The Dentist And The Law

CONSENT:

Any treatment carried out without consent is an assault in the eyes of the law. Consent can be given in three forms, but must be informed i.e. that patient understands.

– true emergency treatment i.e. to save life, needs no consent.

– the age of consent in the U.K. is 16 years. (for any procedure, medical or dental, including administration of a general anaesthetic

RECORDS:

– all records made in the dental surgery should contain notes on:

i) treatment undertaken

ii) problems encountered eg., Fractured root or instrument

iii) warnings given to patient eg. prior to extraction of lower molar teeth

iv) consent received from patients for complex treatments eg. extensive restoration or surgery

v) any drugs used or prescribed, doses and routes of administration eg. Antibiotic cover, Intravenous sedation etc.

You are advised to hold records indefinitely with a minimum of:

– three years in cases of death/personal injury

– six years in cases of breach of contract eg. unsatisfactory dentures etc. (ref. Limitation of Liability Act 1975)

– eleven years where product liability may be involved.

– however, the time period extends from the date from which the patient was made aware or should be considered to be aware of the problem/injury.

– in the case of a child, the periods extend from the age of majority. (18 years)

CONFIDENTIALITY:

– all verbal or written communication between patient and dentist in the course of professional consultation is secret.

– in law there is no legal duty – the principle is essentially an ethical one. The confidentiality extends to the dental staff. Adherence to the principle may be broken if:

• patient consents to divulge

• court order to divulge

• public interest eg. identification of corpses.

• statutory duty eg. coroner’s court.

REPORTS:

Reports by a dentist called as a witness in respect to dental damage or injury should be:

i) factual – hearsay may be included but must be identified as such.

ii) consent must be obtained from the patient before giving a verbal or written report to the police.

iii) the report should give an impression of:

a) the general state of the mouth

b) individual teeth

c) presence of dentures and/or fixed prostheses and their condition

– at the time of examination only.

iv) dental treatment required and its estimated cost. If all the treatment required is not directly as a result of the relevant incident, this should be made clear.

– a charge for an examination and report is normally made by the dentist.

– aid may be sought by contacting a defence organisation.