By Lisa Fox, B.S.N., D.D.S.
From the Fall 2020 Journal of the Colorado Dental Association
“The nation’s morals are like its teeth: the more decayed they are the more it hurts to touch them.” – George Bernard Shaw
I know we all long for the days of “normal.” For the CDA Council on Ethics and Professional Conduct, those were the days when we discussed topics like over treatment, insurance fraud, inappropriate staff relationships, collusion, etc. But the past six months of the coronavirus pandemic has opened a Pandora’s box of ethical dilemmas that we really haven’t had to face before.
At the end of the day, no matter how righteously we were called into this profession, we, as dentists, still have patients to serve, staff to employ, bills to pay, family to support, and people to care for—all of which require income. To earn this income, we have needed to keep our clinical doors open and treat patients. What ethical sacrifices have we incurred to do this? How many of us hoarded Personal Protective Equipment (PPE) in the spring when the hospitals were experiencing shortages? Were patients and healthcare providers in hospitals put at unnecessary risk because we held on to PPE? These are the REAL ethical issues that we all need to consider.
Even today, we are all experiencing shortages now and then with PPE. Last week it was masks; this week it may be hydrogen peroxide wipes. Are we still buying up all we can possibly find even though it could be at the expense of our own colleagues? How many of us reinvented the definition of “emergency care” in order to treat billable patients during the shut-down? Once we were able to re-open, we were all buffeted about by the constant evolving rules as if we were on a rafting trip down the Arkansas river during the spring run-off. I want to believe that we all considered it our duty to follow the rules and protocols to keep our patients, our staff and ourselves as safe as possible. I dare to ask, if we are told to close our doors again, how many of us would follow every CDC recommendation and state public health order? As a profession, these are serious ethical issues that we face, and we must openly and honestly discuss them.
The point of all this is that we are living in unprecedented times. (And yes, I hate including such an over-used phrase!) But it is true that we have never faced so many new and challenging moral and ethical decisions. And despite all the pages and pages of guidance we’ve been given, we choose our own rules and priorities. Let’s hope that we can all consider who those decisions effect. We must make the safety of the public, our patients, and our staff our absolute priority, and place our financial security second. Maybe by next spring, we can put our PPE anxieties, along with our new collection of masks, up on a shelf somewhere and resume, in some new normal way, practicing the profession we love. Be kind, be honest and be well.
Lisa Fox, B.S.N., D.D.S., is a pediatric dentist in Highlands Ranch, CO. She is a former member of the Colorado Dental Board and currently serves as the chair of the CDA Council on Ethics and Professional Conduct.