Responsibilities of Patients to Dentists

Concept of Reciprocity

• Generally stated, reciprocity is the practice of making a fitting and proportional return of like for like--good for good, and evil for evil.

• Reciprocity is a social norm in all societies.

• Central to: exchange theory (anthropology, sociology), equity theory (social psychology), reciprocal altruism(sociobiology) and rational choice (economics)

Concept of Reciprocity

• In ethics, the concept of reciprocity is most often embedded in discussions of justice, as fairness.

• The notion is that one owes a cooperative beneficial response to the goodwill and helpfulness of another (but owes nothing, or at least not the same thing) to adversaries or free riders.

Concept of Reciprocity

• John Rawls, the influential Harvard professor of philosophy, in his book, A Theory of Justice, has seen justice as fundamentally connected to the mutual advantage of reciprocal transactions and fair play, and the notion of proportionality, which is an element of reciprocity.

Relationships

The case can be made that all good relationships are based on reciprocity, a proportionality in giving and receiving:

– parent / child

– husband / wife

– teacher / student

– friend / friend

– dentist / patient

Reciprocity Between Dentist and Patient

• Dentists have extraordinary duties to patients, summarized in the three basic principles of beneficence, respect for autonomy, and justice.

• These duties are not assumed by the dentist based on any native and unique altruism of dentists in comparison to the remainder of the population, but rather because the dentist receives a benefit from the relationship as well..

What benefits do dentist receive from

patients as a result of caring for them?

Benefits

• Sense of fulfillment/satisfaction

• Sense of meaning/purpose

• Opportunity to exercise abilities

• Artistic joy

• Professional fee from which the dentists living is derived.

• Others

What are the duties of patients to their

dentists?

Duties of Patients

• Fidelity - To the commitments made or implied in the covenant/contract relationship:– respect for professional

knowledge– keeping appointments– confidentiality: regarding what

may be seen or overheard – compliance: treatment procedures,

oral self care, medication-taking– payment of professional fees

Duties of Patients

• Veracity (Truthfulness) - Patient’s accurate disclosure of information required by dentist to treat effectively and safely.

• Justice– Non abuse of the malpractice

system, that is, taking responsibility for predictable undesirable effects of procedures of which they have been informed and to which they have consented.

– Duty to ‘step aside’ in order to benefit someone who is in desperate need.

Duties of Patients

• Autonomy - patient respects the autonomy of the dentist, as dentist respects the patients

• Respect the right to withdraw from the relationship -dentists should be allowed to sever the relationship when they can no longer accept the patient’s goals; in the same way patients have the right to withdraw from the relationship.

Summary

In the reciprocal relationship between dentist and patient, when the partners in the relationship respect the autonomy of one another and are committed to justice (as fairness), dentists will have duties and patients will have corresponding rights. AND... patients will have duties, and dentists corresponding rights.