Professionalism and Ethics

A patient insists on extraction of a restorable molar after informed discussion of options. What is the ethical course?

You realize you accessed the wrong tooth. Best immediate response?

A teenager (15) needs RCT; parent is absent by phone. What is required before starting?

A patient demands antibiotics for irreversible pulpitis without infection. Ethical response?

You suspect elder neglect after repeated missed meds and bruising. Next step?

A colleague treats beyond competence (complex EMS) without training. Your duty?

A pharma rep offers an expensive gift if you promote a medicament. Ethical handling?

Patient refuses rubber dam despite explanation. What should you do?

A police officer requests records without legal authority. Proper response?

A patient asks you to under-document findings to aid an insurance claim.

You wish to post a striking pre/post case on social media. What is required?

A patient lacks decision-making capacity today due to sedation. How proceed?

A referring GDP wants you to upcode for higher reimbursement.

After treatment, the patient requests all records and radiographs.

You discover a charting error from yesterday. Best correction method?

A patient declines recommended RCT after full explanation. What must you do?

You are asked to consult outside your scope (complex oncology pain).

A staff member posts a selfie in operatory with patient visible in background.

Scheduling: A VIP asks to bump an emergency child from the day’s list.

Patient winces during access but gave consent for RCT. Ethical action?

A colleague appears impaired by alcohol at work.

You receive a negative review online with false claims.

Industry invites you to speak and pays travel; you will discuss their product.

A patient cannot afford ideal care. Ethical approach?

A research-minded clinician plans a case series using patient data.

Billing error overcharged a patient last month.

A patient brings a translator who is a minor child.

You disagree with a previous clinician’s work seen on CBCT.

A patient asks for their radiographs to seek a second opinion.

You’re running late and tempted to skip rubber dam to “save time.”

A patient gifts an expensive watch after treatment.

A trainee asks you to sign off on procedures you did not supervise.

A patient requests “no student or assistant present” but presence is required for safety.

You plan to trial an AI tool to draft notes with patient data.

A long-standing patient cannot pay today for urgent care.

You learn a staff member mocked a patient’s accent in the clinic chat.

A referring clinician asks for a copy of your report.

Patient insists on an unnecessary CBCT “for curiosity.”

You must end a doctor–patient relationship for repeated abusive behavior.

A patient requests to change the treatment date on the certificate for work leave.

You co-own an imaging center and plan to refer a patient there. What is the ethical requirement?

A patient has limited English proficiency and complex consent is needed.

You notice yesterday’s note has a factual error. Proper record correction?

A patient asks you to reuse a “single-use” endodontic file to save money.

Your receptionist proposes gift cards in exchange for 5-star reviews.

Your website claims “100% painless root canals—guaranteed.”

A patient requests delaying definitive care for religious observance despite mild risk of progression.

Treating immediate family as primary patients for complex endodontic care—ethical stance?

Delegation: An assistant asks to place a rubber dam and take WL radiographs unsupervised.

You discuss PHI in a busy reception area and another patient overhears.

A patient texts you intraoral photos to your personal phone.

You want to publish a clinical case series from your practice.

A palliative-care patient declines aggressive endodontic therapy and requests pain-focused care only.

The patient asks to audio-record the consultation.

Minor adverse event occurs (brief NaOCl splash on cheek, resolved).

A patient with an unpaid balance requests copies of radiographs for a second opinion.

An adolescent requests confidentiality regarding sexual history relevant to medical risk. Parent is present.

Off-label use of a bioceramic in vital pulp therapy is considered.

A patient seeks a second opinion and asks you to criticize the first clinician.

You must terminate care due to repeated abusive behavior; the patient has active symptoms.