 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 scenario involving a challenging dental care situation. Dr. Ruth Kingsley has just finished examining a new patient, Catherine Haynes, who has come to see her for what amounts to a third opinion. The doctor learns that about six weeks ago, Mrs. Haynes had some expensive bridge work done by Dr. Fitch, a local dentist whom Dr. Kingsley feels is a bit shaky in his technical prowess. So, when exactly did you notice there was a problem with the bridge? Oh, about 10 days ago, I started thinking that it seemed to be loose, so I made an appointment with Dr. Fitch to have it looked at. Did Dr. Fitch give you an explanation for why the bridge seemed loose? He said it was because of my bad biting habits, and that we'd have to replace it and use one with a different design. Bad biting habits. So then you went to see Dr. Wells for another opinion? Yes, and while I was there, the whole bridge just came off. What did Dr. Wells say? He said that he couldn't comment on the case because he had not done the work, and he suggested that I come see you. Please, Dr. Kingsley, this bridge cost me $22,000, and according to Dr. Fitch, the replacement could cost another $15,000 or more. I don't know what to do. How should Dr. Kingsley handle this? Here is some additional information from Dr. Kingsley's oral exam. It revealed that there are significant problems with Mrs. Haynes' oral health, including gingival inflammation around an abutment tooth, which had fractured, causing the bridge to fail. The abutment tooth had fractured where it was connected to the bridge, and an infection developed in addition to the tooth being mobile in its bony socket. In Dr. Kingsley's opinion, this resulted from over-preparation of the abutment tooth. As well, she found untreated generalized periodontal disease with pockets in the 6 to 8 mm range. You may pause the video here and consider the 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 entirely disagree. You may pause the video after each possible solution to consider the implications of each option. Should Dr. Kingsley contact Dr. Fitch to get his side of the story, lodge a formal complaint with the Dental Society or Dental Board, suggest that the patient return to Dr. Fitch for a better explanation without getting involved. Inform the patient of her present condition as Dr. Kingsley sees it. Suggest indirectly to colleagues so that it can be guessed who is involved, that a colleague is not up to par. 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. Patience recollection of what was done and when. The professional code against unjustifiable colleague criticism. Dentists are independent. Their practices are their business. The current health needs of the patient. Complexity and uncertainty of interpersonal relationships. Patient personality and motives. Dentists have obligations to all patients and the profession generally. Many dental practitioners face ethical dilemmas such as this one on any given day. Anticipating how you might deliberate to find a suitable resolution to any such dilemma is good preparation and can aid each practitioner to find their way out of the challenging questions they sometimes must face.