A dentist observes obvious signs of tobacco-related mucosal change but says nothing to the patient about the risks of continued use. Which ethical principle is MOST directly violated?

Correct answer: D. Veracity

• A. Beneficence is the duty to act for the patient's benefit. It is arguably implicated, but the specific failure described — withholding known information — is more precisely a breach of truthfulness.
• B. Non-maleficence is the duty to do no harm. Silence here is an omission of a duty to inform rather than an infliction of harm.
• C. Autonomy is the patient's right to self-determination. It is DOWNSTREAM of the violation: without truthful information, the patient cannot exercise autonomy meaningfully. Veracity is the principle breached; impaired autonomy is the consequence.
• D. CORRECT. VERACITY is the duty of truthfulness — the obligation to communicate honestly and completely, including information the patient may not wish to hear. Withholding a known clinical finding and its associated risk is a failure of truth-telling. The ADA Principles of Ethics identifies veracity as a core principle, requiring the dentist to be truthful in all professional dealings.

Note: The five ADA principles: AUTONOMY (self-governance), NON-MALEFICENCE (do no harm), BENEFICENCE (do good), JUSTICE (fairness), VERACITY (truthfulness). Exam technique: identify the dentist's ACT, not merely the patient's harm.