Dentistry Interview Ethical Scenarios - Tips,
Techniques & Examples
Ethical scenarios tend to pop up whilst working as a dentist and thus it’s often a key area that assessors and examiners wish to explore during interviews. It can be quite a daunting experience for the interviewee but with the tips and techniques below, it will definitely become easier!
When given an ethical scenario, it can often feel overwhelming. This is because it isn’t a black and white scenario and there’s usually not one correct answer.
The following steps will assist you in formulating a coherent response to any ethical scenario thrown at you:
- Identify the issue at hand. What is the scenario being mentioned and what are the key points? It’s only once you’ve understood the scenario that you can begin to analyse the different sides to it.
- Once the scenario has been fully comprehended, the candidate can then systematically go through the 4 pillars of medical ethics which is also applicable to dentistry. This will help you in analysing the ethical case in a systematic manner and with a logical approach.
This is respecting the patient’s rights and giving them the power to make their own decisions. It can also cover maintaining patient confidentiality
This is centred around ensuring benefit for the patient. Facilitating good towards them.
This is centred around ensuring no harm comes to the patient. This can be directly health related but also covers mental or psychological harm.
Treating everyone equally
These 4 points should be moulded around the case at hand.
Dentistry Example Ethical Scenario:
A patient attends the surgery and refuses to have drilling done to remove caries as they strongly believe in a fully conservative approach to treatment. They do not wish to remove any more tooth tissue. What action would you take in this scenario?
In this scenario, one must first gain an appreciation of the case at hand. What points are being discussed and what is the ethical aspect here?
Thereafter, we move to autonomy. We must ensure patient confidentiality throughout whilst giving them the power to make their own decisions. In this case it is appreciating that the patient has the right to make a ‘no drill’ decision. It is essential at this stage that you explain to the patient what drilling entails and its risks and benefits. Its purpose. As more often then not, patients may make a decision based on misinformation. Thus, it is important to clarify understandings. Ask the patient why they don’t wish to have drilling done, whilst explaining to them why you feel it is beneficial in this clinical case.
Next, we move unto beneficence. This is ensuring that we always benefit the patient. This can present in two different lights. It could be educating the patient over the benefits of drilling (conservatively) if needed, in order to access the caries to prevent further problems. Or it could be giving the patient their right to make their own informed decision and maintain tooth structure should they wish to not have drilling done. If the latter is the case, the clinician can focus on more non-invasive treatment options such as oral hygiene advise, fluoride application or even prescription of a high fluoride toothpaste if indicated.
Thirdly, we move onto non-maleficence. This is ensuring no harm is done towards the patient. Again, this presents as two sides. If the patient does not remove decay via drilling if needed, the decay may get deeper and close to the pulp resulting in an exposure and apical pathology. This can then cause the symptoms to develop into a throb. On the other hand, forcing the patient to have drilling done could cause psychological and mental trauma.
Then we move unto justice. This is the pillar that focusses on ensuring the decisions you make are not causing harmful consequences to the community at large. For example, if the dentist didn’t make it clear why drilling may be needed in certain circumstances, the patient may spread misinformation in the community and this could cause problems.
From the above, we can see that addressing ethical scenarios can be complex and there is not one right or wrong answer. It comes with different perspectives. The assessor wants to see that you have been able to grasp the matter at hand and have been able to identify both sides of the argument. Thereafter, all points should be highlighted in a logical and coherent manner.
Dentistry Interview Ethical Scenarios: Top Tips
- Do not be overtly simplistic nor overly passionate when addressing an ethical case. Being the former shows that you may not have fully understood the matter at hand. Whilst the latter could show you are bias towards one side. Be balanced and moderate in your approach.
- There are many pillars to go through and a scenario could come with various points. Do not allow this to make your argument incoherent and ‘all over the place’. When points don’t flow logically, this could leave the assessor feeling confused. Always try and be systematic in your analysis.
- Always present a conclusion. Address both sides of the argument and conclude in a manner which demonstrates both understanding, empathy and good analysis skills. For example, for the aforementioned scenario, one could conclude by saying, the dentist should convey the reasons for drilling in certain clinical cases with its benefits and associated risks but also respect the patients wishes if they decline treatment. The dentist should always present all options with their pros and cons, alternatives and ensure conservative options are also mentioned should patients only opt for this. The dentist should present all possibilities and ensure the patient has the autonomy to make their own informed decision.
With this in mind, you will be able to tackle any ethical case that comes your way!
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