Ethics Case Study #1: It's nothing personal, doc
Begin this 1 MCE Credit course by reading the case study presented below. Through having previously taken the Foundation's course on Ethics and Jurisprudence, you will be equipped to apply the ethical principles discussed in that course to the case study presented. After reading the case, you will be presented with three case-specific questions to consider. Each of these questions will be related to the content discussed; upon answering each of the questions, you will receive detailed responses regarding the correct answer. Please note that upon completing the 3 question quiz with a passing score of at least 65%, your score will be automatically recorded and you will be issued a continuing education certificate for 1 MCE credit within three-days of completion. Should you have any questions, please contact the NYS Dental Foundation at (800) 255-2100, ext. 282. Thank you for choosing the New York State Dental Foundation for your continuing education.
STEP ONE: Read through the course material. When you complete the course, please continue to Step 2.
Jess Norman is a 40 year old stockbroker in your practice who has had dental care sporadically. This year, when he turned 40, he decided to take more responsibility for his health. As a result, he has come every three months for regular care because he wants to keep his teeth "for a lifetime." His general health is robust, he exercises regularly, his diet is balanced, and he takes no medications or dietary supplements. His firm's dental insurance plan pays 100% of all preventative services, 30% for restorative and prosthetic services, and 80% for extractions. The plan does not cover the cost of endodontic treatment or cosmetic services.
At present, his periodontal health is excellent and he has a Class I occlusion. Many of his teeth are restored. The large amalgam restorations in #14, 19, 30, & 31, are badly broken down. He has an impacted mandibular left third molar (#17). Tooth #18 has a full gold crown placed 10 years ago after endodontic treatment. The 2nd molar appears sound and no further treatment is planned for it.
When you presented the treatment plan initially, Mr. Norman refused extraction of #17 because he was fearful of the procedure. You decided to continue the rest of his treatment and educate him further about the need for the extraction. After several visits, he develops a painful pericoronitis by #17 and agrees to the extraction. Prior to the extraction, you review the procedure and he signs the consent form you use for oral surgical procedures. The consent describes the risks and benefits of surgery including the risk of damage to adjacent teeth and restorations. During the procedure, it is necessary to section #17 and while elevating the roots, the gold crown on #18 is dislodged. When you remove the restoration and assess the remaining tooth structure, you see a vertical fracture that penetrates the bifurcation. You inform Mr. Norman of this finding and the need to extract #18 because it is not restorable. Although he is upset by the news, he appears to understand the circumstances. After the surgery, you take additional time with him and show him the fracture in the 2nd molar root trunk.
He progresses well after surgery. A week later, when you remove the sutures, he reports having a good experience during the surgery and minimal pain afterwards. He says he is ready to proceed with the rest of his treatment. The next day, he calls your office, cancels his next appointment and requests to speak with you. You take the call and he says apologetically that he spoke to an attorney he saw on a television infomercial and has decided to sue you. He says it's "nothing personal," and that he "really appreciates your treatment."You inform Mr. Norman that in your entire time in practice you have never been sued. He responds by saying that he does not want to pay for the cost of treatment and he will drop his suit if you do the implant or partial denture at no cost to him.
STEP 2: Click here to complete the short quiz corresponding to the above case study. You will need to complete this quiz in order for your continuing education certificate to be issued.
You may now continue to the next case study.
Click here to continue to Ethics Case Study #2 >>>
E-mail the instructor with any questions you may have regarding this course.
The New York State Dental Foundation is an ADA-CERP approved provider of continuing education.