Dentistry and the Principle of Justice
How Ethics Informs Oral Health Policy Michael G. Maihofer DDS, FACD Dr. Maihofer is a former editor of the Journal of the Michigan Dental Association, past president of the American Association of Dental Editors and Journalists (AADEJ), and currently serves as president of the Michigan Dental Association.
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ne of the hallmarks of any profession is the requirement that its members adhere to strict ethical standards. This is the defining feature that truly distinguishes a profession from a trade or any other occupation. It grows out of an implied contract between society and that profession. It’s hardly surprising that almost every profession’s ethical code share most, if not all, of five common ethical principles. These include patient or client autonomy, nonmaleficence, beneficence, veracity and justice. Most of us are familiar with many of these principles. We understand patient autonomy as an ethical responsibility to respect the patient’s rights to self-determination and confidentiality. Nonmaleficence and Beneficence refer to refraining from creating harm and the duty to protect the patient’s welfare and place the primacy of their welfare above all else. You could substitute the words “client” or “customer,” for “patient” and easily see how these same
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ethical principles might be applicable across all professions. Likewise, another principle, that of Veracity or truthfulness, has always been a universal guiding principle that lends trust and credibility to any profession. Perhaps the ethical principle which has received the most attention in recent years is that of Justice. It may also be the one ethical principle that has been least examined and understood. By definition, the principle of justice addresses the dentist’s duty to treat people fairly. The American Dental Association’s Code further elaborates on this ethical obligation as follows; This principle expresses the concept that professionals have a duty to be fair in their dealings with patients, colleagues and society. Under this principle, the dentist’s primary obligations include dealing with people justly and delivering dental care without prejudice. In its broadest sense, this principle expresses the concept that the dental profession should actively seek allies throughout society on specific activities that will help improve access to care for all. It might be informative to pick this principle apart to better understand its relevance and importance to both clinical practice, dental education and emerging oral health policy. The first question that comes to mind is, “What does it mean to treat people fairly?” The dictionary defines the word fair as “impartial, frank, open, sincere, honest, unbiased, blameless, uncorrupted, equitable, objective, unprejudiced, evenhanded.” And while those are great 2021 Volume 88, Number 3
