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Informed consent, patient privacy, and patient abandonment are ethical concerns outlined in a recent white paper on charity dental clinics. Some recommendations from the paper include the following:
Informed consent and lack of access to necessary follow-up care are two ethical concerns with charity clinics offering free dental care, according to a white paper from the American Dental Association (ADA).1
Thomas Raimann, DDS, the paper’s lead author, first grew concerned about ethical issues of charity clinics while working as a volunteer and chairing local events. After being appointed to the ADA’s Council on Ethics, Bylaws and Judicial Affairs, he found that other members shared his concerns. The following are some of the ethical issues identified in the group’s white paper:
It is easy for providers to become overwhelmed by the events when caring for a long line of people all needing care. “We need to take a time out and inform people that there may be other solutions to their problems,” says Raimann. The paper recommends giving patients education about the importance of finding a “dental home.” One way to do this is right after registration. “Some events may do that at the end, so it is fresh in patient’s minds,” says Raimann.
“One of the things we came up with was having patients hang on to their records as they move through the event, instead of handing the chart with confidential information to the volunteer,” says Raimann.
Raimann says that a broader ethical issue is the overwhelming number of people who need free care due to lack of coverage and poor access to a dental home. Some states eliminated non-emergent adult dental care as part of cost-containing efforts in their Medicaid programs. “So patients end up either in the emergency department, or at these events,” says Raimann.
Even if a state’s Medicaid program does provide dental coverage, many dentists don’t accept Medicaid patients due to low reimbursement rates. “All we can do is try to do the best we can in continuing to put these events on in the most ethical manner that we can,” says Raimann.
Financial Disclosure: Consulting Editor Arthur R. Derse, MD, JD, Nurse Planner Susan Solverson, BSN, RN, CMSRN, Managing Editor Jill Drachenberg, Associate Managing Editor Dana Spector, and Contributing Editor Stacey Kusterbeck report no consultant, stockholder, speakers’ bureau, research, or other financial relationships with companies having ties to this field of study.