Ethics
By Brian Beirl
D.D.S.
“Dentistry is an ethical issue” Dr. Harold Wirth
This is a big-E. What is ethics? Is it merely doing the right
thing? What is the right thing? Can ethics be taught? Is it
learned throughout life? Does it change according to the
circumstances?
There is no doubt that any attempt to discuss ethics is an
ambitious and daunting task. Even an attempt to define ethics
can be lead us into a labyrinth of philosophies of historic
proportions. Most would agree ethics centers on a certain
commitment to standards. Therefore, for the sake of time and
space, our discussion of ethics will center on three areas of
commitment:
Commitment to others.
The Storytellers of ancient Greece would gather their fellow
travelers around the hearth and tell the tale of the infamous
bed of Procrustes. When the thief, Procrustes, captured unwary
travelers, they would soon experience his unusual hospitality.
He was obsessed with making his “guests” fit in. If one was
too short for his bed he would stretch his captive until they
fit his expectations. If they were too long, he would
literally cut them down to size.
How many times do we find ourselves fitting others into our
own Procrustean bed?
The study of ethics is the study of how we treat others.
Ethics would be a non-issue if we lived without contact with
other beings. Our ethics determine how we interact with those
outside of ourselves.
According to Tom Hanlon a successful CEO and lecturer, ethics
can be defined and described in one phrase.
Being kind to others.
This may seem simplistic, but it does stand the test of most
examples that come to mind:
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The business leaders, past and present, that manipulated the
books were exhibiting no regard or kindness for the millions
of people that they hurt in lost savings and jobs.
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The student that cheats on the test is not just compromising
their own character but is acting out of total disregard for
their school and classmates.
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The dentist that does not consider patient’s individual
temperament, circumstances and objectives, or does not
routinely practice at their optimum level of care, skill and
judgment, may be tempted to “fit” the patient into what is
convenient
Exhibiting kindness to others is difficult when we are not
comfortable with ourselves or who we are. Knowing ourselves,
as discussed in the chapter Ethos, is many times not an easy
road. As we increase our self-knowledge we must be mindful not
to become quite enamored of who we are and, in turn,
judgmental of others. The others’ only sin being; they are not
like us.
In Robert Burn’s poem To a Louse, we observe a pompous woman
that has her nose in air along with her hair. She is quite
active in judging those that are seated in the pews ahead of
her. Little does she know or feel that there are wee beasties
cavorting in her bonnet.
O wad some Power the giftie gie us
To see oursels as ithers see us!
Robert Burns
Getting to truly know those people that enter our lives is the
greatest form of kindness. In a non-judgmental way, we accept
them for who they are and where they are at that time. Dr.
Pankey spoke of pathos, or that which deals with the other.
Pathos is the Greek root word found in empathy and sympathy.
Building healthy and growth oriented relationships is not
about making people fit our comfortable bed. It is meeting
people on their own ground, honoring their beliefs, and being
sensitive to their present circumstances. This commitment to
kindness allows us to treat appropriately with a service that
is centered on what is in the patient’s best, long term
interest.
Commitment to personal growth and education.
Dr. Pankey had very firm thoughts on this subject. When there
was a lapse in ethics he refined it down to two basic areas.
What he called; sins of omission and the sins of commission.
Sins of omission are exhibited when the dentist performs at
the level of their current knowledge. Although they are
practicing to the best of their ability and understanding of
dentistry, an ethical dilemma develops when the dentist ceases
to expand their knowledge. Their dental chair becomes a
Procrustean bed as they practice in their comfort zone. As
their practice stagnates, patients are made to fit the
treatment plan rather being offered appropriate treatment
options. This is the common story of a dentist having twenty
years of experience, which translates into one year of
experience repeated for twenty years.
But what if a decision is consciously made not to incorporate
this knowledge into their practice? This presents a case of a
sin of commission, where the newly acquired knowledge is not
made available for the benefit of the patients. Some dentists
defend what they do to a point of not changing, because to
change would be to admit that they were not doing something
right before. This is very destructive to the evolution of a
practice and the growth of the dentist, staff and their
patient community.
Dr. Pankey’s sin of commission can be reversed by the powerful
concept of the commitment to become a life long dental
student. However, this commitment must be tempered by a high
level of discernment, to insure that new information and
techniques are based on firm scientific principles and proven
concepts. This is a commitment not only to do the right thing
but to know what the right thing is.
Commitment to be financially sound.
In Victor Hugo’s classic novel, Les Miserable, We are
introduced to Jean Valjean. The story takes place during the
desperate times 18th century France. Because of severe
financial pressure and the impending starvation of his family,
Jean Valjean is forced to deny his high ethical standards, and
steal a loaf of bread. He is caught and imprisoned for many
years. However, from the moment of his capture, he leads a
good and virtuous life both in and out of prison, punctuated
with incredible self sacrifice. This is an example of how good
people when placed under financial strain can literally not be
themselves.
Many times the financial condition of the dentist can be a
strong influence on the day to day decision making in a
practice. If there is financial instability in a dentist’s
life, it can affect scheduling, treatment planning, quality of
dentistry, well being of the staff, educational opportunities
and so on. The proper management of money is critical to your
living within your character and ethics.
Although ethics is a personal matter it affects all those
around us.
If we are committed to be kind to others and committed to
personal growth, knowledge and financial soundness, our
ethical dilemmas will be few.
No man is an island, entire of itself; every man is piece of
the continent, a part of the main.
John Donne
Enjoy, Brian Beirl D.D.S.
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