Ethics & Law · patient case question
In Scenario 2, where the patient refuses the recommended extraction, which principles are involved?
Patient case: Ethics and Occupational Exposure
demo: Multiple scenarios in one practice day
chief: Ethical and occupational issues arising during clinic
history: Scenario 1: a patient in pain demands extraction of two restorable teeth; the dentist believes root canal therapy is the better option. Scenario 2: a different patient with a periapical lesion refuses the recommended extraction. Scenario 3: an HIV-positive patient presents with a parulis on the buccal gingiva of #29. Scenario 4: the dentist sustains a needlestick from a used anesthetic needle.
meds: Not applicable
findings: See individual scenarios.
Show answer and explanation
Correct answer: B. The same conflict — autonomy against beneficence — with the dentist obliged to document informed refusal
- A. Neither justice nor veracity is the core tension here.
- B. Correct. A competent patient may refuse treatment. The dentist's duty is to ensure the refusal is genuinely informed — explaining consequences — and to document it. Autonomy prevails, but beneficence obliges thorough disclosure.
- C. A signature does not extinguish the ethical obligation to inform, and a waiver alone is not informed refusal.
- D. Nonmaleficence is engaged, but it does not describe the central autonomy–beneficence conflict.