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The Hands of a Practitioner, the Heart of a Provider

by Officer Shawn L. Naccarato DDS

220 pages; quality trade paperback (softcover); catalogue #03-1474; ISBN 1-4120-1105-1; US$30.00, C$39.00, EUR25.35, £17.57

A comprehensive study of professional ethical concepts relating to modern business entities with particular attention to the ethical, legal, and risk management issues faced by today's dental professionals.

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about the book      about the author      Table of Contents and Preface      catalogue info

About the Book With the recent upswing in professional ethical misconduct, a comprehensive reeducation in ethical concepts is imperative. This text represents my understanding of the ethical principles from early Greek society to today's society. It clearly outlines the logical historical beginnings of ethical thought, gives students a greater appreciation for the validity of established ethical concepts, provides for a greater understanding of the various aspects of professional ethics and legal issues, and presents workable mechanisms for the prevention, management, and resolution of ethical and/or legal situations in the realm of dentistry. While other texts on this subject appear to be written to appeal primarily to one audience (i.e. dentists or dental hygienists); this text will be valuable asset to dental students, dental hygiene students, practicing dentists, and practicing dental hygienists. By utilizing a simple, 'to the point' approach to dental ethics and legal issues; I feel that anyone who reads my textbook will benefit from my apporach to the subject matter. The specific questions that this book will address are listed as follows: What is ethics? Where and how did ethics begin? How are ethics, religion, and the law related as guides for our actions? Are the concepts of Aristotle, Aquinas, and others valid for modern-day professional applications? How do ethical principles relate to the dental profession? What are some of the consequences for violations of ethical principles? What happens when ethical violations become legal problems, and what types of civil and/or criminal issues may practitioners face in today's society? How can practitioners minimize, manage and resolve the various ethical and/or legal situations they may encounter in modern dentistry and dental hygiene?

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About the Author Dr. Shawn Naccarato is a full-time police officer with the Boise Airport Police Department in Boise, Idaho. He attended Gonzaga University from 1980-1984, and he graduated with a Bachelor of Science degree in Biology in 1984. He attended the University of Washington School of Dentistry from 1985-1989. He graduated with Doctor of Dental Surgery degree in 1989. Dr. Naccarato spent the next 11 years working as a general dentist primarily in the south-central part of Idaho. He became interested in law enforcement after a discussion with one of his patients (the sheriff of a nearby county), and he became a Level 1 Reserve Officer in 1992. For the next few years he operated his dental practice during the week and patrolled the streets on weekends. In July, 2000 Dr. Naccarato decided to pursue a full-time career in law enforcement. He attended the Idaho POST Academy as a self-sponsored student, and he graduated from the academy in December, 2000. Dr. Naccarato is a certified Field Training Officer, and he teaches ethics as part of his department's field training program. In addition to his law enforcement duties, Dr. Naccarato currently teaches both ethics and radiology classes at the American Institute of Health Technology School of Dental Hygiene in Boise, Idaho. He a member of the American Dental Association, Idaho State Dental Association, National Reserve Law Officers Association, Fraternal Order of Police, and the Idaho Peach Officers Association. During his off-duty time, Dr. Naccarato enjoys spending time with his family (wife and 4 children) and studying both Kenpo Karate and Brazilian Jiu Jitsu.

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Table of Contents and Preface

Table of Contents
Acknowledgements - 8
About the Author - 10
Preface - 11

Chapter 1 Philosophy and Ethics - 15
General Overview of the Greeks
Types of Philosophy

Chapter 2 Ethical Theories - 19 Functional definition of Ethics
Human Acts vs. Acts of Man
Morally Correct and Morally Incorrect Actions
Human Nature
Human Actors and the Creator
Human Actors and Other Humans
Human Actors and Other Things

Chapter 3 Ethics, Religion, and Law - 25 Ethics
Religion
Law
Natural Law
Positive Law

Chapter 4 Ethics and the Professional - 36 Professional Endeavors
Business
Society, Natural and Positive Law, and our Government
Ethical and Legal Obligations

Chapter 5 Foundations of Ethical Standards - 44 Altruism
Autonomy
Beneficence
Caring
Civic virtue/citizenship
Compassion
Competence
Confidentiality
Empathy
Honesty
Integrity
Justice/Fairness
Non-maleficence
Paternalism
Professionalism
Promise-keeping
Respect/tolerance
Responsibility
Veracity

Chapter 6 Ethical Decision-making Models - 54 The Silver Rule Model
The Golden Rule Model
The Mirror Model
The 10-step Test
The Double Effect Principle
The American Dental Hygienists* Association
Code of Ethics
The American Dental Association Code of Ethics

Chapter 7 Introduction to the Law-Legal Concepts in Dentistry - 108
U.S. Federal Court System
Example of a State Court System
Statutes and Judicial Decisions
Sanctions
Administrative Law
Accessory
Accomplice
Affidavit
Allegation
Acts of Commission
Acts of Omission
Cause of Action
Complaint
Confidentiality
Contracts
Contract Law
Crime
Defamation
Defendant
Discovery
Duty of Care
Elements of a Crime
Felony
Informed Consent
Infraction
Intentional Misrepresentation
Jurisdiction
Jurisprudence
Liable
Libel
Misdemeanor
Motion
Party
Plaintiff
Prima Facie
Principles
Privileged Communications
Probable Cause
Process
Res Ipsa Loquitor
Respondeat Superior
Slander
Standards of Care
Statute of Limitations
Torts
Venue
Vicarious Liability
Voir Dire

Civil Actions and Related Issues in Dentistry
Types of Civil Action
Why Civil Actions Begin
How Civil Actions Begin
Civil Actions in the Dental Office

Risk Management From A to Z

Criminal Actions and Related Issues in Dentistry

Types of Criminal Action
Assault
Battery
Child Abuse Reporting
Conspiracy
Embezzlement
Exposing Others to Contagious Diseases
Fraud
Insufficient Funds Checks
No Funds/Account Closed Checks
Obtaining Controlled Substances by Fraud, etc.
Practicing Dentistry Without a License
Reports to Police of Certain Types of Injuries
Solicitation

How Criminal Actions Get Started

Workplace Violence

Domestic Violence in the Workplace

Employer-Employee Issues
Employer-Employee Relations

Sexual Harassment

At-Will Employment and Employment Contracts

A Brief Overview of Forensic Odontology

Conclusion - 213

References - 220
Preface

A professional is a person possessing great skill or experience in a particular occupation. This definition implies that a requisite level of knowledge or skill has been obtained in a particular field of endeavor. However, the term "professional" has at its core a deeper meaning. Professionals are people who declare or "profess" something about themselves relative to their chosen vocations. In order to declare oneself a professional, an individual must (to some extent) set aside his own interests in order to commit himself and his particular skills for the betterment of the community. A professional accepts the duty to both obtain and maintain the skills necessary to effectively function in his chosen occupation; and he accepts an obligation to perform his duties in a manner which benefits those he serves, others in his profession, and the community at large.

Our world is not in a static state, therefore, the definition of a professional also suggests that the mere possession of a particular skill is not enough, and that some level of growth, adaptation, or maturation is necessary in order for a professional to change as the needs of those he serves dictate.

As dental professionals, we accept a duty to obtain and maintain the skills that have been deemed necessary for us to properly serve and protect our patients. In general, we are relentless in our efforts to maintain and improve our skills in areas such as endodontics, cosmetic dentistry, and periodontics; but we may be somewhat remiss in other areas. Professional ethics is one of the areas that tend to be overlooked by dental professionals in favor of courses that appear to be more relevant to their daily activities.

Ethical principles are "instruments". They do not fit on an operatory table or in a lab drawer, but they are "instruments" nonetheless. Ethical "instruments" are not obtained through osmosis, divine intervention, or coincidence. They must be properly presented, cultivated by experience, and periodically reevaluated in order to function properly. Ethical dilemmas are part of our human situation. They are present in both our personal and professional lives, and how we deal with them defines who we are as human beings. Ethical dilemmas can be as innocent as a simple misunderstanding about the cost of a particular treatment option or as complicated as insurance fraud. Once dental professionals begin to succumb to minor ethical dilemmas, they may find themselves on pathways to more serious ethical violations later in their careers. Dental professionals are vested with the responsibility to be positive role models within their communities both in the office and out of the office. As a result, they are expected to behave in an ethical manner at all times. Although The American Dental Association, local dental societies, and individual state dental boards have been established to both guide and regulate the actions of dental professionals, individual dentists and hygienists must determine for themselves how they will act under certain conditions. Individual practitioners should establish firm sets of ethical standards early in their careers so that they can ensure careers characterized by honesty and integrity. Otherwise, dire consequences such as loss of respect, loss of employment, monetary losses, and/or incarceration can occur. The application of ethical principles in modern dentistry could be paralleled with the Biblical parable of the mustard seed. Specifically, practitioners should plant the seeds of ethical standards early in their careers. The pursuit (cultivation) of ethical tenets will result in standards that will reach others (branches of the mustard plant), and these standards will assist others as they face their own ethical dilemmas (the ability to support many bird nests). This text represents my understanding of the evolution of ethical principles from the early Greek society to today's society with particular emphasis on the theories/postulates of Aristotle and Aquinas. The specific questions that this text will address are listed as follows:

• What is ethics?
• Where and how did ethics begin?
• How are ethics, religion, and the law related as guides for our actions?
• Are the concepts of Aristotle, Aquinas, and others valid for modern-day professional applications?
• How do ethical principles relate to the dental profession?
• What are some of the consequences for violations of ethical principles?
• What are some of the more common ethical dilemmas in the dental office, and how can they be resolved?
• What happens when ethical dilemmas become civil and/or criminal issues?
• How can practitioners minimize their risk relative to ethical, civil, or criminal situations in the dental office?

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Catalogue Information

National Library of Canada Cataloguing in Publication Naccarato, Shawn L. The hands of a practitioner, the heart of a provider / Shawn L. Naccarato. Includes bibliographical references. ISBN 1-4120-1105-1 I. Title. HF5387.N22 2004 174'.4 C2003-904492-0

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