 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. Dr. Ruth Kingsley has just finished an initial examination on a new patient, Carl Whitlock. The doctor has found several areas of concern and is getting ready to discuss these with Mr. Whitlock. As you watch, put yourself in this dentist's position and consider how you might deal with a similar situation in your practice. All right, Carl. We gave you a thorough evaluation and we may have to set up a few more appointments to take care of some problems that we found. Okay. First of all, there's a really significant indication of some gum disease around most of your upper teeth and some of your lower back ones. And I'd like to get that taken care of soon and we can set you up with a specialist for that. And one of your molars has a filling with a leaky margin. Now, in other words, there's a gap where the filling meets the tooth. And we should consider this getting worked on right away before he gets reinfected with decay. You also have a slightly crooked tooth on the top left, but it's a low priority. It isn't affecting your bite or damaging any of your other teeth. So we can get started on replacing that bad filling today. Well, to tell you the truth, Doc, none of those things is what brought me in to see you today. I have no emergencies or problems causing me any pain right now. I'm really here because I want to have you put veneers on my upper front teeth. I looked it up online and saw that you can cap the front ones and really improve my smile. Right now in my sales career, it's very important I look my best every day. It's understandable that you feel that way. Can we consider working on some of your bigger problems first? The periodontal issue is of major importance, and putting veneers into a compromised mouth is detrimental to your overall oral health. I know you want to send me to a specialist and do those other things, but I would never be able to afford all that and still take care of what I really want. The veneers, my smile, it's just a matter of priorities. Look, I understand exactly what you're saying, but the reasons you want to do these other things first, those are your priorities, but patients have priorities too, and frankly, I don't think you are going to talk me into doing all of that in your plan. I really just want to fix my smile, but plus it's all I can afford. Well, how should Dr. Kingsley handle this? 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 disagreeing. You may pause the video after each possible solution to consider the implications of each option. Should Dr. Kingsley attempt to convince Mr. Whitlock that veneers aren't for everyone and that they would not address his significant oral health needs, continue to try to convince Mr. Whitlock that his long-term oral health depends on the plan the doctor has developed, suggest a cleaning, and that the restoration be replaced now, postponing the overall treatment plan for the time being. Explain that patient needs take precedent over patient wants in your office, and suggest that perhaps another dentist might feel differently. Begin the work wanted by Mr. Whitlock while continuing to educate him during treatment. 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. Patient autonomy, the right to choose what they feel is best for themselves. Patient's comprehensive oral needs. Dentist's autonomy, the right to choose what they feel is best for the patient. Legal considerations, verbal skills and confidence of the dentist and hygienist. The prospect that such a patient will become a management problem. 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.