It's natural to want to help those close to you, but the DDU still receives calls from members asking about the possible ethical and professional implications of treating friends and relatives.
The question of whether to treat friends and family is something that all dental professionals will likely have to consider during their careers. People we know personally may want us to treat them; not because they are looking for a favour, but because they trust us.
We will often also want to help our friends and family in any way we can, and each dental professional will likely have their own view on whether they are willing to treat friends and relatives. However, the DDU has received a number of calls from members looking for advice about what the dento-legal implications could be. Therefore irrespective of what your attitude might be towards treating people you know, it may help to be aware of the potential pitfalls.
It is important to remember that there is no absolute restriction on treating relatives. However, GDC Standard 9.1.4 states that, 'You must maintain appropriate boundaries in the relationships you have with patients,' and cautions against taking advantage of your position in the context of your relationships with patients.
The GDC has issued separate guidance on prescribing, which could apply to any prescription only medicine. This guidance states that one aspect of responsible prescribing means doing so 'only where you are able to form an objective view of your patient's health and clinical needs'.
A lack of objectivity could potentially lead to issues that leave a dental professional open to criticism, such as missing another problem in the patient, encouraging addiction through inadvertent over- or inappropriate prescribing, or interfering with ongoing treatment that has been provided by other healthcare professionals. The GDC's guidance is quite specific in this regard when it says, 'Other than in emergencies, you should not prescribe medicines for anyone with whom you have a close personal relationship'.
Each dental professional must ultimately make their own decision about whether they treat friends and family.
The same level of professionalism, as well as other standards such as record keeping, are expected of us irrespective of who we are treating. It is worth asking yourself if the treatment you provide would be influenced in any way by whether or not you know the patient well.
For example, there may be an inclination to offer some form of preferential treatment, which may not be fair to other patients. And because of the levels of trust that may already exist, a dental professional may also assume that the same detailed discussions are not necessary to obtain valid consent, as they would with other patients.
There is also the consideration of what could happen if your relationship with someone close to you were to deteriorate over time. If the individual were to make a complaint, or involve a third party in a dispute, you could face awkward questions about whether you failed to maintain an appropriate boundary with the patient.
Each dental professional must ultimately make their own decision about whether they treat friends and family. Some people will have one rule and apply this universally, while others will make a judgement based on who the person is and what treatment they need.
Before you decide how to handle a request to treat someone you know personally, remember that the same standards apply to all patients, and you need to ensure your relationship does not influence the treatment you provide.
David qualified from Newcastle Dental School in 2002. His post-graduate training included qualifications from the Eastman Dental Hospital and the Royal College of Surgeons, after which he worked in a number of dental settings in the UK and abroad. He has always pursued an interest in the legal aspects of dentistry and has a Master of Laws degree in the Legal Aspects of Medical Practice.
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