What happens when ethics textbooks tell us one thing, but our hearts react differently?
Mary Danusis Cooper, RDH, BS, and
William H. Bruening, PhD
Although laws define the obligations of health-care professionals, these obligations often extend beyond the scope of the law. The health-care provider has ethical obligations that, while they might encroach the boundaries of the law, cannot be legally enforced.
To help determine the ethical obligations health-care professionals should adhere to, the American Dental Hygienists` Association developed a professional code of ethics for hygienists. The Dental Hygiene Code of Ethics describes views on morals and ethics that should serve as a guide. As professionals, dental hygienists often have choices to make in response to issues and dilemmas within their practice settings.
The purpose of the Dental Hygiene Code of Ethics is for its members to achieve “high levels of ethical consciousness, decision-making and practice.” Assuming that a hygienist has achieved these goals, what choice does she make when she is torn between two, mutually exclusive courses of action? When a hygienist knows that selecting either of two alternatives might have both good and bad consequences, the issue is which alternative should she choose? Such a situation is a classical example of a moral dilemma. A moral dilemma exists when “… an agent morally ought to adopt each of two (or more) alternatives separately, but cannot adopt both (or all) of them together.”
A case study
The best way to illustrate a moral dilemma is to look at a specific example. Consider the following case: Carol Smith has been a dental hygienist for 10 years and works full time in a general-practice setting. Her best friend`s husband, Bob McComb, has been a patient of record for the past seven years. Upon updating his medical history at a recent visit, Bob stated that he was HIV-positive. After the initial shock, Carol asked Bob how long he had been aware of his current health status. He told her that he had just been diagnosed HIV-positive within the past month. He also informed the hygienist that his wife was not aware of his condition.