Dr. Porcelli states that the dentist’s ethical responsibility is the proper treatment of the child. I certainly agree with this statement. I believe that the child can be best treated when both parents are informed and agree to the treatment plan the dentist has presented. Anything less is ethical treatment of the child’s teeth, not the child.
Sometimes the ethical professional goes beyond the legal minimum and accepts the burden and the responsibility of educating the patient and the parents, not just for the present, but for the child’s future as well.
I often have met with parents who are married, and yet are not in an amicable relationship, and are unable to agree on the treatment of the child. I have spent time with parents in separate appointments to outline treatment of a child, because the parents do not have good communication. I have presented treatment plans to mom, dad and stepmom, all in the same room. The one thing we had in common was the goal of the best treatment of the child. Are these enjoyable times? Absolutely not, but they result in an understanding about the health of the child by all parties involved.
The situation described in the Ethical Moment was real for me as I began practice. I have not researched the laws of my state, but my attorney has. I have been advised that only the custodial parent has the right to make health care decisions for the child. The situation I encountered was resolved by mediation between the parents’ attorneys and the threat that the child would be removed from the mother’s care if appropriate dental treatment was not obtained. The treatment was completed in my office, and although she was angry and reluctant, in the end, the mother was grateful for the treatment rendered.
Treatment of children is often complex due to relationships. If the health and welfare of the child is placed first, everyone wins.
Note from the Division of Legal Affairs: It is important for dentists to determine and follow applicable state law and to consult with their attorneys. From a risk-management perspective, dentists are wise to secure parental consensus before rendering a course of treatment when it is known that one of the parents has objections or concerns.
