DEONTOLOGY AND PROFESSIONAL ETHICS IN DENTIST’S PROFESSION
Authors: Rybalov O.V. , Lytovchenko I.Yu. , Kolomiets S.V. , Prochankina V.L. 
Published: January 2019

Medicine is a sphere of activity where there are no trivialities, no unnoticed acts, views, experiences. All contact between the doctor and the patient during the course is a system of human relationships, so the outcome of any treatment depends on their level and quality. Through cooperation with a physician, the patient takes an active position, assumes responsibility for his or her health and takes part in recovery. An inextricable set of manual skills and communication skills determines the professionalism of the physician, forming a solid foundation of trust in the patient.

The purpose of the investigation is to consider the specifics of issues of deontology and professional ethics in the work of a dentist in modern conditions.

The professional morale of the doctor is the subject to the goal of health and human life. Hence the well-known ethical principle of therapy: "Non nocere". The basic moral principle states: "Do not harm the patient by providing the patient health care." At the clinical departments of the Medical Academy, one of the goals of training future specialists is the tradition of treatment, when the doctor brings benefits to the patient and does not harm. These approaches are implemented by the teacher during the theoretical part of the class, and especially on the practical one. When studying the section "Periodontology" at the departments of Therapeutic and Surgical Dentistry of UMSA, the ethical principle "Non nocere" is used at the stages of diagnosis of periodontal tissue diseases, the appointment of general treatment, when choosing local therapies, especially in the application of surgical methods (closed and open curettage, , cryo-curettage, gingivectomy, scapular operations, and others). Students learn to apply a differentiated and individualized approach to each patient.

For the modern physician, the highest values must be universal values, therefore, in the process of decision-making, he can not be guided by the notions of moral and other value-added character. The doctor acts as an expert who, based on clinical data and experimental laboratory findings, establishes a final diagnosis, explaining to the patient all that relates only to his disease, leaving out the attention of the patient's vital problems. At the departments of Surgical and Therapeutic Dentistry, during classroom practical classes in the clinic, students, from the first steps of communication with patients, develop basic ethical and moral principles. Students independently conduct a subjective and objective examination of patients, learn to correctly collect the anamnestic data of the disease and life of patients. They analyze the data of the anamnesis, ponder them and make a plan of diagnosis and plan of treatment of their patients. After the differential diagnosis and the establishment of a final clinical diagnosis, under the guidance of the teacher, medical manipulations are carried out.

One of the main ethical and moral principles is the preservation of medical secrets - the physician should not disclose personal information about the patient, as well as express doubts regarding his recovery. In order to gain the full confidence of the patient, the doctor must also preserve family secrets. Medical secrecy is the information the doctor receives during his duties. Starting with junior courses at profile dentistry departments, students learn that the medical secrecy involves the non-disclosure of disease data not only to others, but in some cases to the patient himself. It is necessary to protect the patient from the information that may harm his mental condition and the ability to fight the disease. When using information constituting a medical secrecy in the educational process, in research work, in particular, in cases where they are published in a special literature, anonymity of the patient should be ensured.

Providing medical stomatological services is a complex of activity that requires a lot of knowledge, skills, technology, work from biological elements that can be unpredictable, as well as knowledge of medical psychology. The ethical duty of a dentist is to respect the patient's right to make independent decisions. At the same time, the actions of a dentist are inevitably influenced by such human factors as subjectivity of judgment, fatigue, lack of time, mistakes of other people, technical malfunction of equipment, etc. The peculiarity of the activity of the dentist at the present stage is the comprehensive implementation of the principles of bioethics, which could be considered universal: it is the autonomy of the individual, informed consent, voluntariness, confidentiality, dignity, integrity, vulnerability, justice. Patients want to believe that their doctor always establishes an absolutely accurate diagnosis and never misses the treatment, but it is simply impossible. The combination of human relationships and technological moments increases the likelihood of medical errors. Ethics requires that the physician inform the patient of his or her mistakes if these errors affect the health of his or her health. Open recognition and analysis of mistakes are beneficial both to the patient and to the dentist, and to the whole practice.

Educational medical institutions of the III and IV levels of accreditation, which carry out post-graduate education for cadets and interns, pay great attention to practical activities. The reception of patients is carried out by teachers, along with young doctors or young doctors independently admit patients under the control of a teacher-tutor. Such situation often does not suit patients. They seek quality skilled assistance and do not want to be "trained" to doctors who have only received diplomas. Employees of the higher medical school use the knowledge of ethics and deontology in the relationship between the physician and the patient, and help to build a patient's confidence in a young specialist. The senior teacher explains to the patient the need to attract young doctors to treatment, defines the purpose of this collaboration as a transfer of experience.

In modern medicine, in particular, in dentistry, the patient takes part in the discussion of the treatment process, acquaints himself with the plan of examination and treatment, and gives his written consent to this at the completion of medical documentation, in particular, an outpatient card for a dental patient. The dentist interacts with the patient as a specialist and performs all necessary manipulations. With this aim in improving the medical skills of students and interns, discussions are held with their colleagues, discussions with older and more experienced doctors of complex diseases, clinical examinations, clinical conferences are practiced [4, 5].

Teachers of the dental departments of the academy always educate the students and intern doctors such qualities as a doctor, such as friendly fellowship, availability for contacts, readiness to seek help and help a colleague, justice, and high professionalism. It should be noted that the culture of behavior, together with professional competence, forms the authority of the physician both in the team and among patients. A doctor of proper clinical education is always grateful to his mentors. The key to friendly collegial relationships is deep respect, goodwill and trust, adherence to the established subordination, discipline.