Legal and Ethical Responsibilities

1. 11 Legal and Ethical Responsibilities

2. Objectives • Define the key words. • Discuss the federal and state regulations concerning the use of dental x-ray equipment. • Describe licensure requirements for exposing dental radiographs.

3. Objectives • Identify specific risk management strategies for radiography. • Recognize negative remarks about radiographic equipment that should be avoided. • List the five aspects of informed consent.

4. Objectives • List the radiographic items that must be documented in the patient’s record. • Explain what should be said to patients who refuse radiographs. • Identify the role professional ethics play in guiding the radiographer’s behavior.

5. Key Words • American Dental Assistants Association (ADAA) • American Dental Association (ADA) • American Dental Hygienists’ Association (ADHA) • Code of Ethics • Confidentiality

6. Key Words • Consumer-Patient Health and Safety Act • Direct supervision • Disclosure • Ethics • Federal Performance Act of 1974 • Health Insurance Portability and Accountability Act (HIPAA)

7. Key Words • Informed consent • Liable • Malpractice • Negligence • Risk management • Self-determination • Statute of limitations

8. Introduction • Legal and ethical issues directly relate to radiation safety. • The dental radiographer must understand and respect the law governing the use of ionizing radiation. • The radiographer should be aware of the dental professions’ codes of ethics that guide decisions regarding the use of ionizing radiation.

9. Regulations and Licensure • Equipment regulations • Federal Performance Act of 1974 • Licensure requirements • Consumer-Patient Radiation Health and Safety Act

10. BOX 11-1 Web Sites for Professional Organizations

11. Legal Aspects • Risk management • Patient relations • Informed consent

12. Box 11-2 Radiography Safety Audit for Risk Management

13. Figure 11-1 Radiographer wearing a radiation monitoring badge. Figure 11-1 Radiographer wearing a radiation monitoring badge.

14. Legal Aspects • To make a decision regarding informed consent, the patient must be informed of the following: • The purpose of taking radiographs • The benefits the radiographs will supply • The possible risks of radiation exposure • The possible risks of refusing the radiographs • The person who will perform the procedure

15. Legal Aspects • Liability • Patient records • Documentation • Confidentiality • Ownership • Retention • Insurance claims

16. Legal Aspects • Documentation: • The patient’s informed consent • The number and type of radiographs, including retakes • The date the radiographs are taken and the name of the radiographer who took them • The reason for taking the radiographs • The interpretive and diagnostic results

17. Procedure 11-1 Procedure for releasing a copy of the patient’s radiographs

18. Legal Aspects • Malpractice issues • Negligence/Statute of Limitations • Patients who refuse radiographs

19. Ethics • Ethics is defined as a sense of moral obligation regarding right and wrong behavior. • Professional ethics define a standard to which all members of the profession are obligated to conform. These professional rules of conduct are called a profession’s Code of Ethics.

20. Goals • Achieve perfection with each radiograph. • Perform confidently and with authority. • Take pride in services rendered and professional advancement.

21. Goals • Keep radiation exposure as low as possible • Avoid retakes • Develop integrity, dedication, and competence

22. Review: Chapter Summary • The dental radiographer should be aware of the laws and regulations pertaining to dental radiography. • Both federal and state regulations control the manufacture and use of x-ray equipment. • State laws require that operators of x-ray equipment be trained and certified or licensed to take dental radiographs.

23. Review: Chapter Summary • Risk management strategies and good patient relations reduce the risk of possible legal actions. • The patient’s records, including the radiographs, are confidential. • The professional’s code of ethics guides the behavior of the dental radiographer.

24. Recall: Study Questions • General • Chapter Review

25. Reflect: Case Study • Consider the following scenario. • You have been working in a practice for over a year and have developed a friendship with another dental assistant. You often socialize together outside of work, and your children play together.

26. Reflect: Case Study • One evening during dinner, your dental assistant friend tells you that even though she has been exposing dental radiographs on patients since she was hired by the practice over two years ago, she does not have the state-required radiation safety certification.

27. Reflect: Case Study • She tells you that the dentist never asked to see her certificate during the job interview. She wasn’t planning to “break the law” but the first day on the job, the dentist explained to a patient that she would be taking the full mouth series, and “not to worry, because she was a competent clinician.”

28. Reflect: Case Study • Your friend explains to you that it would have been embarrassing to tell the dentist at that point that she was not certified, so she exposed the films. After that, she thought about taking a course to prepare for the state examination, but didn’t want to get “caught” taking the exam after she had already been placing and exposing radiographs all this time. She hopes you will keep her confidence, since you are friends.

29. Reflect: Case Study • Reflect on this scenario and answer the following questions. • How has your friend broken the law? • How has this behavior endangered thepatient? Your friend? Your employer? • Describe the legal and/or ethical situation she faces. • Describe the legal and/or ethical dilemma you face.

30. Reflect: Case Study • Reflect on this scenario and answer the following questions. • How could your employer have prevented this situation? • What aspects of the Dental or Dental Assisting Code of Ethics apply to this situation? • Take the role of your friend; what would you have done if you were she?

31. Relate: Laboratory Application • Proceed to Chapter 11, Laboratory Application, to complete this activity.