 This video is presented with the intent of further developing your understanding and application of ethical principles, legal obligations, and the relationship between healthcare professionals and their patients. Watch as we present a relatively common scenario involving a patient request. Dr. Nate Ralston is finishing up an exam with longtime patient Professor Ann Marshall, an anthropologist at the local university. The professor is headed off on a year-long sabbatical to research human-animal disease transmission in one of the poorest regions of Africa. Her trip begins in late January, and presently it is late October. As you watch, try to put yourself in this dentist's position and consider how you might deal with a similar situation in your practice. Well, Professor, what we're going to have to do here is an extraction of that tooth that's been bothering you, and it would be best to put in a bridge to cover that gap. That sounds fine. Do you think we can get it done before my trip? It'll take a series of appointments, but I'm positive we can get all the work done before you leave for Africa. That's good. Now how much is it going to cost? Well, considering the type of bridge we'll have to put in there, two to three thousand dollars, depending on any problems we may have to face. Wow, that's a bit more than I thought. I've already used all my dental coverage this year. This is going to be a problem. Hey, would it be possible for you to do the procedure now and then bill my insurance company after the first of the year? I really can't be handling things that way. What I suggest is you have the work done, pay for it out of pocket, and if need, we can set up a payment plan that will work for you. But Nate, that's why I have dental coverage. I have been putting every extra cent I have away for this trip in Africa. I don't have any extra savings. Look, I'm not going to use my coverage at all next year while I'm in Africa. It'll just go to waste. Honestly, it shouldn't be such a big deal to just post-date it. I have this friend, Dr. Tate. Do you know her? Yeah, she does a ton of mission work over in Haiti and some other countries. She uses what she calls up-coding to pay for some of those mercy trips. Do you think you could do something like that for me? Well, what do you suppose Dr. Ralston should do? You may pause the video here and consider his options or you may continue on to the next section. Here are some possibilities that may have occurred to you. Perhaps it would be beneficial to rate each possibility as, absolutely, you are entirely in agreement. Probably, you think it is a good idea. 50-50, you are not sure. Doubtful, you don't think it is a good idea. Or no way, you completely disagree. You may pause the video after each possible solution to consider the implications of each option. Should Dr. Ralston perform the needed dental work and submit the claims dated in January? Perform the work only if Professor Marshall can pay. Offer to perform the work at a reduced rate as a public service. Make inquiries concerning claims that Dr. Tate is defrauding insurance companies for the public good. Now let us rate the importance of each of these contributing factors as you weigh what is important in your considerations. Rate each one as decisive, important, not clear, little importance, or irrelevant. These contributing factors are as follows. Legal, contractual arrangements with insurance companies. Patients' oral needs and pressing circumstances. Dentists' personal values regarding service. A potential that the inaccurate dating of the procedure will be detected. Dental codes and standards in the community. An overall sense of what is right. Dental practitioners face ethical dilemmas such as this one on any given day. Anticipating how you might resolve such dilemmas is good preparation and can aid each practitioner to find their way out of the challenging questions they sometimes must face.