul: West Group, 2001).Google Scholar
See Beauchamp, supra note 7.Google Scholar
Graskemper, J. P., “A New Perspective on Dental Malpractice,” Journal of American Dental Association 133 (2002): 752-757.CrossRefGoogle Scholar
King, J., “Informed Consent: Does Practice Match Conviciton?” Journal of the American College of Dentists 72, no. 1 (2005): 27-31.Google Scholar
Hajivassiliou, E. C. and Hajivassiliou, C. A., “Informed Consent in Primary Dental Care: Patient's Understanding and Satisfaction with the Consent Process,” British Dental Journal 219, no. 5 (2011): 221-224.CrossRefGoogle Scholar
See Hajivassiliou, supra note 21.Google Scholar
Degerliyurt, K., Gunsolley, J. C., and Laskin, D. M., “What Do Patients Really Want to Know?” Journal of Oral and Maxillofacial Surgery 15 (2010): 2-12.Google Scholar
Hammami, M. M., Al-Jawarneh, Y., Hammami, M. B., Eissa, A., and Qadire, M. A., “Patient's Perceived Purpose of Clinical Informed Consent: Mill's Individual Autonomy Model Is Preferred,” Biomed Central Medical Ethics 15 (2014): 2-12.CrossRefGoogle Scholar
Phillips, R. L. Jr., Bartholomew, L. A., Dovey, S. M., Fryer, G. E. Jr, Miyosh, T. J., and Green, L. A., “Learning from Malpractice Claims about Negligent, Adverse Events in Primary Care in the United States,” Qual Saf Health Care 13, no. 2 (2014): 121-126; S. O. Rogers Jr., A. A. Gawande, M. Kwan, A. L. Puo-polo, C. Yoon, T. A. Brennan, and D. M. Studdent, “Anaylsis of Surgical Errors in Closed Malpractice Claims at 4 Liability Insurers,” Surgery 140, no. 1 (2006): 25-33.Google Scholar
Jury Verdict Research: Current Trends in Personal lnjury vol. 46 (Palm Beach Gardens: LRP Publications, 2007).Google Scholar
Localio, A. R., Lawthers, A. G., Brennan, T. A., Laird, N. M., Hebert, L. E., Peterson, L. M., Newhouse, J. P., Weiler, P. C., and Hiatt, H. H., “Relation between Malpractice Claims and Adverse Events Due to Negligence: Results of Harvard Medical Practice Study III,” New England Journal of Medicine 325, no. 4 (1991): 245-251.CrossRefGoogle Scholar
Beckman, H. B., Markakis, K. M., Suchman, A. L., and Frankel, R. M., “The Doctor-Patient Relationships and Malpractice,” Archives of Internal Medicine 154, no. 12 (1994): 1365-1370.CrossRefGoogle Scholar
See ADA Conduct, supra note 4.Google Scholar
American College of Dentists, Ethics Handbook, available at <https://www.acd.org/ethicshandbook.htm> (last visited January 26, 2017).+(last+visited+January+26,+2017).>Google Scholar
Degennaro v. Tandon, 89 Conn. App. 183, 873 A.2d 191 (Conn. Appt. Ct. 2005).Google Scholar
Murphy, J., “Benefits and Challenges of Informed Consent,” Mayo Clinic Proceedings 83, no. 3 (2008): 272-273.CrossRefGoogle Scholar
Bernard v. Char, 79 Hawaii 371, 903 P.2d 676 (Haw. Ct. App. 1995), aff'd 79 Hawaii 362 (Haw.1995).Google Scholar
See Bernard, supra note 33.Google Scholar
See Koapke, supra note 4.Google Scholar
Ozar, D. T. and Skol, D. J., Dental Ethics at Chairside, 2nd ed. (Washington DC: Georgetown University Press, 2002); M. A. Boyd, K. Roth, S. A. Ralls, and D. W. Chambers, “Beginning the Discussion of Commercialism in Dentistry,” Canadian Dental Association Journal 36, no. 1 (2008): 57-65; M. R. Gillis, “The Dynamism of Professional and Business Identities,” Journal of American College of Dentists 78, no. 3 (2011): 24-28; A. L. Yeager, “Dental Ethics for the 21st Century: Learning from the Charter on Medical Professionalism,” Journal of American College of Dentists 69, no. 3 (2002): 53-60; J. B. Robinson, H. L. Faggart, and L. W. Morrey, “A Synoptic Hisotry of the American Dental Association,” Journal of American Dental Association 58, no. 6 (1959): 19-76.Google Scholar
Pellegrino, E., “Professionalism, Profession and the Virtues of the Good Physician,” Mt Sanai Journal of Medicine 69 (2002): 378-384.Google Scholar
Poll, Gallup, “Honesty/Ethics in Professions,” 2012, available at <www.gallup.com/poll/1654/honesty-ethics-professions.aspx> (last visited January 26, 2017).+(last+visited+January+26,+2017).>Google Scholar
Reid, K. I., Humeniuk, K., Henriksen-Helyer, J., Thor-steindottir, B., and Tilburt, J., “A Comparison of Ethical Characteristics of Dentists; Results of a Community Primary Care Survey,” Journal of American Dental Association 145, no. 8 (2014): 829-834.Google Scholar
Welie, J. V. M., “Is Dentistry a Profession? Part I: Professionalism Defined,” Journal of the Canadian Dental Association 70, no. 9 (2004): 599-602.Google Scholar
Rule, J. T., “How Dentistry Should Approach Its Problems,” Journal of the American College of Dentists 77, no. 4 (2010): 59-74; J. V. M. Welie, M. Simpson, and G. H. Westerman, “The Troubled History of Dental Advertising. Part 4: Ethical Reflections,” Bulletin of the International Dental Ethics and Law Society 2, no. 2 (2002): 8-11.Google Scholar
American Student Dental Association, “Dental Student Debt: Starting a Dental Practice: Can You Afford It?” 2012, available at <http://www.asdanet.org/debt.aspx> (last visited January 26, 2017).+(last+visited+January+26,+2017).>Google Scholar
Bader, J. D., “Challenges in Quality Assessment of Dental Care,” Journal of Ameican Dental Association 140, no. 12 (2009): 1456-1464.Google Scholar
Curley, A. W. and Peltier, B., “Standard of Care: The Legal View,” Journal of American College of Dentists 8, no. 1 (2014): 53-58.Google Scholar
Jenson, L. E., “Six Common Misconceptions about the Standard of Care in Dentistry,” Journal of American College of Dentists 8, no. 1 (2014): 59-63.Google Scholar
Van der Sanden, W. J. M., Mettes, D. G., Plasschaert, A. J. M., van't Hof, M. A., Grol, R. P. T. M., and Verdonschot, E. H., “Clinical Practice Guidelines in Dentistry: Opinios of Dental Practitioners on Their Contribution to the Quality of Dental Care,” Quality and Safety in Healthcare 12, (2003): 107-111R. W. McCluggage, A History of the American Dental Association (Chicago: American Dental Association, 1959).Google Scholar
Orasky, I., “Dr. Know,” The New Republic (2008): 20-21; D. W. Chambers, “Evidence Based Dentistry,” Journal of American College of Dentists 77 (2010): 68-80.Google Scholar
See Beauchamp supra note 7.Google Scholar
See Canterbury, supra note 3.Google Scholar
See ADA Conduct, supra note 4.Google Scholar
See Welie, supra note 40.Google Scholar
See Reid, supra note 39.Google Scholar
Welie, J. V. M., “Social Contract Theory as a Foundation of Social Responsibilites of Health Professionals,” Medical Health Care and Philosopy; see Pellegrino, supra note 37.Google Scholar
Reid, K. I. and Greene, C. S., “Diganosis and Treatment of Temporomandibular Disorders: An Ethical Analysis of Current Pratices,” Journal of Oral Rehabilitation 40, no. 7 (2013): 546-561.CrossRefGoogle Scholar
See ADA Conduct, supra note 4; American College of Dentists, supra note 30; Pellegrino, supra note 37; Welie, supra note 40; Rule, supra note 41.Google Scholar
See Welie, supra note 54.Google Scholar
See Welie, supra note 40.Google Scholar
LVI Global, “What Is Neuromuscular Dentistry,” available at <http://lviglobal.com/research/what-is-neuromuscular-dentistry/> (last visited January 26, 2017).+(last+visited+January+26,+2017).>Google Scholar
See Reid, supra note 55.Google Scholar
TMJA, “The Latest Treatment Craze in TMJ… Neuromuscular Dentistry,” 2015, available at <http://www.tmj.org/site/page?pageId=239> (last visited January 26, 2017).+(last+visited+January+26,+2017).>Google Scholar
American Dental Association, “American Dental Association on Unconventional Dentistry,” 2016, available at <http://www.ada.org/en/about-the-ada/ada-positions-policies-and-statements/unconventional-dentistry> (last visited January 26, 2017).+(last+visited+January+26,+2017).>Google Scholar
Barrett, S., “My Concerns about ‘Holistic’ and ‘Biological’ Dentistry,” 2012, available at <http://www.quackwatch.com/01QuackeryRelatedTopics/holisticdent.html> (last visited January 26, 2017).+(last+visited+January+26,+2017).>Google Scholar
Martin v. Richards, 192 Wis. 2d 156, 531, N.W.2d 70, 78 (Wis. 1995); Derrick, J., “Medical Malpractice Liability for Failure of Physician to Inform Patient of Alternative Modes of Diagnosis and Treatment,” American Law Reports 4th 38 (1985): 901-915.Google Scholar
Morris v. Ferriss, 669 So.2d 1316 (La. App. 4 Cir. 2/15/1996).Google Scholar
See Bernard, supra note 33.Google Scholar
Reid, K. I., “Respect for Patient's Autonomy,” Journal of American Dental Association 140, no. 4 (2009): 470-474.CrossRefGoogle Scholar
Fowler, Jr., McNaughton, M. C., Albertsen, P. C., Zietman, A., Elliot, D. B., and Barry, M. J., “Comparison of Recommendations by Urologists and Radiation Oncologists for Treatment of Clinically Localized Prostate Cancer,” JAMA 283, no. 24 (2000): 3217-3222.CrossRefGoogle Scholar
Veatch, R. M., “Implied, Presumed, and Waived Consent; The Relative Moral Wrongs of Under- and Over-Informing,” American Journal of Bioethics 7, no. 12 (2007): 39-41.CrossRefGoogle Scholar
Lund, J. P., Widmer, C. G., and Feine, J. S., “Validity of Diagnostic and Monitoing Tests Used for Temporomandibular Disorders,” Journal of Dental Research 74, no. 1133 (1995): 1133-1143; C. S. Greene, “The Role of Technology in TMD Diagnosis,” in C. S. Greene, W. L. Hylander and D. M. Laskin, Temporomandibular Disorders: An Evidence-Based Approach to Diagnosis and Treatment (Chicago: Quintessence, 2006): at 193-202.CrossRefGoogle Scholar
See Lund, supra note 70; Greene, supra note 70.Google Scholar
See Greene, supra note 70.Google Scholar
See Reid, supra note 55; Lund, supra note 70; Greene, supra note 70.Google Scholar
See Reid, supra note 55.Google Scholar
See Reid, supra note 55; Greene, supra note 70.Google Scholar
See ADA Conduct, supra note 4.Google Scholar
See Reid, supra note 55; Greene, supra note 70.Google Scholar
See ADA Conduct, supra note 4.Google Scholar
See Reid, supra note 67.Google Scholar
See Canterbury, supra note 4.Google Scholar
Salgo v. Leland Stanford Jr. University Bd. of Trustees, 317 P.2d 170, 181 (Cal. Dist. Ct. App. 1957).Google Scholar
Katz, J., “Informed Consent: Must It Remain a Fairy Tale?” Journal of Contemporary Health and Law Public Policy 10, no. 1 (1994): 69-91.Google Scholar
American Medical Association, “American Medical Association Code of Ethics,” 1847.Google Scholar
American Dental Association, “Transactions of the American Dental Association 6th Annual Session,” The Dental Cosmos 8, no. 2 (1866): 88-90.Google Scholar
See Ozar, supra note 36.Google Scholar
See Veatch, supra note 69.Google Scholar
Paasche-Orlow, M. K., Taylor, H. A., and Brancati, F. L., “Readablity Standards for Informed Consent Forms as Compared with Actual Readability,” New England Journal of Medicine 348 (2003): 721-726.CrossRefGoogle Scholar
See Falaga, supra note 13.Google Scholar
McKneally, M. F., Martin, D. K., Ignagni, E., Martin, D. K., and D'Cruz, J., “The Leap to Trust; Perspective of Chlycystectomy Patietns on Informed Decision-Making and Consent,” Journal of American College of Surgeons 118 (2004): 1172-1182.Google Scholar
Ruhnke, G. W. et al., “Ethical Decision-Making and Patient Autonomy: A Comparison of Physicans and Patients in Japan and the United States,” Chest 118, no. 4 (October 2000): 1172-1182.Google Scholar
Kinnersley, P., “Interventions to Promote Informed Consent for Patients Undergoing Surgical and Other Invasive Health-care Procedures,” Cochrane Database of Systematic Reviews 7 (2013): CD009445.Google Scholar
Valenza, J. A., Taylor, D., Walji, M. F., and Johnson, C. W., “Assessing the Benefit of a Personalized HER-Generated Informed Consent in a Dental School Setting,” Journal of Dental Education 78, no. 8 (2014); 1182-1193.CrossRefGoogle Scholar
Tilburt, J., “Shared Decision-Making after MacIntyre,” Journal of Medicine and Philosopy 36, no. 2 (2011): 148-169; P. Salovey, Emotional Intelligence (New Haven: Baywood Publishing Co, 1990).CrossRefGoogle Scholar
See Tilburt, supra note 93.Google Scholar
See Salovey, supra note 93.Google Scholar
Munk, L. K., “Implications of Sate Dental Board Disciplinary Actions for Teaching Dental Students about Emotional Intelligence,” Journal of Dental Education 80, no. 1 (2016): 14-22.CrossRefGoogle Scholar
See Munk, supra note 98.Google Scholar
See Elwyn, supra note 8.Google Scholar
O'Connor, A., Bennett, C., Stacey, D., Barry, M., Col, N., and Eden, K. et al., “Decision Aids for People Facing Health Treatment Decisions,” Cochrance Database of Systematic Reviews 1 (2014): 1-4; A. Towle and W. Godolphin, “Framework for Teaching and Learning Informed Shared Decision-Making,” British Medical Journal 319, no. 18 (1999): 766-769.Google Scholar
Fink, A. S., Prochazka, A. V., Henderson, W. G., Bartenfeld, D., Nyirenda, C., Webb, A., Berger, D. H., Itani, K., White-hill, T. M., Edwards, J., Wilson, M., Karsonovich, C., and Parmelee, P., “Enhancement of Surgical Informed Consent by Addition of Repeat Back,” Annals of Surgery 252, no. 1 (2010): 27-36.Google Scholar
See Elwyn, supra note 8.Google Scholar
See Welie, supra note 40.Google Scholar