As we are getting closer and closer to starting our careers as instructors, we have to consider the reality that we will be placed in some difficult situations. The gravity of these situations will vary. Some may result in just a staff meeting to discuss it, and some may put us in jeopardy of losing our jobs. When these situations arise, instructors have to be aware and make the best decisions possible.
I do not think I was surprised by this, but it was something I found interesting and would not have considered. CIE (pg. 401) points out that many students have not fully developed their moral standards at this point in their career right now. Although they know what is right and wrong in the world, the do not necessarily know right and wrong in the world of dentistry. As instructors, we are role models in this sense as well. Students see the decisions we make in tough situations and think we must have done what is best for the patient.
CIE also discusses egoism, and I know I have seen this first hand. Egoism is decision making based on what the person thinks is right or will be good for them, rather than the effects it will have on others. I have seen this in private practice where one of the hygienists is completely misinformed about when to charge out a ‘gross debridement’. She was taught one thing (by the dentist), where the code clearly states another. She is doing what the dentist has told her to do, and knows she is increasing production for the office. She is doing it for the good of the office, but forgetting the real needs of the patient.
Students rely on their instructions to know what is right and wrong, so it is our responsibility to teach them why we make our decisions, rather than just doing it for them. For example, if there is a patient that needs SRP but really cannot afford it, we can try to work with them so they get the treatment they need. I do not know if there is any negotiating of fees in the clinic, but I think extenuating circumstances could call for this. By at least asking, the student is shown that the focus is always on beneficence and doing good.
The Handbook of Clinical Teaching summarizes what we need to do to protect ourselves as instructors: use common sense, be fair, know your program policies, and be sure students are treated with respect. Obviously it is important to keep ethics in mind and follow the legal guidelines, not just to keep your job, but to know that you are always doing your best to make the right choices.
I really like the point that you make about students relying on their instructors to work through ethical dilemmas. Because they have not fully developed their own moral code, we must both help them work through these problems as well as help them develop the skills to eventually work through these problems on their own. Instructors who do not help their students work through these ethical dilemmas or do not model good ethical behavior can cause these students to carry unethical behaviors into their careers. It is also important to make sure students know the difference between egoism, deontology, and utilitarianism. Just as in the example you gave, students will then be able to identify the motives behind their decision making.
Lauren,
I agree 100%!!! We, as instructors, must demonstrate good, ethical decisions to our students. We have to be role models because our students will look to us for answers and to be examples to them. I always loved watching how my instructors handled difficult situations because it was a learning process for me and their actions let me know what I should do if I ever faced a similar situation.
I understand the situation of the hygienist that you described. Unfortunately, many things we do (at one of my offices) are for the benefit of not just the office, but for the doctor’s wallet. When it comes to the needs of the patient, I am not to make that call. It is the dentist’s final decision. Even if I post charges, he can (and often does) modify and finalize them. It is an ethical bind that I find myself in frequently. However, I answer to the doctor and he answers to the law. My malpractice falls under his insurance and I am glad. He makes decisions daily that make each of us feel uncomfortable, yet we are powerless.
Thanks for your interesting article. Could you respond and tell me where you obtained the cute graphic at the top? I want to be sure to give appropriate credit when I cite the graphic in my ethics presentation.