The ethical code of stomatology specialists.

THE ETHICAL CODE OF THE EXPERTS OF STOMATOLOGICAL STRUCTURE.

Introduction.

The given code represents an amount of basic principles of professional behaviour at rendering the professional help, which should be a guide for a stomatologist and for all medical personnel in mutual relations with the patients.

Taking into account the items of the legislative - legal documents of Russian Federation in a part of protection of health of the population and rendering medical (stomatological help) and being guided by the principles of humanism, mercy and ethical norms established by international and domestic public associations of the medical workers, the Stomatological Association of Russia (STaR) accepts the present Ethical Code with the purpose of perfection of the mechanism of regulation of the social, economic and medical relations of the legal and physical persons in the system of stomatological help from the position of norms of professional morals and ethics.

1. GENERAL PROVISIONS

1.1. The experts of stomatological structure, being a worthy part of the Russian society, carry out all it's laws, rules and norms of behaviour.

1.2. The given Code is developed in view of real opportunities of a combination of interests of a society, patients and experts of stomatological structure on conditions of mutual respect and mutual understanding.

1.3. The purpose of the Code - is definition, establishment and preservation of ethical norms and rules of professional behaviour and mutual understanding of the experts of stomatological structure at the process of fulfilling their social applicability and professional debt for maintenance of worthy image and prestige of their speciality in society, the system of domestic public health services and International Federation of Stomatologists.

1.4. Action of the Ethical Code and the principles of professional behaviour of the experts of stomatological structure, confirmed by it are distributed to all the workers of stomatological service of Russia irrespective of it's departmental belonging, forms of organization and property of the establishments, where they work.

1.5. The items of the Code and of ethical principles of professional behaviour are accepted voluntarily.

1.6. The infringements of items of the given Code can be discussed by the colleagues independently of the fact, whether the expert is a member of any public professional association or not.

1.7. The decision on declaring of condemnation of actions of the expert of stomatological structure who has broken the norms, established by the given Code of behaviour is accepted by constant bodies of management in the structure regional public Dental Association, by the Council STaR or by the appropriate commissions of bodies of management, and also by the public commission (council) of stomatological establishment, in which the expert of stomatology, who had broken the norms of behaviour established by the given Code works.

1.8. The concept of competence and conformity to the professional status of the doctor - stomatologist, first of all, is determined by knowledge, skill and experience shown in mutual relations with the patients and the society. The expert of stomatological structure should constantly improve his knowledge, carry out treatment in a strict conformity with modern professional standards, using medicines, materials and techniques adopted to application in Russian Federation.

2. AN EXPERT OF STOMATOLOGICAL STRUCTURE AND SOCIETY

2.1. The main professional duty of the doctor - stomatologist is rendering a competent, qualitative and opportune stomatological help to the patients on the basis of the professional knowledge and skills.

2.2. The purpose of activity of other experts of stomatological structure is - rendering of assistance and help to the doctor in view of real opportunities and the level of their competence.

2.3. The urgent help necessarily appears at conditions menacing to the life of the patient, or some actions for it's rendering are undertaken.

2.4. The doctor is obliged in view of the real opportunities to render urgent medical and stomatological help to any member of the society without dependence on his social status, sex, nationality, political convictions, etc.

2.5. The doctor does not owe:

2.5.1. To give the doubtful or obviously false information about his education, qualification or competence;

2.5.2. To refer and to use the awards, diplomas, etc. which he does not have.

2.6. Taking into account speciality of medical education and a role of a doctor in a society, he should support and accept adequate participation in public actions especially in those, where health and healthy image of life are propagandized: in ecological, sanitary - hygienic ones, to propagandize cultural aspects of preventive maintenance and treatment of diseases.

2.7. At the conclusion of the labour contract the expert of stomatological structure takes up all the norms of personal professional responsibility connected with fulfilling his functional duties.

2.8. Carrying out his activity in the society, the doctor is obliged and has the right: to observe his professional independence; to take up all the completeness of the responsibility for his decisions; to reject any attempts of pressure from the part of the legal and physical persons limiting the actions of the doctor at fulfilling by him his direct functional duties.

2.9. Participating in the conditions of collective discussion of professional problems of activity (examinations, commissions, councils, meetings, etc.), a doctor has the right and is obliged to declare about his position, to assert his point of view, and in a case of any form of pressure on him - to address to public and to legal methods of protection.

3. AN EXPERT OF STOMATOLOGICAL STRUCTURE AND STaR

3.1. The relations of an expert of stomatology and STaR are defined by the Charter STaR and the given Ethical Code.

3.2. STaR acts for equality of opportunities for each expert of stomatological structure within the framework of his competence during realization his professional activity in the structure of the Association in getting education, job and at other aspects of his activity in view of opportunities of the Association.

3.3. STaR proclaims both protection and defence of independence of the professional and ethical decisions of a doctor against unreasonable actions of the legal and physical persons.

3.4. The expert of stomatological structure is obliged to observe the requirements and items of the professional standards.

4. A DOCTOR AND A PATIENT

4.1. The basis of mutual relation of the doctor - stomatologist and a patient is defined by the rules of the appropriate legislative - legal documents.

4.2. The doctor never should evade from reception or refuse to help the patients according to racial, national, religious and other attributes.

4.3. The doctor is obliged:

4.3.1. To save medical secret and other items of information, which are important for well-being of the patient. Simultaneously he is obliged to ask any information necessary for him for treatment of the patient from the other doctors. The cases of transferring medical information are not a disclosure of medical secret if the purposes of them are:

- professional advices;

- realization of scientific researches;

- estimations of efficiency of the medical help;

- examination of quality of medical aid;

- realization of educational process;

- prevention of any opportunity of causing serious harm to the patient or other persons;

- definition of the decisions of court;

- in the cases stipulated by the legislation.
In all these cases the doctor should inform the patient on inevitability of disclosing the information and if it is possible to receive his consent.

4.3.2. To address to more competent colleagues, if the inspection, necessary for the patient, and treatment are above the level of his own professional opportunities.

4.3.3. To remember his duty of preservation of health and life of the patient, according to the principle of compassion respect of his rights and human advantage constantly.
4.3.4. To discuss with the patient the alternative plans of inspection and treatment, including advantages, degree of risk and forecast in each case, possible complications, rationality appropriate cost to give the patient the right to make approved choice himself.

4.3.5. At detection of his own erroneous actions which have resulted in a wrong or poor-quality treatment or at detection these cases by his colleagues he should try to correct a mistake and to achieve positive result in treatment without any additional fee.

4.3.6. To inform the appropriate instances about serious damages, any kind of dependence dangerous infectious disease or any other condition, which can make impossible realization of the qualified and safe treatment of the patients.

4.4. The doctor has no right:

4.4.1. To stop the process of treatment, without notifying the patient about it. In case of impossibility of further fulfilling his functions the doctor should arrange on organize of continuity of the treatment.

4.4.2. To give a skeptical estimation or comment about quality of treatment rendered to the patient by other doctor.

4.4.3. To use the technologies and methods of treatment, which have not received a public recognition on the part of the colleagues, STaR or have no appropriate author's (patent) rights established according to the legislation.

4.4.4. To interfere the patient who has decided to entrust his further treatment to any other doctor.

4.4.5. To be engaged in self-advertisement incompatible to the ethical norms.

4.4.6. To impose to the patient the personal biases (religious, political, etc.), making influence on diagnostics and treatment.

4.5. The doctor’s behaviour should promote development of the patient’s feeling of responsibility for his actions during diagnostics, treatment of disease and preventive maintenance of complications.

4.6. The patient has the right:

- to choose the doctor according to his consent;

- to get the authentic information about the condition of his stomatological health within the borders of the doctor’s specialization activity and according to the opportunities of this doctor in granting the specified information;

- to be sure that no other intervention without his consent can be conducted in a stomatological establishment, if the patient is not a source of danger for other people, and the depth of his physical or mental condition do not allow him to accept the appropriate decision.

4.7. The doctor has the right to refuse to fulfill diagnostic and medical measures in the situations:
- not demanding rendering of the urgent help, if the patient has an opportunity to address to other stomatological establishment or to any other doctor; a personal conflict with the patient which has arisen on the initiative of the patient (ignoring of the recommendations, infringement of conditions of reception, drug condition of the patient, alcoholic intoxication etc.), lack of working hours;

- if there can be a real threat to life and health of the doctor or other people during rendering the assistance;

- evasion of the patient from following the rules of the contract made by the doctor himself or the establishment, the interests of which he represented;

- in the cases, when rendering of forced inspection or treatment is assigned on him from the part of the third person. About the motives of his refusal he is obliged to inform the persons who have accepted the decision on forced treatment. In case of development of the conflict with this third person he should address to a managing board of regional stomatological association or STaR.

5. PRINCIPLES OF COLLECTIVE LEADERSHIP

5.1. Each expert of stomatological structure is obliged:

- to do everything depending from him for consolidation of the community of the experts of stomatology;

- to take an active part in the work of Dental Association of the region and RDA;

- to watch regularly after the publications in professional means of information STaR;

- to protect honour and advantage of the colleagues as his own;

- to keep moral cleanliness of stomatological community;

- to interfere actively to the practice of incompetent colleagues, and also to various sorts of nonprofessional persons, damaging the prestige of stomatology and health of the population;

- to be honest and noble in mutual relation with the colleagues to concern faithfully to their knowledge and experience;

- to be ready to share with them his experience and knowledge;

- not to adopt attempts of strengthening of his own authority by discrediting the colleagues by negative statements in their address at the presence of the patients and their relatives;

- to entice patients from the colleagues;

- to be extreme objective in the conclusions and recommendations, which should be directed on improvement of the work of the colleagues when taking part in certification of the work of the colleagues, at realization of examination of their actions;

- to inform in a definite order about the cases of non professional behaviour, about discrepancy of the carried out treatment to the accepted professional standards;

- to disclose the results of rendered researches in case of their urgency for protection of health, propagation of a healthy image of life, the benefits for practical activity (the rights of authors are protected according to the current legislation);

- in relations to the colleagues and patients to adhere only official status of his own professional position.

5.2. The colleagues have no right to condemn an expert, if his action at rendering of medical preventive measures has turned out to be non effective according to:

- distortion of reliability of the information on the part of the patient;

- administrative pressure of the third persons who have not supplied the appropriate conditions for rendering assistance.

5.3. The criticism of a colleague should be well-founded and not humiliate his human advantage. It is necessary to remember, that only professional actions, but not personal qualities of the colleagues can be exposed to criticism.

5.4. The offer of gratuitous help to the colleagues is ethic and humane.

6. THE PRINCIPLES OF INFORMATION MAINTENANCE

6.1. The advertising of stomatological activity should have objective character, not to restrain the interests of other persons, not to carry in itself elements of eulogy and in this way to drive into error the patients, assuming unjustified expectations.

6.2. Giving information through public sources the experts of stomatology should first of all care of preservation of prestige of the trade.

6.3. Information prestige and reputation of an expert should be based on a recognition of his professional abilities on the part of the colleagues.

6.4. The expert is obliged to avoid advertising of his methods of diagnostics, treatment and preventive maintenance of diseases through non professional mass media.

6.5. Advertising the prices on stomatological help and deviation from them is possible only according to mutual contract with the colleagues of concrete administrative territory.

7. RESONSIBILITY FOR INFRINGEMENTS OF NORMS OF THE ETHICAL CODE

7.1. At the case of infringement of norms of the Ethical Code the expert of stomatology can:

- receive censure on the part of the colleagues both in the oral form, and through means of the professional and public information;

- be limited in the rights of the member of the association (rejecting of being a member for the certain time, exception from the structure of managing bodies of the association, etc.).
7.2. All forms of punishments are applied in case of receipt of information about infringement the Ethical Code by any expert. For their studying the regional Dental Association creates a special commission, which carefully examines all the facts referring to the received information. The basis for creation of the commission and the considerations can be: the complaints of the patients, information of the colleagues other information from mass media, excitation of criminal case. At evasion of the expert - stomatologist from participation in the work of a commission without valid excuse commission can work and accept the decisions without him. The commission which has considered materials, prepares the conclusion on their basis, which is brought to a constantly working body of management of territorial association.

7.3. On the basis of the recommendations of the commission the managing body makes a decision, which is in action after 30 days. For this period of time the expert recognized as broken the Ethical Code, has the right to submit the appeal to the Government of STaR, which by it’s decision can suspend the action of the decision accepted by a managing body of a regional association.