ACD Gies Ethics Project
Report #5: Q4 2016
David W. Chambers
Included in this report is progress to the end of 2016. Most of the attention recently has been on arranging the listening sessions in four states and continuing to conduct small experiments that cast light on the issue of ethics in the professions. A substantial paper was written that develops some of the emerging key concepts.
Listening in Various Places
One of the starting points for this project has been to characterize the look and feel of the ethical dimension of oral health in America from the point of view of typical professionals and patients and those who are not patients but could benefit from oral health care. To build a bridge between theory and practice, we need to know the lay of the land on both ends of the bridge.
It has already been determined that much of the action on the ethical dimension of dentistry takes place at the state rather than national level. Four states – California, Ohio, Oklahoma, and North Carolina – have agreed to participate. The first “focus groups” are coming up within a month in Ohio and California. The state dental associations are opening doors to listen to leadership in the profession and the sections of the college in these states are lining up meetings with practitioners. I will provide a minimal structure and be open to what dentists are saying. We are in negotiations with a firm out of Washington to conduct parallel focus groups with patients and those who do not go to the dentist and with national organizations that represent consumer interests.
A small, but significant, study was completed in the past few weeks involving the Board of Regents. There is a sound literature showing that individuals have more than one set of ethical standards, and which set is brought to bear in a given situation can be influenced. This is called “ethical priming.”
The regents and officers of the college competed a standardized values survey and answered some questions about ethical issues in the profession that are ambiguous, such as justifiable criticism, advertising, and fees. The identical questions were asked at the end of our board meeting in Washington, following two days of intensive discussions often focusing on ethics and the profession, and again about six weeks later, with instructions to assume the role of a practitioner. The results were statistically significantly more pro-ethical in the group ethically primed case.
Far from being a cynical finding, this is a demonstration that we can change the ethical tone of the profession by simply being clear and vocal regarding our expectations that colleagues will act ethically. It is also a reminder that the view of ethics in theory, academics, and association meetings may not travel well to chairside. These findings will be written up in a formal fashion and published in our journal.
The presentation at the Fellows Forum in Washington on the ACD Gies Ethics Project has been written as a formal article that is in the fourth issue of the Journal of the American College of Dentists for 2015. A number of landmarks are beginning to emerge.
- Ethics is a dimension of practice distinct from legal, economic, or political standards. It is a distinct measure of value.
- We need leaders in ethics, in addition to leaders who are ethical. We need more dentists who make it easier for their colleges to do the right thing
- Ethics is a community as well as than an individual issue. Placing good people in untenable situations is ineffective, and may even be unethical. We must look at the ethical outcomes our organizations are designed (often without complete forethought) to produce to find effective