Code of Ethics

 

General Principles

 

Article 1

Deontology

 

Deontology of dentistry is the guide of conduct to which all dental practitioners must submit, and is composed of all the rules and regulations of this code regarding the profession of dentistry.

 

Article 2

Nature of the Rules of Ethics

 

1 – The rules of ethics shall ensure patients and the entire community, as well as dentists and the Portuguese Dental Association, that this guide of conduct is fully observed by dentists, as an essential tool for the practice of their profession.

2 – The rules of ethics are compulsory for all dentists, and failure to comply with them shall necessarily lead to the application of disciplinary sanctions.

 

Article 3

Ambit

 

The rules of ethics are applicable to all dentists in every aspect of their professional lives.

 

Article 4

Interpretation and Integration

 

The application of this Code of Ethics must be in accordance with the manners and customs of professional practice and with all the other dentistry regulations, which are essential for the interpretation and integration of this Code.

 

Article 5

Competence

 

The Ethics and Professional Conduct Committee of the Portuguese Dental Association is the only body with the competence to interpret and integrate the rules of ethics, as well as to recognize the disciplinary responsibility of those dentists who infringe upon them.

 

Fundamental rights and duties of dentists

 

Article 6

Independence

 

  1. The dentist’s wide variety of rights and duties calls for absolute independence from any pressure exerted by either personal interests or external influences.
  2. In professional practice, dentists have technical and ethical independence; therefore, they shall assume full responsibility for their actions.
  3. Dentists shall not acquiesce to technical or ethical guidance of those alien to the field of oral health.
  4. Under no circumstances shall dentists be forced to perform professional interventions against their professional will or principles.
  5. The clauses above do not gainsay the existence of institutional technical hierarchies which are legally or contractually established.

 

Article 7

Trade and Mediation

  1. Dentists may not take part in any scheme, agreement or any form of cooperation, with any other person or entity, aiming to obtain illegitimate economic benefits for themselves or for others.
  2. In their practice, dentists may not engage in commercial activity, but may provide patients with goods, appliances and equipment necessary and appropriate to the ongoing treatment.
  3. Practice is understood to mean the integrated space, even if physically disconnected, composed of both clinical and non-clinical areas, which give or suggest an impression of unity to patients.
  4. Save in an advisory capacity, the dentist should not exert any pressure or coercion on patients to purchase medicines, appliances or equipment, and shall respect their freedom of choice.

 

 

Dentists rights and duties concerning their patients

 


Article 8

Fundamental Duty

 

  1. All dentists must guarantee the best possible oral care for their patients, at all times behaving with rectitude and politeness.
  2. Dentists shall be held responsible for inadequate oral care, as well as oral care visibly inappropriate under objective circumstances in which a different behaviour was to be expected.

 

Article 9

Practising Conditions

 

  1. Dentists must provide oral care in the best possible conditions, in order to meet their patients¿ needs for treatment.
  2. Dentists are entitled to their own free clinical and ethical judgements, as well as to make their own decisions concerning diagnosis and therapy, always acting in an independent way.

 

Article 10

Emergencies

 

  1. Dentists must provide their services, for which they are specifically qualified, to any person in an emergency situation.
  2. “Emergency” is understood to mean the imminent danger to the health or the life of a patient.

 

Article 11

Conscientious Objection

 

Dentists have the right to refuse to perform any professional act which goes against their moral, religious or humanitarian principles, or is in breach of medical ethics.

 

Article 12

The Patient’s Freedom of Choice

 

  1. The patient is free to choose his or her dentist.
  2. Dentists shall not agree to provide dental care that does not result from the patients free and direct choice, except when this free choice is physically or legally impossible.
  3. Dentists must support and safeguard the patient’s right of free choice, and shall not participate in any project, scheme or agreement that may constrain the patients freedom or his or her capacity to use that right.

 

Article 13

Change of Dentist

 

  1. Patients are free to change their dentists, who must at all times respect that right.
  2. If requested by the patient, the dentist must help him or her to choose a new dental practitioner, behaving in an unbiased way and following his or her professional principles, in the patients best interest.

 

Article 14

The Dentist’s Freedom of Choice

 

  1. Dentists are free to choose their patients and may, if justified, refuse to provide care.
  2. Dentists shall not, however, exercise any type of discrimination against human rights.

 

Article 15

Duty of Care

 

  1. When treating a patient, the dentist has the obligation to provide that care for which he or she has the training and experience, taking full responsibility for his or her actions.
  2. The dentist’s competence lies basically on his or her knowledge, skill and experience, updated with the most recent advances in the field of dentistry.
  3. If necessary, dentists shall ask for the assistance of a colleague or refer the patient to a more qualified dental practitioner.

 

Article 16

Continued Care

 

  1. Dentists must ensure the continuity of the care provided to their patients.
  2. Nevertheless, dentists are entitled to discontinue a patients treatment when the following three conditions are met:

a) the patient’s health is not jeopardized, if he or she can be attended by another, equally qualified dentist;

b) the dentist has provided all the necessary information for the regular continuation of the treatment;

c) the dentist has informed the patient or his/her family in advance.

  1. The dentist also has the right to interrupt the treatment of any patient who, without any justification, has failed to pay for previous expenses and fees, except in the case of an emergency.

 

Article 17

Disclosure of Information

 

  1. The dentist must inform the patient or his/her family or proxy, about the diagnosis and therapeutic methods to be used, as well as give his/her assessment of the patients oral health.
  2. In case of unfavourable prognosis, the dentist may withhold that information from the patient, though he or she must inform the patient’s family or proxy.
  3. The dentist must discuss the recommended treatment with his or her patient.
  4. When, in connection with a treatment, a drug or product may be administered which is not generally accepted or acknowledged by the dental profession, the dentist shall caution his or her patient about that fact.
  5. Dentists shall not guarantee the full success of an intervention or treatment.
  6. If, after being properly informed, the patient, his or her family or proxy should refuse to submit to the recommended treatment, the dentist shall be entitled to discontinue the patient’s treatment.

 

Article 18

Risky Methods

 

  1. Before deciding on a risky diagnosis or therapeutic method, the dentist shall obtain the consent, preferably in written from, from the patient, or from his or her proxy if the patient is under age or permanently or temporarily incapacitated.
  2. Under no circumstances shall the dentist betray the good faith of his or her colleagues or patients by describing an insufficiently tested procedure as tested and safe.

 

Article 19

Unlicensed and Experimental Therapies

 

  1. Dentists shall avoid the use of any scientifically unfounded diagnosis or therapeutic method and risky experimental treatment, as well as of diagnosis or therapeutic procedure that may induce a morbid state of mind or result in mental disorder reducing self-determination, except when, always in the patients best interest, the patient or proxy has given his or her formal consent, preferably in written form, after being fully informed of the treatment and the risks that it carries.
  2. Under no circumstances shall the dentist betray the good faith of his or her colleagues or patients in what concerns that mentioned above in the previous paragraph.

 

Article 20

Files

 

  1. Dentists shall keep files containing the records of all their patients.
  2. These files are the dentists professional property.
  3. A clinical record for each patient shall be opened and kept up-to-date, detailing the name of the dentist performing each treatment, the patients personal data and medical and dental history, as well as clinical observations, diagnoses and therapies carried out.
  4. Access to the patients clinical record and disclosure of its contents are subject to the regimen of professional confidentiality.

 

Article 21

Confidentiality

 

  1. Dental practitioners are bound to professional secrecy regarding all the information related to their patients and obtained in the course of their professional practice, whether or not this information is contained in the patients¿ clinical records.
  2. Likewise, all the dentists staff, as well as those who assist him or her in the practice of dentistry, must submit to the code of confidentiality regarding all the facts learnt by them in the consulting rooms and in the course of their work, as long as these facts are protected by the dentist-patient confidentiality, for which the dentist will be held accountable.
  3. The dentist can provide information to his or her patient or to a third party designated by the patient.
  4. If, as specified in the previous paragraph, a third party is involved, the dentist has the right to demand a written declaration by the patient, giving this third party power of proxy to act on his or her behalf.
  5. The disclosure of any type of information subject to professional secrecy, except in the cases mentioned in paragraphs 3 and 4, depend on prior authorisation granted by the Portuguese Dental Association.
  6. The disclosure of the data referred to in paragraph 1 for academic, scientific or professional purposes, shall not be considered a breach of professional confidentiality, as long as the identity of the patient is not revealed.
  7. Any depositions provided by the dentist in breach of the code of confidentiality, cannot be used as testimony in a court of law nor in any other type of procedure.

 

Article 22

Fees

 

  1. Dentistry is by its nature a costly activity. Professional acts can be practiced for free, when justified and non-generic.
  2. When setting fees, dentists shall take into account the importance, complexity and difficulty of care, time spent and costs involved.
  3. When so requested, the dentist will give the patient an estimate of the fees involved in the care to be provided, previously defining its value.
  4. Fees may not be dependent on the results, nor shall there be additional fees according to the success of the intervention.
  5. The dentist may not establish, with any person, systems of fees or commissions, or any other form of compensation, in return for referring patients.

 

Article 23

Receipts

 

  1. The receipt shall identify the dental practitioner who has performed the intervention.
  2. It is strictly forbidden to hand out a receipt in the name of a dentist other than that who has carried out the intervention.
  3. Exceptions to numbers 1 and 2 above are those established in articles nos. 26 and 27.

 

 

The practice of dentistry

 


Article 24

Professional Equality

 

The profession must be considered as an association of equals, in which all members have the same rights and duties.

 

Article 25

Publicity

 

  1. The reputation of the dentist should be mainly based on their competence, integrity and professional dignity.
  2. When divulging their activity, dentists will respect the principles of legality, identifiability and veracity, with respect for patients’ rights.
  3. When divulging their activity, dentists will respect the rules defined in specific regulations established by the Ethics and Professional Conduct Committee, without prejudice of the provisions in the advertising code.

 

Article 26

Dentist’s Associations and Societies

 

  1. All dentists¿ associations and societies must be registered in the Portuguese Dental Association.
  2. All dentists¿ associations and societies must appoint a clinical director with deontological responsibility, whose name must be reported to the Portuguese Dental Association.
  3. The patient shall have easy access to the information about the dentist who has attended him/her.
  4. The association or society may issue the receipts and other documents connected to any professional intervention.
  5. The association or society may not refuse to identify the professional, as mentioned in paragraph 3, whether or not he or she is mentioned in the corresponding receipt.
  6. Should there be any doubt about the professionals identity, the clinical director shall identify him/her, lest the clinical director be held ethically accountable.

 

Article 27

Dentists under Contract

 

  1. Dentists may sign employment, service or equivalent contracts with other dentists.
  2. Those dentists having colleagues under contract, as mentioned in the previous paragraph, shall comply with the terms defined for clinical directors.
  3. Also applicable is that which has been stated in paragraphs 3 to 6 of the previous article, with the corresponding adjustments.

 

Article 28

Staff

 

  1. Dentists are accountable for the dental staff who works for them.
  2. Dentists shall control their staffs proper and fair practice.
  3. Staff is understood to mean hygienists, dental nurses, technicians and prosthetics assistants, among others.

 

Article 29

Legal Agreement

 

  1. Whenever considered necessary, the dentist can ask his or her patient to sign a legal agreement.
  2. This legal agreement shall contain a brief description of the treatment, its risks and prognosis.

 

Article 30

Copyright

 

Dentists shall make known the results of any research which may help protect and improve the populations health and well being, without compromising their copyright.

 

Article 31

Marketing Services

 

When carrying out their professional duties in places with social security support, dentists shall not neglect their professional obligations, nor, under any circumstances, forfeit their professional independence or disregard their legal and ethical responsibilities.

 

Article 32

Cease-work

 

In case of cease-work or retirement, dentists shall report this fact to the Portuguese Dental Association, in compliance with the respective statutes.

 

Dentists rights and duties towards the community

 

Article 33

General Principle

 

  1. Dentists shall defend the health of the population, particularly their oral health, as well as the operation and improvement of all institutions related to public health.
  2. Dentists must support and participate in those community initiatives aimed at promoting people’s health and well-being.

 

Article 34

Attitude

 

Dentists shall always keep a dignified attitude towards the profession, avoiding any misrepresentation, distortion or falsehood concerning their training, qualifications and competence.

 

Article 35

Duty of Cooperation

 

Regardless of their right to free and independent practice and of all the other deontological rules, dentists shall cooperate with any initiatives developed by the competent authorities in order to promote the populations health and well-being, specifically dental health.

 

Article 36

Duty of Notification

 

  1. Dentists must notify the Portuguese Dental Association, in a rigorous, objective and confidential manner, about any actions in breach of the code of ethics of which they may be aware, and agree to testify in any such breaches of conduct.
  2. Under no circumstances shall dentists allow or aid and abet the illegal or unqualified practice of dentistry.

 

Article 37

The Dentist as Expert

 

  1. When acting as expert, the dentist shall behave with total impartiality, with the sole objective of performing the task requested.
  2. Further to the previous paragraph, the dentist has the right to refuse to act as an expert in the examination of any person with whom he or she is personally acquainted, which may affect his or her objectivity, or when the dentist’s own interests are at stake.
  3. Before proceeding to the expert examination, the dentist shall make certain that the person to be examined is aware of this circumstance and of the dentists capacity as an expert.
  4. The dentist must decline to act as an expert when the questions posed are not within his or her specific area of knowledge.
  5. When in the capacity of experts, dentists shall be restricted to the task demanded, answering only to the questions posed to them.
  6. The dentist expert shall respect the confidentiality of his or her task, whether or not this has been carried out.

 

Dentists rights and duties towards their colleagues

 

Article 38

General Rule

 

  1. Professional solidarity is a fundamental duty of dentists, who must behave with utmost politeness and civility, encouraging each other’s trust and cooperation, for the sake of their patients.
  2. Class solidarity shall never let professional interests stand above the interests of the patients and the defence of public health.

 

Article 39

Moral Support

 

Dentists owe one another moral support, such as in the following cases:

a) assume the defence of a colleague who may be deprived of it;

b) avoid personal aggressions or demeaning allusions about a colleague;

c) abstain from making public statements about a colleagues skill or methods.

 

Article 40

Public Assertions

 

Dentists shall not make public assertions about a treatment that, to their knowledge, is being used by a colleague, except in his or her presence or with his or her consent.

 

Article 41

Referral of Patients

 

  1. The dentist shall ask for the collaboration of a colleague or refer a patient to a more qualified professional, whenever he or she considers that this is the best safeguard of the patients interests.
  2. When a dentist attends a patient referred to him or her by a colleague in the ambit of a specific collaboration, he or she shall send the patient back once the requested intervention has been completed.

 

Article 42

Change of Dentist

 

  1. Except in emergency situations, the dentist agreeing to treat a patient who has been in a colleagues care may communicate this fact to the previous dentist, explaining, orally or in written form, the reasons for his decision.
  2. The dentist shall do his or her best to persuade the patient to pay any fees or other expenses due to the previous dentist.

 

Article 43

Leading Patients Away

 

Any actions with the purpose of leading patients away from a colleague are strictly forbidden.