THEMATIC ARTICLE

Tana Gilmartin & Marcel L. Van Woensel
University of Manitoba Faculty of Dentistry: Jurisprudence and Ethics Programme

The curriculums for both jurisprudence and ethics are in a continuous process of being renewed. The intent is to develop a more comprehensive curriculum fully integrated throughout the dental students’ time in the faculty. Cooperation and collaboration with other courses is being utilized to reinforce the relevance and importance of these topics in professional development and responsible practice.

The ethics programme

Currently, ethics and professionalism are integrated into the Year I and IV courses - Introduction to Dentistry (RSTD 1120) and Practice Management (RSTD 4170) respectively. Between the two courses, ethics has eleven hours of specific lectures and presentations.

As part of the renewal process, many of the ethical concepts presented in Year IV are now being introduced in Year I. The early introduction of the topics will allow for deeper, more developed discussions on ethics and professionalism in the students final year. Because the current Year IV students did not have early introduction of these issues, their programme focuses on similar topics but with more emphasis on clinically relevant scenarios.

The programme covers the following areas:

• Concept of a Profession/ Professional Responsibilities

• Structure and Purpose of Licensure and Peer Review

• Ethical Theories and Principles

• Codes of Ethics

• Ethical Issues Faced by Dentists

• Ethical Decision Making.

The goal of programme renewal is to develop a formal ethics curriculum integrated throughout all four years of the dental programme with the focus on fundamentals in first year and a knowledge appropriate practice and clinical focus through the second to fourth years.

The jurisprudence programme

Awareness of legal issues relevant to dental practice begins as part of a three hour presentation to Year I students (first term) on the legal obligations and duties of dentists in Introduction to Dentistry (RSTD 1120).

The topic of informed consent is presented in detail by providing extensive notes and a one hour discussion in Interdisciplinary Case Studies (DENT 4020) at the beginning of first term Year IV. As part of the process, the students are required to apply the concepts of informed consent to their chosen case study patient. Year IV students must demonstrate their understanding of informed consent by presenting their approach to ensuring their interdisciplinary case study patient is fully informed and consents to the treatment planned. The presentation consists of a draft written version describing the conversational method and information necessary to meet the current consent standards. The student receives thorough feedback and recommendations for redraft. A final written document is then developed by the student taking into consideration the reviewers comments for marking. All students are encouraged to videotape their actual patient informed consent session so a reviewer can provide additional comment.

By underlying the dental students’ education with the concepts of informed consent, it presents an opportunity to improve the dental students’ communication skills and appreciate the value of the didactic course materials. Additionally requiring students to identify and explicitly express the diagnosis, prognosis, options, risks and benefits for treatment of oral health conditions, will allow students to better comprehend the interrelationships of the various fields of dentistry. New graduates will be more prepared to meet the increasing expectations of the public for information and knowledge while increasing confidence in them as dentists and the professional as a whole.

Dental Jurisprudence (RSTD 4160) consists of 18 hours of presentations in second term of Year IV by course coordinator and lecturers with expertise in negligence, contracts and human rights. The course has comprehensive written notes giving a background in legal concepts but the focus of in-class discussions is the application and nuances as they relate to the practice of dentistry.

Students are expected to demonstrate an awareness and understanding of the following topics:

• Basic concepts of the Canadian legal system;

• Definition and duties of a professional to patients and public;

• Tort law - definitions of assault, battery, negligence, defamation; elements of a negligence action;

• Negligence and professionals - malpractice and informed consent;

• Principles and techniques to reduce malpractice lawsuits;

• Human rights legislation;

• Business organizations;

• Elements of a valid legal contract;

• Legal requirements for privacy and patient confidentiality;

• Criteria for accurate, complete and confidential records.

Discussions are ongoing to integrate as appropriate many of the legal concepts - especially informed consent - throughout the four year programme. The effort is to make jurisprudence issues an instinctive part of the new graduates thought process rather than distinctive from the practice of dentistry.

About the Authors

Dr. Tana Gilmartin (Ethics) is a sessional instructor/lecturer for the department of Restorative Dentistry at the Faculty of Dentistry, University of Manitoba.
Dr. Marcel L. Van Woensel (Jurisprudence) is a sessional instructor/lecturer for the department of Restorative Dentistry at the Faculty of Dentistry, University of Manitoba.

The authors can be reached at: t_gilmartin@umanitoba.ca

Citation

Gilmartin, T. & Van Woensel, M. L. (2009). University of Manitoba faculty of dentistry: Jurisprudence and ethics programme. Bulletin of the International Dental Ethics and Law Society 9(2), 3-5.