With an eye toward helping the next generation of dentists adhere to important ethical principles, a cadre of ethicists in the health professions, educators, and leaders in organized dentistry met June 7–8 at the Symposium on Integrity and Ethics in Dental Education at ADA Headquarters.
Hosted by the ADA councils on Education and Licensure and Ethics, Bylaws and Judicial Affairs in collaboration with the American Dental Education Association (ADEA) and American College of Dentists (ACD), the event included 78 participants who heard from students and experts in higher education, dental education, and testing.
Research and observational data indicate an erosion of ethical norms in society as a whole, said speaker Charles Bertolami, DDS. Medicine, science, the military, sports, and the public and private sectors have experience with cheaters, and dental schools are starting to feel the repercussions.
Deans and faculty from dental schools in Nevada, New Jersey, and New York shared their experiences with recent ethical breaches that involved students trading clinical procedures, using a faculty password to approve treatment, and sharing unreleased questions and answers from the National Board Dental Exam, and the impact those incidents have had on their institutions.
The cases are disheartening to dental education program faculty who take seriously their role in developing ethical practitioners. But there is a big difference between teaching about ethics and teaching ethics, said Bertolami, dean of the University of California at San Francisco School of Dentistry.
In his widely recognized paper from the Journal of Dental Education, “Why Our Ethics Curricula Don’t Work,” Bertolami suggests that it’s not enough to simply teach students about ethics without demonstrating how they are used in practice. Advancing the ethics curriculum to the next level, he says, requires that we also show how this works in practice. It’s difficult to achieve this type of ethics curriculum in didactic courses because “how” can only be accomplished by role-modeling in dental schools.
“There is this idea of having ‘an ethics conversation’ with students now,” said Richard N. Buchanan, DDS, dean of the State University of New York at Buffalo School of Dental Medicine. “You demonstrate your own ethics, for example with recordkeeping. You explain this is why accuracy of communication is essential, because patient welfare depends on it. We’re starting to have these conversations, and I think that is part of the solution.”
Strange as it is, students can go through 4 years of dental school without ever seeing a dentist practice dentistry, Bertolami notes.
“We have an obligation to role model, to teach and demonstrate morals and ethics to dental students,” he said. “It used to be a given that if you were a doctor, society would trust you. It’s dangerous to go into practice and society with that expectation. We have to help students realize that. You have to show you are trustworthy first.”