I do not believe that there is any significant difference between the dentist-patient relationship and the physician-patient relationship. Both the dentist and the physician have an obligation to promote the patient’s well-being. The dentist is just focused on the oral health of a patient. The endodontist should not accede to Patrick M’s desire to have a root canal performed on each of his teeth. I think that the endodontist is correct in feeling that it would be unethical to remove healthy tissue. The patient has healthy teeth and this procedure may never be indicated by his conditions. Even though Patrick is a fervent survivalist and does not want to experience a toothache, his desire is likely to cause him infection that can spread leading to suffering. In this particular case, I think that paternalism of the endodontist is appropriate and that the obligation to promote the patient’s well-being overrides the respect for the patient’s autonomy.
There is no difference between the dentist-patient and the physician-patient relationship. Both are trusted health care providers expected to act in the best interest of the patient; the difference is only in their area of knowledge. I do not believe the endodontist should perform root canals on all of Patrick M.’s teeth. The procedure alone creates the possibility of damage to a tooth or teeth, even a fracture between the roots. In addition, pain is the body’s signal that something is wrong. If Patrick’s teeth are desensitized and a condition later develops he will have no way of knowing until it is into his gums or jaw and difficult to treat. Therefore, performing the root canals actually increases, not reduces, the risk of a problem later. Taking it one step further, Patrick could go on to ask for his gall bladder or appendix removed to prevent ever having a problem with them. No surgeon would even consider removing a healthy organ because the risks of surgery/anesthesia are much too high. No medical procedure is warranted until the benefits outweigh the risks.
I do not think there is a difference between physician-patient and dentist-patient relationship. The main goal of both is to keep their patients healthy and happy. Part of this relationship involves shared decision making; talking and deciding about the best means of treatment for the patient. A patient cannot receive treaments or surgeries just because they are desired. A health professional can override their wants if a health issue is not involved. I do not feel the dentist should proceed with Patricks' desires. A root canal is an involved procedure that is very painful. It would be causing damage, not treating it. The dentist should not inflict pain on the patient if there is no need to. The dentist would be cutting out perfectly healthy tissue. With any surgery, there is always a risk of infection. If the benefits do not out-weigh the risks, the procedure should not be done. In this case there are no benefits because the procedure is not needed.
I don’t personally agree with the dentist’s view that it is unethical to remove healthy tissue. This same principle can be applied to a patient wishing to have a vasectomy (“damaging” an otherwise healthy organ) or a patient wishing to have plastic surgery for aesthetic reasons. Each of these examples reflects the overarching need for a physician (or dentist) to respect their client’s wishes. In this regard, I don’t think the dentist-patient relationship is any different from the physician-patient relationship. Both are employed to ensure the ongoing health of their patients. That being said, the procedure Patrick M wishes for does not further his health in any way, and could actually end up hurting him if the procedure goes wrong, or if he doesn’t recover as planned. For this reason, along with my superstition that Patrick M is suffering from a psychological disorder, I think the dentist should not accede to Patrick M’s desires without first trying to inform him fully of what the procedure would entail, along with alternatives to the surgery (namely, psychiatric help). Just as any doctor can refer someone to a specialist (ex: an orthopedic surgeon for someone with a hurt arm), a dentist should be able to refer a patient to a psychiatric specialist before committing to any outlandish procedure. This way, the dentist is ensuring full knowledge and health to his patient.
I disagree with the desire to remove any healthy tissue, in this case I do not believe the issue of autonomy should apply. I believe both medical personnel should be communicating because the issue of Patrick M. attempting to ensure preserving his teeth & by having all of his teeth desensitized and wanting a root canal on healthy teeth is something that is warranting a psych evaluation. I agree with Lauren the the dentist should not be inflicting a painful procedure on a patient that doesn't warrant it. Further more the whole idea presented to dentist and endodontist and one referring to the other shows there is a significant difference because the dentist should not of referred the patient to the specialist and taken the time to explain the dangers and reason for unwarranted surgery. The surgeons feelings the removal of healthy tissue is unethical shows that he has standards to live up to and a conscience.
This case is similar to a man wanting a vasectomy. Both procedures involve a patient who desire a procedure that really have no medical need. Patient autonomy must be respected for a vasectomy so the same rules should overall apply to Patrick as well. However, I do not feel that men receive vasectomies for their own personal desires. There is probably some kind of outcome that is beneficiary to other people than just the patient. For example, the man may not want any more children, which also benefits the wife. Or either him or his partner may have some kind of disorder they do not want to risk passing along to a child. Lastly, pregnancy may pose serious risk to his partner. So at what point is patient autonomy overriden by the physician or dentist? If a man can receive a vasectomy without medical reason, then legally Patrick should be able to receive the root canals. But morally, are either procedures permissable?
I think the dentist/pt responsibility and doctor/pt responsibility is the same in a sense that they both have the responsibility to inform the pt of the right and wrong thing to do about their health/dental care. I think the doctor/dentist knows more about what is appropriate for their pt's and should inform them before letting them make the decision. Patrick probably shouldn't have the procedure done but he is an adult and even after the dentist telling him what is best for him he makes the decision to have the root canal, the dentist should do it. After all, he is the one paying for the procedure. This is also the same for the man who wants a vasectomy even though he has no children. But, in America today, doctors will not let a woman who has no children have her tubes tied. I think they should have it done if they want it and they are paying for it anyways.
Removal of the vasa deferent is different from removing health tissue that can lead to serious and maybe death. Removal of the vasa deferent is a simple procedure that stops the flow of sperm to prevent bringing children into a unwanted environment. I don't believe the two issues are equal in comparison.
Although I would NEVER have this done and I think it is strange, I think the patient has the right to have the surgery. Plastic surgery is acceptable even though it involves a risk. So is getting braces; it is simply a cosmetic procedure in most cases. As a social worker, I would want to have the patient looked at before receiving the surgery, but that alone could bring up issues of discrimination against his personal beliefs. And what about people who have no dental insurance. Is it unethical for them to not get a root canal even if they can't afford it? I understand that the dentist could be hesitant about this, and his job is to promote the well-being of a his patient. He should have the right to not do the surgery, but then direct the client to someone who can better assist his wishes. Although a doctor sees more life-threatening cases than a dentist, they both have an obligation to their patients.
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I do not believe that there is any significant difference between the dentist-patient relationship and the physician-patient relationship. Both the dentist and the physician have an obligation to promote the patient’s well-being. The dentist is just focused on the oral health of a patient.
ReplyDeleteThe endodontist should not accede to Patrick M’s desire to have a root canal performed on each of his teeth. I think that the endodontist is correct in feeling that it would be unethical to remove healthy tissue. The patient has healthy teeth and this procedure may never be indicated by his conditions. Even though Patrick is a fervent survivalist and does not want to experience a toothache, his desire is likely to cause him infection that can spread leading to suffering. In this particular case, I think that paternalism of the endodontist is appropriate and that the obligation to promote the patient’s well-being overrides the respect for the patient’s autonomy.
There is no difference between the dentist-patient and the physician-patient relationship. Both are trusted health care providers expected to act in the best interest of the patient; the difference is only in their area of knowledge. I do not believe the endodontist should perform root canals on all of Patrick M.’s teeth. The procedure alone creates the possibility of damage to a tooth or teeth, even a fracture between the roots. In addition, pain is the body’s signal that something is wrong. If Patrick’s teeth are desensitized and a condition later develops he will have no way of knowing until it is into his gums or jaw and difficult to treat. Therefore, performing the root canals actually increases, not reduces, the risk of a problem later.
ReplyDeleteTaking it one step further, Patrick could go on to ask for his gall bladder or appendix removed to prevent ever having a problem with them. No surgeon would even consider removing a healthy organ because the risks of surgery/anesthesia are much too high. No medical procedure is warranted until the benefits outweigh the risks.
I do not think there is a difference between physician-patient and dentist-patient relationship. The main goal of both is to keep their patients healthy and happy. Part of this relationship involves shared decision making; talking and deciding about the best means of treatment for the patient. A patient cannot receive treaments or surgeries just because they are desired. A health professional can override their wants if a health issue is not involved. I do not feel the dentist should proceed with Patricks' desires. A root canal is an involved procedure that is very painful. It would be causing damage, not treating it. The dentist should not inflict pain on the patient if there is no need to. The dentist would be cutting out perfectly healthy tissue. With any surgery, there is always a risk of infection. If the benefits do not out-weigh the risks, the procedure should not be done. In this case there are no benefits because the procedure is not needed.
ReplyDeleteI don’t personally agree with the dentist’s view that it is unethical to remove healthy tissue. This same principle can be applied to a patient wishing to have a vasectomy (“damaging” an otherwise healthy organ) or a patient wishing to have plastic surgery for aesthetic reasons. Each of these examples reflects the overarching need for a physician (or dentist) to respect their client’s wishes. In this regard, I don’t think the dentist-patient relationship is any different from the physician-patient relationship. Both are employed to ensure the ongoing health of their patients. That being said, the procedure Patrick M wishes for does not further his health in any way, and could actually end up hurting him if the procedure goes wrong, or if he doesn’t recover as planned. For this reason, along with my superstition that Patrick M is suffering from a psychological disorder, I think the dentist should not accede to Patrick M’s desires without first trying to inform him fully of what the procedure would entail, along with alternatives to the surgery (namely, psychiatric help). Just as any doctor can refer someone to a specialist (ex: an orthopedic surgeon for someone with a hurt arm), a dentist should be able to refer a patient to a psychiatric specialist before committing to any outlandish procedure. This way, the dentist is ensuring full knowledge and health to his patient.
ReplyDeleteI disagree with the desire to remove any healthy tissue, in this case I do not believe the issue of autonomy should apply. I believe both medical personnel should be communicating because the issue of Patrick M. attempting to ensure preserving his teeth & by having all of his teeth desensitized and wanting a root canal on healthy teeth is something that is warranting a psych evaluation. I agree with Lauren the the dentist should not be inflicting a painful procedure on a patient that doesn't warrant it. Further more the whole idea presented to dentist and endodontist and one referring to the other shows there is a significant difference because the dentist should not of referred the patient to the specialist and taken the time to explain the dangers and reason for unwarranted surgery. The surgeons feelings the removal of healthy tissue is unethical shows that he has standards to live up to and a conscience.
ReplyDeleteSo, no one has provided a satisfying answer to Rea's analogy to a vasectomy. How is this case like a man wanting a vasectomy and how is it different?
ReplyDeleteThis case is similar to a man wanting a vasectomy. Both procedures involve a patient who desire a procedure that really have no medical need. Patient autonomy must be respected for a vasectomy so the same rules should overall apply to Patrick as well. However, I do not feel that men receive vasectomies for their own personal desires. There is probably some kind of outcome that is beneficiary to other people than just the patient. For example, the man may not want any more children, which also benefits the wife. Or either him or his partner may have some kind of disorder they do not want to risk passing along to a child. Lastly, pregnancy may pose serious risk to his partner. So at what point is patient autonomy overriden by the physician or dentist? If a man can receive a vasectomy without medical reason, then legally Patrick should be able to receive the root canals. But morally, are either procedures permissable?
ReplyDeleteI think the dentist/pt responsibility and doctor/pt responsibility is the same in a sense that they both have the responsibility to inform the pt of the right and wrong thing to do about their health/dental care. I think the doctor/dentist knows more about what is appropriate for their pt's and should inform them before letting them make the decision. Patrick probably shouldn't have the procedure done but he is an adult and even after the dentist telling him what is best for him he makes the decision to have the root canal, the dentist should do it. After all, he is the one paying for the procedure. This is also the same for the man who wants a vasectomy even though he has no children. But, in America today, doctors will not let a woman who has no children have her tubes tied. I think they should have it done if they want it and they are paying for it anyways.
ReplyDeleteRemoval of the vasa deferent is different from removing health tissue that can lead to serious and maybe death. Removal of the vasa deferent is a simple procedure that stops the flow of sperm to prevent bringing children into a unwanted environment. I don't believe the two issues are equal in comparison.
ReplyDeleteAlthough I would NEVER have this done and I think it is strange, I think the patient has the right to have the surgery. Plastic surgery is acceptable even though it involves a risk. So is getting braces; it is simply a cosmetic procedure in most cases. As a social worker, I would want to have the patient looked at before receiving the surgery, but that alone could bring up issues of discrimination against his personal beliefs. And what about people who have no dental insurance. Is it unethical for them to not get a root canal even if they can't afford it? I understand that the dentist could be hesitant about this, and his job is to promote the well-being of a his patient. He should have the right to not do the surgery, but then direct the client to someone who can better assist his wishes. Although a doctor sees more life-threatening cases than a dentist, they both have an obligation to their patients.
ReplyDeleteFriendly and quick. For a person who hated going to the dentist I am not dreading my next cleaning!
ReplyDeletepainless root canal treatment in chennai
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ReplyDeleteHi, I find reading this article a joy. It is extremely helpful and interesting and very much looking forward to reading more of your work.. víosa turasóireachta canada
ReplyDeleteI ran into this page accidentally, surprisingly, this is a great website. The site owner has done a great job writing/collecting articles to post, the info here is really insightful. You just secured yourself a guarenteed reader. Clinica dentale Tirana
ReplyDelete