Ethics Corner
Code of Ethics
Dental hygienists work in interprofessional collaborative environments. They are accountable to codes
of
ethics, in conjunction with professional standards, workplace policies, and laws and regulations
that guide
practices and behaviours. In achieving
these requirements, they fulfill their contract with society to meet a high standard of ethical
practice.
Read the
report
describing the development of the Code of Ethics.
The CDHA Code
of Ethics sets out the ethical principles and responsibilities which apply to all
members of the
dental hygiene profession across all
practice areas including clinical care, education, research, administration and any other role
related to
the profession of dental hygiene.
In addition, the Ethical
Guidelines for Educators helps educators to make professional decisions. It is
grounded in 6
ethical principles and
provides a framework of shared values.
Oh Canada! Talking Ethics
Oh Canada! is our membership-based publication that provides a forum
for the
communication of dental hygiene and oral health information, as well as product information and
association
news. Each issue contains a "Talking
Ethics" column where members share common ethical dilemmas encountered during dental hygiene
practice.
Authors offer insight and share experiences about how to approach these complex cases. Read the
articles by
selecting the year below:
Select a Year:
In September 2024, CDHA released a revised version of
the Dental Hygienists’ Code of Ethics,1 integrating diversity,
equity, and inclusion (DEI) principles into its guidance for
the profession. As self-regulated health professionals, dental
hygienists have an ethical responsibility not only to stay
current with evolving codes of ethics but also to incorporate
them into daily practice, ensuring a safe, non-judgmental
environment for our clients/patients.
Our profession has earned the trust and respect of the “multicultural, multigendered public” (my
phrase) and the allied
health care professionals, due to our Process of Care, diligent oral and overall health
education, and health promotion
competence.
As a person ages, their need to access health care services
increases. At the same time, however, their ability to access
these services decreases.
Ignorance of palliative dental hygiene oral care (PDHOC)
is an ethical issue because it may lead to inadequate care
and unnecessary suffering. When health care providers or
caregivers are unaware of the importance of appropriate
oral care techniques, inadequate or substandard care can
result. Clients, patients, and/or residents of long-term care
homes may experience pain and discomfort, which are both
avoidable and ethically problematic.
Canada’s new federal dental care program ranks highest in the ongoing advocacy work of the
Canadian Dental Hygienists Association (CDHA) on behalf of the profession and vulnerable people
in Canada. The theme of this issue of Oh Canada! is “Treating vulnerable populations,” including
medically compromised clients, clients in remote communities, and seniors.
Overinflated targeted production goals in dental hygiene practice management are affecting
access to care and presenting dental hygienists with an ethical dilemma. The topic should
not be a whispered discussion among dental hygienists, but rather should be honestly framed
so the narrative can be directed towards finding an ethical solution that sustains access to
quality care and removes barriers to upholding the principles and responsibilities outlined
in the Dental Hygienists’ Code of Ethics.
Society’s mores change over time as the values and
attitudes of the public evolve. Governments create
legislation and policies that reflect these deeply held values
to meet the needs of the public. They communicate their
intentions through various departments and ministries
to regulatory authorities and boards. As self-regulated
primary health care providers to Canadians of all races and
ethnicities, dental hygienists are mandated to be culturally
competent, avoid discrimination, and put the needs of their
clients and students first.
As dental hygienists, you should take to time to get to know
the source of products and materials used in your practice.
Too often price dictates buying decisions. Everyone is
looking for a good deal, but do you really know the product
you are using and understand the support system behind
the product? What would happen if an adverse client event
took place?
As dental hygienists and regulated health care professionals,
we are entrusted with the oral health care of our community.
Our responsibility and accountability to safeguard public
health and well-being are the cornerstone of our profession.
Canadians are counting on us!
Launching a mobile independent dental hygiene practice is no small feat. It requires
ingenuity, perseverance, and a
significant amount of problem-solving skills. In particular, as my fellow mobile independent
dental hygienists already
know, our ethical responsibilities as health care professionals do not decrease in any way
simply because we are now
mobile. We still have the same ethical responsibilities as dental hygienists practising in a
clinical setting, but now the onus
is on us to ensure we have the means to meet the necessary standards of practice while on
the move.
There is nothing normal about life right now. Some parts of the world
are open for business, some have limitations and safety restrictions in
place, and others are in complete lockdowns with various industries
closed until further notice. We as oral health professionals are already
accustomed to very strict infection control standards, but even we
have stepped it up a notch: now donning N95s, face shields, and very
fashionable bouffants.
Fifteen years ago, if someone had used the term “social
media,” would you have known what it meant? I know I
wouldn’t have. The evolution of social media platforms
in that short period of time has changed how we interact
with one another.
The global society has been changed by the coronavirus
(COVID-19) pandemic, as the risks of cross-contamination
and importance of infection control are now more clearly
known and understood by people of different cultures,
age groups, and economic status. This heightened
awareness could weaken public trust in the ability
to receive safe, effective dental hygiene care now
and in the future.
The distinction between an employee and a contractor is
not a trivial one. It has implications not only for you but
also for the practice(s) in which you work. How you choose
to be designated will affect your rights and obligations, as
well as the way in which your income is taxed and the
deductions available to you. Being paid as a contractor
when you are really an employee could expose you (and
the practice) to significant liability to the Canada Revenue
Agency (CRA).
It appears the phrase "quality assurance requirements"
continues to create feelings of anxiety for many dental
hygienists. We all know that maintaining competence
includes a commitment to be a lifelong learner. In order to
grow, we need to embrace the significant changes that are
coming to our profession.
The Canadian Human Rights Commission, established in 1977, aims
to ensure that everyone in Canada is treated fairly, no matter who
they are.1 According to the commission, harassment is a form of
discrimination that comprises unwelcome remarks, jokes, threats or
intimidation based on your race, religion, sex, age, disability. Any
unwelcome physical contact, such as touching, patting or pinching, is
also considered harassment.
Do you have any personal biases against the recreational
or medicinal use of cannabis that would interfere with
your professional responsibilities? Our life experiences
and worldview inform our opinions and create bias. Yet,
as regulated oral health care professionals, our obligation
is to provide relevant, objective information from credible
sources when communicating with clients, groups, and
communities. We must always seek out appropriate,
professional resources to acquire new knowledge and
enhance our health promotion efforts.
Part 2 is a complement to Part 1: Ethical Responsibilities
of Online Instructors, which was published in the Summer
2018 issue (pages 45–46). It must be emphasized that
ethical responsibilities are intertwined and each affects the
other in an online learning environment: the classroom,
the educational institution, the instructor, and the student.
For example, in Part 1 various aspects of privacy breaches,
confidentiality, access, and cultural sensitivity were
discussed. All parties are affected and all parties are
part of the solution.
The intent of this contribution is to discuss briefly, and by
no means fully, the ethical responsibilities of instructors
and students in the online education classroom context.
Part 1 introduces the ethical obligations of instructors
teaching online; Part 2 in the Fall/Winter issue will explore
the same subject as it pertains to online students.
During our dental hygiene studies we were meticulous about assessing the
submandibular,
submental, and occipital lymph nodes. We palpated on either side of the
sternocleidomastoid
muscle and felt the differences to the temporalis and
masseter muscles, and we assessed the temporomandibular joints while
asking the client to
open and close.
There are many questions that the dental hygienist should consider when
exposing clients to
radiation. When a radiograph is prescribed, the dental hygienist must
understand why the
radiograph is necessary, how many radiographs are
required, how much exposure to radiation the client will receive, and if
the client has
received radiation exposure recently from other medical procedures.
On August 5, 2016, the federal Controlled Drugs and Substances Act was
amended to include
the Access to Cannabis for Medical Purposes Regulation (SOR/2016- 230)
(ACMPR).1 The
process documented in the ACMPR is more transparent, and
patients are now able to legally obtain, use, and carry cannabis for
medical purposes after
registering with Health Canada.
Dental hygienists play a vital role in protecting and promoting the health
of individuals,
communities, and populations. As regulated health professionals
practisingin variety of
settings, dental hygienists encounter ethical challenges
when faced with situations requiring a balance of opposing values,
beliefs, and
obligations.
We accept that, as self-regulated professionals, dental hygienists are
obligated to provide
for the well-being of their clients and society as a whole. Using the
Process of Care model
(Figure 1) in this situation is a systematic way
to determine your next step.
The Dental Hygienists’ Code of Ethics states that a dental hygienist’s
primary
responsibility is “to the client.” Furthermore, dental hygienists are
bound to conduct
themselves in accordance with applicable laws and guidelines, and
are mandated to report non-compliance that they may witness.
Oral cancer changes a person’s life. The impact of an oral cancer diagnosis
on the
individual, their family, friends, and community is significant. Yet
cancer survival rates
are improving, thanks to early detection, improved access
to care, and recent enhancements in treatment protocols.1 Dental
hygienists, as primary
care providers or practitioners in health care, provide dental hygiene
care according to
our regulatory body, scope of practice, and code of
ethics.
The term “social media” (also known as Web 2.0) describes Internet-based
technologies that
allow users to interact and collaborate with others online. These
applications include
Facebook, Twitter, YouTube, etc. With this interactivity,
social media is viewed as the interface of new technology and social
communication to
create (or co-create) new knowledge.1 Social media is a wonderful tool
for the
dissemination of health information, as well as for engaging
professionals
to connect, communicate, and share resources in various platforms.
As health care providers we have a duty to ensure that we are giving our
clients the best
possible advice based on the best possible evidence. Yet what is our
role when an emerging
trend gains rapid popularity in the absence of sufficient
high-quality evidence of safety and long-term consequences?
As health care providers we have a duty to ensure that we are giving our
clients the best
possible advice based on the best possible evidence. Yet what is our
role when an emerging
trend gains rapid popularity in the absence of sufficient
high-quality evidence of safety and long-term consequences?
Family violence is an important issue that affects many Canadians across the
country.
According to the Government of Canada’s February 20th media release
announcing $100 million
in funding to support victims of violence and their children
Dental supplies are regulated products under the Food and Drugs Act and
Medical Devices
Regulations. When a company wishes to sell products from a specific
manufacturer, and the
manufacturer will not authorize them to sell those products,
the company will often obtain the products through other means and sell
them anyway. The
marketplace for such unauthorized products is commonly referred to as
the “grey market.”
We have all noticed advertisements offering free teeth whitening to new
clients. It seems
harmless enough and a tempting inducement to attract new clients.
However, such incentives
may not be ethically sound or adhere to your college
regulatory guidelines with respect to advertising.
As the number of dental hygienists practising independently grows across
Canada, dental
hygienists may believe that they must offer “something special” to
attract clients.
Unfortunately, some dental hygienists inadvertently undertake
inappropriate advertising activities, which are in conflict with the
principles outlined in
the Dental Hygienists’ Code of Ethics and may result in an investigation
from dental
hygiene regulatory bodies
One of your close friends is having difficulty completing her continuing
competency
requirements for her regulatory college. The deadline to submit proof of
completion of
professional development activities is looming. Your friend
knows that you have successfully completed an online course that she is
currently enrolled
in but does not have the time to complete on her own. She asks you to
sign into the exam
under her ID and complete the exam for her. She
promises to learn all of the material once her life circumstances
change.
The public expects their health care professionals to collaborate and put
their interests
first. For more than fifty years, Canadian dental hygienists have
provided ethical care to
their clients within a cooperative team-oriented framework.
With the evolution of the profession and recognition by provincial
governments to legislate
self-regulation, dental hygienists are obligated to accept more
responsibilities on behalf
of the public.
CDHA’s Dental Hygienists’ Code of Ethics, revised June 2012 is the
cornerstone of dental
hygienists’ commitment to ethics. It sets down ethical principles and
responsibilities for
the dental hygiene profession. It also helps define
accepted behaviours, promotes high standards of practice, provides a
benchmark for members
to use in self evaluation, and establishes a framework for professional
behaviour and
responsibilities. All CDHA members are required to
understand and comply with the code and follow its guidelines in their
practice.
I once made a conscious thought to keep track of how many times I lied in
one day. I
included those times when I stretched the truth, and told what is
commonly called “white
lies”. The number was staggering.
In 2002, CDHA developed a Code of Ethics that serves as a foundation for
ethical practice
in dental hygiene. This document sets down the ethical principles and
ethical practice
standards of the dental hygiene profession. Clients, colleagues,
and the public expect dental hygienists to be guided by, and to be
accountable under, the
principles articulated in this Code. Although the primary users of the
Code of Ethics are
CDHA members who are employed in a variety of practice
settings, some dental hygiene regulatory authorities and provincial
associations adopt the
CDHA Code of Ethics as their provincial Code of Ethics. Dental
hygienists are accountable
to other codes of ethics/ethical guidelines including
those of their provincial regulatory authority and their work place.