Dulce Paramo
5/27/2023
Ethical dilemma:
You have been working for an older dentist whose dental care provided to all the patients is
becoming what you would consider substandard. You wonder if you should report him since his
treatment is bordering on being harmful to patients. However, the patients are older, are not
aware that the treatment is substandard, and probably would not receive any care elsewhere
because he charges very little for his treatments. You like working for him and he cares greatly
for his patients.
This complex ethical dilemma requires the analysis of various steps to ensure its optimal
resolution for the well-being of the patients, the doctor, and myself.
Step 1 – Identify the dilemma and principles in conflict.
The main concern in this situation is that the dentist is providing substandard dental care for his
patients. The dilemma relies on whether I should report this situation or not.
Healthcare providers must follow the basic principles of ethics and use them as a guideline to
justify their actions and choices regarding patients' treatment and care. These principles include
regard for self-determination (autonomy), nonmaleficence, beneficence, justice, veracity, and
confidentiality.
The situation described previously violates the principles of autonomy, non-maleficence, and
potentially beneficence, and veracity. The following principles are compromised because of the
actions of the dentist:

Autonomy: Patients have the right to receive adequate information regarding their
diagnosis and treatment plan, which is necessary for them to make informed and
unbiased decisions. However, in this scenario, patients are not receiving accurate and
relevant information and are unaware that the treatment they receive is substandard.

Non-maleficence: Providers have the obligation to do no harm to patients. By providing
substandard and potentially harmful treatments, the dentist is violating this principle.
The following principles could be compromised if the dental assistant, who is aware of the
situation, remains silent:

Beneficence: This principle refers to the idea of acting in the best interest of the patients,
meaning that the actions are ethical as long as they represent a benefit for the patient
because sometimes not causing harm is just not enough. In this case, by choosing to
remain silent, I would fail to act in the patient's best interest. Reporting the dentist would
help prevent potential harm and allow the patient to receive appropriate care.

Veracity: Involves telling the truth. This principle is very straightforward, by not telling the
truth about the substandard care provided in the office, I would be violating this principle.
Step 2 – Determine whose interests are at stake and to what extent.
First and most importantly, the patients, their interests are at stake because they are receiving
substandard care and they are unaware of it. Even though the dentist is charging very little fees
for the treatments he provides, it doesn’t justify the potential harm that the patients are exposed
to in this situation.
The dentist’s interests are also at stake because he would like to continue with his practice until
he decides to retire, and he probably thinks he is providing good service by maintaining low fees.
My own interests are compromised as well because I like working for him and I see that his
intentions are not malicious. Reporting him would mean that I would lose my job in his office and
I would hurt his feelings.
Step 3 – Apply ethical principles to the alternatives you identified.
The first option would be to report the dentist, this would align with the principles of veracity,
and beneficence, and it would stop the violation of the principles of autonomy and nonmaleficence.
The second option would be choosing not to report the dentist, which would only be beneficial
for the dentist, the patients would continue to receive care that is below the standards, and it
would also put me at risk of losing my license if the office gets sued at some point in the future.
Principles of autonomy, non-maleficence, beneficence, and veracity would be at stake if I were to
choose this route.
Step 4 – Choose an alternative and determine the consequences.
By reporting the dentist, there's a possibility that the patients would receive adequate dental
care, which would be beneficial for the reinstitution and maintenance of their oral health.
However, there's also a possibility that his low-cost practice will cease ad patients who can't afford
other alternatives will remain untreated.
Step 5 – Make the decision and supporting conclusion.
Based on the analysis of this situation following the ethical decision-making steps, I believe it is
justifiable to report the dentist. Several principles are being compromised because of the
substandard care provided, and the patient's well-being is the first priority.